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.
Purpose:
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.
Description:
Our model of faculty expectation setting, assessment, and review (Figure 1) is built upon 3 main processes”
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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.
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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.
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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.
Conclusions:
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.