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Department of Surgery Business Plan. FY 2007/2008. 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. - PowerPoint PPT Presentation
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Department of SurgeryBusiness Plan
FY 2007/2008
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
Integral Part of the
Community Health
Communication to
Stakeholders
Service Expansion Growth &
Recognition
Operation Improvement
Optimal Efficiency and
Resource Utilization
Enhanced Scholarly
Activity and Environment
VisionInternationally
Recognized as a Premier Academic
Department of Surgery in the
Midwest
Core Objectives
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)
Department of Surgery 2007/2008
Program Development Opportunities
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
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
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
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
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
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
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
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
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
Transplant
Recruit Transplant Surgeon
Develop UNOS accredited kidney/pancreas transplant surgery program with nephrology
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
STRENGTHS
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
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
Department of Medicine Department of Medicine Clinical Strategic PlanClinical Strategic Plan
Joint Business Planning Joint Business Planning Session Session
August 29, 2007August 29, 2007
AgendaAgenda
Mission Mission
Leadership ChangesLeadership Changes
Strategic ReviewStrategic Review
MissionMission
Superlative clinical serviceSuperlative clinical service
Outstanding medical educationOutstanding medical education
Focused Translational Research Focused Translational Research
Associate ChairsAssociate Chairs
Dr. Robert DunlayDr. Robert Dunlay EducationEducation
Dr. Robert AndersonDr. Robert Anderson ResearchResearch
Dr. Aryan MoossDr. Aryan Mooss Academic AffairsAcademic Affairs
Dr. Laurel PreheimDr. Laurel Preheim VAVA
Dr. John HurleyDr. John Hurley Clinical AffairsClinical Affairs
New Division ChiefsNew Division Chiefs
Dr. Dennis EsterbrooksDr. Dennis Esterbrooks CardiologyCardiology
Dr. Syed Bin-Sagheer (Interim)Dr. Syed Bin-Sagheer (Interim) GIGI
Clinical PracticeClinical Practice
Clinical GoalsClinical Goals
Develop Cardiovascular InstituteDevelop Cardiovascular Institute
Expand Participation by Private Internal Expand Participation by Private Internal Medicine Practice Groups to increase Medicine Practice Groups to increase teaching opportunities and enhance clinical teaching opportunities and enhance clinical missionmission
Establish Hematology/Oncology Establish Hematology/Oncology Partnership to expand specialty services Partnership to expand specialty services
Clinical GoalsClinical Goals
Redesign and Expand Primary Care SitesRedesign and Expand Primary Care Sites
Improve Revenue Cycle ManagementImprove Revenue Cycle Management
Enhance Customer ServiceEnhance Customer Service
49,952,539
52,454,435
56,542,154
FY 04/05 FY 05/06 FY 06/07
DEPARTMENT OF MEDICINETOTAL CHARGES
24,070,537
25,761,057
27,791,549
FY 04/05 FY 05/06 FY 06/07
DEPARTMENT OF MEDICINENET PATIENT CARE REVENUE
EducationEducation
New Fellowship ProgramsNew Fellowship Programs
RecentRecent– Interventional Cardiology – 2006Interventional Cardiology – 2006– Endocrinology - 2006Endocrinology - 2006
PlannedPlanned– Gastroenterology - 2009Gastroenterology - 2009– Sleep medicine – 2010Sleep medicine – 2010– Nephrology Nephrology – Hematology/OncologyHematology/Oncology
Medical Education GoalsMedical Education Goals
