A Strategy for Surge Management: Senior Residents on the Admitting Frontlines.

Area of Science:

• Healthcare Management
• Medical Education
• Internal Medicine

Background:

• Hospitals face challenges managing patient surges, impacting staff workload and patient care.
• Traditional surge management includes expediting admissions/discharges and increasing staff.
• Internal Medicine (IM) residency and hospitalist programs seek innovative solutions for surge capacity.

Purpose of the Study:

• To evaluate a novel surge management strategy in a community hospital.
• To assess the impact of shifting senior residents into admitting physician roles.
• To determine the effect on physician workload, resident education, and overall hospital strain.

Main Methods:

• A collaborative approach between IM residency and hospitalist programs was implemented.
• Senior residents were shifted to admitting physician roles with indirect supervision.
• An admitting attending physician was reassigned to a new rounding service, increasing total rounding services.

Main Results:

• Over 15 months, patient census and rounding physicians increased substantially.
• Individual physician loads remained minimally different, indicating effective strain alleviation.
• Residents reported appropriate workload, balanced education, and beneficial surge experience.

Conclusions:

• This innovative surge management technique effectively mitigated strain on the hospital system.
• The approach supported resident wellness and education while managing surge demands.
• The strategy shows potential for reproducibility in other community hospitals and scalability in larger institutions.