August 28, 2023

HOMERuN Collaborative: Strategic Planning 2023

The Hospital Medicine Reengineering Network (HOMERuN) is a rapidly growing collaborative made up of more than 50 Hospital Medicine groups from academic and non-academic hospitals across the United States.

Moderators: Marisha Burden, Edmondo Robinson, Shani Herzig, Sunil Kripalani, Jeff Schnipper, Andy Auerbach   Overview: HOMERuN is excited to embark on a strategic planning process to shape the future of the network and advance the science in hospital medicine. As part of this process, we have conducted a SWOT analysis (strengths, weaknesses, opportunities, and threats) and have begun focus groups with the Patient and Family Advisory Council, HOMERuN at large, and the executive committee. We also plan to meet with key leaders outside of hospital medicine to understand important areas that we should consider when building our strategic plan. We also reviewed the mission, vision, and values and have made some edits based upon feedback. Below highlights the progress to date. On our call, we had 54 individuals representing organizations from across the US as well as sites abroad!

Mission, Vision, and Values

Vision: To transform patient care by fostering a culture of innovation, collaboration, and support for hospital medicine teams dedicated to discovering, evaluating, and implementing breakthroughs in health care.   Mission: Empower and nurture hospital medicine teams to develop and implement innovative solutions that elevate the quality, safety, equity, and value of care for hospitalized patients from hospitalization to recovery.

Core Values:   Patient-centered: We aim to ensure that every patient receives care where an individual's specific health needs and desired health outcomes are the driving force behind all health care decisions; and where patients and families are partners with their clinicians in decision-making.   Collaborative: We promote a culture of collaboration that values the contributions of patients, the health care workforce, researchers, and health care systems in the pursuit of innovative solutions. We believe that interdisciplinary and learning-focused work will generate the new ideas and approaches needed to move health care forward.   Diversity: We value and prioritize diversity, equity, inclusion, and justice in all aspects of our work, recognizing that a diverse team and diverse perspectives are essential for driving innovative solutions to improve patient care.   Generalizable: We strive to create innovations and share knowledge that can be applied across different health care systems.   Effective: We commit to rigorous evaluation and continuous improvement of our research and innovations to maximize their impact on patient care and health outcomes.   Sustainable: We invest in the development of future leaders in healthcare innovation, providing inspiration, mentorship, and resources to cultivate the next generation of researchers.

Objectives of strategic planning process Access the full wisdom of the various groups Identify 3-5 most pressing issues and 2-3 big ideas to move forward Draft an initial work plan and timeline for each of the big ideas

We surveyed a sample of the HOMERuN Research Network to understand strengths, weakness, opportunities, and threats (N=32 completed surveys, 60% response rate).

We then thought about and discussed the following: Dreaming big, what would you like to see HOMERuN accomplish in the next 1 to 3 years? What would you like to personally accomplish with HOMERuN (this could be you personally or your hospitalist group)? What does HOMERuN need to do to accomplish these goals?

Themes and Dreams

Build evidence-based care models, designing for sustainability and outcomes Develop the best practices Support research and skill building Networks, mentorship/professional, structured mentorship Multi-institutional collaborations, scaling research Collaborative care team models  Organizational learning — national/international Organizing for change — policy/advocacy, consultative models, social justice campaign Develop/re-imagine funding mechanisms including small grants Data/statistical support, resources/structure Transparency and open calls Proactive approaches Pipeline of translational researchers Advancing the science of hospital medicine Structured formal training for research, scholarship, developing academic careers Sharing best practices on a broad range of topics Cohort registries (e.g., post discharge registry, Jackson heart study, workforce/work models) Virtual hospital medicine research fellowship Amplify the researchers/scholars and work being done in the network (social media) Hub for industry sponsored trials (revenue generation) Support to get funding (mentorship) Partner strategically with other national networks Build partnerships/engagement with community hospitalists, rural hospitalists Leverage hospitalist expertise to drive guidelines and position papers Increased appetite for research, scholarship, QI in the field Leaders for the field of medicine to advance optimal practices Idea incubator Continue to support research, scholarship, QI, and operations while helping to make big R research more accessible Lobby for hospitalist-specific funding/systems focused work; while leveraging hospitalists, can also apply to any institute (cross cutting interests) Shared data models

Key Topic Areas

Incorporate patients, caregivers, families into all of this work How to measure work/ how to define safe census that drives optimal outcomes Thriving teams Diagnostic errors/improving diagnostic processes Transitions of care AI/evolving technology Fragmentation of care Protecting the workforce (learners, clinicians, care team members) Multi-center outcomes research Faculty development, professional development Social determinants of health Diversity, equity, inclusion Diversifying hospitalist workforce Supporting promotions process (external letters) Data sharing Benchmarking (e.g., Vizient-like, given lack of hospitalist service line) Implementation and dissemination IRB ceding/collaborations Value proposition of hospital medicine Understand evolving trends (private equity, community and academic) Virtual care/hospital at home Workplace health and safety Sustainable clinical work/joy of medicine Interhospital transfers Grant writing Expanding who is included: interdisciplinary team members, clinicians, PhDs, patients, those with interests and expertise in areas outside of hospital medicine (occupational health) Importance of inclusiveness of research, scholarship, operations — all bring value Small grants program Survey distribution/vetting surveys/getting feedback

Just Do It, Tactics: Clearly share opportunities (open call) for collaboration and how to get involved Frameworks for authorship and participation Org chart Have agendas/opportunities to participate beyond email/Dropbox (explore where best to share/house) Share formalized process to submit projects Clearly communicate member benefits Repository/list of HOMERuN members and interests to facilitate connections Shared resources (pitch decks, etc., presentations)

We want your feedback! What did we miss? We want each and every member to have a voice in the future. Miss the session? Have more ideas? Please send feedback to Tiffany.Lee@ucsf.edu by September 29, 2023. Our next steps will be to share this with the HOMERuN Executive Committee and being the formal analysis process of the focus groups. As we make our way through the strategic planning process we will be sharing with you each of the next steps and findings and hope to continue to include you all in the work!

Antiracism Workgroup Spotlight

Many of us have cared for patients who are in law enforcement custody and have had complex questions about how best to care for and advocate for them. Scopes and Shields is a new resource created by clinicians to empower health care workers to protect and advocate for their patients who are in law enforcement custody or involved in the criminal justice system.  The group is also collecting any policies your institution may have regarding the care of these patients. If you have any feedback on the website or policies from your institution, please reach out to the HOMERuN antiracism workgroup (Areeba Kara at akara@iuhealth.org and Ashley Jenkins at ashley_jenkins@urmc.rochester.edu).

Our next meeting will be on September 8, 2023.

Image Attributions: Vector images from vecteezy.com

Check out the HOMERuN website for more information. If you would like to join the HOMERuN Collaborative calls, please reach out to Tiffany.Lee@ucsf.edu.