Development and Implementation of an Inpatient Otolaryngology Consultation Service at an Academic Medical Center.

Abstract:

OBJECTIVES:To design and implement a formal otolaryngology inpatient consultation service that improves satisfaction of consulting services, increases educational opportunities, improves the quality of patient care, and ensures sustainability after implementation. METHODS:This was a retrospective cohort study in a large academic medical center encompassing all inpatient otolaryngology service consultations from July 2005 to June 2014. Staged interventions included adding fellow coverage (July 2007 onward), intermittent hospitalist coverage (July 2010 onward), and a physician assistant (October 2011 onward). Billing data were collected for incidences of new patient and subsequent consultation charges. The 2-year preimplementation period (July 2005-June 2007) was compared with the postimplementation periods, divided into 2-year blocks (July 2007-June 2013). Outcome measures of patient encounters and work relative value units were compared between pre- and postimplementation blocks. RESULTS:Total encounters increased from 321 preimplementation to 1211, 1347, and 1073 in postimplementation groups (P < 0.001). Total work relative value units increased from 515 preimplementation to 2090, 1934, and 1273 in postimplementation groups (P < 0.001). CONCLUSIONS:A formal inpatient consultation service was designed with supervisory oversight by non-Accreditation Council for Graduate Medical Education fellows and then expanded to include intermittent hospitalist management, followed by the addition of a dedicated physician assistant. These additions have led to the formation of a sustainable consultation service that supports the mission of high-quality care and service to consulting teams.

journal_name

South Med J

journal_title

Southern medical journal

authors

Huddle MG,London NR Jr,Stewart CM

doi

10.14423/SMJ.0000000000000763

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

118-122

issue

2

eissn

0038-4348

issn

1541-8243

pii

SMJ50490

journal_volume

111

pub_type

杂志文章
  • Gonococcal scalp abscess in a newborn.

    abstract::We have described a 6-day-old male infant who presented with Neisseria gonorrhoeae conjunctivitis and a scalp abscess. Delivery was complicated by rupture of the membranes 24 hours before delivery and fetal monitoring for four hours. The rare scalp abscesses caused by gonococci cleared with penicillin therapy. ...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-198003000-00042

    authors: Brook I,Rodriguez WJ,Controni G,Gold B

    更新日期:1980-03-01 00:00:00

  • Paradoxically developed optochiasmatic tuberculoma and tuberculous lymphadenitis: a case report with 18-month follow up by MRI.

    abstract::We report the first case ofextracranial tuberculous lymphadenitis which paradoxically developed during treatment of intracranial tuberculoma. Our patient, a 15-year-old girl who initially presented with meningitis and intracranial tuberculomas, developed extracranial tuberculomas during treatment for central nervous s...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/01.smj.0000209091.57281.23

    authors: Kalkan A,Serhatlioglu S,Ozden M,Denk A,Demirdag K,Yilmaz T,Kilic SS

    更新日期:2006-04-01 00:00:00

  • Posttraumatic cervical osteophytosis causing progressive dysphagia.

    abstract::Dysphagia is a commonly encountered patient complaint. The differential diagnosis for dysphagia is extensive. One long-recognized etiology of dysphagia is cervical osteophytosis. Degenerative joint disease, ankylosing spondylosis, and diffuse idiopathic skeletal hyperostosis (DISH) can all cause cervical osteophyte fo...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-199708000-00020

    authors: McGarrah PD,Teller D

    更新日期:1997-08-01 00:00:00

  • Hyponatremia in pediatric patients with HIV-1 infection.

    abstract::Hyponatremia has been recognized as a complication in adults with acquired immunodeficiency syndrome (AIDS). We did a retrospective study evaluating the medical records of 86 children (age 4 months to 21 years) with human immunodeficiency virus (HIV-1) infection to determine the frequency and clinical associations of ...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-199510000-00008

    authors: Tolaymat A,al-Mousily F,Sleasman J,Paryani S,Neiberger R

    更新日期:1995-10-01 00:00:00

  • Advice on stroke provided by pharmacies in the United States: implications for treatment and care.

    abstract:OBJECTIVES:Studies have found that some health lines and physician's offices have provided treatment advice other than "call 9-1-1 for an ambulance" to patients who present with a stroke scenario. We assessed the treatment advice given by selected pharmacies in the United States regarding stroke. METHODS:The investiga...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.14423/SMJ.0000000000000262

    authors: Monseau AJ,Whiteman C,Crocco TJ,Davis SM,Barkley J

    更新日期:2015-04-01 00:00:00

  • Metabolic issues in patients with severe mental illness.

