UC Davis Health System
Strategic Planning Update
PHASE II
Developing the New Strategic Plan
DISCUSSION POINTS
 Review of Process to Date
 Phase II Part 1
- Interview Conclusions
- Environmental Assessment
- All-Employee Survey Results
 Phase II Part 4
 Next Steps
1
REVIEW OF PROCESS TO DATE
PHASE I
Evaluate & Review
Current Strategic
Plan
PHASE III
PHASE II
Develop New UCDHS 5-Yr Strategic Plan
Part 1:
Planning
Research
• Conduct
stakeholder
interviews:
evaluate the
current plan,
implementation
and future
alignment with
UCDHS priorities
• Review and
assess UCDHS’
performance on
“Indicators of
Achievement”
- PHASES OF PLANNING
Strategic
Planning
Interviews/
SWOT
Analysis
Stakeholder
Survey
Environmental
Assessment
Part 3:
Define
Strategic
Direction
Part 2:
Define
Global
Direction
Affirm/refine
Vision,
Mission
& Guiding
Principles
Define Goals
Define
Strategy
Design Team
themes &
assignments
Part 4:
Finalize Plan/
Implementation
Planning
AMC Strategies
develops
strategies &
tactics
Revise strategies
based on Focus
Group feedback;
Prioritize strategies
Recommendations
Presented to
Executive
Leadership Team
and Steering
Committee
Develop
Implementation
Plan: target
dates,
accountabilities
Resource
requirements
2
Plan
Implementation
Finalize Strategic
Plan
Implementation
structure and
process
Dashboard
development
Annual
progress
review
Phase II Part 1
Gathering Information to Develop a New Strategic Plan
A. Interview Conclusions
B. Environmental Assessment
C. All-Employee Survey Results
3
PART A.
INTERVIEW CONCLUSIONS
6
PART A. INTERVIEW CONCLUSIONS - Recommended Strategic Priorities*
1.
Develop a patient-focused and responsive care delivery system that optimizes
quality, access and cost effectiveness.
2.
Advance the research enterprise to further UC Davis Health System’s national
reputation as an academic medical center, including using interdisciplinary and
inter-professional approaches.
3.
Build a collaborative, team-oriented, empowered organization.
4.
Create a vibrant, engaging and nurturing learning environment to educate a
new generation of caregivers, researchers and educators.
5.
Select a limited number of targeted interdisciplinary initiatives as strategic focal
points and develop plans accordingly.
6.
Enhance UC Davis Health System’s image and visibility in the local, regional,
national and global community.
* Based on input from 97 individuals; items mentioned with equal frequency were
given the same numeric ranking.
4
PART A. INTERVIEW CONCLUSIONS - Recommended Strategic Priorities*
(cont’d)
7.
Assume a leadership role in improving the health of the community.
8.
Develop a sustainable financial model that provides appropriate support for
all mission areas.
9.
Determine the appropriate mix of primary and tertiary/quaternary care that
UC Davis Health System will provide in the future.
10. Leverage strength in informatics to make continued, innovative
advancements in clinical care, education and research.
11. Build a culture of philanthropy and increase our fundraising success.
12. Recruit, retain and cultivate excellent faculty and staff.
13. Proactively leverage our Integrated Health System to respond to and play a
leading role in designing health reform.
5
PART B.
ENVIRONMENTAL ASSESSMENT
6
FACILITIES UPDATE
Creating a Thriving Academic Campus
 Projects under way
-
PICU on Davis Tower 5
Research II
California Telehealth
Resource Center
Cancer Center Expansion
Parking Structure 3
 Planned projects
-
Funding for Capital Improvements, Equipment, Land
Acquisition  1978 – 2010  Total = $1.6 Billion
Graduate Studies Center
Research IV
Pavilion shelled-space build-out
Rancho Cordova PCN replacement
Natomas PCN clinic
7
Finances and Economic Impact
 Total budgeting; ≅9,700 faculty, residents and staff
 Economic impact study
Health System Margins: 5-Year Trend
under way
 Threats and
uncertainties
- Health-care reform
- State support
- Retirement
benefits; UCOP tax
8
9
STUDENTS
2008 to Present
Male
64
55.65%
Female
51
44.35%
African American
2
1.74%
American Indian
2
1.74%
Latino
1
0.87%
Mexican
1
0.87%
Other Asian
11
9.57%
Filipino
3
2.61%
Pakistani
11
9.57%
Japanese
2
1.74%
Chinese
14
12.17%
Caucasian
61
53.04%
Unknown
7
Total Hires
115
Incoming
Students
URM%
2010
97
24%
2009
93
19%
2008
105
15%
Demographic
UCDHS
Employees
County
Population
African Americans
10%
9%
American Indians
1%
1%
Asian Americans
21%
11%
6.09%
Hispanics
13%
14%
100%
Caucasian
55%
62%
STAFF
FACULTY
Hiring Summary
Class
Year
10
Research Funding:
Quadrupled in Past Decade
 Blue Ribbon
Committee on
Research
 New Vice
Chancellor
for Research
 Indirect Cost
Recovery
Discussions:
2009/2010
SOM Direct
$118.2m
SOM Indirect
$35.7m
Total Grant
Funding
$153.9m
2009/2010
11
SOM
$5.8m
16.2%
Campus
$21.3m
59.7%
UCOP
$8.6m
24.1%
Major Research Grants







