SHM Converge Scientific Abstract ePoster Gallery-Putting the Puzzle Together: Implementing Unit-Base Co-Location

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This document describes a hospital initiative to improve care efficiency by co-locating hospitalist general medicine patients on the same nursing units as their care teams, combined with unit-based multidisciplinary rounds (MDRs).<br /><br />The project was led by an interdisciplinary group including hospitalist physician leaders, nursing leadership, patient logistics, a project manager, and executive oversight. Planning was based on team census, unit capacity, bed availability, and service structure. The rollout occurred in phases: a pilot, expansion to additional teams, and then a maintenance phase. Supporting tools such as daily huddles, secure messaging, and dashboards were created to help maintain co-location. Unit-based MDRs began after co-location stabilized near the target level.<br /><br />The intervention achieved an average of 74% of patients being placed on their primary unit for co-located teams, without increasing emergency department boarding. After implementation, average monthly clinical length of stay decreased by 10.3%, and observed-to-expected length of stay decreased by 22.2%. Case mix index remained stable, and readmission rates did not change.<br /><br />The authors conclude that geographic proximity between hospitalist teams and patients may improve care efficiency and throughput. However, they note that other hospital-wide changes happening at the same time likely also contributed to the reduction in length of stay. Ongoing work aims to expand co-location further and evaluate clinician and patient-centered outcomes such as satisfaction, note completion time, and discharge order timing.

Asset Subtitle

Khanh T. Nguyen

Meta Tag

Author List Andrew W. Schram, Christine Ramos, Danielle Norman, Khanh T. Nguyen, Marius Chivu, Rachel Tyson, Stephenie Blossomgame, Tipu S. Puri

Category Research

Concept Geographic Co-location

Concept Hospitalist General Medicine Team

Concept Interdisciplinary Communication

Concept Unit-Based Co-location

Concept Multidisciplinary Rounding

Distinguished Non-Finalist

Presenter Organization University of Chicago

Presenting Author Khanh T. Nguyen

Track Quality Improvement

Keywords

hospital co-location

hospitalist teams

multidisciplinary rounds

care efficiency

length of stay

patient throughput

nursing units

interdisciplinary care

unit-based rounds

readmission rates

Geographic Co-location

Hospitalist General Medicine Team

Interdisciplinary Communication

Unit-Based Co-location

Multidisciplinary Rounding