Published in the April 2016 issue of Today’s Hospitalist
When it comes to direct admissions, hospitalists face some difficult choices. Our cover story looks at some of those options—and examines whether the experience of hospitalists might get in the way of their efforts to improve direct admissions.
As our coverage points out, hospitalists are grappling with direct admissions for very good reasons. They understandably worry that direct admissions can be an accident waiting to happen. Patients who bypass the ED and then languish on the wards waiting to see an attending can get into trouble that could have been averted by more immediate attention from an ED physician.
And because data show that the number of direct admissions in U.S. hospitals is falling, some sources we spoke with wondered what role hospitalists have played in that trend.
In fact, the relative youth of the specialty means that many of its doctors have little to no experience working in outpatient care. As a result, they may not appreciate why outpatient physicians ask that patients be admitted directly.
The good news is that hospitalists are reshaping direct admissions, developing systems to make it easier for outpatient physicians to make such requests. They understand that appropriate direct admissions can reduce those patients’ length of stay and costs.
But hospitalists are also making the most of their inpatient experience to put necessary safeguards in place. Because they know how quickly patients can deteriorate, hospitalists are creating guidelines that note how recently patients must have been evaluated by their outpatient physician to be eligible for a direct admission. Guidelines also designate which symptoms and conditions aren’t appropriate.
It turns out that direct admissions are another health care transition that needs to be standardized and better coordinated. As our coverage points out, hospitalists are in the thick of those efforts.
Editor & Publisher