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Help Wanted

From: The Hospitalist, November 2011

New program hopes to take hospitalist leadership to the next level

by Thomas R. Collins

SHM’s Leadership Academies have been well received, with at least 1,200 having taken the courses so far. Some of those participants, though, craved something more—some recognition for the ways those lessons are being incorporated on the job in their hospitals.

So this year, for the first time, SHM is offering something beyond the third level of the Leadership Academies. Those who have completed all three levels in the academy can now seek Leadership Certification, based mainly on completion of a project to make a positive change at their hospitals.

Rusty Holman, MD, MHM, director of the academy program and chief clinical officer at Cogent HMG, says the impetus came from past participants.

“Those who have attended the Leadership Academies came forward and said, ‘You know, we’re doing some really important coursework, we’re investing in ourselves in both our knowledge and our skills as leaders. We are furthermore involved in a lot of change efforts within the hospital and improvement efforts—whether it’s related to quality or it’s related to some business function or it’s related to education and training. And wrapping all that together, wouldn’t it be nice if we had some certificate or something from the medical society saying that, yes, we completed this coursework and we have achieved a certain level of recognition and have that recognition come directly from the professional medical society?’”

The project for certification has to be approved, and a performance and growth evaluation has to be completed. Once a project is approved, participants will be connected with advisors to help them along. Those taking the Leadership Academy coursework will have five years to apply that coursework to the certification process. But to be fair to those who have already gone through the academy and may already be near the time limit, anyone can apply their coursework through January 2013.

SHM expects that the certification will take an average of 18 months to complete, but it can be completed in as little as one year or as many as five years.

Rusty Holman, MD, MHM There’s an age-old question: Are leaders born, or are they made? And to me, the answer to that question doesn’t matter. There will never be enough natural-born leaders to get all of this done.

—Rusty Holman, MD, MHM, chief clinical officer, Cogent HMG, director, Leadership Academy, former SHM president

Tina Budnitz, MPH, senior advisor to the CEO of SHM and a chief designer of the Leadership Certification program, says the main idea was to make it relevant and meaningful.

The program was crafted “with adult education principles in mind,” she says. “You get to design a project that’s going to be meaningful for you. We’re also trying to put you into small, networked groups of networked faculty and peers that can provide support for you along the way.”

When participants submit their projects, they’ll get “very detailed feedback” from experts on potential problems and will be directed to resources. If someone proposes a project on deep vein thrombosis (DVT) prevention, for example, they might be directed to webinars on the topic or other hospitals in their area where DVT prevention programs have been implemented so that the participants can contact them if they choose.

Budnitz says Leadership Certification is meant to plug a gap in leadership curriculum at business schools and in coursework in programs like the American College of Physician Executives.

“What they aren’t able to do is provide education in the context of hospital medicine,” she says.

The cost of the program is $2,500. That is in addition to the cost to participate in Leadership Academies, which range from $1,800 to $2,000 each.

One of the first to sign up for the program, Darlene Tad-y, MD, a hospitalist and assistant professor at the University of Colorado Denver, says she already has noticed that she has been able to apply concepts she has learned in the academies to work situations: supervising residents, interns, and medical students as the attending physician, serving on hospital committees, and taking a leadership role within her hospitalist group.

She says the Leadership Certification program makes sense for her because she isn’t sure she wants to pursue an MBA but still wants to refine certain skills.

She said that in her project, she will attempt to improve transitions of care, looking specifically at communication at the time of discharge. The project is one that she likely would have undertaken anyway because it’s important to her institution and patient care, but doing it as part of the certification program gives her more resources, along with the chance to earn the certificate.

Darlene Tad-y, MD I’m not the division head, I’m not the chief, but I don’t think that leadership necessarily is bestowed by a title. I think it’s what you’re doing. It’s the actions that you’re taking and the way that you’re approaching things. And it’s a skill set that I feel like you need to work on and develop.

—Darlene Tad-y, MD, assistant professor, University of Colorado Denver

The skills learned through certification would be helpful to anyone, regardless of their supervisory role, she notes.

“I’m not the division head, I’m not the chief, but I don’t think that leadership necessarily is bestowed by a title,” she says. “I think it’s what you’re doing. It’s the actions that you’re taking and the way that you’re approaching things. And it’s a skill set that I feel like you need to work on and develop. And I think that’s what the certification will help me [with].”

Ilan Alhadeff, MD, FHM, program medical director with Cogent HMG who works at Hackensack University Medical Center in New Jersey, says his project will involve techniques to increase patient satisfaction scores, focusing largely on the communication that drives those scores.

He is taking leadership in the field seriously, particularly because the demands of hospitalists will be heightened amid healthcare reform efforts.

The importance of quality markers and patient experience will only grow, and hospitalists are positioned to have a big impact on them, he says.

“Hospitals are at big financial risk, which could result in further consolidation of healthcare institutions,” Dr. Alhadeff says. “We’re poised to have the biggest impact on those numbers, [moreso] than any individual primary-care doctor.”

Dr. Alhadeff says it might not be easy to fit the project in, considering all the demands on his time already, but it’s something he feels compelled to do.

“I would [call it akin] to telling a patient they need to find time to exercise,” he says. “There’s no time, but we just have to make time and we have to do it.”

Dr. Holman says the important thing is the learning that takes place while participants are involved in the projects, not necessarily the projects’ results. In a project that aims to reduce 30-day readmission rates, for example, a lot can be learned even if the effort fails.

“In fact, in that scenario, we would expect that the lessons learned would be very robust, would be very rich,” says Dr. Holman, a former SHM president. “And the focus would be on both, perhaps technical reasons why readmission rates went up, but [also] a very significant focus on lessons learned about what things undermined the effort or made the effort less than successful. And it’s those lessons learned that help us grow as leaders, and tying it back to things that we learned in the Leadership Academies and applying it to a real-life scenario.”

The academy and the certification program, Dr. Holman says, will create a “self-sustaining” environment in which people may be more likely to participate in the academy if they know they can use their coursework to vault to the next step later, should they choose to do so.

It’s an important time for a new layer of leadership training, he adds, because of all of the challenges facing hospital medicine and healthcare at large. “There’s an age-old question: Are leaders born, or are they made?” he says. “And to me, the answer to that question doesn’t matter. There will never be enough natural-born leaders to get all of this done. So we have to develop people who have the interest and have the potential. We would be squandering a huge opportunity if we didn’t undertake that ourselves.”

Tom Collins is a freelance writer based in Miami.

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