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MISSIONS AND MANDATES

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THE MISSIONS AND MANDATES OF THE ACADEMIC MEDICAL CENTER ... SITE BED TOWER. ACADEMIC ... BREAKFASTS WITH THE EVPHA. WHATEVER IT TAKES ... – PowerPoint PPT presentation

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Title: MISSIONS AND MANDATES


1
  • MISSIONS AND MANDATES
  • CHALLENGES
  • PLANNING FOR THE FUTURE

2
TODAY WE WILL DISCUSS
  • THE MISSIONS AND MANDATES OF THE ACADEMIC MEDICAL
    CENTER
  • CHALLENGES THAT ACADEMIC MEDICAL CENTERS MUST
    ADDRESS
  • THE ROLE OF UK HEALTHCARE IN THE KENTUCKY MEDICAL
    MARKETPLACE
  • THE PLANNING PROCESSES THAT HAVE BEEN INITIATED
    AT THE UNIVERSITY OF KENTUCKY TO ADDRESS OUR
    SPECIFIC ISSUES.
  • THEN, HOPEFULLY WE CAN DIALOGUE

3
MISSIONS OF AND MANDATES TO ACADEMIC MEDICAL
CENTERS
  • EDUCATION
  • CLINICAL SERVICE
  • RESEARCH

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A MEDICAL SCHOOL IS BORN
  • MEDICINE IS A STUDY OF HUMAN GROWTH,
    DEVELOPMENT, AND ILLNESS THROUGHOUT THE LIFE
    SPAN. IT INCLUDES THE BIOLOGICAL, MENTAL,
    EMOTIONAL, SOCIAL, AND CULTURAL FACTORS THAT BEAR
    UPON NORMAL HUMAN DEVELOPMENT AND ITS
    ABERRATIONS. IT IMPLIES AN INTEGRATIVE APPROACH
    AND DENIES THE NECESSITY FOR ARTIFICIAL
    SEPARATION BETWEEN THE TRADITIONAL BASIC AND
    CLINICAL SCIENCES OR BETWEEN UNDERGRADUATE,
    PROFESSIONAL AND POSTGRADUATE EDUCATION. THUS,
    MEDICINE IS AS CONCERNED WITH HEALTH AND ITS
    PRESERVATION AS WITH DISEASE AND ITS DIAGNOSIS
    AND TREATMENT. William R. Willard, M.D.

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EDUCATION
  • THE UNIVERSITY OF KENTUCKY MUST TRAIN THE
    SPECIALISTS AND SUB-SPECIALISTS SERVING KENTUCKY
    SINCE IT SETS THE STANDARD FOR CARE IN SPECIALTY
    MEDICINE IN KENTUCKY.

8
CLINICAL SERVICE RESPONSIBILITIES
  • PRIMARY CARE
  • SECONDARY AND TERTIARY CARE
  • QUATERNARY AND SPECIAL SERVICES

9
PRIMARY CARE
  • WE MUST DO ENOUGH PRIMARY CARE TO FULFILL OUR
    TEACHING MISSION
  • WE MUST ADEQUATELY SERVE SPECIAL POPULATIONS
    THE UNIVERSITY FAMILY
  • WE MUST DO OUR FAIR SHARE IN SERVING THE
    UNDERSERVED
  • WE MUST STRESS THE ROLE OF PATIENT ADVOCACY AND
    THE VALUE AND REWARDS OF LONGITUDINAL CARE
  • WE MUST EMPHASIZE EFFICIENCY AND SERVICE

10
SECONDARY AND TERTIARY CARE
  • MUST DO ENOUGH OF THIS TYPE OF CARE TO MAINTAIN
    ROBUST AND VIABLE CLINICAL PROGRAMS AND
    OUTSTANDING TRAINING PROGRAMS
  • MUST SET THE STANDARD FOR APPROPRIATENESS,
    EFFICIENCY, QUALITY AND SAFETY

11
QUATERNARY AND SPECIAL PROGRAMS
  • PEDIATRIC SUB-SPECIALTIES
  • LEVEL 1 TRAUMA CENTER
  • TRANSPLANTATION
  • INNOVATIVE SURGERY I.E. ROBOTICS
  • ADVANCED NEUROSURGERY
  • INNOVATIVE APPROACHES TO CANCER I.E. BONE
    MARROW TRANSPLANTATION
  • ETC, ETC, ETC

12
MY PERSONAL CLINICAL SERVICE GOAL
  • ANY INDIVIDUAL RICH OR POOR CAN FEEL
    COMFORTABLE THAT SHOULD THEY BE DIAGNOSED WITH AN
    ILLNESS NO MATTER HOW COMPLEX THAT THEY CAN
    GET CARE AT UK HEALTHCARE AND NOT WORRY ABOUT
    WHETHER THEY SHOULD GO TO MAYO CLINIC, THE
    CLEVELAND CLINIC, OR BOSTON.

