Clinical Enterprise Initiative

When patients think of the medical center, they make no distinction between the UNMC College of Medicine, The Nebraska Medical Center, UNMC Physicians, Bellevue Medical Center and Private Practice Associates.

Campus leaders say the more than 11,700 employees of these entities, must do the same as they work toward a more efficient and integrated clinical enterprise. The goal: Be the region’s leading health system, comprised of nationally recognized academic and community-based providers, aligned to deliver the best health care for patients.

Brad Britigan, M.D., dean of UNMC’s College of Medicine and clinical enterprise president, and CEO Bill Dinsmoor announced the new executive leadership structure for the organization in January.

The new leadership structure, built for the future of health care reform, unifies ambulatory clinic and hospital operations. What once were separate operations managed by UNMC Physicians, The Nebraska Medical Center or Bellevue Medical Center are now connected.

“We have been, historically, a collection of tribes,” Dinsmoor said. “That doesn’t work anymore. We can respect our past cultures, but we are building for the future. We are building a new culture.

“We’re in the midst of a profound and historic change in the way health care is organized and delivered.” The integrated approach is necessary to pursue strategic opportunities in an evolving health care environment, said Cory Shaw, senior vice president of the System Provider Network of the clinical enterprise and former chief executive officer of UNMC Physicians.

“We need to think differently about how we deliver care,” he said. “Not just what happens in the four walls of the hospital or in our outpatient clinics, but rather how we move patients across the continuum of care in a seamless way.”

The clinical integration project, which began in 2012, is leading toward a full legal integration of UNMC Physicians, Bellevue Medical Center and The Nebraska Medical Center. Clinical enterprise leaders expect that legal designation to be completed by July. Hundreds of staff members from all corners of the clinical enterprise are currently working on dozens of performance improvement projects that will improve patient experiences, quality, and the work environment.

“It is more important than ever that our entire clinical enterprise be aligned, strategic and focused,” said University of Nebraska President James B. Milliken. “This new structure, thoughtfully developed with the involvement of scores of key health care leaders, positions us very well for success in this new era.”

A new advisory board also has been created to provide the clinical enterprise with advice, support and eventually oversight.

“The level of clinician leadership on this board is extremely important,” Dr. Britigan said. “We’re entering a time in health care when the voice of the provider will be more important than ever in shaping the most efficient and best quality care for our patients.”

“It is a great honor to join the team at a time that such important governance changes are being completed,” said Jeffrey P. Gold, M.D., UNMC Chancellor. “This structure will well serve the future needs of the region, optimizing the resources to provide university quality, patient-centered care. Congratulations to all those with the vision to make this a reality.”

The board’s makeup represents the history of the different organizations coming together to create this new enterprise, Dr. Britigan said. Past members of The Nebraska Medical Center’s board of directors, leaders in academic medicine and research, private practice community physicians and international business leaders will bring an understanding of the importance of innovation and culture to the creation of a successful organization.

The board will serve in an advisory role for the next several months. Leaders expect to form an official legal entity by July, at which time a governing board of directors will form.

In February, more than 500 staff members from across the system began work on 45 performance improvement projects. The projects range in scope from clinical care to financial operations and culture change.

The momentum already has begun. The Accountable Care Alliance (ACA), now covers nearly 17,000 people – the employees of the medical center’s clinical enterprise and Methodist Health Systems.

Jim Canedy, M.D., and Marcel Devetten, M.D., continue their roles as medical leaders with the ACA. Joining them is Troy Wilhelm, current chief financial officer for UNMC Physicians.  Dinsmoor believes the ACA will play a major role in the future of the clinical enterprise, accounting for 50 percent of future revenue.

An agreement was signed by the nine founding health systems of the regional provider network, a group of hospitals that eventually will cover most of Nebraska and parts of western Iowa. The nine founding members are: The Nebraska Medical Center and Nebraska Methodist Health System, Omaha, Neb.; Bryan LGH Medical Center, Lincoln, Neb.; Faith Regional Health Services, Norfolk, Neb.; Regional West Medical Center, Scottbluff, Neb.; Fremont Area Medical Center; Great Plains Regional Medical Center, North Platte, Neb.; Columbus Community Hospital; and Mary Lanning Healthcare, Hastings, Neb.

Also, construction will proceed on a new ambulatory clinic and surgical facility at 41st and Emile streets, as well as an ambulatory surgery facility at Village Pointe in west Omaha.