Introducing Two Leaders – OBGYN Hospitalist Field

This month I’d like to introduce you to two leaders in the ob.gyn. hospitalist field.
The first is Dr. Wayne Farley of Questcare Obstetrics, based in Dallas. It currently has ob.gyn. hospitalist programs in Texas, but has recently expanded to Colorado.

Questcare’s first program was established 5 years ago, and in 2008, Dr. Farley stated: “I’m sure the face of our ob.gyn. hospitalist programs will look much different in 2012-2013.” That vision has proven to be very true, and he still believes that Questcare’s programs will continue to evolve with time.

Dr. Wayne Farley

Dr. Farley attributes the program success of Questcare to its focus on the development of perinatal service lines that the facility could not otherwise support. In fact, they have successfully created a variety of these programs for the facilities with which they are currently contracted and hope to expand them in their future contracts.
Questcare Obstetrics is currently expanding perinatal service lines to include high-risk obstetric referral centers. Even more specialized is the Advanced Maternal & Newborn Institute and Specialty Obstetrics Referral Center at Medical City Women’s/Medical City Children’s Hospital in Dallas. This program offers patient-focused outpatient and inpatient care of pregnancies complicated by fetal anomalies and/or chromosomal aberrations.
In addition to high-risk referral centers and specialty clinics, Questcare also has facilitated the development and implementation of a successful maternal transport program.

With this evolutionary change in Questcare’s ob.gyn. hospitalist programs in just 5 years, it should be interesting to see what the next 5 years bring. Questcare Obstetrics is focusing on providing quality ob.gyn. hospitalist programs, while helping expand targeted service lines for its contracted hospitals.

The development of these programs may seem out of the realm of what ob.gyn. hospitalist programs normally bring to a facility, but Questcare’s programs have brought a significant value-added contribution to the hospital without adding to the overall costs of healthcare.

The second person I’d like to introduce is the current president of the Society of OB/GYN Hospitalists (SOGH):

Dr. Karenmarie K. Meyer

Dr. Meyer is a great advocate of the ob.gyn. hospitalist model, and her goals for the fledgling society include defining what an ob.gyn. hospitalist actually is, delineating the criteria for hospitalist core competency; championing patient safety for women in the hospital, emergency department, and in the labor and delivery setting specifically; adding simulation training as part of our core skill set; and documenting our results through research and publications. Dr. Meyer has led significant progress in all of these areas and SOGH has been recognized as an organization whose members will take the lead in determining how ob.gyn. hospital care is provided in the future.

Passionate about the broadening understanding of the model, Dr Meyer recently stated: “Ob.gyn. hospitalists are much more than just an ‘in-house’ doctor available for emergencies. As our membership and visibility continue to increase, others are realizing this as well. Our members are up to date on current management protocols, and our availability to private physicians and their patients has been well recognized in hospitals utilizing our practice model. Our knowledge, consistency, and reliability will continue to define us as the ‘state of the art.’ ”

Dr. Meyer and SOGH are continuing to identify hospitalists’ core competency criteria and how these will be assessed and certified. SOGH also has been asked to help define the core criteria for the first fellowship in an ob.gyn. hospitalist discipline, which is being offered by Dr. Anthony Vintzileos at Stony Brook in N.Y.; the fellowship will be established at Winthrop University Hospital, Mineola, N.Y. The second program will be at the Fountain Valley Regional Hospital associated with the University of California, Irvine.

As the ob.gyn. hospitalist model matures and changes, Dr. Farley’s and Dr. Meyer’s contributions are exciting and are helping to define and drive the future of women’s inpatient care across the country today.

Originally posted MAY 21, 2013 on ehospitalistnews.com

Recipe for a Successful Ob.Gyn. Hospitalist Program

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.

Qualifications

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.

Team Players

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.

Service Orientation

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