Value of a Hospitalists-Led, Post-Discharge Clinic

MedicalResearch.com Interview with:  Lauren Doctoroff, MD Hospitalist, Hospital Medicine Program Beth Israel Deaconess Medical Center Medical Director, HCA Post Discharge Clinic and PACT Transitional Care Program Instructor, Harvard Medical School Boston, MA 02215MedicalResearch.com Interview with:
Lauren Doctoroff, MD

Hospitalist, Hospital Medicine Program
Beth Israel Deaconess Medical Center
Medical Director, HCA Post Discharge Clinic and PACT Transitional Care Program
Instructor, Harvard Medical School
Boston, MA 02215

MedicalResearch.com What are the main findings of the study?

Dr. Doctoroff: A dedicated post discharge clinic, staffed by hospitalists, led to a shorter interval to a clinic visit for patients after discharge.  Patients with resident primary care doctors and those who are African American were most likely to use the clinic.  The care provided in the clinic, in terms of testing, was consistent with the remainder of the practice.

MedicalResearch.com: 
Were any of the findings unexpected?

Dr. Doctoroff: The fact that the clinic led to a substantially shorter time for all patients post hospitalization in the clinic, not just those seen in the clinic was a surprise.  This likely reflects the significant difference in interval for patients seen in the discharge clinic relative to those seen in the practice as a whole.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Doctoroff: For patients, leaving the hospital can be stressful, and a visit within a few days to a doctor can be reassuring.  Our results suggest that clinics can find novel ways to make sure patients get seen quickly if they look broadly for answers.  By extension, patients should speak with their physicians about this and other models if access following discharge is difficult or delayed.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Doctoroff: The clinical effect of expedited post discharge access, in terms of the effect on decreasing the risks associated with transition, such as medication errors and hospital readmissions, is the natural corollary to this study.

Citation:

The Characteristics and Impact of a Hospitalist-staffed Post-discharge Clinic  

Lauren Doctoroff, Ank Nijhawan, Diane McNally, Anita Vanka,
Roger Yu, Kenneth J. Mukamal       

The American Journal of Medicine – 30 August 2013 (10.1016/j.amjmed.2013.03.025)

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