In today’s health care space, tracking progress and achieving specified metrics are all part of the job. Most fast-paced physician groups incentivize clinicians for efficiency, consistency, quality, and loyalty. Setting and achieving goals, although it might sound somewhat cliche, can play an important role in daily performance, as well as have an impact on long-term satisfaction with an HM career, according to experts in the field.
“Health care insurers and individuals choosing where to obtain health care want evidence that hospitalists are delivering the best care possible,” says Judith S. Treharne, consulting executive at Halley Consulting Group in Westerville, Ohio. “This requires goal setting, measuring performance related to those goals, and continually developing processes that enhance performance in order to achieve goals.”
Hospitalists are at the forefront of healthcare transformations taking place both inside the hospital and when patients are discharged to different settings. The opportunities for setting goals – personal and group-wide – are endless.
For employed hospitalists, goal setting – and achievement – can counter career stagnation, says Sanjay Bhatia, MD, FHM, CDIP.
“They show up, do a job, and go home. Many are not encouraged to develop their careers,” says Dr. Bhatia, chief medical officer, Prime Healthcare–Lower Bucks Hospital, Bristol, Pa.; founding partner, First Docs/Mercer Bucks Medical, Levittown, Pa.; and CEO/president, Prime Clinical Solutions, Freehold, N.J.
Setting goals will help hospitalists establish skill sets and achieve accomplishments that will keep their career growth on track, adds Surinder Yadav, MD, SFHM, vice president of hospital medicine at Emeryville, Calif.–based CEP America, a national organization specializing in acute-care staffing, including hospitalist, intensivist, and emergency medicine programs.
when someone consistently reaches their goals (that is, improving outcomes) and feels accomplished, it enhances engagement of their work, says Treharne, who advises hospitalist groups.
Determine, pursue goals
There are many reasons why goal setting is important. So what guidelines can a hospitalist use to set goals? In order to establish goals for your current role, Treharne advises reviewing your job description – which should be updated as your role evolves.
“Determine what you need to do in order to progress toward meeting these requirements,” she says. “Find out what resources are available to support your efforts.”
Regarding setting career goals, Dr. Jaffer says hospitalists should consider things that really move them.
“For hospitalists in the early stages of their careers, it may take some time to determine them,” he says. “But when a passion develops, hospitalists can identify opportunities which will allow them to create a niche for themselves or an area of expertise.”
Then, hospitalists can work with individuals within their organization and beyond to increase their expertise.
“Find one or more mentors, take educational courses or even pursue an advanced degree, and write about your area of expertise either by publishing articles or abstracts, giving poster presentations, or lecturing,” Dr. Jaffer advises. “That will establish you as an expert and lead to promotions.”
Dr. Bhatia believes it’s natural and important for hospitalists to pursue administrative roles and become experts on how hospitals and post–acute care facilities work, because they transition patients to these institutions and they employ hospitalists. He has also seen hospitalists pursue entrepreneurial goals, such as becoming involved in information technology by developing apps or becoming C-suite executives, and starting other medical-based businesses such as home-based physician visits and telemedicine ventures and even nonmedical-based businesses such as real estate investing. Another avenue is teaching residency programs and developing an academic career.
“The key is to have good teammates, partners, and ancillary staff in each endeavor,” Dr. Bhatia says. “You can learn a lot from them as well. My experiences beyond being a hospitalist make me very valuable as a hospitalist. I’ve found that varied experiences create a synergistic and value-added service to a hospital.”
Stay on target
In order to reach your goals, Dr. Bhatia recommends creating daily task lists as well as setting goals quarterly and annually and evaluating them at those intervals. Determine action steps to reach long-term goals. “I keep these lists on my smartphone, so they’re always in my mind’s eye,” he says. “I look at the big picture on a daily basis and work toward my goals.”
In an effort to help faculty members reach their goals, Dr. Jaffer, when he was a division director at Rush University Medical Center in Chicago, scheduled biannual professional reviews with each team member. It was a formal process adapted from the annual professional review that he learned while at the Cleveland Clinic. Members were asked to complete a faculty self-reflection assessment and answer questions such as:
- Since our last meeting, what committees and educational opportunities have you participated in?
