The timing was perfect for Dr. Syed Raza. Following his residency in 1999, he decided to focus on what was then a budding specialty: hospitalist.
“I like the idea of being the captain of the ship,” says Syed, now the vice president of medical operations at CHI St. Luke's Health – The Woodlands, Lakeside, Springwoods Hospitals, near Houston. In addition to his administrative duties, he remains a hospitalist. “When a patient is in a hospital, we are the primary care provider. We are the ones that should be managing their admission, their medications, the discussions with the primary care doctor, consultants and caregivers. We should be the ones coordinating the care.”
A little more than 20 years ago, no one had even given his job a title. But since 1996, when the term hospitalist was coined, their numbers have grown to more than 57,000 nationwide. According to Amanda Trask, our national vice president of service lines, it is the fastest growing medical specialty of all time. Today, we have more than 900 hospital medicine providers – physicians, physician assistants and nurse practitioners – who care for more than 160,000 patients each year in our community hospitals, academic medical centers and critical access hospitals.
“Three out of four hospitalized patients are cared for by a hospitalist,” Amanda says, “so they provide a tremendous amount of care and have become vital to us.”
Their numbers and importance are growing, particularly in their ability to reduce the length of a patient’s stay. A patient whose care has been co-managed by a hospitalist averages 3.8 days in a hospital setting with no adverse effect on rates of death or readmission. A patient who was not seen by a hospitalist averaged 5.5 days.
“Hospitalists really are unsung heroes because they’re there 24/7 to provide everything you need in the hospital,” Amanda says. “They keep a patient’s care moving forward while keeping everyone in the loop.”
Being part of a system as large as ours has given hospitalists like Dr. Raza a broader perspective on the possibilities for expanding and improving their role.
“Before we became part of CHI, we compared ourselves to other hospitals in Houston,” he says. “When we become part of CHI, we saw people doing stuff better than us. When we get together as a hospitalist subsection, we see a lot of people thinking the same way we’re thinking in terms of being highly effective and more efficient.”
Among the ideas gaining momentum are geographic rounding, in which a hospitalist is assigned to a unit, with nurses, physicians, advanced practice clinicians and case managers rounding together. “Everyone is on the same page,” he says. “What we’ve seen in places starting geographic rounding is that they’re seeing some success.”
We’re also moving away from a business model popular earlier in Dr. Raza’s career, in which hospitalists were in private practice or specialty groups. Instead, we’re moving toward a model in which hospitals manage their own hospitalist group. This helps us work together as one team to improve quality, reduce length of stay and complications, and improve mortality and readmission rates.
Both Amanda and Dr. Raza note that the ultimate goal is to become a destination for hospitalists.
“We want to get to a point where they say ‘CHI is the place to practice,’” he says. “We want to be the place where they come and they stay. That’s when you’ll see the biggest improvements in quality and safety and physician engagement.”