Putting It All Putting It All Together -Together -

Managing Multiple Managing Multiple PrioritiesPriorities

Brian J. Zink, MDBrian J. Zink, MDProfessor and Chair,

Dept. of Emergency Medicine,Alpert Medical School

Lifespan Partners

SAEM Business of Academic Emergency Medicine Boot SAEM Business of Academic Emergency Medicine Boot CampCamp

SAEM Business of Academic Emergency Medicine Boot SAEM Business of Academic Emergency Medicine Boot CampCamp

Objectives

Participants will learn how to address and manage multiple priorities in the business and finances of an academic department of emergency medicine in a mission-based manner.

Participants will learn how to assess institutional priorities and align them with departmental priorities to achieve success in the business of emergency medicine.

Participants will review and participate in discussions of case examples of competing or conflicting priorities and solutions to these situations.

What Business Are We In?

We are not in the banking business.

We are not a corporation looking to increase shareholder value through enhanced stock price and lower cost of capital ratios.

We are not even ‘just’ a high quality healthcare delivery organization …

We are a part of a complex enterprise dedicated to pushing the margin … a balanced program of education, research and patient care.David Bachrach – Physician Executive Coach,

2008

Sound Advice from the Coach

The 3 Responsibilities of a ChairThe 3 Responsibilities of a Chair

1. Develop and Communicate the Mission, Vision and Values of the Department

2. Recruit, Develop and Retain High Quality Faculty Members

3. Be a Good Steward of Your Resources

David Bachrach – Physician Executive Coach, 2006

Mission - Possible?

We have all heard – ““No Margin, No No Margin, No Mission.Mission.””

But should a departmental mission be based and dependent on progressively increasing amounts of money?

If so, how will academic departments survive, much less thrive, when we face cuts to clinical, educational and research funding?

If your mission can’t guide you – what will?

Mission-Based Budgeting

Introduced about a decade ago for medical education and academic medical centers.

Basic Premises:ALL components of AMC mission are identified and assigned value and metrics (not just clinical).Accounts for activity and quality of faculty effort in all areas – clinical, research, education and service.Financial decisions based on a composite view. Non-revenue generating activities are on equal footing with revenue generating activities.

Mission-Based Budgeting: Removing a Graveyard, Robert T. Watson, MD, and Lynn J. Romrell, PhD Academic Medicine, Management Series: Mission-Based Management, 1999.

Beyond Budgeting

Landmark article in 2003 by Jeremy Hope in Harvard Business Review, and subsequent book.

Application in a med school setting – Univ. of MichiganElger WR. Managing resources in a better way: a new financial management approach for the University of Michigan Medical School. Academic Medicine 2006; 81(4):301-305

Basic Premises:Transparency and openness in governance and operationsTeams set up with high degree of accountabilityCreate goals with positive reinforcementContinuous planning with all members of teamControls and metrics – real time

Most academic EM departments are on a scale where “beyond budgeting” practices can be applied.

12 Beyond Budgeting Principles (2011)

Governance and transparency1. Values - Bind people to a common cause; not a central plan2. Governance - Govern through shared values and sound judgement; not detailed rules and regulations3. Transparency - Make information open and transparent; don't restrict and control it

Accountable teams4. Teams - Organize around a seamless network of accountable teams; not centralized functions5. Trust - Trust teams to regulate their performance; don't micro-manage them6. Accountability - Base accountability on holistic criteria and peer reviews; not on hierarchical relationships

Goals and rewards7. Goals - Encourage teams to set ambitious goals, don't turn goals into fixed contracts8. Rewards – Base rewards on relative performance; not on fixed targets

Planning and controls 9. Planning - Make planning a continuous and inclusive process; not a top-down annual event10. Coordination -Coordinate interactions dynamically; not through annual budgets11. Resources -Make resources available just-in-time; not just-in-case12. Controls - Base controls on fast, frequent feedback; not budget variances

www.bbrt.org/beyond-budgeting/bb-principles.html

www.bbrt.org/beyond-budgeting/bb-principles.html

Before Budgeting, Before Allocating…

There is the big picture.

Positive organizational change

Abundance Theory

Appreciative Inquiry

Adaptive Enhancement

Bandelier National Monument, New MexicoBandelier National Monument, New Mexico

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Internally Closed

Self Focused

Externally Directed

Comfort Centered

Other Focused

Externally Open

Internally Directed

Results Centered

From: Quinn, RE. Building the bridge as you walk on it. Jossey-Bass, 2004

Moving Toward a Moving Toward a Fundamental State of LeadershipFundamental State of Leadership

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Four Questions as You Craft Your Four Questions as You Craft Your Vision Vision

Four Questions Four Questions What are we really asking? What are we really asking?

