Outcomes on an inpatient oncology service after the introduction of hospitalist comanagement
Smilow Cancer Hospital (SCH) introduced hospitalist comanagement to the inpatient oncology service to address long lengths of stay and oncologist burnout. To determine the impact of hospitalists on inpatient quality outcomes and oncologist experience. Hospitalists were introduced to one of two inpat...
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| Veröffentlicht in: | Journal of hospital medicine 2023-05, Vol.18 (5), p.391-397 |
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| creator | Morris, Jensa C Gould Rothberg, Bonnie E Prsic, Elizabeth Parker, Nathaniel A Weber, Urs M Gombos, Erin A Kottarathara, Mathew J Billingsley, Kevin Adelson, Kerin B |
| description | Smilow Cancer Hospital (SCH) introduced hospitalist comanagement to the inpatient oncology service to address long lengths of stay and oncologist burnout.
To determine the impact of hospitalists on inpatient quality outcomes and oncologist experience.
Hospitalists were introduced to one of two inpatient oncology services at SCH. Patients were assigned to teams equally based on capacity. Outcomes on the oncologist-led, traditional service (TS) were compared with outcomes on the hospitalist service (HS) 6 months after program implementation.
Outcomes included patient volume, length of stay (LOS), early discharge, discharge time, and 30-day readmission rate. Mixed linear or Poisson models that accounted for multiple admissions during the study duration were used. Oncologist experience was measured by survey.
During the study period, there were 713 discharges, 400 from the HS and 313 from the TS (p = .0003). There was no difference in demographics or severity of illness (SOI) between services. Following adjustment for age, sex, race/ethnicity, cancer type, and discharge disposition, the average LOS was 4.71 on the HS and 5.47 on the TS (p = .01). Adjusted early discharge rate was 6.22% on the HS and 2.06% on the TS (p = .01). Adjusted mean discharge time was 3:45 p.m. on HS and 4:16 p.m. on TS (p = .009). There was no difference in readmission rates. Oncologists reported less stress (p = .001) and a better ability to manage competing responsibilities (p |
| doi_str_mv | 10.1002/jhm.13071 |
| format | Article |
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To determine the impact of hospitalists on inpatient quality outcomes and oncologist experience.
Hospitalists were introduced to one of two inpatient oncology services at SCH. Patients were assigned to teams equally based on capacity. Outcomes on the oncologist-led, traditional service (TS) were compared with outcomes on the hospitalist service (HS) 6 months after program implementation.
Outcomes included patient volume, length of stay (LOS), early discharge, discharge time, and 30-day readmission rate. Mixed linear or Poisson models that accounted for multiple admissions during the study duration were used. Oncologist experience was measured by survey.
During the study period, there were 713 discharges, 400 from the HS and 313 from the TS (p = .0003). There was no difference in demographics or severity of illness (SOI) between services. Following adjustment for age, sex, race/ethnicity, cancer type, and discharge disposition, the average LOS was 4.71 on the HS and 5.47 on the TS (p = .01). Adjusted early discharge rate was 6.22% on the HS and 2.06% on the TS (p = .01). Adjusted mean discharge time was 3:45 p.m. on HS and 4:16 p.m. on TS (p = .009). There was no difference in readmission rates. Oncologists reported less stress (p = .001) and a better ability to manage competing responsibilities (p < .0001) while working on the HS.
