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Choosing a reputable hospital or physician group can be a daunting task. Sometimes, in the case of emergencies, it’s all about convenience rather than instinct. However, if you can do research and choose where you’d like to go ahead of time, a plan of action can be in place from the start; this can eliminate stress and confusion when and if the time comes of needing to seek treatment. If you’ve ever used a search engine like Google to find what you’re looking for, then you know the importance of quality reviews. We all have our bottom line in terms of what we will settle for regarding quality, and those stars next to a professional businesses’ name will set the tone for how likely we are to utilize the service we are seeking.

For simplicity, let’s use the following example – say you live in an area with three major hospitals nearby, and you want to choose the right one for you and your family just in case a situation presents itself. So, you go online to Google or another reputable search engine, and you start typing in “hospitals near me.” The three hospitals you are familiar with all come up with various ratings, so you do some digging and make the decision that the hospital with the best online review ratings wins. You look at the various comments and decide that given the opportunity to choose, you would select this particular hospital for your care. Fast forward…a few months go by, and you need to have an elective procedure done at a hospital. Your physician just so happens to be a hospitalist at the hospital you want to go to. The decision is now easy for you as to where you’d like to go.

At this point, you are feeling confident. You have read several positive reviews regarding what a pleasant experience many people had at the specific hospital and are ready to move forward with your operation. Fast forward again…you had your procedure, your physician was great, but your experience with the hospital was less than impressive. In fact, you were downright displeased with everything from the cleanliness of the room to the pleasantness of the staff and the responsiveness of your health care team. You think to yourself, how can this be? I read review after review that stated this was the best hospital to come to, and all you experienced was the opposite. Was it the fact that you came on an off day? Or perhaps was it something more?

According to the Washington Post, medical care is a robust industry comprised of global review fraud. This is because there is so much competition among physicians, organizations and professional medical institutions, and fake reviews can help boost rankings and sway consumers’ decision making. While Google has various protection protocols in place, scammers can still find ways to create fake profiles, leading consumers to make decisions based on incorrect information.

Although your less than desirable experience at your local hospital may or may not have been related to phony online reviews, this is still something you should be watchful of whenever making decisions based on reviews you see from users.

When searching for health information or reviews online, you can help limit your chances of being a recipient of review fraud by taking the following into consideration:

• Look for reputable sources. These include government resources like the National Institutes of Health, CDC, and WHO, to name a few; universities and academic organizations; nationally recognized hospitals; and health organizations like the American Cancer Society, American Public Health Association, and more. These types of groups are going to have the most reliable information available with editorial boards, expert reviews, and other major checkpoints in place.
• Do your research. When looking at online reviews for health organizations, it’s important to look in more than one place for feedback. Check sources like Healthgrades, WebMD, Google My Business, Yelp, and social media to ensure consistency in reviews and user experiences.
• Beware of generic sounding names or profiles without photos. A lot of fake user reviews are generated from people who do not have a profile picture or have common names like John Doe. Often, you can click on the profile of the user providing the review. If you cannot find other reviews from the user, or limited information, the review may not be valid. If the “person” does have a profile, check to see if they have left poor reviews on multiple other business pages. If this is the case, they could very well have been hired to leave negative reviews.
• Look at the timeline. Generally, reviews are listed in chronological order and are spread out over time. If you notice a spike in reviews over a short period, there is a likelihood of potential deception.
• Look for duplication in reviews. If you are looking over numerous reviews and notice many of them have the same wording or phrasing, it may be that the same person or scammer is providing the same review repeatedly.
• Make sure you check for good grammar. It’s true you may come across legitimate reviews that have poor grammar, but fraudulent, outsourced reviews are more likely to contain poor spelling and syntax, especially if you are seeing this frequently in several reviews.
• Check the 3 and 4-star reviews first. Most likely your most honest feedback will come from people giving 3 or 4 stars on a review. You will see where improvements could have been made, as well as what was satisfactory. It helps give context especially when there are a multitude of 5-star reviews present, even if the superior reviews are all legitimate.

It can be tricky to navigate online reviews, especially for medical organizations. But, by being diligent and following the guidelines above, you can minimize your likelihood of getting caught in the middle of trusting fraudulent reviews. If you find yourself in doubt, or feel like you need more clarification, you may want to contact a few of the reviewers (both negative and positive) to see if they will provide a response. Most scammers will not respond, while real people are more apt to provide an answer with helpful feedback.

If you still feel unsure of what to believe, feel free to contact the health organization directly and ask to speak to their patient relations department. Before contacting the company, be sure to write a list of concerns and questions you have relating to the reviews you saw online. By speaking directly with a representative from the organization, you are likely to get legitimate answers.

