Hospitalists in children’s hospitals: What we know now and what we need to know

Invited Article: Is it time for neurohospitalists?

“…37 Several studies showed pediatric and internal medicine hospitalists reducing the total cost of care by 13.4% and reducing the length of stay by as much as 16.6%. 6,16,31 However, reduction in length of stay and reduced total cost of care only reached statistical significance during the hospitalists' second year of service, which suggests that experience is crucial for efficient delivery of care. 30,36 Another study showed that hospitalists shorten the length of stay but accrue higher costs per day, which indicates that hospitalists may provide more intense treatment during the shorter stay.…”

“…Medical and pediatric hospitalist expertise is based on experience in acute care, ability to navigate inpatient resources and implement quality measures, 41 and close work with case managers. [15][16][17] It is our experience that neurohospitalists provide similar expertise as medical and pediatric hospitalists in acute care and inpatient resource utilization. Training requirements and core competencies have been proposed for neurology, 9 medicine, [17][18][19]21 and pediatric hospitalists 16,20 to fill training gaps of traditional residency programs.…”

“…[15][16][17] It is our experience that neurohospitalists provide similar expertise as medical and pediatric hospitalists in acute care and inpatient resource utilization. Training requirements and core competencies have been proposed for neurology, 9 medicine, [17][18][19]21 and pediatric hospitalists 16,20 to fill training gaps of traditional residency programs. Neurohospitalist subspecialty fellowship education also has been proposed recently, 8,9 and one such program was established in 2003 39 and exists in 2007.…”

“…28,29 Other concerns include patient satisfaction, cost-shifting between inpatient and outpatient practices, and decreased resident autonomy because of more supervision by a hospitalist. 7,16,[30][31][32][33] These issues may also be encountered by neurohospitalists caring for patients with neurologic disease in the inpatient setting who later return to see their primary neurologist and internist in the clinic setting.…”

Staff-Only Pediatric Hospitalist Care of Patients With Medically Complex Subspecialty Conditions in a Major Teaching Hospital

“…3 In 2006, pediatricians represented 11% of the members of the Society of Hospital Medicine, 4 with an estimated 800 to 1000 practicing pediatric hospitalists. 5 Pediatric hospitalists have gained increasing recognition by the American Academy of Pediatrics, 6 which recently issued principles for the development of pediatric hospitalist programs. 7 In 2005, the American Academy of Pediatrics and the Society of Hospital Medicine cohosted the first Pediatric Hospitalist Meeting.…”