Hospitalists are increasingly central to the clinical, financial and operational success of hospitals. Entrusting an outsourced hospitalist practice group to such a key role requires hospital administration to think through the demands and expectations it wishes to create for the hospitalist practice to ensure alignment with the hospital's goals.
Hospital administrators can and should place a series of demands upon outsourced practices operating in their facility. Following is a ten-point road map that hospital administration might consider in order to effectively engage with an outsourced hospitalist practice to optimize prospects for alignment.
1. Deliver clinical leadership. The practice group that can demonstrate true clinical leadership is the group most likely to show alignment with hospital goals. The practice group must possess the leadership skills in a way that are clear to your administrative and medical staff. Not just the practice group leader but all members of the provider team should be expected to demonstrate clinical leadership every day.
2. All hospitalists must be trained and educated on the practice management aspects of hospital medicine. There are many avenues for hospitalists to improve their skills not only clinically — but in communication, organization and leadership. The hospital executive team should not only require a commitment to in-depth training; the hospital in turn should commit to providing, supporting, recognizing and rewarding the group for intensive training.
3. A hospitalist must serve three core constituencies: a) your patients, of course, come first; b) your facility expects loyalty, engagement and involvement; and c) your practice group partners count on your teamwork, reliability, skills and dedication. Hospital executives should satisfy themselves that all three core constituencies are being served appropriately. The very best providers show an ability to deliver satisfaction to all three groups in a seamless and mutually supportive fashion, and they make it look easy.
4. Set clear goals for your hospitalists. Whether or not your relationship with your outsourced hospitalists is a contractual one, there should be a commitment to meet goals that are mutually agreed to be realistic and achievable. There are dozens of goals that the hospital can readily justify as essential for the hospitalist group to meet in support of the hospital; the challenge for the hospitalist practice is to pursue many goals simultaneously and meet them consistently.
5. Hospitalists should be expected to convey an attitude of "willing accountability". You know it when you see it. When this attitude is on display the practice is viewed as a true value- added partner and a source of solutions inside the hospital. Without it, they're just another vendor. An attitude of "willing accountability" inevitably leads to stronger relationships and better alignment between the hospitalists and hospital administration.
6. The hospitalists should view themselves as integral to the hospital's success. Clinically, operationally and financially, the success of your facility rests with your hospitalist group, and the hospitalists must understand both the opportunity and the responsibility this entails. The hospital's reputation for excellence and quality depends on the hospitalists being vested in the success of the hospital; either they are part of their solution or they are part of the problem.
7. The commitment to align with the goals of your hospital must be more than a mindset. For the hospitalist, it is a series of routine daily actions that should be woven into the fabric of the practice group's activities. To put alignment into action, each provider needs a very clear idea of what the facility's goals really are, and his/her own individual role in helping to achieve those goals.
8. Aligning with an outsourced group should be easier, even less costly, than employing your own hospitalists. As a general rule, the focus, expertise, adaptability and resources specific to hospital medicine that an outsourced group can bring to your facility is difficult to replicate in-house. Moreover, to date there is no clear evidence that employed groups deliver superior clinical outcomes, although the MGMA survey on hospital medicine does indicate that employed groups are at a cost disadvantage.
9. The hospitalist group must show that it is ready, willing and able to customize its operations to meet the goals of your hospital. The outsourced group must possess the tools, systems and resources that enables it to execute a customized, facility-specific game plan for your hospital. Together with your facility, the practice should develop the game plan that can be executed consistently and efficiently.
10. Delivering quality care efficiently is the surest way for a hospitalist group to demonstrate value. Delivering this message to the hospitalist group in a way that achieves buy-in to the goals of your hospital will translate into a stable and productive relationship with your outsourced hospitalists.
Hospital administrators invest time, money and human resources in their hospitalist practices — outsourced practices included — and have a right to expect a return on that investment. This is too often an afterthought for hospitalist groups; don;t hesitate to remind them. As healthcare reform begins to impact the inpatient delivery system it is imperative that outsourced hospitalist groups deeply connect with the goals of their hospital to create mutually satisfactory outcomes.
