By Jesse Marx
By Chris Parker
By Jake Rossen
By Jesse Marx
By Michelle LeBow
By Alleen Brown
By Maggie LaMaack
By CP Staff
"Big change fast." That was one of Champy's re-engineering mottos, and Brody was determined to implement it. Even as he was merging the hospital and lobbying at the Legislature, the provost drove the QRTC process faster than it was institutionally capable of moving. When the committee was announced in July 1995, Brody said it would present three things--a case for change, a clear new mission statement outlining vision, values, and goals, and an outline of the next steps for action--all by October. A couple of months later, he extended the deadline to December. When December arrived, Brody announced that "the train is leaving the station," while acknowledging that he didn't know where it was going. As the AHC biweekly publication this thursday put it, "The need for change is so great, [Brody] said, that even though re-engineering plans haven't been completed, decisive actions must be taken."
Those actions included the merger of the hospital with Fairview, a 30 percent reduction in medical school enrollment, creation of a rural health school in Duluth, and a new batch of committees to start "Phase II" of re-engineering. Specifically, this second phase would consist of 10 "design teams" of about seven people a piece to move the AHC through the "implementation" part of the process. Phase III would be the "realization" part. Whether QRTC was ready or not, Brody seemed to be handling Phase I--the "vision" part--pretty thoroughly on his own.
By this point, many AHC faculty members were understandably feeling anxious and confused. For months they'd been promised and threatened with massive, fundamental changes. They'd seen corporate consultants coming and going, and jokingly referred to them as "aliens in Armani suits." They'd read QRTC surveys indicating a strong desire for change among consumers (the re-engineering term for students) and stakeholders alike. Now, change was indeed happening, but nobody really knew what it meant. Nobody could say how the pieces of the University Hospital-Fairview merger would fit together, or what the fallout of a 30 percent drop in enrollment would be, or whether the QRTC vision plan would already be outmoded, overtaken by Phase II, by the time the committee completed its vision plan. In terms of their future, the faculty were still operating with "a blank piece of paper."
They finally got some answers in the first week of February 1996, when the QRTC presented its restructuring plan. The AHC has been a politically charged environment ever since.
The setting was another AHC town meeting. In accordance with Champy's dictum about decisive action, Brody began by telling the assembled faculty and staff that what they were about to see was the new structure of the AHC, and that none of it was negotiable. There were precious few written materials; most of the information was on slides containing a series of charts and boxes. They showed that, instead of seven individual schools of medical discipline, such as nursing, dentistry, or public health, the new AHC would be divided into two enterprises: one devoted to education, one to research, each headed by a vice provost who would assist the provost in performing many of the vital responsibilities now carried out by the deans of the schools, such as configuring the budget, designing the curriculum, and hiring the faculty.
Brody explained that the purpose of the new structure was to create interdisciplinary and multidisciplinary teams for research and education, as well as cut costs by streamlining the infrastructure. But some of the slides contained many boxes for new administrative positions--a faculty member from the school of public health eventually counted 35 of them--including an expansion of public relations and legal affairs. In any case, the restructuring clearly seemed to concentrate more power in the hands of the provost and the two newly created vice provost positions. Brody acknowledged that the change "results in a great deal of personal anxiety for all of us, especially since there are many details that need to be worked out." (In fact, a third vice provost, this one coordinating clinical affairs, was later added.)
After the slide show, the dean from the school of dentistry rose with a pertinent question: If the AHC did away with the structure of individual schools and colleges, what would the fallout be? How would the University continue to solicit loyalty from alumni, who often contribute specifically to the school of medicine, say, or the school of nursing? (Not mentioned was that the University had to retain the schools as discrete entities to keep their accreditation.)
According to medical school professor Carol Wells, Brody replied that it wasn't exactly true that the schools were being done away with. He urged the dean to think of the schools and colleges like a Visa card, where the name has recognition, but everything behind the card, such as the billing and credit checks and so forth, is contracted out to another place. "When he said we could consider the school of dentistry valuable for its name recognition, like a Visa card--that's when I knew we were in trouble," Wells says.
News of the town meeting spread rapidly and further polarized supporters and opponents of Brody and re-engineering among the AHC faculty. At the school of public health, the faculty exercised their right under the school constitution to call an informational meeting to help quell the secrecy and rumor-mongering. Asked why the faculty couldn't also get handouts of the new plan, if in fact it was going to be the new structure, the dean replied that she was told it was confidential and not to be shared. A formal resolution of nonsupport for re-engineering then passed 61-0 with one abstention, and a letter of protest was sent to the Board of Regents--one of three that were made public in the school newspaper of April 16, right next to a story about Coke machines being installed at the student union.