Strategic Reflection

To the YSM Community:

It’s been a quiet month in Lake Wobegon… not so much in Yale School of Medicine (YSM). Nevertheless, in the third week of June, department chairs, deputy deans, Yale New Haven Health System (YNHHS), and university leaders gathered off campus to reflect on the direction of our school and academic health system. Although we have convened before during the pandemic, this retreat felt different—like a homecoming and a new beginning at once. Let me share the conversations.

In the spirit of encouraging collaboration across departments and schools, in each of the last two years a university leader and collaborator from outside YSM has opened our leadership retreat. Last year, Dean Jeff Brock presented his vision for the School of Engineering and Applied Science (SEAS). This year, Nick Turk-Browne, director of the Wu Tsai Institute, reviewed milestones achieved over the institute’s first year.

Deputy deans for research Tony Koleske and Brian Smith led a robust discussion on future trends in research funding mechanisms such as the Advanced Research Projects Agency for Health (ARPA-H) and the Cancer Moonshot, as well as initiatives associated with the NIH’s commitment to Diversity, Equity, Inclusion, and Accessibility. Chen Liu, chair of Pathology, then updated us on the rapid autopsy program and the launch of the YSM Biobank, which provides general biospecimen intake, acquisition, processing, storage, and distribution; investigator or program-initiated tissue banking; clinical trials support, and existing biobank support.

Deputy and associate deans Bockenstedt, Latimore, and Choate led a discussion of career development. In January, we piloted the Faculty Annual Development Questionnaire (FDAQ), a tool to facilitate annual feedback and career development discussions between faculty and departmental leadership. Mentorship and sponsorship are critical to ensuring that all our faculty, regardless of track or seniority, thrive. Over 1,000 faculty from 14 departments participated in the pilot, and a follow-up survey indicated high satisfaction rates with the quality of feedback and impact on career development. This academic year, we have set the goal of departments completing annual meetings using the FDAQ for a minimum of 75% of their faculty. Departments will also choose among other goals aimed at promoting inclusive excellence, such as tracking the proportion of residency, fellowship, and faculty applicants who are women or underrepresented in medicine (URiM); sponsoring career advancing, national leadership opportunities; or tracking the number of faculty nominated for key leadership development opportunities.

Deputy Dean Illuzzi presented the strategic plan for education and preparations for our LCME reaccreditation site visit in October 2023. The group discussed the effective consideration of educational activities in the promotion process, noting a distinction between an extraordinary time commitment to educational activities and engagement in educational scholarship. This academic year, we have revised dean’s office funding to better support leaders in education and high intensity teachers. The group further identified the need to mentor innovators in education to enhance their scholarly productivity. Future work will examine renaming the Clinician Educator-Scholar and Academic Clinician tracks to appropriately differentiate and acknowledge educational scholarship and high intensity teaching.

A significant portion of the retreat was dedicated to our shared commitment to achieve greater strategic alignment between YNHHS and YSM. CEO Chris O’Connor and I reiterated the imperatives for alignment that we shared in our March 28 Beyond Sterling Hall. Specifically, we must be more aligned to realize our aspiration to become one of the premier academic health systems in the country. In addition, better partnership will enable us to flourish in the current difficult health care environment. As a first step, YSM and YNHHS leaders have been meeting to develop a shared strategic plan. This Joint Strategic Planning Committee identified priorities that will most differentiate us as an academic health system (national expertise, clinical research, personalized medicine, application of research, exceptional safety and outcomes, preclinical and clinical education), and those areas where we have the greatest opportunity to improve our performance (access, highly efficient operations, highly coordinated care, multidisciplinary care across the system). Emerging from this work will be a shared strategic vision, future direction, and major priorities. Surprisingly, YSM and YNHHS have never developed a shared strategic plan for our academic health system before.

As our joint strategic plan emerges, it will also guide decision making and coordination among our service lines, operations, and clinical teams. The plan will guide the rationalization of funds flow to support desired outcomes, including the growth of the academic mission. Executing on our strategy will require that we be disciplined, committed to each other and our goals, and data driven. As a first step, we have begun to identify potential shared common metrics—a “single source of truth”—that we can track together as we strive for excellence. We have begun the work to better harmonize Yale Medicine and Northeast Medical Group to coordinate services and provide the highest quality care and consistent service for our patients. Such alignment will also facilitate our academic missions by enabling research and teaching across the system and will further enhance the quality of life of our clinicians by reducing duplication of work. Importantly, joining the retreat (and now campus) were two new leaders who bring insight and experience to guide this work: Pamela Sutton-Wallace, YNHH chief operating officer, and Margaret McGovern, YSM deputy dean and chief executive officer of Yale Medicine.

The final session was led by David Berg, PhD, an organizational psychologist with special expertise in group and intergroup relations. Professor Berg presented a case study that illustrated how organizational events can be explained at the individual, interpersonal, group, and intergroup levels, with each level suggesting different responses and courses of action. The session provided a helpful framework with which to consider alignment and other organizational opportunities.

The retreat concluded with a sense of promise and optimism that I hope I have conveyed by sharing the conversations. Over the coming year, we will broaden these conversations through our regular meetings and through workgroups and town halls. Thank you in advance for your investment and engagement.

Sincerely,

Nancy J. Brown, MD
Jean and David W. Wallace Dean of Medicine
C.N.H. Long Professor of Internal Medicine