Shining light on the hospitalist work after dark

Hospitalists work day and night, but the workloads of each shift are anything but uniform. Evening and overnight ("after-hours") work is not as visible to the health system. We aimed to increase the visibility of the after-hours cross-cover work by implementing standardized documentation practices that also facilitated appropriate billing for hospitalist-provided patient care. Our education session and simple electronic medical record (EMR) note template successfully increased visibility as measured by work relative value units (wRVUs) and trackable after-hours clinical documentation. This visibility creates a foundation for future improvement work to optimize essential-but often under-recognized-hospitalist work after-hours.