SHM Converge Scientific Abstract ePoster Gallery-Introducing Emma: An Enhanced Model for Medicine Admissions

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This document describes the development and implementation of EMMA, the Enhanced Model for Medicine Admissions, at Vanderbilt University Medical Center. EMMA was created to bring ERAS-like process improvement principles to general medical inpatients, aiming to standardize care, reduce variation, and improve efficiency, quality, and patient experience across the admission-to-discharge workflow.<br /><br />The program was built by hospitalists with operational support, then expanded through multidisciplinary workgroups involving nursing, analytics, IT, and other stakeholders. EMMA includes 14 best-practice interventions covering areas such as proactive case management, bedside rounding, discharge planning, early discharge orders, follow-up appointments, handoff communication, provider continuity, pharmacy collaboration, specialty consult optimization, case management coordination, testing avoidance, clinical pathways, mobility, and goals of care.<br /><br />Implementation occurred gradually, with initiatives rolled out on a rolling basis rather than all at once. The team tracked both lagging outcomes and leading process measures to support rapid-cycle improvement. Challenges included limited engagement from busy clinical leaders, change management for frontline staff, coordination across departments, and delays in analytics support.<br /><br />Three example workstreams are highlighted: provider/nurse bedside rounding, discharge follow-up scheduling, and specialty consultation management. Bedside rounding focused on daily communication and showed strong patient experience scores, though data capture limitations remained. Discharge follow-up work aimed to ensure appointments were scheduled within 14 days, revealing gaps for patients without established Vanderbilt providers. Specialty consultation efforts emphasized reducing variation and improving consultant responsiveness, especially because patients with consults had roughly double the length of stay.<br /><br />Key lessons were that dedicated program management, reliable data infrastructure, co-leadership, and strong communication are essential for a complex hospital-wide improvement effort. The authors conclude that EMMA offers a multidisciplinary framework for improving care delivery for heterogeneous medicine patients.

Asset Subtitle

Kelly E. Cunningham

Meta Tag

Author List Allison L. Schwall, Kelly E. Cunningham, Ryan Starnes

Category Innovations

Concept Enhanced Model for Medicine Admissions

Concept Multidisciplinary Intervention

Concept Workstream

Concept Process Improvement

Concept Emergency Room Admissions Service

Distinguished Non-Finalist

Presenter Organization Vanderbilt University Medical Center

Presenting Author Kelly E. Cunningham

Track Value in Hospital Medicine

Keywords

EMMA

medicine admissions

hospitalist workflow

care standardization

discharge planning

bedside rounding

specialty consultation

case management

patient experience

quality improvement

Enhanced Model for Medicine Admissions

Multidisciplinary Intervention

Workstream

Process Improvement

Emergency Room Admissions Service