The first year of a Winneshiek Medical Center pilot program has been a positive experience.
At last week's meeting of the WMC Board of Trustees, Dr. Brian Dougan briefed the Board on how the first year of the Medical Center's hospitalist pilot program fared.
Hospitalist, a term coined in 1996, refers to a hospital-based general physician who cares for hospitalized patients in place of the patient's primary-care physician. In 1996, there were about 1,000 hospitalists in the United States. Today that number has grown to around 30,000.
Findings
Dougan said in addition to having a positive bottom line of around $72,000, the program has seen other benefits as well.
"We've seen a decrease in emergency room transfers (to other facilities) of 15 percent, a decrease in patient length of stays and an increase in observation stays by 65 percent," said Dougan.
Dougan said while data showed no significant change in patient satisfaction, which was already high at 88 percent, patients did indicate they were happier with discharge timing as a result of the hospitalist being more available throughout the day.
Staff satisfaction
In addition, Dougan said he was extremely pleased with some of the staff impressions and cited several areas where the staff had indicated greater job satisfaction since the inception of the hospitalist program at WMC.
According to Dougan, 100 percent of inpatient nurses said they were happy with communication about a patient's condition and treatment from physicians. That's up from just 39 percent prior to the development of the program.
Inpatient nurses also were unanimous in their satisfaction with the coordination of the patient discharge process, up from just 46 percent previously. As a result, 100 percent of the nurses polled said they felt the amount of work they have to do "is reasonable."
They believe the hospitalist program will benefit patient care at WMC, and they feel the overall quality of care at WMC is excellent.
Other perks
Dougan said all of the primary-care physicians he spoke with said they felt the program should continue and that it has been well received by the emergency room staff.
"It definitely has helped the workflow within the emergency room. There is not as much wait time," said Dougan.
Other changes Dougan said had happened as a result of the evolving hospitalist model included moving patient-care conferences to the patient's bedside .
"It's (the program) also been well-received by other staff, such as respiratory and pharmacy. And there's definitely a greater opportunity for education (among the staff) and more access to physicians," he said.
Future plans
Dougan said while the doctors involved in the program have worked hard to make it successful, no one has indicated burn-out from the program.
"We're in the process of recruiting some part-time hospitalists. We'd like to have six physicians, amounting to four full-time and two part-time positions," he said.
"Since it is a bigger time commitment for doctors, it's definitely good that there was an overall financial benefit. When we started this program, we knew if it didn't carry its own weight this wasn't the time to take on a program losing a bunch of money," said Dougan.
Following Dougan's presentation, Gundersen Lutheran - Decorah Clinic Manager Trudy Belay said she wanted to make sure the public understands that Gundersen physicians do continue to care for a significant number of patients within the Medical Center.
Chief Operating Officer Dave Jordahl next thanked Trustee Don Nelson for advocating for the program originally.
"Dr. Dougan and his colleagues have done an exceptional job of formulating it in a way that is possible. I don't think there are too many hospitals this size that have any program like this," said Nelson.
