Focused on the Practice

The Hospitalist. 2009 June;2009(06):

June 1, 2009 | The Hospitalist

The survey identified patient safety, clinical QI, and quality-related IT initiatives as most popular.

Quality Incentive Compensation

In order to track HMG quality incentive compensation, the 2008-2009 Focused Survey asked similar questions about the topic to questions in the 2006-2007 Focused Survey. Quality incentive compensation—paying bonuses or additional payments for meeting QI measures—not only increased markedly in the past two years, but a majority of HMGs also have adopted the practice. The number of HMGs that have quality incentive compensation plans has increased by 39% since 2006, according to the survey.

Nine out of 10 HMGs that receive performance-based compensation reported that the source of the compensation was the hospital or health system. In most cases, the compensation was paid to an individual hospitalist, which represents a shift from 2006, when more groups reported receiving the compensation directly.

The survey also shows that hospitals and HMGs use a number of process measures to evaluate QI incentives, including participation in quality or safety committees, transition of care measures, or core measures for heart failure, pneumonia, and acute myocardial infarction.

New View of Practice Administrators

Another new SHM report reveals that nonphysician administrators (NPAs) are also eager to grow professionally in the HM community. The report, presented at the HM09 Administrators Special Interest Forum, illustrates that many practice administrators—HMG employees responsible for operations and administration—are highly credentialed and actively seeking opportunities for networking and professional development.

Few practice administrators have attended SHM conferences, and many say they are unaware of the resources available to them through SHM.

“Ask most hospitalists, and they’ll tell you that nonphysician administrators are critical to the success and operation of their hospital medicine group,” says Leslie Flores, director of SHM’s Practice Management Institute. “This research indicates that we can do a lot more to promote the existing opportunities for continuing education and collaboration—like the pre-courses and the practice management track at the annual meeting—to help administrators do their job well.”

SHM’s Administrators Task Force commissioned the first-of-its-kind NPA survey. The findings will be used to create new SHM initiatives and materials that promote and define the role of NPAs within the specialty. HM09 included pre-courses on best practices in managing a HM program and inpatient coding and documentation, as well as a variety of breakout sessions on practice management topics.

“Our recent educational sessions and the report represent just a few of the many steps necessary to actively address their needs and improve collaboration between administrators and their physician counterparts,” Flores says.—BS

New Numbers Dispel High Turnover Myth

For years, the conventional wisdom throughout the healthcare community has been that HM suffers from a high turnover rate among its hospitalists. Focused Survey findings suggest otherwise. In fact, turnover rates for hospitalist groups have remained constant since 2005. Nearly a third (31.7%) of HMGs reported no turnover at all within the past 12 months.

“Getting an accurate idea about turnover in hospitalist groups has been an ongoing challenge in our research,” Flores says. “In this year’s Focused Survey, we provided clearer definitions and asked more specific questions to improve our measurement of turnover.”

The added specificity only served to reinforce findings from previous surveys that showed relatively low turnover rates. The most recent research revealed a 12.7% turnover rate, compared with 13% in 2007 and 12% in 2005.

The latest Focused Survey also includes detailed findings on turnover among full-time hospitalists compared with part-time hospitalists.

Part-Time vs. Full-Time

The new data challenge long-held assumptions about the role of part-time hospitalists. The survey queried HMGs about full-time and part-time hospitalist staff, and the proportion of time that each employee covers in the hospital.