Duke Department of Medicine Launches Innovative Leadership Rounds Program

Duke University's Department of Medicine (DOM) is proud to announce the initiation of a new Leadership Rounds Program, spearheaded by Vice Chair for Quality and Innovation, Dr. Michael Pignone. Drawing inspiration from a successful model pioneered at Dell Medical School and Dell Seton Medical Center at The University of Texas, this initiative represents an opportunity to enhance patient care, foster a culture of safety and promote continuous learning within our medical community. 

The Leadership Rounds Program at Duke DOM departs from traditional leadership walk rounds by introducing a novel approach that integrates systems thinking with frontline clinical care, a core component of health system science. Led by Dr. Pignone and comprising members from various leadership echelons across the department, hospital, health system and medical school, this program facilitates regular engagement with medical ward teams to address patient care challenges, clinical complexities, and system barriers in real-time. 

A key figure in this initiative is Dr. Jenny VanKirk, who has been instrumental in organizing these Leadership Rounds. Her efforts dovetail with the residency program's work, led by Drs. Aimee Zaas and VanKirk. At the heart of this initiative lies the belief in bidirectional learning, wherein leaders gain firsthand insights into the intricacies of patient care while imparting institutional knowledge and resources to frontline clinicians. Through structured rounds conducted at least twice a month, leaders actively participate in discussions on medical complexities, clinical dilemmas, and socio-economic challenges affecting patient outcomes. 

One of the key features of the DOM's Leadership Rounds Program is its emphasis on addressing system issues impeding effective care delivery. By engaging with frontline teams in problem-solving discussions, leaders can identify recurring themes and persistent gaps in the current care model, paving the way for higher-level improvement interventions. Moreover, the program fosters collaboration among multidisciplinary teams, facilitating the sharing of experiential knowledge and best practices to optimize patient care. 

In alignment with the DOM's commitment to excellence in medical education, the Leadership Rounds Program serves as a platform for enhancing trainees' systems-based practice competencies. By providing a holistic view of patient care and health care systems, the program equips learners with valuable insights into the broader context of clinical practice, furthering their understanding of health system science. 

Real-time consultative sessions, akin to "super consults," further enrich the learning experience by harnessing the collective intelligence of seasoned clinicians and trainees alike. Clinical conundrums and complex cases presented during rounds stimulate active discussions, leading to refined differential diagnoses, evidence-based management strategies, and enhanced patient care. 

As the DOM continues to refine and expand its Leadership Rounds Program, plans are underway to extend its reach to other clinical sites, including ambulatory clinics. This initiative underscores our unwavering commitment to fostering a culture of continuous improvement, innovation, and excellence in patient care.