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Despite rising costs and a shortage of cardiologists, 心血管(CV)项目仍然是美国急性护理医院收入最高的bet8娱乐之一. 虽然有一个明显的趋势迁移选择性CV程序到门诊(OP)设置, the emergency department (ED) remains a primary access point for hospital encounters.
与 超过85%的美国人可以获得当地或区域紧急STEMI护理系统在美国,每年约有50万急诊患者被直接送往心导管实验室. 因此, 解决维持心脏病学呼叫覆盖的挑战仍然是全国心血管bet8娱乐线领导者的首要任务.
Evolving 趋势 in Call Coverage
普通和介入性心脏病专家通常有24/7随叫随到的覆盖要求, and for some highly specialized programs, 对呼叫范围的需求正在扩大到包括电生理学(EP)和心力衰竭心脏病专家. 与此同时,劳动力方面的限制使得难以维持足够的覆盖面:
- More than 60% of working cardiologists are now over the age of 55, and many older practicing cardiologists are unwilling to cover the required call.
- 美国没有足够的新心脏病专家来填补任何级别的空缺, let alone call coverage.
- 越来越多的心脏病专家正在追求亚专科奖学金并进入实践,期望提供非常有限的呼叫, placing growing pressure on general, noninterventional cardiologists to supply sufficient coverage.
While payment for on-call services in cardiology is not a new concept, it has historically been limited to interventional cardiologists. 然而, since the number of general cardiologists has decreased, 许多组织正在向这些提供商提供补偿,以激励他们支付电话费. 与 current financial pressures, service line leaders must look for creative solutions to sustain call coverage.
以下是心血管项目负责人可以使用的三个基本策略,以更好地管理心脏病学呼叫的长期覆盖率.
策略 One: Be Proactive about Workforce Planning
与 the cardiology physician shortage expected to continue over the next five years, it is critical that provider organizations maintain a comprehensive, 多学科, three-to-five-year workforce plan. 行政领导应与医师领导合作,计划bet8娱乐线路的继承, projected volume growth within existing programs, and future program development.
Specific to cardiology, we anticipate a continued trend toward subspecialization, 这意味着制定指导原则和客观标准对于如何管理一般和亚专业bet8娱乐的呼叫将是非常重要的. 例如, at what point will it be necessary to implement a dedicated EP for call, and how will general call needs be backfilled?
策略 Two: Design a Contemporary Compensation Model
Since there will always be a need for cardiology call, most health systems are choosing to pay for this coverage, even if they haven’t historically.
For both private and employed groups, 在心脏病专家的基本报酬中,通常有一个标准的通话覆盖预期, with additional payments reserved for excess coverage. In addition to meeting regulatory and legal requirements, 当代的薪酬模式应设计如下,以有效管理CVbet8娱乐热线呼叫覆盖率预期:
- 认识到接听电话的负担,并对接听电话的责任和公民身份设定明确的期望
- 清楚地阐明包括电话保险在内的全部补偿方案的价值
- 在整个薪酬计划中嵌入每个子专业的呼叫要求,并建立正式标准,以考虑尚未定义的超额或专业呼叫覆盖范围
- 包括阈值、指导方针和流程,以管理呼叫需求的增长(或收缩)
- 概述减少呼叫或完全退出呼叫bet8娱乐的程序要求和财务后果
CV leaders will want to maximize available physician resources, either through contractual or medical staff bylaw requirements, before incurring the cost of additional on-call services.
策略 Three: Explore Innovative Operational Models
为了帮助减轻普通心脏病学的负担,我们需要新的想法和策略. Below areseveral operational models that may provide solutions. 它们可以根据特定的市场特征和劳动力供应问题进行定制和/或混合匹配.
Call, Consult, and Rounding 团队s
Organizations can implement a shared-care model, under which rotating provider teams composed of general cardiologists, 呼叫需求大的心血管专科bet8网站备用(传统的介入性心脏病专家), and APPs share the call burden. Optimal continuity of care can be achieved when teams rotate weekly, and this model supports efficiency, improved 沟通, and a high level of predictability for the cardiology team and referring physicians. bet8网站备用和app的数量应以平均每日住院会诊和随访需求为基础. 在放电, the patient returns to their established cardiology provider or, if they don’t have one, becomes a part of the admitting cardiologist’s panel.
“First Responder” Coverage
呼叫责任分配给医院bet8网站备用或APP,其主要工作是呼叫. First responders conduct patient assessments, perform histories and physicals, 并以确保患者及时就诊以避免护理延误为目标订购初步诊断,然后分配到最合适的心脏病亚专科bet8娱乐.
Cardiology Hospitalist or Nocturnist Program
这是一个专门的bet8娱乐团队,作为全职医院bet8网站备用和/或夜行bet8网站备用提供心脏病bet8娱乐. 团队 members may include cardiologists, 内科bet8网站备用, 或对心脏病住院患者和疑似心脏问题的观察患者管理有兴趣和技能的pcp, 以及应用程序. To support collaboration, 沟通, and care coordination, these teams are ideally members of the cardiology group.
APP First Call for Night Coverage
可以分配应用程序来处理下班后的第一个电话,这些问题可以通过既定的护理途径通过电话进行管理. While this team is backed up by a cardiologist if there is need for escalation, 这种选择提供了一种安全有效的方式,以尽量减少下班后对心脏病专家的影响.
Telecardiology
通过远程保健技术可以远程管理呼叫,使提供者能够检查病人并获得诊断测试和成像.
修改工作
Though less common in recent years, 一些组织提供修改后的通话时间表,以减轻高容量通话的物理需求. As with any scheduling adjustments, careful planning is required to ensure clinic access is not disrupted or reduced.
兼职族
兼职人员通常是在附近完成奖学金培训并提供兼职支持的研究员, such as night and weekend coverage, to help reduce the call demand on cardiologists.
Senior Interventional Cardiologists in Slow Down
这些心脏病专家可能愿意接受一套普通心脏病学的时间表,以限制他们的同事的总体负担.
When Care Is Critical, So Is Securing Call
As the rate of CV disease continues to rise across the US, CV services will remain a foundational program for hospitals and health systems, making it essential for these organizations to secure sustainable, effective call coverage arrangements. By using some of the strategies outlined herein, you can ensure your patients continue to receive the critical care they need.
bet8娱乐的团队
如果你在你的项目中需要帮助,或者你只是想要更多关于电话覆盖安排的信息, 调用时间表, call coverage compensation, or fair market value services, 我们有一支专注于心脏病学的专业团队,他们可以提供帮助. Learn more about our 简历bet8娱乐团队.
团队-Based Care: Averting the Impending 访问 Crisis in Cardiology
In a team-based care model, bet8网站备用领导的团队的所有成员在提供病人护理方面发挥着不可或缺的作用.
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