Clinical and Translation Science Center:
Lars Berglund; $25M, 5 yrs; NIH UL1
NeuroTherapeutics Research Institute:
Paul Hagerman; $22M, 5 yrs; NIH UL1
Center for Regenerative Medicine:
Jan Nolta; $20M, 5 yrs; CIRM
Center for Biophotonics Science and Technology:
Dennis Matthews; $18M, 5 yrs; NSF
Study of Intensive Treatment for Toddlers with
Autism: Sally Rogers; $15M, 5 yrs; NIH R01
Northern California Children’s Study Consortium:
Irva Hertz-Picciotto; $15M, 5 yrs; NIH
Cancer Center Comprehensive Support Grant:
Ralph deVere White; $15M, 5 yrs; NIH P01
12
Culture of Excellence
 Areas of Distinction
-
Neurosciences
Cancer
Cardiovascular medicine
Telemedicine
Translational science
Community-based participatory research
Genomics and Regenerative medicine
 Novel initiatives at UC Davis that bring
life, physical sciences together
13
Peer-Reviewed Publications at University of
California Institutions with Schools of Medicine
Biomedical Basic Science, Clinical Science and Other Health Related Fields
2003-2007
Source: Thomson US University Indicators 2003-2007
14
Clinical Care: Quality Now;
Designing Future Systems
 Innovative Care
Models
-
ACOs
HIZ
FQHCs
WHA insurance product
Role in UC Center for
Health Quality and
Innovation
 Social Determinants
- University of New
Mexico/UC Davis/ AAHC
conference

