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Department of Surgery Business Plan

Department of Surgery Business Plan

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Department of Surgery Business Plan

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  1. Department of SurgeryBusiness Plan FY 2007/2008

  2. Surgery Mission Our mission is to advance comprehensive healthcare by providing excellent surgical services, conducting innovative research, and ensuring exceptional education for all we serve. Surgical excellence, innovative research, and exceptional education for all we serve

  3. Service Expansion Growth & Recognition Vision Operation Improvement Optimal Efficiency and Resource Utilization Communication to Stakeholders Internationally Recognized as a Premier Academic Department of Surgery in the Midwest Enhanced Scholarly Activity and Environment Integral Part of the Community Health Core Objectives

  4. Department Summary • 2 Endowed chairs • 37,950 Patient encounters • 3,497 Surgical procedures in CUMC OR • 9 Divisions (12 sections) • 35 Clinical Faculty Members • 7 Research/Admin Faculty Members • Residency Programs (preliminary, categorical, orthopedics, emergency medicine, urology) • Fellowship programs (Bariatric, Colorectal)

  5. Department of Surgery 2007/2008 Program Development Opportunities

  6. Cardiothoracic Surgery • Continued development of the Endovascular Program • Recruit surgeon with training in minimally invasive and robotic cardiac surgery • Support expansion of pulmonary service with development of lung reduction surgery • Support expansion and available surgical services for the oncology program with focus on solid tumors (joint program) • Develop clinical and research programs with cardiology and pulmonary medicine

  7. General Surgery • Develop a esophageal program and comprehensive digestive disorders program • Expand new technologies in endoscopic devices (transluminal procedures) and technologies: mucosal resections, trans-oral anti-reflux surgery • Current recruitment of a surgeon who specializes in natural orifice trans-luminal endoscopic surgery (NOTES) • Develop new technologies and expand our experience with hernia repairs • Focus on the heterogeneity of healing and the area of tissue engineering

  8. General Surgery continued Trauma Service • Build trauma team with emphasis on continuity of care. • Achieve accreditation by State of Nebraska and American College of Surgeons. • Continue to integrate the trauma service with the ICU to provide comprehensive continuity of care. • Bariatrics • Expand the program and our area of expertise • Market the Bariatric Center of Excellence designation • Continue the development and integration of a comprehensive program with medicine and psychiatry • Continue development of the weight loss program

  9. Neurosurgery • Expand the referral basis • Expand outreach – Immanuel and Mercy Hospital • Emphasis on tertiary surgery to CUMC • Hire neurosurgeon to develop a comprehensive spine program • Cyberknife program development • Explore functional neurosurgery • Ablative resection and deep brain stimulation with neurologists • Expand the research on injured brain tissue and applications of brain tissue oxygenation • Develop a comprehensive neuro-oncology program

  10. Orthopaedics • Recruit orthopedic spine, sports medicine, joint, and trauma surgeons • Continue expansion of the orthopedic oncology • Continue development of the joint replacement and sports medicine programs

  11. Plastic Surgery Plan for program development involving reconstruction (trauma, oncology, and urology) • Develop a program for cosmetic surgery • Recruit a second plastic surgeon • Continued development of the oral/maxiofacial program with the School of Dentistry

  12. Surgical Oncology • Emphasize solid tumor programs • Disease specific programs (breast, melanoma, prostate, lung and bone metastasis, peritoneal carcinomatosis) • Collaborate with School of Medicine, hospital, and Dept. of Medicine and Radiology to build high profile Cancer Center (clinical, research and education) • Comprehensive Program for Peritoneal Carcinomatosis • Develop a nationally recognized research program • Utilize Federal programs to provide screenings for the underserved • Continue to increase volume in the Comprehensive Breast Clinic in conjunction with radiology

  13. Urology • Recruit urologist with robotic expertise • Develop joint program for prostate cancer. • Develop program of pelvic reconstruction • Area of clinical innovation (Healthcare Advisory Board) • Develop urology residency program in conjunction with UNMC

  14. Vascular Surgery • Recruit endo-vascular trained surgeon • Re-establish vascular lab accreditation • Integrate a vascular practice with a business model that includes several surgeons (UNMA and VA). • Emphasize outcomes research and develop a research program linked to the national initiatives to improve surgical activities at CUMC

  15. Transplant • Recruit Transplant Surgeon • Develop UNOS accredited kidney/pancreas transplant surgery program with nephrology

  16. STRENGTHS • Successful recruitment and retention has led to program development opportunities • Several nationally known programs and surgeons within the Department • Joint program development with other Departments has led to increased volume • Increased outreach locations have enabled better payor mix, higher volumes

  17. WEAKNESSES • Divisions with only one provider -difficult to establish a practice and cover trauma call -at risk if surgeon becomes ill or leaves • Difficulty establishing referral base for new surgeons • Compensation plan -leads to competition between faculty -difficult for Department to absorb negative financial impact from low earning programs • Recent year end deficit from frozen adjustment rate reconciliation in combination with new lower overall adjustment rate has led to financial instability for individual surgeons and the Department

  18. Summary • Recruit • Develop new models for doing business • Build relationships, expand and secure sources of business • Provide highest quality patient service • Support education at all levels • Develop research programs • Establish new compensation plan

