Prospective comparison of curbside versus formal consultations

Authors

  • Marisha Burden MD,

    Corresponding author
    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
    • Denver Health, 777 Bannock, MC 4000, Denver, CO 80204-4507
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    • Telephone: 303-602-5057; Fax: 303-602-5056

    • Co-Principal Investigators.

  • Ellen Sarcone MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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    • Co-Principal Investigators.

  • Angela Keniston MSPH,

    1. Department of Medicine, Denver Health, Denver, Colorado
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  • Barbara Statland MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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  • Julie A. Taub MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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  • Rebecca L. Allyn MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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  • Mark B. Reid MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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  • Lilia Cervantes MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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  • Maria G. Frank MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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  • Nicholas Scaletta MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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  • Philip Fung MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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  • Smitha R. Chadaga MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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  • Katarzyna Mastalerz MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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  • Nancy Maller MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
    3. Northern Colorado Hospitalists, LLC, Fort Collins, Colorado
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  • Margherita Mascolo MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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  • Jeff Zoucha MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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  • Jessica Campbell MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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  • Mary P. Maher MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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  • Sarah A. Stella MD,

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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  • Richard K. Albert MD

    1. Department of Medicine, Denver Health, Denver, Colorado
    2. Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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Abstract

BACKGROUND:

Curbside consultations are commonly requested during the care of hospitalized patients, but physicians perceive that the recommendations provided may be based on inaccurate or incomplete information.

OBJECTIVE:

To compare the accuracy and completeness of the information received from providers requesting a curbside consultation of hospitalists with that obtained in a formal consultation on the same patients, and to examine whether the recommendations offered in the 2 consultations differed.

DESIGN:

Prospective cohort.

SETTING:

University-affiliated, urban safety net hospital.

MAIN OUTCOME MEASURES:

Proportion of curbside consultations with inaccurate or incomplete information; frequency with which recommendations in the formal consultation differed from those in the curbside consultation.

RESULTS:

Curbside consultations were requested for 50 patients, 47 of which were also evaluated in a formal consultation performed on the same day by a hospitalist other than the one performing the curbside consultation. Based on information collected in the formal consultation, information was either inaccurate or incomplete in 24/47 (51%) of the curbside consultations. Management advice after formal consultation differed from that given in the curbside consultation for 28/47 patients (60%). When inaccurate or incomplete information was received, the advice provided in the formal versus the curbside consultation differed in 22/24 patients (92%, P < 0.0001).

CONCLUSIONS:

Information presented during inpatient curbside consultations of hospitalists is often inaccurate or incomplete, and this often results in inaccurate management advice. Journal of Hospital Medicine 2013. © 2012 Society of Hospital Medicine

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