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The purpose of this paper is to present a case study which details the successful development, design and deployment of a leadership course for academic medical department chairs. The course provides a needed local and contextual alternative to the lengthy and often theoretical MBA/MHA.

Faculty developers used a multi-tiered methodology for developing the physician leadership course. The methodology consisted of literature findings, needs assessment, stakeholder input and structured interviews with administrative leaders.

The research, stakeholder input and interviews revealed an increasing number of physician leaders with a general lack of fundamental administrative leadership skills. These shortfalls are largely because of underexposure to core management competencies during medical school and limited contextual knowledge outside their organization. There is an urgent need for leadership development opportunities aimed at current and future academic medical department chairs.

This research is limited by the assumptions that the curriculum meets the ever-changing needs of health-care leaders, the course’s focus on academic medical department chairs within the Texas Medical Center and the lack of long range follow-up data to substantiate the effectiveness of the curriculum content and course structure.

The Academic Medical Department Leadership course offers valuable management skills training which complements standard medical training. Much of the course structure and content is adaptable to physician administrative and leadership positions in all settings.

Although the Academic Medical Department Leadership course is a response to a local concern, the study offers a generalizable approach to addressing the demand for skilled physician leaders.

The purpose of this paper is to examine a pilot program implemented by the Houston Academy of Medicine‐Texas Medical Center Library and The University of Texas School of Nursing at Houston to design the multi‐institutional repository for the Texas Medical Center.

The steps involved in the program are outlined and the lessons learned from the implementation are analyzed.

The success of the institutional repository depends on appropriate communication with faculty, a deep understanding of the publishing process, identifying appropriate partners, designing a flexible technology infrastructure, and engaging in active collaboration with key players. The Library is the logical center for this activity.

The paper should assist libraries with the unique activities involved in creating a viable multi‐institutional repository in a research‐intense academic medical environment.

This paper analyzes the challenges inherent in introducing institutional digital repositories to the academic medical community. Currently, institutional repositories are being developed in only a small percentage of the academic medical centers in the USA.

Sustainable health care combines three key factors: quality patient care, fiscally responsible budgeting and minimizing environmental impact. Although pollution is well understood as a health problem, US health planners have not fully recognized the need to reduce health‐care pollution. Minimizing health‐care pollution, moreover, requires reducing the throughput of energy and materials. Ultimately, sustaining healthy ecosystems requires that health‐care material and energy utilization be limited. However, traditional conceptions of health‐care ethics maintain a philosophy of rescue that makes limiting life‐saving resources, except at a patient’s request, morally worrisome. Moreover, the media image of health care as technologically intensive, together with the common medical view that nature is the enemy, render suspect philosophical perspectives respectful of Earth’s limits. Nevertheless, academic medical centers have advantages as sites for pursuing sustainability: students often uphold environmental ideals, a public health perspective, and an interest in providing services universally; basic biomedical research on campus permits innovative research combining health and environmental considerations; opportunities exist for including environmental concerns in health professional education; some academic medical centers have already stated environmental criteria for purchasing contracts; and health‐care professionals and institutions are increasingly addressing such environmental concerns as mercury use, latex allergies, dioxin pollution, and waste volume. To address these challenges, a visioning process is proposed, designed to formulate a practical plan by means of public, local, and professional participation in the process of articulating creative and morally sound proposals for change.

The use of hospitalists in the care of in‐patients is a relatively new phenomenon in the USA – hospitalists are delivering medical care to patients in private practice, public hospitals, and academic medical centers. Several obstacles hinder understanding of the characteristics of academic medical center‐based hospitalists. These include differences in definitions and nomenclature, differences in job descriptions, roles and administration across hospitalist programs, and in qualifications and credentialing of hospitalists versus other physicians. These differences derive from the heterogeneity of AMCs by bed size, level of local and regional competition, and cultural, utilization and referral patterns. The field needs an agreed definition of the term “hospitalist”. Assuming a good definition, one could take advantage of already good descriptive data on AMCs to quantify hospitalists within AMCs and to study how hospitalist programs vary by AMC characteristics.

Academic health centres (AHCs) are organisations that pursue a “tripartite” mission to deliver high-quality care to patients, undertake clinical and laboratory research, and train future health professionals. The last decade has seen a global spread of AHC models and a growing interest in the role of AHCs in addressing health system equity. The purpose of this paper is to synthesise and critically appraise the evidence on the role of AHCs in improving health equity.

Peer-reviewed and grey literature published in English between 2000 and 2016 were searched. Articles that identified AHCs as the primary unit of analysis and that also addressed health equity concepts in relation to the AHC’s activity or role were included.

In total, 103 publications met the inclusion criteria of which 80 per cent were expert opinion. Eight descriptive themes were identified through which health equity concepts in relation to AHCs were characterised, described and operationalised: population health, addressing health disparities, social determinants of health, community engagement, global health, health system reform, value-based and accountable financing models, and role clarification/recalibration. There was consensus that AHCs can and should address health disparities, but there is a lack of empirical evidence to show that AHCs have a capacity to contribute to health equity goals or are demonstrating this contribution.

This review highlights the relevance of health equity concepts in discussions about the role and missions of AHCs. Future research should improve the quality of the evidence base by empirically examining health equity strategies and interventions of AHCs in multiple countries and contexts.

A crisis in the financial sustainability of the public healthcare sector often compels governments to consider privatization. The purpose of this paper is to summarize various strategies to overcome the challenges facing the privatization of academic medical centers (AMCs) in Saudi Arabia.

