Clinical Programs
Mission and Goals
The mission of the Stanford University School of Medicine's clinical programs is to promote the health of our patient community and advance the frontiers of clinical medicine.
We envision a broad community of physicians, including physician scholars, community-based physician educators, staff physicians, and faculty, among others, working together as members of a Stanford University Medical Center clinical team. This group will ensure the highest quality care for our patients, the highest quality education for our students and trainees, and an environment that encourages continuous improvement in the quality of care through innovative and translational medicine. We envision the medical school's physicians working within a professionally managed organization committed to quality and cost-effective care.
- We support our mission and the fulfillment of this vision by striving toward the following goals:
- Recruit and retain faculty physicians committed to strong leadership, clinical excellence, and innovation.
- Develop relationships with external partners to foster a robust clinical and educational program.
- Integrate undergraduate, graduate, and continuing medical education into all aspects of patient care services.
- Develop and incorporate new knowledge and treatment modalities for disease management through translational and clinical research.
- Develop a flexible and high quality faculty physician's organization to support clinical activities.
Strategic Assessment
The School of Medicine pursues essential elements of its mission through the clinical programs and activities of its faculty. Through direct patient care, the clinical programs contribute to the improvement of health. In addition, these programs provide a critical resource for the translation of science into new and innovative therapies and treatment modalities. In conjunction with the School's research laboratories and instructional facilities, the faculty clinics and the Stanford-affiliated teaching hospitals provide the core resources required for the faculty's pursuit of the medical school's mission.
The medical school's clinical programs enjoy a positive local and international reputation for clinical excellence and innovation as well as strong support from the University, hospitals, and community. Our reputation is well deserved and reflective of the quality and skill of the faculty and students with whom the patients interact. Our success is the product of many years of clinical innovation in tertiary and quaternary care. In addition, the proximity and support of Stanford University, Stanford Hospital and Clinics, and Lucile Packard Children's Hospital, as well as the innovation and entrepreneurism of the Stanford Research Park and Silicon Valley, create a unique climate in which continued clinical innovations and translational medicine flourish.
To build on these strengths and take advantage of opportunities for future success, the medical school's clinical programs must overcome a number of challenges. Among the most significant of these is the absence of defined goals within the finances and operations of the clinical practice. As the setting in which the School concurrently delivers its multiple missions of education, research, and clinical care, it is incumbent upon the clinical practice to develop performance measures reflecting these obligations. The absence of such measures results in organizational structures and management systems with inherent disincentives to practice medicine, namely scarce or ineffectively distributed resources and low salaries relative to private practice.
Recently, the misalignment of missions and incentives has been complicated by the absence of a true faculty practice organization through which program decision-making can occur, realistic performance goals set, operational inefficiencies corrected, and a culture of patient-focused service established.
The continued challenge of defining and pursuing a clinical care strategy appropriate to both the physicians' practice and the two hospitals presents a significant hurdle for the success of the School's clinical programs. A lack of unity in missions and strategies imposes an organizational burden on decision-making that may be incompatible with the rapid pace of change in the local and broader academic health care markets. In an environment of artificially constrained growth, an ability to develop and implement creative alternative solutions will be critical to success.
To adapt to the changing climate in both health care and translational research, we must work united under a set of common goals and respond flexibly while maintaining the integrity of our organization.
Strategic Initiatives
Our mission and vision for clinical programs will be pursued through coordinated efforts in program organization and program innovation.
To achieve our goal of organizational flexibility, we will address the following initiatives:
- Create efficient and flexible opportunities for partial and voluntary involvement of community clinician/educators.
- Segment clinical programs such that nonfaculty physician providers can deliver primary health care tangential to our mission.
- Develop a Stanford University Medical Center (SUMC) and Faculty Physician strategy addressing primary care market consolidations in the local and South Bay areas.
