Effect of hospitalist-care coordinator team on a nonteaching hospitalist service

Background: Although many hospitalists work with clinical coordinators, few studies have evaluated their impact. Objective: The purpose of the study was to evaluate the impact of a hospitalist-care coordinator team on hospitalist work experience, patient satisfaction, and hospital efficiency. Design and Participants: During each of 12 weeks, hospitalists on a nonteaching hospitalist service were randomly assigned to work with a hospitalist care coordinator (HCC) or to work independently. Measurements: Each week hospitalists completed a survey to assess their satisfaction and perceived work efficiency. Patient satisfaction with hospital discharge was assessed by telephone interviews. Hospital efficiency was analyzed with multivariate linear regression using log-transformed length of stay (LOS) and cost as dependent variables. Results: The 356 patients cared for by hospitalist-HCC teams were similar to 337 patients cared for by control hospitalists. Twenty-eight of 31 hospitalists (90%) who worked with an HCC responded that the HCC improved their efficiency and job satisfaction. Seventy-one of 196 eligible patients (36%) completed the postdischarge interview. The mean ratings of overall satisfaction with hospital discharge on a scale of 10 were similarly high in both groups (8.57 vs. 8.37; P = .94). In multivariate regression analyses, LOS was 0.28 days shorter and cost was $585.62 lower for patients cared for by hospitatist-HCC teams; however, these results were not statistically significant (P = .17 and .15, respectively). Conclusions: Hospitalists working in a team approach with an HCC reported improved efficiency and job satisfaction compared with hospitalists working independently. These findings are important in light of growing concerns about hospitalist workload and job satisfaction.