Introduction to Hospital Medicine

Question 1

What is hospital medicine?

Answer 1

• Care for hospitalized patients
• Dedicated clinicians for complex hospital patients

Question 2

What is patient centered care?

Answer 2

• Respectful, responsive care
• based on individual patient preferences, needs, and values, and ensures patient values guide clinical decisions

Question 3

What are benefits of a patient centric model?

Answer 3

• Integrated system
• Evidence based
• Patient and family participate in care plan
• Free and transparent info
• Open communication and full disclosure
• Respond to individual needs, cultural competency
• Shared decision making

Question 4

What are the 2 components of patient-centered care?

Answer 4

Patient experience and patient engagement

Question 5

The sum of all interactions that influence patient perceptions across a continuum of care and is measured by patient surveys

Answer 5

Patient experience

Question 6

What is the most common measurement method for patient satisfaction in hospitals?

Answer 6

HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems)

Question 7

How is patient experience linked to reimbursement?

Answer 7

Medicare reimbursements are based on value based purchasing and are tied to patient satisfaction

Question 8

What are components of HCAHPS?

Answer 8

• Discharge information
• Pain management
• Communication with doctors
• Communication about medicines
• Communication with nurses
• Cleanliness and quietness of hospital environment
• Responsiveness of hospital staff

Question 9

Actions taken by individuals to obtain the greatest benefit from the health care services available to them

Answer 9

Patient engagement

Question 10

When does patient engagement occur?

Answer 10

When patients are empowered to actively participate and be self-efficacious

Question 11

What are benefits of patient engagement?

Answer 11

Better health outcomes, less cost, and greatest value

Question 12

What should we consider when customizing a care plan?

Answer 12

• Literacy level
• Readiness to learn
• Readiness to change
• Learning style
• Family dynamics

Question 13

What are hospitalists?

Answer 13

• Physicians who focus on medical care of hospitalized patient
• Patient care, teaching, research and leadership are roles

Question 14

What is a consultant?

Answer 14

• Other provider needed to provide optimal care
• Role to give recommendations, not become primary provider

Question 15

What are principles of ethical consultation?

Answer 15

• Indicated in complex cases to enhance quality of medical care
• Case summary should be provided to consultant
• 1 physician in charge of patient/attending has overall responsibility
• Consultation should be punctual

Question 16

How do you perform an effective consultation?

Answer 16

• Determine the question
• Look for yourself
• Establish urgency
• Be as brief as appropriate
• Be specific and concise
• Provide contingency plans
• Honory thy turf
• Teach with tact
• Talk is cheap and effective
• Follow up

Question 17

What is co-management?

Answer 17

• Shared responsibility, authority, and accountability for care of the hospitalized patient
• Often between surgeons and hospitalists
• Providers function within scope of practice

Question 18

What are the benefits of co-management?

Answer 18

• Collaborative
• Can lead to decreased length of stay and decreased complication rates

Question 19

What are the 2 models of co-management?

Answer 19

• Hospitalist as primary attending, subspecialist at consultant
• Hospitalist as consultant while subspecialist is primary attending

Question 20

What must exist with co-management to prevent inconsistent expectations or misinterpretation?

Answer 20

Clearly defined structure and excellent communication

Question 21

What are components of traditional consult?

Answer 21

• Requesting physician in charge
• Requesting physician treats primary medical problems
• Specific question addressed
• Consultant does not write orders
• Limited follow-up as needed

Question 22

What are components of co-management?

Answer 22

• Shared responsibility
• Medical/surgical consultant treats primary medical problems
• Broader issues- other conditions
• Consultant writes orders
• Daily follow-up until discharge

Question 23

What are components of team based care?

Answer 23

• Mutual respect
• Accountability
• Effective communication
• Common goals and plans