|
|
 |
Symposium Notes
Pre-Symposium Dinner
A pre-symposium dinner was held on Thursday, July 29th, for participants to meet and network with other attendees. Dr. David C. Leach, the Executive Director of the ACGME, welcomed the group and thanked them for coming to the symposium. After group introductions, he asked attendees to deliberate on the following appreciative inquiry exercise and prepare to discuss it after dinner: Think of a time when your institution was performing at an extremely high level in its efforts to improve graduate medical education, a time you were really proud to be a part of your institution. What made you proud to be a member of your institution? Appreciate Inquiry exercise.
Symposium.
At 7:15 a.m., on Friday, July 30th, Dr. Leach welcomed everyone and reviewed the agenda for the day.
Dr. Charles L. Rice, the Chair of the ACGME, noted that the symposium was of particular importance for the ACGME is interested in ensuring and improving the quality of resident education and experiences.
Dr. Roger Bulger, President of the AHC, underscored the importance of the symposium and explained that the AHC will assume the lead role in addressing issues raised during the course of the symposium.
Highlights from invited speakers presentations:
- Dr. David Satcher, the former Surgeon General of the United States and the current Director of the National Center for Primary Care at the Morehouse School of Medicine, updated the group on the “Healthy People 2010” initiative he had begun as Surgeon General and spoke to the challenges safety net institutions face in trying to meet the goals of this initiative, in particular he focused on Grady Memorial Hospital, one of the nation’s oldest and best known public hospitals.
- Dr. Ron J. Anderson, the President and CEO of Parkland Health and Hospital System, next addressed the group and discussed issues that Parkland Hospital, one of the more nationally recognized safety net institutions, is currently facing. These include significant population growth, increases in the numbers of indigent and uninsured patients (especially out-of-county poor and uninsured), inadequate facilities to serve the increased demands and critical junctures with health care financing issues. Although Dr Anderson noted that federal, state, and local initiatives are addressing these issues, he stressed that safety net institutions need to do further work collaborating and partnering with other hospitals and physicians in order to adequately continue to provide access to healthcare for the poor and uninsured and a good learning environment for residents.
- The next two presentations were variations on a theme. Dr. Leach presented on the importance of providing residents’ a healthy educational environment to become competent physicians, good learning for good healthcare. Ms. Rosemary Gibson, Senior Project Officer at the Robert Wood Johnson Foundation, called for a “competent institution” that would foster a healthy environment for learning, good healthcare for good learning. Ms. Gibson noted that sponsoring institutions that oversee GME need to adopt the principles of the six general competencies, especially those related to systems bases practice, in order to become competent themselves; becoming competent requires “making the invisible visible” and acknowledging and learning from lapses in quality and safety.
- Ms. Christine Capito Burch, the Executive Director of the National Association of Public Hospitals and Health Systems (NAPH), provided an overview of safety net hospitals and health systems, described the unstable financial environment for such institutions, and addressed challenges and opportunities relevant to GME.
- Ms. Rebecca Hirshorn and Ms. Miechal Lefkowitz provided updates on the proposed changes to Medicare GME funding.
- Dr. Jo Ivey Boufford, the former President of the New York City Health and Hospital Corporation and current professor of Health Policy and Public Service at the Robert Wagner Graduate School of Public Service, provided the group some insights from her experiences leading the largest public safety net hospital system in the United States and made the following recommendations to the ACGME and the AHC for future conversations with the safety net community: (1) work and develop educational programs aimed at helping institutions achieve the competencies; (2) assist in developing vehicles to support faculty development through highlighting collaborative efforts or “best practices”; (3) continue and sustain systematic dialogue, and (4) explore advocacy ventures that are “win-win” for everyone involved – that is, efforts that benefit institutions, residency programs, residents, and so on.
Small Group Exercises. After the presentations, participants were asked to retreat to pre-assigned groups and deliberate on the following exercises: (1) imagine an ideal future state where “good learning for good healthcare” has been achieved and describe what it looks like for the resident, faculty, program and the community; (2) what steps need to be taken now so that each of the groups noted above can achieve this future ideal state; and (3) who needs to be involved to achieve the future ideal. Each group nominated someone to report selected responses to the entire group. For a list of the ideas presented to the entire group click select ideas. For a complete list of ideas generated during the exercises click complete list.
Dr. Michael Drake, the Vice President of Health Affairs for the University of California System, provided a summary of key points from the symposium and encouraged the ACMGE and AHC to support future such discussions.
Drs Leach and Bulger thanked participants for attending the symposium and for their input on the exercises. The symposium adjourned at approximately 3:30 p.m.
|
|
|
