Building a Successful Hospitalist Medicine Procedure Service is More than Just Doing Procedures-Slides

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This presentation, "Building a Successful Hospitalist Medicine Procedure Service" by Drs. Jeremy Gentile and Fergus Peacock, outlines the development and implementation of a Hospitalist Medicine Procedure Service (HMPS) aimed at improving procedural care within hospital medicine. The service focuses primarily on procedures such as ultrasound-guided paracentesis, thoracentesis, and skin punch biopsies, with goals to enhance resident training, promote professional growth, reduce patient length of stay, and achieve cost savings.<br /><br />Key considerations for establishing an HMPS include identifying the volume and types of procedures needed, balancing costs and benefits, defining credentialing and training processes, and integrating multidisciplinary collaboration with pulmonary medicine, nursing, and laboratory teams. The presenters emphasize starting small and scaling up, supported by internal staffing, system-wide ultrasound initiatives, and supply management.<br /><br />Training involves mentorship with experienced procedures physicians and a pathway requiring direct observation and competency validation, credentialing, and possibly extended mentorship. Equipment choices hinge on balancing portability, image quality, cost, and integration with hospital systems. Nursing plays an important role in patient preparation, monitoring, and medication management during procedures.<br /><br />Challenges discussed include managing anticoagulation protocols, ensuring quality improvement, coordinating across hospital floors (ICU, medical wards, ED), and addressing billing and coding complexities. The presenters recommend strong clinical and administrative partnerships alongside a clear business plan to support the service's success.<br /><br />In summary, creating a successful HMPS requires a compelling rationale, thoughtful planning on staffing, training, equipment, and integration with hospital services, as well as continuous quality assurance. The service ultimately aims to improve patient care, education, and operational efficiency in hospital medicine settings. Contact information for Drs. Gentile and Peacock is provided for further inquiry.

Keywords

Hospitalist Medicine Procedure Service

HMPS

ultrasound-guided paracentesis

thoracentesis

skin punch biopsies

resident training

credentialing and training

multidisciplinary collaboration

quality improvement

billing and coding