Specialists are skeptical at first
Specialists are skeptical at first
It was a challenge to convince administration officials to invest about half a million dollars a year for 2.4 additional hospitalist FTEs required for a new plan for admitting patients from the ED at Johns Hopkins Bayview Medical Center in Baltimore. However, it was just as hard to convince some specialists to cede the responsibility for admitting patients to their units to a hospitalist, as the new plan required.
"In some institutions, coming up with the money might not be the difficult part," says Eric E. Howell, MD, FHM, director of hospital care for the department of medicine. "For us, it was equally difficult to gain acceptance of the decision to allow the active bed manager [hospitalist] to, in fact, triage for all divisions."
How were the objections overcome? "It was not an overnight process," he concedes. "Probably the main selling point was giving them input into our process." A medicine oversight admissions committee was created, Howell explains. Through monthly meetings, the primary departments continue to have input into the process, he adds.
"With that collaboration, they signed off on it, and ironically, now they love it," says Howell. "The cardiac intensive care unit, for example, which was one of most reluctant, has seen an increase in primary coronary infusions, and door-to-balloon times have gone down."
Edward Bessman, MD, FAAEM, FACEP, chairman of emergency medicine, says, "We made other changes at the same time, but we are now doing angio within 120 minutes 91% of the time, vs. 40% before we began. Our goal is to have 75% under 90; currently it's almost 60%."
It was a challenge to convince administration officials to invest about half a million dollars a year for 2.4 additional hospitalist FTEs required for a new plan for admitting patients from the ED at Johns Hopkins Bayview Medical Center in Baltimore. However, it was just as hard to convince some specialists to cede the responsibility for admitting patients to their units to a hospitalist, as the new plan required.Subscribe Now for Access
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