- Email: [email protected]
Medical School Dean as a Turnaround Agent
Medical School Dean as a Turnaround Agent BENJAMIN P. SACHS, MB, BS; N. KEVIN KRANE, MD; MARC J. KAHN, MD
In November, 2007, Dr. Benjamin Sachs became the Dean of the School of Medicine and Senior Vice President for Health Science at Tulane University School of Medicine. In this article, Dr. Sachs, with input from his colleagues, Drs. Kahn and Krane, describes the process by which a new Dean can implement change in an institution that has gone through crises. The article is written from the perspective of Dr. Sachs, a new Dean, in a new environment, in a new school facing novel circumstances.
F
or the past 29 years I have been as the faculty at Harvard and have had the opportunity to hold a number of administrative positions including Professor and Chair of Obstetrics and Gynecology at Beth Israel Deaconess Medical Center. My background is in clinical medicine and public health/ health policy, and I also have experience and training in management. My passion has always been to make a difference in people’s lives, especially in the quality and delivery of healthcare services to communities in the United States and abroad. Therefore, when asked to interview for the position of Senior Vice President and Dean of Tulane University School of Medicine in New Orleans, a city ravaged by Hurricane Katrina in late August of 2005, I accepted. It was apparent as I completed my initial visit that Tulane’s survival and recovery were remarkable, although New Orleans and the Gulf South remained communities in great need. My interest was particularly piqued after my first interview, when, serendipitously, a fellow airplane passenger recounted how she had just attended Tulane University’s graduation. During the ceremony, when the speaker asked all students who had engaged in community rebuilding to stand, every single student stood. From this simple, yet powerful gesture, it was clear that Tulane was an institution composed of people committed to rebuilding communities and committed to making a difference.
From the Tulane University School of Medicine, New Orleans, Louisiana. Submitted April 24, 2008; accepted in revised form April 29, 2008. Correspondence: Benjamin P. Sachs, MB, BS, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112 (E-mail: [email protected]). THE AMERICAN JOURNAL OF THE MEDICAL SCIENCES
ABSTRACT: Taking on the role as a new medical school Dean in a new city after Hurricane Katrina posed many challenges. To facilitate turnaround, 3 principles were applied: hit the ground running, promote community involvement, and gain a common vision for the future. This article describes Tulane University’s process for implementing change and expands on its vision for the future. KEY INDEXING TERMS: Dean community; neighborhood clinics. [Am J Med Sci 2008;336(2):181– 184.]
Background Even though I had great enthusiasm for Tulane, there was much to think about. Could the healthcare system recover from the disaster? According to data compiled by the Center for Medicare and Medicaid Services and the Agency for Healthcare Research and Quality, compared with the other 49 states, pre-Katrina Louisiana had the highest Medicare costs per capita, and the lowest quality rating.1 Additionally, Louisiana had one of the highest uninsured rates before the storm at 19%, which rose to nearly 23% after the storm.2 After Katrina, hospital beds in New Orleans fell by over 50%, in-patient psychiatry beds decreased by two-thirds, and the number of physicians decreased by over 70%.3 Postgraduate residency positions in the state had similarly decreased by nearly half, and the Tulane fulltime medical faculty had decreased by over 40%.4 Given the rising cost of medical care, a loss of clinical revenue, and the burden of physician recruitment, Tulane’s post-Katrina Medical School Dean was going to have many challenges. One question I frequently found myself answering was “Why New Orleans?” There were many reasons why. Economically, New Orleans is an important city. The Port of New Orleans and the Port of South Louisiana in nearby LaPlace combine to form the largest port system in the world based on annual tonnage. Louisiana ranks in the top 3 states for natural gas production, responsible for 30% of United States oil and gas production, and leads the country in offshore oil production. New Orleans is a unique culture, a blend of its Creole, Cajun, and Anglo roots. There is no better city in the world for food and music. I soon found myself answering the question, “Why not New Orleans?” New Orleans represents the best in America: 181
Medical School Dean as a Turnaround Agent
economic opportunity, a unique culture, and a diverse population. However, the community needs effective leaders to survive. I accepted the job on July 7, 2007 and officially started in November 2007. I spent 3 months commuting to plan my strategy for Tulane in the post-Katrina era. I recognized that the medical faculty members who returned and remained in New Orleans after Katrina were people of courage who had put aside many of their own complex personal challenges to save their community, its people, and the medical school and were working to rebuild the health care system in New Orleans. I began keeping a diary after accepting the position. One early entry read: Signs of hope can be seen everywhere. There is a quiet but powerful revolution going on in this city. This year our medical school received 8300 applications for 175 places. Pre-Katrina, there were 6800 applicants; this is a large increase especially considering that nationally fewer students are applying to medical school (based on 2006 –7 data). Young people, wonderful young people with spirit are being attracted to New Orleans for the opportunity to make a difference. Tulane is the only research university in the USA that requires public service as a requirement for graduation. I am really proud of our medical students. The scientists, physicians, nurses and technicians, men and women who returned after the storm to rebuild are truly people of courage. Not only do they have to contend with ongoing personal challenges, but they also have to help rebuild our university and city. I have huge respect for them. Most days I shine a virtual mirror at them and say, “look what you have achieved in the last 2 years; did you know you had it in you? Imagine what we can build for tomorrow.” It is a privilege to be a member of the Tulane family.
