Home From The Editor Getting smarter about saying "no"

Getting smarter about saying "no"

July 2014

Published in the July 2014 issue of Today’s Hospitalist.

Talk to hospitalists about what makes their workloads untenable at times, and mission creep is cited as a major factor. There’s always one more specialty that needs hospitalists to see its patients, and there’s always a new quality improvement project that needs immediate attention.

Over the last decade or so, hospitalists have cemented their reputation as the go-to specialty when it comes to QI initiatives. But as our cover story points out, hospitalist programs are realizing that saying yes to too many of those requests can cause a serious case of “QI fatigue” among their physicians.

As a result, some hospitalist groups are learning to look much more critically at potential projects. They’re also learning to say “no” to initiatives that may prove to be too much.

Hospitalists aren’t exactly turning their back on QI projects, which have been a mainstay of the specialty. They’re just getting smarter about where they’re going to spend their time and energy.

That’s probably a good thing, because there’s only so much work the specialty can accomplish with its existing workforce. That’s a point we explore in our Q&A, which looks at what happens when hospitalists are stretched too thin.

Researchers found that when hospitalist census crept up, bad things happened “but with one important caveat. Hospital costs and length of stay jumped when patient volume reached critical levels, but quality of care didn’t seem to suffer.

That research is sure to generate a huge sigh of relief for the specialty, which has struggled with growing workloads from its beginnings. It also may help hospitalists make the case the next time they need to say “no” to yet another request to head up a QI initiative.

edoyleEdward Doyle
Editor & Publisher