TEAM Town Hall. November 15 th, Higher Purpose. Greater Good.

Transcription

1 TEAM Town Hall November 15 th, 2017 Higher Purpose. Greater Good.

2 Our vision Set the standard for quality patientcentric care and academic excellence Become the desired destination for faculty, staff, and students by ensuring they are developed and empowered Grow to achieve leading financial results and a leadership position in the market, benefiting our mission, faculty, and staff 2

3 Transformative Excellence in Academic Medicine (TEAM) is about TEAM delivering has established that vision initiatives in six behind key areas each of our priorities Culture: Drive a culture of excellence and accountability Clinical Quality Improve clinical quality across the continuum of care Develop infrastructure for high Continuously performance value-based improve payment highquality patient contracts interactions Develop a patient experience program Patient Access Optimize clinical capacity - develop standards on working hours, productivity, scheduling, and CARTS Reduce and mitigate the impact of cancellations, no shows, & bumps Increase clinical volume Research and Education Sustainably develop programmatic research to grow external funding resources (NIH, clinical trials, and others) Foster growth in teaching and research Improve Graduate Medical and Graduate Research Education Reinstate full LCME accreditation Improve and integrate interprofessional health professions training Integrated Organization Shift to an institute model to enhance performance while maintaining identity Clarify decision rights and accountabilities Integrate academic, research, and clinical components of the development School processes of Medicine & standardize job Redesign budget and funds flow process Improve recruiting, hiring, and titles Centralize & standardize support functions Rollout new faculty compensation model Supporting Capabilities Implement standardized processes to ensure billing & coding compliance Consolidate Epic EHR Transition to the Epic revenue cycle Optimize management support system staffing for effectiveness and efficiency Strategic Plan Develop a 5-year roadmap to achieve fullpotential growth and patient outcomes Implement the Integrated Delivery Network Plan with SSM Build the strategic plan for the clinical infrastructure next 5-10 years Build the new hospital and ACC and move Redesign the academic campus DELIVER QUALITY AND GROWTH IN EVERYTHING WE DO 3

4 Initiative owners have been assigned for each initiative Clinical Quality Patient Access Research and Education Integrated Organization Supporting Capabilities Strategic Plan Initiative Improve clinical quality across the continuum of care Develop infrastructure for high performance in value-based payment contracts Develop a patient experience program Optimize clinical capacity-develop standards on working hours, productivity, scheduling, and CARTS Reduce and mitigate the impact of cancellations, no shows, & bumps Sustainably develop programmatic research to grow external funding resources Improve Graduate Medical and Graduate Research Education Reinstate full LCME accreditation Improve and integrate interprofessional health professions training Shift to an institute model to enhance performance while maintaining identity Clarify decision rights and accountabilities Redesign budget and funds flow process Improve recruiting, hiring, and development processes & standardize job titles Centralize & standardize support functions Rollout new faculty compensation model Implement standardized processes to ensure billing & coding compliance Consolidate Epic E HR Transition to the Epic revenue cycle management system Develop a 5-year roadmap to achieve 'full-potential' growth and patient outcomes Implement the Integrated Delivery Netowrk Plan with SSM Build the new hospital and ACC and move clinical infrastructure Redesign the academic campus Co-Owners Beth Page, Nicole Burkemper Beth Page, Bill Manard Beth Page, Mary McLennan Peggy Fisher, Ali Kosydor, Michael Lim, Jenny Schmidt Peggy Fisher, Ali Kosydor, Michael Lim, Jenny Schmidt Enrico Di Cera, Daniel Hoft, Joel Eissenberg, John Edwards, Paul Hauptman Jane McHowat, Julie Gammack Kevin Behrns, Chad Miller David Pole, Christine Jacobs Bob Heaney, Kevin Behrns, Tom Burris Christina Moore, Bob Wilmott Gary Whitworth, Mike Meyer, Sameer Siddiqui HR/SLUCare Administration, Charlene Prather, Jane McHowat Peggy Fisher, Ali Kosydor, Mike Meyer, David Wathen, Sameer Siddiqui Wes Maurer, Carole Vogler, Yadira Hurley Elizabeth Cooley, Chetana Reddy, Alyce Lanxon Nilesh Patil, Bill Manard Alyce Lanxon, Mike Meyer, Jastin Antisdel Kevin Behrns, Bob Heaney, Jules Grotemeyer Kevin Behrns, Bob Heaney, Jules Grotemeyer Bob Heaney, Don Jacobs, Jeff Brown Bob Heaney, Kevin Behrns 4

