Hospitalists will be both the measured and the measurers. We will need to work with others to decide what data will help tell us how well we are doing, what changes in the systems need to be installed to improve quality, and how to harness all the resources available to be better tomorrow than we are today.
And this leads me to the third leg of this triad. Hospitalists and other physicians can’t do this alone, and we can’t do this under the old model where the doctor has the steering wheel and everyone else waits to see where the ship is going. This may evolve into more of an orchestra, where the physician is the conductor and others are the virtuoso musicians.
Current legal limitations aside, we markedly underutilize the perspective and expertise of nurses, pharmacists, social workers, therapists, and case managers. These other team members often know important information about our patients and about the hospital and available resources. If we had a seamless way to incorporate this knowledge base, patients would get better care, the entire team would feel empowered, and job satisfaction would improve for everyone.
For the past year, senior leaders from SHM have met with senior leaders from the American College of Chest Physicians (ACCP), the American Association of Critical Care Nurses (AACN), the American Society of Health System Pharmacists (ASHP), and representatives of respiratory therapy to examine our current management of acutely ill patients in the hospital and to develop plans to move to a new health system that is patient centered and team driven. AACN has started giving out Beacon Awards to hospital units that demonstrate these values. SHM will partner with ASHP in 2005 on joint research of teams of hospitalists and pharmacists. The Collaborative will look at any examples of collaborative efforts that are in place and working today.
Those of you who think this is pie in the sky should look back at some history. About 15 to 20 years ago, about 10 physicians got together and decided to make California smoke free. Our goal was to remove cigarettes from restaurants, businesses, and the work place by 2000. The doubters said we were up against a multibillion dollar industry and trying to outlaw an addictive substance. Today about the only public place you can still smoke a cigarette in California is out in front of a hospital.
Grand goals can happen when motivated people are willing to make them a priority. Making the patient the focus of health care, creating an environment where teams can flourish, and raising expectations for delivering a quality experience in every hospital will happen in my lifetime. And hospitalists (along with other key stakeholders) will be at the center of this effort. This is the right commitment at the right time. SHM will do our share, and we hope each of you will make this one of your core professional values.