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What’s a Hospitalist? Do You Need One?

photo old man in nursing home - what's a hospitalist?There are over 50,000 hospitalists in the United States, yet chances are you have never even heard the term. What’s a hospitalist? They are doctors, usually internists, who work in hospitals to coordinate and manage the care of hospitalized patients.

These “captain of the ship” doctors work with other hospital-based health professionals to make sure the care is coordinated and integrated, to provide the best quality care possible for each patient.

This specialty has grown significantly in the 22 years since its inception. According to the American Hospital Association, there were less than 1,000 hospitalists in 1996. In 2018, there were over 44,000 hospitalists in the US. This rapid increase was driven by economics as well as the government push for efficiency and quality in healthcare.

What are the advantages of a hospitalist program?

Improved care.

Hospitalists provide personalized medical treatment in partnership with your primary care doctor and other specialists. Firstly, hospitalists have more time for daily patient care. Therefore, if an emergency or other unexpected medical situation arises, a hospitalist can react quickly and see the patient throughout the day as needed. Hospitalists know every specialist and department in the hospital and can follow up on tests and adjust treatment throughout the day as needed.

Improved communication.

photo two doctors talking - what's a hospitalistAn important role of a hospitalist is to improve communication between specialists and primary care doctors. In addition, hospitalists improve communication for the patient and the family; they work full time at the hospital and are more readily available than other doctors. The hospitalist is the focal point of all conversations – between all doctors on the team, the primary care doctor, the patient and the family.

Personalized, family-centered care.

Since hospitalists work full time in the hospital, they are available whenever the patient or family member has a question. That means no more waiting around for your specialist or primary care doctor to share your concerns or ask your questions.

Shorter waiting time for admissions from the ER.

Hospitalists can speed up the process of getting patients admitted from the Emergency Room, reducing the time patients wait for admissions.

Shorter hospital stays.

There is often a reduction in the length of stay when hospitalists coordinate patient care. Hospitalists can reduce the wait time for tests, results, and consultations; their involvement can potentially reduce a hospital stay by as much as a day.

Safer transitions. 

photo emts putting patient in ambulance - what's a hospitalistTransitions of care, within the hospital, to another facility or home, are a dangerous time for patients. There is a high risk of errors due to miscommunication between staff at the current and future locations. A hospitalist can reduce communication errors and other transition issues. A hospitalist may also oversee the patient’s next step in care at a post-acute care facility. For more information on the dangers of patient transitions, read my blog post: The Dangers of Patient Hand-Offs.

Quicker discharges. 

Hospitalists can oversee patient discharges which can speed up the discharge process. Without a hospitalist, patients may wait many hours for a specialist or surgeon to arrive to sign the discharge papers.

Not all hospitalist programs are the same.

The work schedules of hospitalists impact outcomes. Researchers recently analyzed 3 years of patient data at 229 hospitals in Texas. The analysis reviewed the records of 114 ,777 patients who stayed at the hospital between 3 and 6 days. Researchers found great benefits from work schedules that allowed hospitalists to provide continuity of care. For instance, patients who received care from hospitalists whose schedules allowed continuity of care had significantly better outcomes. Specifically, there was an associated lower 30-day mortality after hospital discharge, lower readmissions, and higher rates of discharge to the home. Finally, these patients had lower costs for their 30-day post discharge medical expenses.

Final thoughts.

Today’s healthcare system has moved towards a model where hospitalized patients tend to be even sicker, with more complexity in their cases, than in the past, making the care of a hospitalist even more important. However, some hospitals are looking to cut costs and have begun outsourcing hospitalists which can reduce the time and efforts spent on behalf of each patient.

Learn more….

All hospital stays, as well as hospital discharges, involve risk. Read these blog posts to reduce your risk of problems:

 

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