First Day of School at JSPH

Last week was quite a week at the Jefferson School of Population Health. On Tuesday we hosted our first Orientation to welcome our incoming students, and Wednesday – 09/09/09 – was the first day of classes for the new school. Appropriately enough, President Obama brought his case for health care reform before a joint session of Congress that very same evening.

It’s likely that the students we greeted last week – the inaugural class of the Jefferson School of Population Health – will have witnessed historic changes to the way we organize and deliver health care in the United States – all by the time they complete their first year as a JSPH student. I continue to be amazed at the synchronous path we at JSPH continue to follow with our nation’s top domestic agenda in passing meaningful health care reform. I know that our students are tuned into our national dialogue on health care reform and how it meshes with our mission of preparing leaders with global vision to develop, implement and evaluate health policies and systems that improve the health of populations, and thereby enhance the quality of life.

The healthcare industry plays an increasingly vital role in our national economy, as employer and generator of almost 20 percent of our Gross Domestic Product (GDP). The intensifying complexity of this industry in an era of heightened expectations and scrutiny means that there is both need and demand for professionals and researchers who are well versed and prepared to assume leadership roles in public health, health policy and healthcare quality and safety.

To the members of our inaugural class, we look forward to serving you, and wish you success in the 2009-2010 academic year as we work together to fulfill our mission. The future of the United States as a vibrant nation depends on the nation’s leaders bringing affordable, quality health care to all Americans, and we will play a significant role in training and equipping these leaders for the job.

- Caroline Golab, PhD

Associate Dean, Academic and Student Affairs

Jefferson School of Population Health

SHAPE THE FUTURE

SHAPE THE FUTURE---In a stirring and forceful speech, President Obama delivered a bipartisan centrist message that appealed to our character as a nation. Noting that we cannot fix the economy without fixing health care and promising not to increase the deficit he inherited, the President called for mandated insurance coverage for all Americans. Recognizing that the status quo is untenable, he called for the creation of an insurance exchange and for the so called "public option" to be created whereby those without insurance currently, could get coverage ----noting that it might take up to four years to implement. He also explicitly linked our need to reduce waste, improve quality, reduce hospital acquired infections and practice better team based care to the set of tools needed as part of the solution. From a policy perspective the speech clarified his own views and reinforced the notion that we have to build on the existing system. He did not disconnect insurance from the place of employment, he did not call for a major Medicare overhaul and he did not create major new federal bureaucracies to make his plan operational. Much more work needs to be done but I believe he effectively re--set the clock, re--set the arguments, and crafted a political umbrella under which lawmakers can now operate together. DAVID NASH MD MBA, Dean, Jefferson School of Population Health, Phila, PA

We Are Back and Ready to Go !!!!

This coming Wednesday is a watershed day for Thomas Jefferson University and the new Jefferson School of Population Health. The date is 9--9--09 !! and the significance is the first day of school for all of our students across our three degree programs---Public Health, Health Policy and Quality and Safety. As the founding Dean I am incredibly proud of our team and the nearly two years of work leading up to this momentous day. We are proud to report that the inaugural class numbers more than 115 persons from all across our region with a very heterogeneous set of skills and backgrounds. I want to thank again several key individuals including of course our university President, Dr Robert Barchi and our Senior Vice President for Academic Affairs, Dr Mike Vergare for their amazing support and encouragement. The Dean's staff including Caroline Golab, Alexis Skoufalos, Neil Goldfarb and David Glatter get special kudos for their tireless work. I am indebted to our faculty and staff who share my enthusiasm and are committed to helping to fix what is wrong with our broken health care system. No matter what happens in Washington DC in the next few weeks, our Jefferson School of Population Health is going to be a part of the solution, not just another part of the ongoing problems we all face!! Thanks again and I sure would like to hear about any similar programs and encourage persons to go to our school website at www.jefferson.edu/population_health DAVID NASH

