WVRHEP Strategic Planning Session

Monday, November 14, 2005

Facilitated by Marsha Boggess

SWOT

Strengths:

1. No competition
2. No duplication
3. Utilize existing structure
4. Residents mentoring students
5. Continuity

Strengths:

1. Respect for each

2. Availability of students

3. Services are delivered

4. Local exposure

5. Involving of medical residents and mid-levels in community

6. Availability of clinical experiences

Strengths:

1. Statewide network
2. Partnerships—values and principles
3. Consistent outcomes and message to all stakeholders
4. Power of Federal and State mandates
5. Attractiveness to funders
6. Very good at what we do—proven track record

Strengths:

1. Committed practitioners, community members and staff that support program
2. Longevity
3. Record of success
4. Collaboration between schools and community

Strengths:

1. Damned good!
2. Still in existence
3. Northern is model for combining
4. Passionate about rural health
5. Uniqueness
6. Impacts students’ career decisions
7. Serve as infrastructure for other programs/grants

Strengths:

1. Passion
2. Shared resources
3. Shared vision
4. We are interdisciplinary
5. Training for what society needs
6. Community-based
7. Site coordinator and support staff services to program
8. Continuity
9. Trust
10. Networking

Strengths:

1. 15 years experience
2. All WV counties included—now we’re truly STATEWIDE
3. Financial incentive programs HSTA—new providers
4. We’re making rural placements
5. IT resources = communication evaluation
6. Recruiting rural providers
7. Human resources/network, backgrounds/experiences

Strengths:

1. Maximize funding
2. Ability to adapt
3. Experience/longevity
4. Increased infrastructure for education and evaluation
5. Both RHEP and AHEC ability to expand missions
6. Both have a shared passion
7. Complement
8. Expansiveness
9. Testing solutions to health issues
10. Providing improved education for students and residents
11. Improves health care and health status of communities
12. Providing health care professionals for rural communities
13. Rural preceptors “energized” by having students
14. Some communication works very well

Weaknesses:

1. Confusion among students
2. Collaboration may not occur
3. Potential systems breakdown
4. Potential for duplication and competition
5. Timeframe too short for meaningful projects
6. Student start/stop dates inconsistent
7. Projects for the sake of projects
8. Burdensome guidelines

Weaknesses:

1. Fear of turf battles
2. Too big
3. Uneven exposure to clinical experiences
4. Quality of community service
5. Housing/volume (student)

Weaknesses:

1. Varying strengths of partnership
2. Perceived loss of program identity
3. Challenge in integration of programs
4. Inability to control funding level
5. Confusion regarding roles
6. At mercy of political winds

Weaknesses:

1. Marketing our program
1. Take to every school system in the state
2. Do film/documentary/video

§ Include interview students/slideshow

3. Radio spot
4. Policy makers need to know value and success of program by 3x3 Plus
5. Identify champion in each region to educate other policy makers
1. Communication—between sites and school coordinators about curriculum/scheduling/orientation issues
2. Campus—lack of consistency between sites on quality/standardized level of education
1. Training of field faculty and site coordinators needs to be standard
3. Need start and end rotation dates to be similar between disciplines
4. Getting board members
1. Victims of its own success?
2. We are evaluated on R&R—but we are an educational group

Weaknesses:

1. Different circumstances in different parts of the state
2. Lack of unification
3. Lack of consistency
4. We don’t know that we are the impact in recruitment
5. Don’t emphasize retention early enough
6. Don’t promote RHEP/AHEC enough internally/externally
7. Waste energy missing the “good ole days”
8. IDS/IDE need improvement at some sites
9. Service learning—right balance (school and community)
10. Don’t document what we do very well—inconsistencies

Weaknesses:

1. Confusion about AHEC meeting rural requirements
2. Many receptors don’t understand structure of RHEP/AHEC
3. Site coordinators aren’t involved in student assessment of rotation activities/behavior
4. Challenge—different financial structures, fiscal years
5. Last minute school schedule changes

Weaknesses:

