E0615 - The Impact of the GI Hospitalist Model on Hospital Metrics and Outcomes: Experience of a Large Academic Medical Center

Sharon Klein, MD¹, Cameron Zenger, MD¹, Melissa Latorre, MD, MS^2
1NYU Langone Health, New York, NY; ²New York University Langone Medical Center, New York, NY

Introduction: Within internal medicine the implementation of a hospitalist care model has shown an improvement in hospital outcomes (length-of-stay and readmissions), quality metrics (in-hospital mortality) and cost savings. The hospitalist model has been increasingly adopted by subspecialities including gastroenterology (GI) given its benefits and the growing need to have physicians onsite for inpatient emergencies. A GI hospitalist is a physician who spends the majority of their clinical time overseeing the care of hospitalized patients with gastrointestinal disorders. Additionally, they may be involved in coordinating and executing endoscopic procedures when indicated. Limited data exists on the impact of a GI hospitalist on inpatient care. In this study we evaluate the impact of hiring a GI hospitalist on hospital metrics at a large quaternary care academic medical center.

Methods: We performed a retrospective single center study of patients who received inpatient endoscopic general GI procedures (endoscopy, colonoscopy, and enteroscopy) at an academic quaternary care medical center in the fiscal year before and after hiring a GI hospitalist (September 2016 through August 2018). We compared patient outcomes of interest including mean observed-to-expected length of stay (O:E LOS), discharge before noon (DBN), in-hospital mortality and 30-day unplanned readmission.

Results: A total of 2,092 general GI procedures were included in the analysis. Table 1 summarizes metrics and outcomes before and after hiring a GI hospitalist. We observed a 4% increase in case volume and a significant decrease in the average O:E LOS from 1.21 to 1.11 (p< 0.05) which suggests more efficient endoscopic and periprocedural care. There was also a significant increase in the number of patients discharged before noon with a GI hospitalist onsite (37% vs. 31%, OR 1.3 (95% CI: 1.1, 1.6)). We observed a trend towards reduced in-hospital mortality and unplanned readmissions after hiring a GI hospitalist.

Discussion: Having a GI hospitalist onsite was associated with an increase in general GI procedure volumes and improved hospital outcomes in patients undergoing inpatient general GI procedures. As the role of a GI hospitalist continues to evolve, our data offers nascent evidence to support the utility in embracing this model into more hospitals nationwide.




Disclosures:


Sharon Klein, MD¹, Cameron Zenger, MD¹, Melissa Latorre, MD, MS². E0615 - The Impact of the GI Hospitalist Model on Hospital Metrics and Outcomes: Experience of a Large Academic Medical Center, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.