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Performance of a Hospitalist-run Ward: a Prospective Observational Study

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00997646
Recruitment Status : Unknown
Verified October 2009 by National Taiwan University Hospital.
Recruitment status was:  Recruiting
First Posted : October 19, 2009
Last Update Posted : October 19, 2009
Information provided by:
National Taiwan University Hospital

Brief Summary:
To realize performance of a new system - hospitalist-run ward in Taiwan.

Condition or disease
Performance of a Hospitalist-run Ward

Detailed Description:

The emergency department (ED) of National Taiwan University hospital manages a large amount of patients load in Taipei metropolitan. The short-stay unit in our ED is a pool for those needing observation or following management. However, the length of ED stay seems to be longer than those reported in western literature. It might be caused by limited facility availability of our ward. Actually, the bed vacancy of our ward is not only reserved for patients from ED but also for those from outpatients or other hospitals. A full ward for taking over the patients from ED only might be a solution in the future. However, internists and surgeons who care most of hospitalized patients are currently believed not a career priority because of their high risk and loading but relative low payment by National Health insurance in Taiwan. Under the deficiency of residents for patient-care, a system of hospitalist-run ward should be established.

The role of hospitalist, an in-patient physician, has been discussed since 1996. The pros and cons were debated controversially. The disadvantage is that the continuity of patient care will be interrupted by primary care physician. In addition, discharged summary are usually not completed in following clinic. On the other hand, the hospitalists need less cost than internists in recent studies but the quality and safety was considered similar. Actually, it is widely accepted that hospitalist can do an efficient job of handling inpatient admissions. The field has also continued to grow worldwide in recent decades. A hospitalist-run ward becomes more frequent for common but relatively low risk diseases including exacerbation of chronic obstructive pulmonary disease, pneumonia, urinary tract infection, ischemic stoke, cellulitis and congestive heart failure. Of course, some disease entities need longer length of hospital stay in nature.

We are thus interested in the efficiency of a hospitalist-run ward in Taiwan. Therefore, we set up a hospitalist-run ward for taking over the patients who needed hospitalization from our ED and observe the performance of the ward and the outcome of the in-patients.

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Study Type : Observational
Estimated Enrollment : 500 participants
Observational Model: Cohort
Time Perspective: Prospective
Study Start Date : October 2009
Estimated Primary Completion Date : October 2011
Estimated Study Completion Date : October 2011

Patients in hospitalist-run ward
Patients was admitted from ER to a hospitalist-run ward.
Patients in conventional ward
Patients was admitted from ER to a non hospitalist-run ward.

Primary Outcome Measures :
  1. Cost and quality of this hospitalization [ Time Frame: 2 years ]

Secondary Outcome Measures :
  1. Mortality and morbidity of this hospitalization [ Time Frame: 2 years ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population
The patients who was admitted to a hospitalist-run ward

Inclusion Criteria:

  • age more than 18 years
  • admitted from Emergency department

Exclusion Criteria:

  • without informed consent

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00997646

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Contact: Chin-Chung Shu, MD 8860972653087

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National Taiwan University Hospital Recruiting
Taipei, Taiwan, 100
Contact: Chin--Chung Shu, MD    886-0972653087      
Principal Investigator: Chin-Chung Shu, MD         
Sponsors and Collaborators
National Taiwan University Hospital
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Responsible Party: Chin-Chung Shu, National Taiwan University Hospital Identifier: NCT00997646    
Other Study ID Numbers: 200910008R
First Posted: October 19, 2009    Key Record Dates
Last Update Posted: October 19, 2009
Last Verified: October 2009
Keywords provided by National Taiwan University Hospital: