The Society of Hospital Medicine (SHM) Public Policy Committee published a new white paper calling for policymakers to eliminate hospital outpatient observation status in its current form. In reviewing the current state of policy and listening to the perspectives of front-line hospitalists, SHM believes observation policy has strayed far from its original intent and is in need of significant reform.
In the new white paper, SHM includes perspectives from members on how observation impacts their practice. The sentiment was resoundingly clear: Observation in general, the 2-midnight rule, and NOTICE impede efficiency, strain the doctor-patient relationship, confuse patients in an already stressful situation, and likely reduce patient/provider satisfaction, while adding nothing to patient care.