All hospitals need to make continuous improvements for patients. Those at the frontlines of patient care, including physicians, are best suited to contribute to process improvement. We all recognize that eliciting changes that make the hospital run more efficiently can help physicians enhance patient care and help save a physician’s time.
The Medical Staff and Medical Board at New York Hospital Queens agree that despite mounting physician pressures (less time for patients, increased patient needs, waning reimbursement), our physicians’ integration in the improvement process is critical to patient care and efficiency. Here are examples of several successful changes resulting from integration and collaboration:
Formalized communication program in the Emergency Room. William Wolff, M.D., chairman, the NYHQ Medical Board; Jack Mann, M.D., president, the NYHQ Medical Staff Society and members of the medical staff worked with the Emergency Department to improve communication. The team of physicians identified that there needed to be an improved process for contacting the physicians of patients who were being treated in the Emergency Room. In collaboration with the Emergency Department, Admitting Team and Hospitalist Service, our physicians facilitated a formal way to track patients and liaise with community-based physicians about patient status. The ED Communication desk is accessible 24 hours, seven days a week at (718) 670-1100.
Restructured Hospitalist Service. The Medical Staff Society, along with the Medical Board and the Department of Medicine, called for an upgrade of the Hospitalist Service. Through the new Hospitalist Service, a community-based physician can refer a patient to the hospitalist program by either writing a prescription that states their patient is to be admitted to the Hospitalist Service or by calling (888) 219-9141 at any time, day, night, weekend or holiday. The referring physician will receive a discharge summary that includes the patient’s course of treatment, test results, a discharge medication list, and recommendations given to the patient for a post discharge visit with the referring physician.
Redesign of the Patient Flow Process. Reduction of a patient’s length of stay is most often dependent upon the attending physicians, residents and physician’s assistants starting to plan for a patient’s discharge as soon as a patient is admitted. David Rose, M.D., chairman, Medicine, plans to increase medical staffing levels at the bedside, which should lead to physician interaction earlier in a patient’s admission. Dr. Rose has planning sessions scheduled with the Medical Staff Society and Medical Board to discuss this process and listen to suggestions. Following those meetings and based on recommendations, the plan is to roll out the new process later this year.
We invite our physicians’ suggestions for improvement. To discuss any of these initiatives, please contact Dr. Wolff at (718) 670-2522; Dr. Mann at (718) 670-1419; Dr. Rose at (718) 670-1070, or Stephen Rimar, M.D., senior vice president and chief medical officer, at (718) 670-1549.
Stephen S. Mills, F.A.C.H.E.