February Spotlight — Hospital Medicine: HMS at MLH


Submitted by Jonathan Stallkamp, MD, Medical Director, Hospitalist Medicine Services, MLH


The world of hospital medicine continues to grow, and Main Line Health is no exception to this.  Hospital Medicine at Main Line Health (or HMS as it is better known) is made up of over 100 physicians, nurse practitioners and physician assistants, with plans next year to be well over 110.  That makes HMS the largest hospitalist group in the entire Delaware Valley and one of the largest health system employed groups in the country.  This is a far cry from HMS’s humble beginnings at Bryn Mawr Hospital as a several person group in the mid-1990s — before the term “hospitalist” even existed.


HMS currently cares for the majority of medical admissions and over half of all the admitted patients at our Main Line Health hospitals.  HMS is not just limited to the acute care hospitals.  Over the last few years, we have expanded to provide medical coverage at Mirmont Treatment Center, Kindred LTAC in Havertown, and some night coverage at Bryn Mawr Rehab Hospital.  We are also involved in the wound healing program, utilization review, and peri-operative medicine.


One of the more exciting changes in HMS over the last couple years is the degree of involvement our physicians have had in the operations of the hospital.  Our highly engaged members are involved on multiple committees and have spearheaded several quality initiatives.  In fact, it is hard to find a committee that a hospitalist isn’t on.  One of our physicians reviews all mortalities in the Health System, another leads the Riddle Quality Committee, and for the last two years an HMS physician has won the System Physician Safety Hero Award.


Our engagement and increased involvement has translated into real results.  We were the first physician group in the Health System to go completely electronic.  It has been over two years since HMS has actually written a progress note.  The HMS mortality rate is only 0.27 observed vs. expected.  Not only is this a testament to the great coordinated care we give, but also to the quality of the documentation that we do.  We are also providing this care in a cost-effective manner with an observed to expected length of stay of 0.76 and cost per case index of 0.85.


HMS will continue to strive to improve in these and other areas.  Though our readmission rate is less than expected, we can do better and will be continuing to partner with our primary care partners in a more consistent warm hand off.  We are working with Emergency Medicine in improving patient flow out of the ED and hold joint leadership meetings monthly.  We are also dedicating more resources to improving our doctor communication HCAHPS scores.   Our goal is to be a part in maintaining Main Line Health as a world class organization and in establishing HMS as a leading hospitalist group, not only in the region but nationally.



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