Hospitalist comanagement significantly improved LOS, early discharge, time of discharge, and oncologist experience without an increase in 30-day readmissions.</description><identifier>ISSN: 1553-5592</identifier><identifier>EISSN: 1553-5606</identifier><identifier>DOI: 10.1002/jhm.13071</identifier><identifier>PMID: 36891947</identifier><language>eng</language><publisher>United States: Frontline Medical Communications</publisher><subject>Hospitalists ; Hospitalization ; Humans ; Inpatients ; Length of Stay ; Oncology ; Patient Readmission ; Retrospective Studies</subject><ispartof>Journal of hospital medicine, 2023-05, Vol.18 (5), p.391-397</ispartof><rights>2023 Society of Hospital Medicine.</rights><rights>2023 Society of Hospital Medicine</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c313t-9c37df777b36d2036f5e81023c37ab19508ad2e87efb9700a1cc797a18e65b43</citedby><cites>FETCH-LOGICAL-c313t-9c37df777b36d2036f5e81023c37ab19508ad2e87efb9700a1cc797a18e65b43</cites><orcidid>0000-0002-5623-643X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,27931,27932</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36891947$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morris, Jensa C</creatorcontrib><creatorcontrib>Gould Rothberg, Bonnie E</creatorcontrib><creatorcontrib>Prsic, Elizabeth</creatorcontrib><creatorcontrib>Parker, Nathaniel A</creatorcontrib><creatorcontrib>Weber, Urs M</creatorcontrib><creatorcontrib>Gombos, Erin A</creatorcontrib><creatorcontrib>Kottarathara, Mathew J</creatorcontrib><creatorcontrib>Billingsley, Kevin</creatorcontrib><creatorcontrib>Adelson, Kerin B</creatorcontrib><title>Outcomes on an inpatient oncology service after the introduction of hospitalist comanagement</title><title>Journal of hospital medicine</title><addtitle>J Hosp Med</addtitle><description>Smilow Cancer Hospital (SCH) introduced hospitalist comanagement to the inpatient oncology service to address long lengths of stay and oncologist burnout.
To determine the impact of hospitalists on inpatient quality outcomes and oncologist experience.
Hospitalists were introduced to one of two inpatient oncology services at SCH. Patients were assigned to teams equally based on capacity. Outcomes on the oncologist-led, traditional service (TS) were compared with outcomes on the hospitalist service (HS) 6 months after program implementation.
Outcomes included patient volume, length of stay (LOS), early discharge, discharge time, and 30-day readmission rate. Mixed linear or Poisson models that accounted for multiple admissions during the study duration were used. Oncologist experience was measured by survey.
During the study period, there were 713 discharges, 400 from the HS and 313 from the TS (p = .0003). There was no difference in demographics or severity of illness (SOI) between services. Following adjustment for age, sex, race/ethnicity, cancer type, and discharge disposition, the average LOS was 4.71 on the HS and 5.47 on the TS (p = .01). Adjusted early discharge rate was 6.22% on the HS and 2.06% on the TS (p = .01). Adjusted mean discharge time was 3:45 p.m. on HS and 4:16 p.m. on TS (p = .009). There was no difference in readmission rates. Oncologists reported less stress (p = .001) and a better ability to manage competing responsibilities (p < .0001) while working on the HS.
Hospitalist comanagement significantly improved LOS, early discharge, time of discharge, and oncologist experience without an increase in 30-day readmissions.</description><subject>Hospitalists</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Inpatients</subject><subject>Length of Stay</subject><subject>Oncology</subject><subject>Patient Readmission</subject><subject>Retrospective Studies</subject><issn>1553-5592</issn><issn>1553-5606</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkE1LwzAYx4Mobk4PfgEJeNFDZ16aJj3K8A0Gu-wolDR9unW0TU1SYd_e6JwHT88Lv-fHwx-ha0rmlBD2sNt2c8qJpCdoSoXgichIdnrsRc4m6ML7HSEpVyI9RxOeqZzmqZyi99UYjO3AY9tj3eOmH3RooA9xNra1mz324D4bA1jXARwOW4hQcLYaTWjika3x1vqhCbptfMBRpnu9gS46LtFZrVsPV791htbPT-vFa7JcvbwtHpeJ4ZSHJDdcVrWUsuRZxQjPagGKEsbjXpc0F0TpioGSUJe5JERTY2QuNVWQiTLlM3R30A7OfozgQ9E13kDb6h7s6AsmlWCEEppF9PYfurOj6-NzBVNECZ4qqiJ1f6CMs947qIvBNZ12-4KS4jvxIiZe_CQe2Ztf41h2UP2Rx4j5FzEOfBg</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Morris, Jensa C</creator><creator>Gould Rothberg, Bonnie E</creator><creator>Prsic, Elizabeth</creator><creator>Parker, Nathaniel