Neurohospitalists: an emerging model for inpatient neurological care.
Over the past decade, the hospitalist model has become a dominant system for the delivery of general adult and pediatric inpatient care. Similar forces, including national mandates to improve safety and quality and intense pressure to safely reduce length of hospital stays, that led to the remarkable growth of hospitalist medicine are now exerting pressure on neurologists. A neurohospitalist model, in which inpatient neurology specialists deliver high-quality and efficient care to neurology patients, is emerging to meet these challenges. Benefits of this system may include more frequent, timely neurology consultations in the hospital and emergency department, as well as improved quality of inpatient neurological education for residents and medical students. Challenges will involve defining the relationship of neurohospitalists with primary stroke centers, the economic feasibility of such neurohospitalist systems, and how to train members of this new field. A neurohospitalist model of care is an emerging idea in neurology that would overcome many regulatory, educational, and economic challenges facing neurologists; further research is needed to gauge the effects of this innovative approach.
Josephson
S Andrew
SA
Department of Neurology, University of California San Francisco, San Francisco, CA 94143-0114, USA. ajosephson@memory.ucsf.edu
Engstrom
John W
JW
Wachter
Robert M
RM
D020445:Hospitalists / Q000193:education / Q000592:standards / Q000639:trends*; D006760:Hospitalization / Q000639:trends*; D006761:Hospitals / Q000592:standards / Q000639:trends*; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D017146:Models, Organizational; D009422:Nervous System Diseases / Q000175:diagnosis / Q000451:nursing / Q000628:therapy*; D009462:Neurology / Q000193:education / Q000592:standards / Q000639:trends; D010348:Patient Care Team / Q000191:economics / Q000592:standards; D011787:Quality of Health Care / Q000592:standards; D000078329:Workforce