To achieve our goal of organizational and operational integrity, we will address the following initiatives:
- Develop a Stanford Physicians' Organization in coordination with the two hospitals.
- Develop a data-driven investment model for new program evaluations, funding, and performance expectations.
- Develop an outstanding quality of care program that establishes Stanford as the quality provider of choice for referring physicians and the local community.
To achieve our goal of clinical program innovations and translational medicine, we will address the following initiatives:
- Strengthen opportunities and formalize mechanisms for clinical innovation within the health care delivery systems.
- Integrate clinical research and emerging treatment modalities.
Prioritization and Implementation
The further development, prioritization, and implementation of these initiatives will be pursued by the Senior Associate Deans for Adult and Pediatric and Obstetric Clinical Affairs, working in collaboration with the management teams of the hospitals and in consultation with the medical school's executive committee.
Of the nine initiatives proposed for the Medical School's clinical programs, four have been prioritized for development and implementation in FY2001-2002 and FY2002-2003. These priority initiatives reinforce the importance of the clinical practice and interdisciplinary translational research and medicine in the future success of the Medical School and our affiliated hospitals.
Clinical Program Organizational Projects- Develop a Stanford Physicians' Organization for adult services in coordination with the structure and goals of the Stanford Hospital and Clinics.
- Develop a Stanford Physicians' Organization for pediatric and obstetrical services in coordination with the structure and goals of the Lucile Salter Packard Children's Hospital at Stanford.
The Senior Associate Dean for Pediatrics and Obstetrics Clinical Affairs will work with the Dean, the Chairman of Pediatrics, and the Packard Hospital's management team to develop recommendations for the operational responsibilities, organizational structures, and medical center governance of Physicians' Organizations for both the pediatrics and obstetric services.
Initial recommendations for structural changes and program elements will be developed by fall 2002.
The Senior associate Dean for Adult Clinical Affairs will work with the Dean, the Medical School's clinic department chairs, and the Stanford Hospital and Clinics' management team to develop recommendations for the operational responsibilities, organizational structures, and medical center governance of a Physicians' Organization for adult services.
Initial recommendations for structural changes and program elements will be developed by fall 2002.
Clinical Program Flexibility ProjectsDevelop an integrated Hospital and Faculty Physician strategy addressing primary care market consolidations in the local and South Bay areas.
The Senior Associate Deans for Clinical Affairs will work with both hospitals' management teams to develop recommendations for market strategies intended to support the Medical School's academic programs by ensuring the continued access to local patients required by the faculty's clinical programs and at a volume that will allow the hospitals to achieve their financial performance targets.
Initial recommendations for institutional and professional market strategies will be developed in FY2002-2003.
Clinical Program Innovation ProjectsStrengthen opportunities and formalize mechanisms for clinical innovation within the healthcare delivery systems.
The Senior Associate Deans for Clinical Affairs and the Senior Associate Dean for Research will work with the chair of the faculty committee on clinical research to develop recommendations for organizational and operational initiatives required to support the faculty's pursuit of clinical research opportunities and the eventual translation of research findings into clinical practice at Stanford.
Specific recommendations on clinical research support and more comprehensive recommendations on translational research and translational medicine will be developed for implementation in FY2002-2003.
Projects To Be ScheduledThe remaining Clinical Programs strategic initiatives will be pursued, following the activation of the priority initiatives, as resources and opportunities permit. Implementation plans for these initiatives will reflect the organizational and management structures of the hospitals, the Medical School, and the proposed faculty physicians organizations. These strategic initiatives include:
- Create efficient and flexible opportunities for partial and voluntary involvement of community clinician/educators.
- Segment clinical programs such that non-mission services can be delivered by non-faculty providers.
- Develop a data-driven investment model for new program evaluations, funding, and performance expectations.
- Integrate clinical research and emerging treatment modalities.
- Develop an aggressive quality of care program that establishes the Stanford Faculty Physicians as the quality provider of choice for referring physicians and the local community.
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