These guidelines have an intended goal of establishing principles that guide our College of Medicine faculty as we return to campus, as well as adapt to the future of more flexible work schedules, remote work, telehealth and hybrid work models. These recommendations support and supplement the guidelines provided by The Ohio State University. The following recommendations are designed to optimize the mission of the College of Medicine and to facilitate a workplace of excellence.

Guiding principles

As we emerge from the COVID-19 pandemic and a return to in-person work for many of our areas, the Wexner Medical Center and College of Medicine have defined guiding principles to help inform our decision-making process as we navigate this transition. Many employees will be expected to return to campus to support our mission as a national research and education leader and academic health center. At the same time, the pandemic has taught us that the workplace isn’t limited to our physical buildings, and there are opportunities for us to consider how we might work differently.

To this end, The Ohio State University is embracing the continued viability of flexible work schedules. There are several benefits to flexible work, including increased productivity, improved wellness, reduced stress, better work-life alignment, reduced commute times and a reduction in parking demands. In addition, flexible work enables the Wexner Medical Center and College of Medicine to remain competitive in recruiting talented and diverse candidates and to retain highly-skilled faculty.

To promote consistency and equity across the enterprise and to ensure that the institution’s tripartite mission is met, we have developed the following Flexible Work Guidelines in alignment with the University’s Flexible Work Policy and resources. The College of Medicine has diverse work environments, many of which require specific staffing patterns to function effectively. As a consequence, some settings will require different approaches to flexible work. Additionally, health and safety considerations may preclude a specific flexible work arrangement.

It is important to note that a flexible work arrangement is not a right of employment. It is established at the discretion of the employer and may be subject to change at the discretion of the employer. Further, facilitating and supporting flexible work should not compromise our operations and may be granted when operational need allows it.

General guidelines

Ensure mission-critical needs are met

To effectively support all mission areas, leaders should work together with their faculty members to determine which aspects of their jobs can be effectively performed remotely and what needs to be accomplished on-campus. Leaders must ensure that sufficient faculty are on-campus to support the in-person needs of patients, learners and colleagues; facilitating and supporting remote work should not compromise our overarching missions. It is expected that faculty spend at least a portion of their time on campus.

  1. Patient-Facing Activities: Leaders need to ensure that patient needs are met to maintain the delivery of exceptional health care, whether in-person or remotely. Non-virtual patient-facing activities must be done in-person.
  2. Learner-Facing Activities: Leaders need to ensure they have engaged faculty on-site so that in-person educational and mentoring needs are fully supported. The needs of the learners should take priority over the preferences of the faculty member. Specifically, non-virtual learner-facing activities must be done in-person.
  3. Research Activities: Leaders need to ensure that appropriate research needs are performed including, but not limited to mentoring, data review and management, effort certification, laboratory training, group meetings, etc. Mentoring relationships are encouraged to be done in person whenever possible.
  4. Customer-Facing Activities: Leaders need to ensure that customer needs are met, whether in-person or remotely. Non-virtual customer-facing activities must be done in-person.

Focus on building community

  1. Facilitating a sense of community and camaraderie is particularly important when implementing a flexible work environment; leaders are encouraged to foster in-person interactions with their teams, both business and social.
  2. With remote work in place, it will be important to be intentional about mentoring and supporting junior and new faculty members. This will require a thoughtful approach to ensure the needs of all faculty are met. As part of this, regular opportunities for in-person interactions between junior and new faculty members with more senior faculty should be planned. Leaders might consider assigning a remote work “buddy” for those junior and new faculty members who are working a hybrid or remote schedule as a way to foster connection.
  3. Faculty should engage in regular touch base meetings with learners and other team members as needed.

Reinforce performance management and accountability

Measuring productivity, including performance management, is an ongoing, two-way conversation between the faculty and leader, and that does not stop when a faculty member works a remote, hybrid or flexible schedule. Regardless of when and where faculty and leaders are working, regular performance conversations must occur. Being intentional about these conversations helps both faculty and leaders grow, while creating a work environment where faculty can perform at their best and will ensure business objectives are achieved.

