School of Medicine Administration

CY 2006 Action Plan

Introduction

I think you will all agree that CY ’05 was a tumultuous year for the School of Medicine. It is startling to contrast the turbulence of last year with the relative stability and sense of optimism we are experiencing today.

Calendar Year 2006 Action Plan
Educational Objectives
Clinical Objectives
Research Objectives
Administrative Objectives

Other Action Plan Updates
CY 2005 SOM Action Plan
2004 SOM Action Plan Progress

In CY ’05, we were struggling with an unstable financial situation that made it impossible to offer meaningful contract salary increases to the faculty; that required us to impose strict controls on the filling of new positions; and that dictated a downsizing of some of our programs. An unprecedented increase in the amount of uncompensated care put our entire clinical enterprise in jeopardy and precipitated heated debates among our faculty and staff and with the community regarding the moral and ethical conflicts inherent in our national and especially our local health care system. Additionally, there were major conflicts among and between leadership and governance not only within the School and Health Sciences, but throughout the University.

CY ’06 is a new year in every respect, and is unrolling in a very different way.

We have gained significant new resources from the state that will allow us to offer a reasonable compensation increase to the faculty.

We have established a good relationship with all of the patient advocacy groups and are working together to solve the most difficult problems facing all of us in the health care industry – particularly those around health disparities. We will soon appoint the first Community Relations Director, whose job will include maintaining an open dialog with the community we serve. Our Clinical Enterprise is expanding to be prepared for the opening next April of the new Richardson pavilion, which is on time and within budget.

Just in the past few weeks I have sent out letters to invite students into the first class of the BA/MD program. The admissions committee has accepted an incoming class the majority of whom are from rural NM and representative of the populations we serve. The funding of the first phase of the Domenici Education Building was accomplished and construction has begun. The buildings will be open for use by the fall of this CY. The second phase will begin shortly thereafter.

The Cancer Research and Treatment Center secured NCI-Cancer Center designation, with five years of NCI funding. This was a huge accomplishment, of enormous significance to the Institution and to the State. Cheryl Willman and the many faculty and staff who put their full efforts into this achievement deserve our heartfelt gratitude. We are now turning our attention to becoming one of the fifty or so institutions that will have a Clinical and Translational Science Award, which will replace all of the General Clinical Research Centers in the US, including ours. Our full application to NIH will be submitted in CY’08, and the next two years will see a concerted effort, under the leadership of Mark Burge and Richard Larson, to put all of the components in place to be successful in this effort.

We have resolved our leadership and governance difficulties throughout the whole organization and where there was anger and acrimony before there is goodwill and harmony now. There is a highly effective University leadership team with Dave Harris as Acting President, Reed Dasenbrock as Provost and me serving as both Dean of the SOM and Executive VP for Health Sciences. And within the Health Sciences Center we have a very effective leadership team working hard to address all of the major issues facing us. This team now includes Robert Katz in the newly created position of Vice President for Clinical Affairs. In this role, Dr. Katz will bring a new level of coordination and synchronization between the medical faculty and the staff of UNMH. He will also provide leadership to bring the Faculty Practice Organization into being as an effective representative and manager of the interests of the faculty.

Within the School of Medicine, I have created a new position of Executive Dean who will function as the Chief Operating Officer of the School allowing me to be engaged at the appropriate level HSC- wide and within the School. We are all extraordinarily fortunate to have someone like John Trotter who is so competent and well regarded among the faculty and staff and who was willing to come out of retirement during this interim period to assume this role. We are now actively recruiting internally for his replacement so that he can return to retirement and his part-time role as Vice Dean.

I hope you will agree that all of these changes add up to a huge turnaround for the School of Medicine!

While saying this I will also point out that we still face significant challenges that will require further change in the way we conduct business and carry out our missions. We have a long way to go to address our hospital inpatient and outpatient capacity problems. We still must secure more public funding to appropriately support our public mission associated with the delivery of uncompensated care. We also are engaged in an effort to redefine ourselves in terms of our relationship to the state.

