SHM Converge Scientific Abstract ePoster Gallery-Unc Hospitals: Physician Advisor Resident Elective

Pdf Summary

UNC Hospitals created a Physician Advisor Resident Elective to teach upper-level residents about utilization review, reimbursement, denials, complex discharge planning, and transfer processes—topics often underrepresented in medical training but important for hospital-based practice.  <br /><br />The elective began in 2019 and was adapted to a remote one- or two-week format during the pandemic, with one-on-one teaching from experienced physician advisors in internal medicine, pediatrics, surgery, and emergency medicine. Nineteen residents participated between 2020 and 2022. Before the elective, residents completed a survey assessing knowledge of two key concepts: the Medicare two-midnight rule and the “qualifying stay” requirement for skilled nursing facility placement.  <br /><br />Survey results showed that most residents had at least heard of the two-midnight rule, but fewer understood it well. Specifically, 18 of 19 residents had heard of it, and 68% understood the basics. Awareness of “qualifying stay” was similar, with 68% having heard the term, but only 16% understanding its basics.  <br /><br />The authors concluded that the elective revealed important gaps in residents’ understanding of health care system rules that affect inpatient care and discharge planning. They argue that this systems-based knowledge should be taught before residency completion to better prepare physicians for practice.

Asset Subtitle

Patrick M. O'Shea

Meta Tag

Author List Chris A. Caulfield, Jaydeep Lamba, Leonardo Marucci, Patrick M. O'Shea, Robert W. Lampman

Category Innovations

Concept Physician Advisor

Concept Utilization Review

Concept Two-Midnight Rule

Concept Skilled Nursing Facility

Concept Systems-Based Practice

Distinguished Non-Finalist

Presenter Organization University of North Carolina School of Medicine

Presenting Author Patrick M. O'Shea

Track Education

Keywords

physician advisor

resident elective

utilization review

reimbursement

denials

discharge planning

transfer processes

Medicare two-midnight rule

qualifying stay

hospital-based practice

Physician Advisor

Utilization Review

Two-Midnight Rule

Skilled Nursing Facility

Systems-Based Practice