Hoag intensifies critically ill patient care

June Casagrande

Someday, Dr. Herb Rogove predicts, medical consumers will call

their local hospitals to ask whether they have intensivists. But for

now, Hoag is among just a handful of hospitals blazing a trail for

better care of critically ill patients.

“Our goal is to take care of the sickest of the sick, and their

families as well,” said Rogove, who is creating the intensivist

program at Hoag Hospital. “We’re building a program in which there

will be a physician available in the hospital 24 hours a day, seven

days a week, for the care of the critically ill patient.”

The program is a departure from the traditional model of care,

where nurses handle round-the-clock care but doctors visit only about

once a day. Those doctors are often specialists whose private

practices keep them away from the hospital much of the time. The

intensivist program instead creates a team of doctors, nurses and

other health-care experts trained to care for critical patients. The

physicians are full-time staff members, which creates a number of

obvious and not-so-obvious advantages.

They can respond to emergencies faster. Though they, too, are

specialists, they’re trained to provide critical care to patients

whose illnesses are outside their specialty, clearing the way for the

specialist to begin work immediately upon arrival. Also, as Hoag

Chief Operating Officer and Senior Vice President Steve Moreau points

out, having a physician on staff takes the guesswork out of whether a

nurse should bother a doctor at home in the middle of the night.

“Having the doctors immediately available is very important from a

safety standpoint,” Moreau said.

Traditionally in many hospitals, doctors get paid for visiting the

hospital once a day. This creates a financial disincentive for

doctors to step away from their practices to more regularly tend to

hospitalized patients. Putting a team of doctors on staff to do

nothing but oversee critical patients in the hospital fixes this

problem.

“We’ve taken away that disincentive,” Moreau said.

About half of the patients in Hoag’s 30 critical care beds in the

intensive care, cardiac care and cardiovascular thoracic surgery

units are taking part in the program, which, while still under

development, has been operating about 16 hours a day on weekdays and

eight hours a day on weekends. Hoag has just hired the fourth of five

doctors who will comprise the physician intensivist staff. And

Rogove, who is in charge of recruitment and training, said Hoag’s

24-hour-a-day intensivist program should be up and running 24 hours a

day, seven days a week by mid-October.

The program is also expected to help hospital bed shortages by

making patient stays shorter.

“We can treat patients quicker because they get treated

continuously instead of just once or twice a day,” Moreau said. “It

lowers the length of stay and thus lowers costs, and that helps the

hospital and the community.”

* JUNE CASAGRANDE covers Newport Beach and John Wayne Airport.

She may be reached at (949) 574-4232 or by e-mail at

june.casagrande@latimes.com.