The Physician Manager: A Quality and Efficiency Improvement Strategy Utilizing Hospitalist Leadership

1North Shore University Hospital, Manhasset, NY

Meeting: Hospital Medicine 2007, May 23-25, Dallas, Texas

Abstract number: 96

Background:

Maximal efficiency is increasingly prioritized in the ever‐changing health care environment, and hospitalists are being called on to function beyond their traditional role of patient care provider. Multidisciplinary rounds are increasingly used to improve efficiency and quality of care. Hospitalists often lead these teams, accepting expanded roles in the day‐to‐day operations of the hospital. We believe that hospitalist leadership of multidisciplinary teams can improve the efficiency and quality of inpatient care.

Purpose:

Our purpose is to describe our physician manager model and its potential impact on patient care.

Description:

In our 840‐bed community hospital, 5 academic hospitalists have been designated physician managers of the medical floors. The physician managers lead multidisciplinary team rounds on each floor 3 or more times a week. The team includes the unit nurse manager, floor nurses, care coordinator, social workers, physical therapists, dieticians, and clergy. Members of the medical house staff join rounds weekly. Physician managers remain involved in floor functions throughout the day to provide guidance and assistance as needed. We believe that the extensive and direct involvement of physician managers affects many aspects of the care and service that patients receive:

  • Nursing quality. On team rounds, nurses present their patients, reviewing reasons for admission, active problems, diagnostic and treatment plans, and the need for ongoing hospitalization. Along with providing the nurses with constructive feedback from the physician managers, this gives the nurses a better understanding of the care their patients are receiving. This makes them better patient advocates and allows them to provide higher‐quality care.

  • Length‐of‐stay reduction. Reviewing the need for hospitalization, expediting testing, and identifying discharge needs early all have the potential to reduce length of stay. Direct communication with the physician of record when needed can rectify barriers to efficient care and expedite appropriate discharges.

  • System‐based practice training for house staff. Interacting with the multidisciplinary team allows house staff to develop the skills to navigate the complexities of the health care system.

  • Medication error reduction. Reviewing patient medications allows assessment of their appropriateness, along with detection and resolution of errors in dosing and duplication.

  • Core quality measures. A focused review of patient charts can enhance compliance with core quality measures and preparation for pay‐for‐performance initiatives.

Conclusions:

We have found that the physician manager leadership created numerous opportunities for improvements in patient care and efficiency. Research is planned to quantify the effects on patient safety, satisfaction, quality improvement, and reductions in length of stay and costs. Hospitalists are uniquely positioned and qualified to provide this leadership.

Author Disclosure:

D. J. Rosenberg, Esai, speakers bureau; UCB Pharma, consulting fees or other remuneration (payment), speakers bureau; B. Sherman, Esai, speakers bureau; Wyeth, speakers bureau; Pfizer, speakers bureau; S. Chaudhry, None.

To cite this abstract:

Rosenberg D, Sherman B, Chaudhry S. The Physician Manager: A Quality and Efficiency Improvement Strategy Utilizing Hospitalist Leadership. Abstract published at Hospital Medicine 2007, May 23-25, Dallas, Texas Abstract 96. Journal of Hospital Medicine. 2007; 2 (suppl 2). https://www.shmabstracts.com/abstract/the-physician-manager-a-quality-and-efficiency-improvement-strategy-utilizing-hospitalist-leadership/. Accessed November 12, 2019.

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