For example, a physician may have the skills to do a thyroidectomy, but a particular patient may have special needs. “It is customary to provide a ‘sign-out’ to the doctor covering the call, but this best practice is not always carried out, even though it is essential to providing good care during nights and weekends when a problem may arise,” Dr. Feldman said. “Without knowing the patient, the physician on call may instruct the patient to go to the emergency room. But by having a working knowledge of the patient, the physician on call may be able to offer instructions over the phone or provide care instructions to emergency room staff.”
Explore This IssueOctober 2015
Additionally, having evening and weekend office hours increases patient access to physicians, Dr. Feldman continued. Otherwise, a patient may have to seek treatment at an emergency room.
Another suggestion is to involve more senior and experienced surgeons for high-risk patients. “These doctors may be better suited to manage surgical procedures and recognize potential complications early on,” said Lifei Guo, MD, PhD, chairman of the department of plastic and reconstructive surgery at Lahey Hospital and Medical Center in Burlington, Mass., a teaching affiliate of Tufts University School of Medicine in Boston, where he is an associate professor of surgery.
Many best practices can be employed to prevent otolaryngology patients from returning to the hospital. Among these are partnering with community physicians, using a pre-admission clinic, addressing quality care, preventing SSIs, providing good physician coverage, and involving experienced surgeons more closely in high-risk cases.
Karen Appold is a freelance medical writer based in Pennsylvania.