One of the most challenging conversations in any multi-physician practice or specialty-based hospital employed group is about how to create a fair distribution of on-call and/or inpatient hospital service coverage while balancing the duties of an outpatient practice.
The COVID-19 pandemic has contributed to clinician burnout, and physicians and Advanced Practice Providers (APPs) place significant value on their weeknights and weekends with family and friends. Balancing the frequency and equity of on-call, inpatient rounding, clinic, and Paid Time Off in any group practice is crucial for clinician retention.
Balancing Inpatient Consultation Service and Outpatient Clinic Presence
Blue & Co. has vast experience working with hospital systems who have struggled with this contentious topic, particularly for clients who have acquired or merged private practices into one organization and inherited legacy practices for scheduling. Physician enterprises with specialty groups covering inpatient consultation service at multiple acute care sites, covering Emergency Department on-call service for their specialties, and performing procedures at various hospitals and ambulatory surgery centers find it challenging to maintain a strong and equitable outpatient clinic presence.
The outpatient clinic presence is vital to continue to feed the overall operation with outpatient and inpatient services and revenue, but the inpatient service obligations can overshadow the importance of outpatient clinic time. As a result, the outpatient clinics suffer because clinicians have limited availability for appointments when they are busy covering inpatient service, and patients seek care elsewhere with more expeditious patient access.
Promoting On-Call Scheduling Equity
Many physicians and APPs prefer to find a balance in time in the inpatient and outpatient setting to keep their skillsets sharp, work to the top of their licensure, avoid monotony, and earn a living (for those compensated on a productivity basis). They prefer to see their colleagues serving an equal share of time in those settings as well so that everyone has the same opportunities. They also want to ensure the evening and weekend on-call service obligations are met in a fashion that meets the needs of their patient population while also being fair to all clinicians in these on-call rotations.
When these duties are not divided in a way that is safe for patients and fair to the clinicians, not only will patient care be compromised, but also the clinician population can quickly become disgruntled with hospital administration and seek employment elsewhere.
Blue’s Scheduling Solutions
At Blue, we want to ensure our clients have a fair and transparent process for scheduling on-call, inpatient rounding, outpatient clinic, and PTO while meeting the needs of the client’s patient population. As part of its Ambulatory Service Line Optimization service offering, Blue offers detailed solutions to scheduling these items to take the burden of creating an equitable distribution of duties away from the clinicians so they can focus on providing compassionate, high quality patient care.
Our Physician & Hospital Operations Team at Blue communicates with physician and administrative leaders of our clients to determine the client’s goals in revamping the current scheduling structure, as well as to familiarize ourselves with any legacy practices that may create challenges along the way.
Blue utilizes data from the client’s Electronic Medical Record to help illustrate the intensity of various clinical duties in each of the client’s locations and uses that information to develop recommendations to put forth to the physician and administrative leadership team.
The scheduling process itself is performed electronically utilizing tools in Microsoft Excel to keep a running log of statistics related to frequency of those clinical duties. These tools help to promote transparency and trust within the group when the schedules and statistics are distributed to the group on a routine basis.
Once the initial foundation has been built for the client’s coverage scheduling needs, the more time-consuming setup tasks only need to be revisited on an annual or as-needed basis, most notably as the group expands to more locations or if there is a significant change in clinician staffing. The remaining steps are trainable and repeatable, and they become second nature for our client’s coverage scheduling teams.
If you or any of your colleagues may benefit from Blue & Co.’s coverage scheduling solutions, or any of Blue’s Ambulatory Service Line Optimization services, please reach out to your local Blue & Co. Advisor or contact Jake Lewis or Tony Javorka to schedule a Zoom meeting and learn more.
Jake Lewis, Manager
Tony Javorka, Director