Population Health
-
15
Institute for Population
Health Improvement
School of Societal Health
Faculty Practice Group* Work RVU’s by Department
The increase in work RVUs occurred in all departments.
FY10 Distribution
Department Name
All Other 3%
Neuro 2%
Int Med 24%
Rad Onc 2%
Urol 2%
am Med 2%
Peds 11%
N Surg 2%
Path 3%
Radio 11%
Derm 3%
ENT 3%
Surg 10%
Eye Ctr 5%
OBGyn 5%
Ortho 6%
Em Med 6%
Source: UCDHS Dline RVU Reports
16
FY06
FY10
(9 Mo Annlzd) CAGR
Internal Medicine
331,943
537,328
12.8%
Pediatrics
199,964
249,775
5.7%
Radiology
212,377
236,446
2.7%
Surgery
169,716
225,351
7.3%
Emergency Medicine
86,005
137,184
12.4%
Orthopaedic Surgery
80,510
122,270
11.0%
OBGyn
99,719
115,843
3.8%
UCDHS Eye Center
70,581
103,214
10.0%
Otolaryngology
57,880
72,054
5.6%
Dermatology
46,922
67,854
9.7%
Path & Lab Med
54,216
65,622
4.9%
Neurological Surgery
41,533
50,841
5.2%
Family & Community Me
35,538
44,521
5.8%
Urology
34,033
42,640
5.8%
Radiation Oncology
40,512
42,180
1.0%
Neurology
24,957
40,578
12.9%
All Other
47,223
60,395
6.3%
1,633,627
2,214,098
7.9%
Grand Total
* Exclude Anesthesia department, which reports anesthesia units instead of WRVUs.
Total Inpatient Mortality
Current Quarter
Recent Year
Relative
Performance
O
O
Denom
(Cases)
7,381
30,632
Cases (denom.)
Observed Deaths
Expected Deaths
Observed Mortality (%)
Expected Mortality (%)
Observed/Expected Ratio
Post-Surgical Mortality
Current Quarter
Recent Year
Relative
Performance
O
O
Denom
(Cases)
2,183
9,090
Cases (denom.)
Observed Deaths
Expected Deaths
Observed Mortality (%)
Expected Mortality (%)
Observed/Expected Ratio
Quality and Accountability
Aggregate Score
Current Quarter
Recent Year
Cases (denom.)
Observed Deaths
Expected Deaths
Observed Mortality (%)
Expected Mortality (%)
Observed/Expected Ratio
Relative
Performance
O
O
Denom
(Cases)
6,764
28,096
Obs/Exp
UHC
Ratio
Median
Rank
0.78
0.85
37/104
0.84
0.89
48/106
Current
Last
Recent
Quarter
Quarter
Year
7,381
7,909
30,632
136
155
618
172.35
199.43
727.61
1.84
1.96
2.02
2.34
2.52
2.38
0.78
0.77
0.84
UHC
Obs/Exp
Median
Ratio
Rank
0.85
0.85
56/104
0.91
0.85
66/105
Current
Last
Recent
Quarter
Quarter
Year
2,183
2,318
9,090
39
43
166
45.4
46.95
182.25
1.79
1.86
1.83
20.8
2.03
2.00
0.85
0.91
0.91
Obs/Exp
UHC
Ratio
Median
Rank
0.79
0.85
39/106
0.85
0.88
48/107
Current
Last
Recent
Quarter
Quarter
Year
6,764
7,252
28,096
136
155
614
171.69
197.82
721.36
2.01
2.14
2.19
2.54
2.73
2.57
0.79
0.78
0.85
UCDMC Compared to
Benchmark
Institutions, 4thQ 2009
•
•
•
Total Inpatient mortality
was within the target range
in the 4th quarter of 2009,
according to University
Health Consortium (UHC)
benchmark data.
Post-Surgical Mortality
was worse than expected
in the 4th quarter of 2009
according to UHC data.
The UHC Quality and
Accountability Aggregate
Score for the Medical
Center fell within the target
range.
O = Within target range
O = Worse than target range
Source: University Hospitals
Consortium Clinical Outcomes Report
Thinking Outside “Education” Box:
Schools of Health
I.

