Transcript Slide 1

Millennium Healthcare
Change you CAN believe in
Susan K. Pingleton, MD
Joy McCann Professor of WIMS
Associate Dean,
Continuing Education/ Professional Development
University of Kansas
Why Millennium Healthcare?
• Millennium is 1000 years
A new millennium began in 2000
• Enormous Changes in Healthcare since New Millennium
– Millennial Generation – 1981 to 2000
Women and Minorities in Medicine and Science
–Quality and Safety (1st IOM report in 1999)
 Systems, Teams, patient centered care
–Dollars (many less of them)
–Education now
 Other drivers:
What Millennial Changes Will Impact
You??
• Generational Changes
– Millennials will/are changing all of us
• Gender - Minorities Changes
– Impact of Women in Medicine
• Education:
• Impact of technology
» “Flipping Classroom” -- On-Line Learning
• New Educational Expectations
» Graduate Medical Education – Next Accreditation System
» Continuing Education - Performance Improvement!!
» Interprofessional Team Education
• Other Important Influences:
– Employed Physicians
– Palliative Care
– Role of Nursing
A generation is…
• Born over approximately a 20-year
time period
• Shaped by shared experience
• Known for certain qualities
Generations
Birth Years
Ages in 2011
Silent
1925 - 1945
66 – 86
Baby Boomers
1946 - 1964
47 – 65
Generation X
1965 - 1980
31 – 46
Millennials
1981- 2000
11 – 30
Millennials are not even “digital natives”
(i.e. children growing up with the
internet, 0-11 years old)
Silent Generation
1925-1945 45 million
Defining moments




Stock Market crash
Great Depression
WW II
atomic bomb
Feedback - “No news is
good news”
Baby Boomers
1946-1964 80 million
Defining moments
 Assassination of JFK
 Vietnam
 Civil Rights, women’s
rights (BCP)
 Watergate
 Moon walk
Feedback – “Once a year, with lots
of documentation
Generation X
1965-1980 46 million
Defining moments






Challenger
AIDs
Divorce
Institutional scandals
Three Mile Island
Working parents
Feedback – “Sorry to interrupt, but
how am I doing
Millennials
1981-2000 - 80 million




