01:56pm Monday 23 September 2019

Hospitalist model at University Hospital of Navarra enhances results in seriously ill patients with multiple pathologies

his is the only research undertaken in Spain on the efficiency of the health care provided by a unit of hospital doctors in an area of critically ill patients.

“Although it is difficult to evaluate the results for mortality in a retrospective study, we believe that the good performance obtained is due in part to the ongoing care and evaluation of the patients by the hospital doctors, by means of the different levels of hospital care, from the conventional admittance ward to the Intermediate Care Unit”, stressed doctor Felipe Lucena, specialist in Internal Medicine and person responsible for the Unit of Hospitalists at the University Hospital of Navarra. This team of hospital physicians is made up of doctors Felipe Lucena, Ana Huerta, Félix Alegre and Manuel Landecho, all specialists at the Hospital’s Department of Internal Medicine.

Recently this team of specialists published the results of their research on the efficacy of the working of this medical care model amongst 456 patients with highly complex conditions, admitted to the Intermediate Care Unit (Area of Special Hospitalisation) at this hospital over the past 6 years. The work was published in the specialised international, “Journal of Hospital Medicine”, being the only research work undertaken on this model for health care management in Spain.

The published research analysed the work of the hospitalists’ team in an intermediate health care unit. The impact of these specialists’ tasks may be ascertained in various aspects. The most outstanding are the positive effects on the mortality of the patients attended within this health care model, the importance of multidisciplinary work (in co-operation with various medical specialties) and the enhancement of teaching skills for resident doctors.

Conclusions of the research

The results show, amongst other things, a reduction of 11 % in the mortality amongst the sample of patients studied. According to doctor Lucena, the key to success lies in the labour of the hospitalists when bringing together the work of the different medical specialities that bear on the care of these patients. She also stresses the effectiveness of this model of ongoing health care for the patient, “with both morning and afternoon visits and availability 365 days a year, 24 hours a day”.

In the opinion of this specialist in Internal Medicine, “the benefits achieved over the past 6 months in terms of observed mortality with respect to the expected one, as well as in the growth of the hospitalist model and multidisciplinary work at the Unit, have been very positive, especially because pluripathological patients with highly complex conditions – some with advanced oncological ones – have been involved”. Doctor Lucena bases part of this success “on the working as a team, on the importance of multidisciplinary co-operation and on the dedicated and professional work of our nurses”. Moreover, she believes that “with the patient undergoing surgery, the prior knowledge which the hospitalist physicians have of their situation before operating is very important, as well as their potential complications because, in this way, on facing acute situations, intervention takes place more rapidly and efficaciously”.

Internet reference
Results of a retrospective observational study of intermediate care staffed by hospitalists: impact on mortality, co-management, and teaching. Egileak:Lucena JF, et al. Show all: Lucena J.F., Alegre F., Rodil R., Landecho M.F., García-Mouriz A., Marqués M., Aquerreta I., García N., Quiroga J.
JournalJ Hosp Med. 2012 May-Jun;7(5):411-5. doi: 10.1002/jhm.1905. Epub 2012 Jan 23.
Affiliation Department of Internal Medicine, Division of Intermediate Care and Hospitalists Unit, Clínica Universidad de Navarra, Pamplona, Spain. flucena@unav.es
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