January 23, 1998

Medical center’s future mapped out

Medical center's future mapped out

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Dr. Harry Jacobson addresses VUMC faculty and staff. Photo by Donna Jones Bailey.

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Members of institution leadership taking part in the State of the Medical Center program included (from left) Marsha Casey, R.N., Dr. John Sargent, Dr. James Geraughty, Norman Urmy, Lynn Webb, Ph.D., and George Forsyth. Photo by Donna Jones Bailey.

Vanderbilt University Medical Center faculty and staff got a glimpse of the institution's future at this week's second annual State of the Medical Center program.

It's a future ‹ both in the short term and long run ‹ that's full of growth and possibilities as well as daunting challenges. During several presentations of the State of the Medical Center program at VUMC's Langford Auditorium this week, institution leadership outlined where VUMC is now and presented a map of where the medical center is and how it's going to get there.

"Every good strategic plan begins with a vision of success and a set of goals to achieve that success," said Dr. Harry R. Jacobson, Vice Chancellor for Health Affairs. "Chancellor Joe B. Wyatt and I have talked at some length about what that vision of success might mean, and we have arrived at a conclusion for both the medical center and the university. Simply, we want this institution to secure its place among the top 10 academic centers in the country."

Doing so will be no easy feat. According to Jacobson, reaching this level of distinction will require a hefty investment in people, programs and new facilities.

"I see our current faculty of more than 1,000 doubling in size over the next 10 years," Jacobson said. "We have plans for a significant capital program to support the quality researchers and teachers we have now and to recruit the best and brightest from other institutions across the country and around the world."

The vision to be recognized among the top academic centers in the United States is built around three central themes:

€ Train the best physicians, nurses and researchers possible

€ Focus VUMC's research and discovery efforts on both finding new ways of healing and finding the best way to care for people

€ Provide the best medical care available anywhere.

The cultivation of new knowledge and the quality of research done at VUMC is a key component of the drive toward the upper tiers of the nation's academic centers and is one of the primary elements that distinguishes VUMC from every other health care provider in the region.

Five of the six basic science research departments are among the top 10 in the nation in attracting funding from the National Institutes of Health already.

"In our labs, we may find the next Nobel Prize winner and take the next big step toward curing cancer, or diabetes or discovering the cure for a genetic disease," Jacobson told the audience in Langford Auditorium.

"Recognizing that future scientists will need to be developed, we need to nurture our programs of undergraduate and graduate education. Doing so will ensure that we maintain a steady stream of bright academicians and energetic talents to work with the top-notch faculty we already have."

But, achieving national distinction cannot ‹ and does not ‹ rest on the shoulders of VUMC's research programs alone.

"To be recognized as one of the best, we will have to demonstrate that we provide care that is second to none," Jacobson said. "This means not only taking care of the most complex and acute patients, but also managing the routine care of people throughout Middle Tennessee. We should not only be recognized for the quality of care we offer but also the efficiency with which we offer it."

The cost pressures that continue to impact the nation's health care industry create the need to apply the same skill and talent used to discover new medical treatments and devices to discover the most efficient ways to treat patients.

"Focusing on outcomes and what treatments create the best outcomes should become a hallmark of Vanderbilt's patient care approach," Jacobson said. "Our focus on clinical pathways and quality improvement have given us the tools we need to develop and apply care protocols for people with chronic diseases like diabetes, hypertension, asthma and kidney disease."

Technology transfer ‹ translating discoveries into new therapies as quickly as possible ‹ will play a big role in charting the institution's course over the coming months and years, Jacobson said.

"Our vision needs to show us how to translate our strength in research into an advantage. Imagine that we can translate new discoveries into patents, licenses and corporate collaborations that build a powerful new revenue stream that supports our clinical, research, health care and service missions," he said.

During the last several months, VUMC leadership reviewed the various strategic plans prepared by different components of the medical center. From that effort emerged a sense of how VUMC could maintain its current success into the future.

€ VUMC will need to offer health care services throughout the Middle Tennessee region, not just here at the medical center.

€ The services offered should be comprehensive, so that any person, or any company, can meet all health care needs through VUMC.

€ VUMC does not need to own the whole system ‹ rather, partnerships and alliances with the best quality providers that want to share the benefits of an integrated system and that see their future and VUMC's as intertwined.

€ This integrated delivery system should carry the Vanderbilt name.

"The work that you the faculty and staff have done and the generations of staff, nurses and physicians before us who have devoted their career to Vanderbilt have left a legacy in this community," Jacobson said. "That legacy is a lasting impression in the minds of middle Tennessee that Vanderbilt provides the best health care that can be found anywhere.

"Our advertising campaign is designed to reinforce that concept, so that when we build a partnership with any physician group, with any hospital, ambulatory care provider or nursing home, we want the Vanderbilt name and the 'seal of approval' that our name implies."

One of the most important initiatives over the next year will be to develop and implement plans for patient care center. And these plans, some now under way, represent a drastic change in the way VUMC will do business.

"The effort to build patient care centers will turn us on our ear," Jacobson said. "No longer will we be organized around departments or even locations of care. We will instead be organized around patients with similar health concerns."

These plans call for the development of a seamless care delivery system, where the patient moves from one care setting to the next and one provider to the next with ease, Jacobson said. These patient care centers must be in place and operating flawlessly, for soon they will have to include participation from the staff at other hospitals, affiliated practices and from other new partners.

Another key to attaining the vision of excellence is to somehow track performance. So, over the next months, a set of target performance measures for the medical center will be developed. While the exact structure of these measures has yet to be determined, here are some of the broad themes that need to be addressed:

€ Goals for the quality of care. These should reflect both clinical quality indicators and also customer service indicators ‹ not only did patients feel better, but did they feel good?

€ Indicators that track efficiency at providing care ‹ did we provide great quality but waste resources, or did we provide the right care?

€ Lastly, volume targets that match services provided with staff and resources.

"Sometimes we set our goals based on what we can measure rather than on what is important," Jacobson said. "So part of our effort will be to build new data sources on outcomes, on customer satisfaction and preference and on the performance of our competitors."

Research, education and patient care are the girders that support this medical center; but it's the people, the faculty and staff, that give the institution its heart, soul and blood, Jacobson said.

"Without question, the most important element in our ability to perform as an institution, to provide high quality care for our patients and to give them the best in customer service, is all of you.

"Today's address is part of the effort to invest in the people who make this place work. I want you to know where we are headed and what will be required of you for us to get there," Jacobson said. "We are all proud of the work and effort you have made and I want you to be recognized and rewarded for the exceptional work you do."