8) Define inpatient vs. outpatient management: Differentiate between important inpatient workup and evaluation that can be performed on an outpatient basis to save time and reduce length of stay. When patients can safely leave the hospital to continue work-ups and follow-ups with their primary care providers and specialists, you gain more time the following day—when you are no longer rounding on them.
9) Schedule a time to see family members: Conversations with family members are usually more productive if those times are scheduled. If possible, schedule them after you have seen a bulk of your patients to avoid feeling pressured to cut the meeting short. It is important to know who the family spokesperson is for large families so you can refer other family members to them and avoid multiple call-backs.
10) Develop and maintain good relationships: Your cordial interaction with various hospital department staff (nursing, case management, social work, radiology, and physical therapy to name a few) will help facilitate the inpatient care plan. It certainly helps not to have to wait two or more days to have a diagnostic test performed or assessment made. Sustaining a healthy working relationship promotes an understanding of your expectations for inpatient care.
11) Advocate for constructive change: Much inefficiency is systems based. Thinking about what interferes with your effectiveness in your system and suggesting changes can help a lot. For example, if your institution is going to switch to an electronic medical record, it certainly helps for you or a member of your hospitalist team to get involved in the implementation. Many hospitals are invested in quality improvement—and hospitalists are and should be at the forefront of this change.
As a hospitalist, you can initiate changes within your practice and your hospital’s system to keep things efficient. Making those adjustments sometimes takes time—but they’re well worth the effort.
Meanwhile, maximizing your efficiency can help promote patient throughput, enhance patient satisfaction, improve quality of care and increase job satisfaction. TH
Dr. Magnet is a hospitalist at the Singing River Hospital System on the Gulf Coast of Mississippi and a member of SHM’s Young Physician Committee.