Despite the challenges, I am very optimistic about our School and the opportunities we will have during CY’06 and in the coming years. The CY ’06 Action Plan has resulted from the deliberations of many faculty and leaders of the School. The Action Plan targets are clearly within our grasp. I would like to thank all of the chairs and deans and staff and other faculty who worked so hard to develop the Plan.

CY 2006 SOM Action Plan

14 February 2006

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1. EDUCATION OBJECTIVES

1.1 Implement the combined degree program.

  • Comprehensive plan for summer community-based preceptorships will be developed in cooperation with both the SOM’s established community-based sites and personnel across the state (AHEC, Rural Family Medicine Residency, RHIP and Preceptorship Teaching Network) and the College of Arts and Sciences and University by July 2006.
  • A comprehensive Student Services and Family support plan that includes community mentor participation will be developed by June 2006.

1.2 Integrate the principles of public health with the Medical School curriculum such that all School of Medicine graduates will be eligible for a Certificate in Public Health

  • Evaluate the pilot project to give each medical student experience in Public Health as part of the Phase 3 Ambulatory rotation by July 2006.
  • Evaluate existing pilots such as the Phase II Evidence-Based Medicine course, and the public health components of the Phase III Ambulatory rotation by July 2006.
  • Specific curriculum of the Certificate program will be developed by September 2006 and approved by the SOM faculty by December, 2006

1.3 Increase the number of health professional and residency graduates who practice in New Mexico.

  • The GME Office will work with residency and fellowship directors to develop a plan to recruit &prioritize the selection of SOM students for residency and fellowship by October 2006.
  • The GME Office will develop a plan to identify and recruit New Mexico students who have attended other LCME-accredited medical schools to consider residency training at UNM by August 2006.
  • The GME office will work with UNM departments and community partners to develop a plan for recruitment/retention of graduates of SOM residencies by October 2006.
  • The UNM AHEC Program will work with representatives from the D&TS Programs as well as the CON and COP to develop a plan to increase and enhance opportunities for health professional students to complete clinical experiences in rural and underserved communities throughout New Mexico by December 2006.
  • The UNM AHEC and RHIP will work with all educational programs in the SOM as well as the CON and COP to develop a plan to provide interdisciplinary educational experiences for all students by December 2006.

1.4 Develop advanced degree programs in the Diagnostic and Therapeutic Sciences.

  • Expand the baccalaureate program in radiologic technology to include concentrations in CT and MR technology by December, 2006.
  • Submit request for clinical doctoral program in physical therapy (DPT) by July, 2006
  • Gain approval for advanced masters program in occupational therapy (MOT) by December, 2006
  • Submit request to replace baccalaureate degree in physician assistant studies (BPAS) to masters degree (MPAS) by December, 2006
  • Establish graduate certificates in EMS disciplines by December, 2006

1.5 The MET faculty and HSCLIC faculty will implement the integrated comprehensive plan for simulation computer and web - based instruction, virtual reality, and standardized patients in education and assessment for all of the education programs of the School of Medicine

  • Working with the Department of Surgery, submit a proposal by Spring, 2006 to become an accredited Level I Comprehensive Education Institute (CEI) for the American College of Surgeons
  • Submit a proposal in March, 2006 to the National Library of Medicine to create a Biomedical Informatics Institutional Training Program
  • Pilot use of a new learning management system, Learning Central, by creating the following courses by December, 2006: Banner Privacy Training; and Telehealth Services
  • Expand content in the MEDS database to include Phase III curricular content by September, 2006
  • Host a national conference on Integrative Technology and Evidence-Based Education by February, 2006

1.6 Develop a combined M.D. – M.P.H. program by December, 2006

1.7 Assure a sufficient number of appropriately-trained faculty to carry out the expanded educational programs of the School of Medicine

  • The Office of Undergraduate Medical Education, with the Office of Academic Affairs, will develop a comprehensive faculty development plan for all new faculty, and faculty with newly-identified teaching responsibilities, by July 1, 2006.
    • The UME Office will work with Phase II and required Phase III Clerkship Directors and Office of Student Services to identify the number of additional clinical training sites needed for each clerkship to accommodate increased class size with the BA/MD program by December 2006 and inform the Dean
    • The UME Office, through Teacher and Educational Development and PEAR, will refine the methodology for peer and student evaluation of faculty, including development of personalized recommendations for development of faculty teaching skills, by December, 2006.