13
  • WE MUST REALIZE THAT OUR TRUE COMPETITORS ARE
    OTHER SUCCESSFUL ACADEMIC MEDICAL CENTERS, SUCH
    AS THE UNIVERSITY OF CINCINNATI, OHIO STATE,
    INDIANA UNIVERSITY, VANDERBILT, AND WASHINGTON
    UNIVERSITY IN ST. LOUIS, AND NOT LOCAL COMMUNITY
    PROVIDERS.

14
RESEARCH
  • GENERATION OF NEW KNOWLEDGE - A FUNDAMENTAL
    VALUE OF UNIVERSITIES

15
  • MY PERSPECTIVE
  • THE BEST WAY TO ASSURE THAT WE OFFER STATE OF
    THE ART CARE IS BY PARTICIPATING IN IMPROVING
    THE STANDARD OF CARE. THAT MEANS RESEARCH
    BASIC TRANSLATIONAL CLINICAL AND HEALTH
    SERVICES.

16
UNILATERAL INTRAPUTAMENTAL GDNF IMPROVES
BILATERAL MOTOR FUNCTIONS IN PATIENTS WITH
PARKINSONS DISEASE
John T. Slevin2,5,6,, MD, Greg A Gerhardt,
1,2,5,, Ph.D., Charles D. Smith 2,5,, MD, Don
Gash 1,5, Ph.D., Richard Kryscio 3,5, Ph.D., and
A. Byron Young 4,5, MD
  • Departments of Anatomy and Neurobiology1,
    Neurology2, Statistics and Public Health3 and
    Neurology4and the Morris K. Udall Parkinsons
    Disease Research Center of Excellence5,
    University of Kentucky, Chandler Medical Center,
    800 Rose Street, Lexington, Kentucky, 40536 USA
    Neurology Service, Department of Veterans Affairs
    Medical Center, Lexington, KY6

17
CHALLENGES FACING ACADEMIC MEDICAL CENTERS
  • ECONOMIC
  • EMPHASIS ON QUALITY
  • EMPHASIS ON SAFETY

18
ECONOMIC PRESSURES
  • HEALTH CARE WILL CHANGE BECAUSE OF ECONOMIC AND
    SOCIAL REASONS
  • I DO NOT KNOW HOW IT WILL CHANGE.
  • I DO NOT KNOW WHEN IT WILL CHANGE.
  • I DO KNOW THAT IT WILL CHANGE.

19
ECONOMIC PRESSURE FOR CHANGE
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22
SOCIAL PRESSURE
Millions
23
SOCIAL PRESSURE
24
  • PUNDITS SAY THAT THE ANSWER IS

CONSUMERISM
25
  • SHIFT OF RESPONSIBILITY FOR COST CONTAINMENT

  • CONSUMERS
    THROUGH ECONOMICS
    INCENTIVES

  • AND DISCENTIVES

  • PROVIDERS THROUGH MANAGED
  • CARE APPROACHES
  • INSURANCE COMPANIES
  • THROUGH BENEFITS DESIGN

26
  • PREMISE IS THAT A WELL INFORMED CONSUMER
    (PATIENT) ARMED WITH DATA AND INCENTED BY
    FINANCIAL CONSIDERATIONS (LARGE CO-PAYS AND
    DEDUCTIBLES) WILL MAKE WISE, EFFICIENT CHOICES.

27
MY CONCERNS WITH CONSUMERISM
  • MAKE CRITICAL MEDICAL DECISIONS UNDER FINANCIAL
    DURESS
  • INFORMATION INCOMPLETE AND DIFFICULT TO INTERPRET
  • COSTS MAY INTERFERE WITH GOOD FOLLOW-UP AND
    PREVENTIVE CARE
  • FRAGMENTED CARE BAD FOR QUALITY CARE

28
IF CONSUMERISM IS NOT THE ANSWER SOMETHING ELSE
WILL BE TRIED
  • EVENTUALLY ECONOMIC REALITY WINS OUT

29
THEREFORE WE MUST ALWAYS MAINTAIN A FOCUS ON
COSTS
  • STANDARDIZE SUPPLIES, MEDICINES
  • DECREASE VARIANCE IN CARE

30
THE LARGEST OPPORTUNITY FOR COST CONTAINMENT AT
MOST ACADEMIC HEALTH CENTERS IS IN MEDICAL
MANAGEMENT.
  • TEAM SPORT

31
  • STAYING COST EFFECTIVE
  • WILL KEEP US IN THE GAME
  • TO WIN WE MUST LEAD IN QUALITY, AND WE MUST BE
    ABLE TO DEMONSTRATE OUR QUALITY QUANTITATIVELY

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35
  • WE WILL HAVE A CENTRAL FOCUS ON IMPROVING AND
    DOCUMENTING OUR QUALITY AS QUANTITATIVELY AS
    POSSIBLE.
  • TEAM SPORT

36
TO ERR IS HUMANBuilding a Safer Health System
  • PREVENTABLE ADVERSE EVENTS ARE A LEADING CAUSE
    OF DEATH IN THE UNITED STATES. WHEN EXTRAPOLATED
    TO THE OVER 33.6 MILLION ADMISSIONS TO U.S.
    HOSPITALS IN 1997, THE RESULTS OF THESE TWO
    STUDIES IMPLY THAT AT LEAST 44,000 AND PERHAPS AS
    MANY AS 98,000 AMERICANS DIE IN HOSPITALS EACH
    YEAR AS A RESULT MEDICAL ERRORS.