1. Regular meetings: Leaders should hold regular (i.e. minimum of quarterly) in-person, one-on-one meetings with faculty members to assess their performance and check in on their well-being.

2. Annual performance Evaluations: Annual performance evaluations should be conducted in-person.

3. Clinical productivity: With regard to clinical productivity and operational recommendations, leaders should consider the following:

  • Each department should consider wRVU targets, overhead allotments, and resource utilization when considering the percentage of remote work of clinical providers. Shared spaces, hoteling and decreased consumption of resources may decrease overhead. Remote work does not allow for procedures that may generate more revenue and wRVUs in certain specialties, which may impact the perception of clinical productivity.
  • Non-OSU Location Applications (NOLAs) should be submitted for anyone working outside of an OSU location. Per the OSU Office of Legal Affairs, NOLAs are not required for telemedicine and therefore not needed for providers working from home. With that said, the provider is responsible for knowing where the patient is at the time of the service and validate whether they need a license for that state. Coverage under the University Self Insurance Program (USIP) is dependent on the appropriate license for the services provided.
  • Evaluation of the provider’s performance should occur in routine intervals (e.g. 6 months) throughout the year as a part of a review process to determine if the flexible work arrangement is meeting performance standards and department expectations. Based upon this evaluation, adjustments should be made accordingly.

Operational guidelines

Conduct meetings purposefully

1. Meetings should be scheduled in accordance with the University’s Safe and Healthy Buckeye Events and Gatherings Guidelines.

2. Consider the number of participants, time of day, duration of the meeting and subject matter to be discussed when determining if a meeting should be virtual, hybrid or in- person. Analysis of meeting format should be ongoing based on business needs.

3. Continue to practice proper etiquette for virtual meetings, which includes appropriate use of chat box function, cameras on, professional attire and appropriate background and setting to lead or participate in a virtual meeting.

4. Research- and education-related meetings (e.g., Grand Rounds, scientific seminars) should always offer a virtual option.

5. All clinical meetings should be offered in hybrid form primarily. Clinical meetings include administrative, educational and family meetings.

  • Residents and fellows may attend family meetings virtually as long as they are properly supervised by an attending.
  • Exceptions can be made for certain lectures/grand rounds to be in a primarily virtual or in-person formats at the discretion of the Department/Division leader (e.g., visiting lecturer/speaker, skills assessment/instructional activities, journal clubs).
  • Clinical meetings should not be recorded with the exception of select educational or administrative meetings where sensitive patient information is not being discussed.
  • Leaders should consider incorporating a mandatory in-person meeting to promote collegiality and cohesiveness among faculty.

Determine technology needs

1. Ensure all faculty have the essential hardware, software and accessory equipment when working remotely or onsite. This includes providing sufficient and up-to-date technology in an office or hoteling space. The following serve as best practices, recognizing that due to availability of space and/or resources, areas may or may not be able to implement them:

  • For those faculty members who work remotely 60% of the time or more, their remote office should be equipped with a laptop, docking monitor, additional monitor, wireless keyboard and mouse, and a webcam.
  • For those faculty members who work onsite 60% of the time or more, their campus office should be equipped with a laptop, docking monitor, additional monitor, wireless keyboard and mouse, and a webcam.
  • Dedicated hoteling spaces should be equipped with a docking station, two monitors, a keyboard and mouse, and webcam. Individuals utilizing these spaces will have the ability to connect a personal headset, if desired.

2. Expand the use of electronic signatures for commonly used forms in clinical and pre-clinical research in-house forms. Signatures for external forms are typically dictated by the sponsor.

Assess space and work environment

1. As a general guideline, faculty should be equipped with one office, regardless of location. Examples of this could include:

  • For those faculty members who work remotely 60% of the time or more, they will not have a dedicated workspace on campus but will instead utilize shared and/or hoteling workspaces. Units should consider a future-state where some or all shared and/or hoteling workspaces can be reserved via an online system. Exceptions will be evaluated on a case-by-case basis.
  • For those faculty members who work onsite 60% of the time or more, they will have a dedicated workspace on campus. Exceptions will be evaluated on a case-by-case basis.

