Inside Duke Medicine

A Clear Vision: Part I

In this three-part series, we examine how Duke Medicine’s strategic plans guide success in challenging times.

Today: Part I—Duke University Health System
In coming days, look for:
Part II—Duke University School of Medicine
Part III—Duke University School of Nursing

DUHS: Substantial progress toward long-term goals

Nearly five years ago, Duke University Health System articulated a strategic plan designed to serve as a roadmap to our long-term success.

This plan made a health system-wide commitment to optimizing services, improving the way entities work together and attracting the best faculty and staff.

In implementing and executing the operational actions associated with the strategic plan, DUHS has made significant progress. But there have also been challenges, particularly since the onset of the global economic downturn.

At a time of such financial and economic turbulence, it is important to understand that the organization has had a successful strategic plan which we continue to follow today, and that we are not simply reacting to the evolving pressures of a challenging environment.

“The strategy has proven itself, and we are confident we are moving in the right direction,” said Molly O’Neill, the health system’s chief strategic planning officer. “But current conditions require us to be even more careful stewards of our resources and to stay focused on making the proper strategic investments.”

Competitive pressures, O’Neill added, “did not go away with the addition of economic pressures. The building blocks of the strategy - each of the goal areas - have proven appropriate for the changing environment.”

The following is a review of our seven strategic priorities and how we have executed them thus far:

Optimize services in Durham County
DUHS recently solidified its commitment to the people of Durham County with the completion of a long-term lease extension for Durham Regional Hospital.

Also, a Master Facility Plan has linked Duke University Hospital and Durham Regional in important ways through new specialty programs and transfer center enhancements to serve community needs and help manage patient flows across Duke Medicine.

The creation of hospitalist and intensivist programs has led to greater integration and improved outcomes at Durham Regional, and significant capital investments in radiation oncology, intensive care, information systems, and other services have led to improved patient access and quality of care.

DUHS has also made important commitments to community health through a myriad of projects in Durham, including the Lincoln, Walltown, Lyon Park and Holton clinics, and through Project Access, in which specialists donate time and expertise.

Duke Medicine has made significant progress in meeting the projected workforce shortage in physicians, nurses, and physician assistants through recruitment and expansion of training programs.

As always, all capital investments are subjected to a rigorous needs assessment.

Planning continues for a major addition to Duke University Hospital and the creation of a new Ambulatory Cancer Center, should that project receive Certificate of Need approval from the state this spring. Considering current capacity constraints and projected teaching and health care needs in a dynamic and growing region, it is essential that Duke invest in its long-term future of providing efficient and effective education, research, and patient care for the citizens of North Carolina.

Strengthen our presence in Wake County
The investments made in Wake County have begun to demonstrate the wisdom of this strategy. DUHS facilities and clinical faculty have made significant inroads and have become an important part of addressing the health care needs of the county’s rapidly growing population.

Duke Raleigh Hospital has been upgraded and renovated. The new Duke Medicine Plaza specialty physician building is full, providing Wake County patients more convenient access to Duke faculty physicians.

Also, clinical programs led by Duke faculty, such as the new and growing neurosurgery program, are driving the success of Duke Raleigh Hospital.

Investments in cancer services, orthopaedics and cardiology, as well as state-of-the-art imaging technology, are improving the access to the latest in Medicare care in the community.

New facilities have opened in the Brier Creek area, Knightdale, Morrisville and north Raleigh.

Reorient multidisciplinary programs
The new Duke Heart Center has facilitated greater collaboration and effectiveness among the many specialty care areas in the center, as well as among its faculty. The changes have improved the patient experience and aligned the whole organization around a single goal: patient-centered care.

Plans for similar realignments that break down organizational barriers and support patient-centered care are underway in other clinical areas, including cancer.

Enhance pediatric services
The $7 million, 13-bed, pediatric cardiology intensive care unit - the first in the state - opened at Duke University Hospital in January.

The Division of Pediatric Blood and Marrow Transplantation continues to pioneer the use of umbilical cord blood stem cells and extend this lifesaving therapy across the country.

The Duke University Hospital intensive care nursery is being reconfigured to increase capacity, and Duke University Hospital and Durham Regional Hospital are collaborating on neonatal care.

Duke Children’s Consultative Services has expanded in Wake County through new offices in Duke Medicine Plaza in Raleigh.

Build a structure for ambulatory care

Substantial progress has been made in developing a distinct operating infrastructure for ambulatory care that has resulted in substantial improvements in patient satisfaction, and tremendous success in the reporting of quality outcomes in outpatient services.

The strength of our ambulatory care platform and services is now regarded as essential to the well being of the patient and the organization.

Attract, retain and reward talented faculty and staff
The health system’s clear vision starts with the patient, which we value most above all. We cannot provide the quality care they demand and deserve without quality employees. To recruit and retain the very best, Duke offers excellent benefits and widely-recognized programs for professional development.

Last fall, Advance for Nurses magazine rated the health system as a workplace that excels in opportunities for continuing education, tuition reimbursement and rewards and recognition.

Also, the Employee Tuition Assistance Program benefit increased in January to $5,250 per year to help employees get the education needed to advance their careers.

Duke’s clinical faculty has grown significantly over the past few years and further expansion is planned over the next several years. Duke University Hospital and the Duke University School of Medicine continue to be recognized as among the top ten institutions in the country due to outstanding work done every day by our faculty and staff.

Building upon the strength of the Duke name
Advertising, community outreach and media relations campaigns over the past two years to build brand awareness for Duke Medicine, and its clinical faculty, have been effective.

Those efforts have contributed to Duke’s national reputation for excellence and focused our organizational strength in support of our mission:

To transform medicine and health locally and globally through innovative scientific research, rapid translation of breakthrough discoveries, educating future clinical and scientific leaders, advocating and practicing evidence-based medicine to improve community health, and leading efforts to eliminate health inequalities.

Summing up
We have a clear vision that guides our work toward future success, even in this ever-changing and challenging global economic environment.

The successes show we are headed in the right direction, but now more than ever the economic environment must be monitored for any signal that would require a course adjustment.

We remain mindful that our success today is built upon the excellent work done by our current and past Duke Medicine employees; and it is that solid commitment to our ideals that will guide Duke Medicine successfully into the future.