House doctors enhance patient care

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One year after its start-up, the Niagara Health System’s Hospitalist Program has made such a difference that it has now expanded to cover two hospitals, and the number of Hospitalist Physicians has shot up from one to six. The NHS program started at Welland Hospital Site in autumn 2004, followed by St. Catharines General Site this past summer.

What is a Hospitalist? Hospitalists are doctors who devote the majority of their time to the care of ‘unassigned’ or ‘orphan’ hospital inpatients who have a family doctor with no hospital privileges or no family doctor at all.

“The NHS is very committed to the Hospitalist program because we are seeing the positive results of having physicians who can dedicate most or all of their time to working in hospital,” says Debbie Smith, Regional Director of the Hospitalist Program. “The program has increased the availability of physicians and strengthened our clinical teams. Having these dedicated physicians really improves the quality of care.”

How does the Hospitalist program work? Typically, patients come under the care of a Hospitalist when they are admitted to hospital, or in some cases are transferred to the care of the Hospitalist for their recovery time after surgery. The Hospitalist’s role includes carrying out patient assessments, ordering tests, prescribing medications and monitoring patients’ progress.

To date, six Hospitalists are providing care in the NHS, in addition to the 500 or so family physicians and specialists with hospital privileges. Dr. Claire Miller was the first Hospitalist to join the NHS program. “I think we’ve made a very positive impression on patient care at Welland and now in St. Catharines,” Dr. Miller says. “For me personally, doing 100 per cent of my work in hospital is a good fit.”

The role of the Hospitalist is to not only care for patients, but to also “address the social needs facing an elderly population without a family physician,” explains Dr. Miller. “We work to ensure that patients without a family physician can have what they need when they are discharged home. This can include short term follow-up clinics or referrals to other physicians and agencies within our community.”

Taking the clinical lead for the program as Regional Chief of Hospital Medicine is Dr. Keith Greenway, who joined the NHS this fall. “The NHS has already seen a number of enhancements to inpatient care since introducing the Hospitalist program at Welland Hospital Site a year ago,” said Dr. Greenway. “I am looking forward to building on these successes in partnership with the skilled team of Hospitalists that is already in place, in order to ensure patients receive the best care possible while in hospital.”

“In my short time here, I’ve already noticed that the volume and pace of care has increased at both Welland and St. Catharines hospitals,” Dr. Greenway added.

With the program now firmly in place at Welland and St. Catharines hospitals where the need is greatest, there may be the potential to offer this service to other NHS hospitals, to help with the physician shortage in Niagara. “We’re really fortunate to have the physicians we have,” Debbie says. “They are very committed and dedicated.”