Administrative priorities during COVID-19
The pandemic hasn’t changed Ms. Panek’s administrative priorities, which include making sure her staff has whatever they need to do their jobs and that her providers have administrative support. “The work that’s had to be done to fulfill those priorities has changed in light of COVID though,” she said.
For example, she and her staff are all still off site, which she said has been challenging, especially given the lack of preparation they had. “In order to support my staff and to make sure they aren’t getting overwhelmed by being at home, that means my job looks a little bit different, but it doesn’t change my priorities,” said Ms. Panek.
By mid-summer, Ms. Dede said her main priority has been onboarding new team members, which she said is difficult with so many meetings being held virtually. “I’m not walking around the hallways with these people and having opportunities to get feedback about how their onboarding is going, so engaging so many new team members organically into the culture, the vision, the goals of our practice, is a challenge,” she said.
Taking advantage of opportunities for hospital medicine is another administrative priority for Ms. Dede. “For us to be able to take a seat at every possible table where decisions are being made, participate in shaping the strategic vision of the entire institution and be an active player in bringing that vision to life,” she said. “I feel like this is a crucial moment for hospitalists.”
Lean work, which includes the new team efficiency plans, is an administrative priority for Ms. Smith, as it is for the entire organization. “I would say that my biggest priority is just supporting our team,” Ms. Smith said. “We’ve been on a resiliency journey for a couple years.”
Their resiliency work involves periodic team training courtesy of Bryan Sexton, PhD, director of the Duke Center for Healthcare Safety and Quality. The goal of resiliency is to strengthen positive emotion, which enables a quicker recovery when difficulties occur. “I can’t imagine where we would be, this far into the pandemic, without that work,” said Ms. Smith. “I think it has really set us up to weather the storm, literally and figuratively.”
Ensuring the well-being of his provider group’s physicians is a high administrative priority for Mr. Kharbanda. Considering that the work they’ve always done is difficult, and the pandemic has been going on for such a long time, hospitalists are stretched thin. “We are bringing some additional resources to our providers that relate to taking care of themselves and helping them cope with the additional shifts,” Mr. Kharbanda said.
The hospital medicine team at University of Kentucky Healthcare was already in the process of planning and adopting a new funds flow model, which increases the budget for HM, when the pandemic hit. “This is actually very good timing for us,” noted Ms. Dede. “We are currently working on building a new incentive model that maximizes engagement and academic productivity for our physicians, which in turn, will allow their careers to flourish and the involvement with enterprise leadership to increase.”
They had also planned to expand their teams and services before the pandemic, so in 2021, they’re hiring “an unprecedented number of hospitalists,” Ms. Dede said.
Mr. Kharbanda said that COVID has shown how much impact hospitalists can have on a hospital’s success, which has further highlighted their value. “Most of our programs are holding steady and we have some growth expected at some of our entities, so for those sites, we are hiring,” he said. Budget-wise, he expected to feel the pandemic’s impact for the first half of 2021, but for the second half, he hopes to return to normal.
Other than some low volumes in the spring, Salem Health has mostly maintained its typical capacities and funds. “Obviously, we don’t have control over external forces that impact health care, but we really try to home in on how we utilize our resources,” said Ms. Smith. “We’re a financially secure organization and I think our lean work really drives that.” The Salem Hospital is currently expanding a building tower to add another 150 beds, giving them more than 600 beds. “That will make us the largest hospital in Oregon,” Ms. Smith said.
Positive takeaways from the pandemic
Ms. Dede feels that hospital medicine has entered the health care spotlight with regard to hospitalists’ role in caring for patients during the pandemic. “Every challenge is an opportunity for growth and an opportunity to show that you know what you’re made of,” she said. “If there was ever doubt that the hospitalists are the beating heart of the hospital, this doubt is now gone. Hospitalists have, and will continue to, shoulder most of the care for COVID patients.”
The pandemic has also presented an opportunity at University of Kentucky Healthcare that helps accomplish both physician and hospital goals. “Hospital medicine is currently being asked to staff units and to participate in leadership committees, so this has been a great opportunity for growth for us,” Ms. Dede said.
The flexibility her team has shown has been a positive outcome for Ms. Panek. “You never really know what you’re going to be capable of doing until you have to do it,” she said. “I’m really proud of my group of administrative staff for how well that they’ve handled this considering it was supposed to be temporary. It’s really shown just how amazing the members of our team are and I think sometimes we take that for granted. COVID has made it so you don’t take things for granted anymore.”
Mr. Kharbanda sees how the pandemic has brought his hospitalist team together. Now, “it’s more like a family,” he said. “I think having the conversations around well-being and family safety were the real value as we learn to survive the pandemic. That was beautiful to see.”
The resiliency work her organization has done has helped Ms. Smith find plenty of positives in the face of the pandemic. “We are really resilient in health care and we can adapt quickly, but also safely,” she said.
Ms. Smith said the pandemic has also brought about changes for the better that will likely be permanent, like having time-saving virtual meetings and working from home. “We’ve put a lot of resources into physical structures and that takes away value from patients,” said Ms. Smith. “If we’re able to shift people in different roles to work from home, that just creates more future value for our community.”
Ms. Dede also sees the potential benefits that stem from people’s newfound comfort with video conferencing. “You can basically have grand rounds presenters from anywhere in the world,” she said. “You don’t have to fly them in, you don’t have to host them and have a whole program for a couple of days. They can talk to your people for an hour from the comfort of their home. I feel that we should take advantage of this too.”
Ms. Dede believes that expanding telehealth options and figuring out how hospitals can maximize that use is a priority right now. “Telehealth has been on the minds of so many hospital medicine practices, but there were still so many questions without answers about how to implement it,” she said. “During the pandemic, we were forced to find those solutions, but a lot of the barriers we are faced with have not been eliminated. I would recommend that groups keep their eyes open for new technological solutions that may empower your expansion into telehealth.”