SHM Converge Scientific Abstract ePoster Gallery-The Impact of Geographic Localization on Patient Experience

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In September 2024, Vanderbilt University Hospital’s Section of Hospital Medicine launched Patient-Centered Teams (PaCT), a major structural change aimed at improving patient experience. The initiative included three main elements: geographic localization of five hospital medicine teams to five general care nursing units (69 beds total), creation of two emergency department boarding teams staffed by hospitalists, and adjustment of each team’s 7 a.m. target census to match peer benchmarks. Nursing staffing, communication expectations, and case management/social work support were unchanged.<br /><br />The project was designed by a multidisciplinary group of hospitalist and nursing leaders, along with operations, bed management, transition management, and analytics representatives. Patient experience was measured using HCAHPS survey results, analyzed through Press Ganey top-box scores for patients discharged from PaCT units before and after implementation.<br /><br />Results showed improvements after PaCT began. The five units had higher top-box scores and better percentile rankings for overall hospital rating, time doctors spent with patients, doctors keeping patients informed, and staff working together. Reported potential reasons for these gains included more consistent provider-nurse bedside rounding, more time providers could spend with patients on the unit, more frequent provider-case manager touchpoints, dedicated ED boarding providers, and lower average daily rounding census.<br /><br />Although increased provider handovers can contribute to fragmentation and dissatisfaction, the improved availability and communication within the PaCT model may have offset these effects. Overall, the geographic localization initiative and ED boarding teams were associated with better patient experience, and further work is planned to strengthen multidisciplinary rounding and care coordination.

Asset Subtitle

Kelly E. Cunningham

Meta Tag

Author List Allison L. Schwall, Jolene E. Stover, Julia Anderson, Kaitlyn Anderson, Kelly E. Cunningham, Russell Ledford, Ryan Starnes

Category Innovations

Concept Patient-Centered Teams

Concept Localization

Concept Patient Experience

Concept Emergency Department Boarding Team

Concept Care Coordination

Distinguished Non-Finalist

Presenter Organization Vanderbilt University Medical Center

Presenting Author Kelly E. Cunningham

Track Communication

Keywords

Patient-Centered Teams

PaCT

Vanderbilt University Hospital

hospital medicine

patient experience

geographic localization

emergency department boarding

HCAHPS

Press Ganey

multidisciplinary care

Patient-Centered Teams

Localization

Patient Experience

Emergency Department Boarding Team

Care Coordination