Before you start an OBGYN hospitalist program…

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Forward thinking hospitals see the value of high quality care that prioritizes the safety of both mother and child. The OBGYN hospitalist model is an approach which is quickly being adopted due to its patient focused design. We believe it will become the standard for busy labor and delivery units. Multiple factors prompt hospitals to seek the benefits that come with a OBGYN hospitalist approach. Fortunately, there are several expert resources available who can provide advice on how to start your program. Choosing the consultant or management company to help you succeed depends on your specific needs.

Triggers for Change
A move to a hospitalist model usually stems from the need to improve maternal patient care and safety.  A hospital may have endured an adverse event and its subsequent outcomes, including the obvious impact to the patient and family plus the impact on the care delivery team. In addition to the physical and emotional toll involved, there is significant financial burdens from the potential ensuing malpractice costs. In other cases, the local Maternal Fetal Medicine (MFM) physicians need support or a hospital is faced with a loss in obstetrical patient volume. The reasons for change are unique to each hospital. Transitioning to a successful hospitalist program solution that addresses specific challenges takes a customized approach with thorough understanding and planning, effective implementation, and support. Here are some areas to consider before you start a hospitalist program.  

Expert Advice
The OBGYN hospitalist model has been around for 12-15 years but has reached over 300 programs only recently. Choose a consultant that will help you navigate this transition to an OBGYN hospitalist program. This may be new and uncharted territory for you, but it is not for a skilled consultant. Experience in this field varies. Choose a skilled OBGYN hospitalist consultant who is an influential leader in the field, and versed in program design and implementation.

The National OBGYN Hospitalist Consulting Group’s consultants, Dr. Rob Olson and Dr. Brendan Carroll, are board certified OBGYN physicians and leaders in the industry with a combined 60+ years of clinical and leadership experience. I am the founding President of the Society of OBGYN Hospitalists (SOGH) and a National speaker. Dr. Brendan Carroll is an OBGYN Hospitalist, Medical Director, and a SOGH Board member.  During our initial consultation, our focus is to study and understand your issues and the resources available. As we delve deeper, we discover the specific culture of the hospital and its teams, its unique needs and requirements, which can be driven by staffing, resources, budget, and time.

Customized Needs and Support
Consider how busy your hospital is and how much time you have to invest in designing and implementing a new program. All roles play an important part in quality patient care and safety, which is why a well-designed program requires all to participate.  This includes administrators, nurses, and a physician to champion the project. The amount of time a hospital devotes collaborating with their consultant and the existing structure of the program is a factor in determining the scope of the consultant’s involvement. A hospital that has time devoted to the project and all the key roles available to help structure the program may be able to review the recommendations by the consultant, and run with the blueprint on their own, only working with a consultant for a few months. A very busy unit with limited time to self-start may need a 12 month commitment including on-site and hands-on guidance, regular support, plus reports to track and evaluate their progress. Conversely, a hospital which doesn’t have the key roles in place or the time to design a program may look to a management company to do all the work.

Home Team Advantage
Designing your own hospitalist program in collaboration with a consultant allows you to meet your unique needs, such as the organizational culture. A healthy team dynamic is a vital part of an effective program, and only you and your team know your organization’s culture best. What is the value of being part of the interview process, and choosing a future team member? How important is it to have a local resident in the community working at your hospital? In our experience, the more intrinsic motivation a doctor has with the hospital, program, and community, the more they are part of the team, attached to the hospital’s goals, and the longer they will stay with your team. This means less turnover and disruption. For example, an OBGYN hospitalist who resides in the community and championed the new program is likely more invested than a physician who is commuting from another city, and wasn’t part of the initial planning to design a new program.  A doctor who has been on the medical staff is also known to the existing team and may be seen as more trustworthy, accountable and credible.

Long Term Costs
Your bandwidth, budget and goals will determine if a turn-key solution makes sense, or if a locally designed program is the way to go. “Plug and play” is appealing, especially if the team has limited time to invest in creating a program from the ground up. On top of the usual costs, such as salaries, administration, and malpractice, hiring a management company comes with contractual annual premium costs. At the end of the term, you will need to decide whether to extend the contract or find another solution.  

The hospitalist programs we help design are created with independent sustainability in mind. They successfully run without us after we are finished. Including key members in the planning ensures deeper responsibility, ownership and participation which continues past consultation. Of course, if a specific issue arises and can be dealt with over the phone or through a video conference, one-on-one, or with the team, we are always happy to help.

Healthcare is not a one size fits all environment. If a hospital is looking to improve the quality of care and safety of their mothers and infants, we take a neutral approach, suggesting the best solution for their unique needs and goals. Whether it’s working with an OBGYN hospitalist management company or collaborating with our consultancy approach, we want this concept to spread because we believe an OBGYN hospitalist model makes it safer for women in labor and will positively impact maternal health in our country. At the National OBGYN Hospitalist Consultant Group, we’re happy to share our knowledge. If you have any interest, a question, or just a comment about starting a program or evaluating an existing one, please call or email us. We look forward to hearing from you!


Connect with the National OBGYN Hospitalist Consulting Group on Twitter @ObGHospitalist or LinkedIn

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