SHM Converge Scientific Abstract ePoster Gallery-Cancer Medicine Musical Chairs: Stepping Up the Game for Oncology Hospitalist Care Delivery

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The abstract describes a major inpatient oncology care redesign at The James Cancer Hospital, the third-largest cancer hospital in the U.S. Previously, hospitalized cancer patients were managed by two separate Internal Medicine divisions—Medical Oncology and Hospital Medicine—across 7 floors, creating variation in practice and inefficiencies.  <br /><br />To improve care delivery, the team formed a broad stakeholder coalition including physicians, advanced practice providers, nursing, case management, administration, and others. Using 6 months of census data, iterative PDCA cycles, and change-management principles, they redesigned and realigned the inpatient oncology hospitalist program.  <br /><br />On November 14, 2023, the existing 7 co-managed services were dissolved and replaced with a unified solid tumor hospitalist program called Cancer Medicine (CM). This new structure geographically localized patients so that most of each service’s patients were placed on a single floor, with 7 units dedicated to CM patients and minimal placement of non-CM patients on those units.  <br /><br />The reorganization maintained the same patient capacity and case mix index while producing meaningful improvements in throughput and efficiency. Reported gains included the lowest length-of-stay index in several fiscal years, a decrease in observed length of stay relative to expected length of stay, improved ED admission volume despite similar total occupancy, and significantly better boarding hours compared with the pre-localization model.  <br /><br />Overall, the abstract concludes that forming Cancer Medicine successfully aligned and standardized inpatient oncology hospitalist care, improved geographic localization, and enhanced operational performance. The authors also note that future work will focus on further quality and care-process improvements in collaboration with the ambulatory oncology team.

Asset Subtitle

Raquel Reinbolt

Meta Tag

Author List Angeline Pallante, Lisa Graham, Marium Husain, Matthew Stuckey, Megan Mooney, Raquel Reinbolt, Scott Rowley

Category Research

Concept Inpatient Oncology Hospitalist Care

Concept Geographic Patient Localization

Concept Operational Variation

Concept Process Improvement

Concept Service-Line Redesign

Distinguished Non-Finalist

Presenter Organization The Ohio State University Wexner Medical Center & Arthur G James Cancer Hospital and Richard J Solove Research Institute

Presenting Author Raquel Reinbolt

Track Quality Improvement

Keywords

oncology care redesign

inpatient oncology

hospitalist program

Cancer Medicine

geographic localization

length of stay

throughput efficiency

patient care standardization

PDCA cycles

The James Cancer Hospital

Inpatient Oncology Hospitalist Care

Geographic Patient Localization

Operational Variation

Process Improvement

Service-Line Redesign