Evaluating the Impact of a Newly Established Hospitalist Medicine Procedure Service on Length of Stay and Procedural Outcomes: A Retrospective Propensity-Matched Analysis.
Document Type
Article
Publication Date
3-2026
Publication Title
Journal of Hospital Medicine
Abstract
BACKGROUND: Reliance on interventional radiology (IR) has been associated with delays in procedure completion and prolonged hospital length of stay (LOS). Hospitalist medicine procedure services (HMPS) have been proposed as a strategy to mitigate these inefficiencies, though outcomes of newly established programs composed of physicians with minimal ultrasound training remain underexplored.
OBJECTIVE: To evaluate the clinical and operational impact of a newly implemented HMPS composed of hospitalists with minimal prior procedural experience.
METHODS: We conducted a retrospective propensity-matched cohort study at two urban hospitals in Grand Rapids, Michigan, including 920 admitted patients undergoing paracentesis or thoracentesis between April 2021 and May 2023. Patients were matched 1:1 between those treated by IR before HMPS implementation and those treated by HMPS postimplementation. Primary outcomes were LOS and time from procedure order to completion. Secondary outcomes included serious complications.
RESULTS: Following matching (N = 460 per group), HMPS was associated with a 14.8% reduction in LOS (p = 0.001) and a significant reduction in median time from order to completion compared with IR (794.5 vs. 2049.5 min, p < 0.001). Complication rates were low and not significantly different between groups. Multivariable modeling identified order-to-completion time and antithrombotic use as independent predictors of LOS.
CONCLUSIONS: A newly created hospitalist procedure service, staffed by clinicians with limited procedural experience, significantly reduced LOS and procedural delays without compromising safety. Findings suggest that expanding procedural capacity and reducing time-to-procedure is an effective strategy to improve efficiency and throughput in hospitals where IR-based workflows create bottlenecks.
Recommended Citation
Gentile J, Alazmeh S, Soni K, Alsibai T, Wright F, Stowe A, Peacock F. Evaluating the impact of a newly established hospitalist medicine procedure service on length of stay and procedural outcomes: A retrospective propensity-matched analysis. J Hosp Med. 2026. doi: 10.1002/jhm.70311. PMID: 41906637.
DOI
10.1002/jhm.70311
ISSN
1553-5606
PubMed ID
41906637