Abstract
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.
