To describe a practical framework for staffing in pediatric hospital medicine (PHM) that addresses physician turnover and staffing shortages, particularly in light of the challenges identified in the 2024 AAP Workforce Survey.
Approach:
Defining FTE: Establishes what constitutes the clinical workload of a full-time equivalent (FTE) and considers modifications for nonclinical responsibilities, including academic or leadership roles.
Evaluating Staffing Models: Dr. Carter evaluates her division's staffing model, defining annual clinical-hour expectations of 1800 for clinical faculty and 1530 for academic faculty, and incorporating incentives for off-hour shifts.
Program Structure: Focuses on establishing staffing models that balance structural requirements with flexibility to accommodate staff needs, including equitable distribution of off-hour shifts.
Key Findings:
67.6% of PHM programs reported staffing shortages in the 2024 AAP Workforce Survey.
Annual clinical hours for a 1.0 FTE typically range from 1700 to 1900, varying by program type.
40% of programs incentivized off-hour shifts, with 37.1% offering financial incentives, according to the 2024 AAP Workforce Survey.
Interpretation:
The framework provides a structured approach to defining FTEs and staffing models, emphasizing the need for flexibility and equity in shift distribution.
Limitations:
No standard method exists for allocating an FTE's hours between clinical and nonclinical responsibilities, which may vary by institution.
The framework is one possible approach and may not be universally applicable across all PHM programs.
Conclusion:
A tailored staffing model is essential for addressing the unique needs of PHM programs.
