Background: Hospital medicine groups are often quickly expanding, which causes strategic planning to focus primarily on clinical needs and staffing. It can be difficult to find opportunities for goal setting where consensus within the group can be achieved. This is made even more difficult by the typical hospitalist group providing 24/7/365 coverage, so at no one time can all providers participate in meetings. For operational and academic growth, in addition to quality and clinical growth, having a clear group direction is crucial.
Purpose: The aim of the project was to set strategic goals for our group by maximizing provider engagement through the use of existing internal committees and the development of an all-group retreat.
Description: Our section of Hospital Medicine, embedded within a large academic medical center experienced dramatic growth, expanding from 10 to 50 hospitalists and 30 to 130 patients seen daily. This growth has led to specific needs for our hospitalists, identified on a section-wide survey, including the desire for both a sense of belonging and increased opportunities to advance professionally. After significant discussion, section leadership decided to maximize engagement by using existing section committee structure to build the foundation of the retreat discussion. Each of the eight section committees (such as Medical Education, Quality Improvement, Clinical Operations, etc) constructed a Strength/Weakness/Opportunity/Threat (SWOT) analysis prior to the retreat. As SWOTs were presented by committee chairs, opportunities were identified and then prioritized by the group. Highest priority ideas were discussed in small breakout groups and from each of these a SMART objective was developed, working groups were formed and team leaders for each SMART objective identified. The resultant four main objectives were raised to hospital and Department of Medicine leadership in a comprehensive fashion. The first SMART objective of increasing hospital committee participation has been achieved with 5 new hospitalists on hospital committees within 6 months. Regarding the second SMART objective of reducing scut work, the section was able to secure funding to perform a time motion study to identify hospitalist time spent on scut/non-hospitalist work and, based on that data, a pilot of a medical assistant has just been completed and it is likely a new assistant role will be funded by the hospital. The other two objectives have been addressed in significant, though at this time less successful, measure.
Conclusions: Engagement of the entire section through committee pre-work and a retreat led to the formation of hospitalist-driven section strategic goals. The section prioritizes initiatives which increase efficiency, maximize continuity and engage providers with the broader hospital.
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