UMKC School of Medicine / Truman Medical Center
Department of Emergency Medicine
STRATEGIC PLAN
2013
Background
Page
2
Process/Assumptions
Page
2
Vision, Mission and Values Statement
Page
3
Clinical Care / ED Operations
Page
4
Education
Page
5-7
Scholarly Activity / Research
Page
8
Administration
Page
9
Objectives and Priority / Difficulty Grids
Progress Report on 2011 Strategic Plan
Separate Document
UMKC School of Medicine / Truman Medical Center
Department of Emergency Medicine
STRATEGIC PLAN
2013
Background:
The strategic plan for the Emergency Department was extensively updated in 2008, modified
in 2009 and 2011 and progress reports have been produced. There are multiple ongoing
challenges and the purpose of revising the plan was to bring the ED staff physicians (and
others) together to reconfirm the Vision, Mission and Values of the Emergency Department
and to develop and prioritize multiple objectives that must be addressed in order to carry out
the Mission.
Process:
In March 2013, the Chairman produced and distributed a progress report on the objectives
stated in the 2009 plan. Four groups: Clinical Care / ED Operations; Education; Scholarly
Activity / Research; and Administration met to reconsider progress and objectives. Group
members were chosen by the Chairman but all staff and residents were invited to participate
in as many groups as they wished. In addition, nursing, support and administrative staff were
invited. Each group met in March and April and developed objectives. Each objective was
prioritized by importance and difficulty of completion and this assessment was demonstrated
by placement in a “Priority and Difficulty” Grid. This material was distributed to the staff as
well as other stakeholders. After feedback was received, the plan was finalized.
Assumptions:
The assumptions for the revision of this plan are essentially the same as 2008 and 2011:
1) This is a strategic plan addressing objectives necessary to accomplish the mission of the
ED and this is not a business plan. It was assumed that fiscal issues would remain “as is”
for the near term and with rare exception are not addressed in the plan. It is also noted
that the economy and the Accountable Care Act will impact on our ability to accomplish
objectives (positively or negatively.)
2) The overall priorities of the department are: 1) Clinical Care, 2) Education, 3) Scholarly
Activity and 4) Administration. It is understood, though, that all are important and all
must be addressed to a greater or lesser extent.
3) It is understood that the ED is closely tied to UMKC School of Medicine, Truman
Medical Center and University Physicians Associate but there was no attempt to directly
tie the ED plan into any of the other entities’ plans. None of our objectives conflict with
the goals of any of these organizations and in fact, most are in general, if not specific,
alignment.
4) The ED has a dual leadership structure with physician and resident leadership separate
from nursing and support personnel leadership. The plan was developed with input from
all groups and objectives can only be accomplished with close cooperation among all
staff. In places this is explicitly stated in objectives, but in many it should be implicit.
2
UMKC School of Medicine / Truman Medical Center
Department of Emergency Medicine
Vision, Mission and Values Statement
2013
Vision Statement:
The Department of Emergency Medicine is the best place to receive, deliver, teach and learn
emergency medical care.
Mission Statement:
The Department of Emergency Medicine will improve our community’s health by providing
state-of-the-art patient centered emergency medical care to anyone at any time, by teaching
emergency medicine to health care professionals, and by conducting research designed to
expand the limits of knowledge in our specialty within a professional learning environment.
Values Statements:
1.
2.
3.
4.
5.
Patient care comes first and should be: safe, timely, effective, efficient, equitable and
patient centered.
Treat everyone as we want to be treated.
Teach and learn something new every day.
Look for a better way to do everything.
Have fun, enjoy the work.
3
Emergency Medicine Strategic Plan:
Clinical Care / ED Operations 2013
URGENCY LEVEL
Medium-Low
Medium
Medium-High
High
2 1
5
Very
Difficult
Low
4
3
Medium
Difficult
6
Less Difficult
IMPLEMENTATION (COST?)
LEVEL
Very Low
1) Improve ED throughput (ED throughput is multi-­‐factorial and includes multiple issues both inside and outside the direct control of the ED) • Collaborate with the Hospital Throughput Committee o Operationalize “90 minute consult process” • Continue to work with ED Throughput Committee o Continue to improve communication and teamwork with nursing o Enhance collaborative protocols (including pain, asthma and multiple others) o Enhance “Intake” processes 2) Optimize staffing • Expand faculty triple coverage as fiscally possible • Consider mid-­‐level providers for triple coverage and/or intake process 3) Optimize utilization of electronic health records • Consider utilization of scribes in some situations • Consider utilization of voice recognition software • Implement ongoing training in “tips and tricks of the trade” in EHR documentation 4) Improve collaboration with other specialties • Increase use of standardized ordersets and clinical pathways o Chest pain, STEMI, Hypothermia, Early Goal Directed Therapy of Sepsis, etc 5) Improve departmental quality and safety • Meet and exceed 90th percentile on ED Core Measures, Physician Quality Reporting System and other TJC and CMS standards • Incorporate National Patient Safety Goals 6) Incorporate publishable research projects into operational/improvement activities whenever possible 4
Emergency Medicine Strategic Plan:
Resident Education 2013
URGENCY LEVEL
Low
Medium-Low
Medium
Medium-High
High
4 5 3 2 1 Very
Difficult
Medium
Difficult
Less Difficult
IMPLEMENTATION (COST?)
