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Department of Medicine Faculty Meeting Monday, September 12, 2016

Learn about the recent faculty promotions, clinical advancements, awards, and financial performance in the Department of Medicine. Stay informed about upcoming events and speakers.

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Department of Medicine Faculty Meeting Monday, September 12, 2016

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  1. Department of Medicine Faculty MeetingMonday, September 12, 2016 • Announcements • AY 2016 Annual Review

  2. Announcements • Section Chief Searches-Update • Hematology Oncology • Infectious Disease • Clinical Faculty Compensation Committee being formed • Evans Junior Faculty Merit Award RFA soon • DOM Website being redesigned • Ceremony to award Seldin Professorship- Darrell Kotton, October 31- details to follow

  3. Evans Days October 13 and 14 Poster Session Thurs, Oct 13, 9-12 noon Gala Awards Dinner October 13, 2016 • Speakers: • Wilkins Visiting Professor: Glenn Dranoff, M.D., Ph.D., Global Head Exploratory Immuno-Oncology Novartis • Ingelfinger Visiting Professor: John Carrethers, M.D., John G. Searle Professor and Chair, Department of Medicine, University of Michigan

  4. Grand Rounds Speakers

  5. Annual Review 2016 Academic Year • DOM Faculty • Clinical Programs • Research Programs • Education Programs • Faculty Development and Diversity Programs • Finance and Research Administration • Summary • Appendix

  6. Faculty Distribution by Rank

  7. Distribution of Faculty Effort (FTE)

  8. Appointments and Promotions New Hires - 44 Promotions - 14 • 6 Assistant Professors • 1 Clinical Assistant Professor • 4 Associate Professors • 3 Professors

  9. Promotions

  10. Annual Review 2016 Academic Year • DOM Faculty • Clinical Programs • Research Programs • Education Programs • Faculty Development and Diversity Programs • Finance and Research Administration • Summary • Appendix

  11. Clinical Programs

  12. Clinical Highlights DOM Subspecialty Referral Compendium moved into the distribution and implementation phase within NHCs and GIM->housed on BMC Intranet and resource section of Epic Physician Satisfaction/Advocacy Advisory Group established with plans to garner input from faculty and craft practical and innovative solutions to improve clinician satisfaction All sections on target to meet Meaningful Use First DOM Clinical Innovations Award established Epic Optimization • Continued to provide significant input to Epic optimization • 2015 upgrade with improvements to chart review, health maintenance, in-basket organization accomplished early today

  13. Clinical Highlights With BMC strategy team, led several Inpatient Initiatives on patient flow, discharge time, multidisciplinary rounds, Call Center follow-up appointments at discharge and ED sign-out processes In collaboration with CT Surgery, established an interdisciplinary transcatheteraortic valve program; to date, 18 percutaneous aortic valve replacements have been performed successfully without complication Memory Disorders Clinic established in Geriatrics for English and Spanish-speaking patients Care-Givers Stress Reduction Program establishedin Geriatrics

  14. Clinical Highlights Expansion of Tobacco Cessation Program to inpatient setting Ongoing growth of Lung cancer screening/nodule program ICU Alcohol Withdrawal Protocolestablished and implemented Continued growth of multidisciplinary Sarcoidosis Program Transgender Medicine and Surgery Center established (first in New England) in addition to transgender medicine elective and transgender medicine curriculum with the medical school Multidisciplinary Thyroid Center established Addiction Medicine Inpatient Consult Service established

  15. Ambulatory Measures

  16. DOM Ambulatory FY16 PerformanceFor the period ending May 31st, 2016 • Month to date • YTD Budget / Goal • Variance YTD % • YTD Status • FY16 YTD Ambulatory volume 20,888 164,590 159,853 3.0% 1 Patient experience 2 89.2% 89.7% 90.9% -1.2% Primary care access 3 78% 81% 80% 1.0% Specialty access 4 49% 49% 56% -7.0%

  17. Visit Volume (period ending August 31,2016) Source: BMC Dashboard/SDK

  18. Ambulatory New Pt. Access (14 d)(period ending July 31, 2016) 18

  19. Patient Experience (likelihood to recommend)(period ending June 30, 2016) 30 19

  20. Inpatient Measures

  21. DOM inpatient clinical operations FY16 performance • FY16 YTD • Goal1 • YTD Status LOS O/E • Last three months • 0.891 • (Apr - Jun) • 0.899 • (Oct - Jun) 1 • 0.903 Avg. discharge time • 3:01 PM • (May - Jul) • 2:59 PM • (Oct - Jul) 2 OBS LOS (hours) • 2:37 PM • 36 hours • (Oct - Jun) • 35 hours • (May - Jul) 3 • 35 hours Readmission rate • 18.84% • (Apr – Jun) • 18.58% • (Oct – Jul 4 • 17.49% 1 To calculate department level goals, individual patients given department level goal and then calculated an average across the relevant patients. Note will change slightly every month given distribution of patients and last month of readmissions data is provided from an internal predictive model developed by the Data Analytics & Reporting team Source: SDK, Data Analytics & Reporting team 21

  22. DOM Inpatient Discharges N=9467 N=9297 N=9681 N=9728 N=10571

  23. DOM Average Length of Stay N=5.5 N=5.72 N=5.16 N=4.83 N=4.72

  24. Clinical Financial Performance

  25. Clinical Volume (# wRVUs)

  26. Reimbursement $ per wRVU

  27. Clinical Collections ‘$M

  28. Clinical Metrics - The Positives Ambulatory visit volume up 1.4% (above budget) Primary care access for new patients remains high Patient experience (likelihood to recommend) above goal in most sections LOS shorter than goal in Geriatrics, Heme-Onc, Gen Med teams, MP Hospitalists Readmission rate lower than goal for Gen Med, Heart Failure and Geriatrics wRVUs increased slightly Receipt lag decreased by 2.1 days Days in Accounts Receivable decreased (>90 days 13.9%)

  29. Clinical Metrics- The Negatives Progress in improving access uneven across the department and access still too low in several sections Average discharge time remains later than goal Readmission rate above goal in Cardiology, Heme-Onc, ID, Hospitalists and Renal services Payment per wRVUdecreased and clinical collections decreased First time denials increased 3.4%

  30. Quality Performance

  31. Quality Highlights BMC Preventable Harms Index (PHI) O/E 0.959 BMC patient experience above QUEST goal, UHC 45th percentile ≥ 70% (YTD 72.9%) Early Warning System implemented QI/PS trainee pathway growing in popularity PGY2 QI curriculum - increasingly meaningful projects IPASS handoff bundle implemented successfully DOM residents attended and presented QI projects at national IHI conference

  32. Mortality O/E Trend(April 2014-June 2016) Medical Patients BMC Patients

  33. Clinical and Quality Goals for AY17 Improve physician and staff satisfaction in the Ambulatory setting Work with eMERGE team on improving efficiency and effectiveness of EMR Fully implement Evidence-based /Consensus Criteria for Referral to Specialty Clinics to integrate primary and subspecialty care; integration within Epic Increase outpatient visit volume and improve new patient access Implement physician component of patient experience initiatives Continue to develop initiatives to improve discharge time and patient flow

  34. Clinical and Quality Goals for AY17, con’t Continue IPASS implementation Work with BMC to meet the publically reported preventable harm index goal (with specific work in CAUTI, CLABSI, C diff, and DVT prophylaxis) Evaluate whether unintended disparities (or just differences) exist in our ambulatory and inpatient goals and metrics

  35. Annual Review 2016 Academic Year • DOM Faculty • Clinical Programs • Research Programs • Education Programs • Faculty Development and Diversity Programs • Finance and Research Administration • Summary • Appendix

  36. New Research Awards ($m)(excludes VA, NEIDL, and RWMC)

  37. ECIBR Overview Over 224 Faculty Members, and over 133 core participants since 2009 • 55 from Department of Medicine • 26 from basic science departments • 12 from dental school, 8 from School of Public Health and 27 from Charles River Campus of BU • 13 collaborators from outside BU 148 funded grants (out of 272 applications) 459 co-PI interdisciplinary publications since 2009

  38. Ongoing Affinity Research Collaboratives HOST-PATHOGEN INTERACTION: THE CASE OF PNEUMONIA (PneumoniARC) Dr. Jay Mizgerd THROMBOSIS TO HEMOSTASIS IN HEALTH AND DISEASE (Drs. Vipul Chitalia, Jean Francis, Mark Sloan and Katya Ravid) ETIOLOGY AND PATHOGENESIS OF ORAL CANCER (EPOC)
Drs. Maria Kukuruzinsa, Avrum Spira and Maria Trojanowska