Still uncertain or feeling overwhelmed? Let us help! Advanced Care Hospitalists can answer any questions you have about finding a reliable hospital or hospitalist. Contact us today for more information.

Contact Advanced Care Hospitalists to Learn More

ACH is a Lakeland-based hospitalist group providing comprehensive patient care in community hospitals across Central Florida. If you are interested in learning more about our programs, services, providers or becoming a partner facility, please call us at 863-816-5884 or fill out a contact form online.

Did you know that in the United States alone, there are roughly 12 million people (1) each year that are affected by a medical diagnostic error? And of those, it’s estimated that between 40,000 and 80,000 people die annually from the complications of misdiagnoses. (2) This complex issue touches nearly every area of health care – from primary care, to hospitals, to large health care organizations and many other types of practices in between.

An initial incorrect diagnosis often derives from systemic problems rooted in our everyday practices and procedures in health care. So how do we tackle this? Unfortunately, it may not be as easy as a 1-2-3 overnight fix, but there are certain measures we can take to lessen medical misdiagnoses and improve diagnostic accuracy and outcomes over time.

One way that medical misdiagnoses can be reduced is by utilizing artificial intelligence, or AI.

According to the Wall Street Journal,

“a type of artificial intelligence known as deep learning could help medical experts pinpoint problems faster and more accurately. Deep learning includes using algorithms, or computer programs, that search for, identify and analyze problems without direction from people, though many humans still guide the algorithms today.” (3)

If more hospitals begin to utilize AI, we might start to see an improvement in overall diagnoses especially within medical imaging like CT and MRIs, as well as medical reports and lab results. AI can also assist hospitalists in making swifter and more sound decisions, while considering more holistic possibilities when making a diagnosis.

Another way to help combat misdiagnoses is to utilize a robust EHR (electronic health record) platform that allows hospitalists to coordinate care through comprehensive medical records and notes. By employing an EHR platform correctly, physicians can constantly monitor the status of their patients and stay on the same page across the span of care coordination. The key here is for clinicians to actively stay engaged in their patients’ medical history and deploy care reflective of their status. Issues usually arise when a lack of communication is present and hospitalists don’t do their due diligence in checking a patient’s medical history, medication lists, or most up-to-date clinical notes. EHR platforms not only help circulate insights and important lessons, but they also help to keep all clinicians abreast of any new or pre-existing symptoms that need to be addressed. Using an EHR can assist with identifying issues head on and limiting delays in proper care.

In addition to the above, there are several other ways to limit misdiagnosis within our health care system, including:

• Instituting a liability system within the organization you are a part of that includes checks and balances among providers. This includes creating a culture of identifying and learning from all mistakes and errors, and subsequently establishing a plan of action to ensure the same issue does not arise again.
• Ensuring that continuing medical education is a part of your practice. By keeping up with innovation and new techniques, clinicians can stay informed with precise and appropriate care plans.
• Keeping communication lines open between patients, families, and other medical providers. Collaboration among physicians, pathologists, radiologists, health care professionals and other diagnostic providers is key in reducing misdiagnoses.
• Listening to your patients and focusing on what they are telling you. Sometimes it’s not as easy as “going by the book” with symptom management. If you feel like your patient is describing symptoms that do not correlate to a mainstream diagnosis, be sure to dig deeper. You may need to work together with other medical providers and order additional tests to be sure you are covering all bases. Often, misdiagnoses come from providers making assumptions without going the extra mile to make sure there are no other underlying issues that may be contributing to their medical concerns.
• Follow up on irregular test results and inconsistencies, and don’t stop investigating until a sensible conclusion has been made.
• Create teams within your organization to routinely study diagnostic errors. By studying and submitting ideas and initiatives to improve the diagnostic process, medical teams can learn from past mistakes and move forward in improved performance.

While it can be said that there is no such thing as perfection, especially medically speaking, by implementing a more mindful approach to clinical decision making, we can continue the journey of lessening misdiagnoses and medical mistakes, and hopefully one day, completely leaving these blunders behind for good.

At Advanced Care Hospitalists, we look forward to being a part of the prevention and solution of diagnostic errors and misdiagnoses. Will you join us in continuing to follow and exceed exceptional medical standards that improve the health, livelihood, and outcomes for our patients?

Contact Advanced Care Hospitalists to Learn More

ACH is a Lakeland-based hospitalist group providing comprehensive patient care in community hospitals across Central Florida. If you are interested in learning more about our programs, services, providers or becoming a partner facility, please call us at 863-816-5884 or fill out a contact form online.

