TEAM Town Hall November 15 th , 2017 Higher Purpose. Greater Good. - - PowerPoint PPT Presentation

Higher Purpose. Greater Good.™

TEAM Town Hall

November 15th, 2017

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Our vision

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

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Culture: Drive a culture of excellence and accountability

Increase clinical volume Foster growth in teaching and research Optimize support staffing for effectiveness and efficiency Build the strategic plan for the next 5-10 years Integrate academic, research, and clinical components of the School of Medicine Continuously improve high- quality patient interactions

Transformative Excellence in Academic Medicine (TEAM) is about delivering that vision in six key areas

Patient Access Research and Education Supporting Capabilities Strategic Plan

DELIVER QUALITY AND GROWTH IN EVERYTHING WE DO

Integrated Organization Clinical Quality

• 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 (NIH, clinical trials, and others)

• Improve Graduate Medical and Graduate

Research Education

• Reinstate full LCME accreditation
• Improve and integrate interprofessional

health professions training

• Implement standardized processes to

ensure billing & coding compliance

• Consolidate Epic EHR
• 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

Network Plan with SSM

• Build the new hospital and ACC and move

clinical infrastructure

• Redesign the academic campus
• 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
• Improve clinical quality across the

continuum of care

• Develop infrastructure for high

performance in value-based payment contracts

• Develop a patient experience program

Patient Access Research and Education Supporting Capabilities Strategic Plan Integrated Organization Clinical Quality

TEAM has established initiatives behind each of our priorities

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Initiative owners have been assigned for each initiative

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

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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

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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”

Enhance clinical care and patient experience patient-centric focus Attract research grants and high value clinical cases innovative research Facilitate practical interprofessional teaching education experience

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

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Our goals define a core set of design principles that have informed our institute model design

Design Principles

• Patients come first in the clinic, our research, and our education
• Organize ourselves to deliver interprofessional care
• Integrate our missions of clinical care, research, and teaching
• New model must improve financial results
• Clearer delineation of roles, responsibilities, and accountabilities for leaders
• Funds flow becomes more transparent and oriented towards the objectives of the

School as a whole

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We have defined 11 institutes

FORMAL INSTITUTE NAMES NOT FINALIZED

Neurological Diseases Heart & Vascular Cancer Women’s Children’s Immunology Primary Care Acute Care GI / Liver / Transplant Specialized Care / Surgery Diagnostics / Services

Basic scientists will affiliate with institutes based on their research focus. Academic departments will focus on teaching and professional identity.

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Based on workshops, feedback, and external research, we have defined 11 institutes

CARDIOLOGY HEART & VASCULAR CARDIOTHORACIC SURGERY VASCULAR SURGERY PULMONARY (Non-critical/Non-sleep) HEMONC (Non-surg./Non- transplants) CANCER BONE MARROW TRANSPLANTS OB/GYN ONCOLOGY SURGICAL ONCOLOGY RADIATION ONCOLOGY HEAD/NECK CANCER OB/GYN & WOMEN’S HEALTH WOMEN’S GYN SURGERY BREAST SURGERY OB/GYN UROLOGICAL GYNECOLOGY OB/GYN REPRODUCTIVE ENDOCRINOLOGY PEDIATRICS CHILDREN’S PEDIATRIC SURGERY PEDIATRIC ANESTHESIOLOGY PEDIATRIC ORTHOPEDICS PEDIATRIC UROLOGY PEDIATRIC PLASTICS INFECTIOUS DISEASES IMMUNOLOGY ALLERGY ARTHRITIS/ RHEUM VACCINE CENTER MOLECULAR MICROBIOLOGY & IMMUNOLOGY VIROLOGY NEUROLOGY NEUROLOGICAL DISEASES NEUROSURGERY NEUROSCIENCE CENTER GERIATRICS PSYCHIATRY SPINE SURGERY SLEEP MEDICINE

