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Understanding and Navigating Constant Change in the Academic Medicine Landscape Presenters: Michael Warden, Johmarx Patton, Kathleen Ludewig Omollo Except.

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Presentation on theme: "Understanding and Navigating Constant Change in the Academic Medicine Landscape Presenters: Michael Warden, Johmarx Patton, Kathleen Ludewig Omollo Except."— Presentation transcript:

1 Understanding and Navigating Constant Change in the Academic Medicine Landscape Presenters: Michael Warden, Johmarx Patton, Kathleen Ludewig Omollo Except where otherwise noted, this work is available under a Creative Commons Attribution 4.0 License (http://creativecommons.org/licenses/by/4.0/). Copyright 2014 The Regents of the University of Michigan.http://creativecommons.org/licenses/by/4.0/ MSISMSIS Lunch and Learn - June 13,

2 Introduction Changes exist all around us… ● Job Requirements ● Roles ● Problems ● Location ● Major Projects ● Structure ● Leadership ● Team Makeup ● … where I put my lunch and get my water! 2

3 Public domain image Present. Image CC BY NC University of Michigan, UMHS Media Bank.UMHS Media Bank

4 How many EVPMA’s (interim and permanent) have we had appointed from the University of Michigan Medical School? A. 1 B. 2 C. 3 D. 4 E. 5 Change 4

5 How many EVPMA’s (interim and permanent) have we had appointed from the University of Michigan Medical School? A. 1 B. 2 C. 3 D. 4 E. 5 Change Lazar Greenfield, M.D. EVPMA

6 Constant Change Image CC BY P-A-T-R-I-C-K FlickrFlickr 6

7 Permanent White Water Image CC BY Andy Arthur, FlickrFlickr 7

8 Permanent White Water Image CC BY Pete Bellis, FlickrFlickr 8

9 Academic Health/Medical Centers (AHC/AMC): 3 Communities School of Medicine Teaching Hospital (Clinical) Practice Plan 9

10 Academic Health/Medical Centers: 3 Communities School of Medicine Teaching Hospital (Clinical) Practice Plan 10 University

11 Academic Health/Medical Centers: 3 Communities School of Medicine Teaching Hospital (Clinical) Practice Plan 11

12 Academic Health/Medical Centers: 3 Communities School of Medicine Teaching Hospital (Clinical) Practice Plan 12

13 Academic Health/Medical Centers: Different Models for Governance School of Medicine Teaching Hospital (Clinical) Practice Plan School of Medicine Teaching Hospital (Clinical) Practice Plan Least integrated Most integrated School of Medicine Teaching Hospital (Clinical) Practice Plan School of Medicine Teaching Hospital (Clinical) Practice Plan School of Medicine Teaching Hospital (Clinical) Practice Plan Reference: Levine JK. Considering alternative organizational models for academic medical centers. Acad Clin Pract. 2002;14(2):2–5. 13

14 Academic Health/Medical Centers: Different Models for Governance School of Medicine Teaching Hospital (Clinical) Practice Plan School of Medicine Teaching Hospital (Clinical) Practice Plan Least integrated Most integrated School of Medicine Teaching Hospital (Clinical) Practice Plan School of Medicine Teaching Hospital (Clinical) Practice Plan Reference: Levine JK. Considering alternative organizational models for academic medical centers. Acad Clin Pract. 2002;14(2):2–5. Question: Which one is U-M? A E BC D School of Medicine Teaching Hospital (Clinical) Practice Plan 14

15 Academic Health/Medical Centers: Different Models for Governance School of Medicine Teaching Hospital (Clinical) Practice Plan School of Medicine Teaching Hospital (Clinical) Practice Plan Least integrated Most integrated School of Medicine Teaching Hospital (Clinical) Practice Plan School of Medicine Teaching Hospital (Clinical) Practice Plan Reference: Levine JK. Considering alternative organizational models for academic medical centers. Acad Clin Pract. 2002;14(2):2–5. Question: Which one is U-M? E School of Medicine Teaching Hospital (Clinical) Practice Plan 15

16 AHC - 3D Mission Each of these 3 missions, touch each of the 3 communities, but to varying extents depending on the model ClinicalResearch Education 16

17 AHC - 3D Mission Missions are complementary yet competitive ClinicalResearch Education 17

18 AHC - 3D Mission Missions are complementary yet competitive ClinicalResearch Education + $ - $ 18

19 AHC - 4D Mission? ClinicalResearch Education Community Service 19

20 After the completion of high school, what is the typical duration of education/training before becoming a licensed, independently practicing physician in the US? A. 6 years B. 8 years C. 12 years D. 15 years E. 19 years Education 20

21 After the completion of high school, what is the typical duration of education/training before becoming a licensed, independently practicing physician in the US? A. 6 years B. 8 years C. 12 years D. 15 years E. 19 years Education 21

22 After the completion of high school, what is the typical duration of education/training before becoming a licensed, independently practicing physician in the US? A. 6 years B. 8 years C. 12 years D. 15 years E. 19 years Education Chart adapted from: AAMC 22 Undergraduate Bachelors Degree Years: 4 Medical School (MD) Years: 4 Residency Years: 3-5+ Subspecialty Years: 1-4 Board Certification Recertification Licensure Independent Practice Continuing Medical Education Subspecialty Certification

