UCSF Unveils Strategic Plan to Guide Its Global Leadership in Advancing Health

The University of California, San Francisco (UCSF) has finalized its first-ever campuswide strategic plan, a vision for the future with specific recommendations to guide its global leadership in health sciences.

The strategic plan - the product of a highly inclusive process - calls for making improvements across UCSF's fourfold mission of patient care, education, health sciences research and public service. It recommends building upon UCSF's strengths as a world-renowned academic health center in part by expanding opportunities for translational research, fostering patient-centered care, and advancing interdisciplinary collaboration and global health. The entire plan is posted here.

While pointing toward new directions to bolster UCSF's highly ranked academic and clinical enterprise, the plan does not drastically alter the University's future course or put it in uncharted territory. Rather, it defines an ambitious action plan that UCSF hopes to achieve in the years to come. For example, the plan recommends making substantial investments in UCSF's educational and clinical facilities and infrastructure, particularly by implementing modern information technology for administrative, academic and clinical purposes.

A substantial portion of the plan calls for promoting a more supportive work environment to help UCSF recruit and retain the best people. Another section expands upon UCSF's comprehensive initiative to promote and nurture diversity among faculty, staff and trainees. Importantly, the UCSF Strategic Plan boldly states the University's mission - advancing health worldwide™ - and articulates the collective vision of its many constituencies to guide the University's direction over the next two decades.

UCSF's vision is to:

• Be a world leader in scientific discovery and its translation into improved health;
• Develop the world's future leaders in health care delivery, research and education;
• Deliver the highest-quality, patient-centered care;
• Develop innovative, collaborative approaches for education, health care and research that span disciplines within and across the health sciences;
• Build upon its commitment to diversity;
• Provide a supportive work environment to recruit and retain the best people and position UCSF for the future; and
• Serve the local, regional and global communities and eliminate health disparities.

The strategic planning process began in July 2005, when Chancellor Mike Bishop, MD, appointed a 41-member Strategic Planning Board comprised of faculty, staff, students, residents, fellows and post-doctoral scholars to oversee the creation of the strategic plan. The goals for the plan were twofold: first, to develop a comprehensive, integrated strategic plan based on academic priorities; and second, to collaboratively engage the UCSF community in the process.

In the next few months, the University will begin managing the priorities for 2007-08 by establishing oversight responsibility for each strategy and creating mechanisms to monitor, measure and report results. UCSF will regularly communicate news and information about the plan to ensure that the campus and community at large are informed about the plan and progress. Calling the plan a "very special achievement" during a reception on June 21, Chancellor Bishop thanked those who contributed to it. "This is the largest and most rigorous strategic planning process in the history of UCSF and probably the University of California. The process was remarkably inclusive."

Engaging the Community

The Strategic Planning Board was co-chaired by Executive Vice Chancellor and Provost Eugene Washington, MD, and Elizabeth Blackburn, PhD, Morris Herzstein Endowed Chair in Biology and Physiology in the Department of Biochemistry and Biophysics.

The board consulted with AMC Strategies, LLC, a firm specializing in strategic planning for academic health centers that was retained in December 2005. Board members included representatives from the schools of dentistry, medicine, nursing and pharmacy, Graduate Division, Academic Senate, campus administration and UCSF Medical Center. Additional assistance came from the UCSF Foundation through its Strategic Planning Committee, the Chancellor's University-Community Partnerships Council and the Community Advisory Group.

Members of the campus community at large participated in focus groups, in-depth interviews, several town hall meetings and a campuswide survey. In that survey, 2,092 respondents gave their opinions on the key issues to be considered in developing the plan.

"The strategic plan has been an exceptional accomplishment, not only because of the exciting vision it lays out for the campus, but also because of the process itself," says Charles Bertolami, DDS, dean of the UCSF School of Dentistry. "It engaged literally everyone at every level of the organization, which was crucial because I believe that we are now poised to move forward in some new and exciting ways. I believe UCSF has already begun to be energized by the strategic initiative and I fully expect it will continue to be."