37
  • SAFETY, LIKE QUALITY AND COST CONTROL IS A
  • TEAM SPORT

38
  • CAN YOU EMPHASIZE COST CONTROL AND QUALITY AT
    THE SAME TIME, OR ARE THEY ANTITHETICAL GOALS?

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42
IMPROVEMENTS IN COSTS AND QUALITY
43
PROCESS IMPROVEMENT PIGGY BACK TECHNIQUE
44
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45
Need a system that --
  • INTEGRATES CARE
  • EMPHASIZES MAINTENANCE AND PREVENTION
  • DEVELOPS APPROACHES THAT UTILIZE EVIDENCE-BASED
    MEDICINE AND MEASURES SERVICE AND QUALITY
  • DEFINES WHAT IS OR IS NOT COVERED, AND IS
    COMPREHENSIVE IN COVERAGE FOR MAJOR ILLNESSES
    (STANDARDIZED BENEFIT PACKAGES)

46
  • FUNDAMENTALLY, THE CHALLENGE FOR US IS TO MOVE
    BEYOND INDIVIDUALITY OR A RELIANCE ON DEPARTMENTS
    TO AN UNDERSTANDING OF ENTERPRISE AND
    INTERDISCIPLINARY CARE.

47
A CASE FOR CHANGE
48
CAUSES OF DETERIORATION IN CLINICAL ACTIVITY
  • NO COMMON VISION BETWEEN DIFFERENT ELEMENTS OF
    THE CLINICAL ENTERPRISE
  • NO AGREEMENT ON GOALS
  • INADEQUATE COMMUNICATION
  • STALEMATED DECISION MAKING
  • UNDER INVESTMENT IN FACILITIES AND PROGRAMS
    AGING OF PHYSICAL PLANT
  • INABILITY TO RECRUIT
  • LOSS OF KEY FACULTY

49
THEREFORE IT BECAME CRITICAL TO
  • DEFINE A VISION
  • ESTABLISH GOALS FOR CLINICAL, ACADEMIC AND
    FINANCIAL PERFORMANCE
  • ESTABLISH AND CLARIFY A DECISION-MAKING PROCESS
  • COMMUNICATE EFFECTIVELY
  • RETAIN CURRENT FACULTY AND RECRUIT NEW
    INDIVIDUALS
  • DEFINE PROGRAMMATIC AND FACILITIES NEEDS AND
    COMMIT TO THEM.
  • ESTABLISH FISCAL ACCOUNTABILITY RESPONSIBILITIES
    AND STRICT DISCIPLINE

50
  • AS WE AGREE ON A VISION
  • FOR AND
  • PLAN TO IMPLEMENT WE
  • MUST ENGAGE AND EMPOWER
  • THE FACULTY.

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52
STRATEGY
  • GEOGRAPHIC APPROACH
  • PROGRAMMATIC APPROACH
  • AGE SPECIFIC

53
MARKET DEFINITION
54
COMPETITIVE RELATIONSHIPS
55
PROGRAMMATIC
  • CARDIOVASCULAR
  • CANCER
  • NEUROSCIENCE
  • PEDIATRICS
  • ETC.
  • MUST PLAN IN DETAIL

56
AGE SPECIFIC
  • PEDIATRICS
  • MEDICARE

57
FACILITIES
  • WE MUST.
  • UNDERSTAND THAT WE MUST DEVELOP A HEALTH CARE
    DELIVERY SYSTEM NOT MERELY REPLACE SOME ELEMENTS
    OF THE HOSPITAL
  • DEVELOP A LONG-TERM VISION FOR INPATIENT AND
    OUTPATIENT SPACE NEEDS.
  • UNDERSTAND NECESSARY IMMEDIATE FIXES
  • SITE BED TOWER

58
ACADEMIC
  • IMMEDIATE, INTERMEDIATE AND LONG-TERM NEEDS FOR
    SPACE TO SUPPORT RESEARCH AND TEACHING
  • ALL THE COLLEGES OF THE ACADEMIC HEALTH CENTER
  • MUST BE INCLUDED IN PLANNING PROCESS

59
FINANCIAL PLAN
60
COMMITTEES
61
COMMUNICATION
  • WEBPAGE
  • EMAIL NEWSLETTERS
  • VISITS TO DEPARTMENTS
  • BREAKFASTS WITH THE EVPHA
  • WHATEVER IT TAKES

62
  • OUR SUCCESS IS DEPENDENT ON OUR ABILITY TO
    RECRUIT AND RETAIN OUTSTANDING FACULTY AND
    STUDENTS AND HAVE THEM WORK TOGETHER IN A
    COHERENT CO-ORDINATED FASHION TO SERVE ALL THE
    MANDATES OF AN ACADEMIC MEDICAL CENTER

63
  • WE NEED TO
  • SURVIVE TOGETHER IN ORDER TO THRIVE TOGETHER

64
UK HEALTHCARE MUST SERVE ALL KENTUCKIANS BETTER
AND BETTER
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