It’s back to school for system leaders
Institute teaches leadership skills, cooperation
Health care leaders in Ann Arbor, MI, are returning to school so they can learn how to better care for a highly complex patient: the multisite, multispecialty academic medical center known as the U-M (University of Michigan) Health System.
In collaboration with the U-M Business School, the Health System recently has kicked off its new Health Care Leadership Institute.
The new institute’s program will graduate hundreds of leaders with a shared vision to implement health care strategies simultaneously at U-M Health System.
Hospital, medical school, and health maintenance organization executives are using the 10-month "business of health care" program to advance their skills in health care management and leadership in order to improve the way medicine is delivered at the U-M Health System.
"There are a couple of things underpinning what we’re trying to do," says Allen Lichter, MD, dean of the U-M Medical School.
"The first is that many of us, at least on the physician side, come to leadership without a lot of training in leadership and management. There are a lot of basic skill sets physician leaders especially need to be educated on, and we wanted to provide that forum," he says.
The second driving force of the program, Lichter explains, is bringing all of the system’s top leadership through the same educational process.
"In our complex organization, we will have physician leaders, administrators in the hospital and in the medical school, and leaders in our HMO all speaking the same language and discussing issues together. I believe there is tremendous strength we create when all of us are working together," he declares
Expertise close at hand
To design the curriculum, health care leaders had to look no further than the U-M campus. The design, development, and delivery of the program were directed by the Executive Education Center of the U-M Business School in collaboration with the Medical School. The U-M School of Public Health also is a program contributor.
"The business school is expert at executive education," Lichter observes, noting that the school provides the faculty for the program.
The program is a multidisciplinary learning experience and involves preparatory assignments, class sessions, and "action learning" projects, in which participants analyze and recommend solutions to current U-M Health System leadership on management issues. Participants learn and apply concepts and tools in the areas of strategy; financial management; change management; managerial leadership; marketing strategy and positioning; operations management; information and business process; research and development; innovation, negotiation, and decision making; and strategic human resource management.
In the current class of 2003, examples of the action-learning projects include:
- Managing the Supply Chain: The Case of High-Cost Intermediate Products;
- Obstetrics/Gynecology: Short-Term Capacity vs. Long-Term Planning;
- Blue Cross/Blue Shield: The Value Proposition;
- Clinical Simulation: The Impact of Education and Care.
No more silos?
Among the perceived benefits of the program is the breaking down of the silos so typical in an academic medical center setting. "We tend to function, at times, in our organization as multiple independent businesses," Lichter says.
"As health care has evolved, however, we find patients cross multiple lines, needing to be seen in several different areas. On the financial side, investments may be made in one area, but they can affect several, so we have to start functioning as one organization," he adds.
U-M leaders also believe the new program will ultimately improve the way medicine is delivered at the U-M Health System.
"When we talk about medical care delivery, part of that has to do with efficiency — how our patients see us and how our co-workers see us — and those are some of the areas we are getting into," says Darrell Campbell, MD, chief of staff at the U-M Health System and a student in the program.
Leadership principles not normally studied by physicians will help improve patient safety, he asserts.
"Patient safety is all about communication, at the very lowest levels to the very highest," Campbell explains. "What we’re trying to do as leaders is point out the value and the importance of communication from the front line to the top, and know where the potential mistakes are," he adds.
"Patients need and expect a seamlessness in their care," Lichter says. "Handoffs are not their problem; they are ours. If we do it well, patients and their referring physicians will receive much more efficient and effective health care."
Satisfied students
Campbell and Lichter, both of whom will be part of the institute’s first graduating class, are enthusiastic about their experiences to date.
"We’ve completed four or five sessions, and I think it’s been terrific," Campbell says. "There are a lot of aspects of running a business for which doctors are not very well-prepared. The idea is to merge the different medical interests and work on areas doctors don’t know much about."
For example, he notes, his last session was devoted to developing a team culture and an optimal working environment.
"We’ve looked at how we communicate, the best ways to communicate, understanding stressful conditions, and we shared surveys on how other people see us and characterize our performance and our style," Campbell says. "We also had a daylong session on the basic principles of accounting."
"It has been terrific," says Lichter of his experience as a student. "We have had sessions on basic finance, which has really opened our eyes in terms of how we can use the financial data we have to make better decisions about potential investments. We spent a day talking about the concept of strategy, how one can take an organization, look down the road, and anticipate what will happen in the industry.
"This way, you can make sure you are not only prepared to face those problems, but to even shape how the industry’s future will unfold. We spent our last session talking about organizational culture — what it is, how to measure it, why it’s important, and how it can be changed," he says.
The full-day class sessions take place one day a month for 10 months. Between sessions, participants divide into work groups to take on the action-learning projects.
Essential to each project is the work group’s cross-disciplinary composition, which creates a collaborative experience so that participants gain a clearer understanding of other disciplines and can build more effective relationships across these boundaries. Work groups will spend approximately six hours a month on their action project, which culminates in an oral presentation and a written report.
"We broke up into six teams to tackle six very interesting problems," says Lichter. "There were six members on each team, all from different parts of the organization. We are working on creating a center for spine care, but doing that inside this complex organization is not easy; we’re looking at how we price products, at our interaction with Blue Cross/Blue Shield, and asking what value we can demonstrate that we bring to this interaction."
Looking to the future
Lichter notes that the program will run on a yearly basis, "Until we bring large numbers of leaders through it." As each succeeding class graduates, the U-M Health System expects to see an overall improvement in the business management of health care, as well as in the ability to deliver quality products and outcomes to consumers, payers and other business partners in this 15,400-employee organization.
While the program, for the time being, is open only to internal candidates, future plans for the Institute involve opening up the nondegreed program to health care executives from outside the U-M sphere.
"To the extent that our business school and some of our leaders see value in this, and other health care leaders feel they could benefit, it’s quite possible we could open courses like this for other institutions," says Lichter.
Beyond the obvious tangible benefits of the program, Campbell sees some intangible benefits as well. "One is the camaraderie between the 30 leaders currently participating," he says.
"We don’t often have that opportunity to look at the big picture. We have a whole day during which we can turn off our pagers and think about making this place better. That’s incredibly important," Campbell says.
Need More Information?For more information, contact:
- Allen Lichter, MD, Dean, University of Michigan Medical School, Ann Arbor, MI. E-mail: [email protected].
- Darrell Campbell, MD, Chief of Staff, University of Michigan Health System, Ann Arbor, MI. Telephone: (734) 936-4814.
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