During the initial months as Dean and Senior Vice President, several important principles helped me transition into my role as a turnaround agent at a new university, in a new city: hit the ground running, promote community involvement, and gain a common vision for the future. Hit the Ground Running Tulane had been through a number of strategic planning processes since the storm. I recognized that there would be no tolerance amongst the faculty for more strategic planning. What was needed was definitive action. I was very concerned that, unless I acted decisively, faculty would leave. During the 3 months I commuted, I spent a significant amount of time listening and learning about the environment. I built a network of contacts in New Orleans with the help of friends and colleagues, including business and civic leaders from around the country. I recognized that if I were to make a difference in New Orleans I would need to have strong relationships with business leaders and local community leaders including religious figures, politicians, and minority groups. Good fortune was with me. Shortly after accepting the offer to come to Tulane, the Murphy Oil Company donated their world head quarters building to Tulane. It is a remarkable 240,000 square-foot 182
building with everything from small classrooms to a large auditorium, a gym and a cafeteria; a perfect building for our medical school. I decided early on to build a simulation center at Tulane to have an early win, and in part because of the history of issues with cost and quality off care in Louisiana. The Murphy building would provide the space for Tulane’s Center for Advanced Simulation and Team Training, a $5 million project, where students, residents, faculty, nurses and managers would come together and practice team-training activities to improve patient safety and the quality of care. Additionally, the building would house administrative offices, modernized educational space, and space devoted to students including a health facility. The donation of this building was evidence that Tulane was no longer in a “survival” mode and provided an opportunity to create a new image of a dynamic and expanding medical school— clear evidence of Tulane’s renewal and an opportunity to boost morale. Tulane’s research community was hit hard by Katrina. Many, if not most, researchers lost momentum yet are managing to rebuild their programs. The problem today is the need to upgrade Tulane’s research facilities. Tulane, under the leadership of President Scott Cowen, did an amazing if not superhuman job of reopening and then rebuilding the university post-Katrina. My challenge is to use these achievements as a springboard to move the medical school from a survival mode to a rebuildingfor-the-future mode. The external environment adds to the challenge with purchasing power of National Institutes of Health funding declining. Furthermore, approximately $15 billion of new research facilities having come on-line nationally in the past 9 years resulted in universities competing for a limited supply of funded researchers. To build the case for new facilities, the University President challenged the research community to develop a plan to double externally funded research at the school over the next 10 years. As an agent for turnaround, I believe that new paradigms need to be considered. I believe that the future of biological research will heavily depend on the participation of mathematicians, physicists, chemists, technology specialists, and engineers. Fortunately, one of Tulane’s greatest strengths is our strong collaborative spirit. Very few research universities have the degree of collaboration that exists between the medical school and its sister schools, such as the School of Science and Engineering and the School of Arts and Humanities. The research silos, typical of most universities, have been broken down at Tulane, creating an atmosphere most universities can only dream about. As a result, I am very optimistic about our strategy to put biologic and physical scientists together in the same research environment. August 2008 Volume 336 Number 2
Sachs et al
The clinical enterprise has also moved in a very promising direction. Tulane University Hospital and Clinic has been a joint venture between Healthcare Corporation of America (HCA) and the University since 1995, with HCA having a majority financial interest but the management board having equal representation between the University and HCA. Shortly before my arrival, the Hospital had hired a new physician chief executive officer, Dr. Robert Lynch, with extensive experience in the Veteran’s Affairs medical system. He has a keen understanding of health care systems, and we have a shared vision of the importance of quality improvement and patient safety. The first week of my arrival, I began making weekly hospital rounds with the chief executive officer, demonstrating to the physicians, nurses and residents that we were committed as a team to making the partnership work for the betterment of patient care. Both inpatient and outpatient census figures have risen steadily, and a significant commitment of new resources to the hospital by HCA is particularly encouraging. Figuratively, “hitting the ground running” went beyond my commitment