{"id":576,"date":"2019-04-09T17:19:15","date_gmt":"2019-04-09T21:19:15","guid":{"rendered":"https:\/\/digital.hbs.edu\/platform-mhcdsolutions\/submission\/psychiatry-staffing\/"},"modified":"2019-04-09T17:19:15","modified_gmt":"2019-04-09T21:19:15","slug":"psychiatry-staffing","status":"publish","type":"hck-submission","link":"https:\/\/d3.harvard.edu\/platform-mhcdsolutions\/submission\/psychiatry-staffing\/","title":{"rendered":"Psychiatry Staffing"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p>Behavioral Health staffing challenges:<\/p>\n<p>&nbsp;<\/p>\n<p>Inpatient psychiatry staffing has been a challenge at Region acute care facilities for the last several years.<\/p>\n<p>&nbsp;<\/p>\n<p>Site 1.\u00a0 Acute inpatient quaternary facility with 70 inpatient beds.<\/p>\n<p>&nbsp;<\/p>\n<p>About 4 years ago the psychiatry department of 8 psychiatrists resigned over a 10 day period.\u00a0 This was due to high work load and difficulty with weekend call coverage.\u00a0 This was a work and compensation model designed by the psychiatry group in alignment with the administrative team.\u00a0 When this happened oversight of the department transitioned to me.\u00a0 The work model was redesigned to a 7 days on 7 days off model and the majority of the docs were retained.\u00a0 This required the number of beds to be reduced and cost increased.\u00a0 Subsequently we developed a joint venture with a behavioral health hospital and built a 100 bed freestanding inpatient psychiatry hospital.\u00a0 The acute facility psychiatry unit was reduced to 40 beds as part of the process.\u00a0 These issues have resulted in ED overcrowding with behavioral health patients.<\/p>\n<p>In spite of market level pay and improved work hours, psychiatry staff have been requesting more pay and retention bonuses.<\/p>\n<p>&nbsp;<\/p>\n<p>Site 2.\u00a0 Acute inpatient tertiary facility with 25 inpatient beds.<\/p>\n<p>&nbsp;<\/p>\n<p>Staffed by 5 psychiatrists representing about 3.5 FTE.\u00a0 The senior physician has announced his pending retirement.\u00a0 Now the other three are planning to resign due to work load concerns.\u00a0 We are actively recruiting replacements with little success.\u00a0 While employed by the medical group, this group has reported in through hospital leadership channels.<\/p>\n<p>&nbsp;<\/p>\n<p>Observations:<\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>Psychiatry is in high demand across the nation.<\/li>\n<li>Closure of inpatient psychiatry results in poor service to vulnerable community members.<\/li>\n<li>Closure of inpatient psychiatry results in Emergency Department backlog and longer length of stay.<\/li>\n<li>Telepsychiatry is helpful but has limited availability.\u00a0 Patients with behavioral health diagnoses can be admitted to general medical beds under the care of the hospitalist teams using the single bed certification process.\u00a0 Not an ideal way of caring for this population and not popular with hospitalist teams.<\/li>\n<li>With several staffing and compensation models over the years, psychiatry staffing has been difficult to maintain.<\/li>\n<li><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Inpatient psychiatry staffing challenges<\/p>\n","protected":false},"author":12227,"featured_media":0,"comment_status":"open","ping_status":"closed","template":"","categories":[],"class_list":["post-576","hck-submission","type-hck-submission","status-publish","hentry"],"connected_submission_link":"https:\/\/d3.harvard.edu\/platform-mhcdsolutions\/conversation\/mhcd-solutions\/","yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - 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