Overview of a Workshop on the Role of the Hospitalist in Quality Improvement

Hospitalists have an important role to play in identifying clinical practice and system improvements for optimizing patient care during and after hospitalization. At the 2002 annual meeting of the Society of General Internal Medicine, the Brigham and Women’s–Faulkner hospitalist service presented a workshop on the role of the hospitalist in quality improvement. The purpose of the workshop was to review 3 quality improvement projects and to exchange ideas about the role of hospitalists in quality improvement. In this paper, the authors briefly describe the projects and summarize the discussions that followed each presentation. Hospitalists have an important role to play in identifying clinical practice and system improvements for optimizing patient care during and after hospitalization. Unlike many physicians who primarily work in the outpatient setting, hospitalists encounter problems relating to the efficiency and safety of patient care on an almost daily basis. As a result, hospitalists are in a unique position to identify opportunities for quality improvement in the hospital, and hospitalists invested in quality improvement initiatives should be leaders in implementing change. Until recently, quality improvement efforts at Brigham and Women’s Hospital have been directed largely through retrospective chart review and at morbidity and mortality conferences directed at a limited audience. It is not clear that these reviews have had much impact beyond the individuals involved in the adverse events. In addition, this approach does not capture “near misses” or the denominator of potential cases or address systems problems. At the 2002 annual meeting of the Society of General Internal Medicine, held 2–4 May in Atlanta, GA, the Brigham and Women’s–Faulkner hospitalist service presented a workshop on the role of the hospitalist in quality improvement. The purpose of the workshop was to review 3 quality improvement projects initiated by our service and to exchange ideas about the role of hospitalists in quality improvement. In this paper, we briefly describe the projects and summarize the discussions that followed each presentation. Readmission Evaluation Project