Effect of Geographic Structured Interdisciplinary Rounding on Hospitalist and Medicine Resident Efficiency in a Large Academic Medical Center

1Medstar Georgetown University Hospital, Washington, DC
2Medstar Georgetown University Hospital, Washington, DC
3Medstar Georgetown University Hospital, Washington, DC
4Georgetown University, Washington, DC
5Georgetown University, Washington, DC
6Medstar Georgetown University Hospital, Washington, DC
7Medstar Georgetown University Hospital, Washington, DC
8Medstar Georgetown University Hospital, Washington, DC
9Georgetown University, Washington, DC
10Georgetown University, Washington, DC
11Georgetown University, Washington, DC
12Georgetown University, Washington, DC

Meeting: Hospital Medicine 2013, May 16-19, National Harbor, Md.

Abstract number: 49

Background:

Structured interdisciplinary rounding (SIDR), also known as multidisciplinary rounding, has been shown to improve collaboration between allied medical providers. It may have additional positive effects on patient safety, hospital efficiency, and patient and provider satisfaction. Geographic rounding, in which physicians see patients in 1 medical unit or geographic location, has shown promise in improving the quality and efficiency of hospital care. Less is known about the effect of combining SIDR and geographic rounding, and little is known about the effect of these systems on medicine residents. In October 2012, Medstar Georgetown University Hospital implemented geographic structured interdisciplinary rounding (GSIDR) on selected medicine units. As part of larger study, our aim was to characterize the impact of GSIDR on medicine resident and hospitalist efficiency.

Methods:

In October 2012, the medicine hospitalist service and associated trainees transitioned from a nongeographic system to a unit‐based staffing model. Each resident and intern were paired with a hospitalist who was assigned to an individual medical unit. SIDR was added 1 week later. Prior to the transition, provider mileage was collected using wireless pedometers. Pager numbers were recorded, and the total number of pages was tracked on a monthly basis. The project received full approval by the Georgetown University Institutional Review Board.

Results:

Interns, residents, and hospitalists all experienced a statistically significant reduction in daily miles walked (Fig. 1). Intern and resident mileage dropped by nearly 50%, with attending physicians experiencing a 25% reduction. The number of pages received by interns and residents was also reduced, with interns answering less than half the previous number of pages (Fig. 2). Hospitalists did not have a statistically significant reduction in the number of pages received. The average medicine patient length of stay remained unchanged.

Conclusions:

The first phase of a larger study of GSIDR showed promising gains in medicine resident and hospitalist efficiency. Patient average length of stay remained unchanged. Future directions include evaluating patient safety and hospital efficiency variables, as well as staff and patient satisfaction with the new process.

Figure 1.Average daily miles walked by provider type

Figure 2.Average daily pages received by provider type

To cite this abstract:

Wolk A, Montero A, Sangkharat A, Catalino M, Moroni E, Adams M, Ambrose D, Chung A, Wood J, Erickson C, Gonzalez K, Sheahan P. Effect of Geographic Structured Interdisciplinary Rounding on Hospitalist and Medicine Resident Efficiency in a Large Academic Medical Center. Abstract published at Hospital Medicine 2013, May 16-19, National Harbor, Md. Abstract 49. Journal of Hospital Medicine. 2013; 8 (suppl 2). https://www.shmabstracts.com/abstract/effect-of-geographic-structured-interdisciplinary-rounding-on-hospitalist-and-medicine-resident-efficiency-in-a-large-academic-medical-center/. Accessed July 23, 2019.

« Back to Hospital Medicine 2013, May 16-19, National Harbor, Md.