Soon after I became an ob.gyn. hospitalist, I became one of its biggest and most vocal proponents. I started a website, ObGynHospitalist.com [now ObGynHospitalistConsulting.com], set about learning and educating myself, and eventually became a consultant on establishing different ob.gyn. hospitalist programs around the country.
Through this experience, it quickly became clear which things worked well and which things did not. It also became immediately obvious that every hospital has different needs and problems, and every hospital needs a tailor-made ob.gyn. hospitalist. Fortunately, the hospitalist model is flexible and can adapt to each unique hospital setting.
In a fledgling subspecialty, with hospital corporations investing significant amounts of funding to start ob.gyn. hospitalist programs, there isn’t time (or money) to waste on pursuing the things that didn’t work. It is expected that, even though it’s a new program, it should work well almost immediately. Increased safety, better outcomes, and the elimination of unattended deliveries are immediate results when a program is implemented. What take longer to demonstrate are the benefits to the private obstetricians. But 3-6 months after a program starts, they become ob.gyn. hospitalists’ biggest supporters.
There are some basic ingredients I believe must be present in order to lessen the pain of implementing a new ob.gyn. hospitalist program and increase its chances of success.
Hiring the right people is always a challenge – in any industry. It can be even more so for ob.gyn. hospitalist recruitment. The standard is high: The ideal candidate must not only be board certified, but also a seasoned physician who can handle every true emergency, perform difficult operative deliveries, and counsel, advise, and teach older ob.gyns., family physicians, and midwives who may not be practicing up-to-date evidence-based medicine. This is not a job for a rookie.
The team has to be compatible, flexible, and responsible – and egos must be left at the front door. Communication is vital: Smooth handoff rounds conveying all the necessary information are essential. The hospitalist also must have a personality that enables him or her to quickly bond with all patients and their families after handover. Additionally, scheduling needs to be fair and allow call dates to be traded to fit everyone’s schedule.
Not only do the physicians need to keep their teammates and patients happy, they need to keep everyone happy. They need to look at systemwide improvements, listen to concerns, implement standardized protocols, and always encourage best practices. This is where customer service is imperative, and ob.gyn. hospitalists must go out of their way to ask nurses, staff, and physicians the question: “Is there anything I can do to help?”
Hospital Administration Support
Like all other internal medicine and pediatric hospitalist programs, ob.gyn. hospitalist programs need to be subsidized. It takes approximately $1.3-$1.7 million to start a program, and after a year, it is probably only bringing in about $1 million. The financial investment is worth it to the hospital because it results in better outcomes that lead to lower malpractice costs, as well as happier private physicians. Higher satisfaction in labor and delivery helps with recruitment and retention of nurses and physicians alike. It is also a marketable, competitive advantage that the hospital can use to attract more patients.
Whatever form a local ob.gyn. hospitalist program takes, these four common factors are essential to its foundation. The program must be flexible enough to meet unique local needs while still adhering to proven elements that ensure success.
Originally posted on JUNE 13, 2012 at ehospitalistnews.com