From the Dean: Reflections from the surgical suite

February 28, 2014

Dear School of Medicine Community:

Sometimes I am asked why I choose to continue my surgical practice in addition to serving as dean. There are two reasons. First, I consider it a privilege to be so directly involved with patients, many of whom are young children, and I derive a great deal of professional satisfaction from this, even just one day a week. Second, and equally important, caring for patients gives me a frontline perspective into each of our missions and how they interact to advance human health. I draw on this experience every day in my role as dean to help support, sustain and continually extend the impact of our critical missions.

For example, OHSU recently adopted a continuous performance-improvement model. Grounded in lean production techniques, the OHSU Performance Excellence System, or OPEx, is a set of tools and principles focused on improving the patient experience.

In the surgical suite, I am just one member of an inter-dependent care team of nurses, anesthesiologists, residents and many others, who in turn depend on a team overseeing everything from scheduling to patient transport. The intricate totality of all these moving parts – and their constant dynamic evolution – is hard to truly grasp without direct participation.

This involvement is particularly important during this period of rapid change in our health care system. When we put new models in place – such as OPEx – I am armed with firsthand data and a shared experience with other clinicians as we evaluate their effectiveness. For instance, during an OPEx project in the OR, clinicians and staff identified, analyzed and mapped the flow of each action accompanying a surgery. My clinical activities gave me a deeper connection to understanding the application of this system-based approach as I work with leaders across OHSU to possibly expand the OPEx model into other areas and missions.

Caring for patients also puts me in direct contact with medical residents and students from a range of disciplines training in the hospital or clinics. In this environment, I gain insights into how people learn, which informs my efforts to join with others and continually improve OHSU's education mission across all programs.

Maintaining patient care activities also allows me to see firsthand the role of discovery in patient outcomes. During the last three decades, in otolaryngology health care alone, I have witnessed a dramatic evolution stemming directly from new knowledge about, for example, the genetic basis of auditory mechanisms, hearing loss and other aspects of head/neck physiology. Today, our ability to help patients with head and neck cancer, hearing impairment and sinus disease is remarkably different from my first years in delivering care. Watching a young child with profound hearing loss function in their classroom with a cochlear implant is a moving experience; we owe such advances to our scientists. Multiply that across each specialty and the cumulative benefits are staggering.

Caring for patients reminds me again and again of the value of mission integration, and how the power of a stable platform for our faculty to engage in and lead our missions of discovery, healing and teaching uniquely advances human health and well-being. Mission integration is, in many ways, one of the School of Medicine's most fundamental strengths. The insights gained from clinical practice are invaluable to me, but feedback from all sources is important. It sounds clichéd, but I hope you know how much I value your input and draw on it as we navigate through these challenging and exciting times. My door is always open. Except when I'm in surgery.

Best Regards,

Mark Richardson, M.D., MBA
Dean, OHSU School of Medicine
President, Faculty Practice Plan