Impact of an On-duty Pulmonologist on the Activity of a Respiratory Medicine Department

Carrera, Miguel; Palou, Alexandre; Sala, Ernest; Balaguer, Catalina; de la Peña, Mónica; Agustí, Àlvar

doi:10.1016/S1579-2129(08)60087-7

Archivos de Bronconeumología

ISSN: 0300-2896

Archivos de Bronconeumologia is an international journal that publishes original studies whose content is based upon results of research initiatives dealing with several aspects of respiratory medicine including epidemiology, respiratory physiology, pathophysiology of respiratory diseases, clinical management, thoracic surgery, pediatric lung diseases, respiratory critical care, respiratory allergy and basic research. Other types of articles such as editorials, reviews, and different types of letters are also published in the journal. Additionally, the journal expresses the voice of the following scientific societies: the Spanish Respiratory Society of Pneumology and Thoracic Surgery (SEPAR; https://www.separ.es/), the Latin American Thoracic Society (ALAT; https://alatorax.org/), and the Iberian American Association of Thoracic Surgery (AIACT; http://www.aiatorax.com/).

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Vol. 44. Issue 9.

Pages 484-488 (January 2008)

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Pages 484-488 (January 2008)

Original Articles

DOI: 10.1016/S1579-2129(08)60087-7

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Impact of an On-duty Pulmonologist on the Activity of a Respiratory Medicine Department

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Miguel Carrera, Alexandre Palou, Ernest Sala, Catalina Balaguer, Mónica de la Peña, Àlvar Agustí

Corresponding author

aagusti@hsd.es

Correspondence: Dr A.G.N. Agustí Servicio de Neumología, Hospital Universitario Son Dureta Andrea Doria, 55 07014 Palma de Mallorca, Islas Baleares, Spain

Servicio de Neumología, Hospital Universitario Son Dureta, Fundación Caubet-Cimera, Palma de Mallorca, Islas Baleares; CIBER of Respiratory Diseases (CibeRes), ISC III, Ministry of Health, Spain

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Abstract

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Objective

To evaluate the impact on health care and clinical management of 24-hour coverage by an on-site pulmonologist in a respiratory medicine department.

Methods

In February 2004, a new respiratory medicine 24-hour duty service was started in our hospital. The activity of the on-duty pulmonologist during the following 12 months was systematically and prospectively recorded. The results were put into perspective by comparing the number of monthly admissions and the mean length of stay during the study period with those of the previous 12-month period.

Results

During the study period, the on-duty pulmonologist received a mean (SD) of 9.02 (5.27) emergency calls every day, performed 202 diagnostic or therapeutic interventions, and discharged 342 patients. During this period, 1305 patients were admitted to the department (mean length of stay, 8.1 days), whereas in the previous 12 months, with no on-site pulmonologist, 1680 patients were admitted (mean length of stay, 9.0 days). This represents a 22.3% reduction in the annual number of admissions and a reduction in the mean stay by almost 1 day (0.9 days).

Conclusions

The provision of an on-duty pulmonologist was efficient because it facilitated patient turnaround.

Key words:

Health care quality

Continuous care

Health care management

Objetivo

Analizar qué impacto asistencial y de gestión clínica tiene la implantación de guardias de presencia física continuada en un servicio de neumología.

Métodos

En febrero de 2004 se introdujeron las guardias de neumología en el Hospital Universitario Son Dureta. Durante un año, hasta enero de 2005, se recogió de forma prospectiva y sistemática la actividad realizada por el/la neumólogo/a de guardia. Con objeto de situar estos resultados en perspectiva, se ha comparado el número de ingresos mensuales y su estancia media durante los 12 meses en que se ha dispuesto de guardia de neumología y los 12 meses inmediatamente anteriores.

Resultados

Durante los 12 meses evaluados, el/la neumólogo/a de guardia recibió una media ± desviación estándar de 9,02 ± 5,27 avisos urgentes cada día, realizó 202 técnicas diagnósticas/terapéuticas y dio de alta a 342 pacientes. Durante este período ingresaron en el servicio 1.305 pacientes (estancia media: 8,1 días), mientras que en los 12 meses previos, sin guardia de la especialidad, habían ingresado en el servicio 1.680 pacientes (estancia media: 9,0 días); esto supone una reducción del 22,3% del número anual de ingresos y una disminución de la estancia media de los pacientes ingresados de prácticamente un día (0,9 días).

Conclusiones

La implantación de guardias de neumología ha sido una medida eficiente, que ha contribuido a agilizar la rotación de los pacientes ingresados.

Palabras clave:

Calidad asistencial

Atención continuada

Gestión sanitaria

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References

[1]

P Chopard, TV Perneger, JM Gaspoz, C Lovis, D Gousset, C Rouillard, et al.

Predictors of inappropriate hospital days in a department of internal medicine.

Int J Epidemiol, 27 (1998), pp. 513-519

Medline

[2]

Heart National, Lung, and Blood Institute.

Morbidity and Mortality: 2002 Chart Book on Cardiovascular, Lung, and Blood Diseases, U.S. Department of Health and Human Services, NIH, NHLBI, (May 2002),

Available from: http://www.nhlbi.nih.gov/resources/docs/02_chtbk.pdf

[3]

M Miravitlles, V Sobradillo, C Villasante, R Gabriel, F Masa, C Jiménez.

