Section of Hospital Medicine | Clinical Services (2024)

Hospitalists staff three of the six general medicine teams, working with residents, interns, and medical students to care for various medically complex patients. 

The General Medicine housestaff services at VUAH are known as the Morgan services, named after Dr. Hugh Jackson Morgan, who served as Chair of the Department of Medicine from 1935-1959.

The direct care hospitalist services at Vanderbilt University Adult Hospital include several teams of physicians and advanced practice providers (APPs) working in concert to provide care for a significant number of medicine patients.

• The Riven services, named after Dr. Samuel Riven, a prominent cardiologist who served on the Vanderbilt faculty for over 50 years, are our flagship hospital medicine teams. Riven is supported during the day by our daytime Admitter, which allows the rounding teams to focus on advancing the care plan and discharging patients.
• Observation Service, which consists of two teams staffed by APPs caring for patients hospitalized under observation status. All the hospital medicine direct care teams have robust admission and cross-cover support during evening and overnight shifts.
• Scoville team, named after Dr. Addison Scoville, a Vanderbilt physician known for his career in diabetes care, consists of a talented group of APPs who address everything from emergent needs to follow-up tasks for our Riven, Observation, Geriatrics, Hospital at Home, VICP, and Palliative Care patients.

Nighttime admissions to these services are performed by hospitalist attendings and moonlighters who staff our nocturnist shifts. 

• Physician Lead, Observation Service: Bethany Scanlan, MD
• Physician Lead, Night Services: Nathan Krishnan, MD 
• APP Lead: Jodi Robbe, MS, PA-C, MHA
• APPP Day Service Lead: Spencer Goudeau, PA-C
• APP Night Service Lead: Tanya Hileman, NP 

Since 2003, the Internal Medicine Consult Service has assisted our surgical and medicine subspecialty colleagues by providing comprehensive internal medicine care for their hospitalized patients at Vanderbilt University Hospital. Our physicians aid with evaluation of acute medical issues, management of perioperative care, and ongoing treatment of chronic medical problems.

The Medicine Consult Service also provides consultation for patients hospitalized at Vanderbilt Psychiatric Hospital who have minor acute medical needs. In addition to providing bedside evaluation and treatment, we teach residents interested in learning more about consultative medicine via an elective rotation in general internal medicine consultation. 

• Physician Lead: Elizabeth Rice, MD, SFHM 

The Vanderbilt Interdisciplinary Care Program (VICP) is a team of physicians, advanced practice providers, case managers, social workers, pharmacists, and nurses whose goal is to provide care for patients that have an established pattern of increasing healthcare utilization. The goal is to provide and coordinate care within the inpatient and outpatient settings to improve health outcomes for this population.

By routinely assessing environmental, behavioral, emotional, physical, functional, and medical needs using standardized tools, the healthcare team will uncover potential barriers to achieving optimal healthcare outcomes. 

• Lead, Taina Ovchinnikov, FNP 

Hospital at Home is an innovative program that delivers hospital level care in the comfort of the patient’s own home. This program is well established at other large institutions and has been shown to reduce mortality, readmission rates and costs when compared to a traditional inpatient model. While this program provides direct benefits to patient care, it can also potentially assist in preserving hospital bed capacity by offloading certain patients who can safely be cared for in the home setting. 

Patients in the ED or inpatient services can be admitted to Hospital at Home after being evaluated by the Hospital at Home clinical team. If eligible, the patient can be transferred home while receiving similar acute care services as he or she would in the hospital. Services provided include phlebotomy, IV medications, continuous remote monitoring of vitals, nursing visits (twice daily), provider visits (daily), and certain specialty consults over telehealth. 

• Physician Lead: Michelle Lewis, MD

The Hospital Medicine Acute Care of the Elderly (ACE) team is an interdisciplinary team of physicians, advanced practice providers, case managers, social workers, pharmacists, and nurses whose goal is to provide exceptional clinical care to adults over age 75.

We align our practice with the social movement model for age-friendly health systems set out by the John A. Hartford Foundation (JAHF) and the Institute for Healthcare Improvement (IHI) known as the 4Ms. This movement emphasizes an essential set of evidence-based practices focusing on the following tenets: What Matters Most, Medications, Mentation, and Mobility. Using this guide in collaboration with our colleagues from the Division of Geriatrics and the nurses of the ACE unit (7th floor Round Wing nursing unit), we strive to optimize the health and care of our hospitalized older adults. 

• Physician Lead: Kate Wooldridge, MD, MPH, SFHM 

The service can be consulted by any team hospital-wide, and we are ready to respond with a portable ultrasound machine and supply cart to perform the requested procedure at the bedside. We are proud to have internal medicine residents who rotate on the team with us, and we look forward to expanding our program to include not just procedures, but also a myriad of diagnostic point-of-care ultrasound skills soon. 

• Physician Lead: L. Tyson Heller, MD 

Vanderbilt Stallworth Rehabilitation Hospital is an acute rehabilitation hospital where Vanderbilt hospitalists staff two key services: Complex Medical Program and Co-Management Program.  

Complex Medical Program: Our hospitalists serve as the primary rehabilitation physicians for patients who have undergone solid organ transplant, hematopoietic cell transplant, ventricular assist device placement or who have other complex medical conditions and need acute inpatient rehabilitation before transitioning to the outpatient setting.

We provide an interdisciplinary approach to patient care that involves pharmacy, physical therapy, occupational therapy, speech language pathology, case management, nursing, and psychology.   

Co-Management Program: Our hospitalists provide Internal Medicine consultation for the patients on the Physical Medicine and Rehabilitation teams. The hospitalists in this program manage the co-morbid medical conditions of patients needing inpatient rehabilitation after hospitalization for Stroke, Cardiac Conditions (CAD s/p CABG or TAVR), Amputation, Polytrauma, Traumatic Brain Injury, or Spinal Cord Injury.     

• Physician Lead: Angela Horton, MD, MPH 

We have 17 Vanderbilt Hospital Medicine faculty credentialed at the Nashville VA Medical Center, adjacent to the VUMC campus. We help care for our veterans across multiple service lines, including the general medicine teaching wards, the consultation/co-management services, the physician utilization management (PUMA) service, and the nocturnist service.  

Of the six general medicine teaching teams, hospitalists attend on two of them as well as a third team part of the year. Due to such a large clinical footprint, our faculty have significant opportunity for teaching at the resident, intern, and medical student levels.  

Our consult/co-management service works closely with psychiatry to staff the combined medical/psychiatric unit and provides medical consultation for our surgical colleagues caring for patients outside of the ICU. 

The PUMA service facilitates efficient delivery of medical care, runs afternoon huddles between multiple support services and our residents, and has a direct line to the Executive Leadership Team of the hospital system to help expedite complex discharges.  

Our nocturnist service is our newest service line, created to fit the needs of the hospital and our veterans. The VA night attending provides case-based teaching to the medicine house staff, with topics such as diagnostic uncertainty on admission and instruction on how to take an interhospital transfer call through our innovative Interhospital Transfer Learning Curriculum, which was started in 2021. 

• Physician Lead: Derek Pae, MD (Service Chief, VA Hospital Medicine)