Hospital-Based Clinicians’ Perceptions of Geographic Cohorting: Identifying Opportunities for Improvement

Areeba Kara, Cynthia S. Johnson, Siu L. Hui, Deanne Kashiwagi

Research output: Contribution to journalArticle

Abstract

Members of the Society of Hospital Medicine were surveyed about geographic cohorting (GCh); 369 responses were analyzed, two thirds of which were from GCh participants. Improved collaboration with the bedside nurse, increased nonclinical interactions, decreased paging interruptions, and improved efficiency were perceived by >50%. Narrowed clinical expertise, increased fragmentation, increased face-to-face interruptions, and an adverse impact on camaraderie within the hospitalist group were reported by 25% to 50%. Academic practices were associated with positive perceptions while higher patient loads were associated with negative perceptions. Comments on GCh benefits invoked improvements in (1) interprofessional collaboration, (2) efficiency, (3) patient-centeredness, (4) nursing satisfaction, and (5) GCh mediated facilitation of other interventions. GCh downsides included (1) professional and personal dissatisfaction, (2) concerns about providing suboptimal care, and (3) implementation barriers. GCh is receiving attention. Although it facilitates important benefits, it is perceived to mediate unintended consequences, which should be addressed in redesign efforts.

Original languageEnglish (US)
Pages (from-to)303-312
Number of pages10
JournalAmerican Journal of Medical Quality
Volume33
Issue number3
DOIs
StatePublished - May 1 2018

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Keywords

  • geographic cohorting
  • hospital medicine
  • interruptions
  • teamwork

ASJC Scopus subject areas

  • Health Policy

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