Resources

1. Singh H, Meyer, & Thomas EJ: The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations. BMJ Quality & Safety 2014;23:727-731. https://qualitysafety.bmj.com/content/23/9/727
2. The Society to Improve Diagnosis in Medicine (SIDM) Frequently Asked Questions. https://www.improvediagnosis.org/facts/
3. Landro, Laura: The Key to Reducing Doctors’ Misdiagnosis. The Wall Street Journal. 2017. https://www.wsj.com/articles/the-key-to-reducing-doctors-misdiagnoses-1505226691?reflink=desktopwebshare_permalink

From health care organizations, hospitals and primary care offices, many clinicians have adopted some form of telehealth practice to ease the burden during the coronavirus pandemic. As the shift has broadened accessibility to treatment, more patients are becoming accustomed to receiving routine care without ever having to step foot outside of their home. So, what does this mean for the traditional hospitalist?

For starters, hospitalists can continue providing quality care, but in a much more convenient way. By partnering with other health care institutions like skilled nursing facilities (SNF), hospitalists can perform a number of services as an extension of their team without ever having to transition to another location. Additionally, clinicians that offer telehealth hospital visits can deliver services to a wide range of populations in need that otherwise may not be able to access care.

Supportive Care

In the case of certain patients that need to transition to an SNF after being discharged from the hospital, telehospitalists can help provide ongoing support. Especially with nursing homes and in the case of patients with complex medical conditions or a developing serious illness, having access to a telehospitalist can give nursing staff a higher competency for quality care. Particularly in the case of overnight shifts, nursing staff can feel more confident with accessibility to qualified physicians.

Lower Readmission Rates

For hospitals and SNF’s alike, keeping readmission rates low is the ultimate goal. This can get tricky though in situations where discharged patients have higher risks for rapid changes in condition. If this happens, the standard protocol for most SNF’s is to send that patient to the emergency room by ambulance. This not only can cause poorer patient outcomes, but also places a burden on surrounding residents and health care workers. In many cases, a telehospitalist can offer appropriate treatment to a patient without that patient needing to leave their bed. In certain situations, if a telehospitalist does deem it necessary for the patient to return to the hospital, they can aid in the transfer and facilitation of care while also helping to reduce wait times.

Increased Retention

Often in SNF’s health care providers are met with challenges such as being understaffed, overworked, and having fewer resources than their peers in similar care settings. Because of this, turnover often tends to be higher in SNF’s and other long-term care facilities. By utilizing a telehospitalist, nurses and clinicians in these settings can establish an immediate connection with a qualified and supportive physician. This is especially helpful for nurses who are working alone, during the nightshift, or with only a small team. Having a partnership with an around-the-clock telehospitalist also reduces the need to disturb an on-call physician or medical director who would normally have to come to the facility in person to assess the situation.

Telehospitalist support can improve the quality of life for patients and other residents as well as outcomes for health care teams and organizations.

As telemedicine solutions become more widely accessible and utilized, it’s important to pause and take a look at the positive difference it can make in all aspects of care. For more information about telemedicine in the hospital setting from Advanced Care Hospitalists, please call us at 863-816-5884 or contact us online.

Contact Advanced Care Hospitalists to Learn More

ACH is a Lakeland-based hospitalist group providing comprehensive patient care in community hospitals across Central Florida. If you are interested in learning more about our programs, services, providers or becoming a partner facility, please call us at 863-816-5884 or fill out a contact form online.

Working in a hospital setting day after day, especially during a national pandemic, can plight clinicians with stress and trauma. It’s without a doubt that extraordinary challenges arise in the blink of an eye, often without warning. Due to the nature of operating out of a hospital, health care workers are often faced with making decisions that result in uncertainty and anxiety. And amidst the coronavirus pandemic, challenges such as burnout, extreme exposure to death and suffering, and personal safety can be at the forefront of a hospitalist’s state of mind.

While we know that health care organizations have programs in place that assist with mental wellness, sometimes in situations as of late, a more comprehensive approach may be needed. In a recent article in Anesthesia & Analgesia (International Anesthesia Research Society) author Cristina Sophia Albott, M.D. outlines the necessity for psychological stress response interventions such as a peer support model program, similar to that of the United States Army Battle Buddies program. In the Battle Buddies program, two soldiers are paired together to help each other in every aspect of life, including training and traveling.

According to Dr. Albott, utilizing a program such as Battle Buddies in the hospital allows health care organizations to

“incorporate evidence-informed stress inoculation methods developed for managing psychological stress exposure in providers deployed to disasters.” *

Using this methodology, Dr. Albott has worked with the Departments of Anesthesiology and Psychiatry & Behavioral Sciences at the University of Minnesota Medical Center to help medical professionals cope with “battlefield conditions” in the hospital.