23 Education 23 Undergraduate Bachelors Degree Years: 4 Undergraduate Medical Education (UME) Medical School (MD) Years: 4 Residency Years: 3-5+ Subspecialty Years: 1-4 Board Certification Recertification Licensure Independent Practice Continuing Medical Education Subspecialty Certification Chart adapted from: AAMC

24 Education 24 Undergraduate Bachelors Degree Years: 4 Medical School (MD) Years: 4 Graduate Medical Education (GME) Residency Years: 3-5+ Graduate Medical Education (GME) Subspecialty Years: 1-4 Board Certification Recertification Licensure Independent Practice Continuing Medical Education Subspecialty Certification Chart adapted from: AAMC

25 Education 25 Chart adapted from: AAMC Undergraduate Bachelors Degree Years: 4 Medical School (MD) Years: 4 Residency Years: 3-5+ Subspecialty Years: 1-4 Board Certification Recertification Licensure Independent Practice Continuing Medical Education (CME) Subspecialty Certification

26 Medical School Faculty Types of Faculty: ●Research ●Instructional ●Clinical ●Adjunct Education 26

27 What are the credentials of primary care providers? A. MD B. DO C. NP D. PA E. Any of the above F. None of the above Clinical Care 27

28 What are the credentials of primary care providers? A. MD B. DO C. NP D. PA E. Any of the above F. None of the above Clinical Care 28

29 Gone are the days of having only 1 doctor... 29

30 New Models I Clinical Care 30 All images from The Noun Project. See references at end for attributions.

31 Research contributions to new knowledge “bench to bedside” “disciplinary guilds” - for reviews of proposals for funding and for verifying results Basic Research Patient-Oriented Clinical Research Improve health outcomes Translation to clinical studies Translation to health care practice 31 Chart adapted from:

32 Research On average, what percentage of research costs are covered by external grants (e.g. government, foundations)? A. Over 90% B % C % D. Less than 30% 32

33 Research A. Over 90% B % C % D. Less than 30% On average, what percentage of research costs are covered by external grants (e.g. government, foundations)? 33

34 Research Based on: National Science Foundation Survey, 2010, Top 125 Ranked Institutions with NSF Support 34

35 Research Before > Now > Future Scope (Data and Team): Small > Big > Massive Approach: Observation > Analysis and Reduction > Synthesis and Integration Job Security: Salary Secure > Tenure Uncertain > No Tenure for Research Control: Investigator > Principal Investigator, Institution, Funder > Program Director Reference: A. Rees Midgley, Biological Science Research: Yesteryear, Today, and Tomorrow. 35

36 Discussion / Activity (15 minutes) Tools and techniques that you can use to focus your efforts and create stability: ●Not To Do Lists ●Stakeholder Mapping 36

37 Not To Do Lists To Do:NOT To Do: USO Program Transition to Operations Process Project Management KPIs Staff Development Knowledgebase Alignment Product Owner training Project Management training classes Legacy Documentation Cleanup Expanded Onboarding “What could I make a good case for doing?” Time? Important? FocusWaste BombsIgnore YN Y N 37 Matrix adapted from: Gregory P. Shea, Leading Change in Medicine and Business: Bridging the Gap, e.d. Sheldon Rovin, Aspen, 2001.

38 Stakeholder Mapping Influence Appreciate Control Those who can ‘control’ the outcome - make the change happen or not happen Those who can ‘influence’ the outcome - make the change harder or easier Those who can ‘appreciate’ that the change is occurring, but have little power in affecting the course Reference: Gregory P. Shea, Leading Change in Medicine and Business: Bridging the Gap, e.d. Sheldon Rovin, Aspen,

39 Stakeholder Mapping Allies Bedfellows Undecideds Fencesitters Opponents Adversaries YesNo Yes No “Does the Stakeholder Agree with you?” “Do you trust the Stakeholder?” Focus time and effort here. Reference: Gregory P. Shea, Leading Change in Medicine and Business: Bridging the Gap, e.d. Sheldon Rovin, Aspen,

40 Closing Remarks 1.Whitewater needs to be managed to have happy, healthy, engaged staff. 1.Change is constant, especially in medicine. 1.Mapping stakeholders and maintaining to do and not to do lists are example techniques to create stability and provide direction amidst that change. 40

41 References Gregory P. Shea, “Leading Change” in Medicine and Business: Bridging the Gap, e.d. Sheldon Rovin, Aspen, Association of American Medical Colleges, Group on Information Resources - 41

42 Image attributions for New Models of Clinical Care on slide 30 All images from TheNounProject.com ●Nurse - CC BY Scott Lewis from the Noun ProjectNurse ●Doctor - Public domainDoctor ●Person - CC BY Alex Berkowitz from the Noun ProjectPerson ●Brain - Public domainBrain ●Pulse CC BY TNSPulse ●Coordinate Patient Care - Public domainCoordinate Patient Care ●Mhealth - CC BY Edward BoatmanMhealth ●iPhone - Public domainiPhone ●Radiography - CC BY Wojciech ZasinaRadiography ●Cardiograph - CC BY Wojciech ZasinaCardiograph ●Surgery - Public domainSurgery ●Blood Glucose Meter - CC BY Danilo Casagrande de AlmeidaBlood Glucose Meter ●Laptop - CC BY Edward BoatmanLaptop 42


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