Department of Emergency Medicine, Pennsylvania Hospital, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 19107, USA.
Am J Med. 2012 Aug;125(8):826.e1-6. doi: 10.1016/j.amjmed.2011.12.005. Epub 2012 Jul 6.
In the United States, emergency physicians and hospitalists are increasingly responsible for managing hospitalized patients. These specialists share a common practice space and similar shift work schedules. Together they govern decisions about use of the most expensive care setting in medicine-the hospital.
Unfortunately, in most institutions there is little collaboration between emergency physicians and hospitalists, resulting in missed opportunities to improve the quality of care and reduce its cost. In this call to action, we challenge emergency physicians and hospitalists to work together to develop protocols for consistent, evidence-based, and expeditious care of patients admitted from the ED; to collaborate in the care of ED patients who can safely be discharged home; to pursue joint quality, hospital leadership, and cost-effectiveness projects; to work in partnership to assure adequate staffing of hospital-based specialists; and to cooperate in the professional, front-line assessment of clinically and fiscally driven policies aimed at assessing the appropriateness of hospital admissions and readmissions.
Hospital care is increasingly driven by emergency physicians and hospitalists. We envision a vital role for ongoing collaboration between them in achieving the goals of patient care, education, and quality and safety outcomes.
在美国，急诊医师和医院医师越来越多地负责管理住院患者。这些专家共享一个共同的实践空间和类似的轮班工作时间表。他们共同决定在医学上最昂贵的护理环境——医院——中使用哪种治疗方法。
不幸的是，在大多数机构中，急诊医师和医院医师之间几乎没有合作，这导致了改善护理质量和降低成本的机会被错失。在这一行动呼吁中，我们向急诊医师和医院医师提出挑战，要求他们共同努力，为从急诊室入院的患者制定一致、基于证据且快速的护理方案；共同合作，安全地将可以出院的 ED 患者送回家；共同开展质量、医院领导力和成本效益项目；合作确保为医院专科医生配备充足的人手；并在临床和财务驱动的政策的一线评估方面进行合作，这些政策旨在评估住院和再次入院的适宜性。
医院护理越来越由急诊医师和医院医师主导。我们设想他们之间持续合作在实现患者护理、教育以及质量和安全结果方面发挥重要作用。
