Prescription for Change

Three new things we've learned about hospitalists

The Physician Executive Council is currently researching how hospitals and health systems can capture more value from their hospitalist programs for our 2015-2016 national meeting series. (You may have seen that we recently launched a brief survey to learn more about your hospitalist program’s structure, challenges, and goals—if you haven’t done so, take the survey now.)

Last month, we attended the 2015 Society of Hospital Medicine (SHM) National Meeting to hear from top hospitalists programs nationwide. And a few weeks ago, we also facilitated a small, focused discussion on hospitalists with a group of approximately 20 CMOs. Read on for three of our early insights.

Hospitalists are uniquely positioned to support the CMO’s agenda

From day one to the closing plenary sessions at the SHM meeting, it was clear that hospital medicine has a big role to play in quality improvement, and is aligned with the CMO’s agenda. The potential impact of an effective hospitalist team is high–many CMOs have told us that their hospitalists care for over 60% of their inpatient admissions. The combination of hospitalist interest in system quality improvement and the high proportion of inpatient care they provide make them a must-have partner for the inpatient CMO.

Yet many CMOs tell us they’re not able to fully leverage their hospitalist program. This is due to a variety of reasons–in some cases, the program is disjointed, or the hospitalist program isn’t equipped to effectively lead quality improvement initiatives.

To solve these challenges, hospitals need to position the hospitalist program as their partner. This partnership is far greater than a specific contractual alignment or incentive model, or even a specific employment model. A true partnership means building a shared vision with the hospitalist group, and supporting the team as it grows to deliver on that vision. We know this no easy task, and so our research premiering this fall will focus on helping the CMO build this this kind partnership with their hospitalist program. (If you’re not already registered for the national meeting, click here.)

Merging disparate hospital medicine groups is a top priority for many organizations

Some of the most popular sessions at the SHM meeting focused on aligning and merging hospital medicine groups. A cohesive, standardized hospitalist group can help CMOs leverage their hospitalists more effectively, but there are other potential benefits too—for example, one CQO told us that greater standardization helped his organization reduce the number of locums tenens used.

But merging hospital medicine groups, especially across facilities, is complex. As a starting point, many systems are establishing dedicated hospitalist leaders with protected time to help analyze variation between sites, and identify opportunities to standardize the program.

Hospital medicine is expanding to post-acute care

The Society of Hospital Medicine’s 2014 State of Hospital Medicine report shows that just over 25% of hospital medicine groups are seeing patients in post-acute care facilities, and demand in this area is continuing to grow. Our early survey data confirms that less than 30% of Physician Executive Council members are using hospitalists in post-acute settings, although many express interest in expanding the hospitalist role in coming years.

The skills needed to effectively work in the post-acute setting are different than the skills needed for acute care–the pace and urgency are different, and hospitalists need additional training and education to effectively adapt their practice. IPC Healthcare, Inc. developed a training module for their hospitalists to effectively work in post-acute settings, and they recently partnered with SHM to build that module into a CME training program. This training portal launched at the SHM meeting, and is now available at SHM’S Learning Portal.

Tell us about your hospitalist program

Want to help inform our hospitalist research? Take our brief survey.

And don’t forget to register for our 2015-2016 national meeting series to learn key imperatives for maximizing your hospitalist program.