1. What result do we 1. What result do we want to create?want to create?

What is our real purpose?Are we in a proactive life stance?Do we have a sense of meaning?Are we challenged and engaged?

2. 2. Are we internally Are we internally directed? directed?

What are we afraid of?What are our core values?What would we do if we had 2% more courage?Are we moving forward no matter what the punishment?

3. Are we other-3. Are we other-focused?focused?

Who is in the relationship?Are we pursuing a purpose larger than us?Are we sacrificing for the common good?Are our relationships full of trust and respect?

4. Are we externally 4. Are we externally open? open?

Are we doing what we do not know how to do?Have we let go of control?Are we embracing feedback?Is our awareness expanding dramatically?

Adapted from: Cameron KS: University of Michigan Business School, 2006

Appreciative Inquiry

A new paradigm for organizational development.

Pioneered in 1980’s by David Cooperrider at Case Western Reserve University.

Derived from experiences and observations at the Cleveland Clinic – physician leadership success.

Has been utilized with positive results by many businesses, organizations, the Navy, etc. to reshape the perspectives and approach of leaders and workers.

What is Appreciative Inquiry?

“It is the discovery for the best in people, their organizations, and the relevant world around them. It is an art and practice of It is an art and practice of asking the unconditional positive questions asking the unconditional positive questions that strengthen a systemthat strengthen a system’’s capacity to s capacity to apprehend, anticipate and heighten positive apprehend, anticipate and heighten positive potential.potential. Instead of negation, criticism and spiraling diagnosis, there is discovery, discovery, dream, design and destinydream, design and destiny. It works from accounts of the “positive change core”. AI links the energy of the positive core directly to any change agenda and changes never thought possible are suddenly and democratically mobilized.”

David Cooperrider, PhD., 2008

What is Appreciative Inquiry?

Appreciative Inquiry is a collaborative and highly participative, system-wide approach to seeking, identifying, and enhancing the “life-giving forces” that are present when a system is performing optimally in human, economic, and organizational terms.

“AI is the ability (a kind of intelligence) to perceive the positive inherent generative

potential in the present.” – David Cooperrider

From: Don Schutt, Ph.D., NCC, LPC, MCDP; Univ. of Wisconsin; A Strength-Based Approach to Career Development Using Appreciative InquiryFrom: Don Schutt, Ph.D., NCC, LPC, MCDP; Univ. of Wisconsin; A Strength-Based Approach to Career Development Using Appreciative Inquiry

Appreciative Inquiry: The “4-D” Cycle

Discovery“What gives life?”(The best of what is)

Appreciating

Discovery“What gives life?”(The best of what is)

Appreciating

Dream“What might be?”

(What is the world calling for)Envisioning Results

Dream“What might be?”

(What is the world calling for)Envisioning Results

Design“What should be--the ideal?”

Co-constructing

Design“What should be--the ideal?”

Co-constructing

Destiny“How to empower, learn,and adjust/improvise?”

Sustaining

Destiny“How to empower, learn,and adjust/improvise?”

Sustaining

AffirmativeTopic Choice

From: Cooperrider, DL, Whitney D, Stavros, JM. Appreciative Inquiry Handbook. Crown Custom Publishing, Inc 2008.

From: Cooperrider, DL, Whitney D, Stavros, JM. Appreciative Inquiry Handbook. Crown Custom Publishing, Inc 2008.

A Non-Traditional Approach

The abundance culture and philosophy.A core of “positive energizers” who are free to do their work.

Investing in our People:“Human relationships and leadership are more important than ever before. The speed and sophistication of technology and information have made human capital the key competitive advantage for most organizations.” Kim Cameron

The Power of Positive People

The 5:1 positive rule for high performance teams.

Unless marriage partnerships, families, or work teams have a ratio of 5 positive comments to every 1 negative comment, the quality of the relationship deteriorates.

Try this out at home!

Positive energizers tend to enhance the work of others. People who interact with or are connected to energizers also perform better.

High performing firms have three times as many positive energizing networks as low performing firms.

Positive Energizers

Positive Performers in the Work Place

Externally focused, advocates.

