Physician Perceptions and Clinical Outcomes of a Novel Standardized Outside Hospital Admission Process.
Publication/Presentation Date
8-5-2026
Abstract
Transfers are high-risk events, and outside hospital admissions lack standardized processes to ensure timely delivery of essential clinical information. We piloted a novel, standardized process for outside admissions to a single academic medical center's resident- and hospital medicine-attending-based medicine services. Following literature review, Epic UserWeb review, and frontline physician input, a workflow and templated electronic health record accept note were developed to centralize outside admission documentation. Completed by physicians during real-time communication with outside physicians, the template captures key clinical data and incorporates a communication checklist. Physician education was delivered electronically and in person. Subjective attending and resident perceptions were assessed via electronic prepost surveys administered 1 week before and 90 days after implementation. Secondarily, exploratory patient clinical outcomes were assessed through 90-day prepost manual retrospective chart review. Survey responses were obtained from 60/38 residents and 12/7 attendings (pre/post). Documentation sufficiency on patient arrival was directionally promising among residents (21.7% vs 39.5%, P = 0.062). Satisfaction with the admission process and perceived patient safety improved significantly among residents and attendings (P ≤ 0.036). Most respondents rated the note as useful or very useful (84% residents; 86% attendings), and attendings reported reduced time managing outside admissions. The intervention was associated with exploratory, nonsignificant reductions in rapid response team activation, intensive care unit transfer, 30-day readmission, mortality, and length of stay compared with preintervention patients. A standardized documentation and communication process improved physician satisfaction and perceived patient safety, with promising exploratory patient outcomes. Further study is warranted to assess impact at scale.
ISSN
1555-824X
Published In/Presented At
Gallagher, K. E., Riggio, J. M., & Kubey, A. A. (2026). Physician Perceptions and Clinical Outcomes of a Novel Standardized Outside Hospital Admission Process. American journal of medical quality : the official journal of the American College of Medical Quality, 10.1097/JMQ.0000000000000339. Advance online publication. https://doi.org/10.1097/JMQ.0000000000000339
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
42549654
Department(s)
Administration and Leadership
Document Type
Article