SHM Converge Scientific Abstract ePoster Gallery-A "Necessary Evil": Multi-Institutional Rapid Qualitative Analysis of Jeopardy Systems

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This study examined “jeopardy” systems—backup staffing arrangements used by hospital medicine programs when clinicians are sick, on leave, or patient volumes rise unexpectedly. Through five virtual focus groups with 23 participants from 17 institutions, the researchers used rapid qualitative analysis to identify how these systems are structured and what makes them feel fair or unfair.<br /><br />The main finding was that jeopardy systems are nearly universal in hospital medicine, but their design varies widely. Participants described them as necessary, yet often a major source of stress and job dissatisfaction. Common concerns included being called in too often, too many days spent on backup, poor compensation, uncertainty about when backup would be needed, and inconsistent rules across clinicians.<br /><br />Three major themes emerged:<br />1. Jeopardy systems are ubiquitous but highly variable.<br />2. They contribute to physician stress and staffing challenges, especially since COVID-19.<br />3. More fair, equitable, and tolerable systems share certain features.<br /><br />Participants recommended systems that promote a supportive culture, allow sick leave without requiring clinicians to “pay back” time whenever possible, compensate fairly for both being on call and being called in, and minimize uncertainty. They also emphasized equity across providers, avoiding unfair “grandfathering” of some staff into better arrangements, and considering flexible or remote work options for childcare-related needs.<br /><br />The authors conclude that although jeopardy systems are often unavoidable, hospital leaders can improve them by making them more transparent, better compensated, and more equitable. These findings may help reduce burnout and improve clinician experience.

Asset Subtitle

Kirsten N. Kangelaris

Meta Tag

Author List Andrew D. Auerbach, Angela Keniston, Anne S. Linker, Gopi J. Astik, Gregory Bowling, Jeffrey L. Schnipper, Kirsten N. Kangelaris, Luci K. Leykum, Marisha Burden, Matthew Sakumoto, Shradha A. Kulkarni

Category Research

Concept Jeopardy System

Concept Backup Staffing

Concept Fairness

Concept Equity

Concept Burnout

Distinguished Finalist

Presenter Organization University of California, San Francisco

Presenting Author Kirsten N. Kangelaris

Track Other

Keywords

jeopardy systems

hospital medicine

backup staffing

physician burnout

staffing fairness

rapid qualitative analysis

compensation equity

on-call stress

clinical staffing

workplace dissatisfaction

Jeopardy System

Backup Staffing

Fairness

Equity

Burnout