UCSF also conducted a thorough environmental assessment of national research funding trends, an analysis of key educational factors and clinical services benchmarks, such as patient volume and quality data, as well as an extensive analysis of campus resources, such as UCSF's campus population, finances, facilities and infrastructure. The data collected and reported in the July 2006 environmental assessment report represent one of the most complete pictures of the state of UCSF. At a Strategic Planning Board retreat in July 2006, the board reviewed and discussed the results from the environmental assessment and began constructing the framework for the strategic plan. The board began brainstorming the UCSF mission, vision, values and goals - work that continued over several months. After significant deliberations, the board adopted advancing health worldwide™ as the UCSF mission statement, and building upon this mission, a formal vision with strategies began to emerge.

"The plan provides a careful analysis and vision for all of the key activities of the campus," says Nancy Adler, PhD, director of the Center for Health and Community. "It is exciting to rise above the day-to-day issues to lay out our goals and develop a plan for how to achieve them. It was an inclusive process with ample opportunities for everyone's voice to be heard. The process itself was community-building."

Identifying Strategies

In October 2006, six strategy design teams with about 40 representative stakeholders per team were tasked with developing specific recommendations to realize UCSF's vision. The teams completed their work in March identifying 42 strategies. The strategies run the gamut from exerting UCSF's leadership to achieve universal health care coverage for the people of California and the nation to forming more strategic alliances with UC Berkeley and other UC campuses, universities, private industry and partners around the world.

"This plan gives us a roadmap for the next decade at UCSF," says Kathy Dracup, RN, FNP, DNSc, dean of the UCSF School of Nursing. "As a health sciences campus, UCSF is unique among the UC campuses. Much of our growth has been the result of the amazing developments in health care and health care-related science in this country over the past four decades. The plan provides important direction for us as we continue to grow and expand our efforts to improve people's health."

The strategic plan will help guide decisions at UCSF, which faces critical challenges such as coping with decreasing state financial support, responding to dramatic advances in science, medicine and technology, and preparing for an anticipated surge in professional school enrollment to address major shortages of physicians, nurses and pharmacists in California. UCSF also must prioritize investments at its major campus locations. UCSF currently has more than $900 million in requests for fundraising support. The strategic plan calls for building a medical center at Mission Bay to meet growing patient demand, ensuring that San Francisco General Hospital continues to function as a major UCSF research site, and investing in programs and capital projects at Parnassus and Mount Zion.

Major strategies in the plan include:

• Developing centers for future health sciences to house multidisciplinary research programs dedicated to discovering new solutions to prevent human suffering;
• Providing campus core research facilities that offer advanced, innovative instrumentation and specialized services needed by a broad spectrum of the research community;
• Addressing patient care capacity, such as building a new medical center at Mission Bay, to meet immediate and long-term needs of the clinical enterprise;
• Ensuring that students and trainees are immersed in a culture that embraces interdisciplinary, interprofessional and transdisciplinary educational programs;
• Promoting a more supportive work environment in part by ensuring that professional development and career advancement opportunities are available to all;
• Creating a more effective governance structure in part by making organizational changes to support the overall strategic direction for UCSF; and
• Collaborating with global partners to eliminate major health disparities and reduce the burden of disease on the world's most vulnerable populations.

Building on Strengths

The plan proposes numerous proactive measures to advance UCSF's remarkable record of biomedical achievements.

UCSF has developed powerful, internationally recognized basic science and clinical research programs that target multiple diseases - neurological disorders, cardiovascular disease, cancer, immunological and infectious disease, genetic disorders and regeneration medicine, to name a few.

"These basic and clinical research efforts could transform prospects to prevent, treat and cure many chronic disabling diseases," the plan states. "UCSF is uniquely poised to build upon these existing strengths to develop translational approaches with the potential for application in the diagnosis and management of the most important diseases of our time."

To promote cohesion between basic and translational scientists, the plan calls for developing centers for the future of health sciences to house multidisciplinary research programs dedicated to discovering new solutions to prevent maladies and prevent human suffering. Drawing on the findings from the UCSF Global Health Sciences strategic plan, the campuswide plan also recommends integrating UCSF's expertise in biological, population, social/behavioral and clinical sciences, in collaboration with global partners, to eliminate major health disparities and reduce the burden of disease on the world's most vulnerable populations. The plan also calls for developing a new generation of global health leaders capable of transcending cultures, borders and disciplines to find creative solutions to global health problems.

The strategic plan also calls for promoting civic engagement in all facets of UCSF activities to strengthen partnerships between the campus and the community. For example, the plan recommends continuing to develop the recently created UCSF University-Community Partnerships Program, enhancing opportunities for the local community to provide meaningful input into UCSF affairs and planning and strengthening partnerships with schools and colleges to enrich educational programs in those institutions, particularly for students from disadvantaged backgrounds.

