Division of Hospital Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York.
J Hosp Med. 2014 May;9(5):320-3. doi: 10.1002/jhm.2160. Epub 2014 Jan 29.
With current healthcare reform and calls for improving care quality and safety, there is renewed emphasis on high-value care. Moreover, given the significant healthcare resource utilization for patients with chronically progressive illnesses or for patients at the end of life, innovative and efficient care delivery models are urgently needed. We propose here the concept of a sentinel hospitalization, defined as a transitional point in the patient's disease course that heralds a need to reassess prognosis, patient understanding, treatment options and intensities, and goals of care. Hospitalists are well positioned to recognize a patient's sentinel hospitalization and use it as an opportunity for active integration of palliative care that provides high-quality and cost-saving care through its patient- and family-oriented approach, its interdisciplinary nature, and its focus on symptom control and care coordination.
随着当前医疗改革和提高医疗质量与安全的呼吁，高价值医疗的重要性再次受到关注。此外，鉴于慢性病患者或生命末期患者对医疗资源的大量利用，创新和高效的医疗服务模式急需建立。在这里，我们提出哨兵住院的概念，定义为患者疾病过程中的一个转折点，预示着需要重新评估预后、患者的理解、治疗方案和强度以及护理目标。住院医师非常适合识别患者的哨兵住院，并将其作为积极整合姑息治疗的机会，通过以患者和家庭为中心的方法、跨学科性质以及对症状控制和护理协调的关注，提供高质量和节省成本的护理。
