UCLA Department of Health Services

Transcription

1 UCLA Department of Health Services Summary of December 4, 2009 Faculty Retreat Discussions Prepared by Nicole Lezin, Facilitator

2 Table of Contents Introduction...1 Program Directors Updates...1 MPH Program...1 Dr.PH Program...2 PhD Program...3 EMPH Program...4 Faculty Survey Responses and Discussion...4 Mission Discussion...6 Budget Discussion...6 Faculty Buy-outs...7 Revenue-enhancing Activities...7 Additional Discussion Items...8 Next Steps...9

3 Introduction On December 4, 2009, members of the UCLA Department of Health Services faculty met for a day-long faculty retreat. The main purposes of the retreat were to: Assess the Department s educational mission; Identify specific changes that better align the curriculum with that mission; and Reach consensus on a response to a memo from the Executive Vice Chancellor (EVC) requesting that Deans and Departments identify specific ways to respond to the University s budget crisis with ideas for increasing revenues and/or decreasing costs. This report summarizes the group s discussions related to these issues, provides a brief overview of presentations by Program Directors that set the stage for these discussions, and lists immediate next steps discussed during the retreat. Program Directors Updates MPH Program Diana Hilberman reviewed findings from a syllabus and competency mapping exercise. The assessment identified gaps or inadequate coverage in the current curriculum in a number of areas: Quantitative skills Project management Leadership (especially a leadership capstone, common in other programs) Quality (covered in a 5-week session, but not extensively enough) Process improvement (with additional content possible in the Quality and Performance Management course) Health information technology and systems (currently 8 sessions, but considered far short of a full course, which is recommended). The assessment also identified a lack of management electives, with many students taking their electives through the Anderson School. 1

4 Diana presented recommended changes to the core courses, keeping constant the number of required and elective units (88) with the understanding that some courses could be two units. Proposed changes include: Dropping the Managed Care course (442), because it is no longer thought to require a separate course. Critical material can be integrated elsewhere (HS 200 and HS 436: Financial management) Separating the existing Process Improvement and Information Systems course (251) into two separate courses: Quality and Performance Management; and Information Technology and Systems; Taking two units from the Ethical Issues in Health course, and devoting them to a Leadership Capstone Seminar (which would address some management and organizational ethics). In addition, there would be some alteration of existing content within courses, emphasizing population health and social determinants of health. These changes, creating clearer homes and tracks within the curriculum for health information technology and quality courses and content. Comments: In response to a question about why only the management track was discussed (and not the policy track as well), Diana noted that a similar assessment of the policy track would take place in 2010, but only the management program is subject to school accreditation. Dr.PH Program Beth Glenn reviewed DrPH competencies developed as part of the program s last major review in They included: Population health perspective Assessment and evaluation Leadership Determinants of health Public health infrastructure Inter-sectoral relationships Systems management 2

5 Organizational management. The DrPH curriculum was assessed to determine which courses covered knowledge areas and skills (analytic methods and leadership and managerial skills) related to each competency. Next steps include identifying some minor revisions to the competencies (particularly in terms of their fit compared to MPH and PhD competencies), identifying potential metrics or other ways to assess whether students are achieving these competencies, integrating competencies more fully into comprehensive exams, and revising the syllabi for DrPH required courses to incorporate the competencies. Comments: A concern was raised about the degree to which exam questions in the DrPH program correlate to competencies. PhD Program Jack Needleman provided an overview of the PhD and MS HS programs, reviewing the number of students and composition of the student body in each program (a mix of 5-8 Bachelors, Masters and MD students each year in the PhD program, recruited mostly regionally, and between 4 and 8 MD, post-doctoral, Robert Wood Johnson Clinical Scholars, and direct recruits in the MS HS program). After reviewing the core curriculum and cognates, Jack described the PhD Committee s work plan for the next year. It includes: determining who the target PhD students are (and how to recruit them); understanding how UCLA s PhD program compares to those of competitors; determining the scope and depth of core department courses and ways to strengthen the curriculum, especially in a competency-based model; determining the scope and content of cognates; understanding the role of financial aid and options (such as mentorships) for linking students to ongoing research; and identifying some priorities for marketing and recruitment. Jack sees the MPH curriculum s current weaknesses as lacking enough emphasis on quality and performance improvement, as well as information technology. In 3