1. Students still complaining about mandatory requirements
2. Lack of consistency between sites
3. Students perceptions—service vs. learning
4. ↓ finances
5. IDE—square peg

Weaknesses:

1. Too easy for RHEP/AHEC to be in the silo
2. Too big/complex
3. Can’t explain what we do—challenge of communicating
4. Hard to communicate significant curriculum changes to all partners
5. Too many definitions of students, different requirements, curriculums
6. Too much potential for overlap and duplication
7. (Models) becomes a weakness when trying to convey what the program is

Opportunities:

1. Longer projects
1. Coordinate with community boards
2. Long-term projects may entice students to consortium
3. Increasing funding—better chance of getting grants
4. Opportunity for standardization
5. Improve health of citizens
6. Opportunity for better data mining
7. Opportunity for increasing number of residents

Opportunities:

1. Because of lack of funding
2. Evaluation of program
3. Sharing between disciplines of oral (mouth) health issues
4. Move from health programs to implementation

Opportunities:

1. Integration between didactec and field
2. Take our national status to higher levels
3. IOM recommendations on competencies
4. To locate new funding pots
5. Collaboration allows for more partners to educate funders and public
6. Opportunity to do large scale CBPR research and interventions

Opportunities:

1. Explain more clearly AHEC/RHEP to students
1. Meet monthly at least AHEC/RHEP
2. More formal meeting between campus/schools and RHEP/AHEC (on RHEP meeting agenda)
3. Appreciate and applaud the differences
4. Onsite and medical director work together to connect with/convey curriculum expectations
5. Performance committee could go out and train others within the region
1. Are we asking too much/not enough of preceptors?
2. Are expectations correct?
6. Create promotional DVD for good orientation/expectation/policy $19.95
1. Student
2. Preceptor
3. Community
4. Agency’s
5. Schools
6. Hospitals
7. Share DVD with policy makers
8. Include legislators on Advisory Panel

Opportunities:

1. Establish a network
2. Become a model for the country
3. Broaden the pipeline to include others from rural areas who will stay rural
4. Develop more community based residencies
5. Determine future needs of communities through growth and retirement
6. Change to show impact on health outcomes (HP objectives)
7. Growth of medical schools—more opportunity to recruit for rural
8. Incentives/loan repayment—provide better information

Opportunities:

1. Working at graduate level
2. Identifying programs (cardiac) where both can collaborate
3. Create, develop unique educational opportunities for students
4. Structure a new program that encompasses (or integrates) both RHEP and AHEC
5. IDS→IDE
6. Working together→sustainability in funding

Opportunities:

1. Related to #4 weaknesses (handout)—what difference does it make! Fuzzy is good
2. Unify reporting to LOCEA—add AHEC outcomes oriented
3. Linking retention to program (i.e. alumni become faculty and stay?)
4. More marketing to the state public
5. IDE—better way?

Opportunities:

1. Opportunity in areas of health policy planning for RHEP/AHEC to participate/collaborate/communicate/contribute
2. Better evaluation of rural curriculum (more depth of education)
3. Faculty development
4. Build upon what’s working well/what can be changed
5. Grant proposals strengthened
6. Information clearinghouse

Threats:

1. Loss of funding sources
2. One program overshadowing the other
3. Politics
4. Lack of public awareness

Threats:

1. Money runs out (diverted)
2. RHEP vs. AHEC
3. Are we using funding the way intended?

Threats:

1. Federal and State funding and political “winds”
2. Overt and covert turf battles
3. Perceived duplication of bureaucracy
4. Change and/or inertia
5. Changing accreditation standards
6. FEAR

Threats:

1. Losing funding
2. Burn-out of faculty
3. Time of preceptors (too many patients; not enough time to teach)

Threats:

1. $$$—State and National
2. Silo thinking
3. Politics
4. Back of preceptors—more students
5. Dilution—can’t easily describe—“no longer just about the students or communities”

Threats:

1. Funding!!!
2. Pessimisson→skeptics
3. New identities/lost identities—who’s who?
4. Conflict of scheduling
5. Medicaid cuts
6. Adapting to accreditation/curriculum changes of schools
7. Turf wars
8. Loss of positions
9. Loss of housing

Threats:

1. Funding cuts
2. Negative student comments getting to policy makers
3. Program capacity—more students, less dollars, less staff, less quality
4. Success complacency
5. Lack of understanding for school/program requirements

Threats:

1. $$$
2. Seen as duplicative to funders
3. Customer (student) satisfaction
4. Hidden agendas and how you overcome
5. Staff burnout due to added responsibilities
6. Institutional endorsement??

