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Musculoskeletal Service Line Review Session #1 Dean’s Meeting – January 6, 2010

Marcy Bolster, M.D. Service Line Medical Director. Musculoskeletal Service Line Review Session #1 Dean’s Meeting – January 6, 2010. Nancy Tassin, MSN, RN Service Line Administrator. Tab 1 COM Departments involved in SL SL Strategic Goals (3-5 year big bets)

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Musculoskeletal Service Line Review Session #1 Dean’s Meeting – January 6, 2010

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  1. Marcy Bolster, M.D. Service Line Medical Director MusculoskeletalService Line Review Session #1Dean’s Meeting – January 6, 2010 Nancy Tassin, MSN, RN Service Line Administrator

  2. Tab 1 • COM Departments involved in SL • SL Strategic Goals (3-5 year big bets) • 2010-2011 Progress towards Strategic Goals • What is going well in SL? • Opportunities for improvement in SL • SL Leaders input on SL as a structure Tab 2 – SL Dashboard Tab 3 – SL Goal (LEM) Performance • Executive Summary – Annual LEM Performance • Executive Summary – 2011 Pillar Performance YTD • 2011 LEM Monthly Report Card Tab 4 – SL 5/10 Plans • Performance YTD towards goal • Plan Tab 5 – SL Miscellaneous Reports

  3. COM Departments involved in SL • Significant • Medicine (Rheumatology, Endocrinology) • Orthopaedics • Radiology • Others • Gynecology/Women’s Services • Neurosurgery • Pediatrics • Psychiatry • Surgery (Transplant, Breast, Bariatric) • Urology

  4. SL Big Bets (3-5 year strategic goals) • Osteoporosis • Vision: Destination Center for the management of bone health and the diagnosis and treatment of osteoporosis & its complications • Increase bone health screenings and awareness for high risk patient populations • Increase new patient visits • Continue to foster interdisciplinary collaborative approach to osteoporosis at MUSC (rheumatology, endocrine, radiology) • Develop disease management program for fragility fracture • Establish clinical trials for osteoporosis • Joint Health • Vision: Destination Center for the full continuum of joint care • Establish the process for full diagnostic and therapeutic continuum of care for Joint Health • Promote non-operative management of joint disease • Increase the spectrum of therapeutic/interventional offerings for joint disease • Establish clinical trials in joint disease • Joint regenerative care

  5. Step Components of MSK Joint Healthcare ReconstructionJt.Replacement Replacement MIS; Jt.Resurfacing; Partial Jts. Biologic Regeneration Repair & Look scope & MIS Non-Op Care Rehab. Care Complex Revisions major surgery VI Increasing treatment intervention V IV Levelsof Care (Opportunities) 6 modern categories of management for joint health III II I consult eval. Aging Timeline (Progressive Degenerative Cascade of Life)

  6. SL Big Bets (3-5 year strategic goals) • Sports Medicine • Vision: Destination Center for the injured sports participant of all ages • Superior diagnosis & therapeutic management of pain and injury related to athletic activities • Develop programs of expert interdisciplinary care for the sports participant involving collaboration with other specialized care available at MUSC • Pulmonary, Allergy, Cardiology, Primary Care • Promote optimal performance in athletic activities by stressing injury prevention and promoting healthy lifestyles • Focus on performance improvement and returning the injured sports participant to activity • Growth • Vision: Increase size of selected programs as basis for developing a future differentiated strategy • Increase new patient visits by 12-15% over 2 years in the following specialties: • Hand (Orthopaedics & Plastic Surgery) • Foot & Ankle • Shoulder • Joint Replacement • Increased productivity, efficiency & patient volume of listed programs

  7. 2010-2011 Progress towards Big Bets • Osteoporosis • Collaboration with Transplant, Bariatric and Breast Surgery • Developed Vitamin D supplementation protocol for these patients • Developed algorithm for bone health assessment for these patients • Nurse Navigator will follow-up with services • Met with Dr. Sarah Stapleton’s M.D. VIP Program • Nurse Navigator will follow-up with service • Ongoing Community Outreach • On-site bone density screenings • Community education programs • OP Faculty meeting every 2 months • DXA faculty collaboration meetings quarterly (includes operations) • OP Journal Club held every 2 months • Site selected for a clinical trial (Eli Lilly) hip fracture study; March 2011 (inpatient and outpatient clinical trial) • Joint Health • Peri-operative management of immunosuppressive medications in joint patients: Guidelines est. 12/1/10 • DVT complication management program: SL to meet with Hospitalists and UIM • Non-Interventional Joint Health Operations meetings being held • Met with Steve Valerio and Dr. Costello re: Mt. Pleasant location • SL discussion with Ortho to increase productivity of current vs. need to hire new proceduralist • Discussed in Rheumatoloy Clinical Trials meeting to enhance study recruitment

  8. 2010-2011 Progress towards Big Bets • Sports Medicine • Interdisciplinary retreat, May 2010(40-50 attendees) • Evaluated the Trainer Model • Concussion Management/Neurosciences collaboration (operations meeting held and f/u meetings scheduled) • Primary care sports medicine meeting held • Programs in schools for athletic directors & coaches • IMPROVE Model for the performance program was presented to PT • Spring Break camp at Blackbaud Stadium • MUSC Sports Medicine Performance Program, scheduled Summer 2011 • Pre & Post Program performance testing performance training; education on nutrition & injury prevention • Growth • Market analysis underway

  9. What is going well in SL? • SL Medical Director and SL Administrator collaboration • Interdisciplinary patient care within the Center for Osteoporosis and Bone Health (Launch 11/30/09) • Template for approach for other Big Bets • National recognition • Longitudinal patient focused care • Collaboration with other specialties for high risk patients • Interdisciplinary patient care for Sports Medicine • Workout sessions (quarterly meetings for all in SL and those supporting SL) • Progress on 5/5 plan • Implant contracts • Medication savings (IVIg) • Growth in Center for Osteoporosis and Bone Health • DXA scans and new patient visits

  10. Orthopaedic engagement in SL opportunities Joint Replacement Hand Program Opportunities for improvement in SL

  11. Promotes interdisciplinary care of the patient Within the SL Between SLs Exemplified by Osteoporosis and Bone Health with: Transplant General Surgery Bariatric surgery Breast surgery Prostate Cancer surgeons Women’s Health Initiative Optimizes patient centered care Helps to break down the “silo” effect Input on SL as a structure

  12. Tab 2SL Dashboard • November 2010 dashboard from Enterprise Analytics

  13. Click on image to open PDF

  14. Tab 3Goal Performance • Executive Summary – Annual LEM performance • Executive Summary – 2011 Pillar performance YTD • 2011 LEM Monthly Report Card

  15. SLL Goal (LEM) PerformanceExecutive Summary - Annual Green – 4; Yellow – 3; Red - <2.5 Scale 1-5; 4 is goal attainment

  16. SLL Goal (LEM) PerformanceExecutive Summary – YTD Green – 4; Yellow – 3; Red - <2.5 Scale 1-5; 4 is goal attainment

  17. Click on image to open PDF

  18. Tab 4SL 5/10 Performance YTD • 5/10 Performance YTD • 5/10 Plan Executive Summary

  19. SL 5/10 Performance YTD

  20. MSK 5/10 plan

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