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I've always been curious how others have their SBAR conversation with the hospitalist for an ED admission.
Do you technically "ask" the hospitalist to admit the pt or do you "tell" the hospitalist to admit the pt? I hear residents and colleagues with a variety of styles and always hear subtle variations that go something like this:
1) SBAR discussion....."So, Dr. X I'm going to admit this pt to an inpatient telemetry bed under your service. Do you have any questions?"
2) SBAR discussion...."So, Dr. X, I'd like to admit this patient to an inpatient telemetry bed under your service. Do you have any questions?"
3) SBAR discussion...."So, Dr. X, if it's ok with you....I'd like to go ahead and admit this pt to an inpatient telemetry bed under your service. Do you have any questions?"
I'm just curious how you guys phrase your admission conversations with the admitting docs. I've found that if I'm at a place where I'm friends with these guys and there's no wall culture, I tend to assess whether the hospitalist is ok with the admission so that they can feel (rightly so) that they are the ones admitting the pt and I'm making a conscious effort to ascertain their comfort level with the admission. If I were a hospitalist, the last thing I would want is an EM doc "telling me" what I need to do with no input on my end. I just think that's rude and unprofessional. I mean, technically none of us have admitting privileges in the first place.
That being said, if I'm working in hospitals with a "wall culture" I tend to "tell" them I'm admitting the pt and not give any wiggle room where they can avoid/delay/stall and want to prevent the impression that any of this is debatable. All that being said, it's becoming much more rare for me to even feel the need to consciously think much about it since I'm somewhat of a minimalist these days and probably have one of the lowest admission rates so usually if they need to come in on my watch, the admission was completely unavoidable and I tend to feel that most hospitalists that know me realize that in advance.
How do you guys facilitate your admissions? It's a subtle point but I feel like so many people have a variety of ways in how they approach the conversation and it's always fun for me to listen to other docs on the phone when I'm working in a double or triple coverage shop. I get a kick out of listening to the residents (usually interns) get to the point in the conversation where they need to admit the pt and they start to repeat themselves and go blank on how to "seal the deal", lol.
(Any input from hospitalists/future hospitalists is welcome. I've always been curious if these guys get offended by a conversation where they are "being told" the pt will be admitted to them and they don't get a sense of a request from the ED doc.)
Do you technically "ask" the hospitalist to admit the pt or do you "tell" the hospitalist to admit the pt? I hear residents and colleagues with a variety of styles and always hear subtle variations that go something like this:
1) SBAR discussion....."So, Dr. X I'm going to admit this pt to an inpatient telemetry bed under your service. Do you have any questions?"
2) SBAR discussion...."So, Dr. X, I'd like to admit this patient to an inpatient telemetry bed under your service. Do you have any questions?"
3) SBAR discussion...."So, Dr. X, if it's ok with you....I'd like to go ahead and admit this pt to an inpatient telemetry bed under your service. Do you have any questions?"
I'm just curious how you guys phrase your admission conversations with the admitting docs. I've found that if I'm at a place where I'm friends with these guys and there's no wall culture, I tend to assess whether the hospitalist is ok with the admission so that they can feel (rightly so) that they are the ones admitting the pt and I'm making a conscious effort to ascertain their comfort level with the admission. If I were a hospitalist, the last thing I would want is an EM doc "telling me" what I need to do with no input on my end. I just think that's rude and unprofessional. I mean, technically none of us have admitting privileges in the first place.
That being said, if I'm working in hospitals with a "wall culture" I tend to "tell" them I'm admitting the pt and not give any wiggle room where they can avoid/delay/stall and want to prevent the impression that any of this is debatable. All that being said, it's becoming much more rare for me to even feel the need to consciously think much about it since I'm somewhat of a minimalist these days and probably have one of the lowest admission rates so usually if they need to come in on my watch, the admission was completely unavoidable and I tend to feel that most hospitalists that know me realize that in advance.
How do you guys facilitate your admissions? It's a subtle point but I feel like so many people have a variety of ways in how they approach the conversation and it's always fun for me to listen to other docs on the phone when I'm working in a double or triple coverage shop. I get a kick out of listening to the residents (usually interns) get to the point in the conversation where they need to admit the pt and they start to repeat themselves and go blank on how to "seal the deal", lol.
(Any input from hospitalists/future hospitalists is welcome. I've always been curious if these guys get offended by a conversation where they are "being told" the pt will be admitted to them and they don't get a sense of a request from the ED doc.)