“Our multilevel, resource-efficient, and scalable approach places two key tools directly in the hands of providers: (1) a peer support Battle Buddy; and (2) a designated mental health consultant who can facilitate training in stress inoculation methods, provide additional support, or coordinate referral for external professional consultation. In parallel, we have instituted a voluntary research data-collection component that will enable us to evaluate the intervention’s effectiveness while also identifying the most salient resilience factors for future iterations. It is our hope that these elements will provide guidance to other organizations seeking to protect the well-being of their medical workforce during the pandemic. Given the remarkable adaptability of human beings, we believe that, by promoting resilience, our diverse health care workforce can emerge from this monumental challenge with new skills, closer relationships, and greater confidence in the power of community.” *

Often, when health care organizations become overwhelmed with the demands of responding to crisis, clinicians can suffer with PTSD including anxiety, grief, depression, and negative thought patterns. Additionally, clinicians of differing age groups experience varying types of stress from one another. Because of this it is suggested that a peer support pair should be similar in their age and experience.

While programs like the one described above are either non-existent or still in infancy stages across the spread of American hospitals, the model shown by Dr. Albott shows promise. By taking note of how a program like this can be emotionally encouraging, health care organizations can decide how to best integrate and sustain a peer support model in their specific area of expertise. By sharing trials and challenging encounters with one another, peer support programs can help limit worries and mental distress among providers and caregivers and give them a greater sense of self-purpose.

The key takeaway here is the importance of fostering positive mental health in hospitals and medical institutions. By identifying and addressing stressors head on before they become an issue, health systems can curtail turnover, fatigue, and mental hardship among clinicians by implementing a program that focuses on connectedness, compassion, and support.

Want more information? To read the entire Anesthesia & Analgesia journal article, click here.

Contact Advanced Care Hospitalists to Learn More

ACH is a Lakeland-based hospitalist group providing comprehensive patient care in community hospitals across Central Florida. If you are interested in learning more about our programs, services, providers or becoming a partner facility, please call us at 863-816-5884 or fill out a contact form online.

Resources

*Direct quotes from Cristina Sophia Albott, M.D. – Anesthesia & Analgesia (International Anesthesia Research Society).

Albott, Cristina Sophia et al. “Battle Buddies: Rapid Deployment of a Psychological Resilience Intervention for Health Care Workers During the COVID-19 Pandemic.” Anesthesia and analgesia vol. 131,1 (2020): 43-54. doi:10.1213/ANE.0000000000004912

Continual success in the hospital revolves around teaching and learning. Both teaching and learning are key ingredients to keeping hospitalists educated, well-informed, and abreast of the latest in medicine.

Teaching and learning go hand in hand. While it’s not only valuable to stay up to date with continuing education, but also just as important to take time out to share that knowledge with other team members. As the Roman philosopher Seneca once said, “while we teach, we learn;” and that’s because teaching improves self-efficacy, confidence, and motivation. Have you taken any time out recently to brush up on your CME and then pass that information along to your colleagues or leadership team?

Continuing Medical Education

Clinicians should consider continued learning an endeavor for the duration of their medical careers. Not only is it essential for maintaining and developing knowledge, skills, and relationships, it ensures the overall safety in individual and team clinical practices. While CME takes on various forms, the current COVID-19 pandemic has pivoted most continuing education towards utilizing online platforms.

With so many competing priorities, it can be easy to tune out or not take full advantage of opportunities for collaboration with virtual CME. Studies published in PubMed have shown that CME has been effective at improving clinical skills, however, multiple exposure and instructional techniques should be employed whenever possible.

These educational methods may include any of the following (National Institutes of Health):

• Academic detailing
• Audience response systems
• Case-based learning
• Clinical experiences
• Demonstration
• Discussion group
• Feedback
• Lecture
• Mentorship
• Problem-based or team-based learning
• Programmed learning
• Readings
• Role play
• Simulation
• Standardized patient
• Writing and authoring

Whichever CME route you decide to go, it’s important that you put yourself in a learning environment that will allow you to grow, refine your skills, and improve the quality of your care as a medical practitioner.

Peer-to-peer Participation

Although CME is one of the most important steps you can take in excelling in your specific industry, did you know that peer-to-peer education and mentorship is also just as important?  Peer-to-peer learning should be a supplemental initiative to standard CME. Learning by teaching is a strategy that has gotten a lot of attention lately, and for good reason. When someone learns something and goes on to teach it to someone else such as a peer, the person teaching develops a greater understanding of the material and improves learning outcomes. This method also helps to develop social-emotional learning skills, too.

