Hospitalists Engagement and Retention Survey is a report that rates hospitalists' morale (in the full range of hospital settings) based upon a survey of hospitalists, implemented by Johns Hopkins Medicine. The results include a score that can be compared to other hospitals to help you gauge your staff against the national average.

The Hospitalists Engagement and Retention Survey Includes:
- An Overview of the Survey Process and the Report
- Survey Implementation by Johns Hopkins
- Survey Data Analysis by Johns Hopkins
- Downloadable Morale Index Report that Includes:
- Hospitalists' Perceived Morale
- Individual Morale Scores
- Characteristics of Participating Hospitalists
- Highlights
- Top Most Important Drivers of Morale
- Open-Ended Comments
- The Morale Index Score (MIS), which compares your hospitalists' morale to all others measured by Johns Hopkins nation-wide

Below you will find a series of questions and answers that will guide you through the objectives, implementation, outcomes and lessons of Hospitalists Engagement and Retention Survey.

The Hospitalists Engagement and Retention Survey surveys hospitalists in a hospital. The survey results are analyzed by Johns Hopkins hospitalists and biostatisticians and incorporated into a report that includes a score that can be compared to other hospitals to help you gauge your staff against the national average. With this report, hospital leadership can address existing problems in an effort to retain experienced and valuable hospitalists.

What problems or objectives does this Solution address?
Most hospitals do not currently measure morale, at least not through a standardized measurement tool. They rely on luck or leadership to help navigate these issues with varying success. Standard staff surveys do not often adequately address issues crucial to hospitalists. The Hospitalist Engagement and Retention Survey is being used throughout the Johns Hopkins-affiliated hospitals so that hospital and department leaders/managers can adequately measure hospitalist morale and help identify areas for programmatic improvement, with the aim to increase overall hospitalist satisfaction and retention rates.

Hospital medicine is the fastest growing medical specialty in the past 25 years, with an estimated 30,000 hospitalists across the United States and an estimated need for 45,000 to 60,000 more in the coming years. Hospitalists tend to be relatively early in their career, and given that demand exceeds supply, they are often able to change jobs easily. Perhaps for that reason, Hospitalists are likely to be sensitive to work-life balance and career satisfaction.

Recruiting new hospitalists can easily exceed $10,000 per individual, and with the average turnover rate of 12.5% to 18%, recruitment can add significant costs financially. Conversely, retaining hospitalists can reduce costs. Research shows that an experienced hospitalist (2+ years) can reduce healthcare costs by $800 per case and decrease length of stay by a half-a-day.

Were there any alternatives considered?
There are other surveys of hospitalists—the Society of Hospitalist Medicine (SHM) does a survey, as does Press Ganey. Two aspects of the Hospitalist Engagement and Retention Survey make it unique in the marketplace:
- Staff satisfaction surveys are often targeted at broad audiences, and, therefore, the questions tend to be more generic and less specific to hospital medicine.
- Also, hospital medicine is a growing field, and many traditional surveyors do not have the expertise to generate the Hospitalist specific questions that JH does. SHM's survey (it is also the MGMA survey) is mostly financial/work flow based. It reports the effects of morale (turnover, salary) but not morale itself.

How was the Solution developed?
It was developed in 2009 by the hospitalists at the Johns Hopkins Bayview Medical Center, one of the oldest hospitalist programs in the United States. The goal was to survey our own hospital medicine staff. The results were illuminating, and we set out to refine and expand the survey questions (now at approximately 50) and conduct the survey at other Johns Hopkins Health System sites, so that hospital and department leaders/managers can adequately measure hospitalist morale and help identify areas for programmatic improvement, with the aim to increase overall hospitalist satisfaction and retention rates.

What does it take to implement? Maintain?
Implementing the survey requires only buy-in from whomever is responsible for hiring, on-boarding, managing and retaining hospital medicine staff.

Were there any organizational considerations?
As one of the oldest hospitalist programs in the United States, we wanted to both better understand why staff stayed and departed and what we could do to retain experienced staff.

Which Benchmark/Pertinent Metrics are recommended to use with this Solution?
Hospitalists will be surveyed one time, online. The greater percentage of physicians who take the survey, the more accurate and useful the results.

Where the outcomes of implementing this Solution?
Hospital and Department leaders have implemented the following as a result of their Hospitalist Engagement and Retention Survey:
- A Lactation Room was Established that Helped Retain Several Key Hospitalists
- Mandatory Moonlighting Policy was Revamped
- New Scheduling Protocols were Put in Place
- Hospital Leadership Improved their Direct Engagement with Hospitalist Staff

Mid-level leadership was established to both improve understanding between leadership and hospitalists and advocate on their behalf with leadership.

What does it take to successfully sustain the Solution?
The buyer should identify possible interventions that will improve morale and resulting retention.

Is this Solution currently in-use at any other hospitals?
Yes, the Hospitalists Engagement and Retention Survey is currently in-use at two academic hospitals and three community hospitals including hospitals within The Johns Hopkins Health System.