Leadership Challenges at the Convergence of Higher Education and Health Care Reform

Transcription

1 Leadership Challenges at the Convergence of Higher Education and Health Care Reform Association of Schools of Allied Health Professions- Spring Meeting, March 2015 Mark S. Sothmann, Ph.D. Vice President for Academic Affairs and Provost Medical University of South Carolina

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3 Health Professions Leadership Challenges Institutional Funding and Decision-Making Accountability Institutional Post Tenure Review Educational Technology Investing in Online Learning Information Security

4 MUSC Base Appropriations FY

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6 Common University Budget Models Incremental 60% of Institutions Centrally driven Current budget is base Needs to be periodically re-based to avoid entitlements Re-base rarely happens Formula/Performance 20% of Institutions Base funds are allocated to divisional heads Divisions further allocated funds based on strategies/missions Limits incentives and connections to central strategies Incentive-Based 20% of Institutions Devolution of revenue ownership Allocates all direct and indirect cost to revenue units Utilizes subvention fund to priorities Accountability for annual surpluses and deficits

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8 Universities Implementing Recent Higher Education Budget Redesigns Responsibility Centered Management Fiscal Years

9 Leadership - Better Decision Making System Transparency of Funds Flow Disperses Institutional Decision Making Revenue Enhancement Cost Control

10 Legacy Budget Model 10

11 Responsibility Centered Management

12 Implications for Deans Less focus on securing money from the provost More focus on external markets to generate revenue Control internal direct costs Managing faculty work and time Central services cost and services reviews Not all deans cut out for this model

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14 Considerations if Implementing I suggest you support and take active role! Cannot communicate enough with your faculty Advocate that there be a re-basing of state appropriations based on agreed upon allocation rules A Hold Harmless implementation is necessary Build implementation rules that are re-visited in 3-5 years

15 Institutional Accountability Suzanne Thomas, Ph.D. Professor, Department of Psychiatry Director, Office of Institutional Effectiveness Darlene Shaw, Ph.D. Professor, Department of Psychiatry Associate Provost, Educational Affairs and Student Life

16 Accountability 60% of States have adopted policies to allocate public funds for higher education based on outcomes President and Vice Presidents salaries are increasingly being tied to institutional outcome measures

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18 The Holy Grail An effective, university-wide strategy that is embraced by the faculty and has no conflict, either actual or perceived, with academic freedom that integrates the institution and balances accountability with continuous quality improvement

19 It Starts With Assessment- No One Thinks it is a Four Letter Word Assessment is measuring (qualitatively or quantitatively) progress in one s mission Tells you how well are you doing- what it is you purport to do The debate in higher education is not whether assessment should occur

20 The tension is in its perceived purpose Accountability Audience=External Intent=Summative Feels like=judgment Use of results=reporting out Reference points=comparative or fixed standards; external benchmarks Continuous Quality Improvement (CQI) Audience=Internal Intent=Formative Feels like=data-driven improvement Use of results=multiple feedback loops Reference points=longitudinal; comparison to target Ewell, PT. Assessment, accountability and improvement (2009) Learningoutcomesassessment.org

21 The continuum Accountability CQI Where stakeholders generally fall in their interest in assessment Federal Government State Government State Higher Ed Commissions Boards of Trustees Faculty Students Unions Regional Accrediting bodies Professional Accrediting bodies University Administration

22 The $64,000 question How do you develop an assessment strategy across the enterprise that achieves one without sacrificing the other? Beats me

23 A plan that s worked for us (so far in our 4 th year) P/VP Salary Plan Accountability Deans Metrics Unit Assessment plans CQI

24 P/VP Salary Plan Audience: State government; BOT; President and VP s Emphasis is primarily accountability, but results are used to show leaders where resources might best go for CQI Outcome Measures Education (faculty effectiveness as teachers; student achievement; student satisfaction; licensing exam results) Research (percentile rank in research funding & research expenditures) Employee engagement

25 Deans Metrics Audience: Provost; Deans Emphasis is balanced between accountability and CQI. Deans see how their college compares to all others on campus and to itself over time; they see areas where their college can improve and they know which units might need focused attention Outcomes Employee engagement Student satisfaction Quality education

26 Unit Assessment Plans Audience: Unit directors; Academic program directors Emphasis is primarily on CQI. Assessment plans are developed by the unit director in cooperation with Office of Institutional Effectiveness and final product is approved by the Dean Outcomes Unit specific; Standardized other uses to relate to accountability Deans review results at least every three years

27 Faculty Accountability and Tenure- A Perpetual Political Minefield 1980 Nationwide 80% Tenured/Tenure Track 20% Non-Tenured 2010 Nationwide 40% Tenured/Tenure Track 60% Non-Tenured

28 Accountability and Tenure Public Perception Zogby Poll 82% of people polled believe tenure needs to be abolished or modified

29 States Political Questioning Tenure Since 2011 Utah Pennsylvania Florida South Carolina Michigan Texas Arizona Kansas Wisconsin

30 Just Do Away With Tenure! Univ. of Minnesota Tenure War- mid 1990s Origin with Academic Health Center and guaranteed tenured physician salaries Result: Nationwide move to: Physician practice plans Hospital Authorities Result: Nationwide move to post tenure review (Assessment) state required states required AAUP opposes dismissal (Accountability) with post tenure review and focus is on faculty development (CQI)

31 Universities Accountability on Post Tenure Review: Mid- 2000s Research University- 2,711 performance reviews, 4 unsatisfactory ratings Seven large university systems examinednot one dismissal Post tenure review not being performed even when required by state law Virginia, Colorado lawsuits due to sloppy post tenure review

32 American Council of Trustees Statement on Post Tenure Review (Assessment) Academy has responded to public accountability largely with form rather than substance University should develop a system of carrot and sticks University should be transparent in post tenure review policies and their self assessments

33 Implications for Deans Tenure is a political minefield so best know its history and delicate balance of competing forces Academic Health Centers- Basic sciences tenured faculty losing research grant funding (academic performance) and post tenure review Balance Accountability with CQI in post tenure review State legislatures asking provosts results of post tenure reviews- provost asking deans A sloppy post tenure review can complicate legal

34 Leadership Challenges and Online Learning

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37 Leadership Challenge-Online Learning- Where and What to Invest Approximately 5.3 million students are taking online courses 3% increase from 2013 to 2014: lowest in 13 years Health Professions Campuses 80% offer online degree programs 62% Nursing 28% Public Health Raises Leadership Questions- Who is not offering and why not?? Can we impact student debt??

38 Student Debt: 80-90% Take Out Loans DMD $210,000 MD $184,000 PharmD $128,000 Phy.Ther. $ 90,000 Phy.Asst. $ 75,000 Occ.Ther. $ 63,000 MHA $ 74,000 Ph.D. $ 84,000

39 Other Online Leadership Considerations Lack of well-developed studies on cost effectiveness Lack of well-developed analytics generally Resistance from faculty- takes many forms Constantly evolving technologies

40 Leadership Challenge- Sensitive Information Protection Tegrity Lecture Capture System Allows recordings to be associated with academic courses Allows recordings to be publicly viewed via the following:

41 Patient Data Breach In 2015, a professor published multiple recordings containing patient data via a public course A cursory viewing of public courses discovered sensitive data Forensic course analysis revealed that of 111 recordings, 18% contained identifiable patient data Creating a public course has been disabled until further notice

42 Resulting Actions

43 Questions/Comments