Symposium 1: Can We Quantitatively Measure Leadership?

Moderator: Dean Taylor, MD, FAOA
Panelists: Joseph Weistroffer, MD, FAOA; Mark Peterson; Leah D. Houde, PhD

Objectives:
1. To help to define the definition of leadership and give examples of different styles of leading.
2. To discuss barriers in identifying and developing orthopaedic leaders.
3. To develop solutions to improve leadership development leaders in orthopaedic surgery.

Summary:
The term leadership is considered a practical skill that is thought to encompass an individual’s ability to guide others, teams or organizations. The American Orthopaedic Association is considered the organization that houses the leaders in our profession. This organization gives educational offerings on leadership to its membership. Research and special literature often debates the definition of leadership, demonstrates contrasting approaches within different cultures, and discusses a variety of styles in the application leadership. In addition, it is often asked, “if these offerings are really working?”, “how does an organization measure leadership?”, and “can the processes be systemically applied?”. In addition, should research be developed and fielded to build a database for this topic in the field of orthopaedic surgery or medicine? The purpose of this symposium is to actively engage membership by leading discussions on the definition of leadership and to determine if there are metrics to quantitatively measure and teach leadership.

Symposium 2: Expanding Diversity Need Not Compromise Quality: What Can We Learn From the Military?

Moderator: Anthony Johnson, MD, FACS, FAOA 
Panelists: Jennifer Weiss, MD, FAOA; Matthew Schmitz, MD, FAOA; Kristy Weber, MD, FAOA

Objectives:
1. To recognize the historical and contemporary diversity and inclusion efforts utilized by the US Military over time to become one of the most representative, as well as the most respected, institutions in the nation.
2. To be aware of strategies for adaptation into a civilian academic program.
3. To foment discussion on the perceived vs. real threats to the specialty of Orthopaedics as well as the realistic vs. aspirational goals regarding diversity.

Symposium 3: Rapid Fire

In response to attendee feedback, we've added a twist to the standard symposium format. Join us for the "Rapid Fire" interactive discussions covering four different critical issues covered in two hours.  

Topics:
  1. The Generation Gap: Teaching Methods and Expectations – Samir Mehta, MD, FAOA 
    The newer generation of students have a different way of learning than the ways most experienced and senior faculty learned. The terms of "scut-work" and "service" have been redefined. Information can be found more quickly, but some faculty feel this is of lesser quality and leads to only short-term memory. Some argue that this quickness in finding the answer has led to a demand by the current student to have immediate feedback and evaluation. Thinking along the lines of “This is not how we did it,” “when I was a resident we ….”, or “this generation is entitled” creates a breakdown in the faculty-student relationship and thus creating a generation gap within teaching.
  2. Educating Your Competition – Jonathan P. Braman, MD, FAOA   
    Educating a learner that soon becomes your financial competitor can cause an internal dilemma. Teaching the learner to improve, while giving them the tricks of our trade, improves patient care. But, in doing so, are you creating your own competition? The assumption that we all want our students to become better surgeons than ourselves is commonly quoted, but some faculty do not give all the details if they know the learner is moving across town to be their competition.
  3. The Real Meaning: Yelp Scores – Scott E. Porter, MD, MBA, FACS, FAOA  
    Press Ganey scores and patient experiences from surveys have been used to help define the quality of providers. These scores assist with end-of-year bonuses and have been used as marketing points on websites, billboards, etc. The methods on how these scores are generated and allowing patients to give their comments openly on social media is thought to demonstrate a lack of validity. We are currently emphasizing this more with no real standardization.
  4. Defining the Qualified Resident: To Bill or Not to Bill for my PA – Terrance D. Peabody, MD, FAOA
    CMS allows surgeons to bill for PAs and surgical assistants if there is no qualified resident available. Yet, there is no clear definition on the term “qualified.” Some educators feel that if a resident has been accepted into an ACGME accredited program then they are "qualified," yet some only define an upper level resident as "qualified." The pressures for an attending to have their PA be budget-neutral is real. Thus, how do we, as educators, fulfill this CMS term?

Symposium 4: Quality Improvement and Patient Safety: How Leadership Can Create a Culture of Safety

Moderator: Kevin Shea, MD, FAOA; Julie Samora, MD, PhD, MPH
Panelists: Antonia Chen, MD; Steven Frick, MD, FAOA; Philip Turner (President of the British Orthopaedic Association)

Objectives: 
1. Attendees will acquire an understanding of the role of leadership in developing a culture of safety 
2. Participants will learn skills to incorporate all members of the team, including the Board of Directors, in promoting quality and safety 
3. Participants will learn how to incorporate Evidence Based Medicine into their clinical practice
4. Attendees will acquire an understanding of high reliability systems

Summary: 
With rapidly changing medical and surgical advancements, modern healthcare systems must adapt in the face of evolving challenges. Healthcare costs are rising in an unsustainable fashion and new metrics are being utilized to evaluate outcomes. The Institute of Medicine has defined six domains to improve our increasingly complex healthcare system, including: safety, timeliness, effectiveness, efficiency, equity, and patient-centeredness. This symposium, which will focus on patient safety and quality care, encompasses all of these domains. It is of paramount importance to focus on minimizing adverse events, and enhancing overall healthcare value, which necessitates following evidence-based guidelines. True leaders can foster a culture where all providers feel comfortable not only openly discussing adverse events without fear of retribution, but also encouraging partners and team members to utilize evidence-based practices. This symposium will discuss how a great leader facilitates effective teamwork by communicating clear objectives, involving input of team members, and empowering members to actively participate. Each member of the team should be working toward the shared objective of safe patient care. 

