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Background Communication failures occur often in the inpatient setting. Efforts to understand and improve communication often exclude patients or are siloed by discipline. Objective We aimed to identify barriers and facilitators to effective communication within interdisciplinary inpatient internal medicine (IM) teams using a participatory research approach. Design We conducted a single‐center participatory mixed methods study using group‐level assessment (GLA) and concept mapping to iteratively engage stakeholders. Stakeholder groups included patients/families, IM faculty, IM residents, nurses and ancillary staff, and care managers. Stakeholder‐specific GLA sessions were conducted. Participants responded to prompts addressing interdisciplinary communication then worked in small groups to synthesize the qualitative data into unique ideas. A subset of each stakeholder group then sorted ideas through a concept mapping exercise. Multidimensional scaling and hierarchical cluster analysis were used to generate a concept map of the data. Results Participants generated 97 unique ideas that were then sorted. The research team chose an eight‐cluster concept map representing patient inclusion and engagement, processes and resources, team morale and inclusive dynamics, attitudes and behaviors, effective communication, barriers to communication, the culture of healthcare, and clear expectations. Three larger domains of patient inclusion and engagement, organizational conditions and role clarity, and team dynamics and behaviors were noted. Conclusion Use of a participatory research approach made it feasible to engage diverse stakeholders including patients. Our results highlight the need to identify context‐specific facilitators and barriers of interdisciplinary communication. The importance of clear expectations was identified as a prioritized area to target communication improvement efforts.

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defined as the proportion of Medicaid or uninsured patient encounters during that time. The highest quartile, representing SNH, was compared to that in lower-burden hospitals. RESULTS: Liver transplant recipients at SNH were more often black and of lower socioeconomic status (p < 0.01), but had similar Model for End-stage Liver Disease (MELD) scores (20 vs 20 vs 18) compared with recipients at medium and low burden hospitals. Lengths of stay (11 days vs 11 vs 10) and readmission rates (36.8% vs 37.1% vs 35.4%) were similar; however, SNH demonstrated higher in-hospital mortality rates (5.2% vs 4.5% vs 2.9%, p < 0.01). Despite these differences, patients who underwent LT at SNH and survived the perioperative setting achieved equivalent overall and graft survival rates at a median follow-up of 2 years (p > 0.05) (Figure). CONCLUSIONS: Despite differences in perioperative outcomes at SNH, these centers achieve equivalent long-term patient and graft survival rates for vulnerable patient populations requiring LT. Strict care standardization, as achieved in LT, may be a mechanism by which outcomes can be improved at SNH after other complex surgical procedures.

E-cigarettes are handheld devices that are used to aerosolize a liquid that commonly contains nicotine, flavorings, and polyethylene glycol and/or vegetable glycerin. These products vary widely in design and style (Figure 1); from the disposable "cigalikes" to vape pens, mods, tanks, and pod systems such as JUUL, there has been a dramatic increase in the recognition, use, sale, and variety of products. 1 In addition to the known risks of e-cigarette use, with youth nicotine addiction and progression to cigarette smoking, there is evidence of a wide range of health concerns, including pulmonary and cardiovascular effects, immune dysfunction, and carcinogenesis. 1 The emergence of patients with severe lung injury in the summer of 2019 highlighted the harmful health effects specific to these tobacco products. 2 Ultimately named EVALI (e-cigarette, or vaping, product use-associated lung injury), there have been 2,807 hospitalized patients with 68 deaths reported to the Centers for Disease Control and Prevention (CDC). 2,3 This clinical progress note reviews the epidemiology and clinical course of EVALI and strategies to distinguish the disease from other illnesses. This is particularly timely with the emergence of and surges in COVID-19 cases. 4 SEARCH STRATEGYAs the first reports of patients with e-cigarette-associated lung injury were made in the summer of 2019, and the CDC defined EVALI in the fall of 2019, a PubMed search was performed for studies published from June 2019 to June 2020, using the search terms "EVALI" or "e-cigarette-associated lung injury." In addition, the authors reviewed the CDC and US Food and Drug Administration (FDA) website and presentations on EVALI available in the public domain. Articles discussing COVID-19 and EVALI that the authors became aware of were also included. This update is intended for hospitalists as well as researchers and public health advocates.