A specialist team approach for personal support of patients who repeatedly come to hospital during the nighttime

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  • Ishikura Ai
    Department of Nursing, Kitasato University Hospital
  • Aoyama Naoyoshi
    Research and Development Center for New Medical Frontiers, Department of Comprehensive Medicine, Division of Internal and Emergency Medicine, Kitasato University School of Medicine Department of General Medicine, Kitasato University School of Medicine
  • Nakamura Motomi
    Department of Psychiatry, Kitasato University School of Medicine
  • Kawatani Hiroko
    Medical Support Department Patient Service Center, Kitasato University Hospital
  • Soda Akira
    Medical Support Department Total Support Center, Social Work Room, Kitasato University Hospital
  • Tanabe Satoshi
    Medical Support Department Total Support Center, Kitasato University Hospital Research and Development Center for New Medical Frontiers, Department of Advanced Medicine, Division of Therapeutic Endoscopy, Kitasato University School of Medicine

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Other Title
  • 多職種検討会による夜間外来に繰り返し受診する患者に対する個別的支援の試み
  • タショクシュ ケントウカイ ニ ヨル ヤカン ガイライ ニ クリカエシ ジュシン スル カンジャ ニ タイスル コベツテキ シエン ノ ココロミ

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Abstract

<p>To advance the quality of medical care during the nighttime in the Department of Internal Medicine, Kitasato University Hospital, doctors on night work are divided into those who provide medical care for hospital patients and those who provide medical care for ambulatory patients. The doctors performing the medical care for ambulatory patients have revealed that some patients who repeatedly come to hospital during the nighttime do not receive disease-specific treatment because of individual and/or familial and/or social backgrounds. To construct a support system for such patients, we have set up a specialist team composed of a doctor and a nurse for ambulatory patients during the nighttime, a nurse for outpatients during the daytime, and a medical mediator, social worker, and psychiatrist. Alongside a consulting psychiatrist, the specialist team objectively interprets the medical condition and treatment for the patient, and then discuss and develop a specific strategy for how the patient will receive disease-specific treatment in regular outpatient visits during the daytime. The team then facilitates strategy of sharing and interaction between healthcare providers. Even though issues may arise between the patient and the healthcare provider following implementation of the strategy, the team will continue to support the patient and the healthcare provider until the issue is resolved. This integrated solution through a specialist team resulted in less stress for the healthcare provider and lead a more pleasant experience for the patient and the healthcare provider during the patient's recovery. Due to a shift in demographics and disease structure, a specialist team including a doctor, a nurse, a medical mediator, a social worker and a psychiatrist, as described here, is critical for personal support of patients. </p>

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