Neurochirurgie
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Comparative Study Observational Study
Optimizing medical postoperative care: Role of the hospitalist in a department of adult neurosurgery. Prospective comparative observational study.
There is no consensus on responsibilities in postoperative care in neurosurgery, although this has grown in recent decades with an aging population and increasing chronic diseases, making management more complex due to patient age and comorbidity. Co-management between surgeons and medical physician has emerged in the English-speaking world and in the private sector in France, in orthopedic, vascular and neurosurgical departments, which moreover increasingly call for medical involvement. The present study therefore addressed the question of the role of the hospitalist in optimizing medical perioperative care in neurosurgery. We analyzed postoperative medical and surgical complications, requests for specialist opinions and hospital stay according to the presence of hospitalists. ⋯ Postoperative care in neurosurgery can be improved by the presence of a hospitalist, reducing the rates of complications, requests for specialist opinion and hospital stay. The job description, work schedule and organization and financing remain to be defined. Studying other organizations to supplement the present benchmarking could help strike a better balance between time-saving and reinforcement of the medical-surgical team on the one hand and enhanced budgeting for comorbidities and care optimization on the other.