Solution-finders, well-connected with good networks.

Willing to take on challenges in an innovative way. Adaptable.

All of these are core characteristics of …

High Performance Teams (source: Losada &

Heaphy, 2003)

Team PerformanceHigh Medium Low

Positive Statement Ratio

5.6 to 1 1.8 to 1 0.36 to 1

(supportive, encouraging, appreciation)

Inquiry/ Advocacy Ratio

1.1 to 1 0.67 to 1 0.05 to 1

(questioning versus asserting)

Others/Self Ratio

0.94 to 1 0.62 to 1 0.03 to 1

(external versus internal focus)

Connectivity Average

33 22 18

(mutual influence, assistance, interaction)

Approaches to Organizational Improvement

Approach #1What problems are we encountering?What are the major obstacles to success?How can we close the gap between our problems and effective solutions?

Approach #2What is working here?What is the best we have ever done?What are our peak experiences?How can we close the gap between our highest aspirations and sustainable achievements?

Comparing Approaches to Improvement

PROBLEM SOLVINGPROBLEM SOLVING

Problem Identification:

Identify problems or needs

Cause Analysis:

Analyze symptoms & root causes

Identify Solutions:

Generate alternative that address problems

Action planning:

Design interventions that address or solve problems

BASIC ASSUMPTION:

Our job is to overcome major problems.

APPRECIATIVE CHANGEAPPRECIATIVE CHANGE

Appreciating and Valuing:

Identify peak experiences

Explaining Success:

Identify elements of the best past successes

Creating Sustainability:

Identify what should be continued in the future

Designing a Destiny:

Design interventions that create an ideal future

BASIC ASSUMPTION:

Our job is to embrace and enable our highest potential.

The Heliotropic Effect

Focusing on abundance gaps, compared to deficit gaps, leads to the organization turning toward the positive, instead of reacting to the negative.

Capitalizing on Strengths

Identifying people’s strengths and building on them creates more benefit than identifying weaknesses and trying to correct them.

Managers who spend more time with their strongest performers achieved double the productivity.

In organizations where workers have a chance to “do what they do best everyday,” productivity is 1.5 X greater than in normal organizations.

People who are given feedback on their strengths are significantly more likely to feel highly engaged and to be more productive than people who are given feedback on their weaknesses.

Students who are given feedback on their talents have fewer days of absenteeism, less tardiness, and higher GPAs than students who get no feedback on their talents.

If you see your cup as half full, it may one day runneth over;

if you see it as half empty, it never will.

Yeah, but…

Aren’t most organizations fraught with problems?

Can any leader or manager afford to ignore difficulties?

Is a positive approach to change just a white-wash of serious challenges?

Won’t any organization fail if it doesn’t focus on its weaknesses and liabilities?

In light of major challenges faced by most organizations and leaders, what is the relevance of virtues and an abundance approach to change?

Why Don’t Positive Factors Get More Attention?

A systematic bias exists in people - negative factors are more powerful and influential than positive factors.

People are: More upset by losing $50 than elated by winning $50.More affected by one traumatic or negative event than by one positive or happy event. More affected emotionally & do more mental work from a single negative piece of feedback than from a single positive piece of feedback.

Therefore, the abundance model faces some stiff resistance.

Associations Between Organizational Virtuousness & Performance

An abundance culture, virtuousness and positive dynamics are significantly and positively related to organizational performance.

A long term view is part of the abundance culture.

A study of the airline industry after 9/11.

Approach to Downsizing - Southwest

Despite losing $1 million per day in the weeks following the attacks, Southwest refused to lay off employees. CEO Jim Parker said: “Clearly we can’t continue to do this indefinitely, but we are willing to suffer some damage, even to our stock price, to protect the jobs of our people.”

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Why Does Virtuousness Enhance Performance?

Virtuousness has an Virtuousness has an amplifyingamplifying effect. effect. Virtuousness perpetuates more virtuousness (psychological broadening & building effects).Builds social capital (trust, information sharing, learning, etc.)Fosters pro-social behavior (inherent disposition toward helping).

Virtuousness has a Virtuousness has a bufferingbuffering effect. effect. Virtuousness serves a protective function against trauma. Resiliency is developed (strengthening, limbering and replenishing).Negative effects of downsizing are mitigated (psychological, emotional, psychological and social effects).

