Established as The Skamokawa Eagle in 1891

Clinic board comments on hospital admissions

The Wahkiakum Family Practice Clinic recently announced that the clinicians will no longer admit patients to the hospital. This has raised several questions, and the clinic advisory board summitted the following to address those questions:

First, how will this work? There are three different ways a person might go to the hospital. The first is by ambulance. When the ambulance arrives at the Emergency Room at St. Johns, the patient is checked and triaged. Those needing urgent life saving care will see a doctor from Cascade Emergency Associates almost immediately. Those who are relatively stable will be seen as soon as possible. If a person needs to be admitted for a stay in the hospital, the on-call doctor from PeaceHealth, Kaiser or the Kirkpatrick Medical Group will admit the patient, and someone from that group will take care of the patient while he or she is in the hospital.

The second way a person could go into the hospital is when the patient is going to have a procedure that requires hospitalization. In this case, the patient and the doctor who provides the procedure will have worked everything out in advance. The patient will be scheduled and expected to report to the hospital at a specific time. So, if a person is having a surgery or a baby, arrangements will have been made in advance by the surgeon’s office or the OB-GYN practice that is seeing the patient.

The third way that a person might go to the hospital is to drive in on your own to the emergency room. In the same manner as arrival by ambulance, the person will be checked for the seriousness of the situation. Those needing immediate, life saving care will be seen almost immediately, and those who can wait will be taken in order of the seriousness of their condition.

In all three cases, if the patient has any medical information in the computer at the clinic, their records are fully available to the hospital by our shared computer network. Once the patient is released, the clinic providers will be here to continue their care after their hospitalization. Our clinicians wish to be actively involved in all outpatient care of their patients.

Second, why did the clinic advisory board make this change? Foremost, the cost of clinicians continuing to go into the hospital once or twice a day, depending on time of day patients are admitted, actually costs the clinic at least $79,000 annually. This figure would go up as gas prices go up. Also, admitting and following patients in the hospital is a 24 hour a day, seven day a week commitment. With a small clinician staff, it has been very physically taxing for our clinicians. When the clinic Advisory Board looked at other clinics around the state, they found there are very few that still do direct admissions of patients. Making this change has the dual benefit of saving the clinic money and allowing much more time for patient care in the office.

What do other clinics do? Instead of admitting and following their patients in the hospital, most clinics work with a doctor at the hospital who is called a hospitalist. That doctor is a specialist in coordinating the care of patients in the hospital with the clinics they serve. Right now, PeaceHealth has a limited number of hospitalists, and they are unable to take additional patients at this time. The clinic will continue to work with the on-call doctors at PeaceHealth to ensure quality patient care during hospital stays.

PeaceHealth is considering hiring a new Family Practice Hospitalist later this year. The Clinic Advisory Board is committed to continuing to work with PeaceHealth to identify a hospitalist to work with the clinic. This discussion will continue until a solution is found to better serve the clinic’s patients.

 

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