- What types of quality improvement projects and presentations have you done?
- What achievements are you most proud of?
- Regarding the goals you listed at your last review, where have you had the most growth? What would you define as opportunities for growth?
At Rush, Dr. Jaffer asked members of his division to set one or two professional goals each year. “I suggested they set goals that will make them feel fulfilled professionally, so their careers remain gratifying,” he says.
Hospitalists should play an integral role in developing a hospital’s strategic and operational plan. “By having hospitalists provide feedback in the planning process, prior to annual finalization of the plan, the hospital’s and hospitalist program’s objectives can be aligned,” Treharne says. “It’s important that their goals align, in order for both to be successful.”
Dr. Jaffer suggests starting at the beginning of each fiscal year. HM groups should, as a team, create quality, operational, and efficiency goals, which align closely with the hospital’s goals. Some examples: clinical productivity work relative value units (wRVUs), doctor-patient communication scores, observed-to-expected length of stay, readmission rates, and percentage of patients discharged by 1 p.m.
“We set goals both as individuals and as a group,” Dr. Jaffer says. “Then, we create a scorecard for each hospitalist on a quarterly basis and share each hospitalist’s data with them, as well as create a group dashboard. As a group, hospitalists can view both individual data and the group’s data. This feedback helps them identify where they need to improve their performance.”
Dr. Bhatia has found that setting group goals on a quarterly basis works well. Goals involve recruitment needs, patient satisfaction, case mix index, Hospital Consumer Assessment of Healthcare Providers and Systems (), utilization, and length of stay.
“Metrics should be recorded and shared monthly by either the hospital’s information technology department or the hospitalist group’s software,” he says.
Data: top of mind
Each provider needs to understand that success for the team also means individual success.
“Focus on helping each other to achieve high performance and high quality care,” Dr. Yadav says. “Engage with each other and with the hospital at large. Aim to be involved in projects and to help find solutions to problems or barriers within the system.”
When you implement a change in a process and expect to see improvement regarding a particular measure, be sure to give the new process adequate time to shift the outcome.
“Many good ideas have been cast aside because they were deemed unsuccessful before there was sufficient time for the process to stabilize and the improvement to be seen,” Treharne says.
When setting targets and measures, set expectations regarding how long the new process will need to be in place prior to evaluating the change.
“Pilot programs are often a good way to try something out before completely changing a process with potential unwanted outcomes,” she says.
If a clinical operational or efficiency goal that involves the whole group and performance is below target, look to best practices to help you achieve success, Dr. Jaffer says. Create a work group and appoint a champion.
Hopefully, reaching your goals will translate into success.
“Success for me is about having a positive impact on people and processes, and being content with my personal life and having time and resources to pursue my passions,” Dr. Jaffer concludes.
Setting Goals for Now and Then
When looking to set goals, Treharne recommends starting with long-term goal setting.
“Set goals for the next year, or five years and beyond, by establishing a vision – dream to be more than you are today,” she says. “Envision a future that gets you excited to participate in change and come to work every day.”
- I could become more valued in my job by doing _____.
- I could make more income by _____.
- I’d like to increase my knowledge of _____.
Then, develop short-term goals that will help you work toward achieving your long-term goals.
“Map out a path from today using the metrics available and applicable to the future state,” Treharne says. “Creating that path allows you to determine the short-term goals. How far can you get in what period of time? Be realistic, but stretch yourself so you’re not complacent.”
Document this path in a quarterly action plan with a complementary monthly tactical plan. Plans should identify accountable parties, resources needed, data requirements, and timelines, Treharne says. Review your progress monthly.
Check in and articulate your goals with those in your inner circle – seek their advice on a regular basis, Uy says. Measure results and be willing to adapt if you’re not progressing as you’ve envisioned.
Karen Appold is a freelance writer in Pennsylvania.