The effect of a hospitalist service with nurse discharge planner on patient care in an academic teaching hospital
| Autor: | Kim Evans, Gerald R. Hobbs, Niti S Armistead, Paul R. Ogershok, Shanthi Manivannan, D. Michael Elnicki, H. Carl Palmer, Alan K. Halperin |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Male Attitude of Health Personnel Specialty Nurses Patient care Teaching hospital Patient satisfaction Patient Admission Nursing Medicine Humans Hospital Mortality Hospitals Teaching Average cost Aged Quality of Health Care Service (business) Health Care Rationing business.industry General Medicine Service personnel Length of Stay Middle Aged Patient Discharge Hospitalization Schedule (workplace) Outcome and Process Assessment Health Care Hospitalists Patient Satisfaction Female Patient Care business |
| Zdroj: | The American journal of medicine. 111(8) |
| ISSN: | 0002-9343 |
| Popis: | To evaluate the impact of implementing a hospitalist service with a nurse discharge planner in an academic teaching hospital.Inpatient medicine service was provided by hospitalists, general internists, and specialists. Service personnel were identical except that the hospitalist service also had a nurse discharge planner. Hospitalists attended 4 months per year (compared with the 1 month by most other attending physicians) and had no outpatient responsibilities during the ward months. Patients were admitted alternately based on resident call schedule. Major outcomes included average costs of hospitalization, length of stay, and resource utilization. Quality measures included inpatient mortality, 30-day readmission rates, and satisfaction of patients, residents and students.Hospitalist-attended services had lower mean (+/- SD) inpatient costs per patient ($4289 +/- $6512) compared with specialist-staffed services ($6066 +/- $7550, P0.0001), with a trend toward lower costs when compared with generalist-attended services ($4850 +/- $7027, P = 0.11). Hospitalist services had shorter mean lengths of stay (4.4 +/- 4.0 days), compared with generalists (5.2 +/- 5.2 days) and specialists (6.0 +/- 5.5 days, P0.0001 for hospitalists vs. both groups). Readmission rates were similar in all groups. Mortality rates were higher in the specialist group [5.0% (44 of 874)] compared with hospitalists [2.2% (18 of 829)] and generalists [2.6% (20 of 761), P = 0.002 for specialists vs. both groups, P = 0.09 for generalists vs hospitalists]. Satisfaction results were uniformly high in all groups, with no significant differences.Hospitalist services with a nurse discharge planner were associated with lower average cost and shorter average length of hospital stay, without any apparent compromise in clinical outcomes or patient satisfaction. |
| Databáze: | OpenAIRE |
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