National survey on the activity of internists in shared care – Interconsultations in Spanish hospitals☆

Abstract Objectives To analyse the activity of interconsultations conducted by the departments of internal medicine, communicating their importance to managers and offering information to these departments to improve their organisation. Methods A cross-sectional study was conducted using an interconsultation activity survey (on-demand consulting activity for other departments) and shared care (consulting activity provided in a regulated manner to other departments). Results We received 120 surveys that corresponded to 108 public and 12 private hospitals. Forty-five percent of the surveyed hospitals had a specialised interconsultation unit, and 31% had shared care. The department most frequently helped by the presence of a stable consultation unit (65% of the cases) was orthopaedic and trauma surgery. Fifty-five percent of the departments of internal medicine surveyed had an interconsultation activity record since the start of their activity. Ninety-two percent of the departments lacked a protocol that regulated interconsultations, and in 74% of the cases, the interconsultation was on demand. Conclusions The interconsultation activity is generalised in the departments of internal medicine, but only 45% of these departments have interconsultation units, and only 33% provide the shared care modality. The survey reflects the shortcomings of training and some confusion in the concept of interconsultations. The considerable majority of departments lack organisational interconsultation protocols.