Focus, Focus, Focus

Good morning.

As we move into April 2022, I begin my eighth year as vice chancellor. The end of most days comes rushing at me at 100 mph – time simply moves too fast. 

People often ask what I am most proud of from my time in leadership. Or, what has been the best part or greatest challenge. Of course, the answer to all of that NOW is our organizational response during the COVID-19 pandemic.

But the last seven years have been about much more than just the trials of the last two. As I think back, there have been a number of significant events.

To start with, in the summer of 2015, shortly after I became VC, a small group of us visited several academic medical centers across the country that have similar characteristics as we do – such as location in a rural state, a large population of underserved patients, offering the only tertiary and quaternary services in a state/region, etc. We selected these academic medical centers because we felt some component or components of their organizations were more advanced than we were and we could learn something from them – and we did. Several of the key takeaways were around the importance of data management, telehealth, modern operational processes and flexibilities to operate in a more businesslike manner. Using what we learned, we put a number of new initiatives in place to lay the foundation for our future. 

One of those critical initiatives, which took two years to see to fruition, was the passage through the Mississippi Legislature of the Health Care Collaboration Act of 2017. This legislation gives us the ability to enter into joint ventures with partners and provides for some operational flexibilities we didn’t have before. This was a vital foundational piece for our future growth.

Another crucial foundation piece that was put into place in 2015 was the development of our clinical quality program. Prior to the arrival of Chief Medical Officer Dr. Michael Henderson, we had many good and well-intended efforts around quality and patient safety but they were not focused and not well coordinated. Dr. Henderson put in place a comprehensive plan, laid the path, built the team, engaged the organization and changed the culture – again, critical foundation work – which has led to our amazing journey and fantastic progress. To this day, QUALITY continues to be our top strategic priority.

I am so proud that we have been able to open state of the art facilities for research and for education since I took over as the Medical Center’s leader. All of our schools have grown, applicant demand is high and excellent outcomes demonstrate the high quality of our programs (thanks to our dedicated faculty). The original reason UMMC was “born” was for education and that remains the very heart of all we do. 

Since 2015, the level of external funding for research and the number of annual publications by our faculty have both more than doubled. Strengthening research lays the necessary foundation for elevating our standing among academic medical centers. This makes it easier to recruit outstanding faculty and paves the way for higher success rates with funding agencies. Grants begat grants. Success begets success. Collaboration leads to more collaborations. Stronger research and science lead to cures, new treatments, better patient care. All of this positively impacts the education and experience of our students. The entwinement of our missions is what makes up the very core of an academic medical center. No mission stands alone.

In our clinical mission, we have increased and strengthened key partnerships across Mississippi - laying the foundation for the future. We are growing telehealth locations and services almost daily. We have expanded many of the unique and advanced services that only can be found here, at the state’s only academic medical center. Our stroke, ventricular assist device and trauma programs have received ongoing accreditation. Our transplant program (the only one in the state) has been recognized recently for its excellent patient outcomes. We have opened a spectacular Children’s Hospital expansion to enhance care for the state’s sickest babies, children and teens. The Center for Advancement of Youth, providing vital child development assessment and treatment services, moved into a new home in 2019 and has already outgrown the space as we strive to meet the needs of children and their families from all over Mississippi. In every area, there is high demand for our clinical services. Our Department of Dermatology successfully launched a very active rural clinic in Louisville. And it bears mentioning the heroic work of relentlessly caring for the state’s most ill COVID-19 patients since the spring of 2020 by everyone in our health system. And always, we are a resource for other hospitals in the state. I have said publicly on several occasions lately that each day we accept 30-40 patients in transfer from other hospitals around the state, patients who need expertise not available in their local community. It is an honor to serve in this role for all of Mississippi. 

Also, we are wrapping up our largest ever philanthropy campaign and will soon celebrate raising $100M for the Kathy and Joe Sanderson Tower. (Spoiler alert – our next campaign focus will be for a Comprehensive Cancer Center.)

We have had incredible support from our legislators and state leaders. We have faced some tough political winds, but the positive support for UMMC far outweighs the headwinds.

We are stronger today financially than we were before these challenges. This is true whether looking at standard specific financial metrics (such as days cash on hand), the robustness of our business processes, or the skill and expertise of our finance and budget teams. Looking at the overall finances, our revenue has grown from 1.38 billion in 2015 to 1.76 billion now.

