News & Resources
May 9, 2022

Like It? Share It

Collaboration and Engagement Improve Continuity of Care in Hospital Medicine

Featured Articles

Hospitalists face many barriers when caring for admitted patients. From emergency department holds, discharge delays and more, these challenges can stem from a lack of transparency of expectations, unstable leadership, lack of support for emergency room physicians impacting patient flow and more. All these obstacles affect patient care, but they can also cut deeply into hospital revenue and negatively impact operations and clinician experience.

Identifying Needed Change in Hospital Medicine

In order to overcome these challenges, hospital medicine programs must foster collaboration and engagement. This extends beyond the hospitalist team’s cooperation amongst themselves. With the reliance on other departments’ performance, it is vital hospitalist teams engage their peers in the emergency room, case management and nursing to improve continuity of care and target key metrics – ultimately providing patients a higher level of care.

To achieve this, departments must see issues of continuity as collective problems to tackle together. Setting clear expectations for tackling these issues must come from strong leadership and clear direction.

How TeamHealth Improves Continuity of Hospitalist Care

As an experienced innovator in hospital medicine, TeamHealth customizes approaches to improving process and quality for each facility. At Saint Vincent Hospital, a 260-bed facility just outside Boston, the team focused on increasing leadership efficacy, providing transparent data, outlining clear goals and reinforcing collaboration.

Facility medical directors are first-hand advocates for teams to ensure they have the support and resources needed to provide exceptional care. These boots-on-the-ground leaders helped improve data transparency and align both short- and long-term goals. With a vast number of data points, it can be difficult for individual clinicians to pinpoint the most valuable metrics and areas for the varied stakeholders involved. However, alignment of goals and valued metrics among individual clinicians, team leaders and facility leadership eliminates ambiguity and provides clear strategic priorities.

Furthermore, engaging individual clinicians, teams and departments in active collaboration is key to ensuring continuity of care and patient experience. Monthly meetings with the hospitalist team and hospital leadership allows for alignment of goals. Moreover, regular meetings with the team allows for individual data comparison and coaching – increasing accountability. Departmental collaboration among the ED and case management, to name just two, improves patient flow processes. All these tactics work together to create an engaged team to deliver vital care.

Results and Success at Saint Vincent

At Saint Vincent Hospital, the team saw immediate successes. With 100% retained incumbent clinicians, the facility experienced a seamless transition with swift improvement in quality and key metrics. Some of the key targets included admission order time, discharge order time and query response time and observation hours. The team has continued to enact positive change over one year, with current results:

  • Admission order time: The goal was to lower time to below 60 minutes, well under the previous average of 111 minutes before TeamHealth. Within two months the average was brought down to 40 minutes and continues to remain in the 30-minute range for the year.
  • Discharge order time: Goal was to have at least 30% of discharge orders to occur before 10 am and 50% before noon. This was met for the whole year and during the most recent month, 37% of discharge orders occurred before 10 am and 63% before noon.
  • Query response time: The goal was to have query responses under two days with an agreement rate of 85%. Both targets were met for the whole year and current averages for the hospitalist team is .86 days with 91% agreement rate and 100% response rate.
  • Observation hours: The goal was to have under 30 observation hours. The new average for the team is 26 observation hours.

Not only has the team seen enduring improvements in these key data points, but the hospital’s acuity and case mix has also increased, partially through better documentation, allowing the facility to provide higher levels of care to patients who need it most.

Sustained Improvements in Hospitalist Care

A healthy and successful hospitalist division is vital to a facility’s success and to the community’s wellness. Because of this, it is paramount that teams engage in sustainable tactics to enhance care quality and patient experience. Change must persist beyond quick fixes that offer short-term metric improvement. With a sharp focus on long-term goals, TeamHealth’s hospital medicine program focuses on building steady, stable partnerships with our facility partners to ensure longevity of exceptional care delivery.

To learn more about how our program can help transform hospital performance, get in touch with us.