Hospital medicine programs have a responsibility to maintain high standards of clinical excellence, patient safety, and efficiency for all hospitalists within their program. Organizational change, program growth, and faculty turnover make this endeavor challenging. Developing a thoughtful monitoring, evaluation and feedback process is essential to successfully maintain the highest standards of care.
Describe our programmatic approach to maintain the highest standards of clinical care and professionalism through a robust onboarding process, continuous individualized faculty feedback, and summative faculty evaluations.
Our model of faculty expectation setting, assessment, and review (Figure 1) is built upon 3 main processes”
New hospitalist onboarding s encompasses a detailed programmatic orientation, structured peer shadowing and multifaceted review of clinical documentation for appropriate clinical decision-making and documentation (Table 1). Faculty new to our institution are provided additional resources and mentorship to ensure a smooth transition into the overarching health system as well as our program. In the first 6 months, leadership meets individually with each new hire to review initial evaluations.
Continuous faculty feedback focuses on peer evaluations and case-specific quality reviews for all hospitalists. Peer evaluations of handoff quality via a standardized online tool are reviewed monthly by service directors, with the goal of providing timely feedback on clinical and/or professional performance. Clinical or professional concerns as well as all patient deaths are reviewed and discussed with the involved parties.
Summative evaluation is delivered in an annual meeting with the program leadership. A cumulative assessment reviewing quality of clinical care, teaching scores, professionalism/collegiality, and academic productivity is provided. Content for the assessment incorporates information from the onboarding process, faculty feedback, nursing survey and a faculty self-evaluation form regarding areas of programmatic improvement and future career goals.
A foundational cycle of feedback with an explicit, detailed onboarding process has enabled our academic hospitalist program to sustain a culture of safety and quality, while weathering significant change and turnover. Similar processes could be incorporated in a modular fashion for any hospitalist program.