SHM Converge Scientific Abstract ePoster Gallery-Hospitalists' Perspectives on Consultation Process: A Qualitative Analysis to Guide Innovation

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This qualitative study examined hospitalists’ and emergency department physicians’ perceptions of the consultation process at an academic institution. The objective was to identify areas for improvement as inpatient care becomes more complex due to aging populations, multimorbidity, polypharmacy, fragmented systems, social determinants of care, and rising resource demands.<br /><br />An online survey was distributed to all hospitalist and emergency medicine physicians. Comments were analyzed using open, line-by-line coding to identify recurring themes. The most commonly mentioned issues involved acknowledging consult requests, agreeing to evaluate, completing the initial consultation, follow-up after the first consult, the sign-off process, transfers between services, and supervision.<br /><br />Results showed both positive and negative comments, with negative feedback centering on delays, communication problems, willingness to place orders, and the quality of recommendations. The analysis generated several actionable proposals. These included documenting when consultation requests are waived, tracking the time from consult order to written recommendations, ensuring staffing matches consult volume, and performing root cause analyses for delayed consults. Other suggestions focused on documenting discussions of recommendations with primary teams, recording timelines for follow-up evaluations, adopting standardized sign-off notes, documenting rationale for disposition decisions, and strengthening mechanisms for dispute review during service transfers. The study also emphasized enforcing supervision protocols for residents, fellows, and advanced practice providers.<br /><br />The authors concluded that frontline provider feedback provided meaningful insight into the main challenges in the consultation process. This led to tailored institutional solutions, including new consulting service guidelines incorporated into hospital bylaws. Future research will be needed to assess the impact of these changes on quality of care, provider satisfaction, and hospital performance metrics.

Asset Subtitle

Giuseppe Annunziata

Meta Tag

Author List Ankur Segon, Giuseppe Annunziata, Gouthami Nalakonda

Category Research

Concept Hospital Consultation Process

Concept Delay

Concept Communication Issue

Concept Open Coding

Concept Provider Comments

Distinguished Non-Finalist

Presenter Organization The University of Texas Health Science Center at San Antonio Joe R. & Teresa Lozano Long School of Medicine

Presenting Author Giuseppe Annunziata

Track Quality Improvement

Keywords

hospitalist

emergency medicine

consultation process

qualitative study

inpatient care

communication delays

consult request

service transfers

supervision protocols

hospital bylaws

Hospital Consultation Process

Delay

Communication Issue

Open Coding

Provider Comments