From the December 2013 issue of DOTmed HealthCare Business News magazine
When Christopher Kane joined UC San Diego Medical Center in 2006, the hospital didn’t have a urology program.
Seven years later, it’s one of the top ranked urology programs in the country. Kane spoke with DOTmed Business News about how that evolution came about and offered advice for others looking to do the same.
DMBN: Tell me a little about yourself. How did you get to where you are today?
I’m a Californian. I grew up in the San Francisco Bay Area, went to UC Davis as an undergrad and got an engineering degree. I came back to San Francisco to run a cancer fellowship program at UCSF, and helped run the residency program, and ultimately, was vice chair of the urology department at UCSF. Next, I had the chance to come to San Diego, which was a very different environment. UC San Diego had a a great scientific university, a great scientific medical school, but it’s fairly young, and didn’t have a large clinical enterprise comparatively speaking. So I was brought here really to help grow and develop the urology program.
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DMBN: What went into building the urology department at UCSD?
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First you have to find who you are today. I think one of the important things that we did, even when I was interviewing, was try to understand what our strengths were. We had some great young faculty. We had some senior urologists who really had done some impressive things in their careers. And we had a great scientific background at the university, and a growing enterprise in general with a relatively new cancer center. And then, I compared where UCSD was in 2006 with where the top programs in the country were, and tried to understand the difference — what made a great program a great program, when compared to a smaller program like UCSD. Then we just put together a systematic plan of how to build those elements and which are the most important to build first. We just had to grow expertise and clinical volume, and add faculty, and build relationships with our scientists to try and improve the scientific quality of the program. There were a number of elements to that, so it doesn’t all happen overnight, and it doesn’t happen without institutional support.
DMBN: What is one challenge you’ve had to deal with in building the program?
I think one of the most challenging things to do for any leader is to understand when a program has serious weaknesses, and that involves people, of course. How do we manage improvement that really depends on the will and change of others? I think that’s really the challenge, getting alignment with the people who work with you and getting their help when change is needed. That sounds easy, but it can be very threatening to the people who you’re asking to change. Sometimes, people will choose to leave the organization, and that’s always difficult to try to understand when people aren’t the right fit. Then the other part of that is recruiting, and bringing in talent, trying to choose that right person, whether it’s a young faculty member, or a mid-career faculty member, trying to choose the right resident or fellow, or the right staff member to help the faculty member. If you don’t get the right people engaged in your team it can be a real challenge.
DMBN: How has health care reform impacted your hospital?
CK: What I try and take away from it is some of the big themes. For instance, one would be that we have to deliver greater value. It’s easy to throw around these terms, but it’s more challenging to put very concrete goals on it. I think one of the things we’re really trying to do is to be very conscience of the safety of our interventions, making sure that our interventions are following existing published guidelines when they’re available, and really trying to measure our practice much more than we did even just a few years ago. We have much better informatics tools to do that from the electronic health records to tracking our inpatient complications, it’s really much more effective. It’s not just a destination —– we’re on a journey of enhanced measurement to better the quality of care.