SHM Converge Scientific Abstract ePoster Gallery-Making a Pact: Development and Implementation of a Geographic Localization Initiative

Pdf Summary

Vanderbilt University Hospital faced a capacity crisis and needed to reduce length of stay (LOS) to improve throughput and care more patients. Prior internal efforts had not significantly reduced LOS. In response, the hospital developed PaCT (Patient-Centered Teams), a geographic localization initiative for Hospital Medicine (HM) teams.<br /><br />Before PaCT, HM teams cared for patients across 20 units in four buildings, creating inefficiency and weak collaboration with nursing units. The project aimed to design a feasible, effective, and sustainable localization model that would improve efficiency, quality, and patient experience. Key success factors included executive leadership sponsorship, early stakeholder engagement, dedicated workgroups, strong project management, and frequent communication. The design also incorporated lessons from peer institutions and VUH’s own staffing and unit structure.<br /><br />Implementation occurred in two phases. Phase 1 localized five HM teams with five nursing units in one tower serving general medicine floors and created two emergency department boarding teams. The operations command center (OCC) processes were also redesigned. Phase 2 expanded localization to three additional HM teams on a 36-bed medicine stepdown unit, applying lessons learned from the first phase.<br /><br />After implementation, two-thirds of HM teams were localized, and 97% of patients were assigned to PaCT teams. Early in the rollout, daily coordination between HM and OCC was needed for team and bed assignments. Compared with pre-implementation, PaCT teams showed reduced LOS, more early discharges, better patient experience, and improved collaboration between providers and nurses.<br /><br />Overall, an executive-sponsored multidisciplinary team successfully implemented a major systems change to localize hospital medicine patients, with ongoing efforts to optimize workflows and evaluate long-term impact.

Asset Subtitle

Russell Ledford

Meta Tag

Author List Allison L. Schwall, Kaitlyn Anderson, Kelly E. Cunningham, Pamela Robertson, Russell Ledford, Ryan Starnes

Category Innovations

Concept Localization

Concept Length of Stay

Concept Patient-Centered Teams

Concept Hospital Medicine Team

Concept Phased Implementation

Distinguished Non-Finalist

Presenter Organization Vanderbilt University Medical Center

Presenting Author Russell Ledford

Track Value in Hospital Medicine

Keywords

Vanderbilt University Hospital

capacity crisis

length of stay

Patient-Centered Teams

hospital medicine localization

throughput improvement

nursing collaboration

operations command center

patient experience

multidisciplinary implementation

Localization

Length of Stay

Patient-Centered Teams

Hospital Medicine Team

Phased Implementation