The Competing Values FrameworkThe Competing Values Framework

Culture Type: ADHOCRACYOrientation: CREATELeader Type: Innovator

Entrepreneur Visionary

Value Drivers: Innovative outputs

Transformation Agility

Theory of Innovativeness, vision, Effectiveness: & constant change

produce effectivenessCulture Type: HIERARCHY

Orientation: CONTROLLeader Type: Coordinator

Monitor Organizer

Value Drivers: Efficiency Timeliness Consistency &

Uniformity Theory of Control & efficiency withEffectiveness: capable processes

produce effectiveness

Culture Type: MARKET Orientation: COMPETELeader Type: Innovator

Entrepreneur Visionary

Value Drivers: Innovative outputs

Transformation Agility

Theory of Innovativeness, vision, Effectiveness: & constant change

produce effectiveness

Culture Type: CLANOrientation: COLLABORATELeader Type: Facilitator

Mentor Team-builder

Value Drivers: Commitment Communication Development

Theory of Human developmentEffectiveness: & high-commitment

produce effectiveness

Cameron K. and Quinn R., Diagnosing and Changing Organizational Culture, Jossey Bass, 2006Cameron K. and Quinn R., Diagnosing and Changing Organizational Culture, Jossey Bass, 2006

Long-term Change

Individuality Flexibility

New Chang

e

Internal Maintena

nce

Stability Control

External Positioni

ng

Incremental Change

Fast Change

Values and Profiles of the Four Values and Profiles of the Four CulturesCultures

Value: Community & Knowledge

Typical Situation:A communication united by shared beliefsCompetency is closely linked to unique abilities Strong identification with a lifestyle Think…Harley-Davidson, Bloomsbury Publishing, Universities Value: Efficiency & Quality

Typical Situation:Scale & scope of organizational processes is very large & complexGovernment regulations & standards determine business practicesFailure is not an option Think…Boeing, US Army, Medical Centers

Value: Speed & Profits

Typical Situation:Shareholder demands are the primary driverAggressive competition changes the market dynamics through mergers & acquisitions Investors demand quick financial resultsThink…GE, Microsoft, Investment Banks

Value: Innovation & Growth

Typical Situation:Differentiation creates significantly higher margins A new methodology changes the gameAn industry is situated around blockbuster inventionThink…Pixar, Schwab, Start-ups

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Organizational Leadership ProfileOrganizational Leadership ProfileThe Collaborate CultureAn organization that focuses on internal maintenance with flexibility, concern for people and is sensitive and friendly place to work where people share a lot of themselves. It is like an extended family. The leaders, or head of the organization, are considered to be mentors and, maybe even, parent figures. The organization is held together by loyalty or tradition. Commitment is high. The organization emphasizes the long term benefit of human resources development with high cohesion and morals being important. Success is defined in terms of sensitivity to customers and concern for people. The organization places a premium on teamwork, participation and consensus.

The Create CultureAn organization that focused on external positioning with a high degree of flexibility and individuality. A dynamic, entrepreneurial & creative place to work. People stick their necks out & take risks. The leaders are considered to be innovators & risk takers. The glue that holds the organization together is commitment to experimentation being on the leading edge. Readiness for change & to meet new challenges are important.

The Control CultureAn organization that focuses on internal maintenance with a need for stability and control. A very formalized and structured place to work. Procedures govern what people do. The leaders pride themselves on being good

The Compete CultureAn organization that focuses on external positioning with a need for stability and control.A results oriented organization. The major concern is getting the job done. People are competitive and goal oriented. The leaders are hard drivers, producers andcoordinators, organizers, and efficiency minded.

Maintaining a smooth running organization is most critical. Formal rules and policies hold the organization together. The long term concern is on stability and performance with efficient, smooth operations. Success is defined in terms of dependable delivery, smooth scheduling, and low cost. The management of employees is concerned with secure employment and predictability.

The organization’s long term emphasis is on growth & acquiring new resources. Success means having unique & new products, or services. Being a product, or service, leader is important. The organization encourages individual initiative & freedom.

competitors. They are tough and demanding. The glue that holds the organization together is an emphasis and success are common concerns. The long term concern is on competitive actions and achievement of measurable goals and targets. Success is defined in terms of market share and penetration. Competitive pricing and market leadership are important. The organizational style is hard-driving competitiveness.

