“We’ll ask if there’s anything they want us to convey to the new doctor” before we go off shift, says Dr. Yim.
The hospitalists at Samsun Santa Barbara Medical Foundation take great care with transitions during shift changes because they are aware that mistakes can happen if communication is incomplete.
“Hand-offs are one of our biggest challenges,” says Dr. Yim. “Ours aren’t formalized, but we follow a standard practice of leaving what we call an ‘off-service note.’ This is very comprehensive, almost like a discharge note, and includes all important details. In addition, the outgoing and incoming hospitalists have a sign-off conversation, either in person or over the phone, to cover any social issues or dynamics. With Robin, for example, pain control was an issue.”
Dr. Yim told Orr and Cook the results of the tests.
“Dr. Yim came in on Tuesday, and it was like passing a baton in an Olympic race,” recalls Cook, who is an expert and author on customer service. “Both [of the hospitalists] have empathy, [a skill that is] relevant and timely, and a sense of urgency.”
Orr agrees that Dr. Yim’s care was as helpful as Dr. Trautwein’s.
“Both hospitalists made sure I was treated as a human being; they weren’t just treating my pain,” she says. “Dr. Yim made sure I got what I needed at discharge, which was very necessary. He was on top of it and made sure it included follow-up.”
In Praise of Hospitalists
Despite her profession, Orr says she had never heard of hospitalists before meeting Dr. Trautwein. In addition to her gratitude to him for diagnosing her cancer, she was very impressed with how the role of hospitalist affected her care.
“I felt that having a hospitalist helped streamline the process,” she says. “I was admitted through the ED in the middle of a weekend night, when labs were closed and I had no access to my primary care physician. Despite the timing, there was continuity and follow-through, and there was speed of action.”
Orr was particularly impressed at how the various departments of the hospital worked together, with a hospitalist acting as her champion with all of them.
“[Eric] has a familiarity with hospital resources and knew who to call and when to call,” she says. “He passed the baton between people in such a way that I felt I would not be dropped between departments. There were great communications, and it helped with the ease of streamlining and continuity, and it certainly helped my peace of mind.
“From the perspective of a health professional, I could see that a hospitalist helps eliminate waste,” Orr continues. “I know that hospital resources are so precious, and when someone can help expedite a procedure or test, it’s extremely valuable.”
Orr had a first-hand view of how hospitalists streamline processes and influence care for individual patients. Her experience as a patient was an educational time for her, even with her substantial background working with hospitals.
The Hospitalist’s View
While Dr. Trautwein is pleased with the outcome of his assessment of Orr, he insists that he was doing his job. In fact, he believes the toughest part of being a hospitalist is not detecting hidden illnesses, but building trust.
“The biggest part of my day is communicating. I feel like I don’t have much time to establish trust with patients,” he admits. “That’s by far the hardest thing about the job. You only get one pass to go over their medical history, but you also have to build a rapport with them. It’s not easy.”