to rebuilding the infrastructure but also reflected my commitment to personal health and building relationships with students and faculty. We started a Sunday morning running club for interested students, residents, and faculty. Meeting at picturesque Audubon Park every Sunday morning, the running club demonstrates a vitality and commitment to physical health. The club provides a great opportunity for the Deans to meet students on a very informal basis. Promote Community Involvement Since Katrina, New Orleans has been in the midst of a public health crisis. Limited access to primary care and mental health services, limited access to specialty care, declining physician numbers and salaries, and even an average physician age that is 10 years greater than the national average are all major challenges that continue to face the city. In addition, residency positions have been reduced, forcing current students to leave the region for training. Before Katrina, the New Orleans’ underserved and uninsured received care at the statefunded Charity Hospital and its outpatient clinics. After the storm, Charity Hospital closed and has only partially been replaced by University Hospital, a joint teaching facility shared between Louisiana State University and Tulane. In Boston, I had seen community health centers work, and I see tremendous opportunity to rebuild healthcare in the region using new models. My philosophy is best conveyed by the following story: I arrived in Boston 29 years ago from England. The 1960s and 70s were troubled decades in Boston. Racial tensions were running
THE AMERICAN JOURNAL OF THE MEDICAL SCIENCES
high over the busing issue, and the economy was in a tailspin. Massachusetts had been heavily reliant on the manufacturing industry. As this economic sector declined, there appeared to be little to replace it. Unemployment was high, violence was common, the waterfront was derelict and few would venture downtown at night for dinner. Last, but by no means least, the number of people without health insurance was high, and the infant mortality rate was amongst the highest in the nation. In my opinion it took 2 governors in the 1980s, 1 Democrat and 1 Republican, to sow the seeds of the success we see today. First there was a marked expansion of community health centers, health centers that also functioned as community centers. I was always struck by the sight of school children going to the neighborhood health center to do their homework because it was a safe place. But above all, I believe that, because the communities took responsibility, the centers became the glue that bound the neighborhoods and gave people pride in their communities. Today, faculty members compete to work in the neighborhood health centers. Salaries are competitive and they provide the opportunity for research in clinical medicine/public health. Boston is not the only city to have discovered the benefits of community health centers; one only has to look at San Francisco, Chicago, and New York, and Birmingham, Alabama to find successful examples.
I have seen the concept of neighborhood health centers work. To help facilitate Tulane’s mission in the community together with newly-appointed Dr. Karen DeSalvo as Vice Dean for Community Affairs and Outreach, and Dr. Harvey Makadon, an outside expert with extensive experience in community health centers, we developed a business plan demonstrating economic viability of our neighborhood health center concept within 8 weeks of my arrival. A team of local business leaders, community leaders, and the newly appointed Vice Dean, visited Boston to see how these centers function. This trip was accompanied by significant media coverage to publicize our notion of primary health care in postKatrina New Orleans. Additionally, having politicians and business leaders witness first-hand the value of neighborhood health centers has greatly assisted our getting local buy-in for this plan. Gain a Common Vision for the Future Finally, team building is important for any new Dean. Toward that end, we have developed a new
Figure 1. Tulane’s vision—mission statement.
183
Medical School Dean as a Turnaround Agent
vision/mission statement for our school that incorporates the unique setting and needs of post-Katrina New Orleans. As important as the final product, the exercise is an opportunity to create a shared vision for the future. Although still being finalized, this project has already resulted in a logo with the motto “We Heal Communities” as the centerpiece (Figure 1). I believe that this message will allow us to move forward to do our jobs, to better our city, and to care for our patients. Healing communities is what we are about. It is the vision for our future.
184
References 1. Jencks SF, Huff ED, Cuerdon T. Change in the quality of care delivered to Medicare beneficiaries, 1998 –1999 to 2000 – 2001. JAMA 2003;289:305–12. 2. Smith EB. Hospitals in New Orleans see surge in uninsured patients but not public funds. USA Today. March 26, 2006. 3. Rudowitz R, Rowland D, Shartzer A. Health care in New Orleans before and after Hurricane Katrina. Health Aff (Millwood) 2006;25:w393–w406. 4. Krane NK, DiCarlo RP, Kahn MJ. Medical education in post-Katrina New Orleans: a story of survival and renewal. JAMA 2007;289:1052–5.
