Implementing a Hospitalist Program in a Critical Access Hospital

Dougan, Brian; Montori, Víctor M.; Carlson, Kurt W.

doi:10.1111/jrh.12190

Cited by 6 publications

(6 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Past efforts to integrate academic hospitalists into CAHs improved quality metrics and provider satisfaction but were economically infeasible due to low patient volumes. 22 In contrast, virtual providers can distribute their efforts across multiple areas, including covering additional CAHs, providing local patient care at their home facility, or completing academic projects. By combining two or more CAHs into a single provider, sufficient patient volume can be generated to dedicated personnel.…”

Section: Discussionmentioning

confidence: 99%

The Virtual Hospitalist: A Single‐Site Implementation Bringing Hospitalist Coverage to Critical Access Hospitals

Kuperman

Linson

Klefstad

et al. 2018

Journal of Hospital Medicine

View full text Add to dashboard Cite

BACKGROUND On‐site hospitalist care can improve patient care, but it is economically infeasible for small critical access hospitals (CAHs). A telemedicine “virtual hospitalist” may expand CAH capabilities at a fractional cost of an on‐site provider. OBJECTIVE To evaluate the impact of a virtual hospitalist on transfers from a CAH to outside hospitals. DESIGN, SETTING, AND PARTICIPANTS A six‐month pilot program providing “virtual hospitalist” coverage to patients at a CAH in rural Iowa. MEASUREMENTS The primary outcome was the rate of outside transfers from the CAH Emergency Department (ED). The secondary outcomes included transfer from either the ED or the inpatient wards, daily census, length of stay, transfers after admission, virtual hospitalist time commitment, and patient and staff satisfaction. The preceding 24‐week baseline was compared with 24 weeks after implementation, excluding a two‐week transition period. RESULTS At baseline, there were 947 ED visits and 176 combined inpatient and observation encounters, compared to 930 and 176 after implementation, respectively. Outside transfers from the ED decreased from 16.6% to 10.5% (157/947 to 98/930, P < .001), and transfers at any time decreased from 17.3% to 11.9% (164/947 to 111/930, P < .001). Daily census, length of stay, and transfers after admission were unchanged. Time commitment for a virtual hospitalist was 35 minutes per patient per day. The intervention was well received by the CAH staff and patients. CONCLUSIONS The virtual hospitalist model increased the percentage of ED patients who could safely receive their care locally. A single virtual hospitalist may be able to cover multiple CAHs simultaneously.

show abstract

Section: Discussionmentioning

confidence: 99%

The Virtual Hospitalist: A Single‐Site Implementation Bringing Hospitalist Coverage to Critical Access Hospitals

Kuperman

Linson

Klefstad

et al. 2018

Journal of Hospital Medicine

View full text Add to dashboard Cite

show abstract

“…The trend indicates that hospitals build in areas that are more numerous and more densely populated. This situation means that populations living in disadvantaged, peripheral, and island regions have low access to hospitals 7,17 . Figure 3 is a scatter plot between the poverty depth index and the percentage of households easily accessible to the hospital in Indonesia.…”

Section: Resultsmentioning

confidence: 99%

Hospital Accessibility in Indonesia

Nantabah,

Effendi,

Agustina

et al. 2021

MLU

View full text Add to dashboard Cite

The government's task is to ensure easy access for the public to the health facilities needed. The study aimed at analyzing ecologically the factors related to the accessibility of hospitals in Indonesia. The ecological analysis conducted using secondary data from the Ministry of Health of the Republic of Indonesia report in 2018. The study takes all provincesas samples. Apart from households easily accessible to the hospital, five other variables analyzed as independent variables were total population, population density, poverty depth index, poverty severity, and population percentage completing primary education. Data were analyzed using a scatter plot. The study results found that the higher the total population in a province, the higher the percentage of households easily accessible to the hospital in that province.Thehigher the population density in an area, the higher the percentage of households access to the hospital in that area.On the other hand, the higher the poverty depth index in a region, the lower the percentage of households easily accessible to the hospital in that province. Moreover, the higher the poverty severity index in a region, the lower the percentage of households easily accessible to the hospital in that region. Finally, the higher the percentage of the population completing primary education in a province, the higher the percentage of households easily accessible to the hospital in that province. It concluded that five independent variables were analyzed related to the accessibility of hospitals in Indonesia.

