For an update on progress made since the retreat, please see a letter from the Chair and Beth Harleman, MD.
Minding the Gap: How do we promote sustainability and a positive workplace experience for our faculty and staff in a world of changing expectations?
The Department of Medicine held its fourth annual strategic-planning retreat at the Golden Gate Club in the Presidio on September 30, 2013. Over 100 members of the department and distinguished guests discussed how the department could best adapt to significant changes in the research-funding environment and improve patient access, while also addressing the work experience for faculty and staff.
Beth Harleman, Associate Chair for Strategic Planning and Implementation, welcomed guests and introduced department chair Talmadge King. Talmadge opened the program by reviewing the current state of the department. He noted that the DOM is successful by nearly all measures including financial status, reputation in each of its mission areas and in its track record in development. However, challenges exist due to budget cuts, national decreases in NIH funding for research and uncertainty about the impact of healthcare reform. Goals for the strategic planning retreat were to:
- Raise awareness about workplace experience/satisfaction;
- Integrate resources in all pillars (clinical care, education, research and policy) to address problems;
- Encourage "disruptive thinking" about how we fund research, deliver and structure care and provide education;
- Reap the benefits of collaboration across the DOM;
- Reinforce DOM's responsibility and role in improving employee engagement;
- Build on the sense of community within DOM by bringing people together in the retreat, but also focus on concrete action plans.
Please click here for a view of Talmadge's entire presentation (only available to UCSF faculty and staff).
Victor L. Schuster, the keynote speaker for the retreat, is Senior Vice-Dean at Albert Einstein College of Medicine. He acknowledged that the current challenges faced by academic medical centers make it difficult to agree upon a new model system of care. These challenges in healthcare have similarities to those faced by the airline industry. Yet over time, the airline industry has grown safer and more accessible to customers, provides good value and outcomes, offers economies of scale, and continues to innovate. Is patient safety harder to achieve than airline safety? Can we be successful in this new environment? Dr. Schuster's recommendations are to:
- Be impatient with activities not culminating in improved health;
- Make a big tent of reward systems surrounding health; recognize and reward everyone involved in the endeavor, not just the "innovators";
- Redefine "basic" research for a Department of Medicine as that work which is closely aimed at improving health;
- Make the practice serve the patients’ schedule and needs, rather than the faculty’s;
- Relentlessly pursue safety and quality outcomes in the pursuit of health;
- Embrace the coming financial waves as a pathway to better patient access, experience, safety and outcomes.
Please click here for a view of Dr. Schuster’s entire presentation (only available to UCSF faculty and staff).
Beth Harleman next shared data about the UCSF DOM work experience from three recent surveys: the UCSF Faculty Climate survey, the Gallup Poll on staff engagement and the UCSF Primary Care Practice survey. Main concerns for faculty include research funding, financial compensation and work-life balance. The greatest sources of satisfaction for faculty include intellectual stimulation and interactions with colleagues and trainees. Some reasons quoted for staying at UCSF included:
- Highly competent, committed, mission-driven faculty and staff.
- They love teaching residents and enjoy working with esteemed colleagues in all the specialties
- The people, innovative environment, and inspiration provided by our outstanding trainees.
- A move toward true team-based care that values everyone's time, physicians included.
- Opportunities to identify new collaborative partnerships, collegiality, spirit, dedication and non-hierarchical structure.
- Because there is growth and opportunity within complex organizations in flux.
Please click here for a view of Beth’s entire presentation (only available to UCSF faculty and staff).
In the afternoon session, Ralph Gonzales, Associate Chair for Ambulatory Care and Clinical Innovation, gave a brief overview of the work that is being accomplished as part of Ambulatory and Clinical Care Innovations efforts at all three hospital sites in San Francisco. Bill Seaman, Associate Chair for Research, highlighted key initiatives to promote research in the Department and asked the audience to think broadly about the future of research in the UCSF DOM.
Participants broke up into small groups to brainstorm ideas and provide solutions to one of the following two questions:
- What could UCSF do if NIH funding disappeared tomorrow?
- What could UCSF do to create a more satisfying work environment?
The top eight ideas will be listed for two weeks in October 2013 on UCSF's Open Proposals to allow all members of the DOM to review and provide comments on each proposal. The Department's top leadership (the Chair's Council) has agreed to implement the top vote-getting proposals during this current academic year.
A special thanks to the retreat facilitators: Bonnie Johnson, Elissa Keszler, Sarah Kim, Maria Dall'Era, Carmen Peralta, Christine Razler, Bill Seaman and Vivek Jain. And to those faculty who participated in the closing Fishbowl: Kirsten Bibbins-Domingo, Denise Connor, Jeff Critchfield, Maria Dall'Era, Miriam Gonzalez-White, Vivek Jain, Alka Kanaya, Suneil Koliwad, Catherine Lucey, Carmen Peralta, Niraj Sehgal, Rebecca Shunk and Louise Walter.
Pilar Bernal de Pheils