Building and Sustaining Co-Management Programs in Hospital Medicine: A Technical Report and Operational Guide-Appendix E

Appendix E - Examples of Interservice Agreements

Pdf Summary

The document is an appendix with examples of interservice agreements within a hospitalist co-management model, highlighting collaborative protocols between different departments to streamline care and management of patients.<br /><br />**Example 1: Medicine/Orthopedics/ED Interservice Agreement, Stanford University**<br /><br />- **Admissions**: Criteria are detailed for admitting patients with acute fractures and other orthopedic conditions unless the patient has specific severe medical issues necessitating admission to a medical service instead of orthopedics.<br />- **Hip Fracture Protocol**: This protocol involves a specific operational time and responsibilities, with a surgical co-management (SCM) service aiding orthopedics.<br />- **Emergency Department Role**: The ED's role includes assessing and deciding the appropriate admitting service following predetermined criteria.<br />- **Consults**: SCM provides consultative roles for evaluation and management of medical issues for orthopedic patients, delineating specific procedures for acute and non-emergent issues.<br />- **Transfer Requests**: Guidelines are in place for transferring patients between orthopedics and medical services based on the changing nature of a patient's medical conditions.<br /><br />**Example 2: Hospital Medicine/Cardiology Collaborative Practice Agreement, Riverside Health System**<br /><br />- **Goals & Objectives**: Aim to provide high-quality care to patients with primary cardiac issues.<br />- **Admission Process**: Specific conditions determine whether cardiologists or hospitalists admit the patient, emphasizing a structured triage system.<br />- **Consult Process**: Requires direct communication between providers and mandates that consults include timely management and clear documentation.<br />- **Roles & Responsibilities**: Define responsibilities of hospitalists and cardiologists, focusing on managing primary medical vs. cardiac issues.<br />- **Transfer of Care**: Protocols for switching the primary care focus, emphasizing the importance of communication and mutual agreement about service transfer.<br />- **Dispute Resolution**: Establishes methods for resolving disagreements regarding treatment plans and roles.<br />- **Metrics**: The success of the collaborative practice is measured by service quality, patient satisfaction, and resource utilization.<br /><br />These agreements are designed to ensure coherent, safe, and efficient patient care through clear communication and shared responsibilities among healthcare providers.

Keywords

interservice agreements

hospitalist co-management

collaborative protocols

patient care

admissions criteria

hip fracture protocol

emergency department role

consultative roles

transfer requests

dispute resolution