From June 2014 presentation by Michael Warden, Johmarx Patton, and Kathleen Ludewig Omollo of University of Michigan Medical School Information Services to their colleagues in the department.
Drawing upon the concept of "permanent white water," the presenters explore the constant change and churn that affects academic medical centers such as UMMS and tactics for how to thrive in such an environment. The presenters highlight trends and models within the education, research, and clinical domains.
Downloadable versions in PPTX and PDF are available at http://open.umich.edu/node/9706/.
2024.03.23 What do successful readers do - Sandy Millin for PARK.pptx
Understanding and Navigating Constant Change in the Academic Medicine Landscape - June 2014
1. Understanding and Navigating Constant
Change in the Academic Medicine
Landscape
Presenters:
Michael Warden, Johmarx Patton, Kathleen Ludewig Omollo
Except where otherwise noted, this work is available under a Creative Commons Attribution 4.0 License
(http://creativecommons.org/licenses/by/4.0/). Copyright 2014 The Regents of the University of Michigan.
MSIS Lunch and Learn - June 13, 2014
1
2. Introduction
Changes exist all around us…
● Job Requirements
● Roles
● Problems
● Location
● Major Projects
● Structure
● Leadership
● Team Makeup
● … where I put my lunch and get my water!
2
3. 1868-1891. Public domain image.
3
2012- Present. Image CC
BY NC University of
Michigan,
UMHS Media Bank.
4. How many EVPMA’s (interim and permanent) have we had
appointed from the University of Michigan Medical School?
A. 1
B. 2
C. 3
D. 4
E. 5
Change
4
5. How many EVPMA’s (interim and permanent) have we had
appointed from the University of Michigan Medical School?
A. 1
B. 2
C. 3
D. 4
E. 5
Change
Lazar Greenfield, M.D.
EVPMA 2002-2003
5
13. Academic Health/Medical Centers:
Different Models for Governance
School of
Medicine
Teaching
Hospital
(Clinical)
Practice Plan
School of
Medicine
Teaching
Hospital
(Clinical)
Practice Plan
Least integrated
Most integrated
School of
Medicine
Teaching
Hospital
(Clinical)
Practice
Plan
School of
Medicine
Teaching
Hospital
(Clinical)
Practice
Plan
School of
Medicine
Teaching
Hospital
(Clinical)
Practice
Plan
Reference: Levine JK. Considering
alternative organizational models for
academic medical centers. Acad
Clin Pract. 2002;14(2):2–5.
13
14. Academic Health/Medical Centers:
Different Models for Governance
School of
Medicine
Teaching
Hospital
(Clinical)
Practice Plan
School of
Medicine
Teaching
Hospital
(Clinical)
Practice Plan
Least integrated
Most integrated
School of
Medicine
Teaching
Hospital
(Clinical)
Practice
Plan
School of
Medicine
Teaching
Hospital
(Clinical)
Practice
Plan
Reference: Levine JK. Considering
alternative organizational models
for academic medical centers. Acad
Clin Pract. 2002;14(2):2–5.
Question:
Which one is U-M?
A
E
B C DSchool of
Medicine
Teaching
Hospital
(Clinical)
Practice
Plan
14
15. Academic Health/Medical Centers:
Different Models for Governance
School of
Medicine
Teaching
Hospital
(Clinical)
Practice Plan
School of
Medicine
Teaching
Hospital
(Clinical)
Practice Plan
Least integrated
Most integrated
School of
Medicine
Teaching
Hospital
(Clinical)
Practice
Plan
School of
Medicine
Teaching
Hospital
(Clinical)
Practice
Plan
Reference: Levine JK. Considering
alternative organizational models
for academic medical centers. Acad
Clin Pract. 2002;14(2):2–5.
Question:
Which one is U-M?
E
School of
Medicine
Teaching
Hospital
(Clinical)
Practice
Plan
15
16. AHC - 3D Mission
Each of these 3 missions,
touch each of the 3
communities, but to
varying extents
depending on the model
Clinical Research
Education
16
17. AHC - 3D Mission
Missions are
complementary yet
competitive
Clinical Research
Education
17
18. AHC - 3D Mission
Missions are
complementary yet
competitive
Clinical Research
Education
+ $
- $
- $
18
19. AHC - 4D Mission?
Clinical Research
Education
Community
Service
19
20. After the completion of high school, what is the typical
duration of education/training before becoming a licensed,
independently practicing physician in the US?
A. 6 years
B. 8 years
C. 12 years
D. 15 years
E. 19 years
Education
20
21. After the completion of high school, what is the typical
duration of education/training before becoming a licensed,
independently practicing physician in the US?
A. 6 years
B. 8 years
C. 12 years
D. 15 years
E. 19 years
Education
21
22. After the completion of high
school, what is the typical
duration of education/training
before becoming a licensed,
independently practicing
physician in the US?
