Preparing the Workforce Teams of the Future. AAMC Council of Deans, Western Region August 31 September 2, 2012

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1 Preparing the Workforce Teams of the Future AAMC Council of Deans, Western Region August 31 September 2, 2012

2 Future workforce challenges, opportunities Reform requires new team approaches to health care How do we change health professions education to provide needed skills? How do we stimulate an interprofessional culture? How do we change research training and approaches to embrace team science? How will new care models alter how academic health centers pursue missions in education, research and patient care? 2

3 Future workforce challenges, opportunities Team approaches impact academic health center culture, finances, operations How do we ensure effective team function across traditional professional silos? What are the financial implications of team approaches for academic health centers? How should leadership drive/support team care, team learning and team research? 3

4 Team Leadership Organizational model: Schools of Health 4

5 Team Leadership Schools of Health model: Promotes UC Davis Health System vision, mission Our Vision A healthier world through bold innovation Our Mission Improving lives and transforming health care 5

6 Team Leadership Schools of Health: Form follows function 6

7 Team Learning New approach to curriculum development Interprofessional education competencies Example: Pain Management Interprofessional education special experiences Example: Summer Institute on Race and Health Interprofessional education medicine/nursing courses 7

8 Team Learning New approach to education across UC Davis, UC system Programs in medical education (PRIME) Nursing Science and Health-Care Leadership graduate group Systemwide UC nursing school curricula Proposed Bachelor s degree in Health Sciences 8

9 Team Learning New approach to student experience Interprofessional social experiences Interprofessional student-run clinic Interprofessional student interest groups Quality Improvement Student Interest Group Interprofessional Health Informatics Interest Group 9

10 Team Learning Education challenges, opportunities New ways of teaching, learning Affordability for students, universities, society Flip the classroom Utilize technologies (virtual anatomy, virtual learning space, social media, mobile apps) Change lock-step training, teaching to competency-based training Redefine faculty roles (lectures small groups) Redesign classroom space, use of alternative learning venues 10

11 Team Focus New approach to centers of excellence Institute for Population Health Improvement Mission address all determinants of health Interprofessional initiative in Schools of Health Multidisciplinary programs; state/federal contracts and grants of ~ $72 million during first year Health Informatics Institute Vision single institute spans nursing, medical, public health informatics Mission use informatics to catalyze new models of care and improve health outcomes 11

12 Team Research New approach to research Innovation at the interface, intersection of disciplines Requires new core competencies Team science: New people New questions New approaches New infrastructure, resources 12

13 Team Research New approach to research Howard Hughes Medical Institute s Integrating Medicine into Basic Science Training program Fosters translation of basic science discoveries into new treatments Enrolls biology, engineering graduate students Building Interdisciplinary Research Careers in Women's Health Foster biomedical research careers in women s health; accelerate interdisciplinary research 13

14 Team Research New approach to research Mentored Clinical Research Training Program Prepare trainees for clinical/translational team-science research Provide multidisciplinary didactic curriculum with mentored research for medicine, veterinary medicine degrees Nursing Science and Health-Care Leadership Graduate Group Interprofessional PhD research Doctoral students from nursing, public health, mental health, informatics Includes over 40 faculty from nursing, medicine, public health, sociology, pharmacy, health informatics, psychology, statistics, nutrition 14

15 Team Research New approach to research # Publications: 8 # Collaborators: 31 # Ties: 219 % Cross-degree: 57% % Cross-discipline: 65% General Medicine Pediatrics Pathology Radiology Rheumatology Statistics/Math Life Sciences Epidemiology Social Sciences/Psychology Other Discipline MD PhD MD + PhD Other degree 15

16 Team Research New approach to research Interprofessional team approach attracts new resources Hartwell Team Elva Diaz, PhD Department of Pharmacology molecular targeting Nitin Nitin, PhD Department of Biological and Agricultural Engineering sirna nanoformulation Noriko Satake, MD Department of Pediatrics leukemia-targeted therapy Kit Lam, MD, PhD Department of Biochemistry and Molecular Medicine leukemia-specific targeting, nanodelivery Jan Nolta, PhD Director, Stem Cell Program xenograft models, clinical trials 16

17 Team Research New approach to research Organizational cohesion Disciplinary excellence Goal focused Collaboration Quality improvement Stagnating, deteriorating public health Recombinant innovation Cognitive diversity High-risk exploration, positive deviance Creative conflict Clinical systems innovation Increasing health-care capabilities, expenditures 17

18 Team Research Research challenges, opportunities New reward structure, culture to encourage team science Interdisciplinary collaboration to enhance competitive position for public, private funding Interprofessional approach to recruiting, training, retaining Efficient utilization of shared resources Cross-functional solution to decrease in cross-subsidization 18

19 Team Care New approach to clinical care Residency teams design initiatives to improve care Medical residents from all 23 programs develop, implement, analyze methods to improve patient-care delivery Daily huddles increase patient, care team satisfaction Coordination of care, patients specific needs Nursing leadership, quality improvement initiatives 19

20 Team Care Clinical care challenges, opportunities Transform traditional health-care silos to embrace team workforce Translate team-care into new health-care delivery models Develop team approaches to cost, time efficiencies to address impact of reform on clinical reimbursements Structure clinical systems to operate in team-based environment 20

21 Team Leadership Challenges for academic health centers Culture teams Unions, guilds impact team structure, function Interprofessional training, team approach introduces new path to leadership Financial workforce New compensation models to reflect roles, responsibilities instead of degrees; differentiate research, teaching, clinical compensation rates Financial institution Payment reform threatens cross-subsidization NIH changes reduce funding Less government support for higher education 21

22 Team Leadership Challenges for academic health centers Leadership Address emerging paradigm of leadership positions based on qualifications beyond degrees, formal training Incorporate team-based factors into new organizational model of institutional management Develop team-based procedures, tools to assess performance Create faculty compensation structure to distinguish teaching, clinical time 22

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