  19. Department of Medicine Clinical Strategic Plan Joint Business Planning Session August 29, 2007

  20. Agenda Mission Leadership Changes Strategic Review

  21. Mission Superlative clinical service Outstanding medical education Focused Translational Research

  22. Associate Chairs • Dr. Robert Dunlay Education • Dr. Robert Anderson Research • Dr. Aryan Mooss Academic Affairs • Dr. Laurel Preheim VA • Dr. John Hurley Clinical Affairs

  23. New Division Chiefs • Dr. Dennis Esterbrooks Cardiology • Dr. Syed Bin-Sagheer (Interim) GI

  24. Clinical Practice

  25. Clinical Goals • Develop Cardiovascular Institute • Expand Participation by Private Internal Medicine Practice Groups to increase teaching opportunities and enhance clinical mission • Establish Hematology/Oncology Partnership to expand specialty services

  26. Clinical Goals • Redesign and Expand Primary Care Sites • Improve Revenue Cycle Management • Enhance Customer Service

  27. Education

  28. New Fellowship Programs • Recent • Interventional Cardiology – 2006 • Endocrinology - 2006 • Planned • Gastroenterology - 2009 • Sleep medicine – 2010 • Nephrology • Hematology/Oncology

  29. Medical Education Goals • Increase Clinical Volume for Student Learning Opportunities • Enhance Department Support for Medical Education Programs • Improve Learner Evaluation Process • Add newer simulation technology

  30. Research

  31. Research Goals • Develop Genetics/Proteomics Research (September 2007) • Improve Infrastructure and Admin Support • Strengthen Mentoring of New Researchers • Increase Collaboration with Basic Science • Recruit More Investigators • Establish Division of Clinical Research

  32. Department Strengths • Clinical - Cardiology - GI Advanced Endoscopy - Internal Medicine - Nephrology - Pulmonary/Critical Care

  33. Department Strengths • Outpatient • Cardiology (metro and rural) • Rheumatology (metro and rural) • Dermatology (metro and rural) • Nephrology (dialysis- metro and rural) • Clinical Diabetes Expertise

  34. Department Strengths • Research - Allergy/Immuno-modulation - Bone Health/Osteoporosis - Community Health Center/Health Disparities

  35. Current Weaknesses • Small Faculty Size • Lack of Inpatient Teaching Opportunities • Limited Fellowship Programs • Lack of Research Focus/Facilities • Limited Philanthropy • Limited full-time Gastroenterology • Limited Hematology/Oncology • Aging Clinical Facilities

  36. Opportunities forMedicine Services • Diabetes Program • Specialty Hematology/Oncology Partnership • Nephrology/Transplant • Gastroenterology • Women’s Health (Cardiac, Osteoporosis, Preventive Services, etc)

  37. Opportunities for Distinction Omaha Market • Cardiovascular Services • Rural Satellite Cardiac Services • Nutrition/Metabolism/Obesity Center • Osteoporosis - Women’s Heath • GI - Advanced Endoscopy Procedure Center • Executive Health

  38. Opportunities Cont. Expand Community Sites • Explore New location in South Omaha • Consolidate Dundee GIM and Diabetes in Dundee Business District • Explore new site with CMA (Benson or Council Bluffs?)

  39. Threats • Competitor expansion in rural markets • Lack of CMA/CUMC Presence in Metro Market • UNMC Research Growth/Philanthropy • Financial Strength of Competitive Health Systems

  40. Faculty Recruitment FY 2007 Clinical - Laura Armas, MD – Endocrine - Robert (Trip) Wear, MD – Pulm/CC Research • Langjuan Xiao, PhD – ORC • Peng Xiao, PhD – ORC • Gary Xiao, PhD - ORC

  41. Faculty RecruitmentFY 2008 Cardio-EP - Arash Aryana, MD Cardio Interventional - Michael White, MD Cardiology Imaging (2) Pulmonary/Sleep GI Generalist Hematology Oncology Infectious Disease Internal Medicine – CUMC

  42. Capital Requirements • Primary Care Clinic Expansion/Remodel • CUMC Clinic Expansion/Remodel • Research Lab Consolidation/Remodel • Infusion Center Development

  43. New Program Support Nutrition/Obesity Start-up Hospitalist Program Rural Satellite Development Community Awareness/Marketing

  44. 2007/08 Planning -- Overall Strategy • Echo Laboratory Accreditation by Feb ’08 • Life Flight PCI Rapid Response to CUMC • Additional Telemetry Beds at CUMC • Exceed Quality Benchmarks • Customer Service Excellence • Capital Expenditure Budget - $1.2M • New EP Lab • New Echocardiography Machines

  45. Cardiac CT Angiography MRI 3-D Echo PET 2007/08 Planning -- Overall Strategy • Planning new clinical areas of expertise with faculty recruitment & in collaboration with other disciplines/departments • Vascular expansion • Diagnostic Testing • Interventional Procedures • Imaging

  46. 2007/08 Wellness Emphasis • Expansion of Corporate Worksite Programs • Tobacco Treatment • Executive Physicals in conjunction with other Medicine Divisions • Other Wellness-based Lectures/Programs • Nutrition • Exercise • Establish name recognition for CU/CUMC • Tobacco-free CU Campus

  47. 2007/08 Risks to Plan Implementation • Lack of faculty recruitment • Private practice $ enticement • ↓ interest in academic medicine • Encroachment on market share • Heart hospital in West Omaha • Cardiac Transplant program at UNMC

  48. CREIGHTON PSYCHIATRY2006-07 Highlights & Plans for 2007-2008 Business Plan 2007-2008