AHRQ Innovations Exchange | Surgical Hospitalist Model Enhances Access to Surgical Consultations, Increases Physician Perceptions of Quality at Academic Medical Center

Surgical Hospitalist Model Enhances Access to Surgical Consultations, Increases Physician Perceptions of Quality at Academic Medical Center

Snapshot
Summary
The University of California, San Francisco Medical Center realigned its surgical team to provide increased coverage and consultations in the emergency department and general acute care units through use of rotating surgical "hospitalists" who take call for a week at a time (rather than the traditional 24-hour on-call shift). This program, believed to be the first large-scale implementation of a surgical hospitalist model in the United States, resulted in quicker response time for consultations and, according to physician surveys, shorter emergency department length of stay, better patient satisfaction, improved professionalism and resident supervision, and better overall quality of care.

See the Additional Considerations section for new information regarding surgical collaboration and professional satisfaction and the Use By Other Organizations section for updated data on surgical hospitalist programs (updated March 2010).

Evidence Rating
Moderate: The evidence consists of pre- and post-implementation data on response times for appendectomy, post-implementation data on overall response times, before and after comparisons of usage of the consult service, and physician surveys of their perception of the program.

Developing Organizations
University of California, San Francisco, Dept. of Surgery and Dept. of Medicine

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AHRQ Innovations Exchange | Surgical Hospitalist Model Enhances Access to Surgical Consultations, Increases Physician Perceptions of Quality at Academic Medical Center