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Assigning Hospitalists to Units

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  • #25342

    Lorax
    Participant

    Fair point. but does that kill the idea?
    I can see lots of advantages to cohorting:
    ·        The Dr. being more familiar with the unit(s) they are assigned to (physical equipment, locations, paperwork processes & people)
    ·        Less wasted time for the Dr. traveling about the hospital to see their dispersed patients.
    ·        The Dr would become very adept at dealing with particular issues (if they were assigned to a Telem. Unit or a Peads unit…)
    Would it be possible to get round the issue of transferred patients getting different MRPs by making a rule that a transferred patients Dr stays responsible for them?
    Coop. I guess we need a definition:
    Cohorting= assigning a Dr to one unit of floor
    Lorax

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    #61058

    Lorax
    Participant

    Also,
     
    LOS may not be directly (or clearly) effected by cohorting but the Dr would have more time to spend with patients as opposed to walking great distances when they are dispersed (ie more Value Added (VA) time and less wasted effort).
     
    You may not see Length Of Stay (LOS) decreasing (its one of those numbers that is difficult to see move), but the quality of care would likely improve and you wouldn’t have to listen to people complaining that they were sure the could discharge patient X but couldn’t get the Dr to write the order because they were at the other end of the hospital.
     
    I think this is at least 3 cents worth now…

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    #61061

    Brit
    Participant

    Good points – I’d like to toss in one more issue – physician satisfaction.
    This will vary by certain physicians in terms of cohorting and patinet pattern.  First – they might not like to “walk the halls” – meaning travelling to see patinets across the continuum or to other areas of the hospital.  They may also want to have a variety of patients and would be willing to walk for them.  Their satisfaction is a reality we have to face due to the pressure they can put on the system flow..

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    #61062

    Sheri
    Member

    The idea of the doctor staying with the patient until they are discharged is good as long as your patients aren’t transferred often.  In our organization, since bed availability is an issue, it is more likely that a patient will be transferred during their stay.  This would result in the physician following patients more often than staying in their assigned area.
    I think there are advantages and disadvantages to both approaches.  The key is to determine your measures of success (i.e. LOS, patient/physician/staff satisfaction) and see which has the most favorable impact.
    Sheri

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