HOSPITAL MEDICINE TODAY
Here’s a common scenario in hospital medicine.
A nurse, physician or administrative team creates the patient assignment list in the morning before rounds, equally distributing the physician workload. The complexity of each case, however, isn’t factored into the assignments. There are just too many variables to consider.
That results in some complicated cases going to a few physicians, causing them to get behind or overworked because of the extra workload. Frustration invariably sets in. Some may try to fix the problem by manipulating the assignment process or by pulling in favors. But that stirs resentment from others or it puts undue pressure on the people creating the assignments.
Worse still, overloaded physicians may completely miss a patient during rounding and must scramble to get caught up. Naturally, the patient and his or her family aren’t happy if they’re not seen all day by a physician and their survey scores reflect it.
All of this is further complicated because there’s no systematic application of continuity of care in place. So if and when a patient returns, he or she must see a brand new attending physician, adding to the feeling of healthcare “by revolving door.”