Background: Accurate attribution of quality metrics to individual hospitalists is crucial for quality improvement and value-based care initiatives. However, the collaborative nature of inpatient care with frequent patient handoffs makes fair attribution challenging. The current understanding of variation in hospitalist quality metrics comes primarily from studies using attribution methods based on who oversaw the majority [...]

Background: Hospital scheduling and structure has the potential to smooth the flow and impact quality outcomes. The most predominant hospitalist schedule follows the seven-on/seven-off scheduling where hospitalists would switch off service after the 7th day, also known as switch day, to the next incoming provider. However, there is limited data on which hospitalist switch day [...]

Background: “Geographic rounding” describes physicians focusing on patient care in a single hospital unit. Studies have suggested that geographic rounding may improve efficiency and communication. Prior to our pilot, physicians at EUHM were seeing patients distributed across 13 units making rounding inefficient and care coordination challenging. Methods: We designed a geographic-based rounding system on unit [...]

Background: Quality incentive programs are increasingly used in hospitalist groups and can drive improvement in focus metrics (1,2). Due to the nature of hospitalist work including frequent signout and handoffs, group rather than individual metric attribution can be considered for certain metrics and incentive targets set for either individual or group performance. Purpose: We investigated [...]

Case Presentation: A 66-year-old male presents as an urgent new patient evaluation to rheumatology with new complaints of abrupt bilateral hand and foot swelling for six weeks with difficulty flexing fingers and toes. The swelling remained constant throughout the day, not improving with activity or rest. The patient was recently seen by his primary doctor [...]