    1.8 Assure sufficient support services for the expanded educational programs of the School of Medicine

    • The Offices of UME and Student Affairs, with input from CAP, will develop a budget proposal for expanded student academic support services by March, 2006.
    • The Office of Undergraduate Medical Education, with the Office of Diversity, will broaden outreach programs to all minority and underserved populations in New Mexico, to further strengthen the diversity of our educational programs, by December, 2006

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    2. CLINICAL OBJECTIVES

    2.1 Continue refining and implementing the current Clinical Enterprise Strategic Plan by focusing on the following high priority actions

  • Patient Satisfaction: meaningful improvement toward the goal to be at or above the Press-Ganey 50th percentile by December 2006
    • Ambulatory Care: 3% increase in visits for CY06.
    • Inpatient Care: 1% increase in discharges for CY06
    • JCAHO Accreditation: maintain full accreditation
    • OSIS Utilization: increase utilization of OSIS to 60% for CY06
    • Develop integrated multidisciplinary Endovascular Center with signed MOUs between stakeholders by December 2006

    2.2 Improve the shared organizational culture between UH and SOM.

    • Develop a succinct, shared core purpose or vision by December 2006
    • Engage consultant and develop a mechanism to train physicians in management and leadership by December 2006
    • Significantly improve patient, staff and faculty satisfaction on standardized survey instruments by December 2006

    2.3 Working with the other components of the HSC, the SOM will develop a five year clinical strategic plan representing its full state-wide mission. A draft plan will be open for review and comment by July 2006

    2.4 Create a structure to support UNM Children’s Hospital (UNMCH) by December 2006

    • Develop and implement the UNMCH Staff Model
    • Develop and gain approval for UNMCH Executive Medical Director
    • Develop, gain approval for, and implement the UNMCH Executive Committee chaired by the UNMCH Executive Medical Director

    2.5 Create a coordinated Women’s Health Program by December 2006

    • Finalize a multidisciplinary team of faculty with active interest in women's healthcare by March 2006
    • Raise the Pres Ganey score for the inpatient maternity service from 78 to 81 by December 2006
    • Make significant progress in process improvements and advanced access by December 2006
    • Complete a centralized website pertaining to women's healthcare by July 2006
    • Finalize and move subspecialty service lines (urogynecology, gynecologic oncology, reproductive endocrinology/infertility, maternal-fetal medicine, gynecology ultrasound, general gynecology) to off-campus clinics

    2.6 Create in collaboration with University Hospital a backfill plan to assure strategic utilization of space made available by the opening of the Richardson Pavilion.

    2.7 Develop a Community Partnership program which would:

    • Create by December 2006 and widely communicate a Community Health Report Card that will assess, on an annual basis, progress towards improving community health
    • Establish a long-term strategic plan that would address social determinants of disease; assess methods to: improve Health Professions workforce shortage areas expand access to specialty care and; study the potential of establishing regional health extension centers.

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    3. RESEARCH OBJECTIVES

    3.1 Develop nationally recognized research foci that address national and state health priorities

    • Submit CTSA planning grant and obtain internal and external funds for supporting training, educational and clinical research components.
    • Determine how the four research Signature Programs in the School of Medicine should be supported and interfaced with CTSA effort for the benefit of the School of Medicine and the Community, i.e., Infection and Immunology, Neurosciences, Vascular and Diabetes, and Oncology.
    • Identify mechanisms for facilitating research collaborations between basic science, outcomes/community-based, and clinical faculty.
    • Identify 1-2 new grant initiatives for each Signature Program through the Research Strategic Planning Group (RSPG) that will increase funding by aligning grant applications with areas of identified research strength.
    • Develop strategic plan for HSC space planning
    • Work with Main Campus on joint efforts seeking federal funding and prioritization
    • The UNM Clinical/MIND Imaging Research Center will develop self-sustaining, bench-to-bedside research programs, integrating disease-specific clinical research with MRI and MEG technology to better diagnose and treat neurological and psychiatric disorders

