Continuity of Care
The most common question we hear in reference to our Hybrid medicine practice is “If there is a different inpatient doctor every day or two, how will the patient receive continuity of care?” Whether the question comes from the hospital executive, Medical staff, a prospective physician, or the patient and/or patient’s family, the question inevitably comes up. We certainly understand the trepidation and this same question was carefully considered during the design of our Hybrid program. The answer to this question had a significant impact on the implementation of the design and management of our clinical operations!
Appropriate Care vs. Continuity of Care
The appropriateness of the care provided, whether by one or more than one physician, is more important than the same physician day after day.
The traditional view of continuity of care generally revolves around the concept of the same physician providing the medical care of a patient’s inpatient stay. The problem with this view is that just because you receive medical care from one physician for your entire stay, if the treatment plan was not correct, the continuity of care from that single physician would be more harmful than helpful. The appropriateness of the care provided, whether by one or more than one physician, is more important than the same physician day after day.
Physician like autonomy in “practicing” medicine, however they all agree that providing evidenced-based medicine is the best treatment plan for a patient. Appropriateness of care begins with developing practice patterns and protocols based on identifying the best evidenced-based medicine for each patient’s medical condition. Once the appropriate treatment plan has been identified and effectively documented in the patient’s chart based on standards of care and communicated to the nursing staff, the patient will be on the path of receiving the best medical care regardless of the amount of physicians involved in their care.
We work with our physicians and hospital to create protocols for the most common diagnoses cared for in each hospital.
While physicians agree with evidenced-based treatment plans, the reality is that without constant discussion, training and education from HospitalMD
, the successful implementation of this practice with multiple providers will not work. That is why we have designed our Hybrid program to tackle this issue aggressively. We work with our physicians and hospital to create protocols for the most common diagnoses cared for in each hospital. These protocols are discussed in our monthly meetings and are updated as new and more effective treatment plans become known. We review all of the charts to determine whether the protocols are being followed by each physician, and if not, allows us to bring them specific data to the individual physician to discuss any deviations. This allows us to provide a consistent and appropriate plan of care to each patient, regardless of whether the physician changes every day or every 3 days.
Communication between the nursing staff and physicians must be given the highest priority.
In addition to our evidenced-based medicine protocols, our communication between our physicians and hospital staff plays a vital role as well. The reality is the nursing staff will spend more time with each patient than the physicians will. This means the communication between the nursing staff and physicians must be given the highest priority. That’s why we implement mandatory nurse rounding with the physician as well as at hand-offs at physician shift change. This helps the nursing staff and physician to work together as a team to provide each patient the best care possible. We have never received a complaint from a patient that there was too much communication! This teamwork environment allows us to provide the most appropriate care possible to each patient!
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