LEVEL
Very Low
1) Successfully implement “Milestones” methodology • Develop “Clinical Competence Committee” • Incorporate milestones throughout the resident evaluation process 2) Continue to qualitatively improve resident education • Increase opportunities for simulation (both high fidelity and task training) • Increase opportunities for intra and cross disciplinary training o Team training • Increase opportunities for asynchronous learning o May need enhanced “web presence” via to optimally implement • Enhance curriculum with more opportunities for learning about and participating in quality, safety, wellness and professionalism activities • Improve ultrasound education • Improve mass casualty and disaster education 3) Increase faculty participation (Core faculty must participate in 25% of didactic educational activities per updated RRC rules) 4) Recruit highest caliber and more diverse applicants • Continue work on Residency Program “branding” (potentially via website and other social media) 5) Incorporate publishable research projects into educational activities whenever possible 5
Emergency Medicine Strategic Plan:
Student Education 2013
URGENCY LEVEL
Low
Medium-Low
Medium
Medium-High
High
4 3 2 1 Very
Difficult
Medium
Difficult
Less Difficult
IMPLEMENTATION (COST?)
LEVEL
Very Low
1) Continue to qualitatively improve medical student education • Clinical o Explore electronic medical records utilization by students o Continue to work with nursing to better allow students to accomplish procedures when appropriate o Implement EMS ride-­‐along program as soon as feasible • Didactics o Work with new clerkship director to re-­‐evaluate ongoing didactics and implement changes as necessary to optimize rotation § Consider enhancing on-­‐line and case-­‐based activities as well as enhanced use of simulation o Implement “shelf test” as soon as possible 2) Continue to engage with Emergency Medicine Interest Group • Field “Sim Wars” team for 2013 SAEM Regional Meeting • Work with medical student leaders to develop a curriculum and schedule activities more optimally 3) Improve extern recruitment • Review and optimize extern application process (i.e. set higher VSAS requirements) 4) Incorporate publishable research projects into educational activities whenever possible 6
Emergency Medicine Strategic Plan:
Faculty Education 2013
URGENCY LEVEL
Low
Medium-Low
Medium
Medium-High
2 3 1 Very
Difficult
High
Medium
Difficult
Less Difficult
IMPLEMENTATION (COST?)
LEVEL
Very Low
1) Continue to offer support for ongoing professional development activities • Funding advanced training (i.e. Graduate Certificate in Health Professions Curriculum and Evaluation) • Support for involvement in TMC/UPA Leadership Development Course 2) Develop skills retention program for faculty physicians • This could become a “product” to offer to as a CME course 3) Incorporate publishable projects into educational activities whenever possible 7
Emergency Medicine Strategic Plan:
Research / Scholarly Activity 2013
URGENCY LEVEL
Low
Medium-Low
Medium
Medium-High
High
7 6 1 3 2 5 4 Very
Difficult
Medium
Difficult
Less Difficult
IMPLEMENTATION (COST?)
LEVEL
Very Low
1) Continue to seek and support funded research • Initiate the BARDA (Biomedical Advanced Research and Development Authority) Influenza Study (Office of the Assistant Secretary for Preparedness and Response in the DHSS) • Successfully complete the STOP-­‐MRSA Study • Continue to support the Emergency IDNet • Work with the Quintiles Preferred Partners Program to increase participation in industry sponsored studies as appropriate 2) Reinvigorate and redesign the ED Research Committee • Meet periodically • Staff, resident, research personnel representation • All (resident) projects are proposed and presented to the committee o Incorporate this into the Resident Research Timeline • Review and Approve requests for funding from the ED Internal Research Grant 3) Improve utilization of the ED Research Director • Better incorporate the Director into the resident research education process as well as into the ED Research Committee process 4) Reinvigorate the ED Internal Research Grant Process 5) Continue to work with the Research Staff to facilitate enhanced administration of research projects 6) Develop research groups within the Department • EMS, Operations, Education, Other 7) Work with other Departments in a collaborative way • Informatics (Dr Williams), Performance Improvement (Dr Roberts) 8
Emergency Medicine Strategic Plan:
Administration 2013
URGENCY LEVEL
Very Low
Low
Medium-Low
Medium
Very
Difficult
5 High
3
2 1 4 Medium
Difficult
7 8 Less Difficult
IMPLEMENTATION (COST?)
LEVEL
6 Medium-High
1) Increase administrative support • Work with ED Administration to obtain a 2nd Education Coordinator Position 2) Develop and enhance Emergency Medicine Sections • EMS Section o EMT, AEMT and Paramedic Program • Toxicology Section 3) Enhance ultrasound capabilities • Obtain new US Machine with improved data management system 4) Improve faculty evaluation and incentive plans • Better align both with strategic plan and mission, vision and values statement 5) Continue to work with Security, Nursing and others to improve workplace safety 6) Initiate planning for the Great Plains Regional SAEM Meeting (2014) 7) Enhance UMKC/TMC Emergency Medicine “branding” • Improve EM website • Consider initiating a Departmental “Facebook” account 8) Continue to update the Departmental strategic plan 9