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June 24, 2005

The article below was written by Dr. Deckers and is published in the current edition of Connecticut Medicine, the journal of the Connecticut State Medical Society.

“Focus and Choices” – and Lessons Learned; Transformational Change at the University of Connecticut Health Center

Peter J. Deckers, M.D.

In 2006 the University of Connecticut will celebrate its 125th Anniversary. Its academic health center, the University of Connecticut Health Center (UCHC), is much younger, this May graduating the 34th classes of the School of Medicine and Dental Medicine. Despite its youth, UCHC has become, very quickly, a large credible part of the parent university’s array of academic assets and also represents a growing clinical and community public health resource for the State of Connecticut.

The contributions of UCHC over the past three decades are enormous, though not widely known. Specifically, in keeping with the original legislative mandate and intent, over 2,500 physicians and over 1,100 dentists have been educated and professionally prepared in an integrated curriculum that is considered by all to be “very innovative and responsive” to the recent evolution, some would say revolution, in healthcare delivery in the United States. Many of these graduates practice in Connecticut. For sure, the medical staff infrastructure of most of the state’s hospitals has been renewed by our alumni/alumnae. Likewise, each year 150 PhD students are enrolled in seven different areas of biomedical science and a similar number of master’s degree candidates are studying in the public health professions. Many of our PhD in Biomedical Science and Master of Public Health graduates contribute to the academic integrity of the state’s universities, discover new knowledge in our pharmaceutical and biotechnology industries, and are an important part of the public health workforce.

Academic health centers, to remain relevant and vital, must discover new knowledge through biomedical research. University of Connecticut Health Center is no exception, and in the past six years, we have more than doubled our extramural research funding to approximately $100 million/year. Important contributions include understanding the genetics and pathophysiology of some forms of vision loss as well as those associated with addictions, alcoholism and aging; exploring fundamental pathogenetic mechanisms governing bone loss and the cell biology associated with bone repair, the quantification (Virtual Cell) of molecular events in living cells in our nanobiotechnology national resource known as the Center for Cell Analysis and Modeling, and seminal advances in vascular biology, and in the creation of vaccines to treat cancer and infectious diseases. Experiments are already underway in exciting and promising areas of future discovery utilizing the potential therapeutic value of stem cells.

Institution of operational efficiencies as well as best management and administrative practices resulted in revenue and expense improvements of over $65 million in the past five years. This, and a “culture of hard work” adopted by faculty and staff have rejuvenated the clinical domain, eliminated the deficiencies of the late 1990s, allowed a measurable and improving clinical financial gain and established a real pride of accomplishment in everyone. In FY2006 our university hospital (John Dempsey Hospital) will exceed 10,000 discharges and 280,000 ambulatory visits, and while the severity of medical and surgical illnesses remains high, length of stay will continue to decrease. There will be more than 525,000 visits to members of our multidisciplinary faculty practice. We will continue to effectively and humanely manage all of the routine and increasingly complex health-care needs of the men and women incarcerated in our state’s penal system.

Yes!—the University of Connecticut Health Center is a big business delivering a true multifaceted societal good with an expense budget exceeding $636 million in FY2006 and a full- and part-time work force exceeding 5,200 people. We generate approximately $534 million in revenues and our academic activity benefits from a $103 million state subsidy yearly. Our economic impact on the economy of the state is real and growing, a fact that should be and, I am sure, is an increasing source of pride for our governor and legislators, given their past and present trust in our ability to manage difficult change in a difficult environment.

But all that is where we were or are. It is history to be learned from and built on, never to be satisfied with. What, more importantly, are the immediate and long-term “destinations” of the UCHC, as this state’s only public academic health center?

Such “destinations” are best described in our new integrated vision and mission statement designed today for full implementation by 2020. Our goals and objectives for the future were developed through the hand-in-glove efforts of faculty, staff and our engaged board of directors. This plan is now being operationalized. It is a blueprint that allows strategic “focus and choices” in all domains.

First and foremost, the University of Connecticut Health Center will be admired nationally for the quality of the health professionals it trains and be viewed as a model for the integration of the latest knowledge into the provision of health care and disease prevention. We will transfer this new knowledge into routine community practice. Our biomedical and public health research at all levels will be relevant, contributory and transforming. Our signature programs in cancer, musculoskeletal disease, cardiovascular medicine and public health will have a national reputation based upon translational clinical research such that patients from a broad geographic area will seek out the UCHC for prevention, diagnosis and treatment of biomedical problems. Regionally we will have a strong reputation for utilizing the most effective care practices as well as developing and maintaining the highest levels of patient safety and satisfaction. The best students will want to attend our schools and the most skilled faculty and staff will want to join our organization. We will be an indispensable partner to the state in health-care policy development and make important and significant contributions to the improvement of the health of Connecticut’s citizens particularly in underserved, under represented communities. We will manage an effective, sensitive patient, student, faculty and staff-centered business on all levels.

There are four important, indeed transforming, new elements. They are:

  1. Bench to bedside (T1 or translational) research built on solid fundamental basic science investigations will now be central to our signature programs and will fit well with the roadmap of the National Institutes of Health.
  2. Community health-care research (T2) and public health will enable evidenced-based medicine to be more universally applied and disease prevention or early detection in populations at risk to become the norm.
  3. Our Collaborative Center for Clinical Care Improvement (C4I) will study, develop, test and implement “best practices” designed to eliminate nosocomial infections, medication errors, falls and inappropriate control of chronic pain and will, through scholarship, facilitate transfer of these strategies to others.
  4. Our educational offerings at all levels will be innovative, responsive and effective and, where possible, state-of-the-science electronic offerings will be developed to allow any time, distance learning.

Finally, our new strategic directions will increasingly integrate us with the academic competence of the larger university to enable both the University and the Health Center to exploit the full scale and breadth of their combined human, technical, financial and physical resources as they together pursue their critical missions. In that regard, multiple collaborations involving the School of Agriculture, Allied Health, Business, Dental Medicine, Medicine, Nursing and Pharmacy have already been developed. Most significantly a major public health initiative that will enable the development of doctorate programs in public health with tracks in social and behavioral health, occupational/environmental health, health systems management and health policy is being actively considered. Interprofessional, collegial education which will engage our schools of Nursing, Allied Health, Pharmacy, Medicine and Dental Medicine, at the least, should and will be just around the corner.

I cannot imagine a more exciting, challenging time for all—or a more stimulating time to pursue a career in the health sciences at this region’s premiere public research university and its academic health center!

Be peaceful!