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Performance Improvement: A Multi-Hospital Health System Case Study

Case Studies

Hospital Information

Facility Type: Central Florida-based multi-hospital regional health system

TeamHealth Services: Hospital Medicine

TeamHealth Impact

  • Length of stay dropped to 6% below benchmark
  • Provider satisfaction increased to the 97th percentile among TeamHealth clinicians
  • Patient satisfaction scores rose above the 75th percentile for the first time in three years
  • Use of locum tenens physicians eliminated


A Central Florida regional health system was experiencing performance issues metrics issues within its two facilities. Several ownership and leadership changes in the hospitals’ hospitalist services group had left the facilities with low patient and provider satisfaction, lengths of stay that were well above benchmarks, and problems with recruiting and retaining physicians.


In September 2017, the system brought TeamHealth aboard to assume management of the hospital medicine departments in both hospitals. TeamHealth’s first step was to install in a facility medical director who had a successful record of leadership. With stable leadership in place, TeamHealth delivered the additional support and resources needed to improve performance.

The new facility medical director began adopting systems and processes that were more equitable for clinicians, resulting in improved physician engagement and satisfaction. As an example, the facility medical director hired a full-time admitter and increased the number of physicians who would be available to take admissions when resident physicians reached their caps. This change eliminated the common flow bottleneck that can result when physicians become overwhelmed on busy days.

The hospital medicine team also began partnering with case management and nursing to address long lengths of stay. During multidisciplinary meetings, the combined teams collaboratively discussed patient cases with the goal being to optimize safe and timely discharges. The facility medical director used opportunities to review charts and identify activities or processes that could deliver additional education on evidence-based care. He also began to periodically round with physicians and coaching, as appropriate, on physician/patient communication.


After one year, the health system’s hospital medicine teams moved geometric length of stay index from 122% to 106.2%, well below the health system’s benchmark of 112%. Provider satisfaction increased to the 97th percentile among TeamHealth clinicians, and patient satisfaction scores rose above the 75th percentile for the first time in three years. TeamHealth also recruited for and filled nine vacant positions, thereby eliminating premium labor expenses and the use of locum tenens.


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