title: Hospitalists on an inpatient tertiary care oncology teaching service.
abstract: OBJECTIVE
  Hospitalists provide quality care in various inpatient settings, but the ability of hospitalists to provide quality inpatient care for patients with complex cancer has not been studied. This study explores outcomes with a hospitalist-led versus medical oncologist-led house staff team on an inpatient medical GI oncology teaching service.
  
  
  METHODS
  This observational retrospective cohort study examined 829 patient discharges from August 2012 to January 2013 on the GI oncology inpatient teaching service at Memorial Sloan Kettering Cancer Center, a tertiary cancer center in New York, New York. We compared average length of stay (ALOS), 30-day readmission rates, establishment of new do not resuscitate (DNR) orders, nosocomial pneumonia and urinary tract infection (UTI) rates, radiographic and laboratory tests per patient, and disposition on discharge between hospitalist-led and oncologist-led teams.
  
  
  RESULTS
  Median years of clinical experience was 6 (range, 4 to 9 years) for hospitalists and 7 (range, 0.5 to 36 years) for oncologists. ALOS (hospitalist led, 5.6 v oncologist led, 5.2 days; P = .30), readmission within 30 days (hospitalist led, 14% v oncologist led, 16%; P = .44), new DNR orders (hospitalist led, 18% v oncologist led, 19%; P = .90), nosocomial pneumonia (hospitalist led, 0.5% v oncologist led, 0.7%; P = .63) and UTI rates (hospitalist led, 0.5% v oncologist led, 0.7%; P = .63), number of radiographic studies and laboratory tests, and disposition on discharge were not significantly different between groups.
  
  
  CONCLUSIONS
  A hospitalist-led inpatient service with house staff represents a novel approach for caring for hospitalized GI oncology patients with cancer.
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY kood@mskcc.org.
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Koo
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Tabitha N
authors.initials: TN
authors.lastname: Goring
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Leonard B
authors.initials: LB
authors.lastname: Saltz
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Marina
authors.initials: M
authors.lastname: Kerpelev
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Chhavi B
authors.initials: CB
authors.lastname: Kumar
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Cori
authors.initials: C
authors.lastname: Salvit
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Helen H
authors.initials: HH
authors.lastname: Chung
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Ghassan K
authors.initials: GK
authors.lastname: Abou-Alfa
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Martin
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Egan
mesh_terms: D000368:Aged; D003428:Cross Infection / Q000453:epidemiology; D005260:Female; D020445:Hospitalists / Q000706:statistics & numerical data*; D006760:Hospitalization; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008495:Medical Oncology / Q000193:education*; D008875:Middle Aged; D010359:Patient Readmission; D016414:Resuscitation Orders; D012189:Retrospective Studies; D013038:Specialization / Q000706:statistics & numerical data*; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D063128:Tertiary Health Care