Onboarding new hospitalists: Current trends from a nationwide survey

BACKGROUND: Onboarding physicians into a new organization occurs frequently in Hospital Medicine, but variations in structure and content lead to challenges in optimizing effective onboarding processes.

OBJECTIVE: To capture current onboarding practices in Hospital Medicine groups by surveying academic institutions across the United States to highlight similarities, differences, and opportunities.

METHODS: A cross-sectional survey distributed through REDCap over a 3-month period to hospitalist division directors through the Hospital Medicine Reengineering Network (HOMERuN). Survey questions were drafted and refined initially through the Medical Education Affinity Group in HOMERuN. Quantitative data were analyzed using IBM SPSS Statistics (Version 29). Descriptive statistics were calculated for demographic variables. Chi-square tests were conducted to explore relationships between variables.

RESULTS: Out of 68 institutions surveyed, 30 (44%) responded, most of the institutions' new hires transitioned directly from residency or fellowship programs without prior experience practicing as hospitalists. More than half (53%) of institutions conclude their onboarding program before the start of work for new hires. The majority of hospitals shared common topics in onboarding, such as clinical workflow, billing and documentation, logistics and geography, electronic health record, hospital policies, admission and discharge processes, sign-out, and cross-coverage.

CONCLUSION: Variations exist in our nation's Hospital Medicine onboarding programs, but common practice is found in content topics. Understanding these practices, as delineated in our study, is the first step toward collaborations to create standardized strategies in hospitalist onboarding to strengthen this important practice in the field.