Office of Health Professions Education

Office of Health Professions Education Business Plan Kelly J. Caverzagie, MD Vice-President for Education Nebraska Medicine 986430 Nebraska Medical Center Omaha, NE 68198-6430 Mobile: 402-350-2058 Email: kelly.caverzagie@unmc.edu

Table of Contents 1. Background The Imperative for Change... 3 2. The University of Nebraska Medical Center (UNMC) and Nebraska Medicine A Brief History... 4 3. OHPE Mission, Vision and Objectives... 5 Mission Statement... 5 Vision Statement... 5 Objectives... 5 4. Services Provided and Products Expected of the OHPE... 6 Clinical Quality and Interprofessional Practice and Teamwork... 6 Continuing Education for Health Care Professionals... 7 Rural and Community Development... 8 Operations, Growth and Support of Innovations... 9 5. Organization and Management... 10 6. Marketing Plan... 10 7. Proposed Budget... 11 Personnel... 11 Operating Costs... 11 Program Development... 11 Travel... 11 Grand Total... 11 2

1. Background The Imperative for Change In the groundbreaking 2001 report Crossing the Quality Chasm: A New Health System for the 21 st Century, the Institute of Medicine called upon all health care constituencies to pursue fundamental, sweeping redesign of the entire health delivery system. Indications for this recommendation included the extreme lack of clinical coordination amongst providers within and between episodes of care, the inability to translate knowledge into practice, the historic focus on management of acute disease processes as opposed to chronic care management and the tolerance of unnecessary waste leading to increased and unsustainable health care costs. Put simply, the health delivery system was incapable of meeting the needs of the public it served. To guide these redesign efforts, the IOM introduced six aims for health system improvement such that all care should be safe, effective, efficient, patient-centered, timely and equitable. Achieving these aims will require that healthcare professionals work together in interprofessional teams to deliver evidence-based and high value care, focus on the management of patient populations, apply principles of data-driven quality improvement and rededicate efforts towards reducing health care disparities. Accomplishing this change requires fundamental redesign of the structures and processes in which health professions and organizations function. Health professions education must respond to this change by ensuring that the knowledge, skills, and attitudes of future health care professionals are consistent with this objective. Current and future trainees and faculty must learn and demonstrate competence in new skills such as interprofessional team-based practice, population health management, quality improvement, and informatics. Academic health centers must transform health professions education to ensure competence in these new skills while accommodating diverse learning styles, enhancing technology, and creating supportive clinical learning environments throughout the educational continuum. Many efforts by national accrediting and certifying bodies are working to support this transformative change (e.g. ACGME CLER program, Milestones, AMA Transforming Medical Education, Maintenance of Certification, ACCME, ANCC, ACPE, IPEC competencies). The University of Nebraska Medical Center (UNMC) and its clinical partner, Nebraska Medicine, are responding to this need for transformational change in health care delivery by establishing an Office of Health Professions Education (OHPE). The goal of the OHPE is to align the educational and clinical activities of UNMC and Nebraska Medicine to support their common interest in providing high quality health care. The OHPE, which will be housed within Nebraska Medicine, is intended to facilitate the alignment and integration of educational activities, services and programs between the academic and clinical partners. While intended to be flexible and responsive to emerging needs, the OHPE has four areas of focus: (1) Clinical Quality and Education, (2) Inter-professional Practice and Teamwork, (3) Continuing Education for Health Care Professionals and (4) Rural and Community Development. These four areas were chosen by a multi-stakeholder task force from both UNMC and Nebraska Medicine and are based upon the strategic needs of UNMC and Nebraska Medicine and the potential for meaningful impact. This document is the business plan for formally establishing and funding the OHPE. It contains the mission and vision for this office, the services and products to be delivered, a description of how the office will be integrated into the existing organizational structures, and the preliminary budget needed to achieve the mission. The implementation of the OHPE is expected to evolve over time. 3