A</creator><creator>Weber, Urs M</creator><creator>Gombos, Erin A</creator><creator>Kottarathara, Mathew J</creator><creator>Billingsley, Kevin</creator><creator>Adelson, Kerin B</creator><general>Frontline Medical Communications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5623-643X</orcidid></search><sort><creationdate>202305</creationdate><title>Outcomes on an inpatient oncology service after the introduction of hospitalist comanagement</title><author>Morris, Jensa C ; Gould Rothberg, Bonnie E ; Prsic, Elizabeth ; Parker, Nathaniel A ; Weber, Urs M ; Gombos, Erin A ; Kottarathara, Mathew J ; Billingsley, Kevin ; Adelson, Kerin B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c313t-9c37df777b36d2036f5e81023c37ab19508ad2e87efb9700a1cc797a18e65b43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Hospitalists</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Inpatients</topic><topic>Length of Stay</topic><topic>Oncology</topic><topic>Patient Readmission</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Morris, Jensa C</creatorcontrib><creatorcontrib>Gould Rothberg, Bonnie E</creatorcontrib><creatorcontrib>Prsic, Elizabeth</creatorcontrib><creatorcontrib>Parker, Nathaniel A</creatorcontrib><creatorcontrib>Weber, Urs M</creatorcontrib><creatorcontrib>Gombos, Erin A</creatorcontrib><creatorcontrib>Kottarathara, Mathew J</creatorcontrib><creatorcontrib>Billingsley, Kevin</creatorcontrib><creatorcontrib>Adelson, Kerin B</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hospital medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morris, Jensa C</au><au>Gould Rothberg, Bonnie E</au><au>Prsic, Elizabeth</au><au>Parker, Nathaniel A</au><au>Weber, Urs M</au><au>Gombos, Erin A</au><au>Kottarathara, Mathew J</au><au>Billingsley, Kevin</au><au>Adelson, Kerin B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes on an inpatient oncology service after the introduction of hospitalist comanagement</atitle><jtitle>Journal of hospital medicine</jtitle><addtitle>J Hosp Med</addtitle><date>2023-05</date><risdate>2023</risdate><volume>18</volume><issue>5</issue><spage>391</spage><epage>397</epage><pages>391-397</pages><issn>1553-5592</issn><eissn>1553-5606</eissn><abstract>Smilow Cancer Hospital (SCH) introduced hospitalist comanagement to the inpatient oncology service to address long lengths of stay and oncologist burnout.
To determine the impact of hospitalists on inpatient quality outcomes and oncologist experience.
Hospitalists were introduced to one of two inpatient oncology services at SCH. Patients were assigned to teams equally based on capacity. Outcomes on the oncologist-led, traditional service (TS) were compared with outcomes on the hospitalist service (HS) 6 months after program implementation.
Outcomes included patient volume, length of stay (LOS), early discharge, discharge time, and 30-day readmission rate. Mixed linear or Poisson models that accounted for multiple admissions during the study duration were used. Oncologist experience was measured by survey.
During the study period, there were 713 discharges, 400 from the HS and 313 from the TS (p = .0003). There was no difference in demographics or severity of illness (SOI) between services. Following adjustment for age, sex, race/ethnicity, cancer type, and discharge disposition, the average LOS was 4.71 on the HS and 5.47 on the TS (p = .01). Adjusted early discharge rate was 6.22% on the HS and 2.06% on the TS (p = .01). Adjusted mean discharge time was 3:45 p.m. on HS and 4:16 p.m. on TS (p = .009). There was no difference in readmission rates. Oncologists reported less stress (p = .001) and a better ability to manage competing responsibilities (p < .0001) while working on the HS.
Hospitalist comanagement significantly improved LOS, early discharge, time of discharge, and oncologist experience without an increase in 30-day readmissions.</abstract><cop>United States</cop><pub>Frontline Medical Communications</pub><pmid>36891947</pmid><doi>10.1002/jhm.13071</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-5623-643X</orcidid></addata></record> |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | Hospitalists Hospitalization Humans Inpatients Length of Stay Oncology Patient Readmission Retrospective Studies |
| title | Outcomes on an inpatient oncology service after the introduction of hospitalist comanagement |
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