BOOK
Obstetric and Gynecologic Hospitalists and Laborists, An Issue of Obstetrics and Gynecology Clinics, E-Book
(2015)
Additional Information
Book Details
Abstract
The Ob/Gyn Hospitalist, the newest subspecialist in the field of obstetrics and gynecology, has the potential to improve patient safety, patient and provider satisfaction, workforce challenges and clinical outcomes. Programs are exploding across the country, mirroring the growth of the internal medicine hospitalist programs 10 years ago. Ob/Gyn hospitalist jobs are the most sought after in the field. We will present the history of the Ob/Gyn Hospitalist movement, available evidence to date supporting Ob/Gyn Hospitalists, and where we believe the field is going.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Obstetric and GynecologicHospitalists and Laborists | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Foreword: The Ob/Gyn Hospitalist: An Expanding Area of Practice Deserving Our Attention\r | vii | ||
| Preface: Obstetric and Gynecologic Hospitalists and Laborists\r | vii | ||
| Laborist to Obstetrician/Gynecologist–Hospitalist: An Evolution or a Revolution?\r | vii | ||
| A History of the Hospitalist Movement\r | vii | ||
| Hospitalists and Their Impact on Quality, Patient Safety, and Satisfaction\r | vii | ||
| Roles of Obstetrician-Gynecologist Hospitalists with Changes in the Obstetrician-Gynecologist Workforce and Practice\r | viii | ||
| What is an Obstetrics/Gynecology Hospitalist?\r | viii | ||
| The Role of Obstetrics/Gynecology Hospitalists in Reducing Maternal Mortality\r | viii | ||
| Impact of Obstetrician/Gynecologist Hospitalists on Quality of Obstetric Care (Cesarean Delivery Rates, Trial of Labor Afte\r | viii | ||
| Potential Impact of Obstetrics and Gynecology Hospitalists on Safety of Obstetric Care\r | ix | ||
| Sleep Deprivation\r | ix | ||
| Obstetrics Hospitalists: Risk Management Implications\r | ix | ||
| Organizing an Effective Obstetric/Gynecologic Hospitalist Program\r | ix | ||
| Business and Organizational Models of Obstetric and Gynecologic Hospitalist Groups\r | x | ||
| Obstetrics and Gynecology Hospitalist Fellowships\r | x | ||
| OBSTETRICS AND GYNECOLOGY CLINICS\r | xi | ||
| FORTHCOMING ISSUES | xi | ||
| December 2015 | xi | ||
| March 2016 | xi | ||
| June 2016 | xi | ||
| RECENT ISSUES | xi | ||
| June 2015 | xi | ||
| March 2015 | xi | ||
| December 2014 | xi | ||
| The Ob/Gyn Hospitalist: An Expanding Area of Practice Deserving Our Attention | xiii | ||
| Obstetric and Gynecologic Hospitalists and Laborists | xv | ||
| Laborist to Obstetrician/Gynecologist–Hospitalist | 415 | ||
| Key points | 415 | ||
| REFERENCES | 417 | ||
| A History of the Hospitalist Movement | 419 | ||
| Key points | 419 | ||
| INTRODUCTION | 419 | ||
| EARLY HISTORY OF HOSPITALISTS | 420 | ||
| MODERN HISTORY OF HOSPITALISTS | 420 | ||
| EARLY CHALLENGES AND SOLUTIONS | 422 | ||
| Growth of Hospital Medicine/Drivers of Hospital Medicine | 423 | ||
| CURRENT STATE OF HOSPITAL MEDICINE | 423 | ||
| What Do Hospitalists Do Today? | 425 | ||
| OUTCOMES | 425 | ||
| Research Providing Evidence of Hospital Medicine Effectiveness | 425 | ||
| COMMON ISSUES FACING HOSPITAL MEDICINE TODAY AND POTENTIAL SOLUTIONS | 427 | ||
| FUTURE OF HOSPITAL MEDICINE | 427 | ||
| HOSPITAL-FOCUSED SPECIALTIES | 428 | ||
| OBSTETRICS AND GYNECOLOGY HOSPITALIST MODEL | 428 | ||
| SUMMARY | 429 | ||
| REFERENCES | 429 | ||