INSTITUTES

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Based on workshops, feedback, and external research, we have defined 11 institutes

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

INSTITUTES

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Example: Geriatrics

CARDIOLOGY HEART & VASCULAR CARDIOTHORACIC SURGERY VASCULAR SURGERY PULMONARY (Non-critical/Non-sleep) HEMONC (Non-surg./Non- transplants) CANCER BONE MARROW TRANSPLANTS OB/GYN ONCOLOGY SURGICAL ONCOLOGY RADIATION ONCOLOGY HEAD/NECK CANCER OB/GYN & WOMEN’S HEALTH WOMEN’S GYN SURGERY BREAST SURGERY OB/GYN UROLOGICAL GYNECOLOGY OB/GYN REPRODUCTIVE ENDOCRINOLOGY PEDIATRICS CHILDREN’S PEDIATRIC SURGERY PEDIATRIC ANESTHESIOLOGY PEDIATRIC ORTHOPEDICS PEDIATRIC UROLOGY PEDIATRIC PLASTICS INFECTIOUS DISEASES IMMUNOLOGY ALLERGY ARTHRITIS/ RHEUM VACCINE CENTER MOLECULAR MICROBIOLOGY & IMMUNOLOGY VIROLOGY NEUROLOGY NEUROLOGICAL DISEASES NEUROSURGERY NEUROSICENCE CENTER GERIATRICS PSYCHIATRY SPINE SURGERY SLEEP MEDICINE

INSTITUTES

Example

Many advancement opportunities in geriatrics are related to the aging brain Enables research differentiation and market competitiveness

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Example: Endocrinology

HEPATOLOGY/ LIVER CENTER GI/LIVER/ TRANSPLANT LIVER/KIDNEY TRANSPLANTS NEPHROLOGY GASTROENTEROLOGY GENERAL SURGERY (incl. colorectal surgery) TISSUE TYPING PATHOLOGY DIAGNOSTICS/ SERVICES NON-INTERVENTIONAL RADIOLOGY OPHTHALMOLOGY SPECIALIZED CARE/SURGERY OTOLARYNGOLOGY (Non-cancer) DERMATOLOGY (Including skin cancer) ORTHOPEDIC SURGERY (Non-spinal/Non- trauma/Non-pediatrics) ADULT UROLOGY COSMETICS OUTPATIENT ANESTHESIOLOGY (Procedural) EMERGENCY MEDICINE ACUTE CARE CRITICAL CARE TRAUMA SURGERY ORTHO TRAUMA RECONSTRUCTIVE PLASTIC HOSPITALISTS INPATIENT ANESTHESIOLOGY INTERVENTIONAL RADIOLOGY GENERAL INTERNAL MEDICINE (Non-hospitalists) PRIMARY CARE FAMILY MEDICINE MEDICAL FAMILY THERAPY BEHAVIORAL HEALTH ENDOCRINOLOGY PAIN ANESTHESIOLOGY SLUCOR & POP. HEALTH

INSTITUTES

Example

Positioning within Primary Care is critical for patient onboarding and continuity of integrated care, given the focus on diabetes cases

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Example: Orthopedic surgery

HEPATOLOGY/ LIVER CENTER GI/LIVER/ TRANSPLANT LIVER/KIDNEY TRANSPLANTS NEPHROLOGY GASTROENTEROLOGY GENERAL SURGERY (incl. colorectal surgery) TISSUE TYPING PATHOLOGY DIAGNOSTICS/ SERVICES NON-INTERVENTIONAL RADIOLOGY OPHTHALMOLOGY SPECIALIZED CARE/SURGERY OTOLARYNGOLOGY (Non-cancer) DERMATOLOGY (Including skin cancer) ORTHOPEDIC SURGERY (Non-spinal/Non- trauma/Non-pediatrics) ADULT UROLOGY COSMETICS OUTPATIENT ANESTHESIOLOGY (Procedural) EMERGENCY MEDICINE ACUTE CARE CRITICAL CARE TRAUMA SURGERY ORTHO TRAUMA RECONSTRUCTIVE PLASTIC HOSPITALISTS INPATIENT ANESTHESIOLOGY INTERVENTIONAL RADIOLOGY GENERAL INTERNAL MEDICINE (Non-hospitalists) PRIMARY CARE FAMILY MEDICINE MEDICAL FAMILY THERAPY BEHAVIORAL HEALTH ENDOCRINOLOGY PAIN ANESTHESIOLOGY SLUCOR & POP. HEALTH

