Note exactly everyone involved in co-management, points out this point: get everything in writing. At least, says Dr. Stalzer of Augusta Health, « we want nurses not to call one person all the time » – usually the hospital doctor – « just because hospital doctors are more easily accessible and easier to manage. » Writing the responsibility of each department « allows us not to feel like a jolt when we tell nurses that postop pain is something for which they should call the surgeon. On the other hand, we`re going to manage diabetes, so call us. She noted that hospital doctors thought that specialists used to not react when they were called to a co-worker because they were too busy and wanted to do all their work. In fact, at the time, these patients were not on the list of specialists with a new GI. But even in the face of these harsh feelings, hospital doctors say there are ways to improve co-management. They point out that programs like Dr. Camphor are Georgia`s leaders. The SHM white paper proposes a checklist containing important issues that need to be addressed when developing a co-management agreement.
Among the topics discussed are the identification of champions on both sides of cooperation as well as hospital administration, which is an essential third. In UNC hospitals, a formal and written agreement describes a clear division of responsibilities between hospital medicine and orthopedic surgery. The provision focuses on the management of patients with hip fractures, said Dr. Liles. The « rules of engagement, » which should be defined in a written agreement on services, include clarifying a common vision, mutual objectives and expectations, and the promise of value identified for both parties under the agreement. Appropriate patients should be defined, as well as what happens at night and on weekends, the channels of administration and communication, and how conflicts are handled. In light of this recent announcement, there are five things you should know about co-management agreements. ACCORDING At the current Hospitalist Compensation – Career Survey 2019, 84% of hospital respondents said they were involving patients with specialists – and that they felt comfortable most of the time in the care of non-medical patients. Exceptions? Psychiatry and neurosurgery. While only 63% said they were comfortable managing neurosurgery patients, they were even fewer (46%) reports that he may inquire about a comfortable co-management with psychiatry. Nor could he let surgeons engage out of the hook for prosecution with patients once the operation was performed, and he could not exceed the limits of the scope of the practice.
Then intensive negotiations began for a written co-management agreement. Reciprocal Discomfort During these meetings, Dr. Usman says he expects « complaints from hospital doctors whether they are knocked down or surgeons don`t come and see their patients in time. » Surgeons have often heard him say that hospital doctors don`t know enough about postop care, or « they`re not fast enough for my patients. » « You should never expect the other group to do anything. It must be defined and discussed in the agreement, » he said. « For example, in patients with hip fractures, we know that some things are critical, such as the timing of the operation. B, proper prophylaxis and timing of the elimination of the Foley catheter. We are very specific about the team responsible for each of these steps. The Society of Hospital Medicine has resources to help, said Dr. Atchley. The SHM website contains a white paper on co-management.
There is also a list called HMS Exchange, in which hospital doctors can discuss co-management topics. Surgical Co-Management by Hospitalists Improves Patient Outcomes Hospital physicians have also committed to developing their knowledge of neurocritical care. Their new interdisciplinary intracranial group – neurosurgery,