| Hospitalists and Their Impact on Quality, Patient Safety, and Satisfaction | 433 | ||
| Key points | 433 | ||
| BACKGROUND | 433 | ||
| HOSPITALISTS AND PATIENT SAFETY | 434 | ||
| Device-Associated Morbidity | 435 | ||
| Medication Safety | 435 | ||
| Venous Thromboembolism Prophylaxis | 436 | ||
| HOSPITALISTS AND QUALITY | 436 | ||
| Care Transitions | 436 | ||
| Comanagement of Surgical Patients | 439 | ||
| End-of-Life/Palliative Care | 440 | ||
| HOSPITALISTS AND PATIENT-CENTERED CARE | 440 | ||
| EMERGENCE OF SUBSPECIALTY HOSPITALISTS | 441 | ||
| SPECULATION OF IMPACT ON OBSTETRIC-GYNECOLOGIST HOSPITALIST | 442 | ||
| SUMMARY | 443 | ||
| REFERENCES | 444 | ||
| Roles of Obstetrician-Gynecologist Hospitalists with Changes in the Obstetrician-Gynecologist Workforce and Practice | 447 | ||
| Key points | 447 | ||
| INTRODUCTION | 447 | ||
| CHANGES IN THE OBSTETRICIAN-GYNECOLOGIST WORKFORCE AND PRACTICES | 448 | ||
| More Female Obstetricians-Gynecologists | 448 | ||
| Emphasis on Work-Life Balance | 449 | ||
| More Subspecialization | 450 | ||
| Larger Practices and Employed Physicians | 450 | ||
| Universal Electronic Health Records and Standardizing Health Care | 450 | ||
| Emphasis on Quality and Performance Improvement | 451 | ||
| Transformational Forces Leading to Change | 451 | ||
| ROLES OF OBSTETRICIAN-GYNECOLOGIST HOSPITALISTS | 452 | ||
| Work-Life Balance and Physician Support | 452 | ||
| Standardization of Care and Quality Improvement | 453 | ||
| Financial Considerations | 454 | ||
| REFERENCES | 454 | ||
| What is an Obstetrics/Gynecology Hospitalist? | 457 | ||
| Key points | 457 | ||
| INTRODUCTION | 457 | ||
| What Is an Obstetrics/Gynecology Hospitalist? | 458 | ||
| Do Obstetrics/Gynecology Hospitalists Improve Care? | 458 | ||
| How Do Obstetrics/Gynecology Hospitalists Improve Care for an Individual Patient? | 459 | ||
| How Do Obstetrics/Gynecology Hospitalists Improve Care on a Departmental Level? | 459 | ||
| What Skills and Educational Background Are Needed to Be a Good Obstetrics/Gynecology Hospitalist? | 459 | ||
| Can Any Obstetrics/Gynecology Physician Be an Obstetrics/Gynecology Hospitalist? | 460 | ||
| Why Should You Consider Becoming an Obstetrics/Gynecology Hospitalist? | 460 | ||
| REFERENCES | 460 | ||
| The Role of Obstetrics/Gynecology Hospitalists in Reducing Maternal Mortality | 463 | ||
| Key points | 463 | ||
| INTRODUCTION | 463 | ||
| POSTPARTUM HEMORRHAGE | 464 | ||
| Background | 464 | ||
| Preparation | 465 | ||
| Recognition and Initial Measures | 466 | ||
| Diagnosis and Definitive Management | 468 | ||
| Summary | 469 | ||
| COMPLICATIONS OF PREECLAMPSIA | 469 | ||
| Background | 469 | ||
| Acute Hypertensive Crisis | 470 | ||
| Background | 470 | ||
| Recognition and management | 470 | ||
| Pulmonary Edema | 472 | ||
| Background | 472 | ||
| Recognition and management | 472 | ||
| Impact of Obstetrician/Gynecologist Hospitalists on Quality of Obstetric Care (Cesarean Delivery Rates, Trial of Labor Afte ... | 477 | ||
| Key points | 477 | ||
| INTRODUCTION | 477 | ||
| CESAREAN DELIVERY | 478 | ||
| TRIAL OF LABOR AFTER CESAREAN DELIVERY AND VAGINAL BIRTH AFTER CESAREAN | 480 | ||
| The Obstetrician-Gynecologist Hospitalist and Cesarean Delivery Rates | 480 | ||
| Laborist Programs and Effect on Trial of Labor After Cesarean Delivery | 481 | ||
| Neonatal Outcomes and Obstetric Hospitalist Coverage | 482 | ||
| SUMMARY | 483 | ||
| REFERENCES | 483 | ||
