Leadership Lessons: Learning from Crossing BordersCarrie L. Byington, MDTexas A&M University and SystemVice Chancellor | Health ServicesJean and Thomas McMullin Professor and Dean | College of Medicine

Disclosure

Carrie L. Byington, MD has • Intellectual property and receives royalties

from BioFire Diagnostics• A relationship as a scientific advisor for

IDbyDNA

Objectives

• Discuss a leadership journey and the lessons learned from crossing borders

• Discuss examples of crossing borders for the academic healthcare missions including clinical care, education, mentorship, translational science

A blank wall of social and professional antagonism

Marion Spencer Fay, PhDDean and President Women’s Medical College of Pennsylvania1946-1963

“greatest satisfaction [was] to see girls with a burning desire for education in medicine grow into mature, skilled women who go out and make splendid records in hospitals, in public agency work, in private practice all over the world,”

By far, the greatest predictors of the occurrence of sexual harassment areorganizational.

Medicine is so broad a field, so closely interwoven with general interests, dealing as it does with all ages,sexes and classes, and yet of so personal a character in its individual appreciations, that it must be regarded as one of those great departments of work in which the cooperation of men and women is needed to fulfill all its requirements.

Elizabeth Blackwell, MD1850

• Where do I Come From?• Respect• Excellence• Leadership• Loyalty• Integrity• Selfless Service

Carmen Lomas Garza

Acceleration

Medical knowledgewill double

every 73 daysby 2020

TIME TO DOUBLE MEDICAL KNOWLEDGE IS DECREASINGENMED

CONVERGENCE

CONVERGENCEThe Third Paradigm Shift

Paradigm Shifts: Molecular Biology and Genomics

Convergence: The Future of Health

Convergence is the integration of historically distinct disciplines and technologies into a unified whole that creates fundamentally new opportunities for life science andmedical practice

Phillip Sharp, Tyler Jacks, and Susan Hockfield editors

MIT 2016

Interprofessional Team-Based Practice: Addressing Big Issues

Byington , C Pediatrics July 2012

Measure Baseline Implementation P-Value

Core Labs 60% 80% <0.001

HR 68% 74% <0.001

Viral Testing 76% 84% <0.001

Antibiotic Formulary

77% 92% <0.001

D/C Antibiotics 47% 63% <0.001

D/C Home 48% 75% <0.001

Quality Measures-Decreased Variation

Outcome P-Value

Diagnosis of UTI (29%) <0.001 Diagnosis of Viral Illness (40%) <0.001 Antibiotics in LR Infants (26%) 0.002 Length of Stay (27%) <0.001

= Readmission (< 1%) 0.70

Admission of Bacteremia or Meningitis at First Encounter

91% vs. 99% (p=0.06)

Infant Outcomes

Disparities PRE-EBCPMWhite URM P-Value

Identification of HR

47.2% 43.8% 0.01OR 0.87

(0.79-0.97)HR discharged home for care

9.3% 12.1% 0.004OR 1.35

(1.15-1.60)Unscheduled Admission

5.3% 9.1% < 0.001OR 1.80

(1.31-2.45)

POST EB-CPM

White URM P-ValueIdentification of HR

46.5% 47.8% > 0.05

HR discharged home for care

10.5% 9.3% > 0.05

Unscheduled Admission

4.1% 4.1% > 0.05

Medical Education

AAMC Building Bridges and Spanning Boundaries Award: Innovations in Research and Research Education--2014

128 Graduates109 with BS25 in Graduate Programs24 in Medical School33 Employed in Biomedical Research

“My parents taught me: your education is not just for yourself. And if you think it’s just for yourself, you’re wrong. You need to

clear the path for others on your way up the mountain top.”Monique Tulley-Bahe (Navajo-Dine)

Courtney Welsch, MS IVInaugural Alonzo and Margot Byington Endowed Scholar for Rural Physicians in Training

Cadet to Medicine, Military Academies,And Veteran Early Assurance Programs

ENGINEERING MEDICINE

Developing physicianeers to create the futureof health care through innovation

Research and Mentorship

Courtesy of University of Arkansas TRI

Translation is Hard-Be Persistent

PCR will never be used in clinical labs

Growth in PCR Testing at a Single Large US Laboratory (ARUP)

Wittwer,C Clinical Chemistry 2015

Senior Scientific

Staff Peer

Self

Matrix Mentoring Model

Byington et al Academic Med 2016

AAMC Building Bridges and Spanning Boundaries Award: Innovations in Research and Research Education2019

Accountability through Policy Making

• Promotion and Tenure• Salary Equity

• Start-up Equity

• Parental Leave

• Available to all faculty, Followed, Transparent

Priorities

Lessons Learned

• Hold onto your values• Step up—advocate for others—patients,

students, and trainees come first• Be fearless--cross borders and to learn

from others• Be persistent--see opportunities in

challenges• Be bold—invent the future• Let your life experiences and skills shape

your unique leadership contributions

14 million patients280,000 students227,00 faculty and staffMedicine, Dentistry, Nursing, Pharmacy, Optometry, Public Health, Veterinary Med

Women admitted into medical school in 1874