SHM Converge Scientific Abstract ePoster Gallery-Closing an Academic Institution: A Quality Analysis From the Inside

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This abstract examines how a hospital maintained quality during a prolonged closure process. While the negative effects of hospital closures on nearby institutions are well known, fewer studies look at the closing hospital itself, especially when closure is delayed.<br /><br />In late 2023, Mount Sinai Beth Israel announced a 10-month closure plan for its 230-bed hospital. However, due to external complications, the hospital kept operating well past the planned July 2024 shutdown date, eventually averaging 55 hospital medicine/critical care beds. By July 1, 2024, the hospitalist group was the only inpatient service still intact. With no trainees, the team shifted from an academic model to direct care supported by locum physician assistant-paired shifts.<br /><br />Despite major staffing and operational changes, quality metrics did not worsen. In fact, unadjusted Q3–Q4 2024 results showed improved median and mean length of stay, slightly better discharge-before-noon rates, fewer excess days, and improved hospital-acquired infection rates. Mortality remained stable compared with the period before July 1, 2024. Patient experience in the HCAHPS “doctor communication” domain also remained steady.<br /><br />The authors suggest that a declining case mix index and lower census may have helped, but they emphasize that a stable core of experienced hospitalists likely played a major protective role in preserving quality, throughput, and patient experience during the hospital’s extended closure period.

Asset Subtitle

Patricia Dharapak

Meta Tag

Author List Beth G. Raucher, Daniel I. Steinberg, Jolion McGreevy, Julie M. Pearson, Patricia Dharapak

Category Innovations

Concept Hospital Closure

Concept Inpatient Care Quality

Concept Length of Stay

Concept Transition Period

Concept Efficiency

Distinguished Non-Finalist

Presenter Organization Mount Sinai Morningside West

Presenting Author Patricia Dharapak

Track Quality Improvement

Keywords

hospital closure

quality metrics

hospitalists

patient experience

length of stay

infection rates

mortality

throughput

staffing changes

case mix index

Hospital Closure

Inpatient Care Quality

Length of Stay

Transition Period

Efficiency