Society of Hospital Medicine Creates Self-Assessment Tool for Hospitalist Groups

Figure 1. The 10 Key Principles and 47 Key Characteristics of an Effective Hospital Medicine Group¹

Principle 1: The HMG has effective leadership

Characteristic 1.1: The HMG has one or more designated hospitalist practice leaders with appropriate dedicated administrative time.

1.2: The HMG has an active leadership development plan that is supported with appropriate budget, time, and other resources.

1.3: The HMG’s hospitalist practice leader has an important role within the hospital and medical staff leadership.

Principle 2: The HMG has engaged hospitalists

2.1: The HMG conducts regularly scheduled meetings to address key issues for the practice, and the hospitalists actively participate in such meetings.

2.2: The HMG’s hospitalists receive regular, meaningful feedback about their individual performances and contributions to the HMG and the hospital/health system.

2.3: The HMG’s vision, mission, and values are clearly articulated and understood by all members of the HMG team.

2.4: Hospitalists in the HMG know the performance status of both the group and the hospital.

Principle 3: The HMG has adequate resources

3.1: The HMG has defined its needs for non-clinician administrative management and clerical support and is adequately staffed to meet these needs.

3.2: All HMG team members (including physicians, nurse practitioners, physician assistants, and ancillary staff) have clearly defined, meaningful roles.

3.3: The HMG has followed an objective approach to determine its staffing needs.

Principle 4: The HMG has an effective planning and management infrastructure

4.1: The HMG prepares an annual budget with adequate financial and administrative oversight.

4.2: The HMG generates periodic reports that characterize its performance for review by HMG members and other stakeholders.

4.3: The HMG has a current set of written policies and procedures that are readily accessible by all members of the HMG team.

4.4: The HMG has a documentation and coding compliance plan.

4.5: The HMG is supported by appropriate practice management information technology, clinical information technology, and data analytics.

4.6: The HMG has a strategic or business plan that is reviewed and updated at least every three years.

Principal 5: The HMG is aligned with the hospital and/or health system

5.1: The HMG develops annual goals that align with the goals of the hospital(s) it serves and the goals of the hospitalists’ employer (if different).

5.2: The HMG’s compensation model aligns hospitalist incentives with the goals of the hospital and the goals of the hospitalists’ employer (if different).

5.3: The HMG collaborates with hospital patient relations and/or risk management staff to implement practices that reduce errors and improve the patient’s perception of the hospital.

5.4: The HMG periodically solicits satisfaction feedback from key stakeholder groups, which is shared with all hospitalists and used to develop and implement improvement plans.

Principle 6: The HMG supports care coordination across care settings

6.1: The HMG has systems in place to ensure effective and reliable communication with the patient’s primary care provider and/or other provider(s) involved in the patient’s care in the non-acute-care setting.

6.2: The HMG contributes in meaningful ways to the hospital’s efforts to improve care transitions.

Principle 7: The HMG plays a leadership role in addressing key clinical issues in the hospital and/or health system: teaching, quality, safety, efficiency, and the patient/family experience

7.1: The HMG’s hospitalists are committed to teaching other members of the clinical team.

7.2: The HMG actively seeks to maximize effectiveness of care by consistently implementing evidence-based practices and reducing unwarranted variation in care.

7.3: The HMG’s hospitalists champion and model behaviors intended to promote patient safety.

7.4: The HMG contributes in meaningful ways to hospital efficiency by optimizing length of stay and improving patient flow.

7.5: The HMG contributes in meaningful ways to improving the patient and family experience.

7.6: The HMG contributes in meaningful ways to optimizing clinical resource utilization and cost per stay.

7.7: The HMG’s hospitalists demonstrate a commitment to continuous quality improvement (CQI) and actively participate in initiatives directed at measurably improving quality and patient safety.

Principle 8: The HMG takes a thoughtful and rational approach to its scope of clinical activities

8.1: The HMG has a well-defined plan for evolving the scope of hospitalist clinical activities to meet the changing needs of the institution.

8.2: The respective roles of the hospitalists and physicians in other specialties in treating patients, including patients that are co-managed, are clearly defined with a mechanism to resolve issues with regard to scope and responsibilities.

8.3: The HMG uses appropriate references to define the clinical responsibilities of hospitalists.

Principle 9: The HMG has implemented a practice model that is patient- and family-centered, team-based, and emphasizes effective communication and care coordination

9.1: The HMG’s hospitalists provide care that respects and responds to patient and family preferences, needs, and values.

9.2: The HMG’s hospitalists have access to and regularly use patient/family education resources.

9.3: The HMG actively participates in interprofessional, team-based decision-making with members of the clinical care team.

9.4: The HMG has effective and efficient internal hand-off processes for both change of shift and change of responsible provider.

9.5: When serving as attending physicians, the HMG’s hospitalists (in coordination with other clinicians as appropriate) assure that a coordinated plan of care is implemented.

Principle 10: The HMG recruits and retains qualified clinicians

10.1: Hospitalist compensation is market competitive.

10.2: The HMG’s hospitalists all have valid and comprehensive employment or independent contractor agreements.

10.3: The HMG’s hospitalists are actively engaged in sourcing and recruiting new members.

10.4: The HMG has a comprehensive orientation process for new clinicians.

10.5: The HMG provides its hospitalists with resources for professional growth and enhancement, including access to continuing medical education (CME).

10.6: The HMG measures, monitors, and fosters its hospitalists’ job satisfaction, well being, and professional development.

10.7: The medical staff has a clear mechanism to credential and privilege hospitalists, and the hospitalists hold unrestricted staff privileges in the applicable medical staff department.

10.8: The HMG has a documented method for monitoring clinical competency and professionalism for all clinical staff and addressing deficiencies when identified.

10.9: A significant portion of full-time hospitalists in the HMG demonstrate a commitment to a career in hospital medicine.

10.10: The HMG’s full-time and regular part-time hospitalists are board certified or board eligible in an applicable medical specialty or subspecialty.