The effect of geographic rounding on hospitalist work experience: a mixed-methods study

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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.

Original languageEnglish (US)
Pages (from-to)124-131
Number of pages8
JournalHospital Practice
Issue number2
StatePublished - 2022


  • Geographic assignment
  • burnout
  • hospitalists
  • interruptions
  • patient care team
  • provider satisfaction
  • quadruple aim
  • quality improvement
  • teamwork
  • unit based rounding

ASJC Scopus subject areas

  • Health Information Management
  • General Medicine
  • Clinical Biochemistry


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