Perspectives from the 108th Interagency Institute for Federal Health Care Executives

Submitted by CDR Jean Makie, Chair, Dietitian/Nutritionist Professional Advisory Committee

The Interagency Institute for Federal Health Care Executives is a 2-week course that has been offered semi-annually over the past 50 years. The 108th session was held 19-30 September in Washington, DC. This program is sponsored by the following five Federal health services: the Departments of the Army, Navy, Air Force, and Veteran Affairs and the U.S. Public Health Service. It is planned by the Training and Education Committee of the Interagency Institute for Federal Health Care Executives, which is composed of senior representatives from each Federal health service.

Up to 60 medical and health service executives are nominated by the sponsoring agencies to attend each Institute. The participants have demonstrated competence in health care executive management. The individuals are selected by their respective agency to participate in the Institute because of their potential for senior management positions. The academic preparation of those who attend varies widely, with a representation of graduate and professional degrees including Ph.D., M.D., P.E., D.D.S., M.A., M.H.A., M.P.H., B.S.N., M.B.A., and a variety of other formal educational backgrounds.

Fifty-two (52) individuals attended this year’s Institute: 14 officers were from the U.S. Air Force, 11 were from the U.S. Army, 12 from the U.S. Navy, 11 were from the Veterans Healthcare Administration, and 7 were from the U.S. Public Health Service, 6 of whom were officers in the Commissioned Corps of the U.S. Public Health Service (Corps). Additionally, one officer from the health service of an allied nation is also invited to attend, and this year an officer from the Canadian Forces attended. The six Corps officers represented the Food and Drug Administration (FDA), Indian Health Service (IHS), and the Federal Bureau of Prisons (BOP). They also represented the diversity of professional categories within the Corps: dentists, engineers, pharmacists, hospital administrators, dietitians, and nurses. These officers were CAPT José Cuzme (Engineer category), Director, Division of Facilities, Planning and Construction, IHS, located in Rockville, MD; CAPT Beverly Dandridge (Nurse category), Nurse Recruiter, Federal Bureau of Prisons, located in Washington, DC; CDR Jeffrey Fritsch (Pharmacy category), Regulatory Review Officer, FDA /Office of Orphan Products Development, located in Rockville, MD; CAPT Christopher Halliday (Dental category), Acting Director, Division of Oral Health, IHS, located in Rockville, MD; CDR Jim Lyon (Health Services category), CEO, Santa Fe Service Unit, IHS, located in Santa Fe, NM; and myself, CDR Jean Makie (Dietetics category), a Senior Regulatory Project Manager, FDA/Center for Drug Evaluation/Division of Reproductive and Urologic Products, located in Silver Spring, MD.

The purpose of the Institute is to provide an opportunity for seasoned, practicing Federal health care executives to examine some of the current issues in health care policy and management and to explore their potential impact on the Federal health care systems. The Director of the Institute is Dr. Richard F. Southby, Executive Dean and Distinguished Professor of Global Health, at The George Washington University Medical Center, Washington, DC. He is also Adjunct Professor of Preventive Medicine and Biometrics at the Uniformed Services University of the Health Sciences, Bethesda, MD.

Given the diverse experiences of Federal health care executives selected to attend the Institute, the course structure is purposefully maximized by presenting new materials resulting from research and experience as well as examples and case studies from the contemporary national health policy arena. Faculty members seek involvement and interaction from the participants to stimulate understanding and communication across traditional agency boundaries. The goals of the Institute include:

To provide an opportunity for the seasoned, practicing Federal health care executive to examine the most pressing current issues in health care policy and management. To explore the potential impact of these trends and issues on the Federal health care sector. To promote excellence in patient care by fostering the concepts of teamwork, evidence-based practice, application of information technology, outcomes-oriented performance improvement, and responsible leadership. To present to policymakers, higher level officials, and academicians the views of practicing Federal health care executives on present and future courses of action. To foster communication, sharing, and mutual understanding within the Federal health care sector. To increase the level of enthusiasm and pride in the job done by the Federal health care sector. To build lasting human networks within the Federal health care sector. To build inter-service and national perspectives on health care issues and trends. To broaden participants’ interests in trends and issues in the health care arena.

