[email protected] 1 Seamless co-operation between GP and Hospital Staff – an utopia? Gunnar...
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[email protected] om 1 Seamless co-operation between GP and Hospital Staff – an utopia? Gunnar Németh, MD, PhD Professor of Orthopaedic Surgery, Karolinska Institute Director of Medical Development, Capio AB [email protected] www.capio.com www.ki.se 8th Nordic Conference for University Hospitals and Faculty Deans (UHFD) 26 Aug, 2004, University of Turku
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Transcript of [email protected] 1 Seamless co-operation between GP and Hospital Staff – an utopia? Gunnar...
Seamless co-operation between GP and Hospital Staff – an utopia?
Gunnar Németh, MD, PhDProfessor of Orthopaedic Surgery, Karolinska Institute
Director of Medical Development, Capio AB
[email protected] www.capio.com www.ki.se
8th Nordic Conference for University Hospitals and Faculty Deans (UHFD)26 Aug, 2004, University of Turku
Why co-operation?
• Today there is a general scarcity of resources
• The patient needs one “general manager”, not be treated as a number of separate organs
• I would say that the GP is not a gate keeper. This is something repressive - hampering patients access to adequate treatment
it would be preferable if the GP has a holist approach, with a stewarding function, guiding the patient through the system – being his or her representative
How?
Focus on the different interfaces
1. GP
2. GP hospital
3. In hospital
4. Hospital GP
5. Other interfaces
GPHosp
1. GP
• The general practitioner must be provided the resources needed
– Sufficient time for patients
– Colleagues to discuss and interact with
– Collaboration with district nurses, PT:s, social insurance officers and psychologists
– CME
– Polyclinics – doctors from hospital having outpatient clinics on a regular base
GP Hosp
2. GP Hospital
• Co-operation should be characterised by
– Increased accuracy
– More precise issues/questions in referrals
– More involvement
• Resulting in
– Decreased number of referrals
– Less double work
– Better results
GP Hosp
3. In hospital
• Well defined responsibility
– Investigation by hospital doctor or organ specialist is part of a more comprehensive care taking
– The investigation should be
• Well adjusted
• Targeted
– Respect in co-operation
• Avoid double work
• Do what is requested
• Close contact with referring doctor
GP Hosp
Consider safety and effective capacity Consider safety and effective capacity for the patient for the patient
3. In hospital, cont.
• Why not employ a GP in the hospital department?
• Broadens the scope for organ specialists
• A very good “communicator” with primary care
• Special circumstances – more needed – in surgical specialities
– Admission visit before surgery
– Increased co-morbidity among our elderly
– Provides expertise to nurses
GP Hosp
4. Hospital GP
• Always clear answers to issues on referral
• In general GP:s (in Sweden) appreciate a summary with a clear conclusion rather than copies of medical records “too undigested”
• Always send information to GP when a patient is discharged
• In cases of doubt – phone the GP or district nurse!
GP Hosp
5. Other interfaces
• Courses with joint faculties
• Shadowing colleagues
– Outpatient clinics
– In-hospital procedures
• Common activities, for example symposia with broad subjects covering both parties aspects of diagnostics and treatment
GP Hosp
Future …
• Several of the wonderful Finnish IT solutions we have heard of here today should be rolled out, e.g.
- Shared knowledge base with common cases and principles for referrals
- Electronic referral system
- Shared electronic medical records
- A web based system for reporting of adverse events (incidence reporting)
- Associate practitioners and certify them for certain measures
GP Hosp
So… Is seamless co-operation between GP and Hospital an utopia?
No!
I think it is a possibility,
gaining our patient and stimulating us
