A day in the life of a hospitalist is not spent in a vacuum. Every day in hospitals across the country, hospitalists coordinate patient care with a host of other physicians, caregivers, and administrators. One minute, a hospitalist could be managing a patient’s treatment with a physician assistant; the next minute, the hospitalist could be reviewing a diagnosis from a cardiologist. The same hospitalist might finish the shift by reporting valuable quality-improvement (QI) data to the hospital’s management staff.
It’s that kind of collaboration that is the hallmark of HM, so it makes sense that the same level of collaboration take place between SHM and a bevy of other healthcare-related organizations.
“The delivery of hospital-based care is a team sport,” says Joe Miller, SHM’s executive advisor to the CEO. “It requires coordination across disciplines, from clinical to managerial. Hospital medicine is in the middle of a complex system, and we can’t do it ourselves. If we’re going to be successful, we need to forge partnerships.”
Those partnerships have been critical to SHM’s ability to create educational programs and practice management resources. It also factors into SHM’s efforts to enhance patient satisfaction and advocate for QI in healthcare. The list of SHM’s partner organizations and joint projects is an alphabet soup that includes the nation’s most influential professional societies, academies, and government entities, each of which is working to improve the delivery of care to hospitalized patients.
Small Start, Quick Growth
The relationship between SHM and the American Medical Association (AMA) began as a simple research project and has grown into a deeper collaboration. In 2007, the AMA’s Organized Medical Staff Section (OMSS), the department that advocates on behalf of physicians who are members of medical staffs and other organizations, wanted to increase understanding of how hospitalists, primary-care physicians, and other physicians work together in the hospital setting. The association collaborated with SHM to conduct a survey and obtain feedback from hospitalists.
The 2007 survey found that there was still work to be done between the organizations, namely the need for a set of guiding principles for a successful hospitalist practice. OMSS, SHM, AHA, and the Joint Commission developed the principles, which were recently endorsed by OMSS at the association’s annual conference in June.
“We feel they’re appropriate and make sense,” says Jim DeNuccio, director of AMA’s Organized Medical Staff, Group Practice, and Senior Physician Services.
The 2007 survey and the principles for a hospitalist practice have led to a new survey, conducted this year, to track how the issues and challenges within a hospital have changed. The initiatives are just the beginning of a long-term relationship between SHM and AMA.
“It’s very important for all of us to work together to continue to grow,” says DeNuccio, who cites AMA’s courses in practice management, QI, and patient safety as educational opportunities for hospitalists. “Our interest is in the patient. That’s what this is all about. The AMA and OMSS feel strongly that the profession needs to call the shots about how care is delivered in hospitals. They see that engaging the hospitalist is in the interest of the patient.”
SHM and AAPA: Educating Together
Hospitalists and physician assistants (PAs) work hand in hand to care for their patients. At the national level, SHM and the American Academy of Physician Assistants (AAPA) are coordinating educational programs to ensure PAs and hospitalists are properly informed and learning from the same page.
“It’s a very broad spectrum,” says Sharon Kulesz, AAPA director of alliance development and education. “We provide physician assistants with information about hospitalists, and we provide physicians with information about the benefit of working with physician assistants.”
Along with the American Academy of Nurse Practitioners (AANP), AAPA and SHM have coordinated educational programs at SHM’s annual meeting for hospitalists, and recently developed a stand-alone “Boot Camp” series for nurse practitioners and physician assistants to learn more about HM.
Kulesz notes, however, that not all of the education is exclusively for hospital-based workers. Some of the efforts are geared toward educating the public about hospitals’ patient-care teams. Regardless of the topic or the audience, the key is a comfortable working relationship between teams, she says.
“Our work with SHM is the model that I would like to use in all of our collaborations,” Kulesz says. “SHM gets us. They get what we can do and how a collaborative approach can be of benefit to everyone. It’s like an extended family.”
The new Hospital Care Collaborative takes a team approach to hospital-based care. More than simply a partnership, the group brings together groups that represent healthcare professionals in the hospital—hospitalists, nurses, case managers, respiratory therapists, social workers—to find common approaches to QI and patient safety.
“As a group, the Hospital Care Collaborative is looking for ways to work together to improve the care of the hospitalized patient,” says Larry Wellikson, MD, FHM, CEO of SHM. “We’ve developed common principles, which have been ratified by each of our boards. At its core, the collaborative is looking for real-world ways to integrate medical professionals and help hospitals take a new approach to patient care.”
Part of the answer is in the education, development, and promotion of high-performance teams in hospital settings, Dr. Wellikson says. For instance, if a patient is admitted to the hospital with a blood clot, each team member has the opportunity to contribute his or her expertise and coordinate with others. The hospitalist might make the diagnosis, which leads to the prescription from the hospital pharmacist. With the diagnosis and list of prescriptions in hand, a nurse can then explain to the patient how the medications will affect their daily routine.
“In modern healthcare, no one professional or professional society can have all the perspectives you need,” Dr. Wellikson says. “In SHM’s approach, we’re looking at the hospital as a community, not a building. The problems we’re trying to solve are complex, and it requires an all-hands-on-deck approach. Knitting the perspectives and expertise together will be the key to treating the patient in the 21st century.” TH
Brendon Shank is a freelance writer based in Philadelphia.