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Hospitalists Can Help Reduce "July Spike" in Hospital-Acquired Complications


The number of inpatient hospital-acquired complications (HACs) typically spikes in July, but hospitalists can be instrumental in reducing this annual uptick, according to the lead author of a study on the "July effect" in hospital admissions.

Researcher Timothy Wen, MPH, a medical student at the Keck School of Medicine of University of Southern California in Los Angeles, examined patient discharge data collected nationally from 2008 to 2011 and found that July admissions had a 6% increase in the likelihood of HAC occurrence compared with admissions during all other months.

Wen, whose research findings were published in the Journal of Hospital Medicine, links the increase with the arrival of new residents, medical students, and hospital faculty in July. He says the annual staff changes can challenge the efficiency of hospital systems and processes.

Fortunately, hospitalists can help to reduce complications during and beyond this time of transition, Wen says.

“Because of their role,” Wen says, “hospitalists have a unique opportunity to not only utilize their institutional knowledge of the system and their patients but also to train residents in navigating the system with improved communication skills and working with ancillary staff. We believe that an initial step in resolving the outcomes associated with the 'July effect' is to have improved communication between ancillary, trainee, and attending staff. Furthermore, we believe that burden of surveillance during this transition period may require additional support from more senior ancillary and attending staff as the new trainees and faculty become more acquainted with the processes of a new hospital and service.”

HACs are a chronic issue for inpatients, contributing to longer lengths of stay and higher hospital costs. Wen says his study is among the first to “address the disparities in HACs between these time periods” and suggests more research on the impact of HACs is needed.

"HACs represent not only egregious complications of high cost and burden to hospitals and patients, but they are also a surrogate marker of adverse events that are preventable through systemic changes," he says. "We need future studies to continue to identify this disparity and its impacts, as well as research into novel initiatives and training protocols to work on reducing these HACs."

Visit our website for more information on reducing HACs.

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