Main Line Health and Quality

I am very pleased to report that after one year on the Board of Governors of the Main Line Health hospital system in suburban Philadelphia, I have now been appointed the Chair of the Board Quality and Safety Committee and a member of the Board Executive Committee. MLH is a very successful system of five acute care hospitals and one rehab hospital. They are largely a private practice based physician culture with partially salaried chiefs of service across the hospitals. They have a consolidated medical staff and a robust quality and safety apparatus already in place. I hope to bring my ten year experience as a Board member of Catholic Healthcare Partners , in Cincinnati OH, to MLH. At Catholic Healthcare Partners we began the quality journey of the Board nearly seven years ago and now, CHP is a national leader in governance engagement in quality. MLH will one day share this distinction, I am sure. With health reform looming, with a less than stellar ten year effort post the IOM report "To Err is Human," MLH has a real governance challenge ahead. I am humbled and excited to be a part of this wonderful organization and I look forward to the work ahead. How is your system managing the governance challenges of qualitya and safety?? DAVID NASH

What Health Reform Plan??

The Obama administration is working in overdrive to create a health reform package that could possibly be passed this summer. That is the headline we are all reading. The challenge, among many, is "what exactly is the proposed plan?"Like you, I am very concerned that the real work is being done in the basement of the White House by a very small number of non elected leaders. Sure, the press has been pretty good to date with a "down payment" on reform via the ARRA and lots of talk about the benefits of the infusion for information technology. However, the actual proposed legislation is leaking out in bits and pieces as the various interest groups inside the Beltway try hard to get their hands on real information. I hope we keep our eye on the four pillars of reform---create value, insure everyone, change the payment system and promote coordination. The pillars represent real reform, everything else is tinkering around the edges. At the Jefferson School of Population Health we are tracking these developments carefully but we need your help too. We must continue to press for transparency here and we must make sure that the four pillars are embodied in any legislative proposal. I am interested in your views too. DAVID NASH

The 18th Annual Grandon Lecture

Each year for the past 18, we have sponsored a nationally prominent person in the broad field of health policy to come to Jefferson and deliver a talk on a timely topic. Past speakers have included persons such as John Iglehart, Peggy O'Kane, Jack Rowe, and others. This year, Dr Tom Nasca, the CEO of the ACGME in Chicago, delivered the address. He linked the work of the ACGME, the group that accredits every residency program in the nation, to the need for improved quality and safety in the delivery of health care. He demonstrated that professionalism today also means an awareness of these issues and an ability to allocate resources appropriately and furthermore, a deeper understanding of the "systems" nature of care. He also met with all of our residency program directors from our teaching hospital, nearly 80 individuals who represent almost 750 trainees across all disciplines, to discuss the challenges of accreditation such as limited duty hours and the like. Clearly, there are important links between accreditation, duty hours, professionalism and health care reform. We need to provide a health care work force ready to meet the challenges of a reformed system. The ACGME is a core component of meeting this challenge. What is your residency program doing to meet the challenges of health reform?? How are you working to promote accountability and a deeper understanding of the systems nature of care?? I am interested in your views, DAVID NASH

OUTLIERS--The Story of Success

Malcolm Gladwell is one of my favorite authors. His last two books, the Tipping Point and Blink, became best sellers. I reviewed both books in our Jefferson Health Policy Newsletter in 2001 and 2005, respectively. His newest book, OUTLIERS-The Story of Success, is another hit!! I especially enjoyed chapter 7--The Ethnic Theory of Plane Crashes. This could serve as a primer on the basic tenets of Crew Resource Management--the study of improved cockpit communication and its connection to safer flights and fewer crashes. Essentially, CRM teaches pilots, copilots and other crew members a standardized form of communication that empowers everyone to participate in a safe flight. It reduces "mitigated speech" patterns and helps to preserve communication "against the authority gradient" with out punitive damages. I am convinced that healthcare teams could use a heafty dose of CRM and that training programs across most hospitals would benefit as well. Imagine for a moment a team making rounds that chooses to ignore the third year student who has a crucial piece of history, taken from the patient, that may dictate a change in therapy?? Would your team be willing to listen to the lowly third year student, especially if her information would contradict what the attending has already decided?? Think about it, and let me know!! DAVID NASH