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Hospitalist Versus Subspecialist Perspectives on Reasons, Timing, and Impact of Consultation.
J Healthc Qual. 2017 Mar 24;:
Authors: Pacitti K, Mathew A, Royse A, Elliott JO, Jordan K
Abstract
BACKGROUND: Hospitalists frequently consult medical subspecialists in the management of inpatients. Given the potential impact on health resource utilization, it is important to understand the working relationship between these groups.
METHODS: A cross-sectional survey of hospitalists, n = 655, and subspecialists across Ohio (nephrologists and endocrinologists), n = 293, was conducted to investigate perceptions and communication about reasons, timing, and impact of hospital consultations.
RESULTS: Survey response rate was 13.3%. Hospitalists were more likely to report subspecialty request to serve as admitting physician with subsequent consultation 63.2% versus 26.7%, p < .001. Hospitalists with a daily workload ≥15 patients per day were more likely to report that this impeded their ability to manage details of patient care versus hospitalists with <15 patients per day, 53.2% versus 24.1%, p = .02, and resulted in subspecialty consultation for problems manageable by the hospitalist, 38.3% versus 6.9%, p = .003. Hospitalists were less likely than subspecialists to report major impact from consultation 50.0% versus 81.0%, p = .001 and they were more likely to report direct communication for urgent consults 97.3% versus 48.8%, p < .001.
CONCLUSIONS: Future work should be aimed at addressing hospitalist workload, improving communication, and ensuring appropriate need and timing of consultation.
PMID: 28346245 [PubMed - as supplied by publisher]