SHM Converge Scientific Abstract ePoster Gallery-Admitter Rounder Model's Impact on Clinician Satisfaction and Patient Quality

Pdf Summary

This project evaluated a new hospitalist “admitter-rounder” staffing model at the University of Wisconsin Division of Hospital Medicine. The change was made in April 2022 to improve clinician well-being after pandemic-related workload concerns. Previously, hospitalists worked 12-hour shifts that combined both rounding and admissions. The new model separated duties into primarily 10-hour rounding shifts plus dedicated admitter shifts.<br /><br />A task force developed the new structure, and the division adopted it after review and voting. Six months after implementation, hospitalist physicians (n=28) and advanced practice providers (n=8) completed a satisfaction survey. Most respondents felt the new model was an improvement: 78.6% of physicians and 100% of APPs said so. Many also reported fewer days leaving work exhausted, especially APPs.<br /><br />To assess patient-care impact, the team compared the 12 months before and after the change, examining readmission rates and length of stay across seven hospitalist services and the overall hospital. Overall, there was no meaningful worsening in hospital operations. University Hospital readmission rates were 11.4% before and 11.7% after the change, while length of stay was 6.58 days before and 6.65 days after. Individual service-level values varied, but no consistent negative trend was seen.<br /><br />The main benefits were improved physician and APP satisfaction and a more sustainable work structure. Challenges included increased handoffs, especially during the 5 p.m. to 7 p.m. cross-cover period, requiring better communication processes. The team plans continued monitoring of patient safety, satisfaction, admitter usage, and staffing balance to fine-tune the model.

Asset Subtitle

Sara Westergaard

Meta Tag

Author List Nicole Bonk, Samantha Murray-Bainer, Sara Westergaard, Sarah Ahrens

Category Innovations

Concept Admitter-Rounder Model

Concept Combined Rounding and Admitting Shift

Concept Length of Stay

Concept Readmission Rate

Concept Physician Sustainability

Distinguished Non-Finalist

Presenter Organization University of Wisconsin School of Medicine and Public Health

Presenting Author Sara Westergaard

Track Value in Hospital Medicine

Keywords

hospitalist staffing model

admitter-rounder

clinician well-being

hospital medicine

shift redesign

physician satisfaction

advanced practice providers

readmission rates

length of stay

handoff communication

Admitter-Rounder Model

Combined Rounding and Admitting Shift

Length of Stay

Readmission Rate

Physician Sustainability