SNHMC hosts networking events for physicians to improve communication between hospitalists and specialists/primary care physicians.
Resolution: For SNHMC, examine possible response to variability, including:
- Hire/redeploy nurses and/or secretaries for discharge paperwork;
- Create a four-hour chest pain unit staffed by physician assistants;
- Re-examine seven on/seven off staffing. Does another model work better?
- Create a convenient care center separate from the ED;
- Hire moonlighters for night shifts;
- Serve more referring physicians to boost productivity; and/or
- Enlist pulmonologists to assist with ED surges.
Having peeked beneath the surface of SNHMC’s hospitalist program’s performance what lies at the heart of its success—or of its failure? By conventional vision, it’s curious; ALOS actually increased, 30+ internists still cover their hospitalized patients, admissions peaks and valleys, and program subsidies for the foreseeable future.
None of that fazes Sue DeSocio, FMP’s president and COO, who laments the dearth of benchmarking tools that accurately reflect the impact of hospitalist programs.
“At the beginning, we were sure we had everything down pat. We’d keep the hospitalists very busy and with a complement of four, we’d break even. Not even close,” she says. But she judges the program a success, as do Dr. Marshall and Wilhelmson, because it addressed FMP’s family practice physicians’ need to focus on their outpatient practices and avoid hospital work.
Patient satisfaction and hospitalist job satisfaction are high and RN turnover is nearly 12% lower than other New Hampshire hospitals. SNHMC avoided a hospitalist turf war with a successful joint venture with its chief competitor, and, perhaps most importantly, incorporated the hospitalists into FMP’s multi-specialty practice rather than taking the easy way out with outside contracting. Or you check with Drs. Fulton and Kammila, who plunged into the chaos of a start-up, worked impossibly long days, and are still there today because they believe in how they’re practicing medicine. TH
Marlene Piturro regularly writes “Practice Profiles” for The Hospitalist.