2. Spaces may need to be reconfigured to accommodate health and safety guidelines as outlined by the University’s Safe and Healthy Buckeyes website.

Assess recruitment and onboarding practices

1. Departments should utilize a hybrid faculty recruitment process.

  • All initial screenings of candidates should be conducted virtually
  • Once the candidate pool has been narrowed, Departments have discretion to determine if and when the remaining interviews rounds will transition to in-person

2. New faculty are required to participate in virtual medical center orientation, but on-boarding should either be fully in-person or offered in a hybrid model.

Patient care guidelines

Faculty must ensure that the needs of the patient, providers and learners are met to maintain the delivery of exceptional health care, whether working in-person or remotely. The following outlines the essential requirements necessary to provide a safe, efficient and valuable clinical encounter for the patient and provider. These should be considered when evaluating the effectiveness of various work settings in which patient care is delivered, whether that be remotely or in-person.

1. Privacy – Ensure patient protected health information and conversations remain confidential in accordance with HIPAA policy.

2. Functioning software/hardware (see Technology guidelines)

3. Ability to communicate effectively with patients – Address any language barriers, including ESL, Non-English speaking requiring interpreter, HOH/Deaf population requiring ASL interpreter or assistive devices.

4. Ability to evaluate and assess the patient’s chief medical complaint(s) effectively (i.e. perform necessary exam or obtain necessary vitals)

5. Ability to deliver a good patient experience

6. Appropriate clinical support staff

  • Nurse/MA communication process to assist with patient and provider needs
  • Availability of staff needs to be equivalent despite work setting of provider or staff member

7. Emergency procedures in place to support patients

  • Pink slip availability
  • 911 process/EMS protocols

8. Teamwork/collegiality among providers and staff

9. For ongoing clinical care of chronic conditions, patients should be seen in-person at least annually, with specific considerations of the type of clinical practice and patient circumstances to determine frequency of in-person visits.

10. For providers with a disability or health limitations, the Department/Division should provide reasonable accommodations.

Education guidelines

Faculty are expected to provide the best educational experience possible for our learners and embrace this opportunity to provide flexibility in delivering educational content, especially for students with unique needs. Programs and course directors should be flexible but thoughtful about the best formats for each class, and when virtual or hybrid formats are chosen, it should be ensured that similar high-quality education is provided to each learner, whether they are in person or logging in virtually.

General

1. Individual programs will need to evaluate what is best for their learners, as some programs lend themselves to virtual learning (e.g., radiology), while others are more effective in person (e.g., lab-based courses).

2. Programs should refine their expectations and policies for delivering content to their learners in the era of remote work/learning. Program handbooks should be updated to reflect any changes and these changes should be clearly communicated to program faculty and trainees.

3. Programs should continually evaluate their training to ensure they are meeting the needs of their learners in the best way possible

4. While programs should set expectations for when faculty can teach remotely, the needs of the learners should take priority over the preferences of the faculty member.

5. Programs should be intentional about bringing learners together as often as possible to facilitate community building. This is important for unit cohesion and for allowing learners to get to know faculty members. It will also allow faculty to work with learners in a variety of settings, which is invaluable for writing letters of recommendation. Bringing learners and faculty together will be especially important when new class cohorts are assembled.

6. Programs should create policies for how students can advocate for more/different interactions with their mentor(s) when needed. Programs may consider assigning a program faculty member as an ombudsman or student advocate so students have an identified person with whom they can discuss perceived deficits in their training.

Lecture-based training

1. Programs will need to follow University rules on what is allowed for lecture-based classes.

2. If programs/lecturers expect learners to be present, it is expected that the faculty member will also be present unless the faculty member is in quarantine.

