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“I enjoyed working with Synaptic Healthcare as they put the hospitalist program together. I was part of the initial staff, and benefitted from the development of a collegial atmosphere. I enjoyed working with all of the other staff involved in the hospitalist program. The program was also helpful to the primary care staff, relieving a lot of the call burden, and relieving some of the stress associated with responsibility for both inpatient and outpatient medicine.
All my interactions with Synaptic so far have been positive. I look forward to working for Synaptic within the hospital program for Holy Rosary Healthcare for years to come.”
– Derek Gilbert, M.D., Hospitalist
Hospitalist Programs
The purpose of a hospitalist program is to improve coordination of care, quality of care, and patient confidence and satisfaction. A dedicated inpatient program improves staff and provider satisfaction through better quality, availability and communication. An added side benefit is to provide relief from call responsibilities for primary care physicians.
Beginning in 2010, Synaptic Heallthcare’s Hospitalist Program helped Holy Rosary Healthcare (HRH) in Miles City, Montana make progress in all these areas.
Synaptic partnered with HRH marketing and communication personnel to develop material to educate patients and community members. HRH moved from an acute care facility to a Critical Access Hospital about the same time as the hospitalist program started, which heightened the imperative to focus on care management to work within the limit of 25 acute care beds.
HRH and Synaptic Healthcare are in continuous dialogue in encouraging Billings Clinic providers to refer into the program. In 2011, Synaptic remains active in recruiting more full time coverage, which will allow for greater coverage for the surgeons.
Hospitalist Program Success
Patient transfers have been dramatically reduced since the inception of a hospitalist program at Holy Rosary Healthcare in the summer of 2010.
Daily interdisciplinary rounds with the care team now coordinate care. Quality of service from providers, staff and ancillary services has risen as a result. Communication is consistent.
Holy Rosary Healthcare pharmacy documented improved utilization of medications that are on formulary. This improvement resulted in cost savings for the facility and for patients.
Better medication management was documented in poly-pharmacy situations. Patients that see several physicians and specialists are often prescribed medicines by each of their healthcare professionals. Multiple prescriptions that are not tracked with a medication management program can result in higher risks of drug interactions and side effects.
The hospitalist program has now celebrated its one-year anniversary. The program has required many changes in the way care is provided, and it will continue to evolve and gel. As the community and medical staff embrace this innovative program and realize its full potential, the facility and the community will reap the benefits.
Patient Satisfaction

The overall patient satisfaction through Avatar prior to the hospitalist program was 53.42%. Since the program began it is 63.06 %. HRH also launched an overall service excellence program that started about the same time as the hospitalist program and the results from both are impressive. Synaptic has identified a process for conducting hospitalist patient satisfaction interviews with a random selection of patients. These results will be shared at the end of calendar year 2011.
The program has received much support from nursing staff and other associates. They see the improved coordination of care.
Improving Palliative Care
Palliative Care is comprehensive, compassionate, holistic healthcare that meets the special needs of patients experiencing serious illness. We provide patients and their families with physical, emotional, spiritual support while helping to relieve symptoms to improve quality of life. Our gentle approach to chronic serious illness and end-of-life care gives patients choices in their own care, upholds their dignity and helps them find meaning in life. Even when a cure is not possible, healing may occur.

“The evidence is unarguably clear at this
point that the early employment of palliative
care resources lengthens and improves quality
of life for those with serious life-limiting or
life-threatening conditions.”
– Pastor Steve Rice, Clinical Chaplain
and community leader

“In the past few months two new programs have been offered at Holy Rosary Hospital: a Hospitalist Program and a Hospice/Palliative Care Program.
I had first hand experience of receiving care under these programs. I was recently hospitalized for several days and diagnosed with atrial fibrillation and possible blood clots. My overall care came from the new Hospitalist Program. They supervised my treatment and correlated all my medications and care.
Having observed the Hospitalist and Palliative Care programs in action, both as a patient and as an advisor,
I strongly support this as a way to provide broader and better overall patient care. These programs provide continuous care for persons with complicated or chronic conditions.”
– James Lucas, Attorney, October 2011
Core Quality Measures Recorded: Hospitalist Program

Core Measures are a set of care processes, which were developed by The Joint Commission, the nation's predominant standards-setting and accrediting body in health care, to improve the quality of health care by implementing a national, standardized performance measurement system. The Core Measures were derived largely from a set of quality indicators defined by the Centers for Medicare and Medicaid Services (CMS). They have been shown to reduce the risk of complications, prevent recurrences and otherwise treat the majority of patients who come to a hospital for treatment of a condition or illness. Core Measures help hospitals improve the quality of patient care by focusing on the actual results of care.
There are 33 Core Measures altogether, in 4 categories (acute myocardial infarction, community-acquired pneumonia, congestive heart failure, and surgical care improvement project). Under each category, key actions are listed that represent the most widely accepted, research-based care process for appropriate care in that category.
The Core Measure data is collected on all hospitals and the value (percentage) given in each category is based on how often these care processes are met when a patient with a certain diagnosis is cared for. So a 100% score for a given month, quarter or year reflects that every patient cared for in that diagnosis group met every criteria for that pathway of care.
