SHM Converge Scientific Abstract ePoster Gallery-A Randomized Trial Comparing 5 Day to 7 Day Clinical Block Lengths on Patient Outcomes and Hospitalist Experience

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This randomized trial compared 5-day versus 7-day clinical block lengths for hospitalists at a single academic medical center to assess both patient outcomes and provider experience. The study included 95 hospitalists and was conducted from July 2020 through December 2021. Half of each hospitalist’s direct-care rotations were assigned to each block type.<br /><br />Patient outcomes were measured using length of stay, discharge by noon, 30-day readmission, and 30-day mortality. A total of 2,191 patients were managed under the 5-day model and 1,894 under the 7-day model, with no meaningful baseline differences between groups. There were no significant differences in any patient outcome between the two block lengths.<br /><br />Provider experience was assessed through end-of-block surveys evaluating satisfaction and burnout. Hospitalists completed 397 of 627 surveys (63.3%). Satisfaction scores did not differ significantly between the two schedules. However, burnout was significantly higher during 7-day blocks than 5-day blocks (mean 2.38 vs 2.11 on a 1–5 scale, p=0.0008). After adjusting for clinical time and fiscal year, 7-day blocks were associated with more than twice the odds of higher burnout compared with 5-day blocks.<br /><br />Overall, the trial found that shortening hospitalist blocks from 7 days to 5 days did not improve or worsen patient outcomes, but it was associated with lower physician burnout without reducing satisfaction. The authors conclude that shorter block lengths may help mitigate burnout, and they suggest future research should examine additional patient and provider outcomes, such as patient satisfaction and quality improvement metrics.

Asset Subtitle

Sarah Apgar

Meta Tag

Author List Armond Esmaili, Bradley A. Sharpe, Ethel Wu, Margaret C. Fang, Nicole Boyd, Sandra Oreper, Sarah Apgar, Shradha A. Kulkarni

Category Research

Concept Hospitalist Clinical Block

Concept Hospitalist Block Length

Concept Length of Stay

Concept 30-Day Readmission

Concept 30-Day Mortality

Distinguished Non-Finalist

Presenter Organization University of California, San Francisco

Presenting Author Sarah Apgar

Track Quality Improvement

Keywords

randomized trial

hospitalists

clinical block length

5-day schedule

7-day schedule

patient outcomes

length of stay

30-day readmission

physician burnout

provider satisfaction

Hospitalist Clinical Block

Hospitalist Block Length

Length of Stay

30-Day Readmission

30-Day Mortality