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VUMC has prospered by developing internal and external clinical care programs supportive of
and compatible with education and research, research programs supportive of and compatible with
education and service, and academic programs consistent with its University setting.
VUMC is responding to new constraints and opportunities in its environment by maximizing its
existing advantages through a variety of internal initiatives:
- Delivery of patient-focused care, provider-friendly, currently being implemented through:
- V-CARE
- Collaborative care/critical pathway development
- Decentralization of services
- Training multi-skilled workers
- Integration of VU-based health care delivery: seamless, inter-disciplinary, holistic
- Developing a more cohesive group practice:
- Principles of practice
- Uniform fee schedule
- Improve quality and timeliness of consultative practice
- Practice guideline
- Developing regional care networks:
- Working with other providers to establish a more organized regional network
- Improving and building relationships with referring physicians
- Building a primary care network in the immediate Nashville area
- Reaching people off-site
- Bringing in off-site expertise
- Developing managed care models:
- Managed care contracting
- HMO development
- Developing programs to serve VU employees and their families
- Strengthening our ability to act and speak with one voice
- Improving competitive cost position by continued improvement in unit costs and practice patterns
- Integrating primary care clinics
- Strategic program development; providing an economic base for development and basic operations;
capitalizing on existing strengths and identifying new sources of revenue:
- Community and industry-based care agencies
- Technology transfer, start-up companies, etc.
- Consulting services to health care organizations
- Research for the commercial sector
- Creation of centers of excellence
- Exploration of Radiology PACS to support consult process
- Strategic investments in faculty based on anticipated directions in science
- Telemedicine
- Implementation of new policies and procedures for use of federal funds and allocation and
recovery of indirect costs.
- Enabling outcome-driven decision making:
- Obtaining data about what we do and providing feedback loops
- Making evaluation and outcome measures integral to all programs
- Making sure the need for outcome measures does not corrupt the process
- Providing for long-term measurements, where needed
- Implementing hard rules on accountability and documentation
- Establishing evaluation systems to support compensation based on individual skills and performance
of the organization as a whole
- Providing data to allow consideration of cost-based budgeting: separating the management of process
efficiency from decisions about process utilization
- Developing the information technology infrastructure:
- Establishment of the Informatics Center
- IAIMS grant and planning process
- Installation of backbone network
- Internet access
- New biomedical library with increasing amounts of on-line material
- Recognition of informatics as an academic discipline
- Implementation of patient care information system
- Installing local area networks
- Development of computer-equipped instructional laboratories in the schools
- Sharing research information
- Developing policies and procedures databases
- Developing capabilities for environment scanning and timely access to competitor data
- Commitment to process improvement:
- Collaborative care initiative and documentation
- Fiscal and physical decentralization
- Streamlining management structures
- Organizing to obtain maximum leverage of staff
- Comprehensive training for employees
- Empowering decision making at all levels and involvement of hospital and clinic staff
in quality improvement
- School of Nursing's educational effort for quality improvement and involvement of other VUMC management
- Emergency Department's patient satisfaction project
- Plans to streamline and automate paper-based processes
- Selective adoption of curricular changes and development of new educational offerings:
- Incorporating new units of curriculum available on media such as video and computer-based instruction
- Exploration of problem-based learning in School of Medicine
- Encouraging new curricular designs and providing multiple tracks, as long as the experience is licensable
- Assessment of Medical School's curriculum from generalist's perspective
- Development of continuing and non-traditional education
- Establishing the life-long learning paradigm
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