Community Response 2008 Strategic Leadership Retreat

The culture at Stanford...

(Rizk) How do we change the culture at Stanford so that it is focused on quality at all levels and dimensions?

Metrics of clinical quality...

(Tabb) Metrics of clinical quality need to address clinical practice outcomes in a manner that allows comparisons across the nation. They must also have "local credibility" in order to drive clinical care processes. What are the similarities and differences that apply to:

medical vs surgical;

adult vs pediatrics;

community vs academic

innovation and clinical research vs standardization and evidence-based medicine

What is the role of Informatics...

(Lowe) What is the role of Informatics in fostering the highest quality patient care? How might Stanford leverage Informatics to improve the safety and quality of care?

How can we leverage quality and safety...

(Sandborg) How can we leverage quality and safety in our highly innovative and tertiary/quaternary care environments to enhance our institutional profile (e.g., payor contracting, public transparency, reputation, research)?

How can we measure the clinical quality of...

(Marsh) How can we measure the clinical quality of individual providers, particularly when much care is dependent upon the work of teams? And how can we handle quality measurement for low-volume providers, such as UTL faculty who may devote 25% or less time to patient care activities, and across a wide spectrum of health conditions?

Given our faculty caps...

(Rizk) Given our faculty caps and clinical responsibilities, how do we ensure career development for each faculty line?

Do instruments for assessing clinical excellence...

(Sharek) Do instruments for assessing clinical excellence need to be particularly good at identifying low-quality physicians or identifying high-quality physicians? Or should our efforts be dedicated to finding instruments that will distinguish clinical quality throughout the entire spectrum?

How heavily should clinical performance be weighted...

(Garber) How heavily should clinical performance be weighted in the different faculty lines - UTL, MCL, and Clinician Educator? What are the best incentives to put into place to promote superior clinical performance throughout SHC?

How should we select the highest quality projects...

(Byerwalter) How should we select the highest quality projects and opportunities to present to our donor community? How do we strike a balance between the multiple meritorious needs and expectations – especially between our primary missions in research, education and patient care?

Recognizing that the quality and excellence...

(Mochly-Rosen) Recognizing that the quality and excellence in basic science is what distinguishes Stanford, how do we assure it remains outstanding in the future?

Inadequate and overcrowded research animal facilities

(Greenberg) How important is it to our research effort to solve the problem of inadequate and overcrowded research animal facilities and where does it fit in our assignment of research priorities?

Cultural parameters of zero-sum game

(Kirkegaard) Cultural parameters of a zero-sum game. How can we create a culture that acknowledges quality through measures other than accumulated resources?

There is a feeling among...

(Nusse) There is a feeling among many basic science faculty that they are being ignored in the current medical center and university environment. How should we address this? What do we need to do to assure that we have the best balance among our priorities and also the highest overall quality of our faculty our research programs?

What practical steps can we take...

(Horwitz) What practical steps can we take to make sure that the goals of the hospitals and the school are more closely aligned in terms of allocating resources to the research mission of the medical center?

As we select faculty...

(Stevenson) As we select faculty, how do we assure that we are really getting the highest quality individuals - in basic science and in clinical medicine? How do we balance programmatic needs with individual excellence? As we approach the faculty billet cap, how will we choose among multiple departmental needs when each billet becomes available? What role can non-faculty positions play in meeting needs for which there are no available faculty billets?