Background: Research suggests that high workloads in the inpatient setting (often measured through patient encounters/visits) contribute to increased hospital length of stay, increased costs, and delayed discharges. High workloads also negatively impact our quality improvement efforts and result in a mismatch in job demands and job resources leading to clinician burnout. To date, there is [...]

Background: Research suggests that high workloads in the inpatient setting (often measured through patient encounters/visits) contribute to increased hospital length of stay, increased costs, and delayed discharges. High workloads also negatively impact our quality improvement efforts and result in a mismatch in job demands and job resources leading to clinician burnout. To date, there is [...]

Background: Backup systems (jeopardy) are utilized by hospital medicine programs to staff clinical services in the cases of illness, leave and unexpected increases in clinical volumes. In the context of increasing hospitalist burnout and increased staffing needs during and after the COVID pandemic, a focus on how jeopardy contributes to clinician experience has emerged as [...]

Background: Situated in coastal Florida, the four hospitals/1,000 beds in the Health First Integrated delivery network are located right in hurricane alley. Our hospitalist program had to plan for, communicate, and execute our hurricane staffing and disaster plan twice in one year. Purpose: Lessons learned from the implementation of our Hospitalist staffing and disaster plan [...]

Background: Provider continuity can improve many aspects of an inpatient stay however, there is a lack of data on whether it could affect mechanical ventilation weaning. During the COVID-19 pandemic, many patients required tracheostomies and mechanical ventilation. This study evaluated whether provider continuity could increase mechanical ventilation weaning outcomes in the inpatient setting. Methods: Data [...]

Background: The SARS-CoV-2 (COVID-19) pandemic has led to challenging staffing situations for health systems. Rapid increases in patient volumes, coupled with clinician illness, need for quarantine/isolation as well as other workforce restrictions, have required systems to become nimble in clinician staffing. To overcome these challenges, novel approaches have been utilized including the employment of non-traditional [...]

Background: Cross-covering patients overnight is part of standard Hospitalist practice, however there is little understanding of the workload contribution. Much of the current literature for hospitalist productivity focuses on wRVU, day census, or number of admits per shift. These metrics are not applicable to cross cover since it is largely non-billable work. A cross sectional, [...]

Background: The COVID-19 crisis has put an unprecedented strain on the US healthcare system (1). Hospital Medicine (HM) has been on the front lines of the crisis response (2). Multiple surges and troughs are expected before the pandemic subsides with a very large surge predicted for the winter of 2020-2021 (3). As the HM service [...]

Background: Hospitalist groups must be able to respond to unexpected staff absences due to sick calls, personal emergencies, and unanticipated leave, all of which have substantially increased since the 2020 coronavirus pandemic. They also need to be able to respond to ongoing fluctuations in census related to seasonal respiratory viral surges, as well as institutional [...]

Background: Providers have a variety of situations arise on shift that challenge or inhibit their ability to provide care to patients, sometimes with advanced notice but often without. Most programs have coverage systems in place for emergent needs, but these are less than ideal for immediate and short-term situations (Table 1). Without a set policy, [...]