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Lessons In Community Servant Leadership: Lessons In Community Servant Leadership: Public Health, Pimps and Pit BullsPublic Health, Pimps and Pit Bulls

Gerard Clancy, M.D. President, University of Oklahoma, Tulsa campus

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Tulsa, OklahomaTulsa, Oklahoma

MSA almost 1,000,000

3rd component of University of Oklahoma is the OU Tulsa campus with undergraduate and graduate programs in health sciences, engineering, architecture, social sciences, urban design, public administration and more…

OU School of Community Medicine – practice plan, PAs, medical student track, residency and fellowship programs. A regional campus of OU College of Medicine.

August 2011: “Oklahoma will start atNo. 1 in USA TODAY preseason poll”

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The State’s Next Challenge - Securing Primary Care for Expanded Medicaid PopulationsLeighton Ku, Ph.D., M.P.H., Karen Jones, M.S., Peter Shin, Ph.D., M.P.H., Brian Bruen, M.S., and Katherine Hayes, J.D .

# 1

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An Engineering Project = “DemocratizationAn Engineering Project = “Democratization””

“In the 20th century, science and medicine combined to create great benefit for humankind leading to a 30 year expanded life expectancy. The imperative of the 21st century is the democratization of those benefits.”

Mullan, AAMC 2010Democratize This !Democratize This !

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2009 design rendering

Fall 2011 progress

NORTH TULSA - 14 year difference in life expectancy, 40% of regional population but only 4% of physicians...so we put up new clinics in schools, apartment complexes, raised $20,000,000 for a new specialty clinic and changed our name….

Age Adjusted Death Rates by Zip Code:14 Year Difference Between North and South

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““Is Tulsa North Being Is Tulsa North Being

Pimped by OU?” Pimped by OU?” January 2010January 2010 ““To Tulsa north’s ‘rescue,’ Oklahoma University has come. Unquestionably, medical care is To Tulsa north’s ‘rescue,’ Oklahoma University has come. Unquestionably, medical care is

needed in Tulsa north. Why then, pose such a negative question when OU appears to needed in Tulsa north. Why then, pose such a negative question when OU appears to be doing the right thing?”be doing the right thing?”

““Our answer….Pimps use the bodies of women to make money. For whatever reason, the Our answer….Pimps use the bodies of women to make money. For whatever reason, the

women are vulnerable. The residents of Tulsa north are very vulnerable because of women are vulnerable. The residents of Tulsa north are very vulnerable because of their poor health outcomes. Hundreds of millions of dollars will be spent ostensibly for their poor health outcomes. Hundreds of millions of dollars will be spent ostensibly for better health care for Tulsa north residents. Who gets the money for such an endeavor? better health care for Tulsa north residents. Who gets the money for such an endeavor? OU will. Who receives $20 million dollars for building the facility? Manhattan OU will. Who receives $20 million dollars for building the facility? Manhattan Construction has been selected as the contractor.” Construction has been selected as the contractor.”

““If a healthy community is the goal of OU, does it not recognize that a healthy community If a healthy community is the goal of OU, does it not recognize that a healthy community involves more than improving traditional healthcare facilities and services? A healthy involves more than improving traditional healthcare facilities and services? A healthy community must have a good economy and a chance for good jobs for its residents. community must have a good economy and a chance for good jobs for its residents. Tulsa north’s personal sense of well-being and its ability to thrive socially and Tulsa north’s personal sense of well-being and its ability to thrive socially and economically are tied together. It is impossible to have a healthy community without a economically are tied together. It is impossible to have a healthy community without a strong educational and economic engine in its midst.” strong educational and economic engine in its midst.”

““Why do we pose the question, “Is Tulsa north being pimped by OU?” Do not pimps use Why do we pose the question, “Is Tulsa north being pimped by OU?” Do not pimps use bodies to get income? OU will receive income from treating sick bodies. When will OU bodies to get income? OU will receive income from treating sick bodies. When will OU learn that the elimination of healthcare disparities among population groups is not a learn that the elimination of healthcare disparities among population groups is not a zero sum game?” zero sum game?”

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Our history (1921) Our history (1921) is the key to is the key to understanding ourunderstanding ourhealth disparities.health disparities.

Only recently moves towards Only recently moves towards reconciliation, leaves Tulsa with reconciliation, leaves Tulsa with lingering mistrust and separation.lingering mistrust and separation.

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OU Architecture and Engineering –OU Architecture and Engineering –24% local construction24% local construction

Recruited new Recruited new Pharmacy next doorPharmacy next door

OU Nursing - Taste of North TulsaOU Nursing - Taste of North TulsaOU College of Education - Early OU College of Education - Early Childhood Education CenterChildhood Education Center

Focused work in North Focused work in North Tulsa to “improve health”Tulsa to “improve health”

… … pushed us as a campus to a pushed us as a campus to a community servant model.community servant model.

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OU Urban Design Studio

Faculty and students led a planning initiative for neighborhood redesign

- Gray are existing buildings- White are planned new buildings

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1. Medical Education and Health Workforce

- Physician Assistant program – established, HRSA grant for expansion, partnership with FQHCs

- Teaching Health Center planning- School of Community Medicine track- Summer Institute

2. Team Care– Patient Centered Medical Home

payment from Oklahoma Medicaid and Blue Cross for primary care, severe mental illness, pediatric diabetes, palliative care

3. Care Coordination – Partnership with Oklahoma Medicaid

for patient navigation, web-based consultations.

– 3026 grant application for “rehospitalization avoidance”

4. High Cost Patient Pilot planning grant with CMS Innovation Center

– 1 of 15 pilots across the US with Oklahoma Medicaid for Mini ACO for Medicare – Medicaid high cost patients

5. Health Information Exchange (ARRA)– 1 of 15 across US - $ 12,000,000

infrastructure grant (Beacon) tracks community’s health

6. Oklahoma Center for Healthcare Improvement

– Takes community’s health measures and puts improvement actions in place

7. Sent OU team to Dartmouth’s Masters in Health Delivery Sciences

8. LEAN Grant (US Dept of Labor)– Toyota LEAN strategies in health

care, streamline administrative and care processes

A Unique Window in Time for Building Community Servant Infrastructure: A Unique Window in Time for Building Community Servant Infrastructure: Increasing region’s capacity (not just OU) to care for underserved populations under a value-based (outcomes) payment model:

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Two Very Short Stories from our OU StudentsTwo Very Short Stories from our OU Students

I. The Power of Public Health Data and Honesty

II. It is Hard to Exercise when you are Face to Face with Pit Bulls

OU School of Community MedicineSummer Institute - Photo Voice Exhibit

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Lessons Learned:1. Honesty about “what is not

right.”2. History – understanding

what drove division and mistrust.

3. Broader views of health.4. Takes more than medicine,

clinics and hospitals to actually improve health.

5. Health reform programs offer great opportunities for change pilots.

6. You will be tested.7. Quote from faculty recruit:

“This is why we went to medical school in the first place….and this is why we work at medical schools…”

SUMMER INSTITUTE 2011SUMMER INSTITUTE 2011 Green – Medicine, Yellow, Physician’s Assistants, Orange – Social Work, Apricot – Nursing, White – Human Relations, Tan – Business, Lavender – Urban Design, Gray – Pharmacy, Yellow – Library Sciences, Blue – Allied Health, Black – Fine Arts, Pink – Public Health

We begin the year with the Summer Institute – followed by Faculty, Staff and Student Leadership Academies throughout the year.