February 12, 2015

Rounds: A message from the Vice Chancellor for health Affairs

As we begin 2015, many at VUMC would say they have experienced more change in the last year than at any time in their careers.

As we begin 2015, many at VUMC would say they have experienced more change in the last year than at any time in their careers.

Jeff Balser, M.D., Ph.D.

Yes, we are in a very strong position, battle-tested and ready to meet the challenges ahead. But it still feels to nearly everyone as if the ground has shifted. Not surprising, considering the events of 2014:

• Health care experienced the largest reduction in revenue growth in nearly a half century, falling well below the continued growth in health care expense (drugs, supplies) and causing all providers and systems to find ways to do more with less. And with the President’s budget proposal out last week, it is clear that reductions in payments to those providing care will continue unabated.

• Our reliance on technology and information systems, from computer terminals to handheld devices, to perform our work seems to grow exponentially. With the implementation of Vanderbilt Outpatient Order Entry (VOOM) this past year, we have created a unique opportunity to more consistently deliver state-of-the-art and cost-effective care, while also to satisfy the ever-expanding documentation requirements thrust upon our industry.

• Consolidation of health care, including hospitals and physician groups, swept across the U.S., with mergers and acquisitions up 12.5 percent in the most recent quarter, year over year. In this rapidly evolving marketplace, the expansion of our Vanderbilt Health Affiliated Network (VHAN) has been remarkable, approaching 50 hospitals and more than 3,200 clinicians in four states.

Today, we find ourselves not only the most trusted resource for health care in Middle Tennessee, but in collaboration with partners, sharing this responsibility across a growing region of the country.

In the midst of these epic changes, we announced a fundamental change in the financial and legal structure of the Medical Center, forming a nonprofit entity that will remain seamlessly connected to Vanderbilt University in all of our academic endeavors, but will allow us to be more nimble and responsive to future changes in the economics of health care delivery.

It will be increasingly important for VUMC to strengthen collaborations with health systems and clinicians across the region, while investing even more in myriad programs and facilities here on our main campus.

This Medical Center has existed for 141 years, since the School of Medicine was incorporated into Vanderbilt University in 1874. I believe the accelerating cascade of change over the past few years, and our resilience through that change, has positioned VUMC in an extraordinary way, such that we now find ourselves at an inflection point in that long and distinguished history. So in “forging ahead,” as we are prone to do, the manner in which we deploy our energy and know-how at this very special time will define VUMC for years to come.

Said another way — this is the ideal time to rearticulate our priorities. While no one feels we should reverse course, or even substantially change our stripes, what we heard consistently through the last employee survey and again in our recent series of Town Hall meetings was that our strategy not only needed “freshening,” but also needed to be better understood.

For some time we have had the Credo, a “values” statement that is foundational and captures how VUMC’s people interact with patients, and with one another. And we acknowledge that VUMC, as an academic medical center now and forever, will be committed to the triumvirate and highly interrelated endeavors of patient care, discovery and education.

What was missing was a statement of how we will leverage our values, as well as our considerable energies, talents and resources to deliver what we all strive for at VUMC — improved health.

We began this process in the fall of 2014, pledging to involve as many people as possible in the creation of a new mission and strategy statement. The goal was to build a narrative — one that captured our present state, or “what” we are today; a new statement of mission articulating our highest aspirations, essentially our “why;” and finally, language that clearly defines the “how,” stating in more precise terms than ever before, the action domains where VUMC will concentrate energy in the future.

The journey to create this statement was one of the most collaborative efforts we’ve ever undertaken. In numerous group sessions, more than 600 faculty and staff gathered to express their thoughts about what should (and should not!) be included.

The dialogue was passionate and rewarding to witness. Hundreds of ideas were collected, coalesced, refined, shared and edited by people from all across the Medical Center.

Along the way I lost count of the number of drafts and revisions. But the process was as important as the final result, as we worked together to produce a statement that is far more than general platitudes anyone could accept (Mom, Pop, and Apple Pie), and yet in its specificity still resonates in some way with each of us, despite our enormous size and diversity in roles and activities.

In future Rounds columns I look forward to spending more time focusing on this statement. In the interim, I hope you take the opportunity to familiarize yourself with it as we build a common dialogue for communicating about VUMC with one another, our patients, and all whom we serve.

And mostly, I hope you will agree this Statement of Purpose is distinctly “ours.”

Jeff Balser, M.D., Ph.D.
Vice Chancellor for Health Affairs
Dean, School of Medicine


Vanderbilt University Medical Center (VUMC) is one of the nation’s longest serving and most prestigious academic medical centers. Through its historic bond with Vanderbilt University, VUMC cultivates distinguished research and educational programs to advance a clinical enterprise that provides compassionate and personalized care and support for millions of patients and family members each year. World-leading academic departments and comprehensive centers of excellence pursue scientific discoveries and transformational educational and clinical advances across the entire spectrum of health and disease.

VUMC’s leadership in the delivery of academically based health care is recognized by the nation’s most trusted advisory bodies and reporting organizations including the National Academies, the Magnet Recognition Program, U.S. News & World Report, the Leapfrog Group, Truven Health Analytics and others. Our Schools of Medicine and Nursing and residency training programs are consistently among the most selective, and are valued for their diversity, innovation and capacity to transform the educational experience, while the breadth of our scientific discovery is propelled by a research enterprise that is consistently ranked among the nation’s top 10.

Our Mission

Through the exceptional capabilities and caring spirit of its people, VUMC leads in the delivery of exemplary health care, improving the lives of individuals and communities regionally, nationally and internationally. We combine transformative educational programs, compelling scientific discoveries, and distinctive personalized care to achieve this goal.

Our Strategic Commitments

We will sustain a collaborative community fully committed to diversity and inclusion and to supporting one another, our patients and their families.

We will deliver the highest quality and safest health care in a seamless manner that always places our patients and their families first.

We will personalize the care of every patient, fully leveraging our knowledge, values and strength in science and technology.

We will invest continuously in the capabilities of our people, helping each of us realize our goals and potential.

We will advance the knowledge of human health through a commitment to research, a passion for learning, and an unyielding pursuit of better ways to deliver care.

We will improve the effectiveness and efficiency of everything we do to achieve greater value for those we serve.

We will provide prompt and continuous access for our patients and colleagues throughout VUMC and the Vanderbilt Health Affiliated Network.