| Potential Impact of Obstetrics and Gynecology Hospitalists on Safety of Obstetric Care | 487 | ||
| Key points | 487 | ||
| INTRODUCTION | 487 | ||
| THE PROBLEM OF MATERNAL MORTALITY | 488 | ||
| INFANT MORTALITY | 488 | ||
| TIMELINESS OF DELIVERY IN EMERGENT SITUATIONS | 489 | ||
| PREVENTABLE PERINATAL OUTCOMES WITH CLOSE MONITORING AND INTERVENTION | 489 | ||
| Hemorrhage | 489 | ||
| Use of Oxytocin | 489 | ||
| THE ROLE OF THE OBSTETRICS AND GYNECOLOGY HOSPITALIST IN PATIENT SAFETY | 490 | ||
| SUMMARY/DISCUSSION | 490 | ||
| REFERENCES | 490 | ||
| Sleep Deprivation | 493 | ||
| Key points | 493 | ||
| INTRODUCTION | 493 | ||
| WHY DO HUMANS SLEEP? | 494 | ||
| SLEEP DEPRIVATION | 495 | ||
| CAN SLEEP DEPRIVATION BE CURED? | 496 | ||
| SLEEP DEPRIVATION IN THE AGE OF ELECTRONICS | 497 | ||
| SLEEP DEPRIVATION IN PREGNANCY | 497 | ||
| EVOLUTION OF WORK RESTRICTIONS FOR RESIDENCY PROGRAMS | 498 | ||
| ATTENDING PHYSICIAN FATIGUE | 499 | ||
| COMBATING SLEEP DEPRIVATION WITH A HOSPITALIST PROGRAM | 502 | ||
| SUMMARY | 503 | ||
| REFERENCES | 504 | ||
| Obstetrics Hospitalists | 507 | ||
| Key points | 507 | ||
| RISK MANAGEMENT, CLAIMS, GETTING TO HAVARTI | 507 | ||
| Common Obstetric Practices That Can Weaken Defenses | 508 | ||
| What makes the holes in the Swiss cheese larger? | 508 | ||
| The Hospitalist Movement | 509 | ||
| How Does an Obstetrics Hospitalist Program Function as a Safety Net for a Perinatal Unit? | 509 | ||
| Is There Objective Evidence That Obstetrics Hospitalists Improve Outcomes and Reduce the Chance for Adverse Outcomes? | 510 | ||
| THE OBSTETRICS HOSPITALIST MOVEMENT AND MODELS OF CARE | 511 | ||
| OVERCOMING CHALLENGES/THE ROLE OF THE RISK MANAGER | 511 | ||
| Cost | 512 | ||
| Patient Satisfaction | 512 | ||
| Provider Satisfaction | 512 | ||
| Establishment of Policies and Procedures Surrounding the Obstetrics Hospitalist Model | 512 | ||
| The Defined Duties of a Hospitalist From a Sample Contract | 513 | ||
| EARLY RESOLUTION, APOLOGY, AND DISCLOSURE | 515 | ||
| SUMMARY | 516 | ||
| REFERENCES | 516 | ||
| Organizing an Effective Obstetric/Gynecologic Hospitalist Program | 519 | ||
| Key points | 519 | ||
| INTRODUCTION | 519 | ||
| CLINICAL EXCELLENCE | 521 | ||
| TEAM LEADER PHYSICIAN OR MEDICAL DIRECTOR | 522 | ||
| WELL ORGANIZED START-UP PROCESS | 523 | ||
| PATIENT EDUCATION/PREPAREDNESS | 523 | ||
| CUSTOMIZATION/PRIORITIZATION OF PROGRAM DESIGN BASED ON THE FACILITY'S NEEDS | 523 | ||
| OBSTETRIC EMERGENCY DEPARTMENT | 524 | ||
| CLINICAL SUPPORT/EDUCATION | 526 | ||
| MATERNAL FETAL MEDICINE SUPPORT | 527 | ||
| STAFF OBSTETRIC SUPPORT | 528 | ||
| OBSTETRIC SERVICE AGREEMENTS | 529 | ||
| NATIONAL QUALITY FORUM AND QUALITY METRICS MONITORING | 529 | ||
| STRATIFICATION OF SUPPORT INITIATIVES | 529 | ||
| COST CONSIDERATIONS | 529 | ||
| SUMMARY | 532 | ||
| REFERENCES | 532 | ||
| Obstetrics and Gynecology Hospitalist Fellowships | 541 | ||
| Key points | 541 | ||
| INTRODUCTION | 541 | ||
| STEPS UNDERTAKEN TO CREATE THE FIRST OBSTETRICIAN/GYNECOLOGIST HOSPITALIST FELLOWSHIP | 542 | ||
| LEARNING OBJECTIVES OF THE OBSTETRICIAN/GYNECOLOGIST HOSPITALIST FELLOWSHIP | 543 | ||
| General Learning Objectives | 543 | ||
| Specific Learning Objectives | 543 | ||
| Clinical duties | 544 | ||
| Educational duties | 544 | ||
| FELLOWSHIP PROGRAM EVALUATION | 544 | ||
| OUR FIRST HOSPITALIST FELLOW RESEARCH PROJECT | 547 | ||
| SUMMARY/DISCUSSION | 547 | ||
| REFERENCES | 547 | ||
| Index | 549 |