Background: Hospital medicine is a high-volume, high-demand specialty where frontline clinicians frequently identify system challenges but lack structured opportunities to influence solutions. Leadership is often occupied with urgent operational needs, leaving hospitalists’ concerns under-addressed. This gap contributes to inefficiency, disengagement, and burnout. An innovative forum—the “Think Tank”—was created to empower hospitalists to generate, prioritize, and implement grassroots solutions in partnership with leadership.
Purpose: The Think Tank was designed to:1. Create a structured venue for hospitalists to raise concerns and generate peer-driven solutions.2. Enhance hospitalist ownership and engagement in process improvement and innovation.3. Improve communication, collaboration, and physician well-being within the division.
Description: The Think Tank is an informal, voluntary monthly gathering held separately for “alpha” and “beta” week hospitalists during their on-week. Each week designates a hospitalist liaison to facilitate discussion, prioritize concerns, and conduct follow-up work (e.g., feasibility assessments, stakeholder outreach, coordination with leadership). Importantly, hospital administration does not attend, allowing hospitalists to brainstorm freely. Updates and progress reports are provided during monthly division meetings, ensuring transparency and accountability.A dedicated WhatsApp group, exclusive to hospitalists in the Think Tank, supplements in-person meetings by enabling real-time communication, project planning, and rapid polling of group sentiment. This structure allows hospitalists to proactively address issues while hospital leadership provides oversight once solutions are ready for implementation.Several initiatives have demonstrated the Think Tank’s impact:• Scheduling Flexibility: Creation of a QGenda-integrated “Flex Schedule,” allowing pooled shift coverage and “bank days,” significantly improving work-life balance.• Billing and Compensation: Identification of underbilling led to faculty billing seminars and the first hospitalist bonus incentive structure at our institution.• Radiology Workflow: Creation of a standardized “study note” by radiology technologists to document reasons for imaging delays, improving communication and patient care coordination.• Discharge Efficiency: Collaboration with nursing leadership resulted in floor-based discharge nurse schedules with contact information, reducing delays in outpatient appointment scheduling.
Conclusions: The Think Tank has become a sustainable, scalable model for hospitalist-driven innovation. By creating a safe, peer-led forum with structured follow-through, hospitalists have implemented solutions that improved efficiency, communication, compensation, and work-life balance. This grassroots approach demonstrates that frontline clinicians, when given space and structure, can drive meaningful change that benefits patients, providers, and institutions alike. The Think Tank model can be readily adapted across hospital medicine programs to foster engagement, reduce burnout, and accelerate innovation.
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