August 2008 Volume 336 Number 2
In November, 2007, Dr. Benjamin Sachs became the Dean of the School of Medicine and Senior Vice President for Health Science at Tulane University School of Medicine. In this article, Dr. Sachs, with input from his colleagues, Drs. Kahn and Krane, describes the process by which a new Dean can implement change in an institution that has gone through crises. The article is written from the perspective of Dr. Sachs, a new Dean, in a new environment, in a new school facing novel circumstances.
F
or the past 29 years I have been as the faculty at Harvard and have had the opportunity to hold a number of administrative positions including Professor and Chair of Obstetrics and Gynecology at Beth Israel Deaconess Medical Center. My background is in clinical medicine and public health/ health policy, and I also have experience and training in management. My passion has always been to make a difference in people’s lives, especially in the quality and delivery of healthcare services to communities in the United States and abroad. Therefore, when asked to interview for the position of Senior Vice President and Dean of Tulane University School of Medicine in New Orleans, a city ravaged by Hurricane Katrina in late August of 2005, I accepted. It was apparent as I completed my initial visit that Tulane’s survival and recovery were remarkable, although New Orleans and the Gulf South remained communities in great need. My interest was particularly piqued after my first interview, when, serendipitously, a fellow airplane passenger recounted how she had just attended Tulane University’s graduation. During the ceremony, when the speaker asked all students who had engaged in community rebuilding to stand, every single student stood. From this simple, yet powerful gesture, it was clear that Tulane was an institution composed of people committed to rebuilding communities and committed to making a difference.
From the Tulane University School of Medicine, New Orleans, Louisiana. Submitted April 24, 2008; accepted in revised form April 29, 2008. Correspondence: Benjamin P. Sachs, MB, BS, Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA 70112 (E-mail: [email protected]). THE AMERICAN JOURNAL OF THE MEDICAL SCIENCES
ABSTRACT: Taking on the role as a new medical school Dean in a new city after Hurricane Katrina posed many challenges. To facilitate turnaround, 3 principles were applied: hit the ground running, promote community involvement, and gain a common vision for the future. This article describes Tulane University’s process for implementing change and expands on its vision for the future. KEY INDEXING TERMS: Dean community; neighborhood clinics. [Am J Med Sci 2008;336(2):181– 184.]
Background Even though I had great enthusiasm for Tulane, there was much to think about. Could the healthcare system recover from the disaster? According to data compiled by the Center for Medicare and Medicaid Services and the Agency for Healthcare Research and Quality, compared with the other 49 states, pre-Katrina Louisiana had the highest Medicare costs per capita, and the lowest quality rating.1 Additionally, Louisiana had one of the highest uninsured rates before the storm at 19%, which rose to nearly 23% after the storm.2 After Katrina, hospital beds in New Orleans fell by over 50%, in-patient psychiatry beds decreased by two-thirds, and the number of physicians decreased by over 70%.3 Postgraduate residency positions in the state had similarly decreased by nearly half, and the Tulane fulltime medical faculty had decreased by over 40%.4 Given the rising cost of medical care, a loss of clinical revenue, and the burden of physician recruitment, Tulane’s post-Katrina Medical School Dean was going to have many challenges. One question I frequently found myself answering was “Why New Orleans?” There were many reasons why. Economically, New Orleans is an important city. The Port of New Orleans and the Port of South Louisiana in nearby LaPlace combine to form the largest port system in the world based on annual tonnage. Louisiana ranks in the top 3 states for natural gas production, responsible for 30% of United States oil and gas production, and leads the country in offshore oil production. New Orleans is a unique culture, a blend of its Creole, Cajun, and Anglo roots. There is no better city in the world for food and music. I soon found myself answering the question, “Why not New Orleans?” New Orleans represents the best in America: 181
Medical School Dean as a Turnaround Agent
economic opportunity, a unique culture, and a diverse population. However, the community needs effective leaders to survive. I accepted the job on July 7, 2007 and officially started in November 2007. I spent 3 months commuting to plan my strategy for Tulane in the post-Katrina era. I recognized that the medical faculty members who returned and remained in New Orleans after Katrina were people of courage who had put aside many of their own complex personal challenges to save their community, its people, and the medical school and were working to rebuild the health care system in New Orleans. I began keeping a diary after accepting the position. One early entry read: Signs of hope can be seen everywhere. There is a quiet but powerful revolution going on in this city. This year our medical school received 8300 applications for 175 places. Pre-Katrina, there were 6800 applicants; this is a large increase especially considering that nationally fewer students are applying to medical school (based on 2006 –7 data). Young people, wonderful young people with spirit are being attracted to New Orleans for the opportunity to make a difference. Tulane is the only research university in the USA that requires public service as a requirement for graduation. I am really proud of our medical students. The scientists, physicians, nurses and technicians, men and women who returned after the storm to rebuild are truly people of courage. Not only do they have to contend with ongoing personal challenges, but they also have to help rebuild our university and city. I have huge respect for them. Most days I shine a virtual mirror at them and say, “look what you have achieved in the last 2 years; did you know you had it in you? Imagine what we can build for tomorrow.” It is a privilege to be a member of the Tulane family.
