Caregiver fatigue can result in hospital negligence. A recent study shows that hospitalists are being overworked to the detriment of patient safety. There has been an increasing trend toward the use of hospitalists to provide primary care services to hospitalized patients. Hospitalists are typically internists or family practice physicians who provide general medical care but restrict their practice to the hospital setting. As with many hospital practices designed to increase profits, this seemingly good idea backfires when it is implemented without adequate staffing.
Two major factors are driving the trend toward the use of hospitalists. One, PCPs prefer to engage in office-based practices that carry a routine weekday schedule. Two, hospitals profit from the use of hospitalists, and advanced practice nurses working under their supervision, who are employed directly by the hospitals. While the concept of the hospitalist sounds good, since hospital-based physicians are allowed to specialize in seeing more acutely ill patients than their office-based counterparts, there are risks inherent in letting profit-oriented hospitals run the show.
The first problem is staffing. The Journal of the American Medical Association (JAMA) published a survey in which 40% of hospitalists reported that their patient load exceeded safe levels at least once a month and 36% reported having an unsafe workload at least weekly. The unsafe staffing had a negative impact on patient assessments and outcomes. The surveyed physicians admitted that understaffing led to unnecessary tests, procedures and consultations, inadequate time with patients, increased readmission rates, poor communication at shift change, and increased patient transfers, morbidity and mortality.
In Ohio hospital negligence cases, it is not necessary to prove that a patient was harmed as a result of inadequate staffing. Not surprisingly, hospital associations have not set standards for safe hospitalist staffing levels, so it would be impossible to prove that staffing was inadequate in any event. And, you can forget about any doctor honestly admitting that they were too busy to do their job properly. However, when unsafe staffing is the root cause of medical malpractice, there are other ways to prove that a hospitalist deviated from accepted standards of medical care.