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 Five essential lessons to consider when building a hospitalist specialty society

The Hospital of the Future Challenges 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 Future Cost pressures

PPACA Value Based Purchasing Bundling Accountable Care Organizations Patient Centered Medical Homes IPAB The Hospital of the Future Cost pressures will become quality pressures Healthcare reform will change how healthcare dollars are distributed

Efficiency Quality “Winning” The Hospital of the Future Cost, quality, and success

Demonstrable quality performance Maximum efficiency The Hospital of the Future The vision How do we do this?

Demonstrable quality performance Maximum efficiency The Hospital of the Future The vision How do we do this? Genuine systems integration is essential

Demonstrable quality performance Maximum efficiency The Hospital of the Future The vision How do we do this?

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. The Hospital of the Future The modern medical staff Trotten, MK & Orlikoff, JE, “New Models for Hospital-Physician Relationships”, Trustee Magazine January 2008

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 integration Hospitalists have to think unconventionally

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 The Hospital of the Future How to achieve genuine systems integration Home team must act as a unit

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

Kuo Y et al. N Engl J Med 2009;360: A Brief History of HM & SHM Astronomically 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%

, , , , ,000 A Brief History of HM & SHM Astronomically quick growth SHM Membership Statistics

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 A Brief History of HM & SHM Society 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 Society of Hospital Medicine in 2011

A Brief History of HM & SHM The 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

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 1.Focus keenly on quality improvement 2.Be healthcare reform facilitators 3.Respect the importance of “branding” 4.Be inclusive versus exclusive 5.Define your uniqueness

How to Build a Medical Society Five essential lessons 1.Focus keenly on quality improvement 2.Be healthcare reform facilitators 3.Respect the importance of “branding” 4.Be inclusive versus exclusive 5.Define your uniqueness

How to Build a Medical Society Focus keenly on quality improvement 1.Define quality comprehensively 2.Understand the definition of value 3.Anticipate the most important quality expectations of your key stakeholders 4.Help your members deliver high value care