The Minnesota Nexus – What’s it about? Why should we care?

Barbara Brandt, PhD, National Center director and associate vice president for education, University of Minnesota Academic Health Center

Next Tuesday, January 7, we will meet for the first time to kick off what we are now calling the “Minnesota Nexus."  I thank you for agreeing to serve on this group for what the Academic Health Center considers to be a significant opportunity.  So, what is it? And why should we care?  Let me give you some background.

In fall 2012, fifty Minnesota leaders from the health systems, government and the university convened in a summit in response to significant feedback to Aaron Friedman, vice president for health sciences and Medical School dean, that graduates of health professions schools, including the University of Minnesota, are not adequately prepared for the rapidly transforming care delivery system.  I give Aaron credit for taking the many comments seriously.  He decided that it was important to convene this group.  Many leaders would not have listened; but we did and we learned. 

Since the summit, Aaron, David Wessner and I have been thinking about how to shape the next steps in response to five areas that emerged as top priorities:  vision, organizational structure, identification of education / training gaps, faculty/preceptor/clinician preparation, and policy / advocacy.  Since last summer, Aaron and David have spoken with health systems, policy and payer representatives to seek your participation on the Minnesota Nexus committee.  When we see you on Tuesday, Brian Sick, who leads a faculty team responding to the opportunity, and I will share with you what we learned and how we have begun to respond and address the concerns at the university.   We look forward to working with you all on the next phase.

I want to underscore, however, how important the feedback we received is not only in Minnesota, but nationally.   What we heard in Minnesota helped us articulate the need for a new relationship between rapidly transforming health care and higher education.  We coined the phrase “the Nexus,” to describe this new relationship and the connection to the Triple Aim, and it has caught on nationally. 

In 2012, we took our new understanding about the Nexus, competed for and were awarded a five-year $4M cooperative agreement from the US Department of Health and Human Services Health Resources and Services Administration to create a National Center for Interprofessional Practice and Education. The Robert Wood Johnson Foundation, Josiah Macy Jr. Foundation and Gordon and Betty Moore Foundation have pledged another $8 M to create a public-private partnership with the University of Minnesota.

In the last year, I have visited many states and have learned that we are ahead in our thinking and implementation in many ways.  There are many challenges and opportunities at the Nexus, and Minnesota has the opportunity to lead.  This past year, we replicated the summit at the University of Colorado, South Dakota, University of Pittsburgh, Vanderbilt University and soon Arizona.  We are learning a lot about the interface and that the feedback the University of Minnesota received last year is pervasive nationally.  It is time to respond and rethink how we can work together differently.

To make the Minnesota Nexus interprofessional, we have asked Brian Rank, Executive Medical Director, Park Nicollet HealthPartners Care System, and Leon Assael, School of Dentistry Dean, to serve as co-chairs.  They have graciously accepted, and we’ve met several times to shape Tuesday’s meeting and anticipate future development. Growthworks, Inc., an organizational development firm, has worked with me for a number of years in Minnesota and on the National Center will serve as facilitators for this effort.

We look forward to seeing you on Tuesday to begin the next stage of this groundbreaking work.   

Thoughts on the Minnesota Nexus

David Wessner, MHA, community liaison, Community University Board and senior fellow, School of Public Health, University of Minnesota

I wanted to share a few thoughts with you before our meeting on Tuesday to hopefully stimulate your thinking coming into the meeting.

Since leaving Park Nicollet and spending more time in the Academic Health Center (AHC) environment I've been increasingly aware of the symbiotic relationship between the greater Minnesota health "system" and the U of M. There are deep interdependencies between what is happening in the community and what is happening at the AHC on many levels; health professional training, health services research, health policy formation and study, and quality improvement efforts.

The one that is most significant, though, in the mind of everyone I've talked to is health professional education. And it is also clear that the development of health professionals is not just the responsibility of the AHC; but it is a shared endeavor of both the AHC and almost all of the care organizations in Minnesota.

There is broad agreement in the health care community that although the quality of health professionals coming out of the AHC is high, there is so much more that could be done to align these graduates with the demands of the care environments they are joining. There is also agreement that this improvement would provide great leverage on improving the entire health system in Minnesota.

But how do we improve this interdependent "system" of health professional development? How is it best directed and aimed? What are its best strategic next moves? How do we establish priorities that are informed by the perspectives of both the university and the broader community of health? How do we make it a continually improving system?

The term "nexus" has been used to brand this effort both in Minnesota and nationally. What is this nexus? We all are familiar with the roles of steering committees and groups; but what are we steering? Let me suggest that one of the most important things that we could do together is to define what the "Minnesota Nexus" is.

If we can become clear in our definition of the Minnesota Nexus, I think our combined experience in leading change efforts will be able to get traction and move us forward toward our aims.

What do you want the Minnesota Nexus to be?