Dayton Area Graduate Medical Education Community
History and Milestones
The Dayton Healthcare environment, through the leadership of area hospital chief executive officers and the Greater Dayton Area Hospital Association (GDAHA), has enjoyed an extraordinary spirit of collaboration in areas of non-competitive activities to the benefit of the greater Dayton area. In addition, the Wright State University Boonshoft School of Medicine (WSUBSOM) has encouraged an interactive, integrated participatory graduate medical education (GME) system since the school's inception in 1975.
Against this backdrop, the origins of the consortium can be traced back to WSUBSOM Resident Education Committee (REC) meeting deliberations in the early 1990s that provided a forum and atmosphere, encouraging collaboration amongst the School of Medicine and teaching medical centers in Dayton. During the National Healthcare Reform debate of 1993-94 there was increased support for the consortia concept in federal legislation such as the Kassebaum/Simpson S1215 bill and the Chaffee/Dole S1770 bill. The Council on Graduate Medical Education (COGME), formed to advise the Congress and the Department of Health and Human Services on GME matters, was also publicly supporting the development of consortia in this same time period. In summary, the national, state, and local conditions leading to the establishment of a consortium in Dayton were very positive.
As a result of the leadership of a small core planning group of four directors of medical education, listed below, and a larger group consisting of all directors of medical education, key faculty, and program directors, the development of the philosophical and organizational structure for a Dayton area consortium was begun:
Dr. Albert Painter, Good Samaritan Hospital
Dr. Julie Lindahl, Children's Medical Center
Dr. Robert Sutton, Kettering Medical Center
Dr. Stanley Kirson, Miami Valley Hospital
A series of GME forums were held starting in 1993 with a discussion of GME financial and organizational reform with guest speakers from the Association of American Medical Colleges, Deloitte & Touche LLP, and COGME. From this series of meetings a justification and structure for a Dayton consortium was developed.
During 1995, a series of presentations were made by the core planning group to teaching medical center CEOs and the dean of Wright State University Boonshoft School of Medicine on the benefits of establishing a GME consortium and a proposed structure for this consortia. These presentations were favorably received and each CEO was provided an inter-institutional agreement for legal review.
At this time the Mr. Joseph Krella, president of the Greater Dayton Area Hospital Association, was approached and asked for his support of the professional staff office. Mr. Krella agreed and immediately made arrangements for support.
With all of the institutions in agreement and the basic management issues resolved, the consortium was ready to begin operations. A proposal to establish the Dayton Area Graduate Medical Education Consortium was made and approved at the November 20, 1995 Greater Dayton Area Hospital Association board meeting. At this meeting, the CEOs approved the formation of the consortium and funded the consortium for one year.
DAGMEC formally began operations on January 1, 1996. An inter-institutional agreement was signed by the below listed hospitals, establishing the initial governance structure for the consortium and thereby culminating several years of effort on the part of Dayton-area hospital cDirectors of medical education to create a more collaborative GME environment.
Original Member Institutions:
Hospital
Children's Medical Center
Miami Valley Hospital
Kettering Medical Center
Good Samaritan Hospital
Franciscan Medical Center, Dayton Campus
Wright-Patterson Medical Center
Department of Veterans Affairs Medical Center
University
Wright State University Boonshoft School of Medicine
Key Milestones following the approval to establish the consortium are outlined below:
The first executive director, Dr. Albert Painter, was selected and started as the first member of the professional staff on January 1, 1996.
The GME consortium was initiated and the Operations Committee was established consisting of all program directors and directors of medical education from the member institutions on January 25, 1996. Dr. Albert Painter was selected to be the first chair of that committee and the Strategic Planning/Consortium Executive Committee. At the same meeting, the Operations Committee agreed to the establishment of work groups as the main vehicles for developing and defining the purpose, organization, and function of DAGMEC and to plan for future activities.
The following work groups were chartered by the Operations Committee on March 29, 1996:
Governance
Strategic Planning/Executive Committee
Primary Care and Ambulatory Care
Quality Assessment/Evaluation
Community Relations and Continuing Medical Education
Government Education Affairs/Relations
Academic and Curricular Planning
Research
Finance
During the late spring and early summer time period, the professional staff function added an administrative assistant for the coordination of work group meetings and a director of plans and programs. The director's position was added to assist in the completion of key plans and the Code of Regulations development and to provide project development/ implementation capability.
In the spring of 1997, the professional staff was re-organized and expanded to include an assistant program manager, as well as a full time administrative assistant for work group and professional staff office support. In addition, the consortium contracted with a CME consultant to assist the work group chair of the Community Relations and Continuing Medical Education (CME) Work Group with the development of an electronic web based CME calendar.
The first initiative of the professional staff function in 1996/97 was to assist the Governance Work Group in the development of DAGMEC's by-laws, later to be called Code of Regulations. The second major undertaking was the successful first resident rotation audit to demonstrate the consortium's ability to successfully collaborate on a project that would provide a return on investment for the member institutions. The third major initiative was the development of the consortium's Strategic and Business Plan.
The activities of the work groups and the professional staff for the first nine months of 1996 closed out with work group activity reports and a report to the Board of Trustees on November 18, 1996, as was originally planned when the work groups were established. Based on this report and a Business and Strategic Plan developed by the professional staff in conjunction with the DAGMEC work group structure, the Board of Trustees approved DAGMEC for three additional years of operation.
During 1997, the consortium's governance structure was finalized through a series of meetings between the Governance Work Group and the Strategic Planning Work Group. This effort culminated cooperative but difficult negotiations concerning the authority and composition of members of the Residency Operations Council Executive Committee. A balance of authority was achieved by providing more institutional representation on the Executive Committee and by leaving the Residency Operations Council dominated by program directors.
As 1997 came to a close, DAGMEC revised its Strategic and Business Plans. A key change was the inclusion of an information management strategy to guide future efforts to manage information and resident scheduling across the member institutions. Throughout 1998, work progressed with Information Engineering Corporation (IEC), which assisted in the development of the information strategy to implement a DAGMEC web site with a DAGMEC electronic continuing medical education calendar. These first efforts would form the foundation of the DAGMEC information network strategy called SHARE Net (Shared Hospital, Academic, Research and Education Network).
Grandview Hospital and Medical Center became a member on January 1, 1998.
A Code of Regulations was finalized in early 1998 that would guide the consortium's governance for the foreseeable future. The Code of Regulations is under legal review and coordination with an expected adoption date of November 1998.
At the beginning of 1999 the Grandview Hospital and Medical Center leadership made a decision that due to financial constraints their institution would withdraw from the Consortium.
In March 1999 DAGMEC embarked on a complete review of its strategic plan which culminated with the Broad of Trustees approving changes to DAGMEC’s mission, goals and objectives and the development of a vision, purpose and values statement.
In July 1999 the DAGMEC Board of Trustees approved the continued operation of the consortium for another three years.