Degree programs
Medicine
- PRIME-Rural
- PRIME-SJV/Merced
Betty Irene Moore
School of Nursing

Master’s degrees
- Clinical Research
- Public Health
- Health Informatics

FNP/PA

MD/PhD
II. Graduate Medical Education
III. Continuing Heath Professionals Education

18
LCME: 2013
We are NOT ready
We are ready
• Our students are more
• Progressive competency is
• Our pathways are better
• Faculty development is
• Our electronic student record
• Student debt is high
diverse
not established
defined
modest
is remarkably innovative
• And much, more
• Early adoption of MMI
• Education deans, assistant
therefore….
• Jim Nuovo will start JCAHO
deans & directors are great
type internal reviews ASAP
• We have a coalition that
works
19
OVERALL RATINGS OF QUALITY
Year 1 and 2 Course Evaluations - 2007-2010
7 = Excellent, 4 = Adequate, 1 = Poor
NUMBER – DEPARTMENTS
COURSE
2009-10
2008-9
2007-8
CHA400 – Cell Bio Hum Anat
Gross Anatomy
6.75
6.77
6.70
CHA403 – Cell Bio Hum Anat
Neuroanatomy
6.56
5.88
5.83
CHA402 – Cell Bio Hum Anat
Cell-Tissue Biology
6.44
6.33
6.34
IMD420E – Med Nephrology
Nephrology
6.16
6.34
6.40
NEU420 – Neurology
Clinical Neurosciences
6.14
5.33
5.57
DER420 – Dermatology
Integumentary
6.01
6.21
6.37
IMD405 – Biochem/Endo/OBG
MERN
6.00
5.61
6.24
IMD420D – Med Cardio
Cardiology
5.93
5.02
5.16
PSY403 – Psychiatry
Psychopharmacology
5.92
5.68
5.36
PMD410A – Pathology
General Pathology
5.88
5.80
5.80
PMD410B-D – Pathology
Systemic Pathology Series
5.88
5.70
6.09
HON420 – Med Oncology
Oncology Series
5.67
4.23
5.27
IMD420B – Med Gastro
Gastroenterology
5.59
5.53
5.56
MMI480B – Microbiology
Microbiology
5.56
5.61
4.87
IMD420A – Med Hematology
Hematology
5.36
5.27
5.29
MDS421A-C – Med / Psych
Doctoring 2 Series
5.33
5.29
5.53
HPH400 – Physiology
Physiology
5.33
4.87
5.53
MDS411A-B – FCM/Med/Psych Doctoring 1 Series
5.25
4.64
5.52
IMD420C – Med Pulmonary
Respiratory System
4.97
4.69
4.56
BCM410A – Bioochem
Molec-Cell Bio
4.85
5.07
4.65
OSU421 – Orthopedics
Musculoskeletal System
4.71
4.75
5.15
PHA400A-D – Pharmacology
Pharmacology Series
4.64
4.44
3.87
MMI480A – Microbiology
Immunology
3.66
5.35
5.43
OBG420 – OB-GYN
Genetics
3.56
4.70
3.78
5.51
5.38
5.45
All Year 1 and 2 Courses
20
Campaign Progress
UC Davis Health System Goal:
$330,000,000
Raised to date:
$223,096,056
Percentage of goal:
67.60%
Endowments market value
$183,972,252
Endowments income transferred
$7,107,680
Dean’s Scholarship Fund market value $553,911.20
*Statistics are as of January 10, 2011 and based on comprehensive results since
July 2006, including the Gordon and Betty Moore Foundation grant.
21
Endowed Chairs
 Endowed chairs and
professorships are a
key priority
 Goal: 100 by 2014
22
PART B.
ENVIRONMENTAL ASSESSMENT
