Page 48 - Hospitalists - Risks When You're the Doctor in the House (Part One)

SVMIC Hospitalists - Risks When You’re the Doctor in the House

If the patient was referred to the hospitalist by another physician

such as a PCP or specialist, the hospitalist must be sure to
notify the referring physician of the refusal of consent.

Communicating with Other Providers

Physician-to-provider breakdowns are common in malpractice

claims, and deficiencies in communication relating to transitions
of care are special concerns for hospitalists. Mistakes made

when a physician is handing off care to another physician are
often called the “Achilles’ heel” of hospital medicine, and for

good reason. Unique risks associated with the discontinuities
inherent in the hospitalist model can happen on admission,

during hospitalization (where a number of hospitalists may care
for one patient), and on discharge. From the admission through

discharge, though, it is the hospitalist who takes on the role and
responsibility of patient care provider, coordinator of care, and

chief communicator.

Research has demonstrated that communication breakdowns

affecting both patient safety and quality of care are more likely

to occur at transition points and in emergency situations. A
transition point is one in which the patient is moved from one
care setting to another, or from the responsibility of one provider

to another. Communication problems tend to happen more often

when there are more providers and care settings involved in a
patient’s care, and there is an increase in the complexity and
variety of systems in use. The more complex a patient’s clinical

picture, the more likely it is that the specialists and ancillary care

providers will be involved in that patient’s care. This may result
in more transition points, and, unfortunately, more opportunities
for communication breakdown, medical errors, and patient

harm.

Page 48