Establishing a Hospitalist
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Establishing a Hospitalist Medical Specialty Society Shaun Frost, MD, SFHM, FACP President Elect, Society of Hospital Medicine Chief Medical Officer – NE Region, Cogent HMG. Agenda. The hospital of the future A brief history of hospital medicine and the Society of Hospital Medicine

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Agenda

Establishing a Hospitalist Medical Specialty SocietyShaun Frost, MD, SFHM, FACPPresident Elect, Society of Hospital MedicineChief Medical Officer – NE Region, Cogent HMG


Agenda

Agenda

  • The hospital of the future

  • A brief history of hospital medicine and the Society of Hospital Medicine

  • Five essential lessons to consider when building a hospitalist specialty society


The hospital of the future challenges facing hospitals

The Hospital of the FutureChallenges facing hospitals

  • Patients are sicker and more complex

  • Hospitals running at capacity

  • Emergency Departments overcrowded

  • Workforce shortages

  • Nurse turnover = 20% annually

  • PCPs giving up inpatient care

  • Surgeons / subspecialists narrowing their scope of practice

  • Hospital – physician relationships

  • Public trust

  • Quality & patient safety

  • Tremendous cost pressures and fiscal responsibilities


The hospital of the future cost and mortality

The Hospital of the FutureCost and mortality


The hospital of the future cost pressures

The Hospital of the FutureCost pressures


The hospital of the future cost pressures will become quality pressures

The Hospital of the FutureCost pressures will become quality pressures

Healthcare reform will change how healthcare dollars are distributed

  • PPACA

  • Value Based Purchasing

  • Bundling

  • Accountable Care Organizations

  • Patient Centered Medical Homes

  • IPAB


The hospital of the future cost quality and success

The Hospital of the FutureCost, quality, and success

“Winning”

Quality

Efficiency


The hospital of the future the vision

The Hospital of the FutureThe vision

  • Demonstrable quality performance

  • Maximum efficiency

How do we do this?


The hospital of the future the vision1

The Hospital of the FutureThe vision

  • Demonstrable quality performance

  • Maximum efficiency

Genuine systems integration is essential

How do we do this?


The hospital of the future the vision2

The Hospital of the FutureThe vision

  • Demonstrable quality performance

  • Maximum efficiency

How do we do this?


The hospital of the future the modern medical staff

The Hospital of the FutureThe modern medical staff

  • Home team

    • Hospitalists*, ED docs, intensivists

    • Maybe radiology, anesthesiology, pathology

  • Important visitors

    • Ortho, cardiology, nephrology, etc.

  • Everyone else

    • PCPs, endo, rheumatolgy, dermatology, etc.

* Hospital medicine, OB-Gyn hospitalists, surgicalists, neurohospitalists, etc.

Trotten, MK & Orlikoff, JE, “New Models for Hospital-Physician

Relationships”, Trustee Magazine January 2008


The hospital of the future how to achieve genuine systems integration

The Hospital of the FutureHow to achieve genuine systems integration

Hospitalists have to think unconventionally

  • Doctors traditionally trained to think of just the patient in front of them

    • How to treat this woman’s complicated delivery?

  • Hospitalists must think about entire system

    • How can we best manage the 100 complicated deliveries that we will attend at this year?

    • How should nursing, pharmacy, the ED be staffed and organized to accomplish this?


The hospital of the future how to achieve genuine systems integration1

The Hospital of the FutureHow to achieve genuine systems integration

Home team must act as a unit

  • All team members collaboratively think through the care delivery tasks

  • “Outside of the box” thinking results in greater efficiencies and effectiveness

  • Roles traditionally performed by physicians become responsibility of others

  • Physicians assume new value added roles


Agenda1

Agenda

  • The hospital of the future

  • A brief history of hospital medicine and the Society of Hospital Medicine

  • Five essential lessons to consider when building a hospitalist specialty society


A brief history of hm shm hm is very young

A Brief History of HM & SHMHM is very young


Agenda

A Brief History of HM & SHMAstronomically quick growth

  • 1995: 9.1% of Gen Med claims by hospitalists

  • 2006: 37.1% of Gen Med claims by hospitalists

  • 1997 – 2006: Odds of receiving care from hospitalist  year over year by 29.2%

Kuo Y et al. N Engl J Med 2009;360:1102-1112


Agenda

A Brief History of HM & SHMAstronomically quick growth

  • 1997 23

  • 1999 800

  • 20011,750

  • 20033,200

  • 20066,300

  • 20087,850

  • 2010 10,000

SHM Membership Statistics

1997-2010


Agenda

A Brief History of HM & SHMSociety of Hospital Medicine in 2011

  • Membership ~ 12,000

    • Growing 18-20% annually

  • Annual Meeting >2,500

    • Growing 30-35% annually

  • Unique Publications

    • Journal of Hospital Medicine

    • The Hospitalist news magazine


Agenda

A Brief History of HM & SHMSociety of Hospital Medicine in 2011

  • ABIM unique MOC in the focused practice of HM

  • Center for Hospital Innovation and Improvement

    • BOOST, VTE prevention, glycemic control

  • Consistently invited to input on significant healthcare policy and regulatory issues

  • True voice in Washington DC

    • Pat Conway, MD, CMO of CMS


A brief history of hm shm the short story

A Brief History of HM & SHMThe short story

Hospital medicine has been successful and rapidly accepted because of the attention it has paid to the forces that are driving hospital change and the evolving hospital medical staff of the future


Agenda2

Agenda

  • The hospital of the future

  • A brief history of hospital medicine and the Society of Hospital Medicine

  • Five essential lessons to consider when building a hospitalist specialty society


How to build a medical society five essential lessons

How to Build a Medical SocietyFive essential lessons

  • Focus keenly on quality improvement

  • Be healthcare reform facilitators

  • Respect the importance of “branding”

  • Be inclusive versus exclusive

  • Define your uniqueness


How to build a medical society five essential lessons1

How to Build a Medical SocietyFive essential lessons

  • Focus keenly on quality improvement

  • Be healthcare reform facilitators

  • Respect the importance of “branding”

  • Be inclusive versus exclusive

  • Define your uniqueness


How to build a medical society focus keenly on quality improvement

How to Build a Medical SocietyFocus keenly on quality improvement

  • Define quality comprehensively

  • Understand the definition of value

  • Anticipate the most important quality expectations of your key stakeholders

  • Help your members deliver high value care


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