Collaborate

Compete

Control

Create

Negative Aspects of These Negative Aspects of These CulturesCultures

Irresponsible Country Club

Individuality Flexibility

Tumultuous Anarchy

Internal Maintenance

Stability Control

External Positioning

Frozen Bureaucracy

Oppressive

Sweatshop

Culture Type: CLANOrientation: COLLABORATEAttributes: Excessive discussion Unproductive participationEmotional dominanceIndividualism

Culture Type: ADHOCRACYOrientation: CREATEAttributes: Unguided opportunismUngrounded visionProgram of the weekPremature responses

Culture Type: HIERARCHYOrientation: CONTROLAttributes: MicromanagementProcedural rigidityOver-regulationIronbound tradition

Culture Type: MARKETOrientation: COMPETEAttributes: Over-exertionTyrannical goal focusUnproductive conflictBlind ambition

Overemphasis & Loss of Balance

Negative Zones

Cameron K. and Quinn R., Diagnosing and Changing Organizational Culture, Jossey Bass, 2006Cameron K. and Quinn R., Diagnosing and Changing Organizational Culture, Jossey Bass, 2006

Organizational Culture – Organizational Culture – Congruence, Strength and TypeCongruence, Strength and Type

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There is no best or right culture, and There is no best or right culture, and balance is not necessarily advantageous. balance is not necessarily advantageous.

Outcomes, strategies, culture and Outcomes, strategies, culture and competencies should be congruent to competencies should be congruent to achieve high performance.achieve high performance.

Key metrics will be different, depending Key metrics will be different, depending on the values and culture of your on the values and culture of your organization.organization.

Culture change occurs through crisis, Culture change occurs through crisis, evolution, or leadership. evolution, or leadership.

Achieving Spectacular Performance – Deviating from “Normal”

Over time, most organizations tend to settle in to a normal, “fallen” state characterized by routines, conformity, hypocrisy, and with a palpable gap between what is and what might be.

“They became what they beheld.”

William Blake

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Organizational Culture ProfilesAn Example of Life Cycle Development in

Organizational Cultures1 2

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Dept EM Culture Previous Dept EM Culture Previous Compared to TodayCompared to Today

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Control Compete

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2008 Current 2008

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Results 2010

Current

Desired

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Competing Values Framework – Competing Values Framework – for the Departmentfor the Department

Recognition that subgroups in the Recognition that subgroups in the Department may have their own Department may have their own subculture.subculture.

Most team efforts will require Most team efforts will require ““competencycompetency”” in all 4 in all 4 quadrants. quadrants.

The tendency is to get The tendency is to get ““bottom bottom heavyheavy””, so we need to maintain our , so we need to maintain our good qualities in the Collaborate good qualities in the Collaborate and Create quadrants. and Create quadrants.

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The Hedgehog Concept in the Social The Hedgehog Concept in the Social SectorsSectors

What drives our resource engine?

What are we deeply passionate

about?

What can we be best

in the world at?

Adapted from Good to Great and the Social Sectors, Jim Collins, 2005

POSITIVE

RESULTS

ACCOUNTABILITY

SENSE OF

COMMITMENT

HANDLE

CONFLICT

TRUST

THE FIVE KEY CHARACTERISTICS

OF A HIGHLY FUNCTIONING

TEAM

Adapted from: Overcoming the Five Dysfunctions of a Team

by Patrick Lencioni

Balance and the Long Term View

Positive organizations with an “abundance theory” approach achieve long term success by: Having well-developed MVV, with each member of

the team “buying in” and helping to develop and achieve the MVV.

Encouraging high quality work and performance with clear expectations, but avoiding high stress or burn out.Support balance in personal-professional lives of the

team Responding to periodic crises and change in an

effective manner, but stay on track in MVV – long-term view.

Having plans for leadership growth and succession

Where Do We Spend Most of Our Where Do We Spend Most of Our Time?Time?

Uniqueness

Strengths

Competencies

Weak Areas

Managing Multiple Priorities

If you can use mission-based management, and positive organizational change approaches in your day-to-day departmental leadership, balancing and tending to multiple priorities becomes much less onerous.

Priorities and bubble up from the organization as high performance and opportunities.

If you can do a good job of BIG THINKING as a leader and and develop and communicate the MMV very well, then the small things have a way of working themselves out.

If you can do a good job of BIG THINKING as a leader and and develop and communicate the MMV very well, then the small things have a way of working themselves out.

ALIGNMENT

OF COURSEOF COURSE we need to be aligned with our hospitals, academic medical centers, medical schools and community.