5 Faculty advisors have been selected by the Faculty Assembly Yadira Hurley Dermatology/Pathology Jenny Schmidt General Internal Medicine Lia Lowrie Pediatrics Anjan Bhattacharyya Psychiatry Sameer Gadani Radiology Gina Yosten Pharmacology & Physiological Science 5

6 Today, we will focus on the institute model, which is critical to achieving our vision For you, and for others, we teach research-inspired, high-value humanistic care patient-centric focus innovative research education experience Enhance clinical care and patient experience Attract research grants and high value clinical cases Facilitate practical interprofessional teaching These focus areas allow us to create positive experiences for our patients, faculty, staff, and students and achieve financial results in support of our mission 6

7 Our goals define a core set of design principles that have informed our institute model design 1 Patients come first in the clinic, our research, and our education 2 Organize ourselves to deliver interprofessional care 3 Integrate our missions of clinical care, research, and teaching 4 New model must improve financial results Design Principles 5 Clearer delineation of roles, responsibilities, and accountabilities for leaders 6 Funds flow becomes more transparent and oriented towards the objectives of the School as a whole 7

8 We have defined 11 institutes FORMAL INSTITUTE NAMES NOT FINALIZED Neurological Diseases Heart & Vascular Cancer Children s Immunology Primary Care GI / Liver / Transplant Specialized Care / Surgery Diagnostics / Services Women s Acute Care Basic scientists will affiliate with institutes based on their research focus. Academic departments will focus on teaching and professional identity. 8

9 Based on workshops, feedback, and external research, we have defined 11 institutes INSTITUTES NEUROLOGICAL DISEASES HEART & VASCULAR CANCER WOMEN S CHILDREN S IMMUNOLOGY NEUROLOGY CARDIOLOGY HEMONC (Non-surg./Nontransplants) OB/GYN & WOMEN S HEALTH PEDIATRICS INFECTIOUS DISEASES NEUROSURGERY CARDIOTHORACIC SURGERY BONE MARROW TRANSPLANTS GYN SURGERY PEDIATRIC SURGERY ALLERGY NEUROSCIENCE CENTER VASCULAR SURGERY OB/GYN ONCOLOGY BREAST SURGERY PEDIATRIC ANESTHESIOLOGY ARTHRITIS/ RHEUM GERIATRICS PULMONARY (Non-critical/Non-sleep) SURGICAL ONCOLOGY OB/GYN UROLOGICAL GYNECOLOGY PEDIATRIC ORTHOPEDICS VACCINE CENTER PSYCHIATRY RADIATION ONCOLOGY OB/GYN REPRODUCTIVE ENDOCRINOLOGY PEDIATRIC UROLOGY MOLECULAR MICROBIOLOGY & IMMUNOLOGY SPINE SURGERY HEAD/NECK CANCER PEDIATRIC PLASTICS VIROLOGY SLEEP MEDICINE 9

10 Based on workshops, feedback, and external research, we have defined 11 institutes INSTITUTES PRIMARY CARE ACUTE CARE GI/LIVER/ TRANSPLANT SPECIALIZED CARE/SURGERY DIAGNOSTICS/ SERVICES GENERAL INTERNAL MEDICINE (Non-hospitalists) EMERGENCY MEDICINE HEPATOLOGY/ LIVER CENTER OPHTHALMOLOGY PATHOLOGY FAMILY MEDICINE CRITICAL CARE LIVER/KIDNEY TRANSPLANTS OTOLARYNGOLOGY (Non-cancer) NON-INTERVENTIONAL RADIOLOGY MEDICAL FAMILY THERAPY TRAUMA SURGERY NEPHROLOGY DERMATOLOGY (Including skin cancer) BEHAVIORAL HEALTH ORTHO TRAUMA GASTROENTEROLOGY ORTHOPEDIC SURGERY (Non-spinal/Nontrauma/Non-pediatrics) ENDOCRINOLOGY RECONSTRUCTIVE PLASTIC GENERAL SURGERY (incl. colorectal surgery) ADULT UROLOGY PAIN ANESTHESIOLOGY HOSPITALISTS TISSUE TYPING PLASTICS/COSMETICS SLUCOR & POP. HEALTH INPATIENT ANESTHESIOLOGY OUTPATIENT ANESTHESIOLOGY (Procedural) INTERVENTIONAL RADIOLOGY 10