"What excites me most about our plan is the impact it will have on the public we serve," says Mary Anne Koda-Kimble, PharmD, dean of the UCSF School of Pharmacy. "We already improve the lives of our neighbors here in San Francisco and our neighbors around the globe. We now have a plan to increase our efficiency, leverage our resources and work across the institution to ramp up our impact. I can't think of a more exciting time to be here. We are at the dawn of interdisciplinary education, translational research and true campus collaboration."

To realize the strategy to become a world leader in scientific discovery and its translation into exemplary health, the plan calls for enhancing UCSF research across multiple sites. This goal was previously articulated in a planning process a couple of years ago that advocated ongoing investment at UCSF's Parnassus, Mission Bay and Mount Zion campuses. But the strategic plan expands on that concept by specifically stating a strategy to ensure that San Francisco General Hospital (SFGH) continues to function as a major UCSF research site. The plan recommends that UCSF focus these efforts on major disease areas that are current SFGH strengths, including health care disparities, HIV/AIDS, bioterrorism and mass casualties and reproductive health.

"I am enormously pleased to hear that San Francisco General Hospital figures prominently in the strategic plan," says Sue Carlisle, MD, PhD, associate dean of the UCSF School of Medicine, who is based at SFGH. "It's a real recognition of the amount and quality of work we do at SFGH."

Another strategy is to expand and enhance technology transfer, the mechanism to transfer discoveries and inventions for public use and benefit. UCSF leads the UC system with the highest number of patents, including the first patent for a method of delivering normal genes in a pill to induce the production of insulin in people with diabetes. The plan recommends advancing new and existing discoveries to a commercial proof-of-concept level, identifying what the industry needs and helping UCSF researchers to meet those needs.

Addressing Weaknesses

In some ways, the plan is a public declaration of UCSF's shortcomings, shedding light on its weaknesses across the University. The candid, constructive criticism aims to focus attention and action to improve UCSF as an employer, public research university, major health care provider and member of the world community. For example, the plan clearly states that "UCSF, as a great university, needs state-of-the-art facilities to incorporate new tools and technologies for educating future health professionals and scientists."

The plan recommends building a new learning center to house flexible and technologically advanced health education facilities promoting active, immersive and team-based learning, an idea proposed by David Irby, PhD, vice dean of medical education in the UCSF School of Medicine. Despite opening new facilities at UCSF Mission Bay, the University still lacks classroom space, particularly at Parnassus Heights, where most of the teaching is conducted. Proposed enrollment projections for the professional schools will create additional shortages.

The plan also calls for making campus core research facilities, which offer advanced, innovative instrumentation and/or specialized services, available to the entire UCSF research community. Currently, core research facilities are developed ad hoc by departments, organized research units and clusters of investigators. Some core facilities lack coordination, resulting in overlapping services and competition, an insufficient user base and poor administrative practices. Others lack resources to update instruments or resources for staff to develop new technological skills. By building new core facilities, researchers from throughout the University can benefit by sharing the tools and technology they need, such as imaging, data management, mass spectrometry and molecular diagnostics.

The plan also recommends ensuring that all clinical services operate with a patient-centered focus. For example, the plan recommends improving patient services, in part by setting formal institutional standards that define clinical obligations, such as timely availability of clinic staff to answer patient questions, allowing for flexible clinic hours, perhaps on nights and weekends, and developing information systems that allow patients to access test results or pay bills online.

It also recommends that the medical center and clinical departments share responsibility and accountability for evidence-based quality and safety initiatives. "There was an overwhelming consensus by all campus constituencies that timely, expert, safe and compassionate patient care is one of our highest, immediate priorities," says Peter Carroll, MD, professor and chair of the Department of Urology. "This plan outlines a clear path to achieve these goals."

Mark Laret, chief executive officer of UCSF Medical Center, who served on the Strategic Planning Board, has worked toward improving patient satisfaction since he first arrived at UCSF in April 2000. He has made improving the quality and safety of patient care a top priority, in part by expanding and modernizing the medical center's facilities and equipment, including investing in electronic medical record systems to improve patient safety. Earlier this year, UCSF Medical Center received a full, three-year accreditation by the Joint Commission on Accreditation of Healthcare Organizations. Laret acknowledges that hospitals and health care providers are experiencing a new era of accountability and transparency, especially as report cards for performance and patient satisfaction proliferate.

