HospitalMedicine'sEvolution: LiteratureSearchandInterviewStudywithPractices

Until recently, practice-management concerns influencing patient and hospitalist satisfaction were not a central fo- cus. During the specialty's early years, research focused on clinical outcomes, efficiency, and cost-effectiveness, but there was little focus on the patient's or hospital- ist's experience with the hospitalist model of care. 2 Abstract Introduction:� Hospitalmedicineisayoungspe- cialtythatisstillevolving.�Initsearlyyears,�research� focusedonclinicaloutcomes,� efficiency, � andcost� effectiveness.� Asthespecialtymatures,� increasing� attentionisbeinggiventothepatientandhospitalist� experiencewiththehospitalistmodelofcare.� Methods:�In�2008,�weconductedaliteraturesearch� toidentifypatients'�andhospitalists'�satisfactioncon- cernsandpotentialstrategiesfortheirresolution.�We� usedourfindingstodevelopasemistructuredinterview� guideasabasisforawide-rangingdiscussionwith� KaiserPermanente� (KP)� hospitalistsandphysician� leadersandKPandnon-KPsubject-matterexpertson� theirpriorities,�concerns,�andsuccessfulpractices. Results:� Respondentsidentifiedsustainability� andcommunicationsincoordinatingcareastheir� high-priorityconcernswithsustainabilityasthetop� priority.� Withinthesebroadconcerns,� theyidenti- fiedcontributingfactorsandtheirinterrelationships.� Factorsinfluencingsustainabilityofthehospitalist� modelincludehospitalistscheduling,� workload,� comanagementresponsibilities,�andrecruitmentand� retention.�Regardingcommunicationsincoordinat- ingcare,�respondentsviewedthemselvesasbeingin� thecenterofawebinvolvingcommunicationwith� patients,� physiciansinotherservices,� nurses,� and� otherhospitalists.� Conclusion:� Promisingapproacheshavebeen� developedtoaddresssustainabilityconcernsandfor� communicatingwithpatients,�physiciansinotherser- vices,�nurses,�andotherhospitalists.�However,�getting� reliablefeedbackonpatientsatisfactionsurveysforin- dividualhospitalistsisacontinuingchallenge.�Despite� theuseofbrochuresandbusinesscardstointroduce� themselvestopatientsandexplaintheirrole,�thereare� difficultiesinestablishingahospitalist-patientbond.