Healthcare organizations, and Academic Institutions alike, that support Graduate Medical Education, must remain committed to a culture of lifelong learning and continuous improvement if they wish to consistently realize the maximum level of value from their programs.

Though the landscape around GME may always be changing, the sponsoring organizations ability to sustain a high level of attention and purpose, regarding medical education, ensures that the entire scope of the administrative and operational processes necessary to support a quality GME experience are being regularly reviewed and refined to maintain optimal efficiency. When programs become operationally inefficient, the resulting educational and financial impact oftentimes is widespread.

Our team at Germane Solutions regularly supports our clients in the review, development, and improvement of their operational processes and supporting framework. Our primary goal is to create mechanisms that best align and satisfy the needs of both GME programs and clinical environments that they train within.

Though each of our clients are unique when it comes to their respective sizes, scope of services, and strategic interests, our operations experts work collaboratively with their key stakeholders to help architect new and improved systems and supporting processes that effectively streamline operational work steps, improve clinical training efficiencies, reduces administrative burden, and promotes an environment where more program and departmental leadership time from can be focused on improving the quality of its educational opportunities that are being delivered to its learners.

GME Evaluation, Quality Assessments & Annual Performance Dashboards

Whether you are a new institution looking for ways to set-up your program oversight process or an existing institution wondering if you’re effectively managing program quality, Germane Solutions’ Operations service line has solutions for you. Through our propriety performance insights, we support any institution in identifying the most appropriate metrics and key performance indicators for assessing anything from program value, operational efficiency, to ACGME Compliance and Accreditation Risk. As a result, our Annual Performance Dashboards can expedite the ACGME-required Annual Program Evaluation, Annual Institutional Review, Self-Studies, and 10-Year Accreditation Visit preparation.

Program Sizing and Structure Development

We partner with Institutional and Program leaders to appropriately right-size programs through either FTE growth or redistribution with the intent of adjusting the GME Footprint to align more solidly with the strategic goals and objectives of the system. By doing so, GME programs become more focused on the educational objectives of their learners and the system more capable of offering positions to graduates who wish to stay.

Clinical Training Model Design and Analyses

We partner with either programs, institutions, or both to create residency and fellowship training models that most effectively leverage resources to cover services, and/or increase protected time for academic, research, and educational pursuits while reducing overcrowding in key learning environments such as the Intensive Care Unit, Emergency Department or Neurology Service. We also provide support to developing a sustainable and robust interdisciplinary learning environment; helping academic partners expand patient care teaching teams to include multiple disciplines including but not limited to nursing, pharmacy, physician’s assistants, and social/case workers.

Infrastructure Development

Our team of leading experts in the field of GME partner with your GME leadership to assess the organizational hierarchy, structure, and resources available for program and institutional oversight. We work within the system to streamline processes and maximize available resources such as MedHub or New Innovations to create a natural flow for work productivity—from the Coordinator level to the GMEC. This development thus assists in alleviating administrative burdens created from additional ACGME oversight requirements while adding value to additional data captured through existing systems.

Residency/Fellowship Marketing and Recruitment

Residency/Fellowship Marketing and Recruitment is a practice that evolves year-over-year. More and more, applicants are reliant upon programs’ digital presence maintained on websites and social media to determine whether they wish to join your program. With a finger on the national pulse of medical student graduates as well as awareness for key features that attract top talent, Germane Solutions partners with your programs, institution, and marketing department(s) to develop an online presence truly reflective of your offerings and attractive to the candidates you hope to train.

Training Opportunities

In addition to the above offerings, our Operations service line is ready and willing to provide training courses for all levels of your GME support community, from Designated Institutional Official (DIO), Administrative Director of Graduate Medical Education, Financial Coordinator, Institutional Review and Program Coordinator/Managers, to Clerkship and Sub-Internship Coordinators.

These case studies provide insight to how we put these offerings together to create value for you.

Operations Case Study: Are We Leveraging GME for Maximum Productivity and Educational Value?

An organization is currently operating over its CMS GME cap allotment, but leadership wishes to avoid closing any of its programs. They sponsor four programs that are a mix of residencies and fellowships. All programs were successful in both recruitment, retention, and graduate outcomes as well as productive clinically in both the inpatient and ambulatory settings.

The Challenge:

Effectively right size the clients GME footprint by reducing as many unfunded resident FTEs as possible without closing any of the programs or impacting key inpatient services that the programs support. Germane will be challenged with measuring resident training costs compared to the funding received by CMS. As leadership does not wish to close any programs, reducing resident FTE will be crucial for the organization to utilize the whole of their CMS Cap.

The Solution:

Through Germane’s GME Evaluation and Program Quality Assessments, Program Value, ACGME Compliance, and an Operational Efficiency Analyses makes crucial information more visible for the organization. For example, Program Value determined both operational and strategic value of each sponsored GME program. ACGME Compliance gave clarity around the educational rationale of provided rotational experiences. The Operational Efficiency Analyses analytically reviewed how each GME program’s resident resources were being deployed throughout the health system at any given time. Once it was determined which GME programs would be affected by this possible reduction in resident resources, new resident rotation modeling was required to verify that resident staffing levels across key services would not be impacted, and that residents would still be able to satisfy ACGME requirements prior to graduation. Lastly, the GME Economic Impact Assessment quantified the resulting economic impact to the organization due to of the reduction of the resident FTE.

The Outcome:

The organization is saving $540,000 per year in perpetuity; creating a long-term sustainable GME Footprint, while all 4 GME programs remained open. The main primary care residency transferred to a new clinical training model that is predictive and well-leveraged to mitigate unintended consequences from reduction. The resident complement was reduced by five FTEs, allowing Hospital to run closer to their CMS Cap. All inpatient and ambulatory services remained fully staffed without work compression or work-life balance issues with all ACGME requirements remaining substantially satisfied.

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