Using a geographic and interdisciplinary strategy to improve patient care outcomes.

78 Background: Long Island Jewish Medical Center at Northwell Health is an urban/suburban academic tertiary care hospital located across the street from the Northwell Health Cancer Institute. The Division of Hospital Medicine partnered with Hematology/Oncology and Palliative Care to co-manage inpatient oncology patients on a geographic unit. The goal was to improve patient care through co-ownership and co-accountability of cancer patients in conjunction with a unit-based collaboration with Nursing, Pharmacy, Social Work, Case Management and Physical Therapy. Methods: A unit-based, interdisciplinary care team was formed consisting of Medical Oncologists, Hospitalists, Palliative Care specialists, Radiation Oncologists, as well as unit based and specialty trained nurses, social workers and advanced care practitioners. The team meets Monday thru Friday during interdisciplinary rounds to collaboratively discuss the care plans of each patient. We recently added a hospital-based medical oncologist to support greater continuity and communication. Results: Since full implementation including improvements in patient cohorting, the oncology care model has resulted in a 20% reduction in Medicare readmissions, a significant reduction in CAUTIs and CLABSIs, a 50% reduction in C.diff, a decreased CMI-adjusted length of stay and an improvement in pain management HCAHP scores, despite a 10% increase in CMI. An interdisciplinary approach has also improved documentation of goals of care discussion from 6% to 40-58%, furthering the idea of providing a unified medical voice to a vulnerable population. Conclusions: The oncology care model highlights that implementing multidisciplinary rounding, co-management and population-based geography can deliver a higher quality and more efficient level of care even in the face of higher patient acuity.