All ETDs from UAB

Advisory Committee Chair

Amy Yarbrough Landry

Advisory Committee Members

Vance Chunn

Larry Hearld

Jeff Szychowski

Document Type


Date of Award


Degree Name by School

Executive Doctor of Science (DSc) School of Health Professions


The hospitalist model for managing patients in the hospital setting has been in existence for over 20 years. The hospitalist model for non-specialty care has been found to improve the efficiency of care, maintain quality of care, and support a higher degree of guideline adherence. However, there has been little research focusing on the use of the hospitalist model for specialty care. As cardiovascular programs have begun to adopt the hospitalist model, many are asking if this model is more effective than the traditional model. The main concern is the potential disruption to the patient-physician relationship that occurs with the hospitalist model raising the question “does the benefit outweigh the potential risk”? The Resource-Based View of the Firm (RBV) theory was used to develop the theoretical framework for this study. According to RBV, organizations seek to establish a competitive advantage, and they become more competitive when they have access to the right resources and possess the capabilities to use the resources in the most effective way. In this case, the “resource” is the cardiology iv provider workforce, and the “capability” is the development of a stronger care model, which is achieved by applying the hospitalist model to CV care. This research postulated that a cardiovascular hospitalist model of care would provide better outcomes in three domains: efficiency of care, quality of care, and guideline adherence. A performance measure was selected in each domain that aligned with previous research focusing on the non-CV hospitalist model. The analyses failed to support all three hypotheses. One finding did suggest that there may be some improvement in the efficiency of care for heart failure patients, while another noted worse outcomes related to quality outcomes in patients with acute MI. Finally, organizations’ percentage of CV care was associated with improved guideline adherence. Although the results were not as anticipated, this research did provide a framework for future research in this area.



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