"Expectations of us are higher than ever," Laret says. "We are going to need to look deep inside ourselves and our organization to understand what it is going to take to succeed in this new era, because it is different than what it took for us to succeed in the previous era. The strategic plan offers us a guide on how we can continue to improve our operations to better meet the needs of our patients."

The plan also identifies a shift toward new business practices, calling for increased accountability, efficiency and transparency for planning, budgeting and allocating resources. The plan recommends distributing to the UCSF community an annual campus budget plan that reports more clearly revenue sources, funds earmarked for discretionary uses and budget allocation.

"While UCSF's decentralized resource planning and allocation processes have served it well in the past, they need to be improved to better address the issues, demands and complexities posed not only by the new strategic plan, but by UCSF's substantial and ongoing building program and by its clinical enterprise expansion," says Steve Barclay, senior vice chancellor for Administration and Finance. "The campus will soon issue a [request for proposals] to solicit consultant expertise to help it revamp these processes and to institute modified and/or new best practices approaches to better serve UCSF as it strives to most efficiently achieve its mission of advancing health worldwide."

Creating a Supportive Work Environment

The bulk of the strategic plan places great emphasis on creating a more supportive work environment for employees.

The concept, originally championed at UCSF years ago, had lost some momentum in recent years, but makes a strong comeback in the strategic plan. In fact, the strategy to promote a supportive work environment lists 18 specific recommendations, some of which address quality-of-life issues, such as the rising costs of education, child care and housing.

"UCSF is facing a potential crisis with regard to the high cost of living in the Bay Area," the plan states. "A concern at UCSF is that many here have found their needs for more domestic space have grown while their incomes have been unable to keep pace with rising rents and sales prices. UCSF is also having difficulty attracting new recruits and applicants because of the widely known high cost of living in the Bay Area."

One recommendation is to provide more attractive and competitive compensation packages for employees, offering salaries that are competitive with institutions in comparable high-cost markets. Other recommendations are to establish a UCSF housing program to develop more affordable, family-sized rentals and single family housing units for purchase by and sale within the UCSF community. The plan also recommends making organizational changes as necessary to promote and support an overall strategic direction for UCSF, grooming and promoting the next generation of UCSF leadership and ensuring that professional development and career advancement opportunities are transparent and available to all. The plan also recommends implementing a review process for senior leadership, which includes reviewing and reporting on achievement toward annual goals, performance expectations and accomplishments.

Jeffrey Bluestone, PhD, director of the UCSF Diabetes Center, co-led the team that looked at UCSF's governance structure and leadership. "The team did an exceedingly good job at identifying the areas where we can improve accountability and transparency, which are critical to any organization and to the success of senior leadership," Bluestone says.

Implementing the Plan

Some members of the Strategic Planning Board, who have since been reappointed to oversee implementation of the plan, will discuss the plan in detail at upcoming town hall meetings on UCSF's major campuses and in the community beginning this fall.

UCSF Public Affairs is implementing a comprehensive communications campaign to articulate the University's mission, vision and future priorities to ensure that internal and external audiences are well informed about the strategic plan. News and information will regularly appear on UCSF Today and the UCSF Strategic Plan website, where members of the campus and community can ask questions and offer feedback. In addition, the dean of each school and the Graduate Division will work to develop an academic vision to fit within the framework of the UCSF Strategic Plan in the months ahead.

"Now we begin the real work of keeping the plan alive," Koda-Kimble says. "If each of us takes responsibility for moving along those pieces of the strategic plan we own, we will become a stronger institution."

For David Gardner, MD, incoming chair of the UCSF Academic Senate, the plan represents a historic opportunity for UCSF. "This is the first time in the more than 25 years I have spent on this campus that something like this has been undertaken," Gardner says. "It will take money and a commitment to shift away from our individual parochial interests and focus on changes that will benefit the campus as a whole."

Adds Chancellor Bishop: "We look forward to working with everyone in our community to realize the shared vision and aspirations delineated in this plan - not just for UCSF, but for the benefit of all."

To foster ongoing dialogue about the plan, UCSF representatives will respond to email inquiries and input sent to Lisa Cisneros, strategic plan communications coordinator.

Related Links: advancing health worldwide™: A Strategic Plan for University of California, San Francisco advancing health worldwide™ website