6 the PhD/MSHS programs, he noted that many cognates need renewal or new leadership (or should be dropped). These programs also lack specific courses or structured training in data management, and the marketing of these programs is weak. In the future, both programs would benefit from developing short courses, institutes or other educational opportunities for professionals and policy makers outside of degree or certificate programs. This would have the potential to increase revenues and also generate greater visibility for the Department and its programs. Distance learning goals and implementation also should be considered for the near future. Comments: A question was raised about the distinctions between two courses 237A and 237C and the degree to which MS HS students are prepared when they transfer to the PhD program. An effort is underway to harmonize these courses so that they are more parallel. EMPH Program [Add summary from slides....] Comments: Faculty members had several questions about the EMPH program s cost structure and how (and whether) its revenues and losses accrue to the Department. The Chair noted that the issues raised about the EMPH program its size, strategy, and emphasis are key, and may lead to discussions about whether the degree should be designated a Masters in Health Administration (MHA) rather than MPH. Faculty anticipate greater demand for the program in the fall. The program is open to people working in community-based organizations involved in participatory research, but GREs may constitute a barrier for some. Suggested options included a special track that is more research-focused, an emphasis on proposal skills, or other short-term programs that fit the needs of partners working in community-based organizations. Faculty Survey Responses and Discussion Prior to the retreat, faculty members responded to an online survey that covered the following topics: The Department s teaching focus and how well it matches community needs, the interests of the Department s faculty as a whole, and individual faculty members; Departmental strengths and weaknesses; Budget issues, including options for increasing revenues and/or decreasing expenditures and allocating investments 4

7 Curriculum gaps and ideas for innovations in content and pedagogy; Opportunities for greater engagement with colleagues and communities outside the Department; Ideas for ways the Department could improve (i.e., doing more or less of various things); and Reflections on the Department s name and whether or not it should be changed. A summary of the 23 responses (not all of which were complete) can be found on the Department s blog site, Discussion of the survey results began with an item that appeared near the end of the survey: what the Department should be called. Some faculty and staff felt that the Health Services moniker is too generic and invites confusion, both within the UCLA community (e.g., differentiating Health Services and Community Health Sciences) and as a brand to be marketed to potential students. (Some felt the confusion about the Department s identity might extend to faculty recruitment, as well.) Tom Rice proposed a change to Department of Health Policy and Management, to reflect the course content and the professional roles pursued by the program s graduates, which sparked a spirited discussion about whether a name change is necessary. Jerry Kominski felt that instead of focusing on the Department s name, each individual program should be strengthened and that the fact that each degree serves distinct audiences is not necessarily a problem to be fixed. Jack Needleman disagreed, noting that some fault lines do exist. For example, he observed, the faculty overwhelmingly focus on research for policy, while the bulk of Masters students enter the program for training in practice an imbalance between faculty and student interests. Others wanted to add the word research to the Department s name, to capture the research emphasis, while some thought this was redundant and was widely understood (by prospective students and faculty alike) to be part and parcel of what Health Services departments do. (Note: After the retreat, Hector Rodriguez shared a summary of programs ranked in the top 10, listing the Department names for each as well as degrees offered in their day and executive programs. The summary can be found at 5

8 Noting that the Departmental name discussion was unlikely to be resolved during the retreat, Fred Zimmerman suggested that the naming discussion be tackled by a small committee that could report back to the group. Another suggestion was to ask a consultant to work with the Department on a more comprehensive brand and identity package (including the name). Mission Discussion Building on the identity/naming discussion, Fred transitioned the group to a discussion of the Department s mission by proposing the issue of costs as a unifying, cross-cutting theme across the curriculum and a way to position the Department as being part of potential solutions, serving a higher social (and national) goal. There was some resistance to this idea. Some felt that a focus on costs might be too narrow a focus, neglecting other important dimensions such as equity, access, prevention, sustainability and quality/performance issues. Others felt that the cost lens whether couched as cost containment, optimizing resources, eliminating waste, creating value and performance, or other terms did relate to ways the system can and should be reformed, since escalating costs by definition reduce options for investing in prevention, quality, access, etc. Related to this point, several faculty members noted that while there is value in training managers for the system we now have, it s also critical to think about training managers and researchers for a future reformed system. Some faculty members noted that the Department recently completed a thorough review and revision of the mission statement, and that further revisions might not be necessary. Along with the naming decisions, the mission discussions and decisions were deferred to a broader branding/identity review that will be undertaken by Jennifer Wortham (see below). Budget Discussion The budget discussion during the retreat was designed to reach some consensus on responding to a memo from the Office of the Executive Vice Chancellor, but covered some broader issues as well. Fred Zimmerman framed the discussion by raising several issues: what to do about classes with low enrollment (i.e., fewer than 10 students), addressing a current deficit in the buy-out system (which normally breaks even, thanks in part to essentially free teaching from faculty in the Cancer Center), and thinking strategically about revenue-enhancing activities for the Department. 6

