UMKC School of Medicine / Truman Medical Center
Department of Emergency Medicine
STRATEGIC PLAN
2011
Background
Page 2
Process
Page 2
Assumptions
Page 2
Summary
Page 3
Vision Mission and Values Statement
Page 4
Objectives and Priority / Difficulty Grids
Clinical Care / ED Operations
Page 5
Education
Page 7
Scholarly Activity / Research
Page 13
Administration
Page 15
UMKC School of Medicine / Truman Medical Center
Department of Emergency Medicine
STRATEGIC PLAN
2011
Background:
The strategic plan for the Emergency Department was extensively updated in 2008,
modified in 2009 and a progress report was developed each year since. 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 April 2011, 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 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:
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 ongoing recession and the recent passage of a comprehensive health
care reform bill will almost certainly impact on our ability to accomplish objectives.
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
2
among all staff. In places this is explicitly stated in objectives, but in many it should be
implicit.
Summary:
The Vision, Mission and Values statements continue to withstand the test of time very
well and remains unchanged.
Clinical Care / ED Operations:
Throughput is the highest priority issue, and is a multi-factorial problem that touches all
departments. The implementation of the “team system” (also known as the “pod
system”) has enhanced ED teamwork. The implementation of electronic medical records
and computerized physician order entry has also impacted ED operations.
Education:
The residency program continues in the midst of its 8 year accreditation cycle (reflecting
its maturity and excellence.) The student clerkship continues to flourish.
Scholarly Activity / Research:
We continue to be a site for the “STOP-MRSA” NIH sponsored collaborative project
within the Emergency ID Net Research Network. We have been able to integrate
research into some operational and educational projects resulting in five presentations at
the 2011 Society for Academic Emergency Medicine Annual Meeting.
Administration:
Extra administrative staffing for the Student Clerkship and Emergency Medicine
Residency Program are critical for continued success of those programs.
3
UMKC School of Medicine / Truman Medical Center
Department of Emergency Medicine
Vision, Mission and Values Statement
2011
Vision Statement:
The Department of Emergency Medicine is the best place to deliver and receive, teach,
learn, and study emergency medical care.
Mission Statement:
The Department of Emergency Medicine exists to improve our community’s health by
providing state-of-the-art 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 an environment which nurtures
professional growth and satisfaction.
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 everyday.
Look for a better way to do everything.
Have fun, enjoy the work.
4
Emergency Medicine Strategic Plan:
Clinical Care / ED Operations 2011
Objectives:
1)
Improve ED throughput
(Optimal throughput is multi-factorial and includes multiple issues outside the
direct scope of the ED)
- Collaborate with reconstituted Hospital Throughput Committee to improve
hospital-wide approach to throughput
- Work with ED Throughput Committee to address issues within the Department
that impact on throughput
- Improve Diversion rates by improving Hospital and ED throughput
2)
Increase faculty staffing (Presently at 40 hours per day)
- Consider expanded use of mid-level providers (in or outside of present Fast Track)
3)
Optimize utilization of Electronic Health Records and CPOE in the ED
- Consider utilization of voice recognition software in the ED
4)
Increase use of standardized order sets and clinical pathways when possible
and appropriate
- Work with Cardiology to decrease “chest pain” admissions by increasing ability
to do more extensive workups in the ED
- Work with partners to re-invigorate post arrest therapeutic hypothermia (necessary for
eventual designation as a “Cardiac Arrest Center of Excellence)
5)
Improve Departmental Quality and Safety
- Incorporate “STEEEP” principles: safe, timely, effective,
efficient, equitable, patient centered
- Incorporate National Patient Safety Goals, particularly: enhanced
communication, hand-washing
- Build a culture of safety in the ED
6)
Improve communication and teamwork with ED nursing
- Optimize collaborative practice protocols (standing orders)
- (See Resident Education Section)
7)
Increase resident coverage (approved for 12/year, funded for 10/year)
8)
Meet the 90th percentile on all ED related Core Measures and the Physician
Quality Reporting System (PQRS)
9)
Utilize the services of the our PharmD position to build a culture
of medication safety
10)
Incorporate publishable research projects into
operational/improvement activities whenever possible
5
Emergency Medicine Strategic Plan:
Clinical Care / ED Operations 2011
URGENCY
LEVEL
Medium–Low
Medium Medium-High
High
1
Very Difficult
Low
7
8
10
Medium
Difficult
9
Less Difficult
IMPLEMENTATION (COST?)
