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Hospital Medicine > Introduction to Hospital Medicine > Flashcards

Introduction to Hospital Medicine Flashcards

1
Q

how did the importance of hospital medicine arise?

A
  • grew out of the increasing complexity of patients requiring hospital care and the need for dedicated clinicians to oversee their management
  • The hospitalist model supplanted the traditional method of caring for hospitalized patients
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2
Q

what is patient-centered care?

via Institute of Medicine

A

care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions

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3
Q

differences between hospital/clinician-centric model vs patient centric model?

A
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4
Q

what are the 2 components of patient-centered care?

A
  1. patient experience
  2. patient engagement
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5
Q

what is patient experience?

A

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

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6
Q

For hospitals, the MC measurement method for pt satisfaction is ?

A

HCAHPS survey

Hospital Consumer Assessment of Healthcare Providers and Systems

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7
Q

what is value based purchasing?

A

Medicare reimbursements are tied, in part, to pt satisfaction portion of survey

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8
Q

what are the components of HCAHPS

A
  1. pain management
  2. communication with doctors
  3. communications about meds
  4. communication with nurses
  5. cleanliness and quietness and hospital environment
  6. responsiveness of hospital staff
  7. DC info
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9
Q

what is patient engagement?

A

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

  • Occurs when pts feel empowered to move to a state of active participation and self-efficacy in managing their health.
  • Engaged pts have better health outcomes, incur less costs, and enjoy greatest value (quality/cost) from health care system.
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10
Q

how can we improve patient engagement?

A

Customize care plan development by considering:

  • Literacy Level
  • Readiness to Learn
  • Readiness to Change
  • Learning Style
  • Family Dynamics
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11
Q

what are the components for high-quality patient centered communication

A
  1. biopsychosocial perspective
  2. patient as a person
  3. sharing power and responsibility
  4. therapeutic alliance
  5. provider as a person
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12
Q

hgih-quality patient-centered communication can lead to what two outcomes?

A
  1. patient outcomes
    - increased satisfaction
    - decreased anxiety/pain
    - improved decision making
  2. familty outcomes
    - increased satisfaction
    - decreased anxiety and PTSD
    - improved decision making
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13
Q

what are hospitalists?

A

physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine.

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14
Q

medical consultation is used when?

A

another provider is needed to provide optimal care for a patient

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15
Q

role of a consultant

A

give recommendations, not to become the primary provider

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16
Q

Principles of Ethical Consultation

A
  1. Indicated In Complex Cases to Enhance the Quality of Medical Care
  2. Case Summary should be provided to Consultant
  3. 1 physician in Charge of Patient/Attending Has Overall Responsibility
  4. Consultation Should Be Completed Punctually
17
Q

how to perform effective consultation

A
  1. Determine The Question
  2. Look For Yourself
  3. Establish Urgency
  4. Be As Brief As Appropriate
  5. Be Specific and Concise
  6. Provide Contingency Plans
  7. Honor Thy Turf
  8. Teach With Tact
  9. Talk Is Cheap And Effective
  10. Follow-Up
18
Q

what is co-management?

A

The Shared Responsibility, Authority and Accountability for Care of the Hospitalized Patient.

19
Q

The Co-management of Patients Between ___ and ____ has Become a Mainstay of Hospital Medicine.

A

Surgeons and Hospitalists

20
Q

differences between the two models of co-management

A
  1. first model - assigns the hospitalist as the pt’s primary attending, utilizing the subspecialist as a consultant.
  2. second model - assigns hospitalist to serve as a consultant to pt while subspecialist is patient’s primary attending.
21
Q

differences between traditional consults vs co-management?

A

Traditional

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

co-management

  • Shared responsibility
  • Medical/Surgical consultant treats primary medical problems
  • Broader issues – other conditions
  • Consultant writes orders
  • Daily follow-up until discharge
22
Q

what is the key to success?

components of team-based care

A
  1. mutual respect
  2. effective communication
  3. common goals and plan
  4. accountability

Hospital Medicine (3 decks)

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