Penn Presbyterian Hospital Medicine Service
Penn Presbyterian Medical Center (previously known as Presbyterian Medical Center) joined the University of Pennsylvania Health System in 1995. Since 2015, Penn Presbyterian Medical Center (PPMC) has been the Level I Trauma center for the UPHS system and is also one of the primary inpatient sites for Penn Orthopedic Surgery. The Hospital Medicine program at PPMC began around 2008 and since then has greatly increased in size over the years. Currently, there are four Hospitalists and five Advanced Practice Providers (APP) that care for 54 patients on four collaborative care teams. Patients on this service are spread across both the inpatient and observation units. A hospitalist (either on our Hospitalist Subspecialty Scholar or Ultrasound Fellowship pathway) and an APP provide cross coverage and facilitate admissions each night. Each collaborative care team is present during daily multidisciplinary rounds, which focus on discharge planning for patients. The team includes representation from social work, case management, and nursing leadership. This is also an afternoon “digital huddle” with case management to review discharge plan updates for the following day. This additional check-in has been effective in facilitating early discharges, which improves patient flow at PPMC.
Medicine Consult/Orthopedics Co-Management
The Hospital Medicine Service at PPMC is also responsible for the Medicine Consult and Orthopedics Co-Management service. The Orthopedics Co-Management service specializes in providing perioperative care for patients on the Orthopedics service along with educational support to the Orthopedics and Podiatry interns, as well as general medical consultation throughout PPMC. Since the trauma service moved in 2015, the program has been immensely successful in decreasing time to the operating room and lowering length of stay, without increasing readmissions.
There are four inpatient house staff teaching teams at PPMC. Our general medicine colleagues from the ambulatory practices, and Penn subspecialty faculty lead three of these teams, while one is led by a Hospitalist from our section. There are also two electives available to Internal Medicine residents at PPMC, a Medicine Consult Elective and a Hospitalist Elective. During the Medicine Consult Elective, senior residents work with a Hospitalist on the Orthopedics Co-Management service, seeing new consults and learning about perioperative medical management. On the Hospitalist Elective, senior residents have the opportunity to work directly with APP’s to manage a small group of patients, under the supervision of the Hospitalist attending. In 2018, the Hospital Medicine program began offering a one-year Ultrasound fellowship at PPMC (the fellows now also rotate at HUP). The fellowship is open to applicants who’ve completed Internal Medicine or family medicine residency or other Medicine fellowships. While the focus of the program is developing ultrasound skills, fellows are also engaged in research and direct patient care.