Implementing a Simpler Approach to Mission-Based Planning in a Medical School

Abstract

Changes in the education, research, and health care environments have had a major impact on the way in which medical schools fulfill their missions, and mission-based management approaches have been suggested to link the financial information of mission costs and revenues with measures of mission activity and productivity. The authors describe a simpler system, termed Mission-Aligned Planning (MAP), and its development and implementation, during fiscal years 2002 and 2003, at the School of Medicine at the University of Texas Health Science Center at San Antonio, Texas. The MAP system merges financial measures and activity measures to allow a broad understanding of the mission activities, to facilitate strategic planning at the school and departmental levels. During the two fiscal years mentioned above, faculty of the school of medicine reported their annual hours spent in the four missions of teaching, research, clinical care, and administration and service in a survey designed by the faculty. A financial profit or loss in each mission was determined for each department by allocation of all departmental expenses and revenues to each mission. Faculty expenses (and related expenses) were allocated to the missions based on the percentage of faculty effort in each mission. This information was correlated with objective measures of mission activities. The assessment of activity allowed a better understanding of the real costs of mission activities by linking salary costs, assumed to be related to faculty time, to the missions. This was a basis for strategic planning and for allocation of institutional resources.

Time to Teach: Addressing the Pressure on Faculty Time for Education

“…One medical school reported mission-based planning that did not attempt to assign relative value (or clinical productivity) but instead focused on the raw cost of each mission in terms of time [20]. The school used a survey of the faculty to define the amount of time spent in each activity, including teaching.…”

A model for evaluation of faculty members′ activities based on meta-evaluation of a 5-year experience in medical school

“…Evaluation of the activities and productivity of the faculty members, especially in education, is very complicated;[ 11 ] however, several solutions have been proposed including the experiences of the universities of Dalhousie,[ 13 ] Texas Health Science Center,[ 14 ] and Wisconsin. [ 15 ] Moreover, several papers have been published in this regard since 1995.…”

A Mission-Based Productivity Compensation Model for an Academic Anesthesiology Department

“…This system is analogous to those used by medical schools to allocate resources among departments. 5 We hypothesized that the productivity-based model would improve clinical practice metrics, faculty salaries, and academic output at our institution.…”