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Characterizing Hospitalist Practice and Perceptions of Critical Care Delivery.

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  • 1Lexington VA Medical Center, University of Kentucky, Lexington, Kentucky, USA.

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Summary

Hospitalists often provide intensive care, especially in rural areas, facing challenges with training and support. This highlights a critical need for better intensivist staffing and patient distribution strategies.

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Area of Science:

  • Critical Care Medicine
  • Hospital Medicine
  • Healthcare Workforce Studies

Background:

  • Intensivist shortages are increasing hospitalist involvement in critical care.
  • This trend necessitates understanding the scope and challenges of hospitalist practice in intensive care units (ICUs).

Purpose of the Study:

  • To characterize the practice patterns of hospitalists working in ICU settings.
  • To assess the challenges and support needs of hospitalists providing critical care.

Main Methods:

  • A web-based survey was administered to hospital medicine physicians across the United States.
  • The survey, comprising 25 items, assessed various aspects of critical care delivery by hospitalists.

Main Results:

  • 77% of surveyed hospitalists provided critical care services, with 66% serving as primary ICU physicians.
  • Rural hospitalists were more likely to be primary ICU physicians and reported greater feelings of practicing beyond their scope and insufficient intensivist support.
  • 67% of hospitalists reported difficulty transferring ICU patients, a factor correlated with practicing beyond their scope.

Conclusions:

  • Hospitalists are extensively involved in critical care, particularly in rural settings, often without adequate training or support.
  • Addressing intensivist shortages and improving patient distribution is crucial to mitigate these challenges.