Kimberly Bloom-Feshbach, Rebecca E Berger, Arthur T Evans, Margaret L McNairy, Leonardo V Lopez, Sharon J Parish
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引用次数: 0
Abstract
Background: There is no established best practice for optimal medical consultant care to address the medical needs of psychiatric inpatients at a behavioral health center (BHC).
Aim: To evaluate the feasibility and acceptability of a hybrid on-site and virtual model of internal medicine consultative care in a BHC.
Setting and participants: To provide continuous medical consultation availability for 233 patients in a BHC, 9 internal medicine hospitalists from the affiliated academic medical center joined 1 full-time internist and 21 medical nurse practitioners, supporting 34 psychiatry providers.
Program description: Hospitalists performed medical evaluation prior to electroconvulsive and ketamine therapies, hybrid on-site and remote consultation for acute concerns, test results, medication effects, and chronic diseases, electrocardiogram review, and pre-admission assessments.
Program evaluation: BHC faculty were anonymously surveyed. 8/8 hospitalists and 11/34 psychiatrists responded. Qualitative data were coded and thematically analyzed. Psychiatrists appreciated hospitalists' expertise, communication, and collaborative problem-solving. Hospitalists found meaning in developing new clinical expertise and caring for vulnerable patients. Hospitalists credited the hybrid role with enhancing work-life integration. Challenges included handoffs, delineation of responsibilities, and virtual work impacting team cohesion.
Discussion: A hybrid consultation model allows hospitalists and psychiatrists to collaboratively care for BHC inpatients with professionally and personally rewarding work.
期刊介绍：
The Journal of General Internal Medicine is the official journal of the Society of General Internal Medicine. It promotes improved patient care, research, and education in primary care, general internal medicine, and hospital medicine. Its articles focus on topics such as clinical medicine, epidemiology, prevention, health care delivery, curriculum development, and numerous other non-traditional themes, in addition to classic clinical research on problems in internal medicine.
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