Medicolegal Issues

SHM Behind the Scenes


You may have noticed a new look to SHM’s Web site. To the naked eye, many of these changes might appear subtle. Behind the nuanced changes to the graphical interface, the content now resides in a completely different structure that allows users to more easily find information and resources.

Why the change? As SHM’s interactive services manager, I have spent a lot of time trying to find pages of content on the SHM Web site that need to be added, updated, or removed. This is not a task for the faint of heart, considering there are more than 10,000 active pages on the SHM Web site.

Hospital Medicine Fast Facts

How to Monitor Hospitalist Performance

Understand your environment: Every hospital medicine practice operates in a unique environment with its own culture, language, goals, concerns, priorities, analytical methodologies, and operational habits. It is important for a hospital medicine group to understand the interests of the organizations in which it works and to communicate using terms, definitions, and analyses consistent with existing practices.

Understand data sources and limitations: Examples include:

  • Billing systems typically capture only billable charges and so do not reflect clinical interventions, such as second patient visits in the same day, for which a charge cannot be generated.
  • Data from hospital information system regarding admitting and attending physicians, consultants, compliance with protocols, and core measures may be subject to data entry errors and should be evaluated for accuracy before inclusion in a practice’s dashboard.
  • Determine types of analyses to perform: Practices undertaking performance monitoring should consider which metrics should be used to evaluate the performance of individual physicians (compared with their practice peers and available benchmarks), and which metrics are the most appropriate for evaluating group performance. Certain metrics will be used to describe both individual and group performance.

What to do with all this information? Consider these questions:

  • Plausibility: Does the information make sense based on what you know about your practice? Is there something about the reported results that does not look right (e.g., data errors, miscalculations).
  • Usability: What are the key take-away points from this report that will be relevant next week or next month? In what areas is individual or group performance not meeting targets? What are the performance trends? What decisions can be made on the basis of this information? What can be done to improve performance in these areas?

To download 'Measuring Hospitalist Performance: Metrics, Reports, and Dashboards." Visit the "SHM Initiatives" section at

About a year ago, after a particularly head-splitting day of trying to find an obscure piece of information, I concluded: “There has got to be a better way to organize the information on this site!” After discussions with key stakeholders, we concluded it was time to completely reorganize our Web site. As a reward for bringing this to everyone’s attention, I was chosen to head the endeavor.

After a couple of minutes of pondering the sheer magnitude of the effort I thought for a moment about taking an extended leave of absence. It would have been easy to sit in my cubicle and pound out a new architecture I thought would work well for the organization’s needs. But the reality was that just about everybody would need a say in the process.

As one of the most prominent faces of the organization, the Web site projects the core of SHM. Its online presence is a major tool for finding and engaging members, promoting SHM’s major initiatives and letting the world know exactly what the hospital medicine movement is about. Because of this, it was imperative that all the individuals involved in making the Society what it is were involved in the process of creating an information architecture for the Web site that would best serve the needs of all our users.

Right from the beginning of the process, it was clear that in order to create an information structure that worked for the organization as a whole, everyone would need to understand the importance of each other’s stake in the content on the Web site. Once there was an across-the-board understanding of the key pieces and groups of information on the site, it would be easier to implement structural changes that made sense to the organization as a whole.

Buy-in needed to occur at a high level early on. From the beginning of this project, I saw an opportunity to use many of the teaching and group-participation skills I learned as a Peace Corp volunteer in Ukraine. Not surprisingly, much of what I used to engage individuals, generate discussions and create ideas actually worked better in a roomful of SHM staff than it did in a classroom packed with hormone driven teenagers who were more interested in knowing if I personally knew Britney Spears than speaking English.

The initial brainstorming and idea-gathering sessions we held laid a solid foundation for restructuring the site’s navigation and information architecture, making it easier to navigate and more engaging for the end-user.

In the end, brute force, hard work, and group collaboration got the job done. Without the contribution and dedication of countless members of the SHM staff and community, this project would not have become a reality.

SHM now boasts a site that is cleaner, easier to navigate, and better showcases SHM’s role as the heart of the hospital medicine movement. A Web site, like many other things in life, is always a work in progress. But we feel confident that what you see today is a significant improvement over its predecessor.

Stop by to check out the result of this organization-wide effort. Comments and suggestions are always welcome as we continue to strive to improve the user experience. E-mail me at

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