February 5, 2010

Balser outlines fresh look at VUMC’s pillars

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Jeff Balser, M.D., Ph.D., talks with faculty members of the Schools of Medicine and Nursing at last week’s meeting. (photo by Mary Donaldson)

Balser outlines fresh look at VUMC’s pillars

In his address last week to faculty of Vanderbilt University Schools of Medicine and Nursing, Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of the School of Medicine, suggested updates and modifications to the narrative statements for the five pillars of activity that more sharply define the Medical Center's path for the coming years.

The specific descriptions of each pillar narrative are still under discussion, but the ideas frame the push to enhance VUMC's standing and recognition among the top academic medical centers in the nation.

“We have reached many of the goals listed under the old pillar statements, so the language needs updating to better reflect where we are headed in the future,” Balser said.

Before a Light Hall audience, Balser discussed each of the pillars.


People Pillar

Balser suggested changing the “people” narrative from “Vanderbilt is a great place to work and is the employer of choice in Middle Tennessee” to “We nurture a distinctively caring and professional atmosphere, as we continuously invest in the individual and collective aspirations of our people.”

He mentioned many departmental leadership changes that have taken place in the last year, and listed numerous accomplishments of medical and nursing faculty. One area he highlighted as an opportunity for improvement is in faculty diversity.

“We have accomplished a great deal in terms of diversity among our students, but that is not sustainable unless we accomplish the same with our faculty,” Balser said.

Balser said he has asked each department head to develop a written recruitment plan and to make sure that underrepresented minority candidates are within applicant pools.


Service Pillar

Balser said the service pillar should not only recognize the Medical Center's historic and visible commitment to its atmosphere and culture, but should also embrace the two populations served by the Medical Center — its patients and its students. He suggested that the old wording, “We will continuously improve how we serve others,” be broadened to “Service to others and collegiality are central characteristics of our culture and define how we approach our patients, our students and the local and worldwide community.”

In regard to patient service, efforts to respond to Balser's challenge at last fall's State of the Medical Center Address to see new patients in all outpatient clinics within 15 days, is progressing. Efforts to re-design patient flow in select clinics have resulted in a 37 percent increase in open appointment slots, Balser reported, without increasing the number of caregivers.

Balser also said a University-wide dedication to graduate student education, announced by Chancellor Nicholas S. Zeppos in a letter to all faculty last week, will mean increasing the support for recruiting outstanding foreign graduate students who are not eligible for National Institutes of Health grants.

“Graduate students, and their mentors, need funding to support early-stage discovery, as risk-taking and early failure are a natural and healthy part of the learning process. We plan to identify funds that will encourage these creative efforts, as the mentor's NIH funds are not always available for this purpose.”


Quality Pillar

Balser touched on a wide range of quality issues. He suggested that the existing quality pillar narrative, “We will provide safe and high quality preventative, acute and chronic patient care,” was too narrow, and proposed instead, “We relentlessly pursue and measure ourselves against the highest quality performance in all areas, from patient care to scholarship.”

One area of focus was a visible effort, across all departments, to increase the number of Vanderbilt discoveries recognized in top-ranked journals.

Balser indicated that every department chair and center director is working to develop their own “citation impact” plan, tailored to their own discipline, which encourages and supports faculty to publish selectively in journals with high impact and visibility.

“Our citation impact is 17th among the top 20 U.S. News academic medical centers. The discoveries our faculty are making deserve greater recognition, and to make progress we need to assure increased citation of our publications,” Balser said.


Finance Pillar

Balser indicated that the “Finance/Growth” narrative, “We will be the leading provider of health care services in the region,” also required some updating.

He proposed a narrative that better captures VUMC's role as a national leader — “We will manage our resources in a manner that supports our long-term obligation to society: to achieve local, national and worldwide impact in improving health.”

Balser said the Medical Center has enjoyed good financial performance over the first half of the 2009-2010 academic year, but that expectations must be tempered with uncertainly around expected cuts in 2010-2011 to Tennessee's TennCare program, as well as the end of stimulus funding from the NIH.

Fundraising efforts have become increasingly important, Balser said. He mentioned the leadership of Susie Stalcup, Vanderbilt's new vice chancellor of Development and Alumni Relations, as one of the important keys to making progress.

He also praised the physician-led Partners in Health campaign for raising $1.6 million and garnering 43 percent faculty participation in the giving program.

The success of stimulus grant applications of more than $90 million has been helpful as well. “We are eighth in the nation for university stimulus funding,” Balser said. “I'm proud and grateful for the very hard work our faculty have put into submitting more than 500 stimulus grant proposals.”


Innovation Pillar

Balser spoke about ways to direct Vanderbilt innovation into formulas that can serve as national models.

“We are all here because of our instincts toward innovation, but for this purpose, I am using the word in a distinctive manner.

“The Innovation Pillar is meant to focus on the aggregation of many creative discoveries into a practical application that moves science, education or clinical care forward in a remarkable way.

“We hope to weave our discoveries together and achieve impact that is greater than the sum of the individual parts,” Balser said.

He mentioned last year's remarkable results demonstrating vastly reduced rates of ventilator acquired pneumonia at Vanderbilt.

“This leveraged our own published discoveries in clinical research, our initiatives in creating evidence-based order sets, and our advances in informatics that present “system of care” information to multiple caregivers at once.”

Similar models will be rolled out soon to pilot new care models in outpatient settings, beginning with the treatment of hypertension, then moving to diabetes and congestive heart failure.

Balser concluded with comments about Vanderbilt's leadership in translating basic science, through informatics, genomics and proteomics, to clinical care, and outlined ambitious goals to one day bring genome-based preventive health information to patients.

“We are leveraging our science and our commitment to teamwork to achieve exponential improvements.

“I do believe our approach will ultimately be adopted as the model for innovation in biomedical science nationwide, and will in many ways define where health care reform is going,” Balser said.