The topics presented during the 2-week period this year were diverse, dynamic, and challenging – encouraging attendees to often think outside of their familiar paradigms of practice and service. VADM Richard Carmona, Surgeon General of the U.S. Public Health Service, discussed the recent challenges Hurricane Katrina presented to current health care delivery systems and public health outreach initiatives. He emphasized the resultant successes achieved from ongoing, collaborative interagency responses to this devastating, natural disaster. The impact of his message was felt by all: Protecting, promoting, and advancing the health and safety of the Nation are imperative objectives of the Corps, and must be a sustainable mission embraced by all of us.

We also heard from speakers on:

Department of Defense (DoD) Force Transformation and the Lessons of Recent War Trauma as a Modern Epidemic A stimulating reflections on the History of Medical Policy and Practice A perspective from the Office of Management and Budget on Defense Health The Role of Forensic Medicine in Disasters Emerging Issues in Health Law and Issues in Health Care Compliance The Role of Veterans Affairs in Federal Health Care Neglected Diseases and Their Impact on Global Health Care Delivery Challenges Facing the DoD in the Federal Healthcare Equation Internet Applications for Military Health Care The Health Professions and Their Organizations IT in Health Care – Success or Failure The Health Policy Scene - 2005 The Business Case for Patient-Centered Care Megaforces Changing Health Care Medicare: Quo Vadis Leadership and Management Issues Confronting a Major Medical Command Financial Markets and Health Care The Proprietary Hospital in the Teaching Environment Obesity and the American Public Biomedical Ethics Institute of Medicine’s Crossing the Quality Chasm Series Hospitals and Homeland Security Post-conflict Healthcare Development: Challenges and Strategies for the Military Impact of an Aging Society on Health Care Lessons Learned from Other Countries: The Federal Republic of Germany Strategic Threats from a Global Perspective How Congress Works The Impact of Oral Health Challenges Facing Academic Health Centers Understanding Behavior Implications for Improving Organizational and Individual Productivity The World Bank’s Role in Reducing Poverty and Improving Health

The 2-week program concluded with participants’ panels; each agency provided an overview of their own challenges and successes working within the various Federal health care systems. The thought-provoking presentations offered throughout the course encouraged participants to contemplate challenges posed by present, anticipated, and unexpected changing environments within national and global political, environmental, and health care arenas. The 52 participants walked into the course with a breadth of experiences in delivering the highest quality of health care and public health initiatives within our Federal systems. We left knowing our work--and that of future Federal health care executives--is not yet done. We left knowing more about some known obstacles facing health care delivery here and abroad. We left knowing that the greatest challenges may be from that which we can not see or predict. And, we left knowing that history and the opportunity for ongoing education and sharing of interagency experiences provide us with critical tools to assess, manage, and intervene--collectively and collaboratively--with foreseeable and unforeseeable health care issues. This year’s interagency participants agreed that the intensive, 2-week course was invaluable.

Future Institutes offer an opportunity for the Corps to be prominent and visible – from both the participant and presenter perspectives. It is our time to be visible and share within the framework of an educational model that, indeed, the Commissioned Corps of the U.S. Public Health Service is successfully “Protecting, promoting, and advancing the health and safety of the Nation” through the rapid and effective response to public health needs, leadership and excellence in public health practices, and the advancement of public health science.

If you have questions or want more information on this excellent training opportunity, contact any of the following officers: CAPT José Cuzme at jcuzme@hqe.ihs.gov; CAPT Beverly Dandridge at bdandridge@bop.gov; CAPT Chris Halliday at Christopher.Halliday@ihs.gov; CDR Jeff Fritsch at jfritsch@oc.fda.gov; CDR Jim Lyon at jlyon@abq.ihs.gov; or CDR Jean Makie at makiej@cder.fda.gov.

Important Note: CAPT Gil Rose, Office of the Surgeon General, is the U.S. Public Health Service contact for the Interagency Institute for Federal Health Care Executives. He can be reached at 301-443-4000 or 301-443-6713 or by e-mail at grose@osophs.dhhs.gov.

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