here - Department of Pediatrics and Human Development

Report
The Future of Academic Pediatrics at
MSU CHM – Supporting Research,
Education and Patient Care
B. Keith English, M.D.
Chair, Pediatrics & Human Development
MSU CHM Community Campuses and
Hospital Partners
Upper Peninsula Region
Upper Peninsula:
Marquette General Hospital
Midland Regional:
•MidMichigan Health (Midland, Alma,
Gladwin, Clare)
•Flint:
•Genesys Regional Medical Center
•Hurley Medical Center
•McLaren Regional Medical Center
Hospital Partners
= Student Clinical
Education Sites
Grand Rapids :
•Spectrum Health
•Mercy Health Saint Mary’s
Traverse City
Midland
Region
Lansing:
•Sparrow Health
Grand Rapids
Traverse City:
Munson Medical Center
Flint
Lansing
Our Challenges
• Changing healthcare environment, shift to
“value-based care” and shared risk
models, clinical performance pressure
• Threats to traditional sources of research
funding
• Need to work with multiple health system
partners
3
Our Opportunities
• Our goal is to improve the health and wellbeing of children – our mission is worth
fighting for!
• We must demand excellence in all of our
missions – patient care, education,
research, and service to our community
and region
4
Too much is at stake
• The future is bright for academic pediatrics –
and for our children
• Remarkable developments in genomics and
other fields offer the potential for the
development of “personalized pediatrics” -individualized approaches to the diagnosis,
treatment, and, most importantly, prevention
of disease
• “Personalized medicine” must start in
pediatrics, not in adulthood – and it will fail if
not brought to populations of patients
Preventive Medicine:
Not A New Concept in Pediatrics!
• Immunization, accident prevention,
obesity prevention, already key
areas
• Genomics will challenge us by
providing a trove of new data that
will allow us to broaden the scope of
preventive pediatrics considerably
Service to the Community and
the Region
• We must be advocates for children in this
region; too many children are at risk for
poor health outcomes
• Improving the health and wellbeing of
children requires structural change,
community engagement, and political will
– and we must partner with community
physicians and community leaders
The Future of Pediatric
Research?
• The future of pediatric research is in team science –
at the bench and in translation
• Focus of clinical research must switch to long-term
outcomes that matter to patients and their families
• Will require robust informatics that will allow
tracking of outcomes and provide the infrastructure
for “personalized pediatrics”
• The genomics revolution can help transform
individual patient care and improve population health
A Shared Vision for Pediatrics
• Demanding excellence in all of our
missions – service, patient care,
education and research
• Setting high standards … together
• Expanding pediatric research by
recruiting clinician-investigators and
basic scientists –
Pediatric Research at MSU
• Translating evidence into practice will
require robust information systems and
strong partnerships with health system
partners and community physicians
• Translational research also requires these
partnerships and this infrastructure
• “Personalized Pediatrics” or “Precision
Pediatrics”
The future of academic pediatrics
at MSU
• Academic Pediatrics can and must thrive
at MSU CHM – the health and wellbeing of
our children is at stake
• Must expand our partnerships between
pediatric faculty, students and residents in
Lansing, Flint, and Grand Rapids
• Faculty recruitment AND retention is the
key to moving to the “next level”
Making the Pie Bigger
• To grow, we cannot fight over the pieces of
the current pie – we must find ways to
enlarge the pie
• Collaboration in patient care, education,
research and outreach/service is the only
way to make the pie bigger and generate
the advances that will improve the health
of our children
Recruiting and Retaining
Outstanding Faculty Members
• If we build it, will they come?
• Need to recruit outstanding faculty
members AND “grow our own”
Retaining Top Faculty: The
Nepenthe Principles
• “Modern Faculty Development: A ModernDay Odyssey”
– Beckerle, et al, Science Translational Medicine, 3: 1-3, 2011.
