Culture Transformation Initiative (CTI) Moving Forward with Advances in Key Areas

Dr. Nancy Lowitt Takes the Lead in Planning and Implementation; Rapid Progress Reported on Several Fronts

The University of Maryland School of Medicine’s Culture Transformation Initiative (CTI) is fully launched by Dean E. Albert Reece and Associate Dean Nancy Lowitt, MD, EdM.  

Following a series of listening sessions and town hall meetings with students, faculty and staff, there are reports from individuals and groups across the UMSOM that awareness of culture issues has increased markedly, and that change is beginning to take place.

“We are moving forward judiciously on a long-range plan that will fundamentally change the culture of the UMSOM in very substantive and meaningful ways,” said Dean Reece.

“I have appointed Dr. Lowitt, who is currently the Associate Dean of Faculty Affairs and Professional Development, to take the lead in working to address the serious concerns that have been raised, while rapidly rolling out a plan that will have both immediate and permanent impact on policies, accountability and our overall organizational culture.”

“We are excited that many of the ideas that we heard from our multiple listening sessions and town hall meetings are now being implemented as part of our larger plan for this initiative,” said Dr. Lowitt. “At the same time, we need to keep the channels open for continuous feedback and improvement and ensure that every voice is heard."

Reports from faculty across the UMSOM indicate that culture issues have become front and center, and that there is awareness that things are beginning to change.

“Certainly, there is heightened awareness of the importance of these issues,” said James Kaper, PhD, Professor and Chair of the Department of Microbiology & Immunology and Vice Dean for Academic Affairs, “Members of our community see that there is an understanding of the imperative to make substantive changes.”

ACTIONS ALREADY INITIATED

Dr. Lowitt pointed out that the UMSOM must ensure that there is diverse, effective and accountable leadership across the organization. She cited actions already initiated to build a broad leadership structure that will guide the CTI moving forward and ensure that leadership is committed to reducing and eliminating harassment, discrimination and retaliation.

• Dean Reece announced a major management re-organization with several women promoted to executive leadership positions at the UMSOM, including Louisa Peartree to Senior Associate Dean and Chief Operating Officer; Donna Parker, MD, to Senior Associate Dean for Undergraduate Medical Education; Sandra Quezada, MD, to Associate Dean for Medical School Admissions; Mary Pooton to Assistant Dean for Development; Elizabeth Lamos, MD, to Assistant Dean for Student Affairs; and Nancy Lowitt, MD, EdM now appointed as Associate Dean and Director of the Culture Transformation Initiative. In addition, James Kaper, PhD, has been promoted to Vice Dean for Academic Affairs. With these promotions and appointment changes, the Dean’s Senior Cabinet is now comprised of 40 percent women.

Dean Reece announced a major management re-organization with several women promoted to executive leadership positions at the UMSOM.

• The Department of Surgery announced that Sheri Slezak, MD, Professor of Surgery and Division Head of Plastic Surgery, has recently been promoted to Vice Chair for Faculty Affairs in the Department. She is charged specifically with focusing on the culture transformation in the department, and is working closely with Dr. Lowitt to address action items identified in various meetings with her colleagues.
  
  Dr. Slezak noted that the Culture Transformation Initiative has already energized existing programs and has re-started women’s groups that had been dormant for several years. “There is tremendous interest in these issues, particularly among our students and residents,” she said, pointing out that 50 percent of the Surgery residents are now women.

• National searches are underway for two chair positions. Dean Reece has reported widespread interest from across the country for the permanent chair of the Department of Surgery. The search firm (Witt Kiefer) has indicated that there have been more than 70 candidates have been nominated for the position. Review and vetting are also underway for the new Chair of Physical Therapy & Rehabilitation Science.
• This month continues leadership training across UMSOM and UMMC for the culture initiatives. This training for faculty physicians focuses specifically on ensuring consistent systems and policies for reporting and reviewing unprofessional behaviors. Led by Anthony Lehman, MD, Senior Associate Dean for Clinical Affairs, and Robert Ferguson, MD, Director of the UMSOM Professional Enhancement Initiative, the training has now been completed by 90 percent of the faculty physicians.
• A Dean’s Culture Transformation Advisory Committee (CTAC) is being finalized and will be announced soon. Additional committees reporting to the Dean’s Office include:
  
