TY - JOUR
T1 - The effect of geographic rounding on hospitalist work experience
T2 - a mixed-methods study
AU - Carlson, Kristy J.
AU - Matthias, Tabatha H.
AU - Birge, Justin R.
AU - Bulian, Brady P.
AU - Richards, Sarah E.
AU - Shiffermiller, Jason F.
N1 - Publisher Copyright:
© 2022 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022
Y1 - 2022
N2 - Objectives: To describe the structure and implementation of a model in which hospitalists focus on a particular hospital unit or area, referred to as ‘geographic rounding,’ and to analyze its effect on hospitalist efficiency, interruptions, after-hours work, and satisfaction. Methods: The leadership of our academic hospital medicine group designed a geographic rounding intervention with the goal of improving provider satisfaction and mitigating burnout. Our quantitative analysis compared the pre-intervention and post-intervention time periods with regard to progress note completion time, after-hours progress note completion, secure messaging communication volume, and Mini-Z survey results. A post-intervention qualitative analysis was performed to further explore the relationship between geographic rounding and the drivers of burnout. Results: Following the intervention, 97% of geographic rounders were localized to one or two geographic areas and 77% were localized to a single geographic area. Following the implementation of geographic rounding, progress notes were completed an average of 29 minutes earlier (p < 0.001). The proportion of progress notes completed after-hours decreased from 25.1% to 20% (p < 0.001). The volume of secure messages received by hospitalists decreased from 1.95 to 1.8 per patient per day (p < 0.001). The proportion of hospitalists reporting no burnout increased from 77.8% to 93% after implementing geographic rounding, a change that did not reach statistical significance (p = 0.1). Qualitative analysis revealed mixed effects on work environment but improvements in efficiency, patient-centeredness, communication with nurses, and job satisfaction. Conclusion: Geographic rounding represents an organization-level change that has the potential to improve hospitalist career satisfaction.
AB - Objectives: To describe the structure and implementation of a model in which hospitalists focus on a particular hospital unit or area, referred to as ‘geographic rounding,’ and to analyze its effect on hospitalist efficiency, interruptions, after-hours work, and satisfaction. Methods: The leadership of our academic hospital medicine group designed a geographic rounding intervention with the goal of improving provider satisfaction and mitigating burnout. Our quantitative analysis compared the pre-intervention and post-intervention time periods with regard to progress note completion time, after-hours progress note completion, secure messaging communication volume, and Mini-Z survey results. A post-intervention qualitative analysis was performed to further explore the relationship between geographic rounding and the drivers of burnout. Results: Following the intervention, 97% of geographic rounders were localized to one or two geographic areas and 77% were localized to a single geographic area. Following the implementation of geographic rounding, progress notes were completed an average of 29 minutes earlier (p < 0.001). The proportion of progress notes completed after-hours decreased from 25.1% to 20% (p < 0.001). The volume of secure messages received by hospitalists decreased from 1.95 to 1.8 per patient per day (p < 0.001). The proportion of hospitalists reporting no burnout increased from 77.8% to 93% after implementing geographic rounding, a change that did not reach statistical significance (p = 0.1). Qualitative analysis revealed mixed effects on work environment but improvements in efficiency, patient-centeredness, communication with nurses, and job satisfaction. Conclusion: Geographic rounding represents an organization-level change that has the potential to improve hospitalist career satisfaction.
KW - Geographic assignment
KW - burnout
KW - hospitalists
KW - interruptions
KW - patient care team
KW - provider satisfaction
KW - quadruple aim
KW - quality improvement
KW - teamwork
KW - unit based rounding
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U2 - 10.1080/21548331.2022.2050649
DO - 10.1080/21548331.2022.2050649
M3 - Article
C2 - 35253585
AN - SCOPUS:85128488060
SN - 2154-8331
VL - 50
SP - 124
EP - 131
JO - Hospital Practice
JF - Hospital Practice
IS - 2
ER -