Symposium 5: "I Have an Idea...Now What?" Mastering Pathways for Orthopaedic Innovation

Moderator: Michael Suk, MD, JD, MPH, MBA, FAOA

Topics and Panelists:
Researcher and inventor (John Antoniou, MD PhD, Canadian Orthopaedic Association President
Incubator (Sandra Cochrane, Assistant Dean, Innovation Center, MBA W Michigan Med)
Innovation in Care Delivery (Phillip Harker, President and CEO, Leavitt Risk Partners)

Objectives:
1. Understand key milestones in the development of new technology for orthopaedic innovation
2. Discuss strategies and option in moving from an idea to reality
3. Discuss the global impacts of “innovation” beyond medical device

Summary:
The Department of Commerce Advisory Committee on Measuring Innovation in the 21st Century Economy has defined innovation as “the design, invention, development, and/or implementation of new or altered products, services, processes, systems, organizational structures, or business models for the purpose of creating new value for customers and financial returns for the firm.” Viewed comprehensively, innovation represents the implementation of new or significantly improved products, services, or processes. It can also imply new organizational models, methods of service delivery, ways of relating to customers, and approaches to marketing. It is well recognized that there is a real need for innovation in health care delivery, as well as in medicine, to address related challenges of access, quality, and affordability through new and creative approaches.

Health care environments must foster innovation, not just allowing it but actively encouraging it to happen anywhere and at every level in health care and medicine-from the laboratory, to the operating room, bedside, and clinics. This symposium will enable mastery of the foundational components of medical innovation as it pertains to the scope of orthopaedic practice.

Symposium 6: Academic Productivity in the Rat Wheel of Healthcare

Moderators: William T. Obremskey, MD, MPH, FAOA 
Panelist: Benjamin A. Alman, MD, FAOA; Sanford Emery, MD, MBA, FAOA; David K. Martin (Australian Orthopaedic Association President)

Objectives:
1. Identify the resources and funding available to improve academic productivity 
2. Understand different incentive structures to reward or incent academic productivity
3. Implement an educational program for resident/faculty of academic resources and available teams to support the process.

Summary:
Academic medicine is challenged to maintain our missions of education and research. The finances of healthcare no longer allow cross subsidization and hospital CEOs value high clinical activity over academic productivity.  We will outline the structure, infrastructure, incentives and education that can help academic teams be successful.

Symposium 7: Registries and Cohorts: How will these Change Clinical Practice and Research

Moderator: Jonathan Schaffer, MD, MBA, FAOA
Panelists: Kurt Spindler, MD, FAOA; Patricia Franklin, MD, MHA, MPH; Gregory Maletis, MD, FAOA; Kevin Bozic, MD, MBA, FAOA; Rod Maxwell( New Zealand Orthopaedic Association President)

Summary:
The majority of research is observational in nature.  The recent development of large-scale registry and cohorts databases provides a unique opportunity to evaluate the treatment and outcomes in musculoskeletal care.  Knowledge of the key design and implementation attributes for each database is required to appropriately interpret the data.  
 
This symposium will provide a framework for the evaluation of the design and implementation metrics by using five different registries and cohorts.  The methodology and collection of data types influences the strength and quality of the clinical decisions based on each system.  The clinical questions will determine where the highest level of evidence can be observed in a specific registry or cohort.  
 

Symposium 8: Is it Time to Create Pathways Toward Earlier Subspecialization Within the House of Orthopaedics

Moderator: Robert Hart, MD, FAOA
Panelists: Ned Amendola, MD, FAOA; Kalpit N. Shah, MD; Leon Rajah (South African Orthopaedic Association President)

Objectives:
1. Review current data comparing Orthopaedic vs. Neurosurgical training pathways for spine surgery
2. Describe initiatives to allow Orthopaedic residents to gain earlier and deeper exposure to their chosen subspecialty
3. Understand residents' perspective regarding current Orthopaedic residency structure and requirements
4. An international View of Orthopaedic surgical training: A South African Perspective

Summary:
Pressures regarding cost and length of post-graduate medical training are mounting. At the same time, issues of surgical readiness are pushing Orthopaedic residents not just to focus on a recognized subspecialty, but to gain deeper experience in their chosen subspecialty earlier in their training. Similar pressures have driven other medical and surgical specialties to create earlier and shorter training options leading to subspecialty credentialing.