Trustees Restructure Governance Johns Hopkins Medicine To Serve Best Interests Of Hospital, Medical School Trustees of The Johns Hopkins University and the Johns Hopkins Health System have approved a new governance structure that retains separate leadership and corporate structures for the health system and the university's School of Medicine but reorganizes them to integrate the medical enterprises in a more systematic way. "This is designed to make one of the nation's pre-eminent academic medical centers more responsive to rapidly changing conditions in the health care arena," said Morris W. Offit, chairman of the university's board of trustees. "It is our responsibility as trustees to ensure that Johns Hopkins Medicine is capable of acting quickly and decisively in a very dynamic marketplace, while maintaining its leadership standing in all of its core missions of education, research and patient care." The new structure will give some added responsibilities to the president of the university and to physician department directors, who share appointments in the School of Medicine and The Johns Hopkins Hospital. The revised organization plan also calls for the dean of the School of Medicine and the president of the Johns Hopkins Hospital and Health System to locate their offices together and to share some staff functions at a site yet to be determined. The reorganization plans--approved in separate meetings of the health system and university trustees on Monday, June 19-- followed four months of intense study by a 10-member joint trustee committee, which made a set of unanimous recommendations to the two parent bodies. The board resolutions did not specify when the changes would go into effect, but they are expected to be implemented swiftly. Key to the new governance structure is the creation of an Office of Johns Hopkins Medicine, which will report to a new 10-member joint trustees board of Johns Hopkins Medicine, with wide-ranging responsibilities for the Johns Hopkins medical enterprises, including strategic planning and development, contracting, joint budgeting, and capital, facilities, and personnel planning. The Office of Johns Hopkins Medicine will consist of the president of the university, the president of the hospital and health system, the dean of the School of Medicine, the executive vice president of the health system, the CEO of Johns Hopkins HealthCare LLC and four physician departmental directors--three from clinical departments and one from a basic science department in the School of Medicine--to be appointed by the board of Johns Hopkins Medicine. The president of the university will chair the Office of Johns Hopkins Medicine and will serve as an ex officio, non-voting member of the board of Johns Hopkins Medicine. The Johns Hopkins Hospital and University have existed as separate corporations since their respective charters in 1867. They work together, however, in an unincorporated partnership called Johns Hopkins Medicine, whose various arms include a joint trustee policy committee and a management group composed of the leadership of Johns Hopkins Medicine. "The trustees of the hospital and health system would like to make it clear that we are building on past and present achievements," said George L. Bunting Jr., chairman of the health system's board of trustees. "We expect this year to have a record number of patient discharges and record revenues as well as a positive bottom line. We intend to build on such momentum, and, by more closely integrating the strengths of the university and the health system, we are positioning Johns Hopkins Medicine to continue its leadership role in the delivery of health services." The new structure is expected to tie together the hospital, School of Medicine and university more closely than at any time since the hospital and university shared the same president, a practice that was discontinued in 1983. Both Offit and Bunting emphasized their interest in continuing the work of Johns Hopkins HealthCare LLC, a physicians service organization formed jointly by the School of Medicine and health system last year to coordinate Johns Hopkins' contractual relationships with managed care organizations and to build networks and alliances with physicians and other health care organizations. On June 20, employees packed Hurd Hall in East Baltimore to hear interim president Daniel Nathans, hospital and health system president James Block and School of Medicine dean Michael Johns reinforce the goals of Johns Hopkins Medicine and put its development into context. Johns concluded the meeting, telling the audience, "I think you ought to take off your Johns Hopkins Hospital hat, take off your School of Medicine hat and put on your Johns Hopkins Medicine hat, and you're going to do a lot better looking ahead at this organization."