Duke University Hospital Experiential Learning Practicum: New Perspectives on Primary Care

Jessica DennisBefore coming to Fuqua, I worked as a strategy and operations consultant and advised pharma and payer companies. My interactions with healthcare industry clients inspired me to pursue the Health Sector Management (HSM) Certificate at Fuqua, but after just a few days at HSM Bootcamp, I realized how little I knew about the drivers of the industry.

The Duke Hospital Experiential Learning Practicum (DUH ELP) gave me the opportunity to learn more about the care delivery side of healthcare. Throughout the semester I worked on a project for Duke Primary Care (DPC), a network of roughly 40 offices encompassing primary care, urgent care, and pediatrics. The DPC Chief Operating Officer oversaw my project and included me in DPC’s Performance Improvement group meetings.

In the past few years, the introduction of new technology as well as the need for more streamlined and coordinated care has helped DPC become more efficient but also challenged employees at each practice to take on new responsibilities. The lines between clinical, clerical, and administrative tasks have become increasingly blurred as employees are required to interact with both the patient and the patient’s electronic medical record. My project for the semester was to support DPC in its effort to clarify roles and responsibilities for key managerial positions at the primary care practices.

Each practice relies on a team of health care administrators, practice medical directors, and nurse managers to manage patient flow and clinical operations. I surveyed and interviewed each of these groups to understand the current state of their leadership responsibilities as well as their perspectives on an ideal future state. The final product was a matrix view of roles and responsibilities that each practice could use as a reference for decision-making and delegation.

In addition to working with DPC, I also had the privilege of shadowing three different leaders within Duke University Hospital. I shadowed the Vice President of Emergency Services and learned about hospital’s training and preparation for potential Ebola patients. I spent a half day with the Chief Operating Officer of the Patient Revenue Management Organization understanding the impacts of the Affordable Care Act on Duke and other large hospitals throughout the state. Finally, I met several members of Duke’s Center for Community Health, a unique group that works to improve access and affordability of healthcare services in several North Carolina counties.

The most important lesson I learned from this experience goes far beyond the trends, frameworks, and statistics of the provider setting; instead, I learned to appreciate the complexities of a large healthcare system. Within the sector, within each system and even within departments of the same system, leaders constantly face competing demands, conflicting interests, and gray areas, but all are seeking the same objective: delivering the best possible care to patients. Advances in technology, policy, and innovation support that objective, but they also introduce new challenges to the system. Addressing those challenges will be complex, but the DUH ELP is one of many HSM experiences that prepares my classmates and me to continue onward with our main objective: pushing the limits of our abilities to positively impact the healthcare industry.