Examining the Impact of a GI Hospitalist Model on the Outcomes of Double Balloon Enteroscopy: A Single Center Retrospective Study

Abstract

Abstract Background A GI hospitalist (GIH) is a physician who practices in the inpatient setting performing consultations and endoscopic procedures. Obscure small bowel bleeding is a common inpatient diagnosis that is difficult to manage and associated with longer hospitalizations. Having an onsite GIH physician with expertise in video capsule endoscopy (VCE) and double balloon enteroscopy (DBE) has the potential to improve patient outcomes. Aims This study will be the first to explore how implementing a GIH model and providing a GIH with training in DBE can affect the outcomes of patients with small bowel pathology. Methods We performed a retrospective study of patients who received an inpatient DBE at an academic medical center before and after initiation of a GIH model and credentialing of a GIH in DBE. We compared outcomes, including procedure volumes, diagnostic and therapeutic yields, procedure duration, time-to-procedure, and length of stay. Results There was a 46.5% increase in the number of DBEs performed by the GIH. The diagnostic yield increased from 56.3–74.0% (OR 2.2, 95% CI 1.2–4.2), and the proportion of DBEs with a therapeutic intervention increased from 38.0–65.4% (OR 3.1, 95% CI 1.4-7.0). The total procedure time increased from 77.8 minutes to 96.4 minutes (p < 0.05) with a GIH. Conclusions Having a GIH perform inpatient DBEs was associated with an increased number of procedures, duration of procedures, diagnostic yield, and therapeutic interventions. The onsite presence of a GIH with competency in DBE improves the care of hospitalized patients with small bowel pathology.