Adoption of a gastroenterology hospitalist model and the impact on inpatient endoscopic practice volume: A controlled interrupted time-series analysis

Abstract

Background and AimsThe gastroenterology (GI) hospitalist staffing model has multiple potential benefits for the inpatient and outpatient care of GI patients. The GI hospitalist model may improve inpatient endoscopy efficiency via better provider familiarity with management of GI emergencies, hospital systems and workflow, and may also increase outpatient endoscopy capacity by decreasing the need for inpatient coverage by outpatient providers. However, the real-world impact of this model on inpatient and outpatient endoscopic volume remains uncertain. MethodsWe conducted a controlled interrupted time series analysis from September 2018 to March 2020 comparing inpatient endoscopy volume at two high-acuity hospitals within the same academic health system, one of which adopted a two-physician GI hospitalist model in July 2019. We also performed a single interrupted time series analysis of outpatient endoscopic volume of the practice employing GI hospitalists. ResultsAfter implementation of the GI hospitalist model, weekly volume of inpatient endoscopic procedures increased by 10.9 (95% CI: [0.6, 21.2]; p=0.024) compared to a hospital using traditional staffing. Outpatient endoscopic procedure volume also increased by 39.8 per week (95% CI: [-5.78, 85.44]; p=0.09), with no change in the number of physicians performing endoscopy. ConclusionsOur findings demonstrate that introduction of a GI hospitalist model increased inpatient and outpatient endoscopic volume in a large academic center.