It’s both expensive and time-consuming to obtain temporary coverage for a hospital or medical practice. Locum tenens clients have every right to expect high-quality care from the locum tenens providers they hire, but even the very best locums may not perform to their full potential if their onboarding isn’t carefully planned.
As a locum tenens physician with licenses in 14 states, I have much experience with the onboarding process. Here are 12 tips for facilities eager to encourage smooth transitions, foster good provider relationships, and provide excellent patient care.
1. Arrange for Provider Sign-Outs
Because lapses in provider communication are a leading cause of medical errors, you can protect your patients by organizing a face-to-face (or phone call) report between the current provider and the locum who is going to be assigned to their census. Studies have shown a 30 percent decrease in error rate when physicians hand off their patient panel in person.
2. Allow for at Least One Day of Training Overlap, If Possible
The incoming provider will adapt best to your unique environment and care process if he or she has the chance to “shadow” the current provider for a day. Various questions will naturally arise and be answered during real-time patient care. In emergency fill situations, this will obviously not be possible; it will, however, help ease transitions in cases where it can be done.
3. Get Your IT Ducks in a Row
Electronic medical records (EMR) systems are difficult to master, and attempting to learn how to navigate in a new one (or newer version of one) in the middle of a full patient caseload is a recipe for disaster. Logins and passwords should be set up long before the locum tenens provider arrives. EMR training needs should be discussed and planned for in advance. If an IT professional is available to sit with the locum during his or her first round of documentation attempts, so much the better.
4. Plan for a Day or Half-Day of Orientation
5. Prepare a Welcome Packet
This packet should include important information about the organization, the assignment, and the facility, including:
- Site maps.
- Parking instructions.
- Orientation schedule.
- Door key codes (if applicable).
- ID badge instructions.
- EMR login and password.
- Dictation codes.
- Cafeteria location and hours.
- A hospital directory with key phone numbers highlighted.
Make sure the locum knows who signs their time sheets and where their office is located. A coding “cheat sheet” may also be appreciated.
6. Invite the Locum to Lunch or Dinner During Their Assignment
This is a friendly way to show that you appreciate them and want to get to know them. Being on the road can be lonely, and most locums appreciate opportunities to socialize.
7. Assign Them a Buddy
Find an affable, hard-working provider to be your hospital ambassador to the incoming locum provider. The “buddy” can introduce the locum around and explain hospital policies and work expectations. They should be available via phone/text for the first week of an assignment.
8. Check the Incoming Locum’s Census List
Do this the day before the locum arrives, and ensure all admission and discharge documentation is complete. There’s nothing more difficult than being asked to discharge a group of patients you’ve never met before on your first day at a facility. If patients must be discharged on the locum’s first day, make sure the previous provider has completed their medication reconciliation and has made an attempt to prepare a discharge summary document for the locum. If patients are admitted to the locum’s service the day before their arrival, make sure the H&P documentation is completed.
9. Make Prescription Pads in Advance
If your providers use prescription pads, make sure you have ones available for your locums. Even though most hospitals print prescriptions from their EMR (or e-prescribe), there are cases where a pad and paper may still be useful, such as prescribing durable medical equipment. If your locum tenens provider might need to do that, print up some pads with his or her name and NPI/DEA number in advance.
10. Make Sure Your Locum Is in the PECOS System
This way, you’ll be able to bill Medicare for their services. Hospitals lose untold millions in locum tenens provider billing each year because they don’t prepare the right documentation in advance. Locum tenens providers are often seen as a “cost center” in the hospital budget, but they can also be a revenue generator if you prepare to capture their billing. Make sure they understand CPT codes and that they provide you with a daily list of their patient census with appropriate codes attached. A productive and billable locum tenens provider is one that will enjoy repeat business at your facility.
See our “Billing for Locum Tenens Services” guide for more info.
11. Plan for an Exit Interview With a Medical Records Liaison
Don’t let your locum tenens provider leave the facility for the final time without checking in with the medical records team to make sure that all of their documentation and orders are signed and complete. It can be difficult to track down locums after they have gone on to another assignment, and incomplete documentation means lost revenue.
12. Schedule Return Visits As Far in Advance As Possible
Many locums fill up their schedules 6 months or more in advance. Don’t wait ’til the last minute to ask them back. And if you do agree on return dates, please, don’t cancel them without significant notice. Remember that locums rely on your assignments to support themselves and their families. It’s not always easy to find alternative work with a short lead time.
The onboarding process does not need to be a difficult one. Get to know your provider, and let your provider get to know you.