  
  • Hot Spots and Immediate Response Committee to address immediate concerns and issues related to diversity and workplace behavior;
  • Policy Development Committee to draft formal workplace behavior policy;
  • Communications Committee to develop the messaging and communications policy for UMSOM’s Culture Transformation Initiative.
• University of Maryland Medical Center/UMSOM Just Culture Committee, is in place to collaborate on CTI initiatives. UMMC’s “Just Culture” Initiative is a metrics-based approach to balance organizational and individual accountability while maintaining a continuous learning environment. The initiative includes mandatory intensive training at all levels of the institution’s leadership with specific algorithms in place to measure effectiveness.
• Dr. Lowitt has formed a CTI Steering Committee which will help guide and implement the CTI plan. This group will oversee several sub-committees and will work closely with Dr. Lowitt to address issues such as diversity policy, workplace culture in clinical and laboratory settings, medical student initiatives, reporting, and communications. Other committees include the following with additional committees of faculty and staff being reviewed:
  
  
  • Chair’s Dashboard Committee is introducing a new “Diversity Dashboard” to UMSOM senior leadership. This will serve as a tool to view faculty data by gender, ethnicity and rank, by department, and aggregated. The dashboard will allow Department Chairs to view their data, reflect on the patterns they may see, and to set goals for increasing diversity at higher ranks in their departments.
  • Clinical Workplace/Clinical Learning Committee is developing education programs suited for clinicians. This Committee will bring together colleagues from Nursing, Hospital Medicine, Medical Student Education, GME, Surgery and Anesthesiology, to focus specifically on the dynamic and changing clinical environments and the workplace cultures that define them.
  • Medical Student Initiatives Committee will continue to meet with individual students and groups of students and has already identified curricular initiatives to develop and implement this year.  Among them is a plan to implement "bystander training" for students and faculty to provide knowledge and skill development in situations where one observes behavior that is disrespectful or unprofessional.
• Dean Reece has appointed an additional committee co-chaired by Jim Kaper, PhD and Mary-Claire Roghmann, MD, MS, to analyze our promotions data and to make recommendations to the CTAC regarding strategies for improving promotion rates for women and underrepresented minority faculty. The committee will work closely with the Office of Research Career Development, led by Associate Dean Wendy Sanders, MA, to support the new Scientific Leadership & Professional Development Program of Faculty, With Special Emphasis on Women and Under-Represented Minorites.
• A confidential email account has been established, TransformMed@som.umaryland.edu to send suggestions, questions, concerns, or feedback to our senior leadership team. This email box is monitored daily by Dr. Lowitt and contributions are brought forward to the Dean or to members of the Dean’s cabinet as appropriate. The email box is actively being used, Dr. Lowitt reports.

OPPORTUNITIES FOR THE UMSOM COMMUNITY TO ENGAGE

A recent meeting of Women in Medicine and Science

Dr. Lowitt referenced several initiatives underway, both to increase diversity throughout the UMSOM as well as to provide a growing number of opportunities for students, faculty and staff to continue the conversation, engage in culture issues, and allow every voice to be heard.

• A series of new workshops, seminars and informal gatherings are being formed (or are continuing) where information can be shared and learned in safe environments.
  
  
  • The UM SOM Women in Medicine and Science group for SOM Women Faculty is being formed with support from the Culture Transformation Initiative and the Office of the Dean. According to Dr. Lowitt, the group’s first professional development panel discussion on January 9^th was a resounding success, with a standing room only audience of more than 150 women attendees and lively participation. An organization meeting for this group will be held on February 13^th at 4 pm in Leadership Hall, and the meeting will be live-streamed for those who cannot attend.
• Departmental initiatives around culture issues are being organized.
  
  
  • The Shock Trauma Center has developed a monthly “Citizenship Program” that will focus on important culture issues, including Title IX reporting;
  • The Department of Surgery initiated a special session on defining appropriate language in interactions with residents and other faculty;
  • A Women in Surgery group, led by Dr. Slezak, is now meeting quarterly for networking and information sharing breakfasts. The group may expand to other departments as well. Kimberly Lumpkins, MD, Assistant Professor of Surgery and Associate Program Director of the General Surgery Residency Program, is leading a new group of women Surgery residents;
  • Faculty development and leadership programs for women are now being offered in the Departments of Anesthesiology, Neurology and Pediatrics;
  • A CTI Innovations Forum will be scheduled for these faculty to share ideas, curricula, outcomes, and provide mentorship for sharing and publishing these programs.

