Since June, senior leaders at the Brigham have been meeting with physicians and other staff during department faculty meetings to discuss the challenges of the current financial environment and provide information about the voluntary retirement opportunity (VRO). While physicians and research personnel are not eligible to participate in the VRO, the meetings have been both an opportunity for leadership to share information and for our faculty to ask thoughtful questions about the challenges currently facing the organization and about its future.

Here are answers to some of the top questions that have been asked during department meetings. (If you have an additional question, please submit a comment using the form below.)

Q: What is the timeline and process for the VRO?

A: Brigham Health is offering the VRO to a group of eligible employees (roughly 1,500 employees at BWH and BWFH) to honor those who are considering retirement, right-size our workforce and decrease labor costs. On June 16, personalized statements were mailed to the homes of those employees who are eligible for the VRO. Employees have until Aug. 4 to apply for the opportunity; the election period closes on Aug. 4. The retirement date will be Oct. 1, 2017, for most employees, with a few exceptions: some employees may leave earlier with their manager’s support or may be asked to defer their retirement date in order to manage the transition of their role.

Q: Why did we make certain capital investments, such as constructing the Building for Transformative Medicine and implementing eCare, if we knew there were financial challenges ahead?

A: Large organizations go through cycles of investment and cash accrual. We have invested in the Building for Transformative Medicine (BTM) as part of our long-term clinical and research strategy. The building will allow us to consolidate increasingly expensive leased space, but will take a few more years before the positive return on investment (ROI) materializes. As a key part of an integrated system, we needed also to make the investment in eCare in order to deliver safe, seamless and integrated care to our patients and to position ourselves for future challenges, including population health management.

Q: My department is already modestly staffed and cannot afford to lose additional support due to the VRO and other reductions. How will this be managed?

A: Workflow redesign isn’t solely about removing positions. Any reductions in staff will be carried out in a very thoughtful and coordinated manner to ensure that our patients remain at the center of everything we do. Analysis of vacancies resulting from the VRO is part of our overall process redesign that will allow us to become more effective in support of our providers and patients, and to look differently at how we all work together across different areas and departments. Managers and senior leaders will collaborate to ensure that the appropriate levels of support are maintained and there is no impact to patient care. In some areas, we will be adding staff to meet specific needs or to support growth.

Q: How can we be expected to move patients efficiently through the system when there are factors that prevent us from doing so?

A: We recognize that we need to improve our processes and address these types of issues. Through our Active Asset Management initiative, clinical and administrative leaders are identifying operational bottlenecks, improving communications and teamwork, and redesigning both our management systems and our workflow in areas ranging from the Emergency Department and inpatient units, through the operating rooms and other procedural areas and into care continuum management and how patients are brought into and through our system. We have already made many significant changes and there are many more to come. The net effect of these will be to make our clinical work easier and more effective for our patients and providers alike.