Abstract
BackgroundDespite the growing prevalence of hospitalist programs in Canada, it is not clear what program features are deemed desirable by administrative and medical leaders who oversee them. We aimed to understand perceptions of a wide range of healthcare administrators and frontline providers about the implementation and necessary characteristics of a hospitalist service.MethodsWe conducted semi-structured interviews with a range of administrators, medical leaders and frontline providers across three hospital sites operated by an integrated health system in British Columbia, Canada.ResultsMost interviewees identified the hospitalist model as the ideal inpatient care service line, but identified a number of challenges. Interviewees identified the necessary features of an ideal hospitalist service to include considerations for program design, care and non-clinical processes, and alignment between workload and physician staffing. They also identified continuity of care as an important challenge, and underlined the importance of communication as an important enabler of implementation of a new hospitalist service.ConclusionsMost hospital administrators and frontline providers in our study believed the hospitalist model resulted in improvements in clinical processes and work environment.
Highlights
Despite the growing prevalence of hospitalist programs in Canada, it is not clear what program features are deemed desirable by administrative and medical leaders who oversee them
The ideal inpatient care model At all three sites, the introduction of the hospital medicine service was a great departure from the historical inpatient care model where community-based family physicians provided Most Responsible Providers (MRP) care to hospitalised patients
The majority of hospital administrators and front line professionals interviewed at three facilities with newly implemented hospitalist services within our regional health system identified the hospitalist model as the ideal inpatient care delivery mechanism
Summary
Despite the growing prevalence of hospitalist programs in Canada, it is not clear what program features are deemed desirable by administrative and medical leaders who oversee them. In Canada, the prevalence of patients with multimorbidity is estimated to be between 10 and 25% and has been increasing. [2] Patients with multi-morbidity utilize higher levels of healthcare resources, including hospitalizations [3, 4]. In the United States and Canada, meeting the care demands for an increasingly older and complex population coincides with concurrent constraints on available resources (such as acute care beds, qualified healthcare professionals, and funding to support increasingly complex technologies) [9]. Studies in the United States (US) have shown widespread acceptance of the hospitalist model among hospital administrators [17, 18]
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