During the initial months as Dean and Senior Vice President, several important principles helped me transition into my role as a turnaround agent at a new university, in a new city: hit the ground running, promote community involvement, and gain a common vision for the future. Hit the Ground Running Tulane had been through a number of strategic planning processes since the storm. I recognized that there would be no tolerance amongst the faculty for more strategic planning. What was needed was definitive action. I was very concerned that, unless I acted decisively, faculty would leave. During the 3 months I commuted, I spent a significant amount of time listening and learning about the environment. I built a network of contacts in New Orleans with the help of friends and colleagues, including business and civic leaders from around the country. I recognized that if I were to make a difference in New Orleans I would need to have strong relationships with business leaders and local community leaders including religious figures, politicians, and minority groups. Good fortune was with me. Shortly after accepting the offer to come to Tulane, the Murphy Oil Company donated their world head quarters building to Tulane. It is a remarkable 240,000 square-foot 182
building with everything from small classrooms to a large auditorium, a gym and a cafeteria; a perfect building for our medical school. I decided early on to build a simulation center at Tulane to have an early win, and in part because of the history of issues with cost and quality off care in Louisiana. The Murphy building would provide the space for Tulane’s Center for Advanced Simulation and Team Training, a $5 million project, where students, residents, faculty, nurses and managers would come together and practice team-training activities to improve patient safety and the quality of care. Additionally, the building would house administrative offices, modernized educational space, and space devoted to students including a health facility. The donation of this building was evidence that Tulane was no longer in a “survival” mode and provided an opportunity to create a new image of a dynamic and expanding medical school— clear evidence of Tulane’s renewal and an opportunity to boost morale. Tulane’s research community was hit hard by Katrina. Many, if not most, researchers lost momentum yet are managing to rebuild their programs. The problem today is the need to upgrade Tulane’s research facilities. Tulane, under the leadership of President Scott Cowen, did an amazing if not superhuman job of reopening and then rebuilding the university post-Katrina. My challenge is to use these achievements as a springboard to move the medical school from a survival mode to a rebuildingfor-the-future mode. The external environment adds to the challenge with purchasing power of National Institutes of Health funding declining. Furthermore, approximately $15 billion of new research facilities having come on-line nationally in the past 9 years resulted in universities competing for a limited supply of funded researchers. To build the case for new facilities, the University President challenged the research community to develop a plan to double externally funded research at the school over the next 10 years. As an agent for turnaround, I believe that new paradigms need to be considered. I believe that the future of biological research will heavily depend on the participation of mathematicians, physicists, chemists, technology specialists, and engineers. Fortunately, one of Tulane’s greatest strengths is our strong collaborative spirit. Very few research universities have the degree of collaboration that exists between the medical school and its sister schools, such as the School of Science and Engineering and the School of Arts and Humanities. The research silos, typical of most universities, have been broken down at Tulane, creating an atmosphere most universities can only dream about. As a result, I am very optimistic about our strategy to put biologic and physical scientists together in the same research environment. August 2008 Volume 336 Number 2
Sachs et al
The clinical enterprise has also moved in a very promising direction. Tulane University Hospital and Clinic has been a joint venture between Healthcare Corporation of America (HCA) and the University since 1995, with HCA having a majority financial interest but the management board having equal representation between the University and HCA. Shortly before my arrival, the Hospital had hired a new physician chief executive officer, Dr. Robert Lynch, with extensive experience in the Veteran’s Affairs medical system. He has a keen understanding of health care systems, and we have a shared vision of the importance of quality improvement and patient safety. The first week of my arrival, I began making weekly hospital rounds with the chief executive officer, demonstrating to the physicians, nurses and residents that we were committed as a team to making the partnership work for the betterment of patient care. Both inpatient and outpatient census figures have risen steadily, and a significant commitment of new resources to the hospital by HCA is particularly encouraging. Figuratively, “hitting the ground running” went beyond my commitment to rebuilding