As the nexus, intersection, and enabler of much in health care and medical education, EMERGENCY MEDICINE is naturally positioned to be essential, at the table, and given a voice.

But, there is an ART to ALIGNMENT.

The Art of Alignment

Possess Institutional Situational Awareness. What are the: PRIORITIES (if

articulated!) PRESSURES RISK TOLERANCE TIMELINES TENURES

Where Are the Win-Win’s?

What are We Both Good At? AI Approach

Case One: Clinical – What Are We?

Your hospital system is forming a new outpatient network and wants to partner with your EM Department to open an Urgent Care with you providing the staffing. Initial analysis suggests that it would be financially neutral for the Dept to staff it with an EP/midlevel team.

Some members of your leadership team feel that urgent care is not really in the realm of EM, and are concerned that this initiative will distract from your educational and research activities.

The hospital system wants an answer in a week and will consider outsourcing the staffing to other EM groups or urgent care entities.

Managing Multiple Priorities

First, take a deep breath and recite or chant your MISSION, VISION AND VALUES.

Assess: do you have enough objective information, data, points of view, and understanding of the options or paths you can follow? If not, take the time to get it.

Discuss: open dialogue; knowledge transparency; input from ALL stakeholders, not just your own people

Decide a Course: use the tools of positive organizational change as a guide; “dream the answer”; find the Win-Win

Communicate the Decision: reference MVV; explain but do not reopen

Case Two: Clinical v. Educational Needs

You and your hospital are concerned about your ability to manage increasing ED volumes. Wait times are up, attending physicians are stressed. The hospital wants to provide three PA positions to help the situation, BUT in return they are requesting that you surrender two of your residency slots so they can expand their neurology and neurosurgery residencies.

Your residency director is apoplectic, but some attending physicians and nurses are supportive.

How do you manage this?

Case Three: Educational v. Clinical Needs

Your Residency Director wants to nix the current Orthopedics rotation for your interns, citing poor education, lack of procedures, and resident dissatisfaction. An ED-based rotation is planned with some Orthopedics involvement.

The Orthopedics faculty members believe the EM Ortho rotation is strong, and are upset that EM wants to change it. They are making some veiled threats about responsiveness to consults in the ED if you do this. Orthopedics consults are already a problem, and you don’t want it to get worse.

How do you manage this?

Case Four: Research v. Clinical Faculty

Your Department offers seed grants to stimulate research activities in junior faculty members.

Some clinically-oriented faculty members want you to use one half of the seed grant money each year to support clinical QA projects (non-research) for clinical faculty members. They argue that departmental revenue is almost totally derived from clinical activity, and they contribute the most to this, so they believe they should be able to get seed money as well.

How do you balance your research v. clinical priorities?

Case Five: Research Outlier

Your leadership team has established two main research areas of focus and support within your department - cardiovascular emergencies and infectious diseases – and support goes to these areas.

A bright and energetic young faculty member has gone out on her own and secured a small research grant in interpersonal violence against women. She wants to grow in this area and requests more protected time so she can do the research and apply for a K Grant.

How do you manage this conflict between the departmental stated areas of focus, and this faculty member’s interests and desires?

Case Six: IP Opportunity

An enterprising faculty member has developed some innovative, patented software for the ED and wants to form a small company to commercialize it. He is requesting that his commitment to the department be reduced to one shift a week while he starts up the company. With his intellectual property and patents, the venture could return a million dollars to the Department if it is successful.

Some of your Departmental leaders think this is a very risky proposition, and do not feel that a “special deal” should be made for this faculty member?

How you manage this opportunity while being fair and open?

Case Seven: International EM

You have a successful and growing international program in Africa. More and more faculty are requesting time to go for month long clinical and educational experiences at the Africa site. The department is covering at least half the costs of these international experiences.

Some faculty members who do not do international work resent the fact that their schedules are altered to allow the international EM faculty to go to Africa, and feel that it is too costly and diverting funds from other areas.

How do you manage this tension between the IEM program and your “stay at home” faculty members?

What Will Be Different When We Go Home?

After this SAEM Bootcamp, we hope that you have better sense of:

Cost accounting, ReimbursementFunding for GME and ResearchRevenue GenerationStrategic and Business PlanningMarketingRisk ManagementHuman Resources

And, an approach that emphasizes positive organizational change and appreciative inquiry.

So, MARCH on out of here and APPLY WHAT YOU HAVE LEARNED!