Some hospitals and medical groups have peer-to-peer programs in place to focus on the importance of teaching through workshops and faculty mentorship pairings. Participants in the programs pair up into groups – peer-to-peer and/or faculty and mentee. Through these pairings, clinicians can talk through specific challenges, new advancements, time management, scenarios, and training. They can also improve in areas such as professional skills, leadership, autonomy, and giving/receiving positive feedback. Because multiple people are involved, this type of education also lessens the burden on a single instructor.

The Best of Both Worlds

When employed together correctly, clinicians can come together to share the common goals of improving patient satisfaction, outcomes, and care, while developing and advancing necessary skills as medicine constantly evolves. Does your hospital focus on the importance of both CME and peer-to-peer participation? If so, make it your priority to take full advantage! If not, perhaps you can make suggestions for these programs and be a catalyst for positive change.

Contact Advanced Care Hospitalists to Learn More

ACH is a Lakeland-based hospitalist group providing comprehensive patient care in community hospitals across Central Florida. If you are interested in learning more about our programs, services, providers or becoming a partner facility, please call us at 863-816-5884 or fill out a contact form online.

A hospitalist is a physician who works full time in a hospital and specializes in providing care and treatment for hospitalized patients. During your inpatient stay, a hospitalist will function as your temporary PCP to oversee and manage your comprehensive care plan. Hospitalists perform around-the-clock examinations, monitoring and treatment management services for patients from the time of admission to the time of discharge. Unlike PCPs, hospitalists don’t normally have outside medical practices, which means their only responsibility is caring for you while you’re in the hospital.

A nocturnist is a hospitalist that works late and overnight shifts. For various reasons, a hospitalist may choose this route. Many challenges and rewards come from working as a nocturnist, including juggling patient exams, and making medical decisions without the resources usually afforded to daytime hospitalists and their surrounding staff. A typical schedule for a nocturnist may include beginning their shift at 8 p.m. and working for eight to 12 hours until they are relieved by their daytime hospitalist counterpart.

Nocturnist Benefits

• Some physicians prefer working at night due to the way their circadian rhythm, or internal body clock works.
• Working overnight allows more flexibility for competing priorities during the day, like raising a family, or running important errands.
• During nighttime hours, hospitals tend to feel quieter. There are usually just as many inpatients at night as during the day, but there are usually fewer people to manage and a smaller core group of practitioners during overnight care.
• Nocturnists typically have more time with patients, allowing for more quality interaction and relationship building. This is partly because there are far less administrative duties and meetings to be a part of.
• Demand for nocturnist positions tend to be higher than daytime hospitalists. Pay tends to be higher on average, too.
• Nocturnists typically have more independence in making clinical decisions. However, if needed, specialists are generally available to assist in situations when needed.

Nocturnist Challenges

• Since most administrative meetings are held during the day, nocturnists still may be required to come in during their “off-time” to attend these meetings.
• Nocturnists usually have unusual schedules that can affect their families’ and friends’ schedules.
• Working overnight can sometimes interfere with developing healthy sleep patterns. Some nocturnists can adjust easier than others, but it can be a difficult modification at first. It’s important to try to stick to a similar routine even on off days to keep a healthy natural circadian rhythm.
• Because it’s generally quieter at night in the hospital, nocturnists often work alone. Due to this fact, nocturnists need to be comfortable working independently.
• Generally, more patients are transferred into ICU during nighttime hours. Because of this, an extremely ill patient may need the full attention of a nocturnist, making it hard for them to tend to their other patients and duties. This may cause a delay in properly preparing additional patients for a daytime hospitalist following the nocturnist’s shift.
• Nocturnists must be proficient in communicating effectively, as well as handling multiple tasks at once while staying cool under pressure.

If you do choose the career path of a nocturnist, here are a few tips to make the job a little easier and more rewarding:

• Don’t overdo it. Working more than three to five nighttime shifts in a row can lead to quick burnout and over exhaustion.
• If possible, keep shifts to under 12 hours. This will keep performance and job satisfaction at a higher rate.
• Avoid caffeine while on a shift.
• Stick to a routine and go to sleep upon arriving home. Ideally it will still be dark outside after an overnight shift. Using blackout shades and sleeping in a cold environment can help with getting to bed and staying asleep.

Whichever path is chosen, whether a daytime hospitalist or a nocturnist, working in a hospital setting can be remarkably satisfying, helping those who need it most while making a positive impact on a person’s quality of life. Which will you choose?

Contact Advanced Care Hospitalists to Learn More

ACH is a Lakeland-based hospitalist group providing comprehensive patient care in community hospitals across Central Florida. If you are interested in learning more about our programs, services, providers or becoming a partner facility, please call us at 863-816-5884 or fill out a contact form online.

