SHM Converge Scientific Abstract ePoster Gallery-An Intervention to Improve the Visibility of Hospitalists' Cross-Cover Activities

Pdf Summary

Our intervention increased the visibility of hospitalist work, especially after hours, and improved wRVU capture through CPT code 99418. Although wRVUs do not fully reflect the value of hospitalists, the intervention helped make after-hours care more measurable to the health system, which may support staffing decisions for hospitalists and nocturnists.<br /><br />The results showed a steady rise in monthly wRVU generation from 99418 over time. In 2023, before the initiative, hospitalists generated a median of 221 wRVUs per month, or 707 per provider. This increased to a median of 496 per month in January–September 2024, or 1,061 per provider, and rose further to 662 per month in October 2024–August 2025, or 1,313 per provider.<br /><br />Implementation patterns suggested that simplifying workflow improved uptake. The EMR note template was adopted quickly and used frequently, while the smartphrase macro saw limited use and remained mostly confined to the provider who created it. From October 2024 to August 2025, the Cross Cover Note template was used 2,326 times, averaging 211 uses per month, and usage remained high into 2026.<br /><br />Overall, the intervention was successful in increasing recognition of hospitalist after-hours work and in improving documentation-related wRVU capture. The higher use of the note template compared with the macro supports the idea that reducing reliance on memory and simplifying steps can improve adoption of new tools.

Asset Subtitle

Haruka Torok

Meta Tag

Author List Ellen A. Overson, Haruka Torok

Category Innovations

Concept After-hours work

Concept Hospitalist

Concept Work RVU

Concept Adoption

Concept Human factors

Distinguished Non-Finalist

Presenter Organization University of Minnesota

Presenting Author Haruka Torok

Track Quality Improvement

Keywords

hospitalist

after-hours care

wRVU capture

CPT code 99418

EMR note template

documentation workflow

nocturnist staffing

health system visibility

cross cover note

billing optimization

After-hours work

Hospitalist

Work RVU

Adoption

Human factors