Outcomes After Implementation of a Cardiovascular Hospitalist Model for Acute Coronary Syndrome

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-8-2026

Abstract

The hospitalist model has evolved over time, with multiple adaptations emerging from its core structure, including "hyphenated hospitalists" functioning within comanagement frameworks. These models have been implemented across medical and surgical specialties and are often associated with reductions in hospital length of stay (LOS) without adversely affecting readmission rates. Building on this concept, Corewell Health West implemented a cardiovascular hospitalist (CV-hospitalist) service line designed to comanage acute coronary syndrome patients, with the dual goals of improving inpatient efficiency and increasing procedural availability for interventional cardiologists.

The CV-hospitalist service was implemented on January 9, 2024, after which all NSTEMI and STEMI patients were admitted under this service. This preliminary analysis describes early outcomes following implementation, focusing on LOS, 30-day all-cause readmission, and 30-day all-cause mortality. Outcomes for patients managed by the CV-hospitalist service were compared with historical cohorts managed by interventional cardiology and the general hospitalist services. Analyses at this stage are descriptive and unadjusted; cohort verification, data cleaning, and refinement are ongoing. Planned future analyses include time-based adjustment, multivariable regression modeling to account for patient- and system-level confounders, and evaluation of additional outcomes including complication rates and guideline-directed medical therapy (GDMT) prescribing patterns.

In this early analysis, patients managed by the CV-hospitalist service demonstrated a shorter mean LOS compared with historical cohorts (3.2 days vs 3.8 days). Observed 30-day all-cause mortality was lower in the CV-hospitalist group (0.7%) compared with historical controls (3.5%). The proportion of patients readmitted within 30 days was similar between groups, with a slightly higher observed rate in the CV-hospitalist cohort (6.9% vs 6.4%). Across service models, the CV-hospitalist group demonstrated the lowest observed 30-day mortality. These findings reflect preliminary, unadjusted data from cohorts that are still undergoing validation and should be interpreted accordingly.

Early descriptive outcomes following implementation of a cardiovascular hospitalist service suggest a reduction in LOS without a clear increase in 30-day readmissions and with low observed short-term mortality. These findings are preliminary and derived from unadjusted analyses of cohorts that are still being cleaned and verified. Ongoing work includes risk-adjusted analyses, time-based modeling, and evaluation of secondary outcomes such as complication rates and GDMT prescribing to more fully characterize the impact of this care model.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 2151

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