    abstract::This article reviews the epidemiology of weight gain and diabetes mellitus in general and in patients with severe mental illness in particular. Body mass index is defined, and possible predictors for weight gain in patients receiving antipsychotic medications are also enumerated. Information on risk of association wit...

    journal_title:Southern medical journal

    pub_type: 杂志文章,评审

    doi:10.1097/01.smj.0000167621.49292.11

    authors: Citrome L,Blonde L,Damatarca C

    更新日期:2005-07-01 00:00:00

  • Smokeless tobacco: health hazard on the rise.

    abstract::There are an estimated 22 million users of smokeless tobacco in the United States, 3 million of them under age 21. We surveyed physicians and patients to determine whether the health hazard of smokeless tobacco was recognized and whether preventive measures were being implemented. Although more than 80% of physicians ...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:

    authors: Gross JY,D'Alessandri R,Powell VL,Rodeheaver A

    更新日期:1988-09-01 00:00:00

  • Effect of physician education and patient counseling on inpatient nonsurgical percutaneous feeding tube placement rate, indications, and outcome.

    abstract:BACKGROUND:The decision to place a percutaneous feeding tube (PFT) in patients who are at the end of life is multidimensional and often complicated. We assessed the effect of physician education and counseling for patients and their surrogates on inpatient nonsurgical (endoscopic and radiologic) PFT placement rates, in...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/SMJ.0b013e3181c9800f

    authors: Swaminath A,Longstreth GF,Runnman EM,Yang SJ

    更新日期:2010-02-01 00:00:00

  • Oligohydramnios sequence (Potter's syndrome): case clustering in northeastern Tennessee.

    abstract::The oligohydramnios sequence (OS) is manifest in newborns when prolonged oligohydramnios has been present during pregnancy. The most important signs are an infant small for gestational age, with wrinkled skin, Potter facies, compression deformities of the limbs, and respiratory distress caused by pulmonary hypoplasia....

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:

    authors: Prouty LA,Myers TL

    更新日期:1987-05-01 00:00:00

  • Timeliness of Treatment Initiation and Associated Survival Following Diagnosis of Non-Small-Cell Lung Cancer in South Carolina.

    abstract:OBJECTIVES:Non-small-cell lung cancer (NSCLC) patient survival depends on a number of factors, including early diagnosis and initiation of treatment. Standard treatment options for patients with NSCLC include surgery, radiation therapy, and chemotherapy. The objective of this study was to evaluate the impact that the i...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.14423/SMJ.0000000000000601

    authors: Bullard JT,Eberth JM,Arrington AK,Adams SA,Cheng X,Salloum RG

    更新日期:2017-02-01 00:00:00

  • Acupuncture: a clinical review.

    abstract::This article summarizes the research base, probable mechanism of actions, and clinical applications of acupuncture. It offers the clinician a deeper understanding of appropriate conditions for which acupuncture may be useful, outlines how to integrate acupuncture into a clinical practice, and describes referral and tr...

    journal_title:Southern medical journal

    pub_type: 杂志文章,评审

    doi:10.1097/01.SMJ.0000140834.30654.0F

    authors: Sierpina VS,Frenkel MA

    更新日期:2005-03-01 00:00:00

  • Spontaneous conversion of supraventricular tachycardia followed by electromechanical dissociation.

    abstract::We present this case to emphasize the potentially fatal outcome of supraventricular tachycardia in infancy, particularly if it has been undiagnosed for several days. Certainly, careful monitoring needs to take place during any attempt at cardioversion or any other noxious stimulation of the patient. Bicarbonate therap...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-199401000-00023

    authors: Callanan DL,Bloom KR

    更新日期:1994-01-01 00:00:00

  • Hypothyroidism with coexistent asthma: problems in management.

    abstract::This case study illustrates the relationship between hypothyroidism and bronchial asthma. As seen here, even slow and cautious restoration of the euthyroid state may lead to problems in the management of asthma. Thus routine or aggressive replacement therapy for thyroid hypofunction in the asthmatic population is not ...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-198403000-00037

    authors: Rowe MS,MacKechnie HL

    更新日期:1984-03-01 00:00:00

  • Massive hemorrhage in an ileal duplication cyst.

