The hospitalist as coordinator: an observational case study

摘要

Purpose - The hospitalist concept aims for integration and continuity of care in inpatient treatment.rnThe purpose of this paper is to understand how the hospitalist function emerges and unfolds on wards.rnTherefore, the paper aims to focus on interaction patterns and the role of the hospitalist.rnDesign/methodology/approach - Building on methodological approaches in health care teamrnresearch, this process-oriented case study used participatory observations and semi-structuredrninterviews. Over a year, 14 observational days were conducted, simultaneously accompanyingrnhospitalists, nurses and surgeons. Observational data illustrate the findings.rnFindings - The hospitalist function was perceived to have a positive impact. He/she serves as anrninformal leader by taking up five interrelated, mostly coordinative roles, which help to cope withrndifferent organisational gaps. The interaction patterns are bilateral, ad hoc, reactive, repetitive andrndependent on chance and people. Roles, tasks and responsibilities are continuously negotiated.rnResearch limitations/implications - Hospitalist research should make use of the debate in healthrncare team research about overlapping roles, tasks and responsibilities. Additionally, one could look atrnthe origins behind the evolvement of interaction patterns and the hospitalist's roles.rnPractical implications - The sole creation of the hospitalist function is not sufficient to tap its fullrnpotential. Organisational issues concerning the interaction processes need to be addressed. In so doing,rnthe professions' orientations must be taken into account.rnOriginality/value - This paper addresses theoretical and methodological gaps in hospitalistrnresearch. Using a process-oriented qualitative design, the findings question the prominentrnstimulus-response assumption. The focus on the interplay of functions and the hospitalists' rolesrnlead to a more comprehensive picture of the patient-related interaction processes.