Over time, many hospitals have developed a formal Hospital Medicine Program, involving a dedicated team of hospital medicine physicians working collaboratively with the hospital and referring physicians. This allows hospitalists, both physicians and mid-level providers, to develop proficiency in the care of complex, acutely ill patients, as well as efficient strategies to assist patients in moving quickly out of the emergency department.

 

Patients have found that they received excellent care by dedicated career hospitalists whose primary goals include providing the highest level of quality, and following up-to-date evidence-based guidelines for best clinical practices. Hospitalists provide care for a wide array of diagnoses; including the most common conditions: heart attack, stroke, congestive heart failure, pneumonia, sepsis, emphysema and kidney failure. Hospitalists have a thorough understanding of the disease process and necessary treatments for most acute medical conditions but will also consult specialists as appropriate. Hospitalists will also admit patients whose conditions were traditionally thought to be purely surgical, like hip fractures. In these cases, we use the term "co-management" to describe the collaborative relationship between the medical doctor and the orthopaedic surgeon in caring for all needs of the patient from admission, through surgery, to recovery and discharge.

 

When developing a new hospitalist program, there are several key elements that must be considered. It is important to understand the relationship that the hospital medicine service will have with the community primary care physicians. Often times, it is the community physicians who provide the impetus to the hospital administration to start a Hospitalist Program, to establish a trusted partnership with physicians who will care for their patients when they require hospitalization.

 

It is also vital that hospital medicine leaders meet with stakeholders in the hospital to identify any unmet needs of the organization. High-priority items include patient safety, quality of care, and cost containment. Advancements in information technology, e.g. electronic health records, require close collaboration with a committed group of physicians to lead the charge on these new initiatives.

 

Prior to starting a new hospital medicine program, it is important to develop a business and strategic plan, both short- and long-term. By focusing on the same goals and following standardized evidence-based clinical practice guidelines, we can ensure the best care for our patients while being good stewards of their healthcare dollars. One of the greatest challenges in hospital medicine is when the demand for services exceeds the supply of available providers. It is easier to predict this staffing need in a well-established program. When starting up a new hospitalist program, careful review of data including numbers of ER visits and admissions helps to guide program leaders in determining the correct number of providers to hire.

 

Lastly, it is vital that the members of the hospital medicine team share a common vision, and that the leader provides a team structure and work environment, promoting a highly effective and collaborative approach to patient care. It is a privilege to care for patients and their families in what is often their time of greatest need. Our team’s philosophy is that we aim to treat all patients like we would want our own family member treated. While the demands on doctors’ time are tremendous, and the pace in the hospital is very quick, our vision statement allows us to slow down, pull up a chair at the bedside, and give each patient the best that we have to offer.