the infrastructure but also reflected my commitment to personal health and building relationships with students and faculty. We started a Sunday morning running club for interested students, residents, and faculty. Meeting at picturesque Audubon Park every Sunday morning, the running club demonstrates a vitality and commitment to physical health. The club provides a great opportunity for the Deans to meet students on a very informal basis. Promote Community Involvement Since Katrina, New Orleans has been in the midst of a public health crisis. Limited access to primary care and mental health services, limited access to specialty care, declining physician numbers and salaries, and even an average physician age that is 10 years greater than the national average are all major challenges that continue to face the city. In addition, residency positions have been reduced, forcing current students to leave the region for training. Before Katrina, the New Orleans’ underserved and uninsured received care at the statefunded Charity Hospital and its outpatient clinics. After the storm, Charity Hospital closed and has only partially been replaced by University Hospital, a joint teaching facility shared between Louisiana State University and Tulane. In Boston, I had seen community health centers work, and I see tremendous opportunity to rebuild healthcare in the region using new models. My philosophy is best conveyed by the following story: I arrived in Boston 29 years ago from England. The 1960s and 70s were troubled decades in Boston. Racial tensions were running
THE AMERICAN JOURNAL OF THE MEDICAL SCIENCES
high over the busing issue, and the economy was in a tailspin. Massachusetts had been heavily reliant on the manufacturing industry. As this economic sector declined, there appeared to be little to replace it. Unemployment was high, violence was common, the waterfront was derelict and few would venture downtown at night for dinner. Last, but by no means least, the number of people without health insurance was high, and the infant mortality rate was amongst the highest in the nation. In my opinion it took 2 governors in the 1980s, 1 Democrat and 1 Republican, to sow the seeds of the success we see today. First there was a marked expansion of community health centers, health centers that also functioned as community centers. I was always struck by the sight of school children going to the neighborhood health center to do their homework because it was a safe place. But above all, I believe that, because the communities took responsibility, the centers became the glue that bound the neighborhoods and gave people pride in their communities. Today, faculty members compete to work in the neighborhood health centers. Salaries are competitive and they provide the opportunity for research in clinical medicine/public health. Boston is not the only city to have discovered the benefits of community health centers; one only has to look at San Francisco, Chicago, and New York, and Birmingham, Alabama to find successful examples.
I have seen the concept of neighborhood health centers work. To help facilitate Tulane’s mission in the community together with newly-appointed Dr. Karen DeSalvo as Vice Dean for Community Affairs and Outreach, and Dr. Harvey Makadon, an outside expert with extensive experience in community health centers, we developed a business plan demonstrating economic viability of our neighborhood health center concept within 8 weeks of my arrival. A team of local business leaders, community leaders, and the newly appointed Vice Dean, visited Boston to see how these centers function. This trip was accompanied by significant media coverage to publicize our notion of primary health care in postKatrina New Orleans. Additionally, having politicians and business leaders witness first-hand the value of neighborhood health centers has greatly assisted our getting local buy-in for this plan. Gain a Common Vision for the Future Finally, team building is important for any new Dean. Toward that end, we have developed a new
Figure 1. Tulane’s vision—mission statement.
183
Medical School Dean as a Turnaround Agent
vision/mission statement for our school that incorporates the unique setting and needs of post-Katrina New Orleans. As important as the final product, the exercise is an opportunity to create a shared vision for the future. Although still being finalized, this project has already resulted in a logo with the motto “We Heal Communities” as the centerpiece (Figure 1). I believe that this message will allow us to move forward to do our jobs, to better our city, and to care for our patients. Healing communities is what we are about. It is the vision for our future.
184
References 1. Jencks SF, Huff ED, Cuerdon T. Change in the quality of care delivered to Medicare beneficiaries, 1998 –1999 to 2000 – 2001. JAMA 2003;289:305–12. 2. Smith EB. Hospitals in New Orleans see surge in uninsured patients but not public funds. USA Today. March 26, 2006. 3. Rudowitz R, Rowland D, Shartzer A. Health care in New Orleans before and after Hurricane Katrina. Health Aff (Millwood) 2006;25:w393–w406. 4. Krane NK, DiCarlo RP, Kahn MJ. Medical education in post-Katrina New Orleans: a story of survival and renewal. JAMA 2007;289:1052–5.
August 2008 Volume 336 Number 2