In this paper, the authors discuss the challenges faced in privatizing AMCs in delivering their core functions such as patient care, medical education and research. Further, the appropriate strategies are listed to overcome these challenges in privatization of AMCs.

The authors described the benefits of privatization that include a reduction in the financial burden on government healthcare expenditure, quick decision making and creation of new financial models to improve healthcare services. On the other hand, the profit motive of private management could create pressure on patients and may divert AMCs from their primary objectives. Therefore, it is imperative for the government to develop and implement appropriate strategies that balance the benefits of privatizing AMCs with eliminating the negative impact of privatization on patient care, medical education and research.

Though AMCs privatization is currently feasible in Saudi Arabia, appropriate strategies are essential to overcome the challenges of its implementation. The government should frame a uniform rules and regulations prior to privatizing public hospitals so that it will fulfill the purpose in an efficient manner.

The purpose of this study is to identify best practices for innovative primary care models and to describe a potential future primary care (PC) model for Texas to address the burden of chronic disease in a population-based approach.

A systematic literature review was conducted and identified 1,880 published records through PubMed using 26 search terms. After abstract and full-text review, 70 articles remained as potential models.

Although there is already a severe shortage of physicians in Texas, emerging practice patterns and choices among physicians are likely to erode access to primary care services in the state. Health-care leaders are encouraged to consider models such as complex adaptive systems for team-based care, pharmacist hypertension care management program and combined nurse-led care management with group visit structure.

As with any study, this research has its limitations; for example, models that might work in one state, or under a unique state-funded academic medical center, might not be “do-able” in another state within the nuances of a different funding mechanism.

Results of this research provide a model for implementing IPCM for the state of Texas first and will guide IPCM planning and implementation in other states.

This study is “land grant-centric” and focused on carrying out the mission of a major, top-tier research university with an emerging college of medicine at an academic medical center.

The prevalence of pediatric anxiety disorders is on the rise but youth have challenges in accessing specialty evidence-based mental health care. As a result, families turn to their pediatric primary care provider (PCP) for assessment and management of anxiety. To increase PCPs’ abilities to manage anxiety, the Extension for Community Healthcare Outcomes (“Project ECHO”) was used. The purpose of this study is to explore the impact of Project ECHO on participating PCPs’ knowledge, self-efficacy and interventions surrounding the assessment and management of anxiety.

Data were collected pre- and post-course across five cohorts. Participants completed a clinical knowledge test, ratings of self-efficacy and self-reported frequencies of in-office interventions. Satisfaction was also measured.

Attendance remained strong, and participants rated high satisfaction. From pre- to post-course, participants demonstrated increased knowledge on almost all objective questions. Participants reported increased self-efficacy across all domains. Finally, participants endorsed increased use of several in-office interventions.

This study highlights the importance of Project ECHO as a continuing education model to enhance PCPs’ abilities and confidence in the assessment and management of anxiety. Future continuing education endeavors should consider Project ECHO as a means of increasing PCPs’ capacity to manage mental health conditions.

To the best of the authors’ knowledge, this is the first study that applied the Project ECHO model to pediatric anxiety as a mechanism of increasing knowledge, self-efficacy and in-office interventions with PCPs.

The purpose of this study is to assess the impact of a new leadership development course for academic medical faculty.

In October 2006, a survey was electronically sent to the 55 faculty attending the Leadership Course for Junior Faculty.

A total of 29 women and 26 men attended a course; 85.5 percent responded to the survey. The course was reported to be beneficial personally and professionally to 88.0 percent and 84.0 percent of women, motivated 47.8 percent of women to seek a leadership position, and helped to secure a leadership position for 30.4 percent. This was comparable with the survey responses of men. Women were significantly more likely than men to seek academic career advancement (83.3 percent versus 55.0 percent, p=0.04) as a result of attending the course. However, women were significantly less likely to have secured a new leadership position since attending the course in comparison with men (4.2 percent versus 18.2 percent, p=0.04). This course also motivated 24.0 percent of women compared with 9.1 percent of men to take additional leadership courses (p‐value not significant). All of the women and 25/26 of the men faculty (46/47, 97.9 percent) reported that they would recommend the leadership course to junior faculty.

Formal training in leadership skills early in an academic career is professionally and personally beneficial to faculty. In particular, leadership courses can successfully motivate and encourage junior women faculty to seek leadership roles in academic medicine by providing them with the knowledge of opportunities in leadership and the skills required for such positions.

The paper presents a subjective assessment of a new leadership course.

The purpose of this paper is to understand the degree to which a quality and safety culture exists after healthcare workers in an academic medical center complete a quality improvement and patient safety education program focused on developing leaders to change the future of healthcare quality and safety.

The safety attitudes questionnaire (SAQ) short-form was used for measuring the culture of quality and safety among healthcare workers who were graduates of an academic medical center’s healthcare quality and safety program. A 53 percent response rate from program alumni resulted in 54 usable responses.

This study found that 42 (78 percent) of the respondents report that they are currently working in a healthcare quality and safety culture, with 25 (59 percent) reporting promotion into a leadership role after completion of the quality improvement education program. This compares favorably to AHRQ culture of safety survey results obtained by the same academic medical center within the year prior revealing only 63 percent of all inpatient employees surveyed reported working in a quality and safety culture.

The study design precluded knowing to what degree a quality and safety culture, as measured by the SAQ, existed prior to attending the healthcare quality and safety program.

This study has practical value for other organizations considering a quality and safety education program. For organizations seeking to build capacity in quality and safety, training future leaders through a robust curriculum is essential. This may be achieved through development of an internal training program or through attending an outside organization for education.