Impact of Hospitalist Programs on Perceived Care Quality, Interprofessional Collaboration, and Communication: Lessons from Implementation of 3 Hospital Medicine Programs in Canada

Results

A total of 377 individuals responded to the online survey between January 8 and February 28, 2018 (response rate 14%). The distribution of respondents generally reflected the size of the respective acute care facilities. Compared to the overall sampled population, fewer nurses participated in the survey (45% vs 64%) while the rate of participation for Unit Clerks (14% vs 16%) and allied professionals (12% vs 16%) were similar.

Out of the 45 people approached for an interview, a total of 38 were conducted from January 3 to March 5, 2018 (response rate 84%). The interviews lasted an average of 42 minutes. Interviewees represented a range of administrative and health professional roles (Figure 1). Some interviewees held multiple positions.

Satisfaction with HM service

Across all sites, survey respondents reported high levels of satisfaction with their respective HM services and identified positive impacts on their job satisfaction (Figure 2). Almost all interviewees similarly expressed high satisfaction levels with their HM services (95%; n = 36).

Perceptions of HM service performance

Survey respondents rated the strength of hospitalists’ interprofessional communication and collaboration with other physicians and with care teams. Roughly two-thirds reported that overall hospitalist communication was “good” or “very good.” We also asked participants to rate the frequency at which hospitalists met best practice expectations related to interprofessional teamwork. Across all sites, similar proportions of respondents (23% to 39%) reported that these best practices were met “most of the time” or “always” (Figure 3). Survey questions also assessed perceptions of respondents about the quality and safety of care provided by hospitalists (Figure 4).

Perceptions of the impact of the HM service postimplementation

The majority of survey respondents reported improvements in the quality of communication, professional relationships, and coordination of inpatient care at transition points after the implementation of the HM service (Figure 5). This was also reflected in interviews, where some indicated that it was easier to communicate with hospitalists due to their on-site presence, accessibility, and 24/7 availability (n = 21). They also described improved collaboration within the care teams (n = 7), and easier communication with hospitalists because they were approachable, willing, and receptive (n = 4).