February 18, 2005

VUMC ready for next level: Jacobson

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Harry Jacobson, M.D., vice chancellor for Health Affairs

VUMC ready for next level: Jacobson

With its thriving clinical program, strong research enterprise and nationally recognized education programs, Vanderbilt University Medical Center is well positioned to embark on the next phase of its evolution.

That phase will involve harnessing VUMC's wealth of resources and focusing them on improving the level of service provided to patients, customers and employees.

“We do so many things so well,” said Harry R. Jacobson, M.D., vice chancellor for Health Affairs, at the State of the Medical Center Address yesterday. “By most measures our School of Medicine is, I believe, one of the top five in the country. In research, we are just now beginning to recognize how powerful we have become. Our clinical program is strong and there is evidence all around that we provide care that is among the best anywhere.

“We have grown remarkably, and we will continue to grow. We are strong financially, and we can do better still. But we have not balanced these strengths with a clear focus on quality, customer service and our employees. We are good, but we must be great,” Jacobson said.

In his annual address to staff and faculty, Jacobson outlined the Medical Center's progress over the past year. Growth and improvement were the key words applicable to all aspects of VUMC's three-part mission of patient care, research and education:

• Patient care — Vanderbilt University Hospital was the only hospital in Tennesse included on the list of America's Best Hospitals compiled by U.S. News & World Report magazine, ranking in the top 50 in nine of 12 major specialties. Forty-six of the 67 physicians in Tennessee listed by the magazine among America's Top Doctors practice at VUMC and VUH was named among the nation's top 100 hospitals by Solucient.

Advances in the area of medical informatics continue to place the Medical Center at the forefront of international efforts to bring the power of technology to bear on health care.

“When President Bush wanted to talk about the promise of medical informatics, he came here (last spring),” Jacobson said. “Not Hopkins, not Harvard — Vanderbilt.”

VUMC has also become the preferred health care destination for Middle Tennesseans. Based on a survey of nearly 2,000 households, VUMC was named the hospital of choice by nearly 16 percent of respondents, more than any other health care provider in the region.

These gains, combined with the resounding first-year success of the Monroe Carell Jr. Children's Hospital at Vanderbilt, have the Medical Center's patient care mission strongly positioned for growth and further improvement.

• Research — VUMC's research enterprise continues to shine. Over the past five years, the Medical Center experienced unprecedented growth in National Institutes of Health (NIH) funding, achieving the highest growth rate in the United States. With a compound annual growth rate of 22.4 percent from 1999 to 2003, Vanderbilt topped Duke University and UCLA for the lead position. VUMC is on pace to attract nearly $300 million in NIH funding in the near future.

Publications remain a strong point, as papers authored by VUMC investigators were ranked in the top five nationally for clinical medicine citations.

“I think that within five years Vanderbilt will be recognized as a powerhouse in biomedical invention and discovery,” Jacobson said.

• Education — The Vanderbilt University School of Medicine continues to be one of the most selective medical schools in the nation and is increasing its number of residents from the nation's top 20 schools.

A key to these efforts is VUSM's ability to attract top-tier faculty, which the school has been able to do with consistent success. Several important additions were made to the faculty during the past year, including Sten H. Vermund, M.D., Ph.D., Amos Christie Chair in Global Health; Nancy E. Chescheir, M.D., chair of the Department of Obstetrics and Gynecology, and Daniel R. Masys, M.D., chair of the Department of Biomedical Informatics.

• Financial/Infrastructure — Financially, VUMC is performing well, with margins in the top quartile. It's still uncertain what impact proposed changes to the state's TennCare program will have on the Medical Center. The changes have not yet been approved by federal regulators and face several court challenges.

The Medical Center's growth is on an upward track, as evidenced by the numerous construction projects under way. Among the new facilities, renovations and expansions in the works are: continuing renewal of Vanderbilt University Hospital; Medical Research Building IV, the $110 million expansion above Light Hall; the Emergency Department's $12 million expansion and; the $79 million Medical Center East South Tower project is being done in two phases; ongoing opening of new clinical space at the Doctors' Office Tower at VCH; renovation of the School of Nursing's Godchaux Hall; and the opening of the Bill Wilkerson Center, the Orthopaedics Institute and the Vanderbilt Eskind Diabetes Clinic.

The growth and success VUMC has experienced over the past few years is admirable and commendable, Jacobson said. But physical growth and financial success alone won't carry Vanderbilt where it needs to go.

“We are a great medical center, but I think that we would all agree that we do not match our world-class knowledge with world-class customer service,” Jacobson said.

That's where elevate comes in. This multi-year program, which debuted in late 2004, is geared toward improving the experience of patients in VUMC's hospitals and clinics as well as improving the work-related satisfaction of staff and faculty.

“We are about to embark on what will become a great journey for all of us,” Jacobson said. “This is much more of a change in the way we do business than just a project. It's not a 'program of the month.' It's a dedicated, focused approach to organizational development.”

Developed by the Studer Group and proven successful at the University of Chicago and elsewhere, elevate relies on a series of simple principles — including balanced goals, leadership development, staff satisfaction, customer service and patient satisfaction — to reshape an organization's outlook on, and commitment to, quality and customer satisfaction.

“I want to develop a Mayo-like brand,” said Jacobson, referring to the Mayo Clinic's worldwide reputation as the ultimate in providing customer satisfaction in the health field.

“We need to do what the Mayo has been successful at doing — we need to organize our way of providing care around our patients, not ourselves.”

The elevate program will touch every person who works at the Medical Center, and during the next year staff and faculty can count on not only hearing more about the initiative, but seeing its principles put into action, Jacobson said. The results of the multi-year elevate program will be clear and measurable and it's expected that both employee and patient satisfaction will rise significantly.

Making employees more involved, more appreciated, more professionally fulfilled and happier translates into having employees who will provide better service to patients and customers, Jacobson said.

“Vanderbilt has become synonymous with quality medical and nursing care, compassion and technology. In every important respect we are the strongest name in the region and the elevate program will help us achieve the goals we have set out for ourselves,” Jacobson said.