It's back to school for system leaders: institute teaches leadership skills, cooperation - University of Michigan Health System

HealthCare Benchmarks and Quality Improvement, March, 2003

Health care leaders in Ann Arbor, MI, are returning to school so they can learn how to better care for a highly complex patient: the multisite, multispecialty academic medical center known as the U-M (University of Michigan) Health System.

In collaboration with the U-M Business School, the Health System recently has kicked off its new Health Care Leadership Institute.

The new institute's program will graduate hundreds of leaders with a shared vision to implement health care strategies simultaneously at U-M Health System.

Hospital, medical school, and health maintenance organization executives are using the 10-month "business of health care" program to advance their skills in health care management and leadership in order to improve the way medicine is delivered at the U-M Health System.

"There are a couple of things underpinning what we're trying to do," says Allen Lichter, MD, dean of the U-M Medical School.

"The first is that many of us, at least on the physician side, come to leadership without a lot of training in leadership and management. There are a lot of basic skill sets physician leaders especially need to be educated on, and we wanted to provide that forum," he says.

The second driving force of the program, Lichter explains, is bringing all of the system's top leadership through the same educational process.

"In our complex organization, we will have physician leaders, administrators in the hospital and in the medical school, and leaders in our HMO all speaking the same language and discussing issues together. I believe there is tremendous strength we create when all of us are working together," he declares

Expertise close at hand

To design the curriculum, health care leaders had to look no further than the U-M campus. The design, development, and delivery of the program were directed by the Executive Education Center of the U-M Business School in collaboration with the Medical School. The U-M School of Public Health also is a program contributor.

"The business school is expert at executive education," Lichter observes, noting that the school provides the faculty for the program.

The program is a multidisciplinary learning experience and involves preparatory assignments, class sessions, and "action learning" projects, in which participants analyze and recommend solutions to current U-M Health System leadership on management issues. Participants learn and apply concepts and tools in the areas of strategy; financial management; change management; managerial leadership; marketing strategy and positioning; operations management; information and business process; research and development; innovation, negotiation, and decision making; and strategic human resource management.

In the current class of 2003, examples of the action-learning projects include:

* Managing the Supply Chain: The Case of High-Cost Intermediate Products;

* Obstetrics/Gynecology: Short-Term Capacity vs. Long-Term Planning;

* Blue Cross/Blue Shield: The Value Proposition;

* Clinical Simulation: The Impact of Education and Care.

No more silos?

Among the perceived benefits of the program is the breaking down of the silos so typical in an academic medical center setting. "We tend to function, at times, in our organization as multiple independent businesses," Lichter says.

"As health care has evolved, however, we find patients cross multiple lines, needing to be seen in several different areas. On the financial side, investments may be made in one area, but they can affect several, so we have to start functioning as one organization," he adds.

U-M leaders also believe the new program will ultimately improve the way medicine is delivered at the U-M Health System.

"When we talk about medical care delivery, part of that has to do with efficiency--how our patients see us and how our co-workers see us--and those are some of the areas we are getting into," says Darrell Campbell, MD, chief of staff at the U-M Health System and a student in the program.

Leadership principles not normally studied by physicians will help improve patient safety, he asserts.

"Patient safety is all about communication, at the very lowest levels to the very highest," Campbell explains. "What we're trying to do as leaders is point out the value and the importance of communication from the front line to the top, and know where the potential mistakes are," he adds.

"Patients need and expect a seamlessness in their care," Lichter says. "Handoffs are not their problem; they are ours. If we do it well, patients and their referring physicians will receive much more efficient and effective health care."

Satisfied students

Campbell and Lichter, both of whom will be part of the institute's first graduating class, are enthusiastic about their experiences to date.

"We've completed four or five sessions, and I think it's been terrific," Campbell says. "There are a lot of aspects of running a business for which doctors are not very well-prepared. The idea is to merge the different medical interests and work on areas doctors don't know much about."