    3.2 Establish a broad research infrastructure-support mechanism that is a model throughout the university and region

    • Streamline the grants and contracts submission, contract completion and grants accounting processes in Financial Services (MTA, CTA, CDA, and PreAward)
    • Work with the pre-award to examine and make suggestions for improvements in processes, tools, training and systems for the pre-award stages of Proposal Stage, Just in Time Stage and Award Stage.
    • Work with pre-award and legal counsel to determine the barriers to efficient negotiation and processing of contracts and other agreements (MTAs, CDA’s, CTA’s)
    • Develop instructional tools such as websites or workshops for faculty in procedures for compliance and contracting issues including obtaining CDAs, MTAs, CTAs, managing COI and obtaining HRRC approvals.
    • Develop mechanism for working with post-award section of Financial Services in order to improve grants accounting and management.
    • Implement plan for more customer friendly yet highly compliant review of individual institutional COI issues that affect the HSC
    • Form a new Conflict of Interest Audit Committee
    • Continue implementation and evaluation of 5-year CTC plan
    • Continue with financial plan to reduce amount of tobacco settlement fund money invested in the CTC from $140,000 to $50,000 over five years
    • Develop education/mentorship programs for new investigators, fellows, residents, students, coordinators, nursing and pharmacy students interested in careers in clinical trials
    • Develop a mentor program for junior investigators interested in learning and conducting industry-sponsored clinical research
    • Identify training opportunities for UNM investigators and coordinators on research conduct and compliance
    • Increase recognition of CTC in primary care practices and throughout the community
    • Develop continual quality improvement programs for compliance units (COI, HRRC, IACUC and Biosafety)
    • Develop a program with GME to train residents in clinical and outcomes research
    • Produce needs assessment for research space

    3.3 Develop Institutional system for retaining existing faculty and recruit new promising faculty

    • Identify funding mechanism for faculty retention
    • Develop funding mechanism for faculty recruitment

    3.4 Provide outstanding training opportunities in disease-oriented research that capitalize on nationally recognized strengths in medical education, the signature research programs and advanced technologies

    • Compete successfully for high-quality graduate students and provide outstanding training opportunities in disease-oriented research
    • Obtain additional revenues to support expansion of Biomedical Sciences Graduate Program (BSGP) student slots
    • Streamline and formalize BSGP processes/functions related to electronic applications and interfaces with OGS, UNM HSC and Office of Research
    • Conduct BSGP intramural evaluation.
    • Increase national visibility of BSGP through representation at National Forums/Meetings, building of local and national networks, extramural funding, service on national education committees
    • Develop 5-year Strategic Plan for BSGP
    • Expand program offerings to support diverse career goals of trainees.
    • Provide outstanding MD/PhD training and conduct program evaluation
    • Streamline and formalize program processes/functions related to degree granting, student due process and tuition payment.
    • Conduct MD/PhD Program evaluation
    • Enhance Postdoctoral fellow recruitment and training
    • Annual review and update of central postdoctoral website that advertises postdoctoral positions and is managed by the Biomedical Research Education Office (BREP) in the Office of Research.
    • Meet with Postdoctoral Association leadership quarterly to identify needs/problems; seek venues for interaction; build trainee network
    • Provide outstanding administrative support for research education programs: BSGP, MD/PhD and Postdoctoral Fellows

    3.5 Establish the UNM-SOM as a leading medical school conducting research with Native American populations.

    • Align research projects to increase funding through the NARCH-III initiative
    • Develop a NARCH-Native-American Scientific Community Advisory Board
    • Organize an Albuquerque Area Indian Health Service IRB in conjunction with the UNM-SOM HRRC
    • Increase the number of Native American researchers through special mentoring and development programs

    3.6 Facilitate and improve the processes for commercialization of intellectual property

    • Meet with relevant persons from the Science Technology Corporation (STC) and identify targets to measure, e.g., disclosures, patents, licenses, start-ups/per year, for the SOM and write a tactical plan with budgeting consideration to increase faculty involvement to achieve those targets

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    4. ADMINISTRATION OBJECTIVES

    4.1 Implement an effective administrative structure for the SOM in light of the appointment of Dr. Roth as EVPHS and SOM Dean.

