Peeking Over the Pond

The Wall Street Journal again writes on potential overnight issues at hospitals.  Evidently there are many.  The Institute for Healthcare Improvement is taking lessons from England’s National Health Service:

The Institute for Healthcare Improvement, a nonprofit group in Cambridge, Mass., is adapting lessons from the United Kingdom, where hospitals also have been learning to cope with new work rules using pilot programs called “Hospital at Night.” Traditionally, U.K. hospitals were fully staffed at night with doctors who worked during the day and slept at the facility overnight. Under new rules, U.K. hospitals are trying to deliver the same care with far fewer doctors on site, with the result that many doctors are coming on for night duty who haven’t seen patients during the day. The pilot programs include new systems for identifying the most ill and deteriorating patients, and for handing off patients between shifts.

While American hospitals have never had the U.K. model of fully staffed hospitals at night, many of the issues are the same. “We’ve had to address many of the problems that have beset nighttime care for decades, which are a problem for health care wherever it is practiced,” says David Gozzard, chief medical officer of Conwy & Denbighshire NHS Trust, one of the hospital systems in the U.K. program. Dr. Gozzard, who is working in a fellowship program at the Institute for Healthcare Improvement, says the U.K. program has enabled his hospital system to reduce the number of patients who need emergency resuscitation during off hours.

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