Among the newest and least understood medical specialties at NCH are our 31 hard working hospitalists. Hospitalists are inpatient “quarterbacks” at the center of the healthcare team, coordinating care and helping produce objectively better patient outcomes, according to a recent Archives of Internal Medicine article.
A decade-old medical specialty, hospitalists are integral to efforts to accomplish our goals of improving safety, quality, and patient experience to yield positive patient outcomes. This past year, NCH hospitalists admitted nearly 33% of the 32,928 inpatients and consulted on many other patients admitted by our 609 other medical staff members. About 23% of these patients were emergency admissions, friends and neighbors who had no idea when they awoke in the morning that they would be sleeping that night in a hospital bed.
Caring for such hospitalized patients, who may or may not have a personal physician, is the mission of the hospitalist, whose work environment is typically limited to the hospital. A hospitalist’s familiarity with the hospital environment enables him or her to potentially spend more time with patients than an office-based physician.
Psychiatric Staff RN Robert Streicher recently shared with me his appreciation of the hospitalist service mentioning as examples Dr. Mario Trance and Advanced Registered Nurse Practitioner-Certified Tara Luke. He noted that the easy availability in a psychiatric unit of a responsive internist or family practice physician—the typical background of our 31 hospitalists—enables a troubled patient to get the best care for both mental and physical concerns. The same is true for patients admitted with a multitude of health problems—heart, orthopedic, medical sub-specialty, surgical or any other problem. Our hospitalist quarterbacks help ensure positive outcomes.
Of course, many factors contribute to great outcomes, especially including our more than 1,191 competent and compassionate nurses and 2,512 support folks, ranging from environmental service to engineering to a multitude of teammates with special skills. Communication is also essential for good outcomes. Patient-centered communication has a positive impact on important outcomes, including patient satisfaction, adherence to recommended treatment, and self-management of chronic illnesses. Teaching of communication skills may have received too little attention in the past compared to technical skills. Consequently, NCH is now focusing on communication skills, with an emphasis on listening to what we traditionally have done best.
CNO Michele Thoman and patient satisfaction expert Paul Clarke, who have initiated many new programs to recognize great patient care and satisfaction, have begun this new initiative centered on communication. As one element, approximately 29% of discharged medical/surgical patients were called 24-to-48 hours after discharge to see how they were doing, if there were any areas of concern, if they understood their medications, or if they had any other questions. Obviously, any concerns were addressed and followed up on as quickly as possible. The patients who received these phone calls (some were not available by phone and not all units were including in this initial phase) were overwhelmingly happier and more satisfied with their hospital experience at NCH. In fact, they were almost five times more likely to rate NCH a “9 or 10” on a 10 point scale. So increased patient communication makes great good sense.
Little things make a big difference when you are sick or recovering. Having hospitalists as inpatient quarterbacks and following up with great communication are just two examples of how NCH can better serve our community.