Increase Clinical Volume for Student Increase Clinical Volume for Student Learning OpportunitiesLearning Opportunities
Enhance Department Support for Enhance Department Support for
Medical Education ProgramsMedical Education Programs
Improve Learner Evaluation ProcessImprove Learner Evaluation Process
Add newer simulation technologyAdd newer simulation technology
ResearchResearch
Research GoalsResearch Goals
Develop Genetics/Proteomics ResearchDevelop Genetics/Proteomics Research
(September 2007)(September 2007)
Improve Infrastructure and Admin SupportImprove Infrastructure and Admin Support
Strengthen Mentoring of New ResearchersStrengthen Mentoring of New Researchers
Increase Collaboration with Basic ScienceIncrease Collaboration with Basic Science
Recruit More InvestigatorsRecruit More Investigators
Establish Division of Clinical ResearchEstablish Division of Clinical Research
Department StrengthsDepartment Strengths
Clinical Clinical
- Cardiology- Cardiology
- GI Advanced Endoscopy- GI Advanced Endoscopy
- Internal Medicine- Internal Medicine
- Nephrology- Nephrology
- Pulmonary/Critical Care- Pulmonary/Critical Care
Department StrengthsDepartment Strengths
OutpatientOutpatient– Cardiology (metro and rural)Cardiology (metro and rural)– Rheumatology (metro and rural)Rheumatology (metro and rural)– Dermatology (metro and rural)Dermatology (metro and rural)– Nephrology (dialysis- metro and rural)Nephrology (dialysis- metro and rural)– Clinical Diabetes ExpertiseClinical Diabetes Expertise
Department StrengthsDepartment Strengths
ResearchResearch
- Allergy/Immuno-modulation- Allergy/Immuno-modulation
- Bone Health/Osteoporosis- Bone Health/Osteoporosis
- Community Health Center/Health - Community Health Center/Health DisparitiesDisparities
Current WeaknessesCurrent Weaknesses
Small Faculty SizeSmall Faculty SizeLack of Inpatient Teaching OpportunitiesLack of Inpatient Teaching OpportunitiesLimited Fellowship ProgramsLimited Fellowship ProgramsLack of Research Focus/Facilities Lack of Research Focus/Facilities Limited PhilanthropyLimited PhilanthropyLimited full-time GastroenterologyLimited full-time GastroenterologyLimited Hematology/OncologyLimited Hematology/OncologyAging Clinical FacilitiesAging Clinical Facilities
Opportunities forOpportunities forMedicine ServicesMedicine Services
Diabetes ProgramDiabetes Program
Specialty Hematology/Oncology Specialty Hematology/Oncology PartnershipPartnership
Nephrology/TransplantNephrology/Transplant
GastroenterologyGastroenterology
Women’s Health (Cardiac, Osteoporosis, Women’s Health (Cardiac, Osteoporosis, Preventive Services, etc)Preventive Services, etc)
Opportunities for DistinctionOpportunities for Distinction Omaha Market Omaha Market
Cardiovascular ServicesCardiovascular Services
Rural Satellite Cardiac ServicesRural Satellite Cardiac Services
Nutrition/Metabolism/Obesity CenterNutrition/Metabolism/Obesity Center
Osteoporosis - Women’s Heath Osteoporosis - Women’s Heath
GI - Advanced Endoscopy Procedure CenterGI - Advanced Endoscopy Procedure Center
Executive HealthExecutive Health
Opportunities Cont.Opportunities Cont.
Expand Community SitesExpand Community Sites– Explore New location in South OmahaExplore New location in South Omaha
– Consolidate Dundee GIM and Diabetes inConsolidate Dundee GIM and Diabetes in
Dundee Business DistrictDundee Business District
- Explore new site with CMA Explore new site with CMA
(Benson or Council Bluffs?)(Benson or Council Bluffs?)
ThreatsThreats
Competitor expansion in rural marketsCompetitor expansion in rural markets
Lack of CMA/CUMC Presence in Metro MarketLack of CMA/CUMC Presence in Metro Market
UNMC Research Growth/PhilanthropyUNMC Research Growth/Philanthropy
Financial Strength of Competitive Financial Strength of Competitive
Health SystemsHealth Systems
Faculty Recruitment Faculty Recruitment FY 2007FY 2007
ClinicalClinical