INSTITUTES

ORTHO TRAUMA ORTHOPEDIC SURGERY (Non-spinal/Non- trauma/Non-pediatrics)

Grouped with other specialties that require excellence in an

• utpatient environment

Grouped with other specialties that are primarily focused on critical care 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.

Example

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Clinical and research faculty input will be solicited as part of the institute affiliation process

Finalization (January) Feedback sessions (Dec. – Jan.) Provide input (by 11/22) Receive survey (11/9)

• Each clinical faculty member has received a survey link via email
• Clinical faculty provide input on their proposed affiliation via the

survey

• Individual conversations with clinical faculty where there are
• utstanding questions about affiliation
• We will have discussions with all research faculty
• Each faculty member will receive a placement memo to confirm

their institute affiliation

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DATES ARE TENTATIVE

Clinical Faculty Research Faculty

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Clinical faculty institute affiliation survey should be completed by November 22nd

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.

51% 86%

• f clinical faculty have

completed the survey

• f faculty who have completed

the survey agree with their proposed institute affiliation

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Institutes will focus faculty on research and patient care, supporting them with a common infrastructure

Institutes

Academic Departments

Infrastructure / Support

Care delivery / protocols Research CARTS allocation Faculty clinical schedules Faculty productivity/ performance / comp reviews Teaching Continuing medical education Residency program Budgeting & funds flow Compensation Ambulatory business planning Clinical staffing Staff management Scheduling Billing / coding Pre-arrival Patient contact center Clinical perform.

metrics/informatics

Patient experience Quality Compliance Extramural professional

• rganizations

Rules of CARTS Faculty offices Research admin. Fellowship program Faculty hiring processes Faculty promotion processes PhD programs & graduate education IT/EHR

Note: highlights key activities, but is not a comprehensive view

Clinical Affairs to set schedules in collaboration with Institutes

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What does this mean for faculty?

• 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

• 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

Institutes Academic Departments Focus on patient- centric care and research Focus on teaching, academic programs, and professional identity

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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

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Shift in activities will support faculty focus on teaching, clinical care, and research - what does this mean for staff?

Clinical Affairs

• Dr. Heaney

Finance

Gary Whitworth

Clinical staff (e.g. RNs, LRNs, MAs) Budgeting & funds flow Scheduling Billing / coding Patient contact center Clinical performance metrics/ informatics Patient experience Quality Compliance IT/EHR Research admin.

INFRASTRUCTURE / SUPPORT

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.

• 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

• Fosters professional

development

• pportunities for our staff

PMO Financial planning and analysis Financial reporting

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This is not restructuring; this is a holistic change to our patient care delivery model driven by your participation and leadership

support infrastructure mindsets governance communication

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Implementation process

OCTOBER NOVEMBER DECEMBER JANUARY 2018

“Blueprint” design Implementation Detailed design

PRELIMINARY Includes finalization of institute affiliations for faculty and engagement of leaders and staff to discuss institute affiliation

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We commit to a transparent process for TEAM, with many

• pportunities for engagement

Announcements One-on-ones Forums

(e.g., department meetings, Town Halls)

TEAM email & website

• Regular e-mail 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

• Continue to submit your thoughts and questions to

TEAM@slu.edu and through the TEAM website

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Questions?

Text Questions to 217-556-1007