We measure patient days for assessing staffing and use LOS as a main performance measurement. Also some other performance management metrics are patient flow, available beds, bed placement. Lately, we've begun to work on documentation compliance with our HIM department.

Thanks, How do you relate patient days and LOS to staffing given the diversity of care. Do you have a set metric? i.e 1 FTE per 100 patient days?- How do you distribute them, say in 12 hour shifts (2/3, 1/3)?

In my rural hospital which is in a health professional shortage area, the human resources of employed physicians is a definite reality. In order to recruit and retain physicians, we offer scholarship stipends, income guarantees and employee contract arrangements and allow candidates in the selection process to choose which model they prefer. The employee model is the preferred method which MDs are choosing. All contracts are on an RVU system for measuring productivity. Because of government audit activity(RACs) and to evaluate quality and standards of care implementation, we apply ongoing monitoring measures to evaluate physician performance in the areas of outpatient and inpatient care. An education segment on employed physicians as an important human resource as it relates to all we are currently studying in this course could probably occupy some time as part of this tutorial.

I am personally responsible for managing an 18 FTE group of hospitalists (among many other specialties. ) We staff a tertiary care facility with 9 teams, 24/7 etc. All teams work (7) 12 hour shifts then are off 7 days. So a 1.0 FTE = 2184 hours, with no vacation time, since they have off 26 weeks each year. Most teams work 0700 - 1900, one team works 1100 - 2300 and one from 1700 - 0700. Each team has one person working each week and one person off. We based the number of FTEs based on how the group is reaching the AMGA/MGMA and McGladery mean average of 4128 RVUs per year. If the group is consistently above that average per FTE we add staff. We also have 2 NPs and 1 PA all of whom work straight days, M-F. They are expected to generate 1500 RVUs each.