CENTRALIZED FELLOWSHIP PROGRAM COORDINATION

Transcription

1 CENTRALIZED FELLOWSHIP PROGRAM COORDINATION A Win-Win (and a Few Challenges!) Affiliation Lisa Brath, MD Director, Pulmonary Critical Care Medicine Fellowship Training Program Stephanie Call, MD, MSPH Associate Chair of Education Director, Internal Medicine Residency Training Program Stella Hamman, BS, RN Program Administrator, Internal Medicine Residency Training Program Rachel Van Hart, BA Program, Internal Medicine Fellowships There are no conflicts of interests to disclose at this time.

2 Why We Centralized A series of misses and near-misses: Mishandling of fellow leave requests Missed Match List deadline Program short-cycled after ACGME site visit Inequity of Support Administrative support provided to program directors was inconsistent among divisions duties were often split between education and division administration Nine divisions were navigating HR, GME, and ACGME systems separately

3 Crunch A General Case Study: coordinators consistently report that other administrative duties take precedence over the needs of the fellowship, even if they are granted protected time. So, what other roles do our fellowship coordinators have? Crunch In our institution, many coordinators are also: Timekeepers Chair or faculty assistants In charge of requisitions and payments Receptionists (phone, mail, fax) Travel and reimbursement coordinators Conference schedulers Credentialing liaisons

4 Crunch Some coordinators also: Write grant applications Reconcile grant expenditures Process physician billing Schedule VIP patients Keep JCAHO files on drug/equipment reps. Facilitate faculty evaluations and promotions Crunch The result of so many competing roles? Needs of fellowship put off until they become an immediate need coordinators struggle to stay current with new regulations Out of practice with web-based fellowship data management systems Burnout and frequent turnover

5 Crunch Now that we re centralized Former fellowship coordinators whose programs were absorbed into centralization were generally sad to let the fellowships go, but they also expressed relief at having the burden of the fellowships lifted. Most acknowledged that the fellowships were not getting the attention they needed, especially with the ACGME requirements becoming more stringent in recent years. Recap: Why did we centralize? Initially fellowships had been left pretty much to their own devices Admin. assistants juggled coordinating with many other duties ACGME requirements were not stringent for fellows in the past, but Fellowships needed some overall supervision and support esp. with looming site visit

6 Our Centralization Process We saw the need for change, so G.J. was hired Her main roles: To provide support (esp. for ID and Nephrology which had no support at all) for Program Directors Fellows To help all the fellowship programs with whatever was needed Job description was formatted on the job We lost her to Arizona after a year Our Centralization Process S. H. came on board as Central She was to continue where G.J. had left off: Primary focus was to prepare multiple fellowships for site visit the following year Instituted monthly meetings with FPDs Continued to help all the fellowship programs with whatever was needed especially ID and Nephrology And to oversee the other fellowships But

7 Our Centralization Process However, admin. assistants of the fellowship divisions Assumed that S.H. would pick up ALL the coordination of ALL the fellowships, and do whatever was needed, and Turned full attention on other aspects of their job Or relocated elsewhere Simultaneously ACGME and GME requirements of fellowships increased and began to parallel requirements of residencies S.H. was attempting to coordinate and prepare for the site visit for eight fellowships AND pick up on or develop the daily administrative pieces of many of the fellowships So Our Centralization Process R.F. was hired to share the load Working collaboratively with S.H., FPDs and Residency PD Eventually all the fellowships (now 20, including subsub-specialties) were divided among three coordinators Each coordinating between 6 8 fellowships Handling all administrative tasks related to fellowship Working very closely with FPDs and fellows from recruitment through graduation and everything in between Including ensuring continued compliance with increasing requirements of ACGME, ABIM, GME, etc.

8 Centralization Models Balanced Centralization Up to three coordinators who are dedicated to a relatively equal mix of small and large fellowship programs Core Program Oversees 4 5 fellowships of various sizes Oversees 4 5 fellowships of various sizes Oversees 4 5 fellowships of various sizes Centralization Models Dependent Centralization One dedicated program coordinator for each large fellowship and one to two coordinators dedicated to multiple, smaller programs Core Program Oversees 3 to 4 small fellowships Oversees 3 to 4 small fellowships Oversees 1 large fellowship Oversees 1 large fellowship Oversees 1 large fellowship Oversees 1 large fellowship

9 Centralization Models Centralized Administrative Oversight A core administrator oversees coordinators who are housed in the divisions Core Program Administrator (Oversight) Worksheet, group discussion

10 Our Current Model There are 20 fellowship programs among nine Internal Medicine divisions Of these, 11 are subspecialty programs and nine are sub-subspecialty Eight programs have either been established or accredited by the ACGME in the past 10 years Only five programs are non-acgme accredited at this time Our Current Model Fellowships are grouped and coordinators assigned by division for maximum effectiveness. Cardiology Nephrology GI ID Rheum. and A&I Endocrinology Geriatrics Hem/Onc & Palliative Pulmonary Critical Care Cardiovascular Disease Advanced Heart Failure Nephrology Nephrology Transplant Advanced Endoscopy GI (Clinical) Infectious Diseases Allergy & Immunology Rheumatology Endocrinology & Metabolism Geriatric Medicine Hematology/ Oncology Hospice & Palliative Medicine Pulmonary Disease & Critical Care Medicine Interventional Pulmonology Electrophysiology GI (Research) Interventional Cardiology Nutrition Hepatology

11 Our Current Model 1 Cardiology Cardiovascular Disease Advanced Heart Failure Electrophysiology Interventional Cards Nephrology Nephrology Nephrology Transplant 2 Gastroenterology Advanced Endoscopy Gastroenterology (Clinical) Gastroenterology (Research) GI Nutrition Hepatology Infectious Disease Rheumatology, A&I Allergy & Immunology Rheumatology 3 Endocrinology Geriatrics Hem/Onc, Palliative Hematology/Oncology Hospice and Palliative Medicine Pulmonary Pulmonary Critical Care Interventional Pulmonology The PD Perspective

12 Stats from PD survey Our Business Model

13 Transition perspective. PROS. CONS Q&A

14 Contact Information