SHM Converge Scientific Abstract ePoster Gallery-Geographic Localization by Hospitalist Team at an Academic Hospital

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This project evaluated a hospitalist team geolocalization initiative at a 700-bed academic medical center, aiming for 90% same-tower and 80% same-unit patient assignment, while also monitoring length of stay and safety balancing metrics.<br /><br />Before July 11, 2022, the hospital used a team-before-bed model. The intervention shifted direct care patients to a bed-before-team model, kept teaching teams largely unit-based, added twice-daily multidisciplinary discharge rounds, pre-assigned boarded ED patients to units, and performed a full patient reshuffle at launch. Weekly reshuffling then continued for direct care patients.<br /><br />Results showed that the initial spike in geolocalization was due to the large reshuffle on 7/11/22. Average correct tower and correct unit geolocalization rates were:<br />- House staff teams: 85.45% tower, 77.91% unit<br />- Direct care teams: 97.09% tower, 90.18% unit<br />- All teams combined: 92.27% tower, 85.27% unit<br /><br />After the intervention, average length of stay declined in August and September, with this decrease identified as non-random special cause variation. Changes in balancing metrics—risk-adjusted 30-day readmissions and risk-adjusted mortality—were not significant.<br /><br />The authors conclude that the project offers a workable model for improving geolocalization in high-capacity hospitals. They attribute the early LOS improvement to stronger multidisciplinary discharge planning and localized care teams, and plan a second PDSA cycle focused on near-100% correct unit geolocalization to further reduce length of stay.

Asset Subtitle

Ryan Bailey

Meta Tag

Author List Anjali Gupta, Ankur Segon, Gregory Bowling, Lisa Dodge, Nelson Tuazon, Patrick J. Palacios, Ryan Bailey, Saket Kottewar

Category Research

Concept Hospitalist Geolocalization Initiative

Concept Geographic Patient Localization

Concept Length of Stay

Concept Same-Tower Placement

Concept Same-Unit Placement

Distinguished Non-Finalist

Presenter Organization Long School of Medicine

Presenting Author Ryan Bailey

Track Quality Improvement

Keywords

hospitalist team

geolocalization

academic medical center

bed-before-team model

patient assignment

length of stay

multidisciplinary discharge rounds

readmission rates

mortality metrics

PDSA cycle

Hospitalist Geolocalization Initiative

Geographic Patient Localization

Length of Stay

Same-Tower Placement

Same-Unit Placement