Virtual world
Connected, techno-savvy
Strong work-life issues
Trust networks more than
institutions
 “Don’t command – collaborate”
 Used to working in teams!
Feedback:
“Whenever I want it at the
push of a button”
Millennials
We want everything to be easy, and we want it
now," said Katie Smith, a student at the University of
Florida. "We have no patience.”
Senior Pulmonary Fellow to EVP of
ACCP:
“I am graduating in less than 1 year from
my fellowship training. I aspire to become
the president of ACCP in 10 years. How can
I get involved with the college from this
stage onwards and how can the college
help me to realize this dream?”
Prensky, Marc. “Use Their Tools! Speak Their Language!” Marc Prensky. March 2004.
http://www.marcprensky.com/writing/Prensky-Use_Their_Tools_Speak_Their_Language.pdf
Millennial
Female Faculty: Status Check
In 2010, ~50% of all
Assistant Professors are Female
Women in U.S. Academic Medicine:
Statistics and Benchmarking Report
2008-2009
Gap Between Men and Women Faculty
Larger gap at senior levels
Professors
Associate
Professors
Assistant
Professors
Many of these faculty members
are Millennials
Millennials
Op-Ed Contributor
“Don’t Quit This Day Job”
By KAREN S. SIBERT
Published: June 11, 2011
http://parenting.blogs.nytimes.com/2011/06/15/more-on-women-andmedicine/?scp=1&sq=women%20in%20medicine&st=cse
Why the Gender Gap Won’t Go Away. Ever.
Women prefer the mommy track.
http://www.city-journal.org/2011/21_3_gendergap.html
Millennials
“Why Women
Still Can’t Have It
All”
July/August 2012 ATLANTIC MAGAZINE
By Anne-Marie Slaughter
Millennials
Rethinking How We Teach The 'Net Generation'
"This new generation comes home and they turn on their computer and
they're in three different windows and they've got three magazines open and
they're listening to iTunes and they're
texting with their friends," he says,
= "and they're doing their homework."
"All these kids that have grown up
collaborating and thinking differently
walk into a university and they're asked
to sit there and passively listen to
someone talking”
Macrowikinomics
Donald Tapscott
19th Century Banking
21st Century Banking
19th Century Marketing
21st Century Marketing
19th Century
Medical Education
21st Century
Medical Education
“Broadcast“ Model of learning
Peter Drucker
“How Khan Academy Is Changing the Rules of
Education”
•By Clive Thompson
• Wired August 2011
Matthew Carpenter, age
10, has completed 642
inverse trigonometry
problems at
KhanAcademy.org.
The Khan Academy isn’t the only site changing the
way we learn—and teach. From lessons on
quantum mechanics that can be downloaded to
your mobile phone to museum-produced video
lectures on expressionism, here are a few other
online tools helping to reshape education.
— Rachel Swaby
http://www.wired.c
om/magazine/2011/
07/ff_khan/all/1
Abstracted from Chest,
Effectiveness of CME, 2009
The World's 100 Most Influential People
TIME 100: The List
Salman Khan
Educator
By Bill Gates Wednesday, Apr. 18, 2012
Toby, Director
of Wellness
The University of Wherever
By BILL KELLER
Published: October 2, 2011
One of Stanford’s most inventive professors, Sebastian Thrun, is
offering his “Introduction to Artificial Intelligence” course online and
free of charge.
His remote students will get the same lectures as students paying
$50,000 a year, the same assignments, the same exams and, if they
pass, a “statement of accomplishment” (though not Stanford credit).
When The Times wrote about this last month, 58,000 students had
signed up for the course. After the article, enrollment leapt to
130,000, from across the globe.
http://www.nytimes.com/2011/10/03/opinion/theuniversity-of-wherever.html?_r=1&hp
“If we can solve this” (technologic
problems), he said, “I think it will disrupt
all of higher education.”
Harvard and M.I.T. Team
Up to Offer Free Online
Courses
By TAMAR LEWIN
Published: May 2, 2012
Learning in Classrooms
Versus Online
Published: July 25, 2012
Op-Ed Contributor
The Trouble With Online
Education By MARK EDMUNDSON
Published: July 19, 2012
Small-Town Doctors Made in a Small
Kansas Town
http://www.nytimes.com/2011/07/23/health/policy/23doctors.html?ref=kansas
NEJM, 2012:366:1051
Faculty development for
Education of Q & S (11/12)
Continuing Education and
Professional Development
SCHEMATIC OF FLOW OF CLER SITE VISIT
Resident meeting
WalkAround
II
Team Huddle and review
CPS/CQO meeting
WalkAround
I
Core faculty meeting
Team Huddle and review
WalkAround
III
Team Huddle and review
Team
Huddle
P.D. meeting
Initial Drafting
Exit meeting
DIO, GMEC Chair,
CEO, CMO/CSO
Initial meeting
DIO, GMEC Chair,
CEO, CMO/CNO
Team prep
meeting
Foundational
Learning
Three Phases of Visit
Review, Clarify, &
Feedback
Note: each walk-around with resident host/escort, opportunity for nursing staff and pt
contact (future). Also governance interview.
IOM, 2007
“Making systems work in health care—shifting from corralling cowboys to
producing pit crews—is the great task of your and my generation of clinicians and
scientists”
Cowboys and Pit Crews
Posted by Atul Gawande
http://www.newyorker.com/online/blogs/newsdesk/2011/05/atul-gawande-harvard-medical-schoolcommencement-address.html#ixzz1VxLSya4F
Today’s world……….
…….academic medical center
Today’s world……….
The 2001 IOM
recommendations
that guide us today
STEEEP
VTE and Post-op Pneumonia in
Hospitalized patients
Today’s World……………
ABCnews.com
In Wisconsin, the number of heart doctors in private practice has declined to 11
percent from 62 percent of cardiologists in 2007, according to the American
College of Cardiology, whose main offices are in Washington. The trend is
similar nationwide.
San Francisco chronicle, November 24, 2012
A Hospital War Reflects a
Bind for Doctors in the U.S.
November 30, 2012
St. Luke's Health System
dominates the market in
Boise, Idaho, and critics say
patients are paying more
Dr. Julie A. Foote, an endocrinologist in Boise,
questions whether patients are getting costDr. David C. Pate, chief executive of St. Luke's,
effective care as a result of consolidation in the says that where costs have risen, the services
medical field
were underpriced before
Op-Ed Columnist
Death and Budgets
By DAVID BROOKS
Published: July 14, 2011
“My only point today is that we think the budget mess is a squabble between
partisans in Washington. But in large measure it’s about our inability to face
death and our willingness as a nation to spend whatever it takes to push it
just slightly over the horizon.”
http://www.nytimes.com/2011/07/15/opinion/15brooks.html?_r=1
&partner=rssnyt&emc=rss
The Quagmire
How American medicine is destroying itself.
Daniel Callahan and Sherwin B. Nuland
“In the war against disease, we have unwittingly created a kind of medicine
that is barely affordable now and forbiddingly unaffordable in the long run”
“Letting Go
What should medicine do when it can’t save your life?”
Atul Gawande
August 2, 2010
Modern medicine is good at
staving off death with aggressive
interventions—and bad at
knowing when to focus, instead,
on improving the days that
terminal patients have left
http://www.newyorker.com/reporting/2010/0
8/02/100802fa_fact_gawande#ixzz1WnylKrFA
IOM,
2010
http://www.nejm.org/doi/full/10.1056/NEJ
Mp1011639
Doctors Inc.
Calling the Nurse ‘Doctor,’ a Title Physicians
Oppose
Patti McCarver, a nurse who recently earned a Doctor of
Nursing Practice degree, calls herself a doctor when she
introduces herself to her patients.
October 1, 2011
Two Different Pictures of Health Care
http://www.nytimes.com/interactive/2010/06/03/business/Dartmout
h-maps.html?ref=business
Summary
Health Care fundamentally changed since the
Millennium – Opportunities exist!
Generational characteristics of our learners & Jr faculty
New drivers of education
Technology – On Line Education
Educational Outcome Expectations – GME, CME, IPE
Quality and patient safety expectations & demands
Others
Employed Physicians
Palliative Care – End of Life care
Role of Nursing
Rural Health