“The last question is, “Do you know your rate of improvement over time?” And again, most people think that they’re getting better much more quickly than they actually are,” Bisognano says. “Walking them through these four questions is often a provocative assessment for them, and it does help them speed up the velocity of improvement in their organization.”
It’s a checklist that attendees may take back to their institutions, or it may just revitalize them to view things in a different way. Either way works for Bisognano, as she sees hospitalists playing a key role in healthcare reform. In particular, she’s impressed with hospitalists leading multi-disciplinary rounds where they can develop strong relationships with nursing, therapists, and others in the care continuum.
“When clinicians are running, specialists are running in and out and they’re looking at a specific piece of data. What I find is if they don’t get an answer immediately, they often order another test,” Bisognano says. “That kind of perpetual ordering of tests delays discharge, and it oftentimes doesn’t get to a diagnosis. But I think the hospitalist takes this more total view of the patient and often has the time to sit and make a decision that doesn’t involve testing repeatedly, but gets to a diagnosis more quickly.”
Richard Quinn is a freelance writer in New Jersey.