Adam D. Singer, MD, is chairman, CEO and chief medical officer of IPC The Hospitalist Company, based in North Hollywood, Calif.
Hospital administrators can and should place a series of demands upon outsourced practices operating in their facility. Following is a ten-point road map that hospital administration might consider in order to effectively engage with an outsourced hospitalist practice to optimize prospects for alignment.
1. Deliver clinical leadership. The practice group that can demonstrate true clinical leadership is the group most likely to show alignment with hospital goals. The practice group must possess the leadership skills in a way that are clear to your administrative and medical staff. Not just the practice group leader but all members of the provider team should be expected to demonstrate clinical leadership every day.
2. All hospitalists must be trained and educated on the practice management aspects of hospital medicine. There are many avenues for hospitalists to improve their skills not only clinically — but in communication, organization and leadership. The hospital executive team should not only require a commitment to in-depth training; the hospital in turn should commit to providing, supporting, recognizing and rewarding the group for intensive training.
3. A hospitalist must serve three core constituencies: a) your patients, of course, come first; b) your facility expects loyalty, engagement and involvement; and c) your practice group partners count on your teamwork, reliability, skills and dedication. Hospital executives should satisfy themselves that all three core constituencies are being served appropriately. The very best providers show an ability to deliver satisfaction to all three groups in a seamless and mutually supportive fashion, and they make it look easy.
4. Set clear goals for your hospitalists. Whether or not your relationship with your outsourced hospitalists is a contractual one, there should be a commitment to meet goals that are mutually agreed to be realistic and achievable. There are dozens of goals that the hospital can readily justify as essential for the hospitalist group to meet in support of the hospital; the challenge for the hospitalist practice is to pursue many goals simultaneously and meet them consistently.
5. Hospitalists should be expected to convey an attitude of "willing accountability". You know it when you see it. When this attitude is on display the practice is viewed as a true value- added partner and a source of solutions inside the hospital. Without it, they're just another vendor. An attitude of "willing accountability" inevitably leads to stronger relationships and better alignment between the hospitalists and hospital administration.
6. The hospitalists should view themselves as integral to the hospital's success. Clinically, operationally and financially, the success of your facility rests with your hospitalist group, and the hospitalists must understand both the opportunity and the responsibility this entails. The hospital's reputation for excellence and quality depends on the hospitalists being vested in the success of the hospital; either they are part of their solution or they are part of the problem.
7. The commitment to align with the goals of your hospital must be more than a mindset. For the hospitalist, it is a series of routine daily actions that should be woven into the fabric of the practice group's activities. To put alignment into action, each provider needs a very clear idea of what the facility's goals really are, and his/her own individual role in helping to achieve those goals.
8. Aligning with an outsourced group should be easier, even less costly, than employing your own hospitalists. As a general rule, the focus, expertise, adaptability and resources specific to hospital medicine that an outsourced group can bring to your facility is difficult to replicate in-house. Moreover, to date there is no clear evidence that employed groups deliver superior clinical outcomes, although the MGMA survey on hospital medicine does indicate that employed groups are at a cost disadvantage.
9. The hospitalist group must show that it is ready, willing and able to customize its operations to meet the goals of your hospital. The outsourced group must possess the tools, systems and resources that enables it to execute a customized, facility-specific game plan for your hospital. Together with your facility, the practice should develop the game plan that can be executed consistently and efficiently.
10. Delivering quality care efficiently is the surest way for a hospitalist group to demonstrate value. Delivering this message to the hospitalist group in a way that achieves buy-in to the goals of your hospital will translate into a stable and productive relationship with your outsourced hospitalists.
Hospital administrators invest time, money and human resources in their hospitalist practices — outsourced practices included — and have a right to expect a return on that investment. This is too often an afterthought for hospitalist groups; don;t hesitate to remind them. As healthcare reform begins to impact the inpatient delivery system it is imperative that outsourced hospitalist groups deeply connect with the goals of their hospital to create mutually satisfactory outcomes.
Adam D. Singer, MD, is chairman, CEO and chief medical officer of IPC The Hospitalist Company, based in North Hollywood, Calif.