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COVID-19 Non-Hospitalist Onboarding Resources

Overview

During the COVID-19 pandemic, many hospitals are seeing unprecedented volumes of patients requiring hospital medicine groups to stretch their current resources and recruit providers from outside their groups to bolster their inpatient services. The Society of Hospital Medicine has put together the following stepwise guide for onboarding traditional outpatient and sub-specialty-based providers to work on general medicine wards.

This was designed to provide an easily digestible program targeted at helping hospital medicine groups to rapidly prepare providers for inpatient practice. Because of the wide variety of needs, this guide is purposely generalized while providing specific tools where available.

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Step 1: Gap Analysis

Knowing the needs and capabilities of your hospital, your group and incoming providers will help you identify what is needed and provide an efficient and rapid onboarding process.

Download Gap Analysis Guide

  1. Provider sources

  2. Provider characteristics

  3. Inpatient needs

  4. Inpatient team structures

  5. Institution characteristics

  6. Logistical needs: pagers, badge access, credentialing, EHR training, billing, training, etc.

  7. Local resources/methods for dissemination of information

Step 2: Connecting Providers to Resources

Take what you identified in Step 1 to connect your incoming providers with the appropriate resources. Remember to use resources that already exist within your institution for on-boarding providers. Enlist HR and practice administrators to eliminate logistical barriers.

Get Connected to Resources

  1. Use the gap analysis as a guide
  2. Clinical resources 
  3. Logistical resources 
  4. Based on your local capabilities, create an easily centralized repository of materials for incoming providers to review when needed

 

Step 3: Scheduling

This will be based on the gap analysis including provider preferences and skills and how many services you need covered and when.

Download Scheduling Guide

  1. Align providers interests, skills and schedules with available shifts

  2. Consider tiered or partnered scheduling 

  3. Schedule as early as possible

  4. Allow incoming providers to choose between multiple shift options

  5. Build back-up shifts into your schedule as much as possible

This section also includes general recommendations for surge planning. 

Step 4: Inpatient Medicine

Hospital medicine is a rapidly changing and growing field. Many advancements have likely been made since the last time your incoming providers worked on an inpatient general medicine service. Giving them some kind of high level-orientation to the practice of inpatient medicine is likely to help with efficiency and comfort.

Consider covering the following topics:

  1. Overall objectives of inpatient medicine (e.g. Problem-focused)
  2. Minimizing harm and low-value care (e.g. Avoiding serial lab tests and images, minimizing consultations)
  3. Criteria for discharge (e.g. Not fully recovered but able to continue recovery elsewhere)

earphones.svg Access SHM Webinar

Telehealth and Inpatient Medicine Strategies for Addressing COVID-19

April 10, 2020 Recording

Tyler Anstett, DO, Assistant Professor, University of Colorado Anschutz Medical Campus and Megan Brooks, MD, MPH, Assistant Professor of Medicine, Duke University Health System cover a broad overview of inpatient medicine, how to apply the broad overview to admission, daily care and discharge and walk you through case studies in addressing COVID-19.

Listen Now

View Slides

Step 5: Feedback and Assessment

Don’t let perfect be the enemy of good enough and expect to make mistakes. Getting feedback from providers during and after their time on service will help you to learn and make adjustments. 

Download Onboarding Feedback Methods

  1. Check-in with providers when they are on-service. Use your Gap Analysis to determine your resources for doing this in multiple formats including digital formats such as email or a Microsoft Teams page.
  2. Consider a brief end-of-service survey.
  3. Use the feedback to make changes to your processes.

 

Other Considerations

This section provides additional material including maintaining provider morale and communication recommendations.

View Materials

 

 

In the interest of continual improvement, please provide feedback to SHM on this content here:

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Acknowledgments

We want to thank the following contributors: 

Tyler J. Anstett, DO
Moises Auron, MD, FAAP, FACP, SFHM
Megan Brooks, MD, MPH, FHM
Tanisha J. Hamilton, MD, FHM
Scott Kaatz, DO, MSc, SFHM
Satyen Nichani, MD, FACP
Raman Palabindala, MD, FACP, MBA, SFHM
Joseph R. Sweigart, MD, FHM, SFHM
Elham A. Yousef, MD, FACP, MSc, FHM

 

Note: The information in any resource collected in these pages should not be construed as medical advice, legal advice, or authoritative guidelines on specific facts and should not be considered representative of the views and/or position of SHM. These resources are not intended as a definitive statement on the subject addressed. Rather, they are intended to serve as a tool providing practical advice and references for the hospitalists who need it and other readers.