December 13, 1996

Pathfinder Meeting: Questions & Answers

Continuing this week in the Reporter, VUMC leadership answers questions submitted by faculty and staff following the recent meetings outlining the institution's strategic direction.

This week's questions were answered by Dr. Roscoe R. Robinson, Vice Chancellor for Health Affairs, and Dr. John S. Sergent, chief medical officer of Vanderbilt Medical Group.

Is there any consideration of an administrative tower? How about tearing down the condemned Oxford House and using that area for future building rather than throwing money into it.

Robinson – For some time we have been looking seriously at our need for a building to house the administrative functions of this medical center. Thus far, however, the need for academic and clinical space has been greater. With limited construction dollars, therefore, such a building has not been possible. We will continue to give such a project high priority in our planning and replacement of the Oxford House has been considered to be one of the possibilities if and when the building becomes a reality.

Are there serious plans for a free-standing Vanderbilt Children's Hospital? The Emergency Department is not up to the standards of Vanderbilt and the community. Are there plans for renovation and expansion?

Robinson – A free-standing Children's Hospital is a possibility that has been discussed for many years, and it will continue to be considered; perhaps becoming a reality sometime in the future. However, there are no immediate plans to build such a facility.

I disagree with the premise of your second question. Our Emergency Department continues to be the best in this region, as is demonstrated by our Level I Trauma Center designation. No other Emergency Department in Middle Tennessee can handle the number of patients with the complexity and severity of illnesses and provide the quality of care as is done in the Vanderbilt Emergency Department. Unfortunately, the current facility was simply not built to handle the numbers of patients being treated there, including children. Plans are under way to provide special relief for children and their families in our ER.

Why did it take so long to respond to the massive marketing campaigns by Baptist and Columbia HCA?

Robinson – It didn't. While we have avoided massive television ad blitzes, we have worked to maintain our presence and emphasize our strengths with the public. The fact that we don't do this with advertisements featuring country music stars or actors doesn't mean that our message and our strengths aren't known.

How much was spent on mailing and notification (buttons, table-top cards, etc.) for this program? How can you justify the expense?

Robinson – Several thousand dollars were spent putting together the Pathfinder information programs and informing staff and faculty about them. We justify the expense on the grounds that it is important for everyone who works here to hear, directly from members of the management team, what our institutional goals are and what we all need to do to achieve them.

How does the medical center view its relationship with the rest of the university (non-medical related).

Robinson – We are all part of the same institution and our relationship is close. Obviously, we share many of the same concerns and goals, especially in education and research.

In relation to the tuition benefit, we were told that this will not be eliminated. However, if the Office of Budget and Management deems this as not allowable (i.e., a "benefit that should not be allowed for highly paid researchers") will VU and VUMC then eat that cost or will it be phased out for new employees and grandfathered for existing employees.

Robinson – There are no plans for any changes in the tuition benefit.

Will medical and nursing students share classes as they will share practice in the future?

Robinson – There are some areas where the education of medical and nursing students overlap, especially in clinical training. The deans of the schools of Nursing and Medicine are constantly studying ways for their schools to do a better job of educating students, and this is one area that may be looked at more closely in the future.

How is it that in 1996 the top 8 people at VUMC are all white and only include one woman? How can you expect to provide services to an integrated society with a homogenous management group?

Robinson – Vanderbilt has the most diverse workforce of any employer in Nashville, and we have targeted more diversity in our management as a goal.

Why is the Vanderbilt credo presented as something new instead of something that should have been done in the past and will continue?

Sergent – Because it really gives new, and more visible emphasis to our old way of thinking. While we individually give patients our total commitment, and we always have, the fact is that we have developed systems within departments which are designed to make our own jobs easier and more efficient. This sometimes tends to leave the patient out, resulting in multiple trips in order to get a single problem taken care of, difficulty with coordinating various activities, etc. By refocusing on the needs of the patient, as our first priority, we really are doing something new.

Unfortunately, health care has not really thought of a systems approach to managing its business, something that has been prevalent in American business for the last 20 or 30 years. By thinking of ourselves as a supplier, and our patients and the payers as customers, we will design systems based on their needs, and hopefully improve our service to them and our market share in the process.