“There has never been a time when we need leaders more than today.” With these words, Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of the School of Medicine, began his quarterly conversation with colleagues at Wednesday’s Clinical Enterprise Leadership Assembly in Langford Auditorium.

“The downsizing effort is over.” With those words, Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of the School of Medicine, announced Wednesday that workforce reduction efforts announced in September at Vanderbilt University Medical Center are completed.

Vanderbilt University Medical Center staff and faculty are preparing for a new health care landscape, one shaped by a lowered payment regime, greater outside scrutiny of health care quality, new rewards and penalties for hospital and provider safety and quality, and the transfer of financial risk for health outcomes from payers to newly affiliated hospitals and providers.

Vanderbilt faculty, staff and students are invited to register online to attend the 2013 State of the Adult Clinical Enterprise address by David Posch, CEO of Vanderbilt University Hospital and Clinics and executive director of Vanderbilt Medical Group, to be delivered Wednesday, Nov. 6 at two locations — at 7 a.m. in Williamson County at the Franklin Marriott, 700 Cool Springs Blvd., and again at 4 p.m. on the Vanderbilt University Medical Center campus at 208 Light Hall.

Evolve to Excel (E2E), a comprehensive initiative designed to strengthen operational practices throughout Vanderbilt University Medical Center to ensure long-term success of the organization, is moving ahead.

The nation’s health care challenges are immense, and Vanderbilt University Medical Center is rising to meet them — with an emphasis on integration, collaboration, and by improving efficiency, quality and service to its patients.

At a midyear Clinical Enterprise Town Hall meeting, those attending were updated on Vanderbilt University Medical Center’s year-to-date performance and the ongoing impact of separate pieces of federal legislation — the Patient Protection and Affordable Care Act of 2010 and the Budget Control Act of 2011, which has come to be known as sequestration.