2. The University of Nebraska Medical Center (UNMC) and Nebraska Medicine A Brief History The University of Nebraska Medical Center (UNMC) is the only public educational institution devoted to health sciences in the state of Nebraska. It is comprised of colleges of medicine, nursing, pharmacy, dentistry, public health, allied health professions and the graduate college in addition to the Munroe-Meyer and Eppley Cancer Institutes. UNMC is one of four campuses in the University of Nebraska system; it is a freestanding academic health science center located in the center of vibrant and growing Omaha, Nebraska. UNMC also has satellite campuses in four cities spread throughout the state. The UNMC operating budget for 2013-2014 was $641.6 million, of which 20.3% is supported by the state of Nebraska. UNMC research support totals over $100 million. The 2014 fall enrollment on the campus was 3,696 students in addition to over 500 medical and surgical residents and fellows. There are more than 4,900 employees and over 1,000 physicians in both academic and private practice. UNMC remains committed to its mission of improving the health of Nebraska through premier educational programs, innovative research, the highest quality patient care, and outreach to underserved populations. Nebraska Medicine, the clinical partner of UNMC, is the most esteemed academic medical center in the region offering exceptional patient care combined with innovative research and education. Together, the hospitals and clinics of Nebraska Medicine provide access to more than 1,000 University and private physicians, 678 licensed hospital beds and approximately 40 specialty and primary care clinics in Omaha and the surrounding area.. On an annual basis, Nebraska Medicine sees about 28,000 inpatients, 430,000 outpatients, and 78,000 emergency room visits. Patient origin includes all 50 states and 53 countries around the world. Nebraska Medicine and UNMC combine to employ greater than 10,000 individuals and contribute approximately $4.2 billion to the local and regional economy. The formal relationship between UNMC and Nebraska Medicine dates to 1997 when the partnership between University Hospital and Bishop Clarkson Memorial Hospital was formed to create The Nebraska Health System. This relationship persisted in various iterations and names until 2012 when leaders throughout the clinical delivery system recognized the need for better alignment of the hospital and its academic and community physicians. As a result, Nebraska Medicine was formed in January 2014 and consists of the clinical integration of The Nebraska Medical Center (the state s largest and highest rated hospital), Bellevue Medical Center (a high quality community hospital located 15 miles south of the main campus) and UNMC Physicians (the historic physician practice plan for academic physicians). UNMC continues to be the academic partner of Nebraska Medicine. The partnership between UNMC and Nebraska Medicine was solidified when on February 1, 2014 Jeffery P. Gold, MD was named Chancellor of the University of Nebraska Medical Center and Chair of the Board of Nebraska Medicine. The Chancellor serves as UNMC s chief executive officer and has responsibility for all aspects of the campus. Our Stand: We are Nebraska Medicine and UNMC. We lead the world in transforming lives to create a healthy future through extraordinary care, discovery and learning. 4

3. OHPE Mission, Vision and Objectives Mission Statement The mission of the OHPE is to facilitate development of a health professions workforce that possesses the knowledge, skills, and attitudes necessary to meet the needs of the patients and populations that we serve. Vision Statement The OHPE will be acknowledged by internal and external entities as being integral to achieving the collective clinical and educational goals of Nebraska Medicine and UNMC. Objectives To achieve the stated mission, the OHPE must align the activities of the clinical and educational units within Nebraska Medicine, UNMC and their partners to: 1. Support a clinical learning environment consistent with the Accreditation Council for Graduate Medical Education s (ACGME) clinical learning environment review (CLER) program, which is intended to improve the ability of all health professionals to provide safe, effective, patient-centered, timely, efficient and equitable care; 2. Support clinical and educational systems that promote quality improvement, teamwork, and interprofessional collaboration and practice; 3. Facilitate the achievement of common strategic priorities that strengthen our collective mission; 4. Strengthen relationships with rural and community partners through education, quality improvement and interprofessional practice; and 5. Minimize unnecessary redundancies in existing educational policies, programs and initiatives. 5

4. Services Provided and Products Expected of the OHPE Services Products Clinical Quality and Interprofessional Practice and Teamwork a - Educational units include all related entities that develop, disseminate or utilize an educational activity, service or program b Clinical units include all clinical service lines, departments, clinics or other operational entity where clinical care is housed or managed c For the purposes of this business plan the word quality encompasses quality improvement, patient safety and patient experience. 1. Facilitate engagement between educational a and clinical units b regarding strategic quality and interprofessional education activities. 2. Facilitate access to and interpretation of clinical data for purposes of quality improvement c and continuing education including Maintenance of Certification (MOC) for physicians. 3. Facilitate communication between educational and clinical units to achieve standardization of team training concepts and systems, approaches to quality improvement and transparency regarding related projects and initiatives. 4. Facilitate a process to incentivize learner, faculty and staff engagement in quality and interprofessional activities. 5. Develop a cohort of interprofessional faculty and staff capable of teaching and assessing quality improvement activities via the Association of American Medical Colleges (AAMC) Teach for Quality (Te4Q) program. 1. Needs assessment and inventory/repository of ongoing and planned activities and curricula for educational and clinical units related to quality improvement and interprofessional education. 2. Roadmap for connecting clinical unit quality improvement projects with those from educational units. This roadmap will include development of synergy between pre-clinical interprofessional education (IPE) and clinical interprofessional practice (IPP). 3. Strategy for incentivizing engagement of faculty and staff from educational and clinical units in activities related to quality and IPP. 4. Successful implementation of the AAMC Teaching for Quality (Te4Q) program. 6