RECOMMENDATIONS

Schools:

1. Incentivize is Required Residency (define???) Participation
2. Clarify role of GM and GNE in this process
3. Better understanding of AHEC
4. Coordinate ↑# students
5. Coordinate education issues
6. Review 3-month requirement
7. Review need for/structure of DDS vs. actual patient experience
8. DDS + Service learning→AHEC
9. Better coordinate scheduling rotations

Community:

1. Media Blitz
2. One organization
3. One manager
4. Better communication
5. Put dollar amount on services—for public and politicians
6. Need more feedback
7. Relevant IDS/IDE sessions
8. Be Nice

RHEP/AHEC:

1. Joint Meetings
2. Educate on how the two programs compliment each other
3. Combine/merge program
4. Keep all partners engaged—address reluctancy
5. Address mandatory requirements--↓ students, ↑ quality; Quality vs. quantity, revisit Kellogg model

Path Forward—Schools:

1. Funding
1. Approach third party payors
2. NC program linking medical education, healthy lifestyles
3. Show savings—pitch to policymakers
2. Educational issues
1. CS/SC needs to be based on school educational objectives; meet with site coordinators/school reps to hash out SC issues
2. IDS/IDE needs to be based on school educational objectives
3. School tracks for rural emphasis→number rotations

Path Forward—RHEP/AHEC:

1. Improving consistencies/inconsistencies

a. How we do service learning

b. Reporting

c. Communication—invite school reps and res. Directors to joint SC/ED meetings

2. Increase marketing

a. Identify partners to assist with this

3. Search for other funding sources

a. Intervention projects…

4. Create a Legislative Team to talk about our future TOGETHER

Statewide Staff:

1. Work with WVPCA and others to address strengths/weaknesses

2. How do we become part of State health planning process?

3. Improving annual report through group process

4. Report program impact by value

5. Value of infrastructure/getting grants

6. How do we define roll of SC/AHEC Director?

7. Student evaluation

PANEL

NF:

1. Gap—Student reflection; submit monthly online re: through experience—make contest with award and publish

2. Limited capacity—create rural track

3. Action: Present to School Curriculum Committee

a. Orientation include information on reflection

4. Create adhoc working groups

MA:

1. Take away history of success and accomplishments

2. Recognize AHEC/RHEP as priority by all schools

3. True value of rural experience

4. Issues are not new—do something about it

CS:

1. Accreditations and curriculum guidelines drive the rotation
2. Must communicate changes to AHEC/RHEP
3. SL and IDE tied to learning objective
4. Need to create structure to deal with issues

BW:

1. Convince all that we are indispensable
2. Ownership issues need to be resolved
3. Emphasize values but don’t tell how to do it—let sites decide
4. RHEP tries to be too much to too many
1. Make the hard decisions
2. Take risks
5. Build local excellence

Action: Bring in Marshall’s people in trenches

AN:

1. Excellent direct patient care—students love that—good role models
2. SL & IDS are serious problem—pay attention here

RM:

1. Students (dental) want to see patients in community
1. Help school and rural faculty community
2. Intend to extend length of rotations for dental students

WORKING GROUP

Chuck

Ralph

Helen B.

Carla

Alicia

Ken Shannon

Dick M.

Alvita

David Bowyer

Bill Shires

Stephanie

Elizabeth

Lew

Phil

Sharon

Dan Brody

JoAnn Raines

April

(Students)

Bob Walker for Marshall Rep

Sandra