February 23, 2012

Leadership training key to managing future: Balser

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Jeff Balser, M.D., Ph.D., speaks at the Clinical Enterprise Leadership Assembly. (photo by Susan Urmy)

Leadership training key to managing future: Balser

Last Thursday, about 750 Vanderbilt University Medical Center leaders attending the Spring 2012 Clinical Enterprise Leadership Assembly watched a brief highlight video of Nadia Comăneci’s performance at the 1976 Summer Games, where the young Romanian became the first female ever to be awarded a perfect score of 10 in an Olympic gymnastics event.

Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of the School of Medicine, asked the audience to imagine the conversations between Comăneci and her legendary coach, Béla Károlyi, before and after that historic performance. Balser’s point was that good coaching can be invaluable for even the best performers.

Balser made the point that in an atmosphere of economic uncertainty and federal budget deficits, the quality of our leadership is “one variable we control” in managing our future. He emphasized that leaders must view their role as one of shepherding a process of continuous change, rather than treating change as an “interruption” in the normal affairs of management.

Just as for musicians or professional athletes, coaching will play an ever-growing role in the repertoire of VUMC leaders. Chief Human Resource Officer Traci Nordberg explained how supportive coaching conversations can be vital for leaders at all levels, and will gradually become an integral part of Credo behavior.

Nordberg and Balser sat in chairs at center stage to conduct a conversation illustrating their point that these exchanges, while sometimes challenging, can and should be supportive and constructive.

To initiate this effort, Balser is preparing to conduct one-on-one conferences with his direct reports about leadership behavior, and encouraged all attendees to be open to doing the same.

Balser and his direct reports plan to engage in a pilot process for leadership coaching to develop a “tool kit” that will be distributed to leaders at all levels. Over time all leaders will receive guidance on strategies for facilitated coaching conversations, receive and review supportive management literature and learn methods to apply these concepts in a continuous manner.

The assembly opened with a progress report by C. Wright Pinson, MBA, M.D., deputy vice chancellor for Health Affairs and CEO of the Vanderbilt Health System. He summarized performance toward clinical enterprise goals in service, quality, growth and finance and innovation.

A few highlights:

• Vanderbilt Medical Group is now providing new patient appointments within 15 days of the initial appointment nearly 66 percent of the time, already surpassing this year’s goal of 60 percent.

• Pinson discussed the importance of every caregiver taking an interest in coordinating care and supporting the physician in charge of coordination, especially when multiple services are involved.

• Use of the Provider Communication Wizard for follow-up communication to referring providers (after clinic visits and hospital discharge) is continuing to improve, but remains slightly behind this year’s goal of 75 percent. Pinson asked leaders to assist any providers who haven’t yet adopted this automated tool.

• Hand hygiene compliance has surpassed 90 percent, a major improvement over 2009, with concomitant improvement in hospital infection rates to be among the very lowest in the nation. This success was cited as a vibrant example of what VUMC can accomplish as an organization committed to performance improvement.

• The Center for Medicaid Services is now linking payment to hospital readmission rates, and VUMC is taking steps to improve its performance in this area.

Finally, Pinson reminded the audience that revenue from the hospitals and clinics helps fund projects across the entire Medical Center — including clinical, educational and research areas — replacing equipment and aiding program development.

“We have a lot of projects that are in the queue; they’re in the queue for quality reasons, for safety reasons, for competitive reasons, for academic reasons,” he said.

The Medical Center is highly focused on greater operational expense control in response to challenges already emanating from federal deficit reduction programs, while preparing for continued challenges in U.S. health care economic reform.

Pinson outlined steps for improving performance. Details are available on the elevate website.