Department of Internal Medicine
Head of the Department: Viera Křížová, MD
Activities of the Department
The Department provides essential clinical back-up for the key areas of the Cardiovascular Program and Neuroprogram in the Na Homolce Hospital, to the inpatient ward and to the Polyclinics, Department of Gastroenterology and Centre for Pulmonary Endoscopy. The majority of hospitalized patients are diagnostic admissions from all internal medicine disciplines, i.e. gastrointestinal, respiratory, cardiac, diabetic and infectious and autoimmune diseases.
The Department treats patients also from other regions. The Department provides specific care for patients with short bowel syndrome and ensures their long-term parental nutrition, which includes treatment of any related complications. Specific interventions a performed under ultrasound guidance (central catheter introduction, diagnostic/evacuation puncture etc.).
Intensive Care Unit
The Unit has a capacity of 8 beds with the possibility of up to 3 beds with ventilation. It also provides a comprehensive intensive care for internally polymorbid patients, often takes over patients with complicated infections for final treatment from other ICUs of the Na Homolce hospital. Most patients are transferred to the Department of Internal Medicine for final treatment from surgical and core programmes of the hospital, some of them are referred by the acute internal medicine outpatient unit and from other hospitals
The standard inpatient unit provides comprehensive internal medical care to a whole spectrum of patients, both patients with acute internal diseases referred by the acute internal medicine outpatient unit, and patients with planned diagnostic and therapeutic treatments. Patients wit internal disease from other Department of the hospital are admitted for treatment (from all Departments, patients with oncological treatment complications and from the chronic haemodialysis programme). Furthermore, patients after invasive procedures (gastroenterology, the Centre of Pulmonary Endoscopy, interventional radiology) are admitted for observation. A number of admitted patients due to oncological treatment complications has increased, and because the Department of Oncology has no inpatient unit, the Department of Internal Medicine has to always find beds under the given situation.
Generally, the care is of an above-regional character. The capacity of beds is low. We also provide inpatient care to patients of the Homolka Premium Care Programme and to relatives of hospital staff. An average hospitalisation duration continuously increases, usually due to long-term parenteral administration of antibiotic treatment and to treat complicated states resulting from long-term physiotherapeutic care. This reduces the availability of free beds and limits the total number of admissions despite the maximum bed occupancy, which is the highest in the entire hospital.
Internal medicine outpatient unit
Physicians of individual specialisations work in specialised inpatient units who closely cooperate and are mutually well substitutable both in the outpatient and inpatient units. A part of the outpatient unit is a pulmonary, gastroenterology and metabolic unit (focused on home par/enteral nutrition, diabetology, endocrinology, lipid consultancy). The obesitology inpatient unit was cancelled (due to a low efficiency and with regard to the cancelled relation to surgeries in the field of obesitology).
Acute internal medicine outpatient unit
In particular, the Department provides treatment and examinations to patients with acute non-surgical problems who have no special referral for a particular specialized examination. Other activities include outpatient infusion therapy and planned diagnostic and therapeutic interventions offered to cover the needs of the Internal Medicine Department.
The acute internal medicine outpatient unit is the most fully used outpatient unit of the Department; the number of treated patient has been continuously growing. In the past year, the total of 6,465 treatments were performed (500 – 600 treatments per month in average). An increase in the number of treated patients can also be expected in the future due to the fact that the outpatient unit partially supplements the lack of an emergency department and that care accessibility in other facilities has been deteriorating. Should the number of patients further increase, it will be necessary to increase the staff of the outpatient unit and extend its areas.
The Unit is the show-case of the Internal Medicine Department. It provides excellent gastroenterology care using a wide range of endoscopic methods. It performs common endoscopy of the upper and lower gastrointestinal tracts, as well as a highly-specialized ERCP examination of bile ducts. It has achieved excellent results in the use of endosonographic techniques, including unique interventions for which patients from the entire country are referred. The care is provided in an inadequate and constrained space.
The previous year witnessed a partial improvement in instrumental equipment due to single invests, but unfortunately, the spatial arrangement of the Gastroenterology Unit is still inadequate in terms of its importance for the hospital and its position within the Prague and frequently national healthcare system. Therefore, it is vital to continue investing both into the technical equipment, and especially spacial arrangement, although considering the findings of the JCI accreditation committee that warned of an unsatisfactory arrangement of the operation at its last visit. Under the current spatial arrangement, the Unit will not meet hygiene conditions at the next JCI accreditation of the Unit, and the accreditation will not be granted.
Center for Pulmonary Endoscopy
The Center for Pulmonary Endoscopy and related specialized outpatient units offer comprehensive bronchologic diagnostics, including autofluorescent bronchoscopy, NBI (Narrow Band Imaging) and endobronchial ultrasonography. The combination of new diagnostic methods with the existing ones, such as PET-CT, provides an exceptional opportunity for early diagnosis and staging of bronchogenic carcinoma followed by pneumo-oncological treatment. The capacity and the use of bronchologic care has been steadily growing, inter alia due to an active cooperation with field pneumologists and other hospitals.
The Department is accredited by the Czech Medical Chamber to train and issue functional licenses in internal medicine, gastroenterology, general medicine, abdominal ultrasonography (F008), endoscopic ultrasonography (F004), artificial nutrition, and metabolic care (F016).
Postgraduate and pre-certification study stays of younger colleagues from other disciplines of the Na Homolce Hospital are annually held at the Department. In the long run, the Department has organized postgraduate courses for physicians preparing for general medicine postgraduate examinations, in cooperation with the Institute of Postgraduate Healthcare Education. To a lesser extent, pre-graduate students of the 1st, 2nd and 3rd Schools of Medicine, Charles University, come within compulsory practice.
Number of physicians 24 full-time + 8 agreements to perform work
Number of nursing staff 47
Number of paramedical staff 9
Number of beds at the standard unit 21
Number of beds at ICU 8
Secretary: +420 257 272 647