Betty Irene Moore School of Nursing
Est. March, 2009
23
Core Values
 Leadership development
 Interprofessional and
interdisciplinary education
 Transformative research
 Innovate technology
 Cultural inclusiveness
24
Research Emphasis
 Healthy Systems
– leadership, policy, system change, informatics
 Healthy People – priority populations:
– aging, rural, diverse communities
25
Distinctions
 A focus on healthy systems and health-care
design to promote health and optimize the
contributions of nursing
 Interprofessional and interdisciplinary program
including group-learning opportunities to
develop collaborative abilities for health-care
teams
 Leadership development to enhance skills and
promote leadership growth throughout program
 Designated emphasis in Health Informatics
26
27
2010 Highlights
 Formation of Nursing Science and Health Care
Leadership Graduate Group
- 28 interdisciplinary faculty from across UC
Davis campus
 UC systemwide approval of the Nursing Science
and Health-Care Leadership Graduate Degree
Program (Ph.D. and M.S.)
 Highly qualified inaugural graduate cohort reflects
diverse expertise, multiple settings and various
populations
 Recruitment of two new faculty members
 Convened National Advisory Council with
prominent interdisciplinary leaders
28
Revenues through 2010
 Research funding:
$2.9 million
 Workforce Investment Act funding secured:
$2.8 million
 Fundraising booked:
$3.3 million
 Gordon and Betty Moore Foundation:
$21. 2 million
29
Fundraising through 2010
 Raised $4,350,342 in philanthropic gifts, grants and
pledges
 10 endowed scholarship funds
 Expanded prospects to 600
 Completed planning study – key recommendations:
–
–
–
–
–
–
Retain $125 million target
Engage in quiet phase June 2010-December 2013
Continue planning study/cultivation interviews
Recruit a campaign cabinet
Kick off public initiative in Jan. 2014 (ending 2017)
Develop a founding board of advisors
30
Inaugural Cohort Statistics
Ph.D. program
M.S. Program
122
71
8
25
Average age
39.8
40.8
Gender (# men/# women)
1/7
4/21
Average G.P.A.
3.81
3.41
Applications submitted
Number enrolled
Academic background (#)
Nursing
Informatics
Business
Public health
Residence (#)
Sacramento
Bay Area
Other CA
6
2
1
1
Nursing
Public health
Nutrition
Other
6
1
1
31
Sacramento
Bay Area
Other CA
Out of state
International
25
2
3
7
13
4
7
1
1
Doctoral Nursing Enrollment
Comparative Data
 Nationally, in 2009 nursing
schools received 1,899
applications for research
Ph.D. programs with 66%
acceptance rate overall
 UC Davis received 122
applications for fall 2010 –
equivalent to 7% of the
2009 applications received
by all schools in the nation
 8 of 122 applicants, a 6.5%
acceptance rate
32
School of Nursing Priority Areas
 Academic life




