Knowledge Center

On-boarding to Prevent the “July Effect”

For teaching hospitals, summer is always a time that is filled with anticipation---and often a bit of trepidation, as well. Although the traditional date when a new crop of resident physicians assumed their duties (July 1) is now past, the process of actively engaging them in the work of the organization is still underway. While these newcomers have completed their undergraduate medical education and are now embarked upon the postgrasduate training that will allow them to practice in the specialty of their choice, they generally have had little or no exposure to or experience with the culture of the hospitals where they will complete their training.

The literature on the impact of the so-called “July effect” on patient safety is mixed. Some studies have shown a marked increase in medication errors, surgical errors,  and inpatient mortality rates, while others have shown no significant change. What seems to be without question is that long work hours and resultant sleep deprivation are definitely factors associated with medical error and patient injuries.

But a factor too often ignored is the profound change in the demographics of the physician workforce that has occurred over the last two decades, and the impact of that change on engagement, efficiency and patient safety---not only in teaching hospitals, but in community hospitals as well.. Traditionally, the physician workforce has been predominantly male baby-boomers. But today, the majority of new physicians are women, and essentially all are Millenials. An article in this month’s newsletter looks at the impact of generational differences on employee---and physician---engagement, while another considers the likelihood that your next CEO will be a GenXer.

The evidence is overwhelming that an engaged workforce---both physicians and staff---produces more efficient, safer, higher quality healthcare organizations. Achieving that engagement requires a multifacted approach (see PDF attached above). But regardless of age, gender or other personal characteristics, perhaps one of the most important steps to achieving an engaged workforce is to use a well-designed, formal onboarding process for all new members of the workforce---both staff and physicians. Such a program can establish the ground rules for engagement from day one---and can go a long way towards minimizing any adverse “July effect” year round.

Check out Gallagher Integrated's chart attached above regarding how to improve the engagement of your organization's physicians.



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William F. Jessee, MD, FACMPE joined Integrated Healthcare Strategies, a division of Gallagher Benefit Services, Inc. in October, 2011, after serving for more than 12 years as President and Chief Executive Officer of the Medical Group Management Association (MGMA).  He also holds an academic appointment as Clinical Professor of Health Systems Management and Policy at the University of Colorado School of Public Health.

Dr. Jessee is one of the nation’s leading experts on physician services management ...

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