INITIATIVES TO IMPROVE TRANSPARENCY AND ACCOUNTABILITY

According to Senior Associate Dean Donna Parker, MD, the issue of transparency is the area most referenced by students. Dean Reece and Dr. Lowitt indicated that some immediate actions are being taken in order for the UMSOM to improve in these areas:

• New work behavior policies for UMSOM are being finalized in coordination with the University of Maryland Medical Center (UMMC) and the University System of Maryland (USM). These policies will address professional behavior expectations and policies related to relationships between superiors and subordinates. The policies will clarify acceptable and unacceptable behaviors for faculty that are consistent with policies for staff, trainees and students.
  
  “These polices are intended to ensure that there is a safe and respectful work environment across the campus and that there will be consequences for those who do not follow the policy,” said Dr. Lowitt. “We want to offer a number of options for members of the community to report a concern, individually or in a group, anonymously or confidentially or with attribution. We are committed to thorough investigations and to transparency in our processes.”
  
  She encouraged individuals to contact her directly with any questions about reporting vehicles and feedback options at her email address, nlowitt@som.umaryland.
• The UMMSafe reporting system at the UMMC, which allows for confidential reporting of errors and unprofessional behaviors at the UMMC, is now actively being used. The “Just Culture” Initiative at UMMC provides clear guidelines for how these reports will be addressed, including follow up procedures. This online reporting system is linked to the UMMC Professional Enhancement Initiative, which focuses on achieving rapid follow-up of reported professionalism concerns, providing easy, confidential and safe online reporting of any incidents of professional misconduct.
• CTI team members will continue to promote the resources available at the University of Maryland Baltimore’s (UMB) Title IX Office. According to Ms. Mikhel Kushner JD, Executive Director of Diversity and Inclusion in the UMB Office of Accountability and Compliance, every Title IX complaint filed with her office is investigated thoroughly.
• The UMSOM will provide regular updates on CTI progress, including monthly features in SOM News and reports on the UM SOM website. The shorthand tag #TransformMed will be used across communications platforms to identify content related to the initiative.

Communications will continue to be a critical component for the CTI, said Dean Reece. “We are not only committed to keeping the strong momentum of this initiative going forward, we are committed to keeping everyone up to date on our progress in each of these areas. Providing transparency, through new programs like the Diversity Dashboard, and the CTI website, as well as through the various committees and listening sessions, will continue to enable all members of our community to stay informed and engaged in the changes that are being made.”

About the University of Maryland School of Medicine

Now in its third century, the University of Maryland School of Medicine was chartered in 1807 as the first public medical school in the United States. It continues today as one of the fastest growing, top-tier biomedical research enterprises in the world -- with 43 academic departments, centers, institutes, and programs; and a faculty of more than 3,000 physicians, scientists, and allied health professionals, including members of the National Academy of Medicine and the National Academy of Sciences, and a distinguished recipient of the Albert E. Lasker Award in Medical Research.  With an operating budget of more than $1 billion, the School of Medicine works closely in partnership with the University of Maryland Medical Center and Medical System to provide research-intensive, academic and clinically-based care for more than 1.2 million patients each year. The School has over 2,500 students, residents, and fellows, and more than $530 million in extramural funding, with most of its academic departments highly ranked among all medical schools in the nation in research funding. As one of the seven professional schools that make up the University of Maryland, Baltimore campus, the School of Medicine has a total workforce of nearly 7,000 individuals. The combined School and Medical System (“University of Maryland Medicine”) has an annual budget of nearly $6 billion and an economic impact more than $15 billion on the state and local community. The School of Medicine faculty, which ranks as the 8^th highest among public medical schools in research productivity, is an innovator in translational medicine, with 600 active patents and 24 start-up companies. The School works locally, nationally, and globally, with research and treatment facilities in 36 countries around the world. Visit medschool.umaryland.edu/