Background: As the COVID-19 pandemic continues, the hospitalist workforce, which has been at the forefront, has been further stretched in both clinical and non-clinical domains. Hospitalists have faced increased clinical workloads due to inpatient volume surges, have been asked to lead hospital administrative pandemic responses, and have had to quickly adapt research to the context of the pandemic. We aimed to understand current workforce concerns and strategies to cultivate a thriving academic hospital medicine workforce, particularly in the setting of challenges faced by the field in the COVID-19 pandemic.

Methods: We conducted qualitative, semi-structured hospitalist focus groups via video conferencing (Zoom). Utilizing components from the Brainwriting Premortem Approach, focus group attendees listed all ideas in the Chat function around current issues that our hospitalist workforce will encounter, identifying the highest priority issues for the hospitalist workforce in the next 1-3 years. The focus groups then discussed and generated additional ideas and thoughts. Following the focus groups, the top 3-5 pressing issues identified by each group were shared across the entire group. We used rapid qualitative analysis, including creating templated summaries and using matrix analysis, to guide a structured exploration of themes and subthemes.

Results: Five focus groups were held with 23 participants from 17 academic institutions. We identified five key areas (Table 1): (1) burnout identification and support for hospitalist wellness (2) maintenance of an adequate workforce to match clinical growth – retention, pipeline development, and staffing models to support high-quality outcomes for patients, providers, and systems; (3) scope of work, including how hospitalist work is defined and whether the clinical skill set should be expanded; (4) maintenance of the academic mission in the setting of clinical growth; and (5) bridging of the gap between the needs of hospitalist groups and hospitals.

Conclusions: Hospitalists voiced numerous workforce concerns in the ongoing COVID-19 era. We have developed a hospitalist workforce prioritized list identified by participants from 17 geographically diverse academic institutions. This work has identified areas of focus to address these key challenges.

IMAGE 1: Table 1 – Key workforce priorities and representative quotes