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At least 145 records · Page 8Linked to original sources
PubMed2005

The role of hospitalists in the management of acute decompensated heart failure.

Heart failure and episodes of acute decompensated heart failure have an important effect on the US health care system, especially the elderly Medicare population. Efforts to improve the quality of care for patients hospitalized with acute decompensated heart failure have focused on creating standardized treatment guidelines based on substantial clinical evidence, but inadequate implementation of these guidelines continues to result in excess morbidity and mortality from heart failure. Hospitalists specializing in inpatient treatment strategies may play an important role in implementing clinical guidelines because their main commitment is to overall clinical treatment of inpatients. This review focuses on current recommended guidelines for diagnosis, treatment, and long-term management of patients with acute decompensated heart failure and the hospitalist's role in providing the oversight needed to adhere to these guidelines and manage this complex disease state.

Acute Disease↗
PubMed2003

Managing a pediatric hospitalist practice requires team approach.

Establishing and maintaining a productive hospitalist program relies on the forging of multiple partnerships involving pediatric hospitalists, community practitioners, and administrative organizations including hospitals and multiple practice groups. When these professional relationships are successful, everyone in the relationship benefits, especially the children and families who deserve the best medical practices that can be offered. Establishing these relationships within defined communities ultimately improves pediatric outcomes.

Chicago↗
PubMed2003

Integrating hospitalists into the pediatric intensive care unit.

The role of the pediatric hospitalist has an extremely bright future in many facets of the pediatric healthcare spectrum. The role of the hospitalist in the PICU is only one of many that shows great promise and will likely change our current models of care for children. The greatest challenge will be the education of healthcare providers who may see these changes as erosion in care, rather than as an important asset in providing quality care for children.

Child↗
PubMed1999

Hospitalist model holds potential for big bed day reductions, huge savings in Medicare risk.

Can you cut your Medicare risk inpatient bed days in half? Proponents of hospitalist programs say you can, and you can claim big savings--some as high as the upper $20s PMPM--when you apply the model to Medicare risk. Find out how to generate such savings, and learn from the experience of the Riverside Physician Network, a California IPA that uses hospitalists to care for its 10,200 seniors.

Aged↗
PubMed2000

The evolution of hospitalist programs.

In just a few years, hospitalist programs have evolved to a third generation, affording key participants an opportunity to reduce inpatient healthcare costs. Because the method of inpatient payment determines the economic winners and losers in the program, the key participants will benefit from the implementation of a program that includes shared incentives. Even though reduced payments for inpatient services might be offset by reduced variable costs for hospitals and increased office revenues for primary care physicians, a hospitalist program is more likely to achieve sustained success if it is structured so that financial rewards are distributed fairly among the participants.

Contract Services↗
PubMedDate not supplied

The benefits of using hospitalists.

A good hospitalist program will more than pay for itself by improving outcomes, reducing length of stay, and enhancing hospital efficiency. Moreover, the program can often attract primary care physicians who prefer to use the service of a hospitalist.

Cost Control↗
PubMedDate not supplied

Hospitalist programs: are they good for your practice?

With the changes brought about in health care delivery by the growth of Managed Care, the attractions of hospitalist programs are becoming increasingly evident. As the programs have grown in usage, and program models have evolved from mandatory to voluntary, primary care physicians (PCPs) and independent practice organizations (IPAs) have begun to recognize their positive impact on their practices, from both financial and logistic perspectives, as well from those of patient care. This article discusses that effect and reviews the procedures and ramifications of one of the newer program models. Quality of patient care and the provision of successful outcomes via clinical guidelines are addressed as indications of successful hospitalist programs.

Attitude of Health Personnel↗
PubMed2002

Hospitalists prove their worth for capitated providers, plans.

For capitated provider organizations, the hospitalist concept is rapidly gaining favor as the evidence of cost-effectiveness continues to mount. In the strongest evidence published to date, a review of five years of evidence-based hospitalist studies reports an average 13.4% cost reduction and 16.6% LOS reduction.

Capitation Fee↗
PubMed2003

Hospitalists as cure for hospitalism.

For much of recorded history, it was difficult to document that care in a hospital improved outcomes. In fact, the term "hospitalism" was coined to describe a variety of iatrogenic maladies that were acquired by hospitalized patients and that often were more deadly than the admitting condition itself. In the modern era, the presumed benefits of hospitalization are achieved at the expense of substantial resources, but even these high costs have not eliminated iatrogenic complications. The hospitalist movement, by which a specialized group of physicians cares for inpatients, especially on medical and pediatric services, has reduced costs, generally maintained the satisfaction of all participants, and appears to have improved the quality of care. Despite concerns about discontinuity of care, hospitalists are likely to become the dominant mode of inpatient care in the United States.

Delivery of Health Care↗
PubMed2004

Hospitalists save $2.5 million and decrease LOS.

Hospitalist program helps readmission rates also decline; satisfaction rates rise. Unassigned patients had caused problems in decision making and follow-up. Other hospitalist programs were benchmarked before partner was chosen.