    abstract::We have described massive intermittent intestinal hemorrhage due to a vascular anomaly in an ileal duplication cyst in a 30-year-old man. This unusual case illustrates that these lesions disguise themselves symptomatically and must be considered in the differential diagnosis of gastrointestinal bleeding. ...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-198412000-00039

    authors: Salameh RN,Hausner RJ,Thomas SJ,Johnson CD

    更新日期:1984-12-01 00:00:00

  • Heparin-induced hyperkalemia.

    abstract::We have described three patients with diabetes and renal insufficiency who had hyperkalemia during heparin therapy. These cases lend support to previous findings, and emphasize the clinical importance of this entity. We believe that heparin-induced hyperkalemia is a potentially life-threatening problem that is more co...

    journal_title:Southern medical journal

    pub_type: 杂志文章,评审

    doi:10.1097/00007611-198711000-00029

    authors: Busch EH,Ventura HO,Lavie CJ

    更新日期:1987-11-01 00:00:00

  • Progressive parkinsonism in boxers.

    abstract::Parkinsonism associated with boxing has attracted recent media attention, yet little has been written about it in the medical literature. This report presents a typical case with a review of the literature. ...

    journal_title:Southern medical journal

    pub_type: 杂志文章,评审

    doi:10.1097/00007611-198905000-00002

    authors: Friedman JH

    更新日期:1989-05-01 00:00:00

  • Topotecan-induced bronchiolitis.

    abstract::Topotecan HCl is an antitumor drug exhibiting topoisomerase 1-inhibitory activity. Topotecan is used in the treatment of metastatic carcinoma of the ovary and as second-line treatment of small-cell lung cancer. Reported dose-limiting adverse reactions to topotecan are primarily hematologic in nature. To date, only one...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-200407000-00018

    authors: Edgerton CC,Gilman M,Roth BJ

    更新日期:2004-07-01 00:00:00

  • Establishing an internal medicine practice: a model to determine economic feasibility.

    abstract::To make informed career decisions, physicians must acquire a basic knowledge in medical management and health care economics as they evaluate the potential survival and growth of a primary care practice. Health care providers considering a specific community and local leaders and hospital administrators attempting to ...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-199404000-00006

    authors: Miller KA,Miller D,Doeksen G,Shelton P

    更新日期:1994-04-01 00:00:00

  • Normal sinus heart rate: appropriate rate thresholds for sinus tachycardia and bradycardia.

    abstract::Conventional rate limits for sinus rhythm--100/min as the tachycardia threshold and 60/min as the bradycardia threshold--were established by consensus and never formally examined. Because clinical experience indicated that both figures were too high, we investigated this formally in 500 normal individuals. Results wer...

    journal_title:Southern medical journal

    pub_type: 杂志文章,评审

    doi:10.1097/00007611-199607000-00003

    authors: Spodick DH

    更新日期:1996-07-01 00:00:00

  • Splenic abscess due to Clostridium septicum in a patient with multiple myeloma.

    abstract::Solitary abscesses of the spleen may occur as a consequence of septicemia from various septic foci, particularly intra-abdominal sites. A variety of causative organisms, including the clostridia, have been isolated. We have described a patient with multiple myeloma who had a solitary splenic abscess due to Clostridium...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-198710000-00029

    authors: Kinnaird DW,Melo JC,McKeown JM

    更新日期:1987-10-01 00:00:00

  • Nodular sclerosing Hodgkin's disease presenting as nephrotic syndrome.

    abstract::A case of nephrotic syndrome due to minimal change renal disease was associated with minimally symptomatic nodular sclerosing Hodgkin's disease in a 15-year-old girl. Although minimal renal disease is the most frequently described biopsy finding in this paraneoplastic syndrome, the combination of nodular sclerosing Ho...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-198205000-00027

    authors: Cale WF,Ullrich IH,Jenkins JJ

    更新日期:1982-05-01 00:00:00

  • Wuchereria bancrofti in a Haitian immigrant.

    abstract::A case of Wuchereria bancrofti filariasis was recently seen in a Haitian immigrant in Charleston, SC. The Caribbean area is a known endemic focus for this organism. With the increased numbers of immigrants from that area, it is likely that other such cases will be seen in the US. ...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-198504000-00032

    authors: Morris RC,Pappas AA,Garvin AJ

    更新日期:1985-04-01 00:00:00

  • Impact of Holidays on Pediatric Trauma Admissions to a Community Hospital in South Florida.