11 Example: Geriatrics Example INSTITUTES NEUROLOGICAL DISEASES HEART & VASCULAR CANCER WOMEN S CHILDREN S IMMUNOLOGY NEUROLOGY CARDIOLOGY HEMONC (Non-surg./Nontransplants) OB/GYN & WOMEN S HEALTH PEDIATRICS INFECTIOUS DISEASES NEUROSURGERY CARDIOTHORACIC SURGERY BONE MARROW TRANSPLANTS GYN SURGERY PEDIATRIC SURGERY ALLERGY NEUROSICENCE CENTER Many advancement opportunities in geriatrics are related to the aging brain VASCULAR SURGERY OB/GYN ONCOLOGY BREAST SURGERY PEDIATRIC ANESTHESIOLOGY ARTHRITIS/ RHEUM GERIATRICS PULMONARY (Non-critical/Non-sleep) SURGICAL ONCOLOGY OB/GYN UROLOGICAL GYNECOLOGY PEDIATRIC ORTHOPEDICS VACCINE CENTER PSYCHIATRY Enables research differentiation and market competitiveness RADIATION ONCOLOGY OB/GYN REPRODUCTIVE ENDOCRINOLOGY PEDIATRIC UROLOGY MOLECULAR MICROBIOLOGY & IMMUNOLOGY SPINE SURGERY HEAD/NECK CANCER PEDIATRIC PLASTICS VIROLOGY SLEEP MEDICINE 11

12 Example: Endocrinology Example INSTITUTES PRIMARY CARE ACUTE CARE GI/LIVER/ TRANSPLANT SPECIALIZED CARE/SURGERY DIAGNOSTICS/ SERVICES GENERAL INTERNAL MEDICINE (Non-hospitalists) EMERGENCY MEDICINE HEPATOLOGY/ LIVER CENTER OPHTHALMOLOGY PATHOLOGY FAMILY MEDICINE CRITICAL CARE LIVER/KIDNEY TRANSPLANTS OTOLARYNGOLOGY (Non-cancer) NON-INTERVENTIONAL RADIOLOGY MEDICAL FAMILY THERAPY BEHAVIORAL HEALTH TRAUMA SURGERY NEPHROLOGY Positioning within Primary Care is critical for patient onboarding and continuity of integrated care, given the ORTHO TRAUMA GASTROENTEROLOGY focus on diabetes cases DERMATOLOGY (Including skin cancer) ORTHOPEDIC SURGERY (Non-spinal/Nontrauma/Non-pediatrics) ENDOCRINOLOGY RECONSTRUCTIVE PLASTIC GENERAL SURGERY (incl. colorectal surgery) ADULT UROLOGY PAIN ANESTHESIOLOGY HOSPITALISTS TISSUE TYPING COSMETICS SLUCOR & POP. HEALTH INPATIENT ANESTHESIOLOGY OUTPATIENT ANESTHESIOLOGY (Procedural) INTERVENTIONAL RADIOLOGY 12

13 Example: Orthopedic surgery Example INSTITUTES PRIMARY CARE ACUTE CARE GI/LIVER/ TRANSPLANT SPECIALIZED CARE/SURGERY DIAGNOSTICS/ SERVICES GENERAL INTERNAL MEDICINE (Non-hospitalists) EMERGENCY MEDICINE HEPATOLOGY/ LIVER CENTER OPHTHALMOLOGY PATHOLOGY FAMILY MEDICINE CRITICAL CARE LIVER/KIDNEY TRANSPLANTS OTOLARYNGOLOGY (Non-cancer) NON-INTERVENTIONAL RADIOLOGY MEDICAL FAMILY THERAPY BEHAVIORAL HEALTH ENDOCRINOLOGY TRAUMA SURGERY ORTHO TRAUMA RECONSTRUCTIVE PLASTIC Grouped with other specialties that are primarily focused on critical care PAIN ANESTHESIOLOGY SLUCOR & POP. HEALTH HOSPITALISTS INPATIENT ANESTHESIOLOGY INTERVENTIONAL RADIOLOGY NEPHROLOGY GASTROENTEROLOGY GENERAL SURGERY (incl. colorectal surgery) TISSUE TYPING DERMATOLOGY (Including skin cancer) ORTHOPEDIC SURGERY (Non-spinal/Nontrauma/Non-pediatrics) Grouped with other specialties that require excellence in an outpatient environment ADULT UROLOGY COSMETICS OUTPATIENT ANESTHESIOLOGY (Procedural) Each orthopedic faculty member will be affiliated with one primary institute that best aligns with their clinical and research focus. Faculty members will still be able to contribute across institutes, e.g. trauma call. However, their performance reviews and time allocation will be managed through their primary institute. 13