- Laura Armas, MD – Endocrine- Laura Armas, MD – Endocrine
- Robert (Trip) Wear, MD – Pulm/CC- Robert (Trip) Wear, MD – Pulm/CC
ResearchResearch- Langjuan Xiao, PhD – ORCLangjuan Xiao, PhD – ORC- Peng Xiao, PhD – ORCPeng Xiao, PhD – ORC- Gary Xiao, PhD - ORCGary Xiao, PhD - ORC
Faculty RecruitmentFaculty RecruitmentFY 2008FY 2008
Cardio-EP - Arash Aryana, MDCardio-EP - Arash Aryana, MDCardio Interventional - Michael White, MD Cardio Interventional - Michael White, MD Cardiology Imaging (2) Cardiology Imaging (2) Pulmonary/SleepPulmonary/SleepGI GeneralistGI GeneralistHematology Oncology Hematology Oncology Infectious Disease Infectious Disease Internal Medicine – CUMCInternal Medicine – CUMC
Capital RequirementsCapital Requirements
Primary Care Clinic Expansion/RemodelPrimary Care Clinic Expansion/Remodel
CUMC Clinic Expansion/RemodelCUMC Clinic Expansion/Remodel
Research Lab Consolidation/Remodel Research Lab Consolidation/Remodel
Infusion Center DevelopmentInfusion Center Development
New Program SupportNew Program Support
Nutrition/Obesity Start-upNutrition/Obesity Start-up
Hospitalist ProgramHospitalist Program
Rural Satellite DevelopmentRural Satellite Development
Community Awareness/MarketingCommunity Awareness/Marketing
2007/08 Planning -- Overall 2007/08 Planning -- Overall StrategyStrategy
Echo Laboratory Accreditation by Feb ’08Echo Laboratory Accreditation by Feb ’08
Life Flight PCI Rapid Response to CUMCLife Flight PCI Rapid Response to CUMC
Additional Telemetry Beds at CUMCAdditional Telemetry Beds at CUMC
Exceed Quality BenchmarksExceed Quality Benchmarks
Customer Service ExcellenceCustomer Service Excellence
Capital Expenditure Budget - $1.2MCapital Expenditure Budget - $1.2M– New EP LabNew EP Lab– New Echocardiography MachinesNew Echocardiography Machines
2007/08 Planning -- Overall 2007/08 Planning -- Overall StrategyStrategy
Cardiac CT Cardiac CT AngiographyAngiography
MRIMRI
3-D Echo3-D Echo
PETPET
Planning new clinical areas of expertise with Planning new clinical areas of expertise with faculty recruitment & in collaboration with other faculty recruitment & in collaboration with other disciplines/departmentsdisciplines/departments– Vascular expansion Vascular expansion
Diagnostic TestingDiagnostic Testing
Interventional ProceduresInterventional Procedures
– ImagingImaging
2007/08 Wellness Emphasis2007/08 Wellness Emphasis
Expansion of Corporate Worksite ProgramsExpansion of Corporate Worksite Programs– Tobacco Treatment Tobacco Treatment – Executive Physicals in conjunction with other Executive Physicals in conjunction with other
Medicine Divisions Medicine Divisions – Other Wellness-based Lectures/ProgramsOther Wellness-based Lectures/Programs
NutritionNutritionExerciseExercise
– Establish name recognition for CU/CUMCEstablish name recognition for CU/CUMC
Tobacco-free CU CampusTobacco-free CU Campus
2007/08 Risks to Plan 2007/08 Risks to Plan ImplementationImplementation
Lack of faculty recruitmentLack of faculty recruitment– Private practice $ enticementPrivate practice $ enticement– ↓↓ interest in academic medicineinterest in academic medicine
Encroachment on market shareEncroachment on market share– Heart hospital in West OmahaHeart hospital in West Omaha– Cardiac Transplant program at UNMCCardiac Transplant program at UNMC
CREIGHTON PSYCHIATRY2006-07 Highlights & Plans for 2007-2008
Business Plan
2007-2008
2006-07 Highlights
Collaborated with NHHS, Region 6, UNMC to develop Lasting Hope Recovery Center
Opened 2nd adult psychiatric inpatient unit (Dr. Qadri-IMC) Added to Child & Adolescent Clinic (Dr. Ogunleye) Increased size and scope of research Local, regional & national awards
– 33% of Faculty Listed as “Best Doctors”
Ended FY 06-07 with a positive bottom line ($89K)
2006-07 Performance
Patient care revenue >30% above projected revenue One new faculty exceeded revenue by 482% of projected!!
