How is NCH adjusting its approach to care to better serve its patients?
NCH is piloting a new unit-based hospitalist 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 the 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 unit-based hospitalist 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 hospitalist 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 approach 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 the first phase of our pilot, we determined that it was in the best interest of our patients to not only continue testing this approach, but expand it to other pilot units.
Is NCH adopting this model to save money by prioritizing its physicians?
The pilot was not implemented 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 conduct this pilot because we believe it will benefit our patients by improving care while in the hospital, including length of stay and related complications.
Are patients required to participate in the pilot?
Patients can opt to be admitted to a pilot unit or a non-pilot unit. Based on bed availability, NCH will do its best to accommodate all requests.
What are the initial results?
The pilot has been in place on 4N at the Baker Hospital since June 2018 and on 4E at the North Naples campus since August 2018. Baker Hospital reopened 3N in early November as the academic unit for our expanding Graduate Medical Education program and has implemented the pilot.
Through our pilot, we have seen decreased hospital-acquired conditions, reduced the average length of stay, reduced readmission rates, and increased patient satisfaction.
We are pleased with the results we have seen to date, but want to ensure our community members also feel confident in the benefits the unit-based hospital model has shown. NCH will be seeking an independent review of the pilot’s results by a third-party and will communicate the findings to the community as soon as they are available.
What is the plan going forward?
Based on these positive initial results, we have determined that it is in the best interest of our patients to continue this pilot.
We will continue to refine and improve the care approach and will be transparent with the results and metrics.
Is this the first step to a closed system at NCH?
This remains a pilot and it is important that we continue analyzing its progress, refining the approach to deliver the best results possible, and consider the community’s feedback.
The constantly changing medical industry demands that we constantly innovate and evolve to better serve our patients – guided by best practices and nationally renowned models.
NCH has always – and will continue to – be committed to fostering collaboration among all those we partner with to provide the highest quality of care. The pilot does not obstruct the participation of primary care or personal physicians. Instead, it promotes integrated care by collaborating with the entire care team, including hospitalists, during their patients’ hospitalization.
Why have I only heard about this pilot in the last few weeks when it has been in progress since June?
NCH is committed to communicating transparently with patients, healthcare providers and our entire community. Implementing new processes and approaches to improve patient care are a part of what we do every day.
The pilot is not a hospital-wide model and we did not expect the reaction we have received from the community.
We understand the importance of real time information and we are committed to sharing updates as we refine and evaluate the pilot. We welcome questions and you may contact us here.