Introducing hospitalists to cancer care comanagement may be associated with decreased lengths of hospital stays for patients, increased inpatient hospital capacity, and reduced stress levels among oncologists—all while maintaining high-quality inpatient care, according to a new study published by Morris et al in the Journal of Hospital Medicine.
“In this [study, we focused on] decreasing inpatient length of stay, but our ultimate goal was increasing the time patients can spend at home,” explained lead study author Jensa Morris, MD, an internal medicine specialist in the Division of General Internal Medicine at the Yale School of Medicine and Director of the Smilow Hospitalist Service at the Smilow Cancer Hospital, New Haven, Connecticut.
Background
Hospitalists specialize in inpatient treatment—and while there has been growth in oncology hospitalist programs at major cancer hospitals, there is a dearth of data documenting the impact that hospitalists may have on a patient’s length of hospital stay. The researchers aimed to fill the knowledge gap and determine how comanagement of cancer care may impact physician stress and burnout.
Study Methods and Results
In the new study, they compared real-time outcomes from both the hospitalist comanagement model and the traditional, oncologist-led inpatient services to assess the impact of hospitalist involvement. The researchers tracked patient volume, length of stay, early discharges, discharge time, and the rate of readmission within 30 days of discharge over 6 months of follow-up.
During the study period, the hospitalist-led program cared for a higher volume of patients than the oncologist-led service. While considering each patient’s background and medical comorbidities, the average length of hospital stay for patients was 4.71 days in the hospitalist-led program compared with 5.47 days in the oncologist-led program. When comparing the two approaches to inpatient cancer care, there was no difference in the number of patients readmitted to the hospital.
The researchers determined that no differences in illness severity were discovered for patients cared for in either care model.
Conclusions
“The other interesting finding is that with a shorter length of stay, we were able to accommodate many more patients—caring for 113 more patients with cancer in the first 6 months of the program,” Dr. Morris highlighted.
The researchers also surveyed oncologists to determine whether having a hospitalist involved in cancer care comanagement affected their stress levels. Oncologists tended to report that working with the hospitalist service was less stressful and time-consuming—making managing other clinical and research responsibilities easier.
The researchers concluded that hospitalist comanagement may significantly improve patients’ lengths of stay and oncologists’ stress levels and allow for earlier discharge—without seeing increases in 30-day rehospitalizations.
Disclosure: For full disclosures of the study authors, visit shmpublications.onlinelibrary.wiley.com.
