September 20, 2018

Changes to adult health system better align patient services

Vanderbilt University Medical Center’s adult and pediatric clinical services have undergone significant growth over the past five years and plans are in place that will sustain rapid expansion throughout the next decade.

Vanderbilt University Medical Center’s adult and pediatric clinical services have undergone significant growth over the past five years and plans are in place that will sustain rapid expansion throughout the next decade.

Examples of new growth currently underway for the adult clinical enterprise are the conversion of Medical Center East’s North Tower into inpatient units, and in the ambulatory domain, the ongoing expansion of walk-in and specialty clinics throughout the region.

Through expansion, the adult health system’s scale and complexity has increased significantly, and will continue to do so as new locations and services are added. For comparison, the adult and pediatric clinical systems are disproportionate in size, with Vanderbilt University Adult Hospital being approximately three times the size of Monroe Carell Jr. Children’s Hospital at Vanderbilt, and adult ambulatory clinics being about five times the size of pediatric clinics.

To more effectively manage this growth, and to better align the Medical Center’s services to address increasing consumerism in health care, a new leadership structure has been created for the adult clinical enterprise that has separate leadership teams for inpatient and ambulatory services.

“After successfully completing major organizational objectives over the past two years, including the separation from Vanderbilt University, implementation of EPIC and achieving Joint Commission designation, we have the opportunity now to address this important initiative to realign the structure of the adult clinical enterprise to better position ourselves for the future,” said C. Wright Pinson, MBA, MD, Deputy Chief Executive Officer and Chief Health System Officer for VUMC.

“Our patients are why we are here. Delivering consistent world-class, patient-focused service has never been more important. People are asking us to meet them where they are, to care for them where and when they need us. To accomplish this we need to accelerate access and rebalance our adult divisions to adopt more standardized practices. Doing so will allow us to have better coordination and increased cohesiveness among our inpatient units, ambulatory clinics, both on and off campus, and with our affiliates.”

In addition to these benefits, Pinson said that reorganizing the adult enterprise will create additional opportunities including improved financial performance through increased productivity and greater expense control, better employee engagement and increased satisfaction for clinicians working on campus and elsewhere.

On Sept. 21, Tom Nantais, MBA, chief operating officer for Henry Ford Medical Group, will join VUMC as the executive vice president for Adult Ambulatory Operations. In this role Nantais will report to Pinson and will oversee the Medical Center’s adult ambulatory enterprise residing inside Davidson County. (See related article on this page.)

Through this transition, Mitch Edgeworth, MBA, remains as Chief Executive Officer for Vanderbilt University Adult Hospital (VUAH). Under the new structure the leadership of VUAH will focus on inpatient surgical volumes, bed management and improving expense control. The Adult Hospital’s leadership team and reporting structure will remain the same. Robin Steaban, MSN, RN, will serve as Chief Nursing Officer and Scott McCarver, MHA, as Chief Operating Officer.

Warren Sandberg, MD, PhD, professor and chair of the Department of Anesthesiology, will continue to serve as the Chief of Staff for Perioperative and Critical Care Services. The responsibilities of Shubhada Jagasia, MD, MMHC, Chief of Staff for Vanderbilt University Adult Hospital and Clinics, will be realigned to provide more oversight for ambulatory operations inside Davidson County. In addition to his other responsibilities, Paul Sternberg Jr., MD, will serve as Chief Medical Officer for Ambulatory Services for areas outside Davidson County. He will oversee medical directors serving outside Davidson County and will also be responsible for eStar interface, insurance interface, patient experience, patient satisfaction, quality and VMG support for outlying clinics.

Currently, VUMC’s ambulatory clinics include 18 locations offering 91 different specialties inside Davidson County. Outside Davidson County, clinics are located across 22 counties in Tennessee. There are three clinics in Kentucky and two in Alabama.

With the adult clinics being divided into two groupings—inside Davidson County and regional—Nantais will lead efforts to optimize scale, increase access, grow the Medical Center’s footprint in primary care services and increase specialty services.

Regardless of location, clinic leaders will be responsible for operational performance, budgets, aligning performance metrics to institutional goals, market growth, recruiting and staffing, and maintaining corporate standards of excellence.

“Our organization is filled with outstanding people who deserve an environment where they can perform their best work. This change will allow us to better focus on personalized patient care and provide a more consistent patient experience,” Pinson said. “The outcome of these efforts will be an even better place for our employees to work, for physicians to practice medicine and our patients to receive care.”