December 8, 2006

Leadership development focus of elevate meet

Featured Image

Leadership development focus of elevate meet

VUMC’s new chief learning officer, Peter Giammalvo, Ph.D., speaks at the recent Leadership Development Institute.
Photo by Susan Urmy

VUMC’s new chief learning officer, Peter Giammalvo, Ph.D., speaks at the recent Leadership Development Institute.
Photo by Susan Urmy

Vanderbilt University Medical Center's program growth, organizational performance and operational challenges were highlighted at the most recent elevate Leadership Development Institute.

About 800 VUMC managers and faculty leaders attended one of two sessions held Nov. 30 and Dec. 1 at the Embassy Suites Hotel in Cool Springs. Topics included current hospital finances and some basics of leadership development. (All presentations are available on an employee Web site, — see Leadership Development Institute VIII.)

Harry Jacobson, M.D., vice chancellor for Health Affairs, started the day with a recap of recent successes and outside recognition for VUMC, including accelerated growth of the Vanderbilt Cardiovascular Institute, various fund-raising successes for the community and for VUMC, the garnering of Magnet status from the American Nurses Credentialing Center, inclusion in Solucient 100 Top Hospitals and Leapfrog Top Hospitals 2006, outside recognition of various VUMC academic specialties as being among the most influential of their type, and a bumper year for VUMC faculty inductions in the Institute of Medicine of the National Academies.

Vanderbilt continues to dominate the region in consumer preference survey scores, and patient satisfaction scores are generally quite high. If there is opportunity for patient satisfaction improvement, it lies mainly in Vanderbilt's clinics, Jacobson said, where scores for quality of care translate to an 80th percentile ranking nationally, and where scores for patients' likelihood to recommend their provider to friends translates to a 65th percentile ranking.

While these scores are well above the national averages, they fall short of elevate goals. A Vanderbilt physician satisfaction survey conducted last summer also shows room for improvement, Jacobson said. The leadership team is developing plans based on these survey results.

Other strands of Jacobson's presentation included growth in research funding (“Spectacular”), growth of the cardiovascular program (“We're clearly on the road to having one of the top heart programs in the country”), and a look at clinical quality (“We are going to lead the nation in quality”).

Regarding financial results, he said Vanderbilt's disproportionate burden of uncompensated care is “the single biggest problem we have from the standpoint of our economic health.”

In a presentation titled “Understanding the Business We Are Leading,” Director of Finance Warren Beck outlined the key role Vanderbilt plays “for those who need health care and have trouble getting it … those of lower economic status and on Welfare, and also those who are uninsured and underinsured.

“We have one of the most liberal sets of policies. We have to be really, really proud of what we're doing in terms of these programs compared to other hospitals around the country,” Beck said.

TennCare, the state's Medicaid program, is “modeled around how not to pay hospitals, and it's unfortunate, but that's what it tends to be,” Beck said. “TennCare has been the biggest challenge for Vanderbilt over the last 12 years, and it will be even a bigger challenge over the next 12.”

Vanderbilt provides far more TennCare services than any other hospital in the region. Meanwhile, forced reduction of TennCare rolls has exacerbated the uncompensated care picture, bringing Vanderbilt's fiscal 2006 cost for charity and other uncompensated care to $74.1 million — that's not forfeited revenue, but actual hospital and clinic spending. The figure comes to roughly twice the Medical Center's 2006 operating margin.

Peter Giammalvo, Ph.D., arrived three months ago as VUMC's first chief learning officer. “I'm the new kid on the block,” he told the crowd.

Besides hosting the seminar, Giammalvo led a segment in which he sketched some fundamentals of people and jobs.

For future organizational performance, nothing is more vital than proper recruitment and selection, Giammalvo said. The five pillars — people, service, quality, growth, finance — are interdependent, and all job development activity needs to address all five, he said. The hardest thing about leadership development is establishing open dialogue around job planning and performance review, he said. Regarding job review and appraisal and the place of core organizational values and professional standards, “We ought to hold folks accountable … and, when they don't measure up, I think we ought to call it,” he said.

He recommends that VUMC fill a majority of leadership positions from within the organization. He said that by March he will present a new leadership development plan to VUMC executives.

The day also included a wide-ranging panel discussion, with Vanderbilt University Hospital CEO Larry Goldberg and Assistant Hospital Director Nancye Feistritzer featured on Thursday, and School of Medicine Dean Steven Gabbe, M.D., and Vanderbilt Medical Group Chief Operating Officer Dave Posch featured on Friday.

The next elevate Leadership Development Institute will take place Feb. 15 and 16.