Hospital Medicine Case Studies

Patients at a large southern medical center faced excessive hold times in the emergency department (ED) before being admitted to inpatient beds. In response, Sound’s Hospital Medicine (HM) and Emergency Medicine (EM) teams collaborated to develop strategies to reduce these delays. Sound teams communicated through a secure messaging platform, conducted daily rounds to address care barriers, and downgraded patients needing less intensive care. This teamwork shortened hold times and improved patient flow, trust, and morale among staff.

Facing a spate of length-of-stay challenges, the Sound Hospital Medicine team at a Southwestern medical center — including internal medicine residency students, supervised by Sound hospitalists —saw an opportunity to work more closely with case management on implementing new protocols to help patients discharge expeditiously and with the appropriate support and resources. Through multidisciplinary rounds, readmissions workflows, addressing avoidable delays, and providing education around the impact of social determinants of health on patient care, the Sound team in collaboration with case managers was able to reduce length of stay and reduce readmissions.

After seeing the positive impacts of Sound’s centralized multidisciplinary rounds (MDRs) at another hospital, including reducing length of stay (LOS), the case management team of a south-central US medical center agreed to pilot a similar program at their hospital. Within nine months of the pilot, the hospital saw a 0.5 day reduction in LOS and stabilization of case mix index and readmissions, among other positive impacts.

The hospital medicine team at a teaching hospital in Texas was experiencing lower-than-desired HCAHPS scores. Sound’s Medical Director and Clinical Performance Nurse implemented leadership discharge rounding with Sound patients improving survey responses, and saw an 8.4 percent absolute increase in HCAHPS scores within six months. They also implemented a formal approach to multidisciplinary rounds and saw an 0.8-day LOS reduction within five months.

In this hospital, Sound's integrated solution brings together hospital medicine, emergency medicine, and critical care to put the patient at the center of care. This integrated approach has led to reduced decision to admit times, reduced ED door-to-provider times, and reduced ED LWBS.