Abstract:Policies and procedures to develop a practical and physician-friendly hospitalists program ' designed to improve and streamline patient care from the ER through discharge and transitional care period. Credentialing criteria and example job description for hospitalist physicians. References, resources.Extract:Hospital care accounts for 40 to 50% of overall health care expenditures. Physicians drive most of the decisions leading to hospitalization and care following admission. Ergo, an effort to improve the efficiency and quality of care for those patients presenting to an ER potentially requiring admission as well as those admitted (either directly or through the ER) has resulted in the development and recognition of a newly (1996) designated term, the 'hospitalist' physician. However, most European nations delegated inpatient care to hospital-based physicians many years ago, while primary physicians provide outpatient care. Currently (2005), 40% of the 5,000 US hospitals employ more than 12,000 hospitalist physicians. Studies compiled by the Healthcare Advisory Board of Washington, D.C. demonstrate that the use of hospitalists has reduced lengths of stay and costs per case across every geographic region in the United States.A 1998 study revealed that most California primary physicians felt that hospitalists had a positive effect on patient care and on their own practice satisfaction. This was particularly true in voluntary hospitalist systems that decreased the primary physician workload without affecting their income or even increasing the income of a capitated primary physician due to cost savings related to more efficient hospital management and decreased lengths of stay. California internists were less accepting than other primary physicians in one study. (Fernandez, et al) Many studies have demonstrated a positive impact on the quality and cost-effectiveness of inpatient care for diverse diagnoses when managed by 'hospitalist' physicians. These can be found in the reference section.

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Hospitalists: Policies, Procedures, Resources - Edition 2009
Published on January 2009
Report Summary
Abstract:
Policies and procedures to develop a practical and physician-friendly hospitalists program ' designed to improve and streamline
patient care from the ER through discharge and transitional care period. Credentialing criteria and example job description for
hospitalist physicians. References, resources.
Extract:
Hospital care accounts for 40 to 50% of overall health care expenditures. Physicians drive most of the decisions leading to
hospitalization and care following admission. Ergo, an effort to improve the efficiency and quality of care for those patients presenting
to an ER potentially requiring admission as well as those admitted (either directly or through the ER) has resulted in the development
and recognition of a newly (1996) designated term, the 'hospitalist' physician. However, most European nations delegated inpatient
care to hospital-based physicians many years ago, while primary physicians provide outpatient care. Currently (2005), 40% of the
5,000 US hospitals employ more than 12,000 hospitalist physicians. Studies compiled by the Healthcare Advisory Board of
Washington, D.C. demonstrate that the use of hospitalists has reduced lengths of stay and costs per case across every geographic
region in the United States.
A 1998 study revealed that most California primary physicians felt that hospitalists had a positive effect on patient care and on their
own practice satisfaction. This was particularly true in voluntary hospitalist systems that decreased the primary physician workload
without affecting their income or even increasing the income of a capitated primary physician due to cost savings related to more
efficient hospital management and decreased lengths of stay. California internists were less accepting than other primary physicians
in one study. (Fernandez, et al) Many studies have demonstrated a positive impact on the quality and cost-effectiveness of inpatient
care for diverse diagnoses when managed by 'hospitalist' physicians. These can be found in the reference section.
Table of Content
Table of Contents
Definitions, introduction (updated 11-05, 2-07)
Utilization of hospital services (updated 11-05, 4-07)
Primary physician concerns
Core competencies for hospital medicine (New 2-06, update 10-06)
Objectives of a hospitalist program
Lessons learned (or should be learned)
Starting a program ' process example (New 2-06)
Laboratory Reports ' failure to review and act on results (New 7-05)
Interactions between hospitalists and ED physicians
Intensivists (updated 6-05, 3-07)
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Nocturnists (New 10-06)
Hospitalist Admission Policy - example
Discharges
-Hospital discharge dictation for medical records (New 10-06, update 4-07, 6-07)
-Hospitalist program post-discharge transitional management of care ' example (New 11-05, update 1-07)
'Handoffs' ' Managing care transitions (New 12-05, update 3-06, 6-06, 11-06, 1-07, 9-07, 1-08) 1
-Example policies, links to other resources
-SBAR
-Checklists (update 1-07, 1-08)
Hospitalist job descriptions
Observation care units ' hospitalist management (New 7-07)
Hospitalist program model in a SNF
Performance standards (update 11-05, 11-07)
Position qualifications
Alternative Job Description for a Hospitalist
The hospitalist as a key member of the inpatient care team (update 9-06)
Rapid Response Teams (RRTs)/Medical Emergency Teams (METs)
(New 12-05, update 2-06, 3-07, 12-07)
Medical Procedures Teams ' hospitalist model/Proceduralists (New 7-07)
Collaborative Care Management by hospitalists of surgical patients (update 8-06, 3-07, 6-07)
Pediatric hospitalists (update 9-05, 12-05, 5-06, 2-07)
Pediatric/neonatal hospitalist programs (update 11-05, 8-06)
Obstetrical hospitalists ('laborists') (New 8-05, update 4-07)
Surgical Hospitalists (New 11-07)
Addiction Medicine: Substance abuse/Alcohol Withdrawal ' hospitalist management (New 10-07)
The robot rounder (New 7-07)
Palliative care: roles of hospitalists (New 3-07)
End-of-life care decisions (New 7-07)
Educating the patient about hospitalist programs (update 5-06)
Explanatory letter to patients re: hospitalist program
Hospitalist recruitment/Hospitalist Organizations (New 4-07, update 8-07)
Collecting charge data/billing for services (New 12-05, update 4-07, 9-07)
Software for hospitalists (New 2-08)
Denials for multiple care
Compensation/employment contract issues (update 5-04, 3-06, 11-06, 4-07)
- 'Pay for Performance' programs
Obstacles to efficient/effective hospital care by hospitalists (update 4-08)
- Rounders vs Admitters (New 8-07)
- Mid-level providers as part of hospitalist group (New 4-08)
- Translation services (New 10-06)
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Resuscitating a failed hospitalist program
Legal challenges (New 8-07)
Immigration law applicable to physicians (New 10-08)
Provision of Emergency Services ' CMS (New 4-07)
Quality Issues (update 2-09)
- Weekend admits (New 7-07)
- Medical Records (New 7-07)
- Pneumonia management (New 1-08, update 6-08)
- AHRQ Safety Toolkits (New 1-08)
Job description example: Group Director of Business Operations, Hospitalists Services. (New 2-08)
References
Resources
AHRQ Safety Toolkits (New 1-08)
Web Links ' Safety & Risk Management (New 1-08)
Web Links - Hospitalist-related
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