3. While in-person training may be the preference and priority, the option for learners to log-in virtually should be maintained whenever possible. This will help accommodate students with disabilities, students on different parts of campus, those who need to quarantine, etc.

Clinical-based training

1. When attendings are working with trainees, attendings should be available in real-time for trainees, in accordance with program requirements.

2. Learners should be educated and involved in virtual patient visits via 3rd party platforms like UPDOX or TEAMs.

  • Platforms should be chosen that will provide the most effective experience firstly for the patient but also the learner.
  • Clearly delineated parameters should be set to ensure patient confidentiality and regulatory standards are being met.
  • Consider verbal acknowledgement and consent from the patient for learners to participate in telehealth encounters.

3. Departments are encouraged to establish a telehealth clinic experience for all clinical learners.

4. Follow ACGME immediate availability guidelines of supervising attending staff.

  • Direct Supervision – The supervising physician is physically present with the resident and patient.
  • Indirect Supervision – With direct supervision immediately available, the supervising physician is physically within the hospital or other site of patient care, and is immediately available to provide Direct Supervision.
  • Indirect Supervision – With direct supervision available, the supervising physician is not physically present within the hospital or other site of patient care, but is immediately available by means of telephonic and/or electronic modalities.
  • When supervising procedures, staff are required to be present in-person or immediately available to provide direct supervision based on the type of procedure.

5. Set rules/expectations regarding engagement and participation by residents and fellows (e.g., discouraging multi-tasking, active participation, etc.).

Non-lecture-based research training

(e.g., training graduate students in wet lab research, laboratory-based instruction)

1. Programs should set and articulate expectations for in-person training for both faculty and learners. Regular in-person interactions should be maintained for every learner.

2. Faculty should consider the needs of the learner, as junior learners may need more in-person meetings than more senior learners.

3. All learners need some minimum of in-person interactions with their mentors.

4. PI’s running research laboratories should ensure trainees are getting enough in-person guidance and feedback on their research-related projects, proposals and publications.

Research guidelines

To realize our goal of pioneering life-altering biomedical discoveries and translating them into breakthrough health care solutions, our faculty researchers need a supportive environment that facilitates high productivity and creativity. Data illustrates that remote work supports and even amplifies productivity and creativity. Further, the many activities associated with research, such as grant and paper writing, etc., lend themselves to being performed remotely. Therefore, leaders are encouraged to support flexible work options for faculty researchers, while recognizing that faculty researchers will need to adhere to the education guidelines for the learners they supervise.

Flexible work arrangement agreement

If a faculty member would like approval to work a flexible work schedule, then he or she must complete and submit the OSU Flexible Work Arrangement Agreement form to his or her Department Chair. Once reviewed and if approved, the Department Chair or designee will notify the faculty member and submit the agreement electronically via HR Connection and saved in the faculty member’s personnel file. The HR Connection portal will be available after July 15, 2021.

If the arrangement changes, the revised agreement, once approved by the Department Chair, will need to be resubmitted to HR Connection and replace the document currently on file in the personnel file.

The timeline below provides a general outline of key dates for the purposes of the Campus Reactivation initiative. It is the expectation that plans would phase into implementation by August 25, 2021, although some units may delay based on business needs.

  • July 15, 2021: Department Chairs that choose to establish a flexible, hybrid or remote work plan for their departments will submit a formal flexible work plan to the Dean’s Office for review and approval via Amanda Thatcher (amanda.thatcher@osumc.edu). Subsequently, individual agreements will then be completed.
  • July 15 through August 16, 2021: Individual flexible work arrangement agreements are completed and, if approved, submitted via HR Connection and saved to personnel files.
  • August 16, 2021: Begin implementation of workplace reactivation plans. If business needs require an earlier start to implementation plans, that is permissible if approved by the Department Chair. Where possible, please allow 30 days’ notice before asking faculty members to return to the workplace.
  • By August 25, 2021: The majority of those returning to the workplace should be back in-person, and flexible work arrangement agreements begin. If additional time is needed fully enact return-to-work plans, this is permissible if approved by the Department Chair.