  39. BU IBRO Boston University Interdisciplinary Biomedical Research OfficeEvans Center for Interdisciplinary Biomedical Research at BU School of Medicinex New Pre-ARCs 2016 Precision Medicine and Neurodegenerative Disease Drs. Rhoda Au, Neil Kowall and Lindsay Farrer) Mobile Health and Informatics (Drs. Belinda Borrelli, Lisa Quintiliani and Julie Keysor) Systems Biology Approaches to Microbiome Research (Drs. Daniel Segrè and Evan Johnson) Metabolic Clinical Research Collaborative (Drs. Jude Deeney, Markus Bachschmid and Barbara Corkey) Pre-ARC in Discussion: Mechanics & Biology of Brain Trauma (Bubbles and the Brain) (Drs. Jacy Bird, Alice White, Ann McKee and Lee Goldstein)

  40. BU IBRO and ECIBR Goals AY 17 Promote Innovative Team Science, Collaborative funding and Metrics at University level within the CTSI and BU Interdisciplinary Biomedical Research Office (BU IBRO) Develop Team Science Focused on Cancer Research in collaboration between IBRO and the Cancer Center (plans in discussions with Dr. Spira) Newly-developed cross-campus thematic seminars and workshops Cross-campus yearly Research Retreat in planning stages for early 2017 Developing with the Boston Museum of Science the Creation of a Yearly BU IBRO Lectureship of Relevance to Current Topics of Interest and Open to the Public • Educational Goals: New IBRO-Post Doc Office Program of Interdisciplinary Research at Post Doc level; continue to develop the MS program

  41. Research Activities, AY16 Number of faculty using the Cores was 124 Sig Grant Awarded to Core – “Temperature-controlled metabolic measurement system for mice.” Increased non-academic off campus Core users to eight companies. Funding Awards: Bridge 2 Pilot 11 K Supplement 6 >95% grant support 21 Training Grant Supplemental 15 New DOM Brochure

  42. Research Activities, AY16 Implemented a new “Center for “Translational Epidemiology and Comparative Effectiveness Research” Implemented a new “Center for Implementation and Improvement Science” Clinical/Basic Grand Rounds Implemented Completed consolidation of Core Management under Thomas Balon First Research Faculty Incentive Plan

  43. Research Goals, AY17 Continue support for Researchers through the “First Step Program:” evaluation of application SpecificAims page Develop approaches to the current funding environment through the “Clinical/Basic/Population Research Collaborations” Work with BU and BMC to facilitate investments in research programs Submit additional SIG grant applications to support Cores Develop improved metrics for Cores and Programs

  44. Annual Review 2016 Academic Year • DOM Faculty • Clinical Programs • Research Programs • Education Programs • Faculty Development and Diversity Programs • Finance and Research Administration • Summary • Appendix

  45. Residency Program Education Activities, AY16 Excellent Match, filling all 4 tracks and recruiting 7 under-represented minorities Intraining Exam Results for three PGY classes ranged from 67th to 81st percentile Asher Tulskyappointed Director of Resident Development Developed coaching program and success team (faculty trained in resident remediation) Jenny Siegel appointed Associate Program Director Sheilah Bernard now Assistant Program Director with roles in remediation, recruitment, and teaching

  46. BU Applicant History

  47. Residency Program Education Goals, AY17 Successfully implement resident coaching program Facilitate better resident participation in scholarly activities with use of recently created faculty research database Improve the quality of academic half day conferences to address educational gaps as identified by topics covered, ACGME survey feedback, and IM-ITE scores Disseminate program’s educational innovations Continue to increase diversity of trainees

  48. Student Education AY ‘16 Evalsfrom Office of Med Educat BUSM for 2016 • ‪95% of students rate the quality of the Medicine 1 Clerkship educational experience as good or excellent • > 95% agree or strongly agree that “residents and faculty were professional role models” • 82% agree or strongly agree that mid-clerkship feedback was useful • Students seek more observation of clinical skills

  49. Student EducationAY ‘16 From AAMC Graduate Questionnaire (GQ): Slippage in Med I evaluation over past few years and below national median for: • Quality of educational experiences • Effectiveness of teaching provided by residents and faculty

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