Better patient outcomes have been seen in hospitals that employ the hospitalist model of care, reports a new study in Human Resource Management (2008;47(4):729—755).
"This study will resonate among hospitalists as something to reinforce what their intuitions have told them," says Joe Miller, study co-author and SHM's executive advisor to the CEO. Although a lot of other studies have shown hospitalists to be more efficient, this is the first to try to understand why, he says.
The study attributes the success of the hospitalist model to a concept known as relational coordination, in which members of the healthcare team are assessed based on their coordination with other team members. In the study, performance outcomes were analyzed in more than 6,000 cases at Newton-Wellesley Hospital in Newton, Mass. between July 2001 and July 2003. On the days when the attending physician was a hospitalist, as opposed to a primary care physician, the relational coordination between the care team—meaning the strength of the communication and relationships between physicians and the other care providers—was statistically significantly higher. This translated into decreased length of hospital stay, reduced hospital costs by $655 per patient, a 41.8% reduction in the risk of patient readmittance, and a 13.2% improvement in coordination.
"Hospitals are being asked to share their performance results and it's being acknowledged that delivering their service requires coordination and cooperation among the various players." Miller says. "I think this study may stimulate more research, and it may stimulate hospital executives to examine the hospitalist program within their organization to achieve these types of results."