SHM Converge Scientific Abstract ePoster Gallery-Enhancing Learning, Efficiency, Value, Access, and Team Experience (Elevate): System Re-Design for Hospital Medicine at the Hospital of the University of Pennsylvania

Enhancing Learning, Efficiency, Value, Access, and Team Experience (Elevate): System Re-Design for Hospital Medicine at the Hospital of the University of Pennsylvania

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Project ELEVATE (“Enhancing Learning, Efficiency, Value, Access, and Team Experience”) was a system redesign initiative for hospital medicine at the Hospital of the University of Pennsylvania. It responded to rising admission demand, emergency department (ED) boarding, delayed team assignment, fragmented communication, and the challenge of preserving the teaching mission without added staffing.<br /><br />With executive sponsorship, the project focused on five areas: admission and patient placement, APP workforce stability, care team communication, coverage models, demand-capacity planning, and practice environment. Key interventions included creating a real-time capacity-demand dashboard, launching an admitting team to handle 10–12 admissions daily, implementing geographic cohorting so teams cared for patients in the same location, and restructuring multidisciplinary rounds (MDRs) to be in-person and more efficient. Additional supports included a hybrid APP-resident team and targeted ancillary services such as phlebotomy and IV placement.<br /><br />Over six months, 8 inpatient medicine teams achieved full geographic cohorting. Results showed improved operational performance and team experience. The observed-to-expected length of stay improved from 1.13 in FY25 to 1.01 in FY26. ED time to hospital medicine team assignment decreased, and admission times shifted earlier in the day, helping decompress the ED sooner. Secure chat volume fell by 32%, with a reduction of about 50 interruptions per person per day and a lower interruption rate by 0.6 minutes. Variability between fall FY25 and FY26 also decreased.<br /><br />Overall, ELEVATE demonstrated that closely sequenced, data-driven redesign can improve throughput, communication, and efficiency while supporting learning and team experience in academic hospital medicine.

Asset Subtitle

Joyce Kim

Meta Tag

Author List Elizabeth Marandola, Jennifer S. Myers, Joyce Kim, Katherine Gelinne, Robert E. Burke, Ryan Greysen, Sara VanCalcar, Seth Toub, Subha L. Airan Javia

Category Innovations

Concept Hospital Medicine Operations

Concept ELEVATE Intervention

Concept Hospital Admissions

Concept Emergency Department Boarding

Concept Multidisciplinary Rounding

Distinguished Non-Finalist

Presenter Organization University of Pennsylvania

Presenting Author Joyce Kim

Track Value in Hospital Medicine

Keywords

Project ELEVATE

hospital medicine

geographic cohorting

emergency department boarding

admission workflow

capacity-demand dashboard

multidisciplinary rounds

team communication

observed-to-expected length of stay

academic hospital efficiency

Hospital Medicine Operations

ELEVATE Intervention

Hospital Admissions

Emergency Department Boarding

Multidisciplinary Rounding