SHM Converge Scientific Abstract ePoster Gallery-Identifying Solutions to Care for Socially and Behaviorally Complex Hospitalized Medicine Patients

Pdf Summary

This project examined how to better support hospitalists caring for socially and behaviorally complex patients, such as those with chronic pain crises, serious mental illness, safety concerns, or difficult family dynamics. These cases are increasingly common and can contribute to clinician stress, reduced job satisfaction, and burnout.<br /><br />The team first used focus groups with hospitalists at a large urban academic medical center to identify practical solutions. They then surveyed all hospitalist attendings and asked them to rank potential interventions both within the division’s control and at the broader health-system level. Thirty-nine hospitalists (22%) responded, with a mix of experience levels.<br /><br />Key findings showed that hospitalists value concrete support over generic education. Within the division, the top-ranked solution was having a clearly identified “escalation point person” who could be contacted depending on the clinical situation. Mandated educational trainings were ranked lowest. At the health-system level, respondents most strongly supported creating a policy and protocol for chronic-pain admission requirements, while building a dedicated med-psych unit was least favored.<br /><br />Open-ended responses highlighted several recurring needs: personalized care plans, emergency department protocols for pain flares, expanded responsibilities for service directors, and structured behavioral contracts for difficult interactions.<br /><br />Overall, the study suggests that hospitalists prioritize timely access to expert backup and clear institutional expectations, especially for chronic pain admissions, rather than more lectures or new specialized units. Using an impact-effort framework helped leadership identify feasible early actions while planning larger system changes.<br /><br />These findings are now informing divisional operations, grant proposals, and advocacy for multidisciplinary admission criteria and care pathways aimed at reducing burnout and improving the sustainability of hospital medicine careers.

Asset Subtitle

Rashmi Manjunath

Meta Tag

Author List Esther Y. Hsiang, Rashmi Manjunath, Smitha Ganeshan

Category Research

Concept Escalation Point Person

Concept Health System Intervention

Concept Protocol

Concept Chronic Pain

Concept Individualized Care Plan

Distinguished Non-Finalist

Presenter Organization Ucsf

Presenting Author Rashmi Manjunath

Track Other

Keywords

hospitalists

burnout

chronic pain

mental illness

clinical support

escalation point person

hospital policy

care pathways

multidisciplinary care

health system interventions

Escalation Point Person

Health System Intervention

Protocol

Chronic Pain

Individualized Care Plan