Estudio epidemiológico de la EPOC en España (IBERPOC): reclutamiento y trabajo de campo.

Arch Bronconeumol, 35 (1999), pp. 152-158

Medline

[4]

M Miravitlles, C Murio, T Guerrero, R Gisbert.

Costs of chronic bronchitis and COPD: a 1-year follow-up study.

Chest, 123 (2003), pp. 78491

[5]

S Kendrick.

Emergency admissions: what is driving the increase?.

Health Serv J, 105 (1995), pp. 26-28

Medline

[6]

MR Carey, H Sheth, RS Braithwaite.

A prospective study of reasons for prolonged hospitalizations on a general medicine teaching service.

J Gen Intern Med, 20 (2005), pp. 108-115

http://dx.doi.org/10.1111/j.1525-1497.2005.40269.x | Medline

[7]

F Campos Rodríguez, I de la Cruz Morón, L López Rodríguez, A Díaz Martínez, M Tejedor Fernández, F Muñoz Lucena.

Adecuación de los ingresos hospitalarios en un servicio de neumología.

Arch Bronconeumol, 42 (2006), pp. 440-445

Medline

[8]

CM Roberts, S Barnes, D Lowe, MG Pearson.

Evidence for a link between mortality in acute COPD and hospital type and resources.

Thorax, 58 (2003), pp. 947-949

Medline

[9]

LC Price, D Lowe, HS Hosker, K Anstey, MG Pearson, CM Roberts.

UK National COPD Audit 2003: impact of hospital resources and organisation of care on patient outcome following admission for acute COPD exacerbation.

Thorax, 61 (2006), pp. 837-842

http://dx.doi.org/10.1136/thx.2005.049940 | Medline

[10]

H Hosker, K Anstey, D Lowe, M Pearson, CM Roberts.

Variability in the organisation and management of hospital care for COPD exacerbations in the UK.

Respir Med, 101 (2007), pp. 754-761

http://dx.doi.org/10.1016/j.rmed.2006.08.016 | Medline

[11]

MT Haupt, CE Bekes, RJ Brilli, LC Carl, AW Gray, MS Jastremski, et al.

Guidelines on critical care services and personnel: recommendations based on a system of categorization of three levels of care.

Crit Care Med, 31 (2003), pp. 2677-2683

http://dx.doi.org/10.1097/01.CCM.0000094227.89800.93 | Medline

[12]

PJ Pronovost, DC Angus, T Dorman, KA Robinson, TT Dremsizov, TL Young.

Physician staffing patterns and clinical outcomes in critically ill patients: a systematic review.

JAMA, 288 (2002), pp. 2151-2162

Medline

[13]

PA Tenner, H Dibrell, RP Taylor.

Improved survival with hospitalists in a pediatric intensive care unit.

Crit Care Med, 31 (2003), pp. 847-852

http://dx.doi.org/10.1097/01.CCM.0000055376.01875.C3 | Medline

[14]

E Sala, L Alegre, M Carrera, M Ibars, FJ Orriols, ML Blanco, et al.

Supported discharge shortens hospital stay in patients hospitalised because of an exacerbation of chronic obstructive pulmonary disease (COPD).

Eur Respir J, 17 (2001), pp. 1138-1142

Medline

[15]

Hospital Universitario Son Dureta.

Actividad asistencial.

Available from: www.hsd.es

[16]

JR Twanmoh, GP Cunningham.

When overcrowding paralyzes an emergency department.

Manag Care, 15 (2006), pp. 54-59

Medline

[17]

R McMullan, B Silke, K Bennett, S Callachand.

Resource utilisation, length of hospital stay, and pattern of investigation during acute medical hospital admission.

Postgrad Med J, 80 (2004), pp. 23-26

Medline

[18]

C Domingo, V Ortún.

Urgencias hospitalarias o colapso crónico: los pacientes crónicos no deberían colapsar urgencias.

Arch Bronconeumol, 42 (2006), pp. 257-259

Medline

[19]

T Pascual-Pape, JR Badia, RM Marrades, C Hernández, E Ballester, C Fornas, et al.

Resultados de dos programas con intervención domiciliaria dirigidos a pacientes con enfermedad pulmonar obstructiva crónica evolucionada.

Med Clin (Barc), 120 (2003), pp. 408-411

Article

[20]

C Domingo, J Sans-Torres, J Sola, H Espuelas, A Marín.

Efectividad y eficiencia de una consulta monográfica hospitalaria para pacientes con EPOC e insuficiencia respiratoria.

Arch Broconeumol, 42 (2006), pp. 104-112

[21]

L Davies, M Wilkinson, S Bonner, PMA Calverley, RM Angus.

“Hospital at home” versus hospital care in patients with exacerbations of chronic obstructive pulmonary disease: prospective randomised controlled trial.

BMJ, 321 (2000), pp. 1265-1268

Medline

[22]

D Meltzer, WG Manning, J Morrison, MN Shah, L Jin, T Guth, et al.

Effects of physician experience on costs and outcomes on an academic general medicine service: results of a trial of hospitalists.

Ann Intern Med, 137 (2002), pp. 866-874

Medline

[23]

L Brochard, J Mancebo, M Wysocki, F Lofaso, G Conti, A Rauss, et al.

Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease.

N Engl J Med, 333 (1995), pp. 817-822

http://dx.doi.org/10.1056/NEJM199509283331301 | Medline