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September 18, 2006

Thoughts on Challenges and Opportunities for UCHC in Academic 2007

To: Health Center Faculty and Staff
From: Peter J. Deckers, M.D.

My friends, please take the time to review the following personal thoughts and reflections that were shared by me this morning with our Board of Directors. I welcome any critique. Thank you.

Clinical (C)

  • The continued, indeed augmented, profitability of John Dempsey Hospital is pivotal. New recruitments now in place and anticipated this year in Cardiology, Cancer and Musculoskeletal Medicine and Surgery should enable significant growth of these signature programs. Leadership is now secure in all four signature programs.
    1. Cardiology: Bruce Liang
    2. Cancer: Carolyn Runowicz, Director and Richard Everson, Deputy Director
    3. Musculoskeletal: Jay Lieberman, Director and Larry Raisz, Deputy Director
    4. Public Health (CPHHP): Eileen Story
  • New leadership and clinical service arrangements must be secured in hospital-based support services i.e. Anatomic Pathology/Laboratory Medicine; Diagnostic Imaging and Therapeutics (Radiology); Anesthesia and Gastrointestinal Endoscopy.
  • The growth and development of the Collaborative Center for Clinical Care Improvement (C4I) initiative has been spectacular and is foundational to our Baldrige (process improvement/quality enhancement) application.
  • Despite external pressures beyond our control (cuts in federal reimbursement for clinical care services of physicians), UC Medical Group (UMG) must become a profit center. This will require development of new interventional services and enhanced throughput and efficiencies at every level, but especially in Medicine, Surgery and Psychiatry.
  • Our university hospital (JDH) has aged in place (>30 years). At the very least the clinical facilities must be significantly upgraded but, to ensure continued financial, structural and organizational stability of the hospital and the UCHC schools, the size of the clinical facility must be seriously rethought.
  • The Farmington Surgery Center is becoming hospital-based and must become much more productive.
  • The Dental Implant Center, as an example of true bench to clinic translation, must become operative.
  • The renovation of the ASB into clinical space must progress on time and on budget.
  • Continue roll-out of relevant and useful clinical information systems must progress on time and on budget.

Research (R)

  • The flattening, in fact functional decrease, of the NIH budget mandates development of a new strategic plan for research that recognizes this trend and is aligned with the strategic direction of the NIH.
  • New faculty with relevant, funded research initiatives that have translational potential must be recruited in several basic science departments. The new research strategic plan must define our focus and priorities.
  • The human embryonic stem cell core facility must be expanded to provide faculty and personnel with the necessary facilities and expertise to respond to this major state research initiative.
  • Modern new research space must be quickly developed (Farm Tech) and antiquated research laboratories (the L building) must be upgraded. All of this must be funded and equipped through UCONN 21st Century bond monies.
  • The formal academic review (as mandated by the bylaws) of several departments will result in additional department and center integration.
  • Clinical research reorganization must be completed and effective Clinical Translational Science Award (CTSA) leadership established. Core resources to support the CTSA must be secured.
  • Knowledge and understanding of all state and federal compliance mandates must be complete, become institutionalized and operative at every level, and able to withstand the scrutiny of any vigorous audit.
  • A research incentive plan that rewards “exceptional” accomplishments must be defined and implemented.

Education (E)

  • The search for the Dean of the School of Dental Medicine must be completed.
  • The new clinical skills/simulation center needs to be brought online and physician leadership identified.
  • Every opportunity to expose our students to the best technologies for e-education and e-learning must be offered.
  • New sites for clinical education, especially ambulatory training, must be found.
  • Further attempts to right size and improve the quality of our GME offerings must be made.
  • GME offerings will be expanded in several specialty areas i.e. Dermatology and Radiology.
  • Continuing Medical Education (CME) offerings both internal and external will be better centralized and become an integrated institutional effort. CME will also be expanded in content and will be better evaluated by the participants.
  • Demographics of the entering medical school class (2010).
    1. 80 new students; women comprise 60% of new matriculants.
    2. Average age is 24 at matriculation.
    3. 84% are Connecticut residents.
    4. 22% of new matriculants are members of underrepresented groups. 14% are Asian. 64% are white.
    5. The average academic characteristics of the class are consistent with recent entering classes (SGPA 3.59, OGPA 3.65, MCAT 30.4, academic score 104).
  • Demographics of entering dental school class (2010).
    1. 39 new students; women comprise 44% of new matriculants.
    2. Average age is 24 at matriculation.
    3. 49% are Connecticut residents.
    4. 18% of new matriculants are members of underrepresented groups. 5% are Asian. 74% are white.
    5. The average academic characteristics of the class are consistent with recent entering classes (SPGA 3.50, OGPA 3.57, DAT 20.0).

Administration (A)

  • The increasing “gap” between academic expenses and revenues of the Schools of Medicine, Dental Medicine and Graduate Biomedical Sciences now approaching 12 million dollars per year can no longer be closed by transfer of clinical profits from JDH. Permanent, responsive enhancement of the academic subsidy of the state to the UC Health Center must occur.
  • The Farm Tech research properties represent a unique, immediate lease/purchase opportunity that must be realized for the sake of continued academic growth (faculty retention and recruitment).
  • The academic (Research and Education) merit plan for faculty must be adequately funded and decisions relative to merit or lack thereof must be defensible. Compensation plans and annual reviews must reward fully productive faculty.
  • Continued implementation of the faculty-sponsored and-driven new bylaws of the schools will occur.
  • Our public health (CPHHP) initiative will become unique to the strategic vision of the UCONN Health Center and its schools.
  • Our strategic decisions regarding expenditure of UC 21st Century bond dollars for UC capital needs over the next decade must be rethought and reallocations made.
  • Changes in leadership in several key clinical departments are anticipated, most notably Medicine. Succession planning must occur for key educators about to retire or step-down from long-term leadership positions.
  • As a minimum goal, a revenue enhancement/expense reduction plan that achieves $9 million in improvements must be implemented to balance a budget of $660 million in expense.
  • New methods of gaining operational and financial efficiency must be identified and implemented.
  • Financial systems must be further refined to allow reliable budget predictions, moment-to-moment assessments of year-to-date performance, and to ensure controls that will prevent or minimize deficit spending.
  • We must finalize comprehensive ambulatory space plans (to complement the work plans for the ASB)—this includes East and West Hartford as well as this campus.
  • We must support new strategic approaches to manage risk and reduce our malpractice costs.

Miscellaneous (M)

  • Efforts will be enacted to enhance diversity in our student body, faculty and staff and to create a culture at the UC Health Center that not only respects but values and promotes differences as good moral and business sense.
  • Philanthropy for our hospital and schools will be significantly improved and a culture of contribution (time, talent and resources) as part of effective stewardship will be established in staff and faculty.
  • The value of the Health Center to the community will be clearly and effectively communicated to all relevant constituencies, including State government, the public, potential donors/supporters, local business, the media, and potential students. This will focus on our unique and distinguishing integration of research, education, and clinical care.