(Dr. Qadri) New NIH grant awarded (Dr. Happe). Psychiatry now has
4 NIH grants (Drs. Wilson 2, Happe 1, and Sullivan 1) Grants increased $1.6M ($1.5M $3.1M) … up 106%!
– Aside concerning research vis a vis hospital
Psychiatry generates new CU business …– Unique referrals: only 19% via CMA, 18% self referred, and 63% via other
agencies and physicians
A total of 3028 new charts opened ‘Case Finders’
Physician Recruitment
Faiz Qadri, MD, started July 2006. Exceptional work ethic Yetunde Ogunleye, MD, started in December 2006. Much
needed child-adolescent psychiatrist Currently recruiting faculty for the Lasting Hope Recovery
Center No physician has left the department in over 5 years
2007-08 Opportunities
New Office via University & School Capital Plan– Main site near CU (Radio Shack?) … with UNMC or alone
Boost faculty liaisons with OB, family medicine, internal medicine & pediatrics
Increase ‘mid-levels’ to reduce outside referral for counseling and therapy to providers outside the department … but new office space needed
Lasting Hope Recovery Center– Multi-disciplinary Statewide Initiative (Unicameral)
Threats
Limitations to expansion … Need to accommodate all faculty, staff and researchers at a reasonable rate
CMA issues (rent & pass-through levies a burden) Alegent Health wants to reduce support for Residency
Training and owes ~$500K Transition in Pediatric EDP at Childrens The gap between private practice and faculty salaries is
widening, to making it harder to recruit.
PSYCHIATRY & the HOSPITAL
Major presence via Consult-Liaison– Exceptional ROI
Opportunities to grow liaison services– Excellent clinical care & research opportunities
LHRC should ‘unpack’ ERs & other beds New office building offers ‘leverage’ Research = Visibility = Market Share Case-finders! Case-finders!! Case-finders!!!
Creighton University Family Medicine
Business Plan
FY 2007/2008
CUMC Family Medicine Admissions
0
100
200
300
400
500
600
700
2004 2005 2006 2007
CUMC Admissions by Group
0
100
200
300
400
500
600
700
2004 2005 2006 2007
Former CU FM
Community
OWCH
CDHC
CU FM
CUMC Admissions by GroupC
U F
am
ily M
ed
CU
Fam
ily M
ed
CU
Fam
ily M
ed
CU
Fam
ily M
ed
CD
HC CD
HC
CD
HC CD
HC
OW
OW
OW O
W
Form
er C
U F
M
Form
er C
U F
M
Form
er C
U F
M
Form
er C
U F
MCom
munity
Com
munity
Com
munity
Com
munity
0
50
100
150
200
250
300
350
400
450
2004 2005 2006 2007
Program Highlights
Positive Bottom Line FY 05/06 and 06/07 Charges increased by 3.5% Patient Visits decreased by 2%
– FTE remained the same replaced one of our most productive providers with a new recruit
– Dr. Baumberger – charges sufficient to eliminate need for start up support
Strengths
Strong, Stable, Experienced Faculty focused on system wide success
Fiscal Stability Strategic positioning of clinics
Weaknesses
Old Market Significantly Understaffed With Providers, and Awaiting Expansion; Patients Turned Away Daily
Lack of System Wide Strategic Plan for Investment in Primary Care
Further expansion impossible until investment issue resolved
Opportunities
Expansion of Old Market Clinic and Provision of OB Services
Development of R.O.I. model Development at Florence Clinic Continued Growth at Eagle Run
– Growth 3%
Threats
Retiring Primary Care Providers within the community and rural referral areas
Subsequent consolidation of community practitioners to existing health systems
Department high producers “burning out” Lack of rational investment model
2008 Planning
o Continue to grow practices to full capacity productiono Increase providers as space allows, and within the
limitations of maintaining a positive bottom line.o With Old Market build out, add one additional
provider July 2008. Ideally a female provider who does OB.
o Work cooperatively with Department of Surgery in the Bariatric Program.
o Work with Dean’s Office, CMA, CUMC to develop ROI investment model for system growth.
