A urologist has difficulty discharging a patient from the hospital due to lack of specialist coordination.
However, writing the order “d/c home if OK by pulmonary, hospitalist, ID, and general surgery services” is going to run into some difficulty.
Each service rounds at different times. Some do it early in the morning before clinic or surgery, some after, some in the early evening. Some consultants round at several hospitals and may not immediately be available for your patient.
Although it would be nice to send a simple text message asking for the discharge blessing, I can’t see how consultants can give an answer without seeing the patient first. The more services involved, the longer that will take.
Maybe some of our hospitalist colleagues can give some tips.
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{ 3 comments }
I pick up the phone and I call them. That’s why hospitals love hospitalists. We communicate.
Agree with Happy. I usually know who I’m going to need “clearance” from each morning for potential discharges, and try to get them on the phone early.
Plus, I’m confident enough in my internal medicine training to know when a patient can be discharged safely, and I’m confident enough in my hospitalist experience to minimize the chances of things being dropped in the post-discharge period.
This does mean that sometimes the consulting service does not get a last face-to-face with the patient, but I have found this to be generally acceptable (academic environment). However, if I need the specialty service in question to convey specific information to the patient (and I realize that they can do it better than I), then I may have to capitulate to the specialist’s schedule.
Let me get this right. The urologist is complaining about a patient who sat o/n because HE did not contact the other players? Not to state the obvious but I also agree with above. pick up the bloody phone or are subspecialist’s time to valuable waste time on the phone?
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