As a hospitalist, you may be faced with a myriad of challenges when it comes to bereavement care. Whether it’s informing family members about the death of a patient, or as the provider, learning to cope with considerable loss on a regular basis – it can be extremely stressful for a clinician to be in a position of delivering such traumatic news, especially in the instance of an unexpected death. Grief reactions come in many forms from bereaved family members and can add an unsurmountable amount of pressure to a physician. Reactions of sorrow from family members may include initial shock, denial, distress, anger, or guilt; all of which can be directed at the provider. This may make clinicians uncomfortable and ultimately feel inadequate in these types of scenarios.

According to the National Institutes of Health, U.S. National Library of Medicine,

“the onus of speaking with bereaved family members about a sudden death of a patient lies on the health care team and should be carried out with utmost priority.” (1)

Because of this, hospitals should have an action plan in place for bereavement protocols that hospitalists can be confident in following.

Establish a Relationship

Once a patient has been established under a hospitalists’ care, that clinician should seek to make contact with a family member, close friend, or relative of the patient on-site. The physician should continue communication throughout the duration of the patient’s stay with one to two family members or close friends to keep communication consistent. If the patient is alone, a phone call to an emergency contact should be made. This conversation should be personable, compassionate, and sincere.

Explain Next Steps

Especially if a patient is in ICU and/or the outlook isn’t promising, family members need to be made aware of the possibility of death. The clinician should explain prognosis and chances of survival to adequately prepare loved ones for what may happen next. Resources such as social work and bereavement services, as well as pastoral care should be offered. Counseling on advanced directives should also be given. It’s often best to handle discussions around the patient’s prognosis outside of the hospital room, in a quiet space like a waiting room or private hallway.

Check In

Even if there is no news to share, simply checking in on the patient and their family can make them feel more comfortable in uneasy times. Something as simple as stopping in to say hello and letting the patient and family know the team is working hard to help them can go a long way.

Continue Communication

It is imperative to keep loved ones in the loop as much as possible about the patient’s condition. This keeps family and/or friends feeling connected to the process as well as their physician. When communication is poor from the start, it makes it that much more challenging to break difficult news. Always be sure to explain any new advancements or changes in the patient’s condition as soon as possible.

Ease the Burden

If a patient has died, the clinician should pull designated family members aside (seated is best) and calmly explain what has happened. The provider should speak in layman’s terms, making it as easy to understand as possible. The provider should offer expression of their sympathy and encourage family members by discussing all efforts made by the health care team to try to save the patient. If the provider feels comfortable, they may also wish to share their faith with the family members, expressing that the patient is no longer in pain, and in a better place (in heaven, with Jesus, etc.).

Clinicians should anticipate an array of questions from loved ones. If a question comes up that the hospitalist does not know the answer to or does not feel comfortable communicating, it’s OK to let the patient know in the most tenderhearted way. If a family member does become irrational or angry, it is best to not engage or respond to the behavior. Instead, refer the person to a counselor, or someone trained specifically in grief management.

Follow Up

A key component of bereavement services includes making condolence calls. Within 7-14 days following the death of a patient, the hospitalist should consider making a phone call to family members to offer their condolences once again and check in to see if there is anything the hospital staff may be able to assist with. Hospitalists should work with social workers and hospital psychologist services to receive education and guidance on proper counsel and support.

In the end, it’s important to remember that a health care team’s commitment to high-quality care is what makes the biggest impact, especially in situations of dealing with grief. By remaining communicative, caring, and consoling, hospitalists and patients’ family members can continue to develop and maintain meaningful relationships that make the grieving process a little less painful for each party.

Contact Advanced Care Hospitalists to Learn More

ACH is a Lakeland-based hospitalist group providing comprehensive patient care in community hospitals across Central Florida. If you are interested in learning more about our programs, services, providers or becoming a partner facility, please call us at 863-816-5884 or fill out a contact form online.

Resources

1. Naik, Sadananda B. “Death in the hospital: Breaking the bad news to the bereaved family.” Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine vol. 17,3 (2013): 178-81. doi:10.4103/0972-5229.117067

COVID-19 has affected almost every facet of life as we know it and will likely continue to impact our society for the foreseeable future. It is likely that as a hospitalist, you have seen quite a few changes in the last year that you weren’t expecting. From variations in hospital admissions, changes in protocols, and potential caregiver fatigue, challenges across the board have placed considerable burdens on health care organizations and personnel. On the other hand, COVID-19 has also forced hospitalists and health care workers to rethink the way they make decisions when it comes to routine care.

