In July 2013, the leaders of Johns Hopkins Medicine accepted an unprecedented challenge: Implement a strategic plan that would ensure that the institution would maintain its excellence in research, education and patient care despite the uncertainties of health care reform and reductions in research funding.
Created by more than 150 faculty members, administrators and staff members, the five-year strategic plan, dubbed Leading the Change, was the first of its kind at JHM. It was designed to guide decisions and business strategies for the entire enterprise in six critical areas: people, biomedical discovery, patient- and family-centered care, education, integration and performance.
Since its launch, the comprehensive effort has addressed the needs — and drawn upon the talents — of the roughly 41,000 employees who work in JHM’s six hospitals, school of medicine, managed care and home care organizations, community physician groups and international organization.
“A strategic plan is only as good as the people who execute the strategies, and faculty and staff members across JHM embraced the plan and did their part to make the vision a reality,” said Dean/CEO Paul Rothman. “Not only was the plan instrumental in guiding our decisions, it helped us become even more innovative and efficient, positioning us well for an uncertain future. I could not be prouder of the people of JHM and the progress we made over the last five years.”
Dozens of new programs and initiatives have led to numerous improvements. They include increasing the racial and gender diversity of JHM executive leadership; implementing the Epic medical record system; creating precision medicine centers of excellence in prostate cancer and multiple sclerosis; launching an accountable care organization; increasing the pipeline programs for community students interested in medicine and science; improving employee health through workplace wellness programs; improving patient access to treatment with dedicated phone lines and expanded hours; creating clinical communities to standardize high-quality care across the enterprise; and introducing a primary care leadership track in the school of medicine.
Moreover, the institution managed these achievements while maintaining its strong bond ratings. It also met, or exceeded, its annual operating targets, according to Ron Werthman, JHM senior vice president and chief financial officer.
The strategic plan has helped to guide JHM during a time of rapid change in health care nationally and locally, says John Colmers, senior vice president for health care transformation and strategic planning. It also laid the groundwork for Innovation 2023, the institution’s new blueprint for the next five years. It will be rolled out this fall.
“Innovation 2023 builds on the success of the first plan, yet remains faithful to all parts of our tripartite mission,” Colmers says. “One important advance is to simplify the goals to make them more understandable to our patients and to our faculty and staff. This will be essential to success over the next five years, which will continue to see serious challenges to academic medical systems.”
Leading the Change was divided into six strategic priorities, each overseen by a group of subject matter experts. The following categories list some of the accomplishments deemed most significant by their accountable leaders.
People: Attract, engage, develop and retain the world’s best people.
The online SuccessFactors human resources system and its employee evaluation tool, myPerformance, allow employees to review their evaluations and document their progress.
- The Office of Johns Hopkins Physicians launches the clinical awards program for physicians and care teams to honor those who embody the best in clinical excellence.
- Entities across Johns Hopkins Medicine improve their health programs, policies and benefits. In 2017, they increase their CDC Worksite Health ScoreCard scores by 18 points, exceeding both the large employer and health care employer benchmarks.
- More than half (54 percent in 2016 versus 43 percent in 2014) of executive senior leadership at JHM is female. In the dean’s office of the school of medicine, 51 percent of the leaders are now women.
- JHM launches diversity councils at each entity. Leadership at JHM also becomes more diverse: Pablo Celnik becomes director of the Department of Physical Medicine and Rehabilitation; Tina Cheng becomes chair of the department of pediatrics; Robert Higgins becomes director of the Department of Surgery; and Colleen Koch becomes chair of the Department of Anesthesiology. James Page Jr. becomes JHM’s first chief diversity officer and Inez Stewart becomes the institution’s senior vice president of human resources.
Biomedical Discovery: Become the exemplary model for biomedical research by advancing and integrating discovery, innovation, translation and dissemination.
- To help offset any loss of government funding for biomedical research, Johns Hopkins establishes school of medicine Discovery Fund Synergy and Innovation awards, Johns Hopkins Discovery Awards and Johns Hopkins Catalyst Awards.
