SHM Converge Scientific Abstract ePoster Gallery-Fill in the Procedural Gap: An on-Call Hospitalist Procedure Team

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The document describes an <strong>On-Call Hospitalist Procedure Team (OPT)</strong> created at an urban academic hospital to fill a procedural care gap for low-volume but important bedside procedures, especially <strong>lumbar puncture (LP)</strong> and <strong>paracentesis</strong>. The motivation was that procedural skills often decline after residency, but a full-time dedicated procedure service may be too expensive or unnecessary for hospitals with only modest demand.

To address this, the hospital formed a team of <strong>five full-time hospitalists</strong> who received additional procedural reinforcement from neurology and liver medicine before starting. These hospitalists remained available for procedures while also caring for their own patient panels. Each team member received an annual stipend of <strong>$10,000</strong>, making the model more cost-effective than maintaining a dedicated full-time procedure service.

From <strong>April 10, 2023 to November 17, 2023</strong>, the OPT completed <strong>78 procedures</strong> at an average of <strong>2.5 procedures per week</strong>. LPs had an <strong>85% success rate</strong> and a <strong>4% traumatic tap rate</strong>, outcomes comparable to those reported for full-time medicine procedure teams. Nearly half of the procedures were done on non-teaching services, while <strong>54%</strong> occurred on resident teaching services. The team also supervised <strong>27 residents</strong>, with OPT involvement in <strong>35% of procedures</strong>, supporting trainee education.

A need-assessment survey of 26 respondents showed that comfort with procedures declines with years since residency, especially for LPs. Overall, the OPT demonstrated that a small on-call model can maintain competency, provide low complication rates, support resident training, and meet procedural demand at significantly lower cost than a dedicated full-time service.

Asset Subtitle

Vinh-Tung Nguyen

Meta Tag

Author List Andrew Dunn, Seunghyup M. Baek, Vinh-Tung Nguyen

Category Innovations

Concept Procedural Skill

Concept Lumbar Puncture

Concept Paracentesis

Concept Hospitalist Procedure Team

Concept Procedure Support Model

Distinguished Non-Finalist

Presenter Organization Mount Sinai Hospital

Presenting Author Vinh-Tung Nguyen

Track Consultative Medicine

Keywords

On-Call Hospitalist Procedure Team

procedural care gap

lumbar puncture

paracentesis

hospitalist competency

resident training

low-volume procedures

cost-effective model

academic hospital

procedure service

Procedural Skill

Lumbar Puncture

Paracentesis

Hospitalist Procedure Team

Procedure Support Model