Hospital of the University of Pennsylvania (HUP) Hospital Medicine Service
The Hospital of the University of Pennsylvania (HUP) was founded in 1874 by the University of Pennsylvania School of Medicine. HUP was the first and remains the oldest continually run university-owned academic medical center in the United States.
The Hospital Medicine program at HUP began in 1998 with a sole purpose of covering two medicine housestaff services and has grown to cover five medicine housestaff services (the Martin general medicine teaching service, considered the flagship teaching service for Penn's internal medicine residency and medical students), and multiple non-resident collaborative care services staffed by hospitalists and advanced practice providers (APPs - Nurse practitioners and physician assistants) - two on general medicine, two on solid tumor oncology and one on neurosurgery. Two APP and hospitalist teams (in our Subspecialty Hospitalist Scholar or Ultrasound Fellowship pathway) provide nighttime cross-coverage and admissions to the medicine and oncology collaborative care services and also urgent medicine consultation throughout HUP. There is also a daytime admitting team staffed by APPs. Our hospital medicine group also serves as the primary medicine consultant to other specialties at HUP and there is designated triage hospitalist who collaborates with the Emergency Department to faciliate throughput and admissions.
The Section has shown exceptional growth and collaboration in the creation of collaborative care models, both in medicine and other specialties. We saw the addition of the first, revised collaborative care team in 2016 and have continued to grow these services over the years, with marked success. These teams have been very successful in improving hospital wide metrics, such as throughput, length of stay, discharge before noon and a reduction in readmissions. Hosptialists on collaborative care teams also lead regular didactics with the hospital medicine APPs.
The hospitalists on each team participate in multidisciplinary rounds, which include representation from case management, social work, nursing and other specialties. A number of our physicians also serve in leadership roles on the medicine inpatient units.
Our newest services include:
Solid Oncology Collaborative Care Team
In July 2017, the Section of Hospital Medicine collaborated with the Division of Hematology and Oncology to formulate a collaborative care team to support patients with oncologic diagnoses. Over the last few years, this service has grown in census and span of coverage and in 2021 we expanded to two oncology teams staffed by hospitalists adn APPs. Patients benefit from expert multidisciplinary care and close communication with their primary outpatient oncologist. In addition, we serve as an active participant in other quality improvement initiatives, such as palliative care outreach and various pilot programs.
Neurosurgery Collaborative Care Comanagement Service
In July 2019, the Section of Hospital Medicine entered into a collaborative agreement with the Department of Neurosurgery. As part of this service, a hospitalist serves as an embedded consultant on their services, working side-by-side with the advanced practice providers, residents and attendings in neurosurgery. Our hospitalist has the opportunity to manage medical comorbidities for a large, medically complex surgical population. The hospitalist also is charged with medical care coordination and participation in the multidisciplinary team as well as leading didactic conferences with neurosurgical APPs.
HUP Cedar Housestaff Services
In July 2022, our Section started to send faculty to attend on some of the housestaff services based at HUP Cedar, a safety-net hospital located in the heart of the West Philadelphia community. As of July 2023, our faculty fully run the housestaff services working with residents from the Mercy Catholic Medical Center program. Penn specialists have also committed to providing critical consultative services either on-site or via telemedicine, but if the team determines a higher level of specialty resources is needed, a transfer to HUP Main can be initiated. Find out more about this exciting partnership with Penn Medicine in this article (be sure to watch the embedded video).