Statement from the NCH Board of Trustees on NCH's patient-centric hospitalist pilot program
'The NCH Board of Trustees participated in a regularly scheduled meeting Tuesday. During this meeting, we evaluated the latest results from the hospitalist pilot program, which continue to be favorable. This includes decreased hospital acquired conditions, lower 30-day readmission rates, shortened lengths of stay and improved patient satisfaction. We also met, while in executive session, with NCH staff members who work on the pilot floors to get first-hand feedback on the pilot operations. The feedback was positive. As a next step, NCH will seek objective / independent verification of the pilot results as part of the ongoing review of past and future results.
While the pilot continues, independent primary care doctors will continue to admit patients and oversee their care on the non-pilot units and partner in the care of the patient with the NCH hospitalist on the pilot units. NCH will continue to honor patients' requests to be admitted by their primary care physician to units not participating in the pilot, a practice that has been in place since the inception of the pilot program. The pilot project also does not impact the role of the specialist in caring for hospitalized patients.
NCH Healthcare System has served Naples for more than 60 years and its legacy is built on an unwavering commitment to our patients and our community. We understand that additional community engagement is crucial and NCH will work tirelessly to provide opportunities to engage in conversations with the community and independent physicians on the pilot program.'
-- Naples Community Hospital Board of Trustees
Frequently Asked Questions
How is NCH adjusting its approach to care to better serve its patients?
NCH is piloting a new patient-centered care model on a few of its inpatient units. In select units at Baker Hospital and our North Naples campus, patients are admitted by an NCH hospitalist – a board-certified NCH physician who is specifically trained to treat patients in a hospital and is physically located and dedicated to caring for the patients on that floor.
Within this hospitalist model, an NCH physician collaborates with each patient's primary care physician, and specialists if needed, during inpatient care. This model fosters the best outcomes and patient experience while at the hospital. It also improves continuum of care after a patient is discharged or returns home.
This care model mirrors the current approach seen in the ER, critical care, cardiac surgery and neonatal units, which feature a dedicated team with whom primary care physicians work collaboratively to support patients.
Can primary care physicians still participate in their patients' care?
Absolutely. This patient-centered care model complements the relationship between patients and primary care physicians. Physicians can see their patients in the hospital, review hospital records and test results, suggest procedures and consultants, and receive regular updates as well as a full report when their patients are discharged.
The on-site hospitalist, rather than the outpatient primary care physician, is responsible for writing notes and entering orders, taking into account advice from all members of the care team including your primary care physician.
The patient-centered care model does not – in spirit nor in practice – remove or replace the critical role of personal physicians in patient care. Instead, it helps restructure the approach to care in a way that allows all physicians and specialists to focus their efforts in a way that best benefits the patient.
This care model also does not change referral patterns; NCH is committed to referring all patients back to their primary care and specialist physicians, with a written summary of their hospitalization when they are discharged from the hospital.
Has anything changed with specialists, such as cardiologists, surgeons and orthopedic doctors?
No. Cardiologists, pulmonologists, gastroenterologists, surgeons, orthopedists, obstetricians and other specialist physicians can continue to participate in patient care exactly as they have in the past.
Why is NCH doing this pilot project?
Our exemplary ratings from CMS are a reflection of our ongoing commitment to quality and the superior outcomes we have delivered to patients throughout our facilities.
Central to our relentless pursuit of excellence is our willingness to innovate and explore new ways to improve the patient experience. In the summer of 2018, we chose to pilot a unit-based hospitalist model of care based on the success of other nationally renowned systems – including UCLA Medical Center, University of Cincinnati Medical Center and Brigham and Women's Hospital.
Based on the results we saw during our pilot of the unit-based, patient-centered care model, we determined that it was in the best interest of our patients to not only continue this approach, but expand it to other units in order to bring the best of our system to every patient in our care.
Is NCH adopting this model to save money?
The hospitalist model was not chosen as a cost-savings measure for NCH, and it is too early to predict how it will affect our organization's bottom line. We chose to pilot this program because we believe it will benefit our patients by improving integration of care as well as reducing length of hospitalizations and related complications.
What are the initial results?
The pilot project has been in place on 4N at the Baker Hospital since June 2018 and on 4E at the North Naples campus since August 2018. Through our pilot, we have seen decreased hospital-acquired conditions, reduced the average length of stay, reduced readmission rates, and increased patient satisfaction.
What is the plan going forward?
Based on these initial results, we have determined that it is in the best interest of our patients to continue this approach.
We will continue to refine and improve the care model and will be transparent with the results and metrics. Baker Hospital reopened 3N in early November as the academic unit for our expanding Graduate Medical Education program. This unit will follow the same care model as the pilot project, with all of the patients managed by the NCH-employed Academic Resident Service and our Academic Hospitalist team.
If these results continue, we plan to roll out this new care model to additional units over time in a structured manner.