A. 6 years
B. 8 years
C. 12 years
D. 15 years
E. 19 years
Education
Chart adapted from: AAMC
22
Undergraduate
Bachelors Degree
Years: 4
Medical School
(MD)
Years: 4
Residency
Years: 3-5+
Subspecialty
Years: 1-4
Board Certification
Recertification
Licensure
Independent
Practice
Continuing Medical
Education
Subspecialty
Certification
23. Education
23
Undergraduate
Bachelors Degree
Years: 4
Undergraduate Medical Education (UME)
Medical School (MD)
Years: 4
Residency
Years: 3-5+
Subspecialty
Years: 1-4
Board Certification
Recertification
Licensure
Independent
Practice
Continuing Medical
Education
Subspecialty
Certification
Chart adapted from: AAMC
24. Education
24
Undergraduate
Bachelors Degree
Years: 4
Medical School
(MD)
Years: 4
Graduate Medical Education (GME)
Residency
Years: 3-5+
Graduate
Medical
Education
(GME)
Subspecialty
Years: 1-4
Board Certification
Recertification
Licensure
Independent
Practice
Continuing Medical
Education
Subspecialty
Certification
Chart adapted from: AAMC
25. Education
25
Chart adapted from: AAMC
Undergraduate
Bachelors Degree
Years: 4
Medical School
(MD)
Years: 4
Residency
Years: 3-5+
Subspecialty
Years: 1-4
Board Certification
Recertification
Licensure
Independent
Practice
Continuing
Medical
Education (CME)
Subspecialty
Certification
31. Research
contributions to new knowledge
“bench to bedside”
“disciplinary guilds” - for reviews of proposals for funding
and for verifying results
Basic Research
Patient-Oriented
Clinical
Research
Improve health
outcomes
Translation
to clinical
studies
Translation to
health care
practice
31
Chart adapted from: http://ncrr.nih.gov/
32. Research
On average, what percentage of research costs are
covered by external grants (e.g. government,
foundations)?
A. Over 90%
B. 60 - 80%
C. 30 - 70%
D. Less than 30%
32
33. Research
A. Over 90%
B. 60 - 80%
C. 30 - 70%
D. Less than 30%
On average, what percentage of research costs are
covered by external grants (e.g. government,
foundations)?
33
34. Research
Based on: National Science Foundation Survey, 2010, Top 125 Ranked Institutions with NSF Support
34
35. Research
Before > Now > Future
Scope (Data and Team):
Small > Big > Massive
Approach:
Observation > Analysis and Reduction > Synthesis and
Integration
Job Security:
Salary Secure > Tenure Uncertain > No Tenure for Research
Control:
Investigator > Principal Investigator, Institution, Funder >
Program Director
Reference: A. Rees Midgley, 1980. Biological Science Research: Yesteryear, Today, and Tomorrow.
35
36. Discussion / Activity (15 minutes)
Tools and techniques that you can use to focus
your efforts and create stability:
● Not To Do Lists
● Stakeholder Mapping
36
37. Not To Do Lists
To Do: NOT To Do:
USO Program
Transition to Operations
Process
Project Management KPIs
Staff Development
Knowledgebase Alignment
Product Owner training
Project Management training
classes
Legacy Documentation
Cleanup
Expanded Onboarding
“What could I make a good case
for doing?”
Time?
Important?
Focus Waste
Bombs Ignore
Y N
Y
N
37
Matrix adapted from: Gregory P. Shea, Leading
Change in Medicine and Business: Bridging the Gap,
e.d. Sheldon Rovin, Aspen, 2001.
38. Stakeholder Mapping
Influence
Appreciate
Control Those who can ‘control’ the outcome - make the change
happen or not happen
Those who can ‘influence’ the outcome - make the change
harder or easier
Those who can ‘appreciate’ that the change is occurring, but
have little power in affecting the course
Reference: Gregory P. Shea, Leading Change in Medicine and Business: Bridging the Gap, e.d. Sheldon
Rovin, Aspen, 2001.
38
40. Closing Remarks
1. Whitewater needs to be managed to have happy,
healthy, engaged staff.
2. Change is constant, especially in medicine.
3. Mapping stakeholders and maintaining to do and
not to do lists are example techniques to create
stability and provide direction amidst that change.
40
41. References
Gregory P. Shea, “Leading Change” in Medicine and
Business: Bridging the Gap, e.d. Sheldon Rovin,
Aspen, 2001.
Association of American Medical Colleges, Group on
Information Resources - http://aamc.org/gir
41
42. Image attributions for New Models of Clinical
Care on slide 30
All images from TheNounProject.com
● Nurse - CC BY Scott Lewis from the Noun Project
● Doctor - Public domain
● Person - CC BY Alex Berkowitz from the Noun Project
● Brain - Public domain
● Pulse CC BY TNS
● Coordinate Patient Care - Public domain
● Mhealth - CC BY Edward Boatman
● iPhone - Public domain
● Radiography - CC BY Wojciech Zasina
● Cardiograph - CC BY Wojciech Zasina
● Surgery - Public domain
● Blood Glucose Meter - CC BY Danilo Casagrande de Almeida
● Laptop - CC BY Edward Boatman
42