February 20, 2004

Jacobson revisits purpose, provides map for the future

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Vice Chancellor Dr. Harry R. Jacobson

Jacobson revisits purpose, provides map for the future

Like a graduate school applicant writing a mission statement, Vanderbilt University Medical Center explored where it fits in the world — what its role is and what makes it unique — and outlined what this meant for the future.

“We are an academic medical center,” Vice Chancellor Dr. Harry R. Jacobson told staff and faculty during the seventh annual State of the Medical Center address on Thursday in Langford Auditorium. “That means that we do three things. We teach the next generation of providers. We treat patients with the lead edge of medicine — with the most advanced care they can get. And it means we carry out research that is vital for advancing medicine.”

Jacobson presented the progress of the past year and the Medical Center’s future goals with a simple reminder, that “being among the best in the world presents us with incredible opportunities,” Jacobson said, “but it also comes with a load of responsibility.”

According to Jacobson, these responsibilities begin with the ability to innovate —to conduct cutting edge research and apply it to clinical practice; and without this devotion to innovation and discovery, Vanderbilt cannot be a great hospital or a world-class institution.

Jacobson welcomed the newest member of the Vanderbilt University Medical Center family, the Monroe Carell Jr. Children’s Hospital at Vanderbilt. He outlined why the freestanding hospital for children was built: to improve services to children and families, to expand adult services to meet demand, to generate philanthropy and to create a competitive advantage as the only full-service provider.

But children’s services are not the only ones getting a face lift.

“Over the next several years we will completely rebuild the University Hospital to make it easier for you and our patients,” Jacobson said. “We plan to commit just about $170 million in the first three phases and almost $300 million overall.” (For more information on the plans to rebuild, see “Rebuilding and expansion of Vanderbilt University Hospital highlighted” below).

Improving the environment in which care is given is important, but ultimately, patient care is first and foremost. Measuring and improving patient care quality are among this year’s top initiatives.

“Along with measuring volumes, revenue, expenses and patient satisfaction, we should measure clinical quality — outcomes, errors, accuracy and efficiency,” Jacobson said.

The Medical Center also seriously considers the needs of employees, making worklife improvement a continuous goal. Last year’s achievements include adoption benefits, back-up child care service, short term disability insurance, training to help managers use worklife benefits and the “Go for the Gold” program that gives employees who have completed a health-risk assessment $10 a month credit in their paycheck. New initiatives, such as the concierge service and a reward and recognition plan are outlined below in “Staff recognition and rewards program announced.”

Jacobson also discussed the success of Vanderbilt’s academic programs and the impact of publications. Vanderbilt was ranked fifth in clinical medicine and first in pharmacology for the most cited publications. Vanderbilt’s research is among the world’s best, according to Jacobson, and the tremendous growth of research enterprise performance serves as evidence. For example, National Institute of Health grants also have increased by more than 20 percent.

“Our research award growth has outpaced space growth,” Jacobson said. “We’re now at full capacity.” This is the rationale behind MRB IV, a $110 million project to be completed in the summer of 2005.

Vanderbilt has also seen increases in all areas of patient care, including higher hospital admissions, clinical visits, emergency care and surgical volumes. Patient satisfaction has remained high, and Vanderbilt continues to be recognized as one of the top medical centers in the nation.

• U.S. News and World Report named VUMC one of only 17 honor roll hospitals. Vanderbilt was also in the top 50 for nine of the 14 major specialties listed.

• National Research Corporation named Vanderbilt the top preferred hospital in Nashville for the fifth year in a row.

• America’s Top Doctors listed 46 Vanderbilt faculty members among the peer selection of top medical doctors.

• In the Solucient Top 100, Vanderbilt was one of the 16 academic centers to make the list, which is based on clinical quality, profitability and cost.

• U.S. News and World Report also ranked Vanderbilt University fourteenth among the best graduate schools in research.

For all of these accomplishments and the tremendous achievements of the past year, Jacobson thanked staff and faculty.

“Thank you for the work you do, the sacrifices you make, and for your incredible devotion to our purpose here,” he said.