Nepenthe -- an “antidote to suffering” in the
Odyssey
The goal is to enhance faculty fulfillment –
better quality of live, satisfaction, retention,
productivity – by using a carrot instead of a stick
Helping Faculty Thrive
(Nepenthe Principles)
1. Value the contributions of individuals
AND teams; the collaborative model
2. Nurture young faculty – mentoring is
critical and the lack of effective faculty
development is a powerful predictor of
faculty dissatisfaction
3. Integrate the personal and the
professional
Helping Faculty Thrive
(Nepenthe Principles)
4. Create inclusive communities
5. Develop enlightened leaders – who
promote fair and equitable treatment of
faculty, transparent decision making, use
of the Chair role in service to the
department, building esprit de corps,
fostering faculty career development
Faculty Leadership in Pediatrics
• Faculty must lead the way if we are to grow
academic pediatrics at MSU
• Pediatric faculty leaders in Lansing, Grand
Rapids and Flint are being asked to tackle the
Departmental “Academic Program Review” in
2014-15 --- Renuka Gera leads this effort and
will talk about it in a few minutes
• Faculty input at last year’s Departmental CrossCampus retreat was very helpful in guiding our
next steps
The Six Key Questions for the APR
1.What do we do?
2. Why do we do it?
3. How well do we do it and who thinks so?
4. What difference would it make whether we did it or
not?
5. Given our present status, how do we intend to
change in ways that help us advance?
6. How will we evaluate our future progress and
successes?
Pediatrics and Human
Development APR: Timetable
• Self-study to be completed by February 1,
2015
• Report to Dean and then Provost in April,
2015
• Great opportunity for strategic planning for
Pediatrics – we want input from ALL faculty
Summary of Cross-Campus Retreat
Pediatrics and Human Development
November 9, 2013
• Presentations from Flint, East Lansing and Grand
Rapids on student and resident education
• Breakout sessions on : Communication,
Engagement with MSU CHM, Mentoring Junior
Faculty, and Obstacles and Opportunities in
Improving Patient Care, Medical Education, and
Pediatric Research
Communication - Action
Steps
• Create an improved, centrally-structured Faculty Directory
with responsibility to update it regularly
– Must be searchable: Campus; specialty; research/educational/clinical interest
keywords
• Consolidate Grand Rounds – and maybe other premier
teaching opportunities
– ?? same date/time AND with appropriate technology in the selected sites
• Research – Research Committee with representative from
each campus – at least 3 largest
• Website upgrade – to allow for coordination through the single
departmental focus
Engagement – Action Steps
• Conduct a faculty inventory
– Specialty, interests, expertise
• Identify tangible benefits of being affiliated with MSU
– Incentivize it; tuition break, parking, MSU email
addresses, library access, etc.
• Improve the promotion and reappointment processes
• Create a single IRB approval process across campus
to facilitate easier collaborative experiences
• Create a defined mechanism/facilitator/meeting to
help manage/network for collaborative research
• Offer more social events to facilitate networking
Mentoring of Junior Faculty
• Some obstacles to Mentoring
– Distance/isolation
– Who are the mentors?
• Peers, senior mentors, etc; need connections/info
• Mentor-mentee relationships must be dynamic
– Lack of time (esp. lack of synchronous time)
Mentoring -- Solutions
• Point person(s)
– Who is this? Division Chief? Chair?
• Workshops:
– P&T/Research/Grant Writing/Clinical/Teaching
• Web resources
– Maintain relationships
– Learning opportunities i.e. lectures, conferences
• Meetings (annual?) to build new relationships
• Mentor policy, support (not an unfunded mandate)
Barriers to Optimal Patient Care
• Institutional Demands
– Generate Revenue
• Private Practice Model
– Teach
– “Do more with less”
• Extraneous/External Demands
– Different hospitals/payers
Ways To Improve Patient Care
•
•
•
•
Shared Conferences
Shared Patients (especially for research interests)
Shared Protocols
Use internal resources vs. external
– Awareness of areas of existing expertise
– More publicity of resources
– Create a collaborative network (similar to an M-line)
centralized database, dedicated person to maintain
• Invest in telemedicine
• Academic Centered Neighborhoods
– Credit for effort important esp. when not reimbursed
• Collaborative effort/umbrella
Improving Medical Education
• Improved relationship with Community
Preceptors
– Recognition
– ?funding
• New Curriculum
• New leadership/new focus
• New curriculum – spotlight on CHM
– No divide between pre-clinical and clinical
– Innovations that advance pediatrics
• Community Engagement
– Student attraction to Peds
– Millennial strengths
Improving Medical Education
• Collaboration Opportunities are Great
–
–
–
–
–
–
–
–
–
-- on Curricula, Assessments,
-- on Conferences
-- in Scholarly Activity
-- between UME and GME – let’s blur the line
between them, for curricula and projects
-- Across Disciplines, Departments and Schools at
MSU
-- Need to identify and collate these resources
Strengthen IT and web resources to enable
collaboration
-- Video-conferencing capabilities must be improved
--Chair’s Education Fund???
