Tracking Device Guided Feedback to Enhance Patient Physician Interaction

All residents and staff members who do not opt out of the study by July 1, 2019 will be included as the final study population. The planned duration of the study is 12 months starting from July 2019 - June 2020. The total time period will be further divided into three phases.

Phase 1 (Observational phase): All residents and staff physicians rotating through the inpatient medicine services during the initial 3 months who agreed to be a part of the study will be provided with Hill Rom tracking devices to quantify the time spent at the patient's bedside by each member as part of the daily practice.

Phase 2 (Intervention phase): Following the initial observational phase, the interventional phase will be 6 months in duration . During this period, the recorded time spent by the individual study participants at the patient's bedside will be compared to their respective peers (e.g. intern to intern, senior resident to senior resident and staff physician to staff physician), and percentile scores will be generated. Time spent by each member of each team at the patient's bedside will be abstracted from the tracking software daily and added on a weekly basis to generate cumulative values by the research coordinator. Patients not assigned to a particular team member will not count towards the denominator. Data will be collected individually for the staff physician, senior resident and intern in each team and compared to peer members in the other teams and converted to percentiles. Based on these percentile scores, the study participants will receive emails and text pages notifying them of the results. The participants whose scores fall in the lower 50th percentile, will be encouraged to increase patient interaction times to reach a target of at least 50th percentile. Striving to stay in the top 50th percentile will provide continuous reinforcement. The participants with scores in the top 50th percentile will receive congratulatory emails to encourage them to keep up the performance. In case of scheduling changes or absences, team members can notify the study coordinator to exclude their data for the said number of days. The percentile scores will be used solely for the purpose of this study and will neither impact trainee evaluation nor their learning objectives for the rotation. Similarly for staff physicians, the scores generated will not be a part of their annual performance reviews.

Phase 3: (Post Intervention observation phase): The final phase of the study will be 3 months. The intervention of feedback emails and text pages will be discontinued and the study participants will only be monitored to see if the past intervention made an impact on their daily clinical practice in terms of time spent with the patients.

At the end of the rotation the study participants will be assessed for their well-being and burnout by surveying them using the standard, validated, IRB-approved, anonymous questionnaires provided by the Accreditation Council for Graduate Medical Education (ACGME), during each of the above phases

Inclusion criteria

• Cleveland Clinic Main Campus Internal Medicine resident or staff physician

Exclusion criteria

• Below the age of 18