Business PlanFY 2007-2008
South Omaha presence Continue to support One World
Community Health Center Opened new “Twin Creek” office in Sarpy
County Staffed by new OB/Gyn generalists
Lisa Rice, MD Kathryn Kenna, MD
Faculty expansion in the following areas Maternal-Fetal Medicine Division Twin Creek Arbor ? Elsewhere in South Omaha
Balanced budget for fiscal year 2007-2008
Young, eager faculty willing to teach Resident education
Added one additional resident this year Student education
16-year average of 12% of each graduating class pursues a career in OB/Gyn, compared to a 6% national average
Strong clinical customer base
Research Small number of faculty
Coverage stretched thin
With Dr. Bonebrake’s departure, we have the opportunity to hire a female perinatologist
Masters program in biomedical science with emphasis on embryology Should facilitate research with basic
science More tuition dollars
Competition in South Omaha Possible loss of support from Bergan
for MFM Loss of faculty to private practice
Continue to hire excellent clinical faculty
Increase research activities Active in medical student and
resident education Nationally recognized in student
recruitment in OB/Gyn
Lack of adequate monetary support Plant facilities - lack of room for
expansion Lack of monetary support for fourth
resident Struggle for surgical equipment we need Battle for surgical times Lack of dedicated Spanish interpreter
Needed 24/7
No pediatric anesthesiologists at CUMC Must deliver babies with anomalies at
Methodist Great loss of revenue as a result
Have one additional resident approved by the Residency Review Committee for each of the next three years for a maximum of 16, but we have no monetary support, so we can’t fill those spots
Keep up with state of the art ultrasound equipment
Resident salaries Monetary support for new faculty
hires Rebuild our plant fund
Creighton University Neurology
Business Plan
FY 2007/2008
06-07 Program Highlights
International Recognition in Parkinson’s Disease Research – Done at CUMC
APDA Coordinator – Located at CUMC
- Covers NE, KS, SD (Lisa Brovold)
- Nebraska PD Registry
Headache/Pain Clinic Multiple Sclerosis Support Center
07-08 Development Opportunities
Recruitment Multiple Sclerosis Support Center Dementia/Alzheimer Support Center Neuro Intensivists/Stroke Care Vision is for Neuroscience Center
– Coordinated Comprehensive Care
Market Factors: SWOT Analysis
Strengths:– Reputation/Respect in PD (APDA Office & Research Activities)– MS Patient Base Maintained– Dedicated Staff
Weaknesses:– Faculty Shortage– Shortage/Inadequate Space– Clinic Renovation
Opportunities: More Market Share for Demographics– Community Support– Multiple Sclerosis/Alzheimer Support– Vascular/Stroke– Neuromuscular– Epilepsy
Threats:– UNMC (Loss of Market Share)– Private Practice– Perception
Physician Recruitment/Retention
Goal: Recruit Faculty with Critical Skills:– EMG, EEG– MS Specialist – No MS Specialist in Nebraska– Dementia/Alzheimer Specialist– Intensivist
Obstacles:– Salary– Lack of Program Support– Insufficient/Poor Appearance
Capital Needs
Three Year Projections:– Additional Space for Faculty/Staff/Patients– Renovation of Current Space
Creighton University Department of Pathology
Business plan
2006/2007
2006/2007 CUMC laboratory Performance Highlights
• New blood bank Director started January 2007 (Lisa Tyler, M.D.)• Implementation of two chemistry analyzer instruments (Roche
Integra 800s)• Implementation of ionized calcium instrumentation• Implementation of osmometer instrumentation• New tissue cassette labeler• New gel technology implemented in blood bank• New bariatric morgue cart• New Stryker saw• Six new phlebotomy carts• Successful CAP inspection for both CUMC and CML laboratories• Successful AABB inspection for CUMC blood bank laboratory
2006/2007 CUMC laboratory Performance Highlights
Clinical Labs Volume Trend
602189659645
815485863453 867013 855531
200000
300000
400000
500000
600000
700000
800000
900000
1000000
2001 2002 2003 2004 2005 2006
Billable units
Anatomic Labs Volume Trend
46985 48136
62653
7204365735
60667
20000
30000
40000
50000
60000
70000
80000
2001 2002 2003 2004 2005 2006
Billable units
2006/2007 CML Performance Highlights
• Successful opening of new Anatomic Pathology (AP) laboratory including implementation of new laboratory information system (LIS) – February 2007
• Began drug testing for Creighton Schools of Nursing, Pharmacy, Medicine, Dentistry and Physical Therapy
• Creighton Medical Laboratories (CML) acquired 20 new clients
2007/2008 CUMC laboratory Program Development
Opportunities• Replacement of hematology equipment
(Sysmex)• Replacement of Access II immunochemistry
instrumentation• Replacement of tissue processors and
microtomes• Purchase of additional storage refrigerator and
freezer banks• Replacement of Vitek 2 Micro ID• Cerner LIS upgrade
Physician Recruitment
• Currently have filled all open faculty positions• New faculty members
– Caishu Deng, M.D. – start date July 1st
(Cytopathology, FNA)
– Hina Naushad, M.D. – start date July 1st
(Hematopathology, Surgical Pathology)
– Susan Repertinger, M.D. – start date July 1st
(VAMC)
– Lisa Tyler, M.D. – start date January 1st
(Blood Bank)– Qingmei Xie, M.D. – start date July 1st
(Hematopathology, Flow Cytometry)
Pediatrics Program Development
2007-2008
MISSION
TO PROVIDE Quality HEALTH CARE TO ALL CHILDREN OF THE OMAHA METROPOLITAN AREA AND THE REGION
TO DO SO WITHOUT REGARD TO RACE, RELIGION OR ABILITY TO PAY
Program Highlights
To expand specialty Pediatrics in Sarpy County, West Omaha, Council Bluffs and at CUMC.Especially in the area’s of:
Gastroenterology Rheumatology
Endocrinology Developmental Pediatrics and
Intensivist (critical care) services Hospitalist Services
Performance
In the last three years there has been general growth of between 3-4% annually in the areas of general pediatrics , Gastroenterology, Pediatric Cardiology and Neonatal intensive care and Allergy services .We had over 20,294 pt visits in 06 at the CU clinic and we are currently averaging approximately 3% over our 2006 numbers. New Intensivist services generated approximately 23% more revenue than originally forcast for the year in only an (8) month period.
