Hospital Medicine communications--it's all in the process
In the spring of 2019, the Division of Hospital Medicine, working with community medical staff, introduced a process to improve communication about hospital admissions. Please consider reviewing this process with your staff to determine the best way to route these calls in your office.
The process works like this:
- Physician Priority Link (PPL) contacts referring practices within 24 hours of admission on all patients on Hospital Medicine service,
- The PPL operator contacts the practice with a request to either:
- Speak with the referring provider (complex admission)* or
- Leave a message for the referring provider with no required call-back (routine admission)
*If the referring provider is not available at the time of the call, PPL will request that the referring provider or covering provider call back that day as soon as available.
The goal was to ensure consistent contact was made on all admissions; provider contact was made on complex admissions; and interruptions were minimized for referring providers on more routine cases. The process has been successful in terms of the calls delivered by PPL operators, but the data suggest there is still room for improvement in the rates of direct provider-to-provider contact for complex admissions. We have been discussing and evaluating this in our Community Practice Advisory Committee.
Based on data from our own practices, we believe provider-to-provider contact might be improved if each practice reviews and discusses the process internally with all staff who take incoming phone calls. Messages from PPL regarding admissions to providers should clearly include whether it is a same day “call back” or a “leave a message” call. The PPL operators who work hard to connect us also appreciate this!
If you have ideas or comments about the process, please contact me (shelly.voet@cchmc.org) or Austin Ostermeier (Austin.ostermeier@cchmc.org). Your continued input is appreciated!
Shelly F. Voet, MD
Executive Community Physician Leader
Leave a message
Patients admitted with one of the following diagnoses and progressing as expected without concerns from the Hospital Medicine team or family will generate a “Leave a Message” call by Priority Link regarding the admission. Practice staff should ideally send the message to the referring provider or primary care provider (PCP). PCPs are welcome to call Hospital Medicine at any time during admission, but a return phone call will not be requested in the following cases:
- Bronchiolitis
- Pneumonia
- Croup
- Dehydration secondary to respiratory illness
- Cellulitis
- Gastroenteritis
- Constipation
- Urinary tract infection
- Hyperbilirubinemia
- Medically cleared psych
Speak with provider or call-back requested
Patients with the following conditions will have a “Provider Call” made by Priority Link request. Ideally, practice staff would ask the referring provider or PCP (or another provider if neither available) to take these calls if available. If no one is available, a call-back will be requested:
- History of medical complexity
- Technology dependent, followed by ≥ 3 specialists
- Directly admitted by PCP
- PICU transfers
- Uncertain diagnoses
- Asthma, FTT, FUS or any other diagnoses not listed above
- Patients not progressing as expected, including those with conditions listed above, or admitted beyond planned discharge date
- Recurrent admissions for similar diagnoses
- Any specific concerns from family or Hospital Medicine team that could be potentially addressed by the PCP
