Changes in physician specialties could also lead to necessary changes for management. While some hospitals may prefer to staff experienced physicians at night for better care, there are potential costs that might come with this, according to a recent Boston Globe article. The source specifically looked at the role of a "chief nocturnalist" at Boston Children's Hospital. This involves assigning experienced practitioners to work during late hours.
There are both pros and cons to doing this, instead of relying on residents or nurses, as is typically done. Nocturnalists have more time during the relatively quiet night hours to focus exclusively on patients, and can provide more direct supervision for transfers, which require doctor approval. However, Children's Senior Associate Physician Dr. Vincent Chiang said that paying physicians for night work costs more initially and requires further incentives.
Using more nocturnalists can also hinge upon the telemedicine program a organization uses. Two years ago, The Association of Staff Physician recruiters cited "nighttime telehospitals" as a way to avoid the problems of overnight call duty.
This source argued that remote bedside care can be less disruptive for physicians, but still create a close relationship between them and patients. For rural care centers without easy access to staff, nighttime telemedicine also helps make up for shortages and accounts for grueling night shifts. Ideally, a telehospitalist could not just interact remotely, but also access electronic health records and other important systems as well.
Trends like this can force hospitals to reassess their IT infrastructure, which may be difficult without skilled knowledge of regulations and compliance. A hospital physician organization or other group can work with LW Consulting's healthcare compliance consultants for an informed way to provide efficient care.