14 Clinical and research faculty input will be solicited as part of the institute affiliation process DATES ARE TENTATIVE Receive survey (11/9) Provide input (by 11/22) Feedback sessions (Dec. Jan.) Finalization (January) Each clinical faculty member has received a survey link via Clinical faculty provide input on their proposed affiliation via the survey Individual conversations with clinical faculty where there are outstanding questions about affiliation We will have discussions with all research faculty Each faculty member will receive a placement memo to confirm their institute affiliation Clinical Faculty Research Faculty 14

15 Clinical faculty institute affiliation survey should be completed by November 22 nd 51% of clinical faculty have completed the survey 86% of faculty who have completed the survey agree with their proposed institute affiliation Each survey is personalized to the recipient, giving them the opportunity to confirm that the proposed institute affiliating makes sense or to propose a different institute affiliation. We will use feedback to schedule individual meetings, as needed. 15

16 Institutes will focus faculty on research and patient care, supporting them with a common infrastructure Care delivery / protocols Research CARTS allocation Faculty clinical schedules Faculty productivity/ performance / comp reviews Faculty offices Institutes Academic Departments Teaching Residency program Extramural professional organizations Continuing medical education Fellowship program Faculty hiring processes Faculty promotion processes PhD programs & graduate education Infrastructure / Support Budgeting & funds flow Rules of CARTS Compensation Ambulatory business planning Clinical staffing Staff management Scheduling Pre-arrival Patient contact center Clinical perform. metrics/informatics Patient experience Quality Compliance Research admin. Clinical Affairs to set schedules in collaboration with Institutes Billing / coding Note: highlights key activities, but is not a comprehensive view IT/EHR 16

17 What does this mean for faculty? Institutes Focus on patientcentric care and research Institutes will be the investment vehicle for clinical and research activities All faculty will report into an institute, led by an Institute Director Institute Directors will oversee activities including faculty performance reviews, CARTS allocation, and clinical schedules Academic Departments Focus on teaching, academic programs, and professional identity Faculty will also be members of academic departments - Faculty titles will reflect membership in that department (e.g., Associate Professor of Neurology ) Academic Department Chairs will oversee academic departments focused on teaching programs and professional identity - A Vice Dean of Education will oversee their work as Academic Department Chairs - Academic Department Chairs will still individually be members of institutes and report to Institute Directors - A single person could serve as both an Academic Department Chair and an Institute Director 17

18 Proposed Institute Director (ID) Hiring Process for a given institute Identify and announce interim IDs Appoint Search Committee and launch formal permanent ID search process Identify and interview internal and external candidates, including interim IDs Finalize offers and announce permanent IDs on a rolling basis 18

19 Shift in activities will support faculty focus on teaching, clinical care, and research - what does this mean for staff? INFRASTRUCTURE / SUPPORT Finance Gary Whitworth PMO Billing / coding Financial planning and analysis Clinical staff (e.g. RNs, LRNs, MAs) Patient contact center Scheduling Clinical Affairs Dr. Heaney Patient experience Quality Compliance Most staff will report directly into Finance or Clinical Affairs Staff will be able to focus efforts on forming best in class infrastructure/ support functions Budgeting & funds flow Financial reporting Clinical performance metrics/ informatics Research admin. IT/EHR Fosters professional development opportunities for our staff Our goal for this program is to achieve growth, but we will need to look differently as an organization to accomplish that. As initiatives move forward and a clearer picture evolves on how this will impact staff, we will be transparent about it. 19

20 This is not restructuring; this is a holistic change to our patient care delivery model driven by your participation and leadership mindsets governance support infrastructure communication 20

21 Implementation process PRELIMINARY OCTOBER NOVEMBER DECEMBER JANUARY 2018 Blueprint design Includes finalization of institute affiliations for faculty and engagement of leaders and staff to discuss institute affiliation Detailed design Implementation 21

22 We commit to a transparent process for TEAM, with many opportunities for engagement Announcements One-on-ones Forums (e.g., department meetings, Town Halls) Regular communications from Dean Behrns and RDO Executive Leads Listening tour: reach out to faculty reps, Dr. Ravi Nayak and Dr. Sameer Siddiqui, to discuss TEAM (feedback can be anonymous) Office hours with Dean Behrns: sign up for periodic office hours with the Dean (contact the Dean s office) Department, division, and staff meetings: reach out to your department chair, division lead, or clinic/business manager to request a TEAM leadership update at an upcoming meeting Town Halls: Attend future town halls to hear about our progress and ask questions TEAM & website Continue to submit your thoughts and questions to TEAM@slu.edu and through the TEAM website 22

23 Questions? Text Questions to

24