Rebuilding and expansion of Vanderbilt University Hospital highlighted

by Paul Govern

In his annual State of the Medical Center address, Vice Chancellor Dr. Harry R. Jacobson said Vanderbilt University Hospital will be rebuilt on its current site and a third bed tower will be added above the Emergency Department. While building a new hospital from scratch would cost $1 billion or more, expansion and rebuilding on the current site can be achieved for approximately $300 million. Here is additional information on the construction project:

• The first phase of rebuilding includes light renovation of the sixth floor to be completed within the next several weeks, the gutting and rebuilding of the fifth floor to be completed within a year, and expansion and rebuilding of the Emergency Department to be completed within 14 months. With its larger patient care rooms and more unified floor plan, the fifth floor rebuild will introduce the redesign pattern to be followed as other areas of VUH are rebuilt. In phase one, total adult inpatient beds will increase from 469 to 501.

• The second phase of the project, to be completed by 2008, includes adding five floors above the ED and using new unified floor plans to link this new tower and the two existing bed towers. This phase will add 70 intensive care beds and will significantly expand operating room capacity.

• The third phase of the project includes adding floors 7 through 11 to the new tower above the ED, again using floor plans that link all three bed towers.

•The current towers will be expanded and squared off, so that, instead of three connected towers, the new hospital will rise as a single rectangular structure. Instead of the current 56 beds per floor, the expanded hospital will have up to 90 beds per floor. Average patient room size will almost double to 310 square feet. All rooms will be private. The size and number of waiting rooms will increase significantly. Nurses stations will be larger and of a more open design. Staff lounge and break areas will be expanded.

• Instead of the current open floor plans found in adult intensive care units, rebuilt ICUs will have individual patient rooms with glass doors, similar to intensive care rooms at the new Vanderbilt Children’s Hospital.

• Oxford House will ultimately be demolished, allowing creation of a main entrance to the hospital and clinic in the form of a circular drive off 21st Avenue South. The entrance will be flanked by parking garages. A wide, glass-enclosed pedestrian bridge will cross 22nd Avenue to an expanded patient and visitor service area, including a larger Courtyard Café and new main elevator banks. The hospital lobby will move to the second floor, allowing Radiology and Emergency to expand into the current lobby space. The new lobby will include a news stand, expanded gift shop, coffee shop and a pharmacy.

• The VUH rebuilding and expansion plan is part of the Vanderbilt University land use development plan. The plan for VUH is a collaboration among Space and Facilities Planning, leaders of clinical departments, Donald Blair Architects (New York), architects Earl Swensson Associates (Nashville), and builders Centex Rogers, Inc. (Nashville).

Staff recognition and rewards program announced

by Paul Govern

Here are some answers about the new program of staff recognition and rewards that Dr. Jacobson introduced in the State of the Medical Center address. According to Susan Mezger, director of compensation with Human Resources, the program design is not yet complete and various aspects may change or be added between now and the start of the program.

What is it?

GEMS, or Gaining Employee Motivation toward Success, is a multi-faceted, multi-tiered program of employee recognition and rewards aimed at motivating staff and aligning individual success with the potential success of the work group and the business strategy of the larger organization. Programs similar to GEMS have been used with success by such organizations as Ritz-Carlton, Federal Express and Bank of America.

What are the rewards?

The complete range of incentives is yet to be determined, but at a minimum the incentives will include such things as merchandise, tickets to movies, performances and events, and bonus days off with pay. It is likely that the program will also include “success” sharing, with employees being paid extra money based on positive annual VUMC financial results. The program of incentives will build over time.

How do you earn rewards?

Some incentives will be designed to reward individual achievements or behavior that reflects the values and goals of the work group. Other incentives will be based on meeting measurable quality goals and financial goals of the work group and the larger organization.

When does it start?

GEMS will start later this year. Managers and supervisors will be trained this summer to carry out GEMS.

Who is eligible?

Vanderbilt Medical Center staff. Departments have always had the flexibility to set up programs of reward and recognition for faculty, and that flexibility will now be expanded to include staff.

Where does GEMS fit with other VUMC incentive programs?

Most other centrally sponsored programs aimed at motivating VUMC staff are annual, such as the pay for performance salary increases, the Commodore Award and the Employee Celebration. GEMS has both immediate and annual components and is closely tied to the achievement of work goals. GEMS provides resources to allow managers and supervisors to design creative programs to motivate their staff, and to share the Medical Center’s overall financial success with those who make it possible.