Market Description
Current market includes Eastern and greater Nebraska as well as Western Iowa and parts of South Dakota
Competition
Potential competitors
UNMC/ Children’s
Currently also key partners
Strengths and Weaknesses
Strengths:
Current reputation and primary care physician referral network.
Rheumatology only provider in region
Alegent, Boys town partnership with GI
Tenet support Intensivist services
The Neonatology group currently manages three out of four of the level three NICU units in the community.
Strengths continuedThe CU Childhood obesity program has won both state and national recognition for its work with inner city children and family’s.
Weakness
Number of faculty needed to provide and or grow services
Competition with Children's and UNMC
Need for capitalized funding to grow services
Hospital Collaboration
Support for Intensivist services, in order to grow inpatient pediatric programs: PICU and General Peds.
Support to create regional Pediatric Childhood obesity center
Space and facilities in order to enhance Specialty care clinics at CUMC
Support for Pediatric Hospitalist Services
Hospital Collaboration
Help develop a food hypersensitivity feeding and swallowing program for children in the region.
Summary
Our primary mission is to enhance and provide quality education and experiences for our Students and Residents while providing quality care for our patients and their families.
The department must collaborate and work with multiple partners in order to achieve its goals
The department also wishes to PLAN and DEVELOP a MAJOR REFERRAL AND RESEARCH CENTER IN the area of NUTRITION AND Child Abuse OVER the NEXT FIVE YEARS
Department of Anesthesiology
Creighton UniversityDepartment of Anesthesiology
Business PlanFY 2007/2008
Department of Anesthesiology
FY 06/07 Performance Highlights
Recruitment of 1 M.D., 1 CRNA
Increased Research funding/efforts
Implemented TeamSTEPPS
Department of Anesthesiology
SWOT Analysis
Strengths: Very experienced staff, well trained, work long hours
Weaknesses: lack of own Residency program, chronic under-funding, CUMC clinical revenue alone cannot support Dept.
Opportunities: able to attract more interest from CRNAs
Threats: financial instability, uncertainty
Department of Anesthesiology
Recruitment
FY 07/08 Goal: New Chairman, 1 staff Anesthesiologist, 1 CRNA
Obstacles: current salary & benefits for Physicians not competitive
Department of Anesthesiology
Capital Needs
Electronic Anesthesia Record: two vendorsgave demo in 2007; approx. cost to implementis about $400K
Glide Scope for emergency airway management
Department of Radiology
Accomplishments ‘06-‘07
Department of Radiology Accomplishments ‘06-‘07
Clinical
1. Brought to and sustained a 90% turnaround time of x-ray reports within 24 hours of the completion of the exam.
2. Collaborated with CUMC in capital equipment purchases. During this academic year, installation was completed on:
a. 64 Multi-Detector CT
b. Angio Suite
Department of Radiology Accomplishments ‘06-‘07
3. Successfully recruited two new faculty members
a. Attila Csordas, M.D.- Chief of Vascular and Interventional Radiology
b. Olaf Kaufman, M.D., Ph.D.Radiology Director for Cardiac CTA Acting Chief of Neuroradiology
4.Sustained and grew the angiography program by recruitment of the Methodist Radiology Group to provide half time coverage in vascular and interventional radiology. The other 50% time was covered by the Chairman of the Department of Radiology.
