An obstetric hospitalist (Ob hospitalist or OB/GYN hospitalist) is an obstetrician and gynaecologist physician who is either employed by a hospital or a physician practice and whose duties include providing care for laboring patients and managing obstetric emergencies. Some Ob hospitalists also have responsibilities including resident and medical student teaching; providing backup support for family practitioners and nurse midwives, assisting private physicians with surgery, assuming care for Ob and Gyn unassigned patients and providing vacation coverage for the private practicing physician.[1]
The first known Ob hospitalist program started in 1989 at Alta Bates Medical Center in Berkeley, California. The number of Ob hospitalist programs has grown exponentially over the past several years, increasing from 61 known programs in 2009 to 194 programs in 2013.[2]
History
The term "hospitalist" was first used in a 1996 New England Journal of Medicine article by Robert Wachter and Lee Goldman[3]. They described a "new breed" of inpatient medical specialist who would be responsible for management of hospital patients. The hospitalists are typically physicians who spend more than 25% of their time caring for inpatients. They have the responsibility for a patient's in-hospital care, similar to the way that primary care physicians are responsible for outpatient care. Wachter & Goodman theorized that doctors who practiced inpatient medicine exclusively would provide care that was more efficient, of better quality, at a lower cost, and ultimately would provide better value for patients.
Since the mid-1990s, the hospitalist movement has experienced significant growth. In 2012, more than 30,000 hospitalists staffed 70% of the hospitals in the US[4]. Originally, the hospitalist community was primarily made up of general internists, family physicians and pediatricians. Specialty-care hospitalists soon followed, including neurologists (neurohospitalists), surgeons (surgicalists), psychiatric hospitalists, orthopedic hospitalists, dermatology hospitalists and obstetricians (termed laboriousts, Ob hospitalists or obgyn hospitalists).
The term laborioust was coined in an article written in 2002 by Louis Weinstein, MD in the American Journal of Obstetrics and Gynecology. Weinstein focused on the demands obstetricians face every day; from their offices, multiple telephone calls and patients in the hospital. In the article he wrote, "To improve the survivability and well-being of the obstetrician, I propose a new focus of practice for the practitioner, to be called the laborist. The laborist position is perfect for the individual who desires to practice obstetrics but who wishes to avoid the aspects of an office practice. This individual is available on the delivery floor to provide prompt, continuous, and efficient care to the laboring patient or to the patient who needs evaluation for an obstetric problem."[5]
In practice
The main function of the hospitalists is to intercede as needed to ensure patient safety and quality care in labor and delivery. This role involves coaching nurses and other staff members, answering questions for patients, families, nurses and physicians, triaging patients for private physicians, monitoring laboring patients, providing care as required and responding to precipitous deliveries and emergencies.
Ob hospitalist programs throughout the country have taken various forms; including programs where physicians on the medical staff voluntarily take 12 or 24 hour shifts to provide continuous coverage for their labor and delivery unit. One such program was developed in response to a hospital requirement that physicians be present during the first 30 minutes after an epidural has been placed. Relieving the medical staff of this responsibility, as well as having a physician present and available to respond to patient emergencies was a significant physician satisfier, and far outweighed the inconvenience of having to spend the night in the hospital once a month[6]. Other voluntary programs provide limited labor and delivery coverage during the hours of the day or night that historically have had the greatest volume of unattended deliveries or untoward patient outcomes because physicians are not present in the hospital. Some Ob hospitalist programs consist of hospital-employed physicians who staff labor and delivery 24 hours a day. Hospitals now have the option of setting up a group of hospitalists under contract or working with existing corporations that provide physician staffing in various specialties, including Ob hospitalists such as Questcare Partners, and TEAMHealth. Integrated Physician Services and OB Hospitalists Group exclusively provide Ob hospitalist staffing and program development.
Impact on patient care
In the traditional patient care model, nurses have been the front line on the labor and delivery unit with patients until the private physician arrives delivery. The physician communicates orders to the nurses when they are contacted about the patient usually via telephone. The nurse and physician generally discuss a plan of care and estimate a delivery time so the physician can come to the hospital in a timely manner. If a patient emergency occurs prior to the arrival of the physician the nurse is responsible for care of the patient. This has been the way most labor and delivery units have been managed since women began laboring and delivering in hospitals.
The arrival of the Ob hospitalists has changed this traditional pattern of care. In a hospital system with a full-time Ob hospitalist program an obstetrician is available in the hospital 24 hours a day. Ob hospitalist are in the unique position of having more experience with obstetrical emergencies than the average private obstetrician because they are present at most of the complicated or emergency cases. This experience increases the quality of the care they provide. In this new model pregnant patients have access to immediate obstetrical care, private obstetricians have an onsite partner who can offer second opinions and assistance with complicated or high risk cases. The hospital staff has a physician available to offer immediate support, education and patient care. The hospital administration has a tangible system in place that directly supports quality care and patient satisfaction.
Are You Looking for Products
Here some products related to "Obstetric Hospitalist".
* amzn.to is official short URL for Amazon.com, provided by Bitly
Get these at Amazon.com
Source of the article : here
EmoticonEmoticon