Combined Management Meeting Updates Jeffersonians on the State of the University

Management personnel from corporate services and the hospital gathered on Friday, February 23, for a combined management meeting. The session included presentations by Robert A. Peterson, senior vice president for administration and finance and chief financial officer and Thomas J. Lewis, senior vice president for healthcare administration and chief executive officer for the hospital, as well as a message from University president Paul C. Brucker, MD.

Mr. Peterson opened the session with comments about Jefferson's response to reduced federal and state funding, lower admissions and patient days at Jefferson Hospital as well as the growth of managed care in our region.

Mr. Lewis stressed that the rate of change has accelerated, increasing the pressure to curtail costs. He noted that admissions are down 3 percent and patient days down 8 percent. He warned that primary care practice acquisition is becoming more competitive and specialty practice acquisition is starting in the region, he also observed.

The senior officers also discussed:

• Jefferson Health System (JHS) Phase II: Integration is proceeding with the hospital having separated from the University as of March 1. In another development both Pennsylvania Hospital and Methodist Hospital have expressed interest in a closer affiliation with JHS. Progress is also being made throughout the integrated healthcare delivery system by integration teams made up of personnel from Main Line Health and Jefferson.
• HealthLINK: Jefferson's healthcare information systems plan is progressing toward its goal of providing a common patient registration system across care delivery sites, including physician offices, inpatient, outpatient, home care and subacute care settings. Cabling and expansion of the network connectivity project on Jefferson's campus continue in order to accommodate the large numbers of networked workstations, printers, servers and hosts to support new applications. Members of the HealthLINK team are also working with Main Line Health to coordinate decision making.
• Cost Restructuring: Teams are continuing to meet to help create ideas to streamline processes so that we can become more efficient and meet the goals established for this project. Mr. Lewis expressed that to curtail costs the teams must achieve their short-term goal of $25 million and the process for implemention must be accelerated. Streamlining of the organizational structure is also under way. This means reducing administrative layers between Mr. Lewis and Mr. Peterson and the employee who delivers service. We will consolidate functions.
• JeFF: The Jefferson Faculty Foundation, consisting of 445 members, replaces the Clinical Practice Plan, and allows Jefferson's full-time faculty to respond more quickly to healthcare marketplace pressures. This single, organized multispecialty group praftice continues to support the University's educational, research and patient-care mission. Mr. Lewis said the hospital is containing costs by tightly managing open positions, restricting travel, closing beds and units and reducing positions. He announced that 200 positions would be eliminated by the beginning of April. In addition, employee benefits are being reexamined as a way to reduce costs. Recognizing the increased importance of strong and increased physician linkages, the following initiatives are also under way:
• JeffCARE ­p; Jefferson's PHO has enrolled the full-time faculty and more than 100 volunteer faculty. A new administrator, Jay Sial, has been hired and Stanton Smullens, MD has been named CEO.
• JAMSO ­p; The Jefferson-affiliated Management Services Organization is providing management and billing services to 13 practices and 25 physicians
• Jefferson is intensifying pursuit of practice acquisition. A new gastroenterology practice, The DiMarino Group, will begin practicing here in April, and we are engaged in a number of primary-care practice acquisition negotiations.

Mr. Lewis stressed the need for Jefferson to change and pointed out several challenges we face:

• the need to increase the pace of our work and to accept the imperfections of the present work environment
• the need to increase the pace of communication. There will be a second set of employee meetings beginning March 13 and management training meetings in April.
• the need to do more with less.

Mr. Peterson stressed the importance of achieving success with all these initiatives as the University copes with multiple financial pressures including:

• increased pressure to contain tuition
• bearing the burden of depreciation as an expense
• reduced Pennsylvania appropriation
• increased competition for outside funding
• reduced physician reimbursement under managed care
• the need to improve efficiency and eliminate redundant functions.

What should managers be doing to accommodate these changes?

• Focus on FY '97 budget preparation
• Reengineer your departments
• Communicate with your staff and with each other

To be successful in our goals, Jeffersonians must:

• exhibit flexibility and adaptability
• challenge our assumptions
• take the initiative
• believe in ourselves.

Dr. Brucker noted the incredible changes that have occurred during his administration and also expressed his gratitude to the audience for all their hard work and dedication to bring us this far toward our goals.