Department of Radiology Accomplishments ‘06-‘07
Department of Radiology Accomplishments ‘06-‘07
5. Stabilized and improved morale in the department despite the departures of three radiologists at about the same time. This was accomplished by ongoing meetings of the chairman with individual attendings, as well as with the attendings as a group and with chief radiology residents individually and with the radiology residents as a group.
Department of Radiology Accomplishments ‘06-‘07
6. Continued success of the Center for Breast Care despite personal challenges for Dr. Mary Davey. In her absence care was provided by our other radiologists credentialed in mammography.
7. Was an advocate for the Werner Institute to be involved in developing a “win-win” relationship in areas that have resulted in major turf battles and institutional disruption throughout the country.
Department of Radiology Accomplishments ‘06-‘07
8. The Radiology Department at CUMC was chosen as the imaging center for the Creighton University athletic program. This was accomplished by concerted effort of the Radiology Department, CUMC Administration and CMA faculty.
9. Developed as part of a multidisciplinary QA team, a grid that lists urgent and emergency procedures. This improved referring clinicians ability to obtain such examinations on weekends and evenings.
Department of Radiology Accomplishments ‘06-‘07
10. Department funded training of four radiologists to be credentialed in cardiac CTA.
11. Initiated a RAD Peer ACR QA program.
12. In radiation oncology, treatment modalities of IMRT and HDR therapy were successfully initiated. This has improved patient care.
13. Balanced the budget.
Department of Radiology Accomplishments ‘06-‘07
Residents1. Written boards in diagnostic radiology;
ranked 5th of 203 programs in North America.
2. Oral boards: all three graduating residents passed on their first attempt.
Faculty1. Jim Phalen – Golden Apple
Program Development Opportunities
for 7/07 – 6/08
Program Development Opportunities for 7/07 – 6/08
A. Develop and participate in multidisciplinary teams for improved patient care, research and revenue.
1. Develop Cardiac CTA program with Cardiology Division whereby Creighton University Medical Center is the provider of choice for patients – facilitated by Werner Institute
Program Development Opportunities for 7/07 – 6/08
2. Contribute to cancer program growtha. Cyberknife project
i. Radiation Oncology
ii. PET/CT
b. Vascular and Interventional Radiologyi. transcatheter embolization
ii. image guided ablative therapy
a. radiofrequency
b. cryoablation
iii. placement of ports for chemotherapy delivery
Program Development Opportunities for 7/07 – 6/08
3. Participate in discussions with Departments of Medicine and Surgery on forming a Cardiovascular Institute - facilitated by Werner Institute
4. Expand Creighton University athletic sports medicine program in collaboration with Orthopedic Division
Program Development Opportunities for 7/07 – 6/08
B. Increase revenues1. PAC Office scheduling of elective exams
within 24 hours
2. Marketa. Vascular and Interventional Radiology
b. Cardiac CTA
c. Interventional sports medicine program
3. Discussions on out-patient imaging center
Program Development Opportunities for 7/07 – 6/08
C. Maximize customer satisfaction1. QA program
a. Turnaround time
b. RAD Peer
c. Pursue enrollment in national calling center (Veriphy) for critical values
d. Monitor PAC office scheduling of out patient procedures
Market Factor - SWOT AnalysisStrengths
1. Faculty2. Desire to increase revenues
Weaknesses1. Absence of an outpatient imaging facility2. PAC Office3. Dual Registration4. CUMC marketing is planned 1 year in
advance – may not take advantage of arrival of new faculty
Market Factor - SWOT Analysis
Opportunity1. Develop an outpatient imaging facility2. Complement existing faculty with new faculty3. New multidisciplinary programs
a. Cardiacb. Uterine fibroid embolizationc. Cancer cared. Interventional neuroradiologye. Sports medicine
Threats:1. CUMC Market Share of 11%
Physician Recruitment/Retention
Goals:1. Retain existing faculty
2. Recruit1. Chief of Neuro Radiology
2. General Diagnostic Radiologist
Obstacles: 1. Salary differential
2. 500 vacancies in 100 academic radiology departments
Capital Needs(3 Year Projections)
Nuclear Medicine Camera
MR Cardiac Package 3T MRI Digital Mammography Prone Stereotactic
Breast Biopsy Table Biplane Angiography
Suite
PACS Upgrade Radiology Information
System Upgrade Voice Recognition
Dictation Upgrade Digital Trauma Room Digital Radiography
Room