Harnessing the Hospitalist Movement (Part 2 of 4): The Power of One

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In our last post, we took a brief look at how the hospitalist movement is impacting healthcare. The question we’re looking to address through this series of posts, however, is, how can you as a healthcare executive harness the hospitalist movement for the maximum benefit and ROI for your organization?

Joe Cantlupe over at HealthLeaders Media outlines four strategies for handling hospitalists. The first strategy is simple: don’t work with too many hospitalist groups. History is showing that this strategy, contrary to what has traditionally been thought, is counterproductive.

Take Lee Memorial Health System. In 2011, Lee Memorial was using around six different hospitalist groups because of its many different locations. However, these multiple groups ended up in bitter competition with each other, and as a result, “were in disarray…and not coordinating care throughout the system, which includes four hospitals. What’s more, patients were unhappy.”

Scott Nygaard, MD, MBA, chief medical officer for physician services, told Cantlupe the program needed order. To fix this, Lee Memorial “changed its contracting procedures, imposed monitoring programs, and contracted with one major hospitalist group instead of different groups.”

It then set about “to revamp its relationship with hospitalists,” developing “a mutually agreed-upon scorecard to measure quality enhancement and put measurable targets in there” and appointing “a joint operating committee…for each campus, which included administrative leadership and a hospital medical group executive committee, to examine the hospitalist structure.”

The next step Lee Memorial took was finding a hospitalist group that could serve its four-hospital system the best. The organization settled on Inpatient Specialists of Southwest Florida, a group out of Fort Myers comprised of 35 hospitalists.

Finally, with standards and specialists in place, Lee Memorial was able to focus on its lagging patient-satisfaction scores. Cantlupe writes, “In Hospital Compare data, when asked if doctors were ‘always’ ready to help out, Lee Memorial Health System scored 73 percent; lower than Florida, 77 percent, and the rest of the nation, 81 percent. However, when rated for always excellent care, Lee Memorial Health System received 20 percent; higher than Florida, 17 percent, and the rest of the nation, 15 percent.”

Nygaard admits that “we’re not there yet,” but he’s optimistic about what the latest scores do show since downsizing its hospitalist program, including 100-percent patient satisfaction with hospitalists.

Cantlupe relates a similar story for Banner Baywood Medical Center in Mesa, Ariz., an organization that also had to reduce the number of hospitalist groups it was using for many of the same reasons Lee Memorial did.

If a hospitalist program isn’t working for your organization, maybe it’s suffering from that old idiom: too many chiefs and not enough Indians.

What are your thoughts? Has your organization suffered from working with too many hospitalist groups? What was your solution?

-by Pete Fernbaugh

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