By Robert M. Wachter MD, Lee Goldman MD, Harry Hollander MD
Thoroughly up to date for its moment variation, Hospital Medicine deals useful, evidence-based guidance for the care of hospitalized sufferers. the one ebook geared at once and solely to inpatient management—and edited by means of the nationwide leaders of the hospitalist field—Hospital Medicine comprises symptoms for admission, instructions for session, tactics for sanatorium discharge, diagnostic algorithms, and important paths detailing powerful, outcomes-oriented treatments for a number of illnesses and problems. New chapters during this variation concentrate on the hospitalist's expanding function in delivering serious care, dealing with surgical sufferers with scientific co-morbidities, making sure sufferer protection and fighting opposed occasions, and directing medical institution structures components comparable to informatics, caliber development, and perform management.
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9 ADDITIONAL READING Auerbach AD, Aronson MD, Davis RB, Phillips RS. How physicians perceive hospitalist services after implementation: anticipation vs. reality. Arch Intern Med 2003;163:2330–2336. Saint S, Flanders SA. Hospitalists in teaching hospitals: opportunities but not without danger. J Gen Intern Med 2004;19:382–383. Wachter RM, Goldmann DR, eds. The hospitalist movement in the United States. Ann Intern Med 1999;130, Number 4, Part 2. Wachter RM, Goldman L. Implications of the hospitalist movement for academic departments of medicine: lessons from the UCSF experience.
Whether hospital care is provided under the traditional approach (stage I), a non-hospitalist rounder system (stage II), or a dedicated hospitalist model (stages III and IV), many of the interface issues for the physician in the hospital are the same. Accordingly, this chapter uses the term hospital physician regardless of model for hospital care and the term referring physician to denote the physician who refers the patient to be cared for by the hospital physician. The referring physician may be a primary care physician or a subspecialist.
This is an area that may see significant changes in the future. When medically appropriate, discharge of patients early in the day can have a significant impact on the number of patients that the institution can serve. Discharge early in the day can be valuable to a hospital, but that value does not appear in commonly tracked statistics such as length of stay or cost per case. CONCLUSIONS REFERENCES As the care of hospitalized patients continues to evolve, ongoing clinical and economic challenges will require adjustments in the care delivery system to ensure the provision of high-value care.