    4.2 Implement strategies to fully execute the “One Faculty” concept among the SOM faculty. The SOM will improve internal communications with faculty, students and staff, as well as with its partners at the VAMC and the University community.

    4.3 The SOM will assure that its faculty, students and staff are well equipped to serve the diverse citizens of New Mexico.

    • Staff:
      • Increase the pool of qualified Under-Represented Minorities (URM) and women to pursue administrative careers as UNMSOM staff through education and training of URM and majority women to the potential opportunities in career paths.
      • Encourage URM and women to pursue degree programs through UNM
      • Targeted recruitment of URM and women for the UNM Management Academy
      • Continue HSC Human Resource (HR) New Managers Training
      • Support HSC HR’s targeted recruitment plans for under-utilized positions.
      • In collaboration with HSC HR, review data from the strategies identified above in November, 2006. Data to be reviewed with SOM department administrators and Deans’ Offices administrators, HSC HR and the Assistant Dean for Administration.
    • Faculty:
      • Increase the hiring and retention of URM faculty by including the Minority Women in Medicine group in the interview process for URM-self identified women applicants by July, 2006.
      • Support the attendance of up to two URM and up to two women faculty to the AAMC Minority, Early Career and Mid-Career seminars by June, 2006. Funding to be provided by the SOM Office of Academic Affairs and the Center of Excellence.
      • Identify and inform URM and women about the AAMC workshops and Groups where URM and women would be expected to develop networking relationships with faculty at other Schools leading to participation on national committees by December, 2006.
      • Add specific content that addresses the issues of URM and women within Faculty Orientation, Leadership courses and other workshops such as negotiation skill building by April, 2006
      • Develop a plan for the identification, skill building and creation of roles for Emerging Leadership with emphasis on URM and women faculty by October, 2006.

    4.4 The SOM will have highly effective programs for faculty development and for faculty and new staff mentoring. The faculty programs will achieve national recognition.

    • Support and participate in “Pathways to Success” mentorship pilot program developed by HSC Human Resource Department.
    • Add a centralized mentoring program by July, 2006 to assist new faculty members in developing a career plan.
    • Interview mentor-mentee pairs from hirings over the last few years by December, 2006 to determine the impact of mentoring assignments
    • Re-evaluate the types, distribution and number of faculty development workshop by October, 2006
    • Formalize the mini-sabbatical process by Sept 2006.
    • Work with GME to develop a plan to enhance the retention of UNM SOM and GME graduates as practitioners within New Mexico and as faculty members within the SOM.

    4.5 Development: The SOM will increase fundraising results by 10% or by $250,000 by December 2006 by doing the following:

    • Create and implement an effective development infrastructure that meets SOM’s prioritized needs, including support and development staff by June 30, 2006.
    • Expand alumni activities that include the house staff and Diagnostic & Therapeutic program alumni.
    • Create visibility for the School of Medicine’s work within the community and with alumni and donors across the nation by creating a speaker’s bureau, involving members of the community in an advisory capacity, find current addresses for 50 lost alumni, and arrange 10 visits for the Dean with major donors or prospects by December 2006.
    • Increase annual expendable revenue 20% by writing 4 audience-specific scripts and segmenting the calling lists. Script message will be supported by a consistent message in other college communication including UNM Med.

    4.6 The SOM will support the development and growth of strategic programs, centers, institutes, and departments, particularly those that advance multi-disciplinary and multi-mission objectives. The SOM will provide the necessary infrastructure to assure the success of both new and existing programs of strategic importance.

