Background:

Hospitalists are increasingly expected to improve patient outcomes while maintaining a high level of efficiency. In addition, attaining high levels of patient and employee satisfaction is critical to a hospital's mission. Creating a research and development clinical unit can help hospitals pilot different initiatives to achieve these goals and better utilize hospitalists as a clinical resource.

Purpose:

To report the establishment of a geographically based hospitalist clinical innovations unit (CIU) aimed at improving patient outcomes and the efficiency of several inpatient processes. The purpose of the unit is continual process redesign with spread to the entire hospital system.

Description:

In 2006, a 23‐bed nonteaching general medical unit was designated as a special innovations unit at an urban independent academic medical center. Nursing leadership and other ancillary services volunteered to be assigned to the unit. Different projects were piloted every 1‐3 months including: deployment of WOW (Wireless on Wheels) computers for physicians and case managers, daily bedside multidisciplinary collaborative rounds (nursing, case managers, hospitalists) focused on patient safety and discharge planning, unit clerks rounding with hospitalists to decrease paperwork, specialized nurse‐managed protocols (potassium, magnesium, bowel), modified hospitalist schedules, and creation of a daily patient agenda.

Conclusions:

Establishing a geographic CIU has energized hospitalist and unit staff around the importance of improved patient outcomes. The project has had some early success in patient satisfaction with nursing care, reduced readmissions, compliance with quality standards, and increased hospitalist efficiency. Lessons learned include focus on physician engagement and variation of practice and improvement of the discharge process. Future innovations will focus on other hospital core measures, such as those in heart failure, length of stay, discharge efficiency, and other components of patient satisfaction. The ongoing activities of this unit illustrate the importance of hospitalists as partners for improvement within the hospital. Hospitalist CIUs have the clear potential to create new models for better care and quality improvement research in the inpatient setting.

Author Disclosure:

P. Watson, none; J. Jeffries, none; M. St. Amand, none; J. Ernst, none; J. Jordan, none; M. Parent, none; A. Curry, none; E. Hummel, none.