SHM Converge Scientific Abstract ePoster Gallery-Impact of Orthopedic-Hospitalist Co-Management on Patient Outcomes and Interdepartmental Collaboration

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This project evaluated the impact of an orthopedic-hospitalist co-management model at UC Davis Medical Center, a 646-bed Level 1 trauma and tertiary care center serving patients from over 33 counties. The service was started in September 2021 to manage orthopedic trauma patients, particularly older adults and fragility fracture cases.<br /><br />Using Epic Caboodle claims data, the team reviewed all inpatient cases involving procedures performed by orthopedic trauma surgeons from January 2020 through September 2024. They measured two main outcomes: case mix index (CMI), as a marker of patient complexity, and length of stay (LOS) relative to expected LOS.<br /><br />After implementation of the co-management service, average CMI increased from 2.26 to 2.42, indicating that the service was caring for more complex patients over time. Despite this rise in complexity, LOS index remained stable, changing from 1.035 to 0.986, which was not statistically significant.<br /><br />Beyond the numerical outcomes, the co-management model produced important operational and relational benefits. Orthopedic surgeons reported greater comfort managing more complex patients because of increased hospitalist support compared with a traditional consultation model. The closer collaboration also improved relationships between the hospitalist and orthopedic teams and created opportunities for new joint initiatives, including inpatient bisphosphonate initiation, earlier pain control for fragility fracture patients, and smoother interservice transfers.<br /><br />Overall, the authors conclude that orthopedic-hospitalist co-management supported care for a more complex patient population without increasing relative length of stay, while also strengthening interdepartmental collaboration and prompting interest from other departments in similar partnerships.

Asset Subtitle

Lucy Z. Shi

Meta Tag

Author List Daniel Black, Jacqueline C. Stocking, Lucy Z. Shi, Mithu Molla

Category Research

Concept Orthopedic-Hospitalist Co-management Service

Concept Orthopedic Trauma Patients

Concept Case Mix Index

Concept Length of Stay

Concept Length of Stay Index

Distinguished Non-Finalist

Presenter Organization UC Davis School of Medicine

Presenting Author Lucy Z. Shi

Track Consultative Medicine

Keywords

orthopedic-hospitalist co-management

orthopedic trauma

case mix index

length of stay

fragility fractures

older adults

hospitalist support

UC Davis Medical Center

inpatient collaboration

patient complexity

Orthopedic-Hospitalist Co-management Service

Orthopedic Trauma Patients

Case Mix Index

Length of Stay

Length of Stay Index