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HM12 SESSION ANALYSIS: Innovative Scheduling as Quality Improvement


Shalini Chandra, MD, MS, Gregory Harlan, MD, FAAP, MPH, Brian Donovan, MD, MMM, FACP, SFHM, and Judy Shumway, DO, MPH, led a standing-room only morning breakout session on Monday at HM12 that focused on the challenges and opportunities of scheduling and rounding.

Dr. Harlan, a hospitalist at IPC, introduced the topic of innovative scheduling by placing the issue in a framework easily understood by hospitalists: quality improvement. He advocated identifying the salient problems faced by each individual group and then applying changes that make sense to each facility and group.

Dr. Chandra, a hospitalist at Johns Hopkins Bayview Medical Center, further elaborated on this by explaining how the PDSA (plan, do, study, act) approach can be used to initiate and assess the changes implemented in scheduling. Metrics such as hospitalist morale, patient satisfaction, length of stay, and time of discharge, can be used to assess the effect of each scheduling change.

Dr. Donovan, medical director of IPC, described a “zone” approach to scheduling. This rounding scheme assigns a hospitalist to a geographic unit, allowing for greater accessibility and higher efficiency. Closer relationships with multidisciplinary personnel can be achieved with this model.


  • Test your scheduling changes with PDSA methods of quality improvement.
  • Multidisciplinary rounds are critical to success.
  • "Zone" rounding allows the development of physician leaders in each zone, and enable more efficiency.
  • Engaging stakeholders in the success of physician scheduling is critical; this may enable more support and resources for these changes from administration.

Dr. Chang is a pediatric hospitalist with the University of San Diego Medical Center and Rady Children's Hospital, San Diego.

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