Benchmarking↗
PubMed2006

Transition of care for hospitalized elderly patients--development of a discharge checklist for hospitalists.

BACKGROUND: Discharge from the hospital is a critical transition point in a patient's care. Incomplete handoffs at discharge can lead to adverse events for patients and result in avoidable rehospitalization. Care transitions are especially important for elderly patients and other high-risk patients who have multiple comorbidities. Standardizing the elements of the discharge process may help to address the gaps in quality and safety that occur when patients transition from the hospital to an outpatient setting. METHODS: The Society of Hospital Medicine's Hospital Quality and Patient Safety committee assembled a panel of care transition researchers, process improvement experts, and hospitalists to review the literature and develop a checklist of processes and elements required for ideal discharge of adult patients. The discharge checklist was presented at the Society of Hospital Medicine's Annual Meeting in April 2005, where it was reviewed and revised by more than 120 practicing hospitalists and hospital-based nurses, case managers, and pharmacists. The final checklist was endorsed by the Society of Hospital Medicine. RESULTS: The finalized checklist is a comprehensive list of the processes and elements considered necessary for optimal patient handoff at hospital discharge. This checklist focused on medication safety, patient education, and follow-up plans. CONCLUSIONS: The development of content and process standards for discharge is the first step in improving the handoff of care from the inpatient to the posthospital setting. Refining this checklist for patients with specific diagnoses, in specific age categories, and with specific discharge destinations may further improve information transfer and ultimately affect patient outcomes.

Aged↗
PubMed1998

The hospitalist: will inpatient specialists improve care?

The number of hospitalists--i.e., practitioners who specialize in the care of hospital inpatients--is growing rapidly in the United States. In part a response to managed care's push for better health outcomes with a minimum waste of time, effort, and money, this new specialty has its own national organization, affiliated with the American College of Physicians. Challenges to hospitalists include minimizing the use of consultations and unnecessary laboratory tests for inpatient care, and ensuring continuity of care once patients leave the hospital.

Continuity of Patient Care↗
PubMed1997

The inpatient's best friend. 'Hospitalists' specialize in managing care of the very ill.

Weston Chandler's business card reads: "Inpatient internal medicine specializing in the care of the hospitalized patient." In other words, he's a hospitalist, or a physician who cares for sick people in hospitals and nowhere else, and he's part of a new movement emerging in medicine. Modern Healthcare spent a day with Chandler to explore what hospitalists do and why their role may lead to more economical healthcare.

Case Management↗
PubMed1998

Hospitalists reduce LOS, slash costs in academic medical center.

San Francisco-based Moffitt-Long Hospital introduced a "managed care service" led by hospitalists who practice and teach cost-effective, evidence-based medicine. Hospitalists can significantly reduce costs and length of stay in an academic setting if they get involved early and steer the trajectory of inpatient care.

Academic Medical Centers↗
PubMed2006

Evidence-based sepsis therapy: a hospitalist perspective.

BACKGROUND: Severe sepsis and septic shock are common and associated with a 30-50% mortality rate. Evidence-based therapies for severe sepsis supported by international critical care and infectious disease societies exist, but are inconsistently employed. METHODS: The epidemiology and definitions of sepsis syndromes are reviewed; sepsis therapies supported by definitive studies in the field, along with the supporting literature, are summarized and presented from a hospitalist perspective. CONCLUSIONS: Compelling observational data supports the importance of early, effective antibiotics. Well-designed randomized controlled trials and/or meta-analyses demonstrate the impact of activated protein C, early goal-directed therapy, stress-dose steroids, and intensive insulin in well-defined subgroups of patients. These therapies reduce the absolute mortality risk associated with severe sepsis by 9.5-16%; the corresponding numbers needed to treat to save one life are 6.25-10.5. While major trials are ongoing and the evidence for several sepsis therapies are limited to single trials, the available evidence indicates that appropriate use of these treatments can substantially reduce mortality from severe sepsis.

Anti-Bacterial Agents↗
PubMed2006

Routine rapid HIV testing in hospitals: another opportunity for hospitalists to improve care.

BACKGROUND: The Centers for Disease Control and Prevention recommends routinely offering HIV testing to inpatients at hospitals with an HIV seroprevalence rate of greater than 1% or an AIDS diagnosis rate of greater than 1.0 per 1000 discharges. This recommendation has not been widely adopted, perhaps because of one of several barriers: the cost of implementing a counseling and testing program; the logistics of HIV counseling and testing on a hospital ward particularly with respect to privacy; concern about the follow-up of HIV test results necessitating patients to return after discharge; and the cultural mindset of screening as an outpatient modality complicated by the fear of raising the possibility of HIV testing and therefore eliciting a negative reaction from a patient who has not requested it. PURPOSE: This article focuses on these barriers and some possible solutions, emphasizing the role of FDA-approved rapid HIV tests, which may decrease follow-up issues for HIV testing programs. It also considers hospitalists, given their frontline status and ability to coordinate the multidisciplinary services and system-wide approach required to implement such a program, as leaders in this area.

AIDS Serodiagnosis↗