Continuing Education for Health Care Professionals 1. Enhance collaboration within and between educational and clinical units to develop continuing education activities that align with strategic needs. 2. Facilitate the utilization of continuing education activities as a strategic asset for Nebraska Medicine and UNMC. 3. Assist clinical and educational units to conduct a needs assessment prior to developing educational activities, services and programs. 4. Assist Nebraska Medicine and UNMC faculty and staff to develop and publish scholarly activities related to educational and quality improvement activities, services and programs supported by the OHPE. 5. Assist Nebraska Medicine and UNMC faculty and staff to seek and obtain external funding related to educational and quality improvement activities, services and programs supported by the OHPE. 1. Needs assessment and inventory/repository of ongoing and planned continuing education activities. 2. List of continuing education activities that address identified quality gaps and strategic priorities of Nebraska Medicine and UNMC. 3. Strategy for sustained and transparent funding of strategic continuing education activities. 4. Common calendar of continuing education activities throughout the enterprise and network. 5. Annual report to demonstrate evidence of support for scholarly activity and pursuit of external funding. 6. Strategy for achieving efficient continuing education accreditation for interprofessional activities. 7

Rural and Community Development 1. Support educational and quality improvement efforts and programs in which UNMC/Nebraska Medicine and community/rural providers can partner to achieve benefit for patients, populations and providers. 2. Further the strong relationship with UNMC alumni through the development and implementation of educational activities, services and programs. 3. Offer MOC credit for physicians within the provider network through the American Board of Medical Specialties (ABMS) Portfolio Program. 4. Expand existing tele-health and tele-medicine capabilities to support tele-education. 1. Needs assessment and inventory/repository of ongoing and planned educational and quality improvement activities related to rural and community partners. 2. Formal partnerships related to education with external partners including the Nebraska Health Network and Regional Provider Network, especially focusing on quality and interprofessional practice. 3. Enhanced network of preceptors for clinical training of Nebraska Medicine and UNMC learners. 4. Successful enrollment in ABMS MOC Portfolio Program. 5. Established tele-education presence for learners and faculty not in Omaha. 8

Operations, Growth and Support of Innovations 1. Facilitate the development and implementation of innovative educational activities, services and programs that support our mission and specific strategic priorities. 2. Remove barriers that prevent collaboration between Nebraska Medicine and UNMC with regards to the four areas of focus. 3. Develop and maintain evidence-based resources to support stated objectives. 4. Assist clinical and educational units to evaluate educational and quality improvement activities, services and programs related to stated objectives. 1. Sponsor five Innovations Grants on an annual basis by providing funding of up to $10,000 to address quality and IPP projects that align with strategic needs of Nebraska Medicine. 2. Engagement of clinical units with iexcel (Interprofessional Experiential Center for Enduring Learning) for purposes of clinical quality improvement and teamwork training. 3. Annual educational conference to demonstrate innovative projects focused on quality improvement and interprofessional practice including an awards and recognition process for those projects. 4. Collaboration with UNMC library services to develop and maintain evidence-based resources and facilitation of scholarly productivity 5. Annual report to senior leadership of Nebraska Medicine and UNMC regarding impact of OHPE. 9

5. Organization and Management The OHPE is an extension of Nebraska Medicine and will be housed within its organizational matrix. The program manager of the OHPE will report directly to the Vice-President (VP) of Education who is part of the senior leadership team of Nebraska Medicine. The VP will interface directly with the UNMC Vice- Chancellor of Academic Affairs, the Deans and Directors of the UNMC Colleges and Institutes as well as other organizational leaders within the UNMC system in order to accomplish the objectives of the OHPE. The proposed organizational chart is summarized below. 6. Marketing Plan The primary focus of the OHPE marketing plan is to make leaders, faculty, staff and trainees within Nebraska Medicine, UNMC and our affiliated partners aware of the mission, objectives, services and intended products of the OHPE. Methods of reaching the target audience will include personal contact, email, brochures and an ongoing and updated web presence. 10

7. Proposed Budget Personnel FTE Salary Benefits Total OHPE Director 1.0 $ 115,000.00 $ 32,200.00 $ 147,200.00 OHPE Portfolio Manager 1.0 $ 70,000.00 $ 19,600.00 $ 89,600.00 OHPE Portfolio Manager 1.0 $ 70,000.00 $ 19,600.00 $ 89,600.00 Administrative Support 1.0 $ 40,000.00 $ 11,200.00 $ 51,200.00 Total Personnel $ 377,600.00 Operating Costs Computers/Technology $ 7,500.00 Office Supplies $ 2,750.00 Professional Membership Dues $ 1,800.00 Total Operating $12,050.00 Program Development Quantity Funds per project MOC Portfolio Program $ 14,950.00 AAMC Teach for Quality $ 18,000.00 Quality Innovation Seed Grants 5 $ 10,000.00 $ 50,000.00 Educational Conference $ 10,000.00 Marketing and Promotion $ 2,500.00 Total Program Development $ 95,450.00 Travel Registration Fees $ 4,400.00 Transportation and Lodging $ 26,800.00 Local Networking Travel $ 1,000.00 Total Travel $ 32,200.00 Total $517,300.00 11