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Physician Update - Speeding up medical admissions

Physician Update Fall 2010

Speeding up medical admissions

By: Ramsey Flynn
Date: September 1, 2010

To get your patient quick attention, call ahead.

You’ve got a sick patient? Daniel Brotman wants you to send him or her right to the head of the line.

It’s natural for physicians to send patients to an emergency department when they need hospital care, says Brotman, who heads The Johns Hopkins Hospital’s hospitalist program. The rub, he says, is that EDs get crowded, physicians get harried, and often patients are telling their stories over and over again to many different providers. They may feel like they’re being passed around like a hot potato. 

Physicians can now change that, says Brotman, simply by calling ahead. “If you have a patient who might benefit from a medical admission at Hopkins,” says Brotman, “you should call HAL and ask for a hospitalist.”

As many physicians already know, “HAL” is short for the Hopkins Access Line, the 24-hour, seven-days-a-week physician-only phone number for consultations, referrals and patient transfers. Since April, says Brotman, Hopkins has begun providing community physicians with round-the-clock access to the hospitalist on call, who has the authority to smooth the way for patients in need of urgent attention.

When a referring physician asks for the Hopkins hospitalist, Brotman explains, in most cases the patient can bypass the ED altogether and instead can be directly admitted to the hospitalist service.

When ED triage is needed, a three-way conversation quickly unfolds between the primary physician, the emergency department and the admitting hospitalist. The result is a facilitated ED admission, says Brotman, in which all key parties know the inbound patient’s essential condition and are expecting that patient when he or she arrives. A full ED evaluation may not be needed at all once the patient is stabilized.

After the patient arrives, says Brotman, the covering hospitalist ensures a quick assessment. Even if a bed is not immediately available, he says, patients are cared for in a special holding unit until the appropriate bed becomes available.

Brotman encourages physicians to think of the enhanced program as one-stop-shopping for Internal Medicine admissions, and he isn’t shy of using other catch phrases normally consigned to the world of consumers. “We’re taking a ‘just-say-yes’ approach,” he says. “We’re striving to say yes on the first phone call. We’re getting patients in quickly, because it’s not safe to do otherwise.”

Please call 410-955-9444 in Baltimore; 1-800-765-5447 outside the region.

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