Innovative, interprofessional educational experiences
Diverse learning organization for all
Robust research
Student excellence and life-long learning
 Community engagement
− Visible, high-impact nursing, health leadership
− Flourishing partnerships at all levels
 Sustainability and Infrastructure
– Evaluation
– Funding
– Space
33
PART C.
ALL EMPLOYEE SURVEY
34
Survey Respondents
Affiliates* at Which Respondents Work or Study
(More than one response was allowed)
Primary Role
Years with UCDHS
Response Rate = 22%
*Because participants were asked to choose all that applied percentages do not total 100%.
35
Top Strategic Issues
Develop a patient-focused and responsive
care delivery system that optimizes
quality, access and cost effectiveness.
Recruit, retain and cultivate excellent
faculty and staff.
Create a vibrant, engaging, nurturing
learning environment to educate a new
generation of caregivers, researchers and
educators.
Build a collaborative, team-oriented,
empowered organization.
• Overall, survey
respondents
identified patientfocused care and
recruitment and
cultivation of
excellent faculty
and staff as their
top two priorities.
Develop a sustainable financial model
that provides appropriate support for all
mission areas.
Assume a leadership role in improving
the health of the community.
Advance research enterprise to further
UCDHS’ national reputation as an
academic medical center, including using
interdisciplinary and inter-professional
approaches.
36
Top Strategic Issues
Enhance UC Davis Health System’s image and
visibility in the local, regional, national and
global community.
Foster creativity, risk-taking, collaboration,
and entrepreneurial partnership, as optimal
ways to encourage learning and pursue breakthrough discoveries and transformative ideas.
Leverage strength in informatics to make
continued, innovative advancements in clinical
care, education and research.
Proactively leverage our Integrated Health
System to play a leading role in designing
health reform.
Develop strategies that serve the state and
nation and address the emerging challenges of
an interdependent, global society.
Determine the appropriate mix of primary and
tertiary/quaternary care that UC Davis Health
System will provide in the future.
Select a limited number of targeted
interdisciplinary initiatives as strategic focal
points and develop plans accordingly.
Build a culture of philanthropy and increase
our fund raising success.
37
• Targeted
interdisciplinary
initiatives and
building a culture of
philanthropy were
ranked at the bottom
of the list.
STRATEGIC ISSUE RANKINGS - Interviewees vs. Survey Respondents
Survey Interview
Ranking Rankings
Strategic Priorities
1
1
Develop a patient-focused and responsive care delivery system that optimizes quality, access and cost effectiveness.
2
12
Recruit, retain and cultivate excellent faculty and staff.
3
4
Create a vibrant, engaging and nurturing learning environment to educate a new generation of caregivers, researchers
and educators.
4
3
Build a collaborative, team-oriented, empowered organization.
5
8
Develop a sustainable financial model that provides appropriate support for all mission areas.
6
7
Assume a leadership role in improving the health of the community.
7
2
Advance the research enterprise to further UC Davis Health System’s national reputation as an academic medical
center, including using interdisciplinary and inter-professional approaches
8
6
Enhance UC Davis Health System’s image and visibility in the local, regional, national and global community.
9
14
Foster creativity, risk-taking, collaboration, and entrepreneurial partnership, as optimal ways to encourage learning and
pursue break-through discoveries and transformative ideas.
10
10
Leverage strength in informatics to make continued, innovative advancements in clinical care, education and research.
11
13
Proactively leverage our Integrated Health System to respond to and play a leading role in designing health reform.
12
15
13
9
14
4
Select a limited number of targeted interdisciplinary initiatives as strategic focal points and develop plans accordingly.
15
11
Build a culture of philanthropy and increase our fund raising success.
Develop strategies that serve the state and nation and address the emerging challenges of an interdependent, global
society.
Determine the appropriate mix of primary and tertiary/quaternary care that UC Davis Health System will provide in the
future.
38
STRATEGIC ISSUES RANKING -
Medical Center vs. SOM Survey Respondents
• Respondents from the
Medical Center and the
School of Medicine ranked
patient-focused care and
cultivating excellent people
as their top two priorities.
• SOM respondents placed
greater importance on
advancing research and
fostering partnerships,
compared to Medical Center
respondents.
39
Phase II Part 4
Developing the New Strategic Plan
40
DRAFT
Guiding
Principles
Vision
Advancing health
through bold
innovation
Excellence
Teamwork/
Collaboration
Compassion
Leadership
Diversity
Mission
Improving lives
and transforming
healthcare
Social
Responsibility
41
VIGOROUS ENGAGEMENT
Approach: Highly iterative, intense cyclical feedback
AMC
Strategies
Steering
Committee
Strategic
Plan
Executive
Leadership
Design Team
Focus Groups
42
October 2010 – January 2011
Approach: Highly iterative, intense cyclical
feedback

Strategic planning steering committee provides feedback
on summary reports from eight design team brainstorming
sessions

AMC Strategies develops draft strategic plan, incorporating
design team work product

Executive leadership team reviews and revises draft
strategic plan

Design team focus groups engage in a critical review of
draft strategic plan

Strategic planning steering committee reviews design team
focus group work
43
Next Steps
44
February 2011 – May 2011
 AMC Strategies to redraft strategic plan, incorporating
feedback from design team focus groups and steering
committee

AMC Strategies to prepare a preliminary list of tactics
based on discussions at design team and steering committee
meetings

Steering committee to review and provide input on the
revised draft of the strategic plan

Metrics to be identified based on feedback from design
team members and the steering committee


AMC Strategies to finalize metrics for each goal
Strategic plan to be finalized – May, 2011
45