Routine care for an inpatient may include labs, imaging, vital signs, monitoring, and other recurrent procedures. Pre-COVID, health care workers likely didn’t have to worry as much about limited personal protective equipment, medication shortages, and overall personal health safety. But now, all visits with a patient must be thoroughly assessed to validate the reasoning for specific care. The questions, “how is this going to benefit my patient,” and “am I providing the best care with the most effective use of resources,” are what a hospitalist must answer prior to visiting a patient each time they enter a hospital room. Delivering this type of care has become a focal point with front line health care workers, especially now, during a time of such uncertainty.

Examples of post-COVID care include:

• Remote monitoring overnight
• Bundling lab work
• Reducing unnecessary tests, treatments, and procedures

Whereas examples of traditional care include:

• Routine overnight vitals – Checking vital signs every four hours throughout the night for low-risk patients can lead to sleep disruptions, which can contribute to higher perception of pain, sleep deprivation, and elevated blood glucose levels. Unless the patient specifically requires frequent monitoring, overnight vital checks may not be necessary.
• Routine lab work – In the case of a clinically stable patient, routine lab work may not be needed. It’s important to assess each patient to determine the benefit versus risk of conducting types of blood tests and how often they should be administered. It’s important to also note, if a patient does need to receive routine lab work, a clear routine should be set, so the blood draw is happening at the same time(s) every day.
• Imaging services – Sometimes a patient may not need the most comprehensive imaging service to diagnose a condition. Instead of wheeling a patient into get an MRI or CT scan, hospitalists should ask themselves, “would a portable x-ray be a better option to start with, so my patient isn’t put into a position of more distress?” If a less invasive imaging option is available and applicable for the condition at hand, it would be wise to start there.

With each of the above examples, clinicians are exposed to potential risk of infection more often. These are risks hospitalists are willing to take for the well-being of their patients, however, we do need to consider the safety and protection of our health care workers too. And, whether the interventions being performed are making a beneficial difference to patients.

Evidence-based care is all about safety, sustainability, and practicality. Clinicians all have the obligation and duty to uphold values that ensure patients receive the right care at the right time. Assessing the value of essential versus nonessential services can positively impact a patient’s outcome.

The future of medicine lies in the hands of our clinicians. By joining together in the effort to advance medical treatment, we can vastly improve the care our patients receive, and the safety of our care teams.

Contact Advanced Care Hospitalists to Learn More

ACH is a Lakeland-based hospitalist group providing comprehensive patient care in community hospitals across Central Florida. If you are interested in learning more about our programs, services, providers or becoming a partner facility, please call us at 863-816-5884 or fill out a contact form online.

*Facts and figures derived from the-hospitalist.org.

As a hospitalist, you visit with and provide treatment plans for many different types of people with various conditions and diseases. Some of the patients you may encounter could benefit from a clinical or health care experimental trial, but you may not be thinking about it at the time of your rounding. Did you know that your day-to-day interactions with patients could be a missing link in advancing clinical research?

Participation in clinical trials is imperative to successful innovation and improvement of health care, so how can you, as a hospitalist, do a better job of encouraging interest among your patients? The answer is two-fold. First, a hospitalist must look at themself as a patient advocate – someone who keeps abreast of the latest in groundbreaking scientific advancements in their area of practice, and then passes that crucial information on to their patients to make informed decisions. Second, a hospitalist should encourage their team and other clinicians to implement new testable interventions to learn more about how and why certain trails work, as well as engage in more experimentation across the board.

Patient Advocate

As someone who patients learn to trust and rely on during their hospitalization, a hospitalist can encourage participation in sound clinical research. By providing resources that review benefits and risks, as well as details for involvement, patients can be introduced to new avenues in which they may have never considered prior.

According to the National Institutes of Health, several studies indicate that proper awareness changes attitudes toward clinical trials, enrollment, and the benefits of participation.

• 85% of patients surveyed were either unaware or unsure that participation in a clinical trial was an option at the time of their diagnosis.

• 75% of the surveyed above said they would have been willing to enroll had they known it was possible.

It is important to take the approach that not many patients will be informed of all the clinical trial options available to them, and that health care providers can greatly increase awareness and participation in clinical trials because of their influence and role in a patient’s journey. It’s also imperative to remember that a patient’s choice to participate (or not) is very personal and unique to their situation.

Innovation

To remain innovative, it is essential to continue experimentation and testing. Patients have the unique opportunity to have a voice in a vast ecosystem of new therapy developments. The scientific and technical advancements from clinical trials hold such strong potential for novel treatments to some of humanity’s most life-threatening diseases and conditions. By encouraging patients to at least check into the requirements that a clinical trial may involve, a hospitalist can help serve as a reminder to continue improving access to promising care.

