Hospitalist Co-Management Program for Neurosurgery Inpatients Reduces Medical Complications and Length of Stay
May 02 2024 - 12:30PM
Medical complications are common among neurosurgical patients and
can jeopardize their clinical results, leading to longer lengths of
stay, higher costs, and higher readmission and mortality rates. A
new study in the May 2024 issue of The Joint Commission Journal on
Quality and Patient Safety (JQPS) evaluated the impact of a
hospitalist co-management program on clinical outcomes in
neurosurgical patients.
The study, “Impact of a Hospitalist Co-Management Program on
Medical Complications and Length of Stay in Neurosurgical
Patients,” aimed to determine whether general neurosurgery
inpatients benefit from a hospitalist-led co-management program in
terms of mortality, complications and use of resources. Researchers
at Hospital Universitario 12 de Octubre, Madrid, Spain, used a
quasi-experimental study design to compare a historical control
period to a prospective intervention arm.
During the intervention period, patients admitted to a
neurosurgery inpatient unit were included in the co-management
program if they were:
- Older than 65 years old.
- Suffered certain conditions such as diabetes, heart failure,
asthma, chronic kidney disease and more.
- Admitted from the intensive care unit (ICU).
The program incorporated two hospitalists into the neurosurgery
team. These hospitalists intervened in the patients’ diagnostic and
therapeutic plans, participated in clinical decisions and
coordinated patient navigation with neurosurgeons.
Findings showed significant reduction in the incidence of
relevant medical complications and length of stay in the co-managed
patients but revealed no difference in in-hospital mortality. This
may be partially explained by the study’s patients’ overall low
mortality rates resulting in a small sample size.
“Growing evidence suggests that co-management is effective when
used in a rational and selective manner rather than as a
hospitalist-take-all approach,” notes an accompanying editorial by
Robert Metter, MD; Amanda Johnson, MD; and Marisha Burden, MD, MBA.
“Evidence from the past two decades suggests that hospitalist
co-management is most beneficial in selected, higher-risk groups of
surgical patients and less beneficial when used routinely for all
patients.”
Also featured in the May issue are:
- Team Relations and Role Perceptions During Anesthesia Crisis
Management in Magnetic-Resonance Imaging Settings: A Mixed Methods
Exploration (Geisel School of Medicine, Dartmouth College, Hanover,
New Hampshire)
- Taming the Wild West of Procedural Safety: Assessing
Interprofessional Teams in Non-Operating Room Anesthesia
(editorial)
- Preoperative Communication Between Anesthesia, Surgery, and
Primary Care Providers for Older Surgical Patients (Geisel School
of Medicine, Dartmouth College, Hanover, New Hampshire)
- Development and Evaluation of I-PASS-to-PICU: A Standard
Electronic Template to Improve Referral Communication for
Interfacility Transfers to the Pediatric ICU (University of Iowa
Stead Family Children’s Hospital, Iowa City, Iowa)
- Refining a Framework to Enhance Communication in the Emergency
Department During the Diagnostic Process: An eDelphi Approach
(University of Michigan, Ann Arbor, Michigan)
- Involving the Patient and Family in the Transfer of Information
at Shift Change in a Pediatric Emergency Department (Hospital
General Universitario Gregorio Marañón, Madrid)
- Improving Outcomes in Patients Sent to the Emergency Department
from Outpatient Providers: A Receiver-Driven Handoff Process
Improvement (University of Iowa, Iowa City, Iowa)
- Implementation of an Interdisciplinary Transfer Huddle
Intervention for Prolonged Wait Times During Inter-ICU Transfer
(Northwestern University Feinberg School of Medicine, Chicago)
- Handoffs and Care Transitions: Interviews with Chris Landrigan
and Theresa Murray (JQPS)
The May issue is part of JQPS’ 50th anniversary celebration.
Each month, a topic of importance to the Journal and The Joint
Commission will be highlighted. In addition to the articles
described above, the May issue has an open-access list of handoff
and care transition articles previously published in the
Journal.
For more information, please visit the JQPS website.
###
Note for editors
The article is “Impact of a Hospitalist Co-Management Program on
Medical Complications and Length of Stay in Neurosurgical
Patients,” by Álvaro Marchán-López, MD; Jaime Lora-Tamayo, MD, PhD;
Cristina de la Calle, MD, PhD; Luis Jiménez Roldán, MD, PhD; Luis
Miguel Moreno Gómez, MD, PhD; Ignacio Sáez de la Fuente, MD, PhD;
Mario Chico Fernández, MD, PhD; Alfonso Lagares, MD, PhD; Carlos
Lumbreras, MD, PhD; and Ana García Reyne, MD, PhD. The article
appears in The Joint Commission Journal on Quality and Patient
Safety (JQPS), volume 50, number 5 (May 2024), published by
Elsevier.
The Joint Commission Journal on Quality and Patient
Safety
The Joint Commission Journal on Quality and Patient
Safety (JQPS) is a peer-reviewed journal providing healthcare
professionals with innovative thinking, strategies and practices in
improving quality and safety in healthcare. JQPS is the official
journal of The Joint Commission and Joint Commission Resources,
Inc. Original case studies, program or project reports,
reports of new methodologies or the new application of
methodologies, research studies, and commentaries on issues and
practices are all considered.
Katie Bronk
The Joint Commission
630-792-5175
kbronk@jointcommission.org