- Precision medicine centers of excellence are established through an inHealth partnership between JHM and the Johns Hopkins University Applied Physics Laboratory. The first centers are created to serve patients with prostate cancer and multiple sclerosis.
- Various departments contribute funding for the Center for Clinical Data Analysis, part of the inHealth Centers of Excellence initiative.
- The JHM Research Council is established to create a new research structure that uses resources from across the enterprise to accelerate collaboration, innovation and quality.
- The Bloomberg~Kimmel Institute for Cancer Immunotherapy is established.
- The school of medicine continues to add and connect new research cores and to implement iLabs.
Patient- and Family-Centered Care: Be the national leader in the safety, science, teaching and provision of patient- and family-centered care.
- In addition to expanding hours for treatment at many JHM hospitals and outpatient practices, efforts to improve patient access include creating the Patient Access Line (PAL) and multidisciplinary service lines.
- The Armstrong Institute establishes and expands its program of clinical communities.
- Johns Hopkins Medicine International’s Language Access Services coordinates an update of medical interpretation policies and services for The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center and Johns Hopkins Community Physicians. These policies, which will apply to all entities, require staff members who encounter patients or family members with limited English proficiency to use one of the approved medical interpretation methods (an in-person interpreter or remote audio or video interpretation) during all medical conversations.
Education: Lead the world in the education and training of physicians and biomedical scientists.
- A primary care leadership track is established.
- Innovative pathways in graduate training include the Johns Hopkins-MedImmune Scholars Program and the Biomedical Careers Initiative.
- The Partnering Toward Discovery series helps enhance collaboration by creating opportunities for productive interaction between scientists and clinicians and, even more specifically, between medical students and graduate students.
- JHM increases its pipeline programs to enhance the ability of minority high school and college students from disadvantaged backgrounds to enter science and health careers by involving them in scientific research programs on the JHH campus. The Summer Academic Research Experience seeks to develop exceptional high school students by introducing them to biomedical research. The Johns Hopkins Initiative for Careers in Science and Medicine aims to develop students into successful professionals, especially in the STEM and health care fields.
- JHM promotes the need for high-value patient care and implements Choosing Wisely, part of the high-value patient care strategy for students and trainees.
Integration: Become the model for an academically based, integrated health care delivery and financing system.
- Epic is successfully implemented. Johns Hopkins Medicine now has a single, integrated electronic medical record system for the entire enterprise, with the exception of Johns Hopkins All Children’s Hospital.
- The Office of Telemedicine is established and works on a multitude of telemedicine projects.
- Johns Hopkins Regional Physicians expands JHM’s clinical footprint and referral network through an integrated delivery system of high-value community practices.
- Through the Sidney Kimmel Comprehensive Cancer Center, JHM integrates its cancer care services at Sibley Memorial Hospital and Suburban Hospital.
- The Johns Hopkins Medicine Alliance for Patients accountable care organization is established.
Performance: Create sustainable financial success and implement continuous performance improvement.
- Johns Hopkins Health System meets or exceeds its operating targets during each year of the strategic plan.
- From 2013 to 2018, JHHS maintains its strong bond ratings while completing major capital and strategic projects in addition to renovation and routine capital needs.
- In 2016, JHHS issues $500 million of bonds to provide for the debt component of capital projects at member organizations (e.g., proton therapy at Sibley Memorial; campus redevelopment at Suburban; and the Research and Education Building at JHACH). JHHS takes advantage of historic low interest rates and obtains interest rate spreads superior to those of similar or better-rated health systems that issue bonds in the same time frame.
- Johns Hopkins HealthCare expands its insurance offerings with the addition of an HMO product for Johns Hopkins’ Medicare Advantage MD plan. With premiums as low as $0 in Baltimore City and $25 in 11 Maryland counties, as well as expansion into Frederick County, this new offering helps Advantage MD grow to more than 12,000 beneficiaries.
- JHM’s new supply chain management organization, Nobilant contracts with national suppliers to standardize medical and surgical supplies across the health system and give clinicians direct access to product selection that meets or exceeds the previous suppliers’ product quality.