Background: The division of the hospital medicine at the University of Florida has 52 attending hospitalist physicians with an average daily census of 200 patients. On any given day, one physician carries 16 patients and practices direct care services. This includes chart review, placing orders, answering pages, coordinating with case managers, requesting consultations, rounding on patients, and talking to the family. Due to the amount of non-physician work, the physicians have less time with the patients. Because of this awareness, the group hired a medical assistant to help with non-physician related work.
Purpose: Two premedical students joined physicians on daily rounds. Initially this was limited to geocentric floors as it allowed for better physician and clinical assistant continuity. After a few weeks, the following activities were deemed the most helpful: o Pre round with patients and nurse and write down the questions they have for the physician o Pending orders during rounds o Calling specialty consults and follow up with consulting physician for updates. o Requesting records o Updating the nurses on plan of care after rounds o Informing the patients and the family regarding any new updates
Description: Physician response: 90.9% reported that the program improved workflow, while 9.1% responded neutral. Around 81.9% were able to spend more time with patients and 18.2% were neutral. 90.9% responded that they could communicate more efficiently with the consultants and 9.1% responded neutral. 81.8% responded that the number of pages decreased when working with a clinical assistant, 18.2% responded neutral. 91% responded that the clinical assistant had a positive impact on quality of care that has been provided, 9.1% responded neutral and 9.1% disagreed. 90.9% responded that the clinical assistant program should continue and expand where 9.1% disagreed. Case Manager response: 100% responded that the clinical assistants made their work better, increased efficiency of the workflow by following up with orders and ensuring that concerns and questions are addressed promptly. They also strengthened the level of communication in delivery of patient care as well as facilitated discharge. Nurse’s response: 75% agreed that the program made work better while 9.1% were neutral and 8.3% disagreed. 83.3% helped to increase the efficiency of my workflow by following up with orders and ensuring that concerns/questions are addressed promptly and 16.7% were neutral. 83.3% strengthened the level of communication in the delivery of patient care and 8.3% disagreed. 83.3% responded that the program should continue and expand, 16.7% were neutral.
Conclusions: Clinical assistants have been a great resource for the attending hospitalist physicians, case managers, nurses as well as for the patients. Their help improved patient satisfaction on the floors where they were deployed. They were considered a resource to assist with patient care and to help clarify the team’s goals for the patient. Overall, the communication between the nurses, consultants, and the patient improved significantly with this program. A clinical assistant’s help was very valuable during the COVID pandemic where they used telephones and video calls to communicate with the patients and assist the physicians while they were busy with patient care. The inability to place orders in the EMR and write notes were a few areas which would have further improved the quality of this project.