Effects of a Medical Intensivist on Patient Care in a Community Teaching Hospital

Manthous, Constantine A.; Amoateng-Adjepong, Yaw; Al-Kharrat, Tamim; Jacob, Badie; Alnuaimat, Hassan; Chatila, Wissam; Hall, Jesse B.

doi:10.4065/72.5.391

Cited by 130 publications

(67 citation statements)

References 16 publications

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“…Intensivist-based care models have been shown to reduce LOS and resource utilization (10,13), and we noted a reduction in ICU LOS and costs with remote management. A lower incidence of complications likely contributed to the cost savings (27).…”

Section: Discussionmentioning

confidence: 62%

“…Data from multiple ICU environments (medical, surgical, pediatric) indicate that intensivist-based care programs reduce complications and deliver improved patient outcomes (7)(8)(9)(10)(11)(12)(13)(14)(15). The value of intensivist care models likely derives from multiple sources.…”

Section: Discussionmentioning

confidence: 99%

“…Avoidable adverse events occur frequently in ICU patients and contribute to adverse outcomes (4 -6). Despite numerous studies demonstrating improved clinical outcomes when ICUs are staffed by full-time intensivists (7)(8)(9)(10)(11)(12)(13)(14)(15), a variety of different care models exist in U.S. ICUs. Commonly cited reasons that most U.S. hospitals do not have dedicated intensivists include concerns about costs, practice preferences, and a shortage of ICU physicians.…”

mentioning

confidence: 99%

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Intensive care unit telemedicine: Alternate paradigm for providing continuous intensivist care

Rosenfeld

Dorman

Breslow

et al. 2000

Critical Care Medicine

345

197

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Intensive care unit telemedicine: Alternate paradigm for providing continuous intensivist care

Rosenfeld

Dorman

Breslow

et al. 2000

Critical Care Medicine

345

197

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“…In developed countries, it has been shown that the full-day presence of PCC specialist in PICUs improves mortality and treatment of PICU patients (8). Since the publication of studies showing decreased mortality in PICUs staffed with a PCC specialist, there has been an increased demand for PCC specialists (9)(10)(11)(12).…”

Section: Pcc Specialistsmentioning

confidence: 99%

Evaluation report of pediatric intensive care units in Turkey

Bayrakçı¹,

Kesici²,

Kendirli³

et al. 2014

Turk J Med Sci

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Background/aim: To collect data from throughout Turkey in order to facilitate the organization of pediatric intensive care units (PICUs), and to develop short-term immediate action plans and draft long-term strategic plans.Materials and methods: A total of 35 specialists including 17 pediatric critical care (PCC) specialists, 9 PCC fellows in training, and 9 pediatricians working in PICUs evaluated PICUs and their infrastructures, mortality rates, appropriateness of indications for PICU admissions, PICU bed numbers, and utilization of those PICU beds.Results: PICU bed numbers, PCC specialist numbers, and PICU nurse numbers are insufficient in Turkey. The high percentage of inappropriate and inefficient use of current PICU beds is also another problem. Conclusion:In the light of this report, it is obvious that pediatric intensive care services are successful and efficient only in the presence of PCC specialists in PICUs. Studies for improving the infrastructure of PICUs and the training of PCC specialists and other health personnel should be started immediately.

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“…In studies documenting improved outcomes and efficiency when intensivists participate in the care of critically ill patients [39][40][41][42][43] , hospitalists were not represented in the control groups. Since no studies have compared hospitalist-based intensive care (with intensivist consultation) to intensivist-based care, the optimal collaborative model between hospitalists and intensivists remains undecided, although hospitalist care of the critically ill may expand if the projected US shortage of critical care physicians materialises 44 .…”

Section: Hospital Medicine As a Career: Defining The Specialtymentioning

confidence: 99%

The evolution of the hospitalist movement in the USA

Baudendistel

Wachter

2002

Clinical Medicine

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-The hospitalist movement represents a novel paradigm of health care delivery in the USA, its evolution hastened by a variety of financial, clinical, and time pressures. Hospitalists are site-defined specialists who spend the majority of their professional time practising in the hospital, and in this respect are similar to emergency medicine or critical care specialists. Community hospitals were the sites of early growth in hospitalist systems, and academic medical centres quickly followed suit. The field has grown rapidly, and now has its own textbook, professional society, training programme, and research and educational agenda. Published research to date has upheld the promise of the hospitalist model: improving efficiency of care by reducing length of stay and hospital costs without compromising quality or patient satisfaction. Future hospitalist research will aim to elucidate the role of hospitalists in the care of critically ill and surgical patients, identify the competencies that will ultimately define this specialty, and expand our understanding of key inpatient issues, such as prevention of nosocomial infections, end-of-life care, and hospital quality measurement. KEY WORDS: hospitalists, job satisfaction, medical specialties, organisational models, outcome and process assessment, patient satisfaction A novel health care paradigm First coined in 1996, the term 'hospitalist' described a new breed of physicians in the USA who focused on the care of medical inpatients 1 . Traditional models of health care delivery in the USA place the primary care physician -a general internist, paediatrician, or family physician -as the physician of record for most non-surgical hospitalised patients, receiving assistance from subspecialists as the need arises. In a hospitalist system, primary care physicians transfer the responsibility for hospital care to an inpatient specialist, whose expertise is defined not by an organ system but by site of practice. The hospitalist then refers the patients back to their primary care physician at the time of discharge. Although a generation ago American primary care physicians spent nearly half their time providing hospital care, they now spend an average of 12% of their time in the hospital 2 .Many influences hastened the evolution of a novel paradigm of health care delivery in the hospital: time constraints on the primary care provider; fewer inpatients for individual primary care physicians; cost pressures on the hospital and medical groups with reduced rates of reimbursement for inpatient services; the heightened acuity of medical inpatients; the accelerated pace of inpatient care; and the evidence that 'practice-makes-perfect' in other medical fields 1 .Originally defined as physicians who spend more than 25% of their time caring for inpatients 3 , the first American hospitalists grew out of a cohort of generalists and specialists already performing the majority of their clinical duties in the hospital. The 1997 survey from the National Association of Inpatient Physicia...

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Effects of a Medical Intensivist on Patient Care in a Community Teaching Hospital

Cited by 130 publications

References 16 publications

Intensive care unit telemedicine: Alternate paradigm for providing continuous intensivist care

Intensive care unit telemedicine: Alternate paradigm for providing continuous intensivist care

Evaluation report of pediatric intensive care units in Turkey

The evolution of the hospitalist movement in the USA

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