9 Fred noted that he did not see either the low-enrollment classes or the buy-out system as crises, but did want to explore ways to make the Department s budget (running a projected deficit of $100,000 this year) more sustainable in the future, buffering the Department from future fiscal adversity while maintaining the Department s focus on educational quality. Faculty Buy-outs If the buy-out system theoretically should pay for all of the classes, it currently falls short: faculty are buying out of 8 classes, but 21 classes are being taught that wouldn t be taught otherwise. The Department relies heavily on adjunct faculty to teach the management curriculum, drawing on their practical experience as well as meeting a need within the Department. Several faculty members noted that there are other reasons for relying on adjunct faculty, beyond meeting a teaching need for a specific course, such as offering training comparable to a post-doctoral experience, or connecting the Department to other departments within the School and university. Faculty also noted the contributions and value that adjuncts offer to the Department, beyond teaching such as committee work and mentoring. One suggestion was to undertake a more systematic assessment of actual adjunct faculty needs. Another was to align the EMPH and MPH programs so that adjunct faculty are not unnecessarily replicated across both programs. Revenue-enhancing Activities In the online survey that preceded the retreat and in a Program Advisory Council meeting, faculty expressed enthusiasm for offering intensive short courses (lasting 2, 3, or 4 days) that employers would pay for, covering topics such as advanced financial management, project management, planning, and information technology. Distance learning and Webinar offerings were a distant second, and there was even less enthusiasm for offering 2- or 3-week summer courses or a self-sustaining degree program. Faculty offered several ideas for revenue-enhancing programs or activities, including: Developing short courses geared to the needs of an untapped market: law firms seeking to bring new associates up to speed quickly on topics relevant to the health care system (especially since the Law School is dropping its health law course); Developing and marketing short courses tailored to the needs of local and regional employers, such as Kaiser Permanente (e.g., covering topics such as an introduction to the health care system, health information technology, quality, and comparative effectiveness); 7

10 Resurrecting the Community Partners program, which at its height generated $40-50,000 each year and contributed to the Department s reserves. In exchange for donations of $5-10,000, local consulting firms, health care employers, and other partners could be offered a free day of consulting from the faculty or other benefits tied to tiers of donations or membership. Offering a lecture series on a timely topic that showcases the faculty s expertise and contributions to national issues (possibly in conjunction with short courses and/or an updated book covering health services topics) that would be offered for a fee or donation. Some concerns were expressed about how these activities could be developed, marketed, and launched, given existing resources among faculty and staff. One suggestion was to explore sharing administrative and marketing expenses with another Department (such as the Medical School). Another concern was how the School and University might encroach on any funds raised through these mechanisms, and whether they would be considered development funds or not. Additional Discussion Items Several other topics were addressed during the retreat: Financial aid especially for students in the PhD and DrPH programs, and to support recruitment of minority students More systematically transitioning doctoral students into funded research slots for the third and fourth years of their programs Understanding the differentiation between the Department s DrPH degree and CHS s doctoral program. (Toni Yancey described them as overlapping to some extent, but differentiated by what a student intends to pursue post-degree, and in which organizational context e.g., a fulltime research/teaching position, versus juggling a combination of teaching, research, and practice, not necessarily within a research institution.) Teaching Health Services courses as part of an undergraduate degree. Pros of doing so were attracting more bright students to the field (and the Department), matching the offerings of competitor institutions, and possibly gaining FTEs to add these courses in the future. Cons included establishing a Departmental commitment that might be hard to maintain (i.e., the courses are large, and resources are not provided for Teaching 8

11 Assistants), and adding a burden of mentoring and advisory responsibilities that are not necessarily covered by support for teaching FTEs. Next Steps Fred Zimmerman suggested that an appropriate use of the Department s reserves would be to hire a consultant to take on the related tasks of developing new initiatives and exploring the branding/identity issues raised during the retreat. Jennifer Wortham offered to take on these tasks in the form of a comprehensive business plan for the Department, linking the marketing/branding issues to a strategic plan for the near future. Jennifer will work with a committee that includes Neal Halfon, Lori Pelliccioni, Diana Hilberman, and Dylan Roby. A short-term priority will be to pursue the idea of customizing a pilot course for law firms, capitalizing on the immediate need and interest. These could be developed and marketed as extension courses (depending on the financial implications); a first step might be to work with members of the L.A. Health Bar to explore law firms interest and long-term commitment. In terms of student quality and curriculum issues (guidelines for core courses and a review for redundancy), faculty agreed that individual program directors would continue to assess these issues and report back to the larger group. 9