    • Center for Native American Health
    • Provide support and leadership for the recruitment of Native American students into the educational programs of the SOM, including the BA/MD degree program.
    • Provide support for Native Americans who are enrolled in HSC educational programs through mentoring, quarterly health forums, providing information on resources, and identifying HSC job opportunities.
    • Implement NIH/IHS funded Native American Research Centers for Health (NARCH) Student Development project in three Navajo chapter communities, Ramah Navajo, ToHájiilee Navajo, and Alamo Navajo.
    • Support the Rural Health Interdisciplinary Program (RHIP) by identifying projects specific to NA communities for student RHIP interns; and establishing NA communities as sites for RHIP teaching.
    • Provide input into the Department of Health initiative to develop strategic public health plan for the state and assume an appropriate role in its implementation.
    • Support the CRTC in providing education and training to native communities on cancer education, prevention, and clinical trials.
    • Organize and hold a UNM Tribal Research summit in partnership with IHS, NM Tribes and NM Dept. of Health.
    • Establish, expand and maintain Tribal partnerships.
    • Establish a NM Tribal Health Advisory committee to work directly with UNM HSC EXEC Vice President.
    • Ethics Institute
    • Provide the BA/MD program with necessary support to help BA students define their new role as a young doctor in training.
    • In collaboration with the SOM, School’s of Law, Business, and Communication and Journalism, develop and implement the Rust Family Ethics Bowl.
    • Develop and teach the research ethics component of the Masters in Clinical Research program being developed for the CTSA.
    • Develop in collaboration with the New Mexico Board of Medicine and the CME office a CME program in medical ethics and professionalism.
    • Develop an ethics program to be telecast through the media to increase public education about ethics and ethical issues.
    • Develop and implement strategies to increase the Institute’s revenue sources.
    • Develop policies and procedures for reimbursements for ethics consultations to entities external to the HSC.
    • Formalize the Ethics Research Consultation Service, including mechanisms to write the cost of the service into grants and contracts.
    • Develop and implement an ethics in medicine award; modeling the program after the one that is in place at the business school.
    • In collaboration with Tuskegee and Gallaudet Universities, develop mechanisms to address the bioethical needs of communities of color related to issues of health care disparities.
    • Establish an external advisory group to forge strategic partnerships and alliances that leverage the Institute’s resources, enhance its sphere of influence and increase its visibility.
    • Institute for Public Health
    • Expand the Strategic Roadmap and employ it to develop HSC curricula, guide research, and inform planning in health and healthcare for New Mexico.
    • Provide leadership in adapting elements of the MPH curriculum into formats that will be appropriate for the MD Public Health Certificate by July 2006.
    • Conduct Phase 3 Ambulatory Rotation and work with PEAR to conduct the evaluation of the rotation by July 2006
    • Assure administrative clearance and identification and development of the MPH components of the combined MD/MPH degree program by August 2006.
    • Develop and present a proposal for off-campus or regional training for professionals in public health practice by July 2006.
    • Develop in collaboration with the DOH a comprehensive education plan to address the needs of New Mexico’s existing public health workforce by December 2006.
    • Support the development of the CTSA planning grant from the perspectives of tying the effort to state priorities, planning for community based research, and developing a research training track in the MPH.
    • Provide input into each of the Signature Research Programs to identify opportunities for translational research that address state priorities and submit plans by December 2006.
    • Create a plan for developing community sites for epidemiologic and participatory research by December 2006.
    • Finance
    • Improve existing databases so that integration of financial and productivity data will support strategic decision making in real time.
    • Strengthen the financial position of the SOM in order to ensure maximal fulfillment of its three missions:
    • Develop a financial plan for FY 2007 that allows for necessary faculty and staff compensation increases and allows for needed capital investment, while maintaining an acceptable operating margin and adequate fund balances.
    • Develop and implement three to five year plans to eliminate departmental deficit fund balances.
    • Implement processes, in collaboration with HSC Financial Services and UNM Controller’s Office, to make monthly accounting adjustments (e.g. accruals) that better reflect real-time financial realities within all units of the SOM.
    • Identify and develop training curriculums for SOM departmental staff to educate staff on areas that will facilitate the accuracy of financial data and give staff an understanding on how to access and use available financial reports.

     

     
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