title: Effects of hospitalist-directed interdisciplinary medicine floor service on hospital outcomes for seniors with acute medical illness.
abstract: OBJECTIVE
  To examine whether a hospitalist-directed interdisciplinary (ITD) team in an internal medicine residency program enhances the hospital and clinical outcomes for seniors with acute medical illness.
  
  
  METHODS
  Seniors admitted to a USA teaching hospital medical floor-teaching services were allocated to the ITD (n = 379) and usual care teams (n = 383). Compared with the usual care team, the ITD team physicians carried out daily "geriatric" assessment and management, and led ITD team meetings.
  
  
  RESULTS
  The mean probability of functional decline on hospital discharge in the ITD team (25%; 95% CI 19-30%) was significantly lower than that in the usual care team (36%; 95% CI 30-43%; OR 0.35; 95% CI 0.10-0.92; P < 0.001). The mean probability of delirium in the ITD team (26%; 95% CI 20-32%) was significantly lower than that in the usual care team (34%; 95% CI 28-41%; OR 0.48; 95% CI 0.16-0.97; P = 0.03). The mean probability of transition to an institution in the ITD team (18%; 95% CI 13-23%) was significantly lower than that in the usual care team (26%; 95% CI 19-32%; OR 0.41; 95% CI 0.14-0.95; P = 0.01).
  
  
  CONCLUSIONS
  Hospitalist-directed ITD team care is associated with reductions of functional decline, delirium and transition to an institution for seniors with acute medical illness.
authors.affiliation: Department of Internal Medicine and Institute of Gerontology, University of Michigan Medical School, Ann Arbor, Michigan, USA; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Yoo
authors.forename: Haesun
authors.initials: H
authors.lastname: Seol
authors.forename: Sun Jung
authors.initials: SJ
authors.lastname: Kim
authors.forename: Janet Miyoung
authors.initials: JM
authors.lastname: Yang
authors.forename: Woo Sang
authors.initials: WS
authors.lastname: Ryu
authors.forename: Too Dae
authors.initials: TD
authors.lastname: Min
authors.forename: Jong Bum
authors.initials: JB
authors.lastname: Choi
authors.forename: Minkyung
authors.initials: M
authors.lastname: Kwon
authors.forename: Sulgi
authors.initials: S
authors.lastname: Kim
mesh_terms: D000208:Acute Disease / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000517:prevention & control*; D020445:Hospitalists; D006760:Hospitalization / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching; D006801:Humans; D033183:Interdisciplinary Communication; D010348:Patient Care Team / Q000458:organization & administration*; D060305:Transition to Adult Care / Q000639:trends*; D014481:United States
keywords: delirium; hospitalist; inter-professional relations; interdisciplinary health teams; quality of health care