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NUMC implements hospitalist programIn early January, New Ulm Medical Center implemented a hospitalist program on its inpatient units – a growing trend in hospitals nationwide in which a physician is responsible to care for only hospitalized patients and might have no clinic practice at all. At the medical center, five New Ulm physicians will rotate their role as hospitalist for one week at a time, while maintaining their clinic practice during the other weeks. During that one week, the physician serving as hospitalist does not see any patients in the clinic and is responsible for the majority of admissions, discharges and daily rounding on hospital inpatients. Previously, if a patient was admitted to the hospital at NUMC, their own primary care physician was responsible for their care, in addition to that physician’s regular clinic duties. The benefits of the new system are many, says Joan Krikava, MD, who is Medical Director at the medical center and one of the five physicians who serves as hospitalist. From a care standpoint, Krikava said, it allows the hospitalist physicians to focus strictly on the hospitalized patients. “They don’t need to divide their attention between patients needing them at the clinic and patients needing them at the hospital,” she said. “Their total focus is on the patients in the hospital and their families.” With the same five physicians serving as hospitalist, they will also be able to hone their skills in regards to hospital medicine. Another advantage is that clinic physicians will be less likely to be called away from their clinic practice to see an inpatient or to admit a patient to the hospital, thus delaying their patients in the clinic. For hospitalized patients, having the same attending physician in the hospital all day every day, and on call overnight, is a real benefit. When Marilyn Stuckey was admitted to the inpatient unit recently for recovery following her total knee surgery, she was pleasantly surprised to have the amount of attention that the hospitalist program afforded her. “When you’re sick, it’s all you can do to handle the pain and your condition and you have to be able to have confidence in the care you are receiving,” Stuckey said. “Any time information about your condition is spread across multiple people, there’s always an opportunity for miscommunication. Having the same doctor overseeing your care means there are fewer people involved.” When Stuckey had a reaction to a pain medication in the middle of the night, she said, “What a relief it was that they called Dr. Krikava – in the middle of the night – and she came right in. Then the next morning when I had a reaction to the second medication, they called her and she was on the unit. She was here in minutes. What a reassurance.” Having the doctor available to respond to medical needs immediately is one thing. But, there is also a huge advantage in having the physician available at almost any time of the day to talk to family members. Nancy (Fering) Johnson rushed to New Ulm from her home in Burlington, Vermont recently when her mother, Ruth (Fering) Black suffered a severe stroke. Her brother came down from the Twin Cities and her daughter arrived from Washington, D.C. Between the three of them coming and going from the hospital, the assurance that there was more than just one little window of time each day during which they could have their questions answered by the physician was a monumental relief. “This was a big change in our lives. We’ve had a lot of things to think about and decisions to make for our mother,” Johnson said. “It was nice to have the consistency of having the same physician to discuss the issues with and knowing that, if she stopped by in the morning and my brother wasn’t here to hear what she had to say, that she could stop back later in the day. “Seeing her around all the time and having her easily accessible to us has been very nice,” Johnson said. “And we were able to have her attention for as long as we needed it – and we needed it.” Nursing staff also benefits from having a hospitalist right on the inpatient units all day long and then having that same physician on call at night. “The hospitalist knows the patient’s condition throughout the day and is readily available to work directly with the nurses caring for that patient,” Krikava added. “If there are questions or concerns through the night, the nurses know we have are familiar with what has been happening with the patient throughout their hospitalization.” Hospitalist services nationwide have become more common in the last 10 years. The trend started in larger hospitals and is now becoming more common place in smaller community hospitals, Krikava said. The five NUMC physicians who will rotate duties as hospitalist are internal medicine specialists Krikava, Daniel Groebner, MD, Sanjay Mishra, MD, and family practice physicians Scott Rysdahl, MD and Daniel Holmberg, MD. All of the medical center physicians were involved in the decision to implement the hospitalist service, Krikava said. There will be some who choose not to use the hospitalist service and care for their own patients when they are in the hospital – that is a decision that has been left up to each individual physician. |
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New Ulm Medical Center
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