Bloom-Feshbach Kimberly, Berger Rebecca E, Evans Arthur T, McNairy Margaret L, Lopez Leonardo V, Parish Sharon J
Section of Hospital Medicine, Division of General Internal Medicine, Weill Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
Center for Global Health, Weill Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
J Gen Intern Med. 2025 Sep 4. doi: 10.1007/s11606-025-09725-x.
There is no established best practice for optimal medical consultant care to address the medical needs of psychiatric inpatients at a behavioral health center (BHC).
To evaluate the feasibility and acceptability of a hybrid on-site and virtual model of internal medicine consultative care in a BHC.
To provide continuous medical consultation availability for 233 patients in a BHC, 9 internal medicine hospitalists from the affiliated academic medical center joined 1 full-time internist and 21 medical nurse practitioners, supporting 34 psychiatry providers.
Hospitalists performed medical evaluation prior to electroconvulsive and ketamine therapies, hybrid on-site and remote consultation for acute concerns, test results, medication effects, and chronic diseases, electrocardiogram review, and pre-admission assessments.
BHC faculty were anonymously surveyed. 8/8 hospitalists and 11/34 psychiatrists responded. Qualitative data were coded and thematically analyzed. Psychiatrists appreciated hospitalists' expertise, communication, and collaborative problem-solving. Hospitalists found meaning in developing new clinical expertise and caring for vulnerable patients. Hospitalists credited the hybrid role with enhancing work-life integration. Challenges included handoffs, delineation of responsibilities, and virtual work impacting team cohesion.
A hybrid consultation model allows hospitalists and psychiatrists to collaboratively care for BHC inpatients with professionally and personally rewarding work.
在行为健康中心（BHC），针对精神科住院患者的医疗需求，尚无既定的最佳医疗顾问护理实践。
评估BHC中内科会诊护理的现场与虚拟混合模式的可行性和可接受性。
为向BHC的233名患者提供持续的医疗咨询服务，来自附属学术医疗中心的9名内科住院医师与1名全职内科医生和21名医疗执业护士合作，为34名精神科医护人员提供支持。
住院医师在进行电休克和氯胺酮治疗前进行医学评估，针对急性问题、检查结果、药物作用和慢性病进行现场与远程混合会诊，审查心电图，并进行入院前评估。
对BHC的教职员工进行匿名调查。8名住院医师和11名精神科医生回复。对定性数据进行编码和主题分析。精神科医生赞赏住院医师的专业知识、沟通能力和协作解决问题的能力。住院医师在发展新的临床专业知识和照顾弱势患者中找到意义。住院医师认为混合角色有助于提高工作与生活的融合度。挑战包括工作交接、职责划分以及虚拟工作对团队凝聚力的影响。
混合会诊模式使住院医师和精神科医生能够合作护理BHC的住院患者，工作既有专业性又有个人成就感。