LEVEL
Very Low
6
2
5
6
3
4
Emergency Medicine Strategic Plan:
Resident Education 2011
Objectives:
1)
Increase emphasis on and qualitatively improve resident education
- Clinical
- Continue to build on ongoing improvements
- Increase feedback to residents
- Didactic
- Increase faculty involvement
- Consider increasing “year specific” teaching
- Increase utilization of simulation whenever possible (specifically will
attempt to have several teaching days per year in the simulation lab)
- Work to develop teamwork via joint physician/nurse training (simulation
based)
2)
Continue to integrate next mandated step (patient outcomes) of ACGME
core competencies into program
3)
Continue to enhance resident scholarly activity (see research section)
- Improve ability of faculty to increase scholarly activity
4)
Enhance peer and faculty mentorship program
- Work to enhance feedback mechanisms
5)
Recruit highest caliber and more diverse applicants
- Work on Residency Program “Branding”
- Consider partnering with KU EM Residency Program on joint projects
6)
Incorporate publishable research projects into educational activities
whenever possible
7
Emergency Medicine Strategic Plan:
Resident Education 2011
URGENCY
LEVEL
Very Low Low
Medium–Low
Medium
Medium-High
Very
Difficult
2
6
3
Medium
Difficult
4
Less Difficult
IMPLEMENTATION (COST?)
LEVEL
5
8
High
1
Medical Student 2011
Objectives:
1)
Continue to improve medical student clinical experience while balancing
needs of faculty physicians and residents
- Work with Clerkship Director to optimize student didactics fully utilizing
“Blackboard” when appropriate
2)
Engage with the UMKC SOM Emergency Medicine Interest Group (EMIG)
when possible
3)
Improve extern recruitment
- Consider engaging with the KU EMIG
4)
Incorporate publishable research projects into educational activities
whenever possible
9
Emergency Medicine Strategic Plan:
Student Education 2011
URGENCY
LEVEL
Very Low
Low
Medium–Low
Medium Medium-High
High
Very
Difficult
4
1
Medium
Difficult
2
Less Difficult
IMPLEMENTATION (COST?)
LEVEL
3
10
Emergency Medicine Faculty 2011
Objectives:
1)
Develop a skills retention program for faculty partnering with the
Youngblood Simulation Laboratory personnel
- Use products developed in this program to enhance resident and medical student
education
- Consider using these products to offer CME courses
2)
Continue organization of a more formal Faculty Development Program
- Consider partially funding enhanced training for selected faculty (Graduate
Certificate in Clinical Research, Master of Public Health, etc.)
3)
Incorporate publishable research projects into educational activities
whenever possible
4)
Establish TMC Emergency Medicine Residency Alumni Society
11
Emergency Medicine Strategic Plan:
Faculty Education 2011
URGENCY
LEVEL
Very Low Low
Medium–Low
Medium Medium-High
Very
Difficult
1
Medium
Difficult
3
Less Difficult
IMPLEMENTATION (COST?)
LEVEL
4
12
High
2
Emergency Medicine Strategic Plan:
Research / Scholarly Activity 2011
Objectives:
1)
Continue to support the STOP-MRSA study and Emergency IDNet studies
2)
Develop and implement an ED Research Committee:
- Meets periodically
- Has staff and resident physician, nurse and research personnel representation
- Purpose:
- Reviews and approves research projects within the ED
- Clearing house of ideas for projects
- Group of interested parties to review projects (and make suggestions for
improvement)
- Review and approve requests for funding from Departmental Research
Account
3)
Recruit or develop a research director (physician or non-physician)
- Full or part-time, physician or non-physician
- See Faculty Development Section
4)
Continue to work with our Research Staff to facilitate enhanced
administration of research projects
5)
Continue to develop groups within the faculty to take better advantage of
research opportunities that are consistent with our local expertise and
situation:
- ID Net
- Educational Issues
- EMS
- Operational Issues
- Shock-Trauma Institute
- Other
6)
Partner with other Departments to facilitate inter-departmental studies
7)
Continue to partner with members of the SOM for study design and
statistical support
13
Emergency Medicine Strategic Plan:
Research / Scholarly Activity 2011
URGENCY
LEVEL
Very Low Low
Medium–Low
Medium
Medium-High
Very
Difficult
3
1
Medium
Difficult
5
7
Less Difficult
IMPLEMENTATION (COST?)
LEVEL
6
High
14
4
2
Emergency Medicine Strategic Plan:
Administration 2011
Objectives:
1) Increase administrative support
- Medical Student/Resident/Faculty
2) Continue to update and improve ED Website
- Initiate a “Facebook” page for the ED
3) Explore income-generating activities for the Department
- Toxicology
- EMS Education
- Simulation
4) Improve Faculty Evaluation and Incentive Plan
5) Improve UMKC/TMC branding for EM
- “Logo” contest
- “Giveaway” items
6) Initiate planning for the 40th Anniversary of the Residency Program founding
(2013)
7) Continue to enhance a Workplace Violence Prevention Program
8) Continue to work on Intra-Departmental organization
- Succession planning
9) Continue to periodically update the ED Strategic Plan
10) Initiate a faculty recruitment and retention plan
15
Emergency Medicine Strategic Plan:
Administration 2011
URGENCY
LEVEL
Very Low Low
Medium–Low
Medium
Very
Difficult
8
4
High
3
1
Medium
Difficult
7
5
6
9
Less Difficult
IMPLEMENTATION (COST?)
LEVEL
10
Medium-High
16
2