Background: Rising inpatient census, limited physical space and unpredictable admission rates introduce communication inefficiencies among doctors, nurses and patients. Purpose: At UC San Diego Health System, we aimed to streamline communication among physicians, patients and other care team members. Description: Two operational changes were made: 1) establishment of team-based geographic cohorting and 2) segregation of [...]

Background: Background: Geographic cohorting (GCh) of clinicians to a single unit may improve teamwork and improve outcomes. The physical proximity between the care team is purported to mediate these positive effects. We conducted an exploratory time-and-motion study of physicians to assess differences in daily activities between GCh and traditionally dispersed or ‘At-Large’ (AL) physicians. We [...]

Background: Geographic co-location, the practice of cohorting a panel of patients on the same hospital unit for a single provider or team, is increasingly popular, with 36.4% of adult hospitalist groups reporting unit-based assignments [1]. Benefits include increased hospitalist-patient interaction time, increased odds of multiple same-day patient visits, improved productivity, and greater interdisciplinary communication [2-4]. [...]

Background: For hospitalist sections that cover a variety of inpatient services from general medicine to oncology, geographic cohorting of patients may be difficult to execute and maintain. The varying influx of admissions and discharges can result in mismatches in available beds and services. Successful implementation of geographic assignment may require considerable costs including institutional support, [...]