Not every day has been positive, though. Some days in the last seven years it has felt like a few bricks in the foundation of our future have crumbled. We have faced cuts to our reimbursement for uncompensated care we provide, cuts to our state appropriation, and a pandemic, to name a few of our challenges. Through these challenges, we have become more efficient, more disciplined and more transparent in all things.

From the standpoint of leadership, we have a chancellor who is publicly and adamantly supportive of the work happening here at UMMC. I cannot overemphasize the impact of the positive support UMMC receives from Dr. Glenn Boyce, University of Mississippi chancellor. We have a very good working relationship with the IHL Board of Trustees, the commissioner, and the board staff. These are essential foundational pieces necessary to achieve our full potential.

In every way, we have worked hard over these years to increase the diversity of experience, wisdom and backgrounds at UMMC in our staff, faculty, trainees and student body. More diversity of thought and input leads to a higher level of excellence and stronger organizational decisions. A few concrete examples of progress include: 

• In the School of Dentistry, the admissions process has been revamped to a “holistic admissions” model. This is progress.
• At 9.2% of enrollment, our School of Medicine ranks 3rd nationally in percent of African American students. The national average is around 5%. I am pleased, but not satisfied.
• Also in SOM, the number of female department chairs in 2015 was 2 (of 23). Today, we have seven (of 23) women leading departments. Again, I am pleased, but not satisfied.
• Our leadership team has changed in the past few years and represents purpose and resolve to be more inclusive and diverse as we move into the future. Of that, I am proud. Leadership of our health system is more diverse – with more women and more people of color – than maybe ever before. That matters. I am pleased, but not satisfied.
• From the October 2021 AAMC StandPoint Faculty Engagement Survey, our faculty reported 81% agreement that UMMC is successful in hiring and retaining diverse faculty. This compares favorably to the 70% average of a cohort of 29 academic health science campuses and the 79% mark reported in our 2018 survey’s diversity, equity, and inclusion dimension. Very good progress.

How do we continue to make progress? By being intentional every day with every decision. I have said before many times: UMMC is a place where the stakes are high and the margin for error is small – every decision is consequential. No decision is immaterial. Every day. Every decision. Be intentional.

As we shift from the acute reaction phase to the chronic management phase of COVID-19, we are a stronger organization than ever. Our new strategic plan is built on the solid foundation we’ve been putting in place since 2015. It is bold and aggressive and ACHIEVABLE. It involves accepting some (well-thought-out) risks. This is new for us – but we are ready. It requires laser sharp, relentless focus. We are ready.

Years ago, I heard Dr. John Hall, chair of physiology and biophysics, remark that the key to success included three things. When he said that, I stopped still and listened, eager to hear what he had to say. He said, “Focus. Focus. Focus.” I think about that often. When challenges seem too huge or too much to tackle – I remind myself to FOCUS on what I can control and where I can make a difference. And then take the next step.

For the future, we have to heighten our focus on science and research. Education is our heart, but it is research that distinguishes us from others. Our strategic plan is very concentrated on efforts to strengthen and further refine our research programs. Areas of focus going forward include: 1. cardiometabolic/renal/obesity; 2. cancer; 3. health disparities/population health; 4. neurosciences; 5. genomics/bioinformatics/proteomics; 6. women’s and children’s health; and 7. medical technologies/biomedical materials. In these areas, our strengths line up with both funding opportunities from the National Institutes for Health and our clinical strengths as well as the disease processes that are impactful to Mississippians.

I am proud of the outstanding leaders here at UMMC – deans, chairs, chiefs, directors, etc. Every person is a leader to someone. No matter your title or degree, your leadership and engagement is part of the culture of UMMC. And it matters. Our experience in the pandemic highlighted this sharply. 

The pandemic brought to light a number of our strengths as well as our challenges. For example, the complex and confounding issues of workforce fatigue and burnout are more prevalent than ever. How do we address this? Maintaining adequate staffing was a challenge pre-pandemic and is even more challenging now. These problems aren’t going away anytime soon. How do we re-imagine a staffing model that eases some of the acute stressors?

From the excitement of our bold strategic plan to the reality of the daily challenges, there is plenty of work to do. I am convinced there are no easy problems left to address – they are all tough. There are many ways in which we can imagine a better and stronger UMMC and many ways in which we will build it for NOW and the FUTURE as we continue to lay a solid foundation for the next 20 years.

In some ways, it seems we are just getting started. Will it be smooth and easy? No. Must we continue to do the hard work to make UMMC a more resilient and vibrant organization 20 years from now? Yes. Let’s buckle up our seat belts and drive hard toward and a healthier UMMC which is a critical part of A Healthier Mississippi.