show abstract

“…Sementara itu di Vietnam juga ditemukan bahwa ketidaktahuan petugas kesehatan tentang sistem administrasi dan sistem pelayanan kesehatan berdampak pada lemahnya pelayanan yang diberikan (Kien et al, 2018). Proses penyampaian informasi oleh petugas di fasilitas pelayanan kesehatan dikonfirmasi juga turut berkontribusi terhadap kualitas pelayanan dan kepuasan pelanggan (Dougan, Montori, & Carlson, 2018). Hasil penelitian di Malawi bahkan menyatakan bahwa masyarakat bersedia membayar 1,8 dan 2,4 kali lebih banyak untuk salah satu faktornya adalah sikap positif dari petugas kesehatan (Lungu et al, 2018).…”

Section: Pembahasanunclassified

Perspektif Masyarakat Tentang Akses Pelayanan Kesehatan

Megatsari

Laksono²,

Ridlo³

et al. 2019

hsr

View full text Add to dashboard Cite

Access to health services is often seen only from the provider perspective, while from the community side as a user is less noticed. Improving the quality of health services access requires a complete perspective on two diff erent sides. This research is designed descriptively qualitative. Data were collected by Focus Group Discussion (FGD), in-depth interview and observation. The research was conducted in Malang Regency in June-August 2018. The study results showed health services access generally the community believes that there are still perceived defi ciencies. Especially on the aspect of physical access, due to poor facilities and infrastructure. In addition, social access was also considered inadequate, because there were still health workers who served with less friendly. This study concludes that people still feel access to physical and social aspects is still diffi cult. It should be recommended to the local government for eff orts to improve physical access, and the Health Offi ce to disseminate health information about the rights of patients to the community. Abstrak Akses pelayanan kesehatan seringkali dilihat hanya dari perspektif pemberi pelayanan saja, sementara akses dari sisi masyarakat sebagai pengguna kurang terperhatikan. Perbaikan kualitas pelayanan kesehatan dari sisi akses memerlukan perspektif yang lengkap dari dua sisi yang berbeda. Penelitian ini didesain secara deskriptif kualitatif. Data dikumpulkan dengan Focus Group Discussion (FGD), wawancara mendalam dan pengamatan. Penelitian dilakukan di Kabupaten Malang pada bulan Juni–Agustus 2018. Hasil penelitian menunjukkan aksesibilitas pelayanan kesehatan yang ada, secara umum masyarakat berpendapat bahwa masih ada kekurangan yang dirasakan. Terutama pada aspek akses secara fisik, dikarenakan sarana dan prasarana yang kurang baik. Selain itu akses secara sosial juga dirasa kurang, karena masih ada tenaga kesehatan yang melayani dengan kurang ramah. Penelitian ini menyimpulkan bahwa masyarakat masih merasa akses dari aspek fisik dan sosial masih sulit. Perlu direkomendasikan pada pemerintah daerah setempat untuk upayaperbaikan akses secara fi sik, dan Dinkes untuk mendiseminasikan informasi kesehatan mengenai hak pasien kepada masyarakat.

show abstract

Implementing a Hospitalist Program in a Critical Access Hospital

Cited by 6 publications

References 11 publications

The Virtual Hospitalist: A Single‐Site Implementation Bringing Hospitalist Coverage to Critical Access Hospitals

The Virtual Hospitalist: A Single‐Site Implementation Bringing Hospitalist Coverage to Critical Access Hospitals

Hospital Accessibility in Indonesia

Perspektif Masyarakat Tentang Akses Pelayanan Kesehatan

Contact Info

Product

Resources

About