Background: Geographic localization of inpatient physician services to nursing units has been suggested to improve teamwork and patient safety among health care professionals, while perceived lack of collaboration has been associated with worse patient outcomes. On our inpatient oncology units, we previously found that large discrepancies exist in perceptions of teamwork and collaboration among professionals, [...]

Background: In most hospitals, physicians provide care to patients across multiple units while nurses are often unit-based, resulting in team dispersion, and potentially impairing teamwork. Geographically localized care teams may demonstrate improved communication between team members and with patients, potentially enhancing coordination of care. However, the impact of geographically localized teams on patient experience scores [...]

Background: Emergency department (ED) overcrowding is associated with a range of negative outcomes, including increased patient morbidity, decreased patient satisfaction, provider burnout, and violence against providers. ED boarding of admitted patients coupled with increasing ED patient volumes contributes to overcrowding. Geographic localization, where hospitalist provider teams are assigned patients on the same inpatient unit, has [...]

Background: Geographic localization (GL) has been shown to improve perceptions of physician-nurse, physician-physician, and physician-Case Management communication. However, data on other benefits of GL are mixed. While some studies show that GL improves time allocated by physicians for direct patient care, others report an increased frequency of workday interruptions and greater time spent on indirect [...]

Background: Hospitalized patients are often cohorted on specific inpatient wards in an effort to improve outcomes and provider satisfaction. When hospitalist beds are fully occupied, patients may be admitted to off-service inpatient units. Dispersion to multiple units has the potential to affect multiple outcomes. Hospitalist groups may develop cohorting programs, either in the form of [...]

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: Prolonged length of stay (LOS) is associated with worse quality outcomes, poor patient satisfaction, and negative financial performance for hospitals. Geographic cohorting of provider teams and their patients could improve LOS, readmissions, and other quality metrics. Many prior studies of geographic cohorting have shown no beneficial effect on these metrics. In 2021, we implemented [...]

Background: Geographic localization is the practice of assigning physician and advanced practice provider teams to patients located in the same inpatient unit. Poor localization of hospital medicine teams at our institution was identified as a top cause of increased Emergency Department boarding and Length Of Stay (LOS). The purpose of our process improvement project is [...]

Background: Improving efficiency and throughput in cancer patients with high acuity is challenging and requires a multi-disciplinary effort to coordinate care delivery. In The James Cancer Hospital, two separate Internal Medicine Divisions (Medical Oncology and Hospital Medicine) have historically provided inpatient oncology hospitalist care to an average daily census of 98 patients throughout The James, [...]

Background: As a strategy to improve throughput and efficiency, Vanderbilt University Hospital implemented geographic localization across several Hospital Medicine (HM) teams and units. This large-scale structural change presents an opportunity to not only improve efficiency and quality metrics, but to improve other patient-centered outcomes including patient experience. Purpose: To assess the impact of a hospital [...]