Making decisions such as enrolling in a clinical trial is confusing and daunting for most patients. As someone they learn to trust in their stay as an inpatient, a hospitalist can bring clarity and assurance. A hospitalist’s role is so much more than simply providing care and treatment for hospitalized patients. Not only are they responsible for ensuring that patients understand their condition, treatment plan, what to watch for, and who to call in a crisis, they play a crucial role in transitional care, follow-up, and readmission. A hospitalist can also provide hope and encouragement in ways they could never imagine – like encouraging participation in lifesaving treatment through a clinical trial.

Sometimes, a clinical trial is not going to be an option. And that’s OK. A hospitalist can continue finding ways to encourage their patients’ healing in several other ways. The important piece of advice here is that as a hospitalist, you keep yourself educated and informed of advancements that may be of benefit for your patients.

Contact Advanced Care Hospitalists to Learn More

ACH is a Lakeland-based hospitalist group providing comprehensive patient care in community hospitals across Central Florida. If you are interested in learning more about our programs, services, providers or becoming a partner facility, please call us at 863-816-5884 or fill out a contact form online.

With the arrival of the vaccine against SARS-CoV-2, there is global optimism. However, with a continued influx of sick patients and health care facilities taking a toll from it, COVID-19 still poses significant clinical challenges.

Throughout the COVID-19 pandemic, it has become critical for hospitals to have enough available beds. A relentless rise in hospitalizations due to the pandemic has made this difficult and has hurt many health care system areas. From postponing elective procedures to reducing admittance of non-essential care, health facilities are stretched beyond their limits and hurting from it. The cancellation of surgical cases paired with high costs for COVID-19 care, and the drop in non-COVID-related ambulatory care have all contributed to steep hospital revenue reductions.

As hospitals continue to bring back volume safely, a smooth and efficient discharge process is crucial to improve patient flow and lessen the need for rehospitalizations. Experts agree that a successful handoff is paramount in preventing avoidable readmissions.

However, factors that influence readmissions are often nonmedical, including:

• Home environment
• Health literacy
• Adherence to prescribed medications
• Ability to keep up with follow-up appointments

So, what does this mean for hospitalists?  

Hospitalists are responsible for ensuring that patients understand their condition, treatment plan, what to watch for, and who to call in a crisis. They play a crucial role in taking care of these transitions and follow-up, even with the above non-medical influences on readmission.

Here are a few key ways to make the discharge process a smooth and timely experience for you and your patients.

Ask the right questions, and then identify the solutions.

Taking a step back and identifying the specific variables that stand in the way of a safe discharge is an essential first step. Ask questions like:

• Why is the patient here?
• Why is the patient still here?
• What has changed, allowing the patient to go home?
• When will the patient be discharged, and where are they going?

Through answers to these questions, hospitalists may be able to identify if patients are well enough to leave and any potential barriers that stand in the way of them doing so. The team can then discuss which patients are ready and create a list of what is needed for their discharge.

Be proactive and accelerate communication.

A lapse in communication can often be traced as the main culprit of a fragmented discharge process. When a patient can be medically identified for discharge, hospitalists need to escalate the directives required to move forward. Instead of waiting for validations from a consultant, actively reach out to them. Additionally, keep the full team in the loop. Utilize cross-functional communication tools, such as a whiteboard, and leave notes that the team can access during different shifts. Visual reminders are a great tool for prioritizing tasks and the need to focus on patient discharge.

Take accountability for the post-discharge process.

After discharge, hospitalists continue to take care of the patient – but in a different way. It’s important to remember that team members are accountable for what happens next. Follow up on pending lab results. Make a post-discharge phone call. Make yourself reachable by phone.

Key ways to better prepare your patient for a smooth transition may include:

• Communicating essential information to the patient and their family.
• Offering a contact for questions that may arise after discharge.
• Promptly communicating with the primary care physician.
• Helping patients make and keep timely follow-up medical appointments.
• Reconciling the patient’s medication schedules.
• Assessing those at greater risk of post-discharge problems or readmissions.

Ultimately, a good discharge experience can be linked to good communication. A lack thereof is a problem and leads to readmissions. As hospitalists, the part we own is communication. When we can commit to not only turning around beds but setting up patients for a successful transition home, we’ll see our health systems significantly improve.

Contact Advanced Care Hospitalists to Learn More

ACH is a Lakeland-based hospitalist group providing comprehensive patient care in community hospitals across Central Florida. If you are interested in learning more about our programs, services, providers or becoming a partner facility, please call us at 863-816-5884 or fill out a contact form online.