    abstract:OBJECTIVES:The data from temperate regions indicate increases in pediatric traumatic injuries during the spring and summer months with anticipated admission spikes on warm weather holidays; hospitals in southern subtropical regions should not anticipate the same trends. The objectives of this study were to identify hol...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.14423/SMJ.0000000000000947

    authors: Eyerly-Webb S,Solomon R,Young L,Bard K,Laituri C,Rosenthal A,Long J

    更新日期:2019-03-01 00:00:00

  • Maternal serum amylase and lipase profiles in pregnancy: determinations in both once-sampled and multisampled patient cohorts.

    abstract::The objective of this study was to determine the effect(s) of pregnancy and of advancing gestation on maternal serum amylase and lipase levels. Thus, serum amylase and lipase concentrations were quantitated in three groups of women. Groups included (1) 118 pregnant women whose serum amylase and lipase levels were meas...

    journal_title:Southern medical journal

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00007611-199602000-00008

    authors: Xydas NP,May JH,Henson MC

    更新日期:1996-02-01 00:00:00

  • Disseminated Candida tropicalis in a patient with chronic mucocutaneous candidiasis.

    abstract::Chronic mucocutaneous candidiasis is a heterogeneous group of immunodeficiencies associated with persistent candidal infections. Patients with chronic mucocutaneous candidiasis are rarely associated with systemic infections caused by other fungi, but almost never by Candida. The authors report a case of a 16-year-old ...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-200408000-00024

    authors: Dixon TC,Steinbach WJ,Benjamin DK Jr,Williams LW,Myers LA

    更新日期:2004-08-01 00:00:00

  • Declines in smokers' understanding of tobacco's hazards between 1986 and 1998: a report from north Georgia.

    abstract:BACKGROUND:The prevalence of smoking in the general US population has declined significantly over the past few decades. Despite this, few studies have examined changes in cigarette attributes perceived by less educated, rural, or southern populations. METHODS:A survey was administered to individuals in clinic waiting ...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:

    authors: Frank E,Denniston M,Pederson L

    更新日期:2002-07-01 00:00:00

  • Rocky Mountain spotted fever: gastrointestinal and laboratory manifestations.

    abstract::Sixty-six cases of serologically documented Rocky Mountain spotted fever (RMSF) from North Carolina are reviewed. Gastrointestinal manifestations were present in 80% of these patients. Because other common expressions of RMSF occasionally do not accompany severe gastrointestinal dysfunction, improper diagnosis and the...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-197806000-00007

    authors: Middleton DB

    更新日期:1978-06-01 00:00:00

  • Effect of a patient care partnership project on cost and quality of care at an academic teaching hospital.

    abstract:BACKGROUND:In 1998, the Patient Care Partnership Project was conducted by general internal medicine physicians and hospital administration in an academic health care center. The project was designed to optimize cost, quality, and service results to inpatients. METHODS:The project focused on improved communication amon...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:

    authors: Palmer HC Jr,Halperin A,Elnicki M,Powers R,Kolar M,Evans K,Anderson K

    更新日期:2002-11-01 00:00:00

  • Left ventricular function in sickle cell anemia: a noninvasive evaluation.

    abstract::There is controversy in the medical literature regarding the significance of "sickle cell cardiomyopathy." In an attempt to clarify this, we studied 14 patients with sickle cell anemia (age range 16 to 36 years) using simultaneous echocardiography and phonocardiography. The values of systolic time intervals and echoca...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-198003000-00020

    authors: Covarrubias EA,Sheikh MU,Solanki DL,Morjaria M,Fox LM

    更新日期:1980-03-01 00:00:00

  • Sacral pressure sores: treatment with island gluteus maximus musculocutaneous flaps.

    abstract::We have used the island gluteus maximus musculocutaneous flap to cover sacral pressure sores. In this report, we describe the surgical anatomy, cadaveric dissections (n = 25), and postoperative follow-up (one to 40 months) in 13 clinical cases. Our results compare favorably with those of other previously reported seri...

    journal_title:Southern medical journal

    pub_type: 临床试验,杂志文章

    doi:

    authors: Rees RS,Reilley AF,Nanney LB,Lynch JB

    更新日期:1985-10-01 00:00:00