Sunday, July 27, 2008

Hospice Medical Staff Development Plans

Trained as a hospital administrator, and having worked in hospital executive positions, I've seen the power of careful and timely hospital medical staff planning in furthering a hospital's commitment to its community's health. Effective medical staff development offers other benefits to the hospital, not the least of which, I've found, is that a link will be created between the physician recruitment campaign and the hospital's strategic plan and its growth objectives.

So, I've wondered frequently since my career headed into the palliative care field, would medical staff development plans (MSDPs)for hospices produce similar benefits? My experience suggests that they would. As hospices move beyond their traditional role of serving terminally ill patients who have elected to use the hospice benefit, and toward a leadership role in shaping end-of-life care throughout their communities, the role of the hospice’s physician staff is being redefined. Hospices are evolving into advanced palliative care organizations in which care spans organizational and professional boundaries, while integrating physician services into a traditional nurse-centric organization, and simultaneously adopting a collaborative model. Such a convergence will, unsurprisingly, strain an organization’s resources and its roles.

At their best, MSDPs are an objective quantification of community need on a palliative care basis. The challenge, we've learned, is identifying a standard for staffing of programs. In developing a plan, we consider the following:
-Variability in clinical commitment of current staff
-Presence and clinical role of providers such as NPs and PAs
-Presence of academic practices that may include teaching and research
-Productivity data to analyze MD capacity to absorb additional volumes

So what can a Hospice MSDP offer to the executive leadership of a hospice?
An assessment of community practice around end-of-life care to identify improvement opportunity, and to translate community needs into physician staffing requirements and associated financial commitments. An assessment of the hospice's current capacity, the identification of competencies that are likely to accelerate growth, and the creation of practice opportunities that attract talent and fill competency gaps. Armed with this information, hospice executives are solidly positioned to make a difference in the palliative care practices within their community.

I'm confident that other hospice execs have had related experiences. I'm curious to learn your feedback.

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