Making colleagues watching and reporting on each other, will create hostile and not trusting work environment.
Rules should be in place and parties involved need to be educated, CCTV or designated people should keep the whole team accountable.
For crucial patient safety matters, Zero-tolerance policy should be implemented.
For teams following the rules without incidents on a quarterly basis rewards and incentives could be helpful.
The disparity in compensation for on-call services is not sustainable in the long run.
This has always been part of physician responsibility, paying extra for it seems a bad practice to begin with.
I think it should be abolished for all, instead it would be better to have another list of criteria to take physicians off the on-calls service, like seniority, clinical and research productivity, faster discharge time, patient satisfaction among many other things.
Being off on-call service should be considered a privilege to be earned.
The academic centers are changing their approch, RVUs are becoming the major criteria, the bean counter does not take in consideration all the other activities that do not produce RVUs, consume time and energy and but add value and quality to physician’s work and as a result improve patient care.
Asking physician to do more in academic setting will affect negatively teaching and research.
Perhaps one solution will be educating bean counters about all the ancillary things we do that add value. So make the compensation value based.
We need good leaders in our field to convey the message to administrators.
we can re-organize academic centers in a different way and create two different pathways a different career paths for physician in academic center the ones that do most of the workload do not have to teach or do research and would be promoted based on that criteria
So researchers can do research and teach But I think it is a partial solution
but I have the feeling this new trend is here to stay until the bean counter will realize it is not working and quality is compromised.
I think it should be part of vision and consequently mission of the institution.Leaders should foster the collaborative mentality and implement it.
Incentives are good but temporary band aids, if people do not buy into the idea.
Leadership needs to launch a cultural campaign.
We did this, it is very challenging and at the beginning very unpopular, even when it goes live it is not done completely, it will be an ongoing process.
We got key people from similar divisions in different organizations in one place on regular basis with technical EHR and IT team and went through each entity and tried to get every body’s consensus, if no agreement (can happen sporadically) somebody in charge called the shuts. The most important factor for all parties to know have to compromise at certain point.
Then when you have a final version established, each division will proceed with training their own personnel.
Not easy, not popular at beginning. It won’t be perfect but can be functional.