ACNP or ACPA Hospitalist

PURPOSE: Heart of Texas Healthcare System will use the services of hospitalists to care for inpatient and Swingbed patients. Local medical staff physicians retain the right to use hospitalist services or follow their patients at their own discretion.

SHIFT: Friday afternoon to Monday morning

SCOPE: Heart of Texas Healthcare System is designated as a critical access hospital and licensed for twenty five beds. Critical access hospital standards are unique. The scope of the Hospitalist Services policy is intended to give guidance when determining if a patient’s condition can be adequately managed at Heart of Texas Healthcare System or if transfer to another facility for a higher level of care is more appropriate. It also sets procedures to be followed when admitting a patient to hospitalist services.

POLICY:

1. Scope of Service: Heart of Texas Healthcare System has a Level IV Trauma designation. As such, patients requiring a higher level of care are stabilized and transferred to an appropriate facility and the appropriate specialist. Typically, patients requiring surgical intervention or intensive nursing care (1:1 or 1:2 nurse to patient ratio) will be transferred. Conditions frequently transferred include, but are not limited to: trauma patients, unstable chest pain, psychiatric disorders, stroke patients, patients requiring surgical services and OB emergencies.

As a critical access hospital, on average, acute inpatient care should not exceed 96 hours per patient. Patients are admitted to Heart of Texas Healthcare System for a variety of illnesses requiring antibiotics and/or re-hydration. Historically, patients with these conditions comprise the majority of admissions to Heart of Texas Healthcare System:

· Congestive Heart Failure

· Pneumonia

· Chronic Obstructive Pulmonary Disease

· Dehydration

· Urinary Tract Infections

· Pyelonephritis

· Gastroenteritis

· Asthma

· Bronchitis

· Renal Failur

· Syncope

· Diabetes Mellitus

· Hypoglycemia

· Atrial Fibrillation

· Transient Ischemic Attack

· Hypertension

· Anemia

· Diverticulitis

· Pancreatitis

· Electrolyte Imbalance

· Wounds

· Pain Management

· Viral Syndrome

· Gout

Patients with the following diagnoses may be admitted as an acute or observation patient, or transferred at the physician’s discretion depending on the severity of the condition:

· Partial Bowel Obstruction

· Diabetic Ketoacidosis

· Pediatric Patients

· Cholelithiasis

· Seizures

· G.I. Bleeds

· Stable Angina

This policy is to serve as a guide. The conditions listed above are not intended to be all inclusive.

2. Hospitalist Admissions: Patients may be admitted to Hospitalist Service from the emergency department or clinical setting. The medical staff physicians retain the right to follow their own patients at their discretion. Patients may be admitted to the inpatient service, placed in observation, or admitted to the Swingbed program. Patients should be placed into observation when performing diagnostics for diagnosis.

3. Admission Procedure

a. Hospitalist Services Not Being Used

The ER provider will contact the primary care physician for admit approval/instructions. If the PCP cannot be reached, the backup physician will be contacted. If the backup physician wishes to use hospitalist services, the procedure for Hospitalist Services Being Used will need to be followed.

b. Hospitalist Services Being Used

The ER provider will make the decision if a patient should be admitted from the emergency department.

Job Type: Part-time

Work Location: In person