Improving Pediatric Research I
• Involve students, residents, fellows
• Increase involvement in research events –
research rounds, research day(s)
• More awareness of resources on our
campuses; more cross-campus
collaboration
• Need a pediatric clinical research network
(PCRN) of MSU sites
Improving Pediatric Research II -Obstacles
•
•
•
•
•
Limited resources and personnel
Different, conflicting affiliations
Conflicts of interest
Inadequate time
Multiple IRBs
Improving Pediatric Research III –
Needs and Opportunities
• Make connections between campuses and
between basic scientists and clinicians
(trainees as bridge)
• Peer review, IRB reciprocity
• Better communication – lack of knowledge
of potential colleagues
• Publicize ongoing research and potential
partnerships
• Recruit new faculty with interest in crosscampus collaboration
Strengthening Academic
Pediatrics at MSU –
Are We Making Progress?
• We need a sustainable clinical critical mass
in pediatrics in Lansing
• New faculty – Dr. Hurwitz in Pulmonary, Dr.
Sidhu in Genetics
• Ongoing recruitment in pediatric Hem-Onc,
ID, Endocrine, and Pulmonary
Stronger Partnership with
Sparrow is essential for building
and sustaining our critical mass
• Sparrow is supporting our Peds Hem-Onc
and ID positions
• Ongoing discussions with Sparrow aim to
develop a robust strategic plan in
pediatrics
• Must address other needs – e.g., Pediatric
Neurology, DBP, Adolescent Medicine
Pediatrics Plays The Leading Role
in Medical Education in CHM
• We have outstanding student, resident
and fellow education in Pediatrics
• Our faculty play the leading roles in overall
student education in CHM – Dr. Gera’s
role as Community Assistant Dean; Dr.
Sudhanthar’s role as Director of Clinical
Skills; Dr. Gold’s role in leading the group
responsible for designing and
implementing the new curriculum
Growing Pediatric Research at
MSU – short-term progress? I
• Actively recruiting for a program leader in
autism-related research in Pediatrics
• Additional positions for investigators in
autism-related field to be posted soon
(e.g., genetics/epigenetics of autism
and/or NDDs)
Growing Pediatric Research at
MSU – short-term progress? II
• Working on Pediatric and Human
Development faculty appointment for
Nicole Jones, Ph.D. (perinatal
epidemiologist, graduate of the MSU T32
training program, currently the Acting
Assistant Director for BRIC – Biomedical
Research Informatics Core)
• Reaching out to basic scientists at MSU
to discuss co-recruitment of faculty
Growing Pediatric Research at
MSU – short-term progress? IV
• Ongoing recruitment of investigators in
Grand Rapids in collaboration with
HDVCH
• Plans for recruiting several investigators in
pediatric neurosciences in near future in
Grand Rapids (in concert with planned
expansion of clinical programs in pediatric
neurology, epilepsy and neurodevelopmental disorders at HDVCH)
Growing Pediatric Research at
MSU – short-term progress? V
• Working to develop pediatric research
infrastructure in Grand Rapids -- short
term plans include recruitment of cancer
biologist Andre Bachmann to Dept of Peds
in Grand Rapids (he will start in January)
Growing Pediatric Research at
MSU – long-term goals? I
• Aim to recruit investigators with interest in
“personalized pediatrics” who can help
build partnerships between basic scientists
and clinicians in Lansing AND between our
campuses
• Long term need for health services
researchers who can bring “personalized
medicine” to populations of patients – the
Holy Grail of medical research
Growing Pediatric Research at
MSU – long-term goals? II
• Plan to build strong partnerships between
East Lansing, Grand Rapids and Flint and
other campuses (e.g., Traverse City) in
pediatric research – taking advantage of
plans for the new research building in
Grand Rapids, the public health expansion
in Flint, and plans for CHM to hire
investigators in Traverse City, Midland,
and Marquette

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