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School of Medicine Administration

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CY 2005 Action Plan

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Introduction

The SOM had a challenging year in 2004. We were required to take steps to lower our costs – including deferring raises for our faculty and Housestaff – while also implementing changes to increase our revenues. The good news is that we are now hitting our revised budget targets for FY05 and that the UNM Board of Regents have taken our cause as the top priority for the 2005 Legislative Session. With their support and the continued leadership of Dr. Eaton and President Caldera, we will be able to absorb the increased costs imposed upon us by the state while we enjoy substantially improved revenue streams in FY06. If these budgetary trends continue, we will be able to cover our increased costs and provide raises to our faculty and Housestaff in FY06.

The new Clinical Enterprise Strategic Plan, which will be executed at the beginning of CY 2005, is expected to generate significant additional revenues through multiple operational improvements. This strategic plan, together with other aspects of our Clinical Action Plan for CY05, will better position us to fulfill our obligations to our patients and others who depend on the quality and breadth of our clinical enterprise.

The educational initiatives in the CY05 Action Plan continue to move forward the objectives of our Five Year Strategic Plan. Several of them - including the BA/MD combined degree program – have been embraced by UNM and State leaders as priorities for our institution and for New Mexico. Our educational programs continue to be understood as major factors in the physical, social, and economic health of New Mexicans.

In a time of tightening federal research budgets, we are taking steps to improve our research support functions and bring new efficiencies into the research environment. Additionally, I have identified the research themes of Infection and Immunology, Neurosciences and Oncology as the main areas of focus for our School and will develop specific strategies to achieve the next level of excellence in these areas.

I am very appreciative of the hard work and sacrifice that all of our faculty and staff made in 2004. Because of this, our experiences in 2005 will be positive and allow us to continue growing our outstanding programs in education research and clinical care. While the CY 2005 Action Plan sets the roadmap for the year, it is likely to be modified at times during it’s implementation and you will be informed of any revisions made to it. I am sure you will agree that the Action Plan will continue to lead us toward accomplishments in which we all can take pride.

Paul B. Roth, M.D.
Dean, School of Medicine
Assoc.Vice President for Clinical Affairs
1/12/2005

EDUCATION

1.1 Develop and implement a combined degree program with UNM College of Arts and Sciences to recruit and retain outstanding New Mexico High School students from diverse, rural, and underserved communities of New Mexico and those with exceptional academic preparation.

• Comprehensive outreach and recruiting plan 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 March 2005.
• A comprehensive Admissions plan, including criteria for matriculation into the School of Medicine and an interview process that includes community mentor participation will be developed by February 2005.

1.2 Integrate the principles of public health and experiences in public health with the Medical School curriculum by expanding the integration of the principles of public health, biostatistics/epidemiology, organization of health systems, evidence-based medicine and a population health research project such that all School of Medicine graduates will be eligible for a Certificate in Public Health

• Evaluate of the pilot project to give each medical student experience in Public Health as part of the Phase 3 Ambulatory rotation by July 2005.
• Evaluate existing pilots such as the Phase I “Caring for the Community” in the Human Structure and Function Bloc, the Phase II Evidence-Based Medicine course, and the public health components of the Phase III Ambulatory rotation by July 2005.
• Specific curriculum of the Certificate program will be developed by April 2005 and approved by the SOM faculty by June 2005
• Have the Certificate in Public Health formally recognized by the University of New Mexico by December 2005
  • (Necessary steps: Internal UNM Approval by the Dean of Graduate Studies, the Provost, the Senate Graduate committee, the Faculty Senate, the Regents; by external approval by NM Council of Graduate Deans, Commission on Higher Education)

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 2005.
• 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 2005.
• 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 2005.
• 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 2005.
• 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 2005.
• Presentation of the Medical Lab Science program to every institution of higher education in the state of New Mexico by December of 2005.
• The Division of Dental Hygiene faculty will develop a plan by December 2005 to operate a distance education dental hygiene program in collaboration with ENMU-Roswell for implementation Spring 2006

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

• Plan an Advanced Masters Program and a Doctoral (Ph.D.) Program in Occupational Therapy by June 2005.
• Develop the basic curricular outline for the Doctor of Physical Therapy degree (DPT) by September 2005.
• Develop a doctoral degree in Medical Lab Sciences by December 2005.

1.5 The MET faculty and HSCLIC faculty will develop an 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 by September 2005.

CLINICAL

2.1 Improve financial product of clinical care

• Improve the payor mix of patients utilizing our clinical services-
  • Attract paying patients – Lobo Care, BC/BS -
  • Identify most promising number that can be accommodated and Implemented program.
  • Improve access to care for paying patients.
  • Improve overall patient satisfaction to 81.1%, Ambulatory 82.4% by Dec. 2004 – June 30, 2005, and 79.3 for inpatient and 80% by December
  • Manage 500 indigent care through Care One and UNM Care.
  • Distribute 1000 indigent/uninsured to First Choice
• Revenue cycle improvements
  • Hire consultants
  • Implement recommendations
• Improve capacity
  • Efficiency of bed utilization – admission and discharge process - Identify work teams; implement recommended accountability from CEO and chairs
  • Rent or build additional clinical space- Discuss options. Decision in two months. Implement in two to three months.
  • OR capacity – Identify key recommendations from team – implement.
  • Increase UNMH bed staffing to 100%.
  • ED overcrowding – Identify metrics, admit time, LWBS, and develop recommendations to improve
  • GI – Cardiology, Neurosciences – address capacity issues with new space.

2.2 Develop Faculty Practice Organization

• Identify priority areas – Productivity standards, contracting, revenue cycle, and facility.
• Select and order.
• Address initial priority area.

2.3 Patient Safety

• Develop a process for medical malpractice claim review and lawsuit review and make sure it feeds back into quality improvement. Tracking, quality, review, and legal representation to reduce premiums.
• Mandate that medical error and patient safety issues are included in morbidity and mortality case conferences for all residency programs and that the results are fed back into clinical affairs reappointment and quality improvement process.
• Result of PIPSQC to be addressed in UH and SOM budgetary process and performance plans.

2.4 Ambulatory

• Improve overall patient satisfaction to 81.19%.
• Identify the Medical Directors for all clinics and clarify roles, goals, and align incentives with hospital managers.
• Access – Implement Advanced access – reduce next available appointment by 20%.

2.5 Inpatient

• Address discharge process.
• Identify the Medical Directors and roles for the units.

2.6 Indigent/Payer Mix

• Improve insured payer mix by .5%.

RESEARCH

3.1 Pursue the top three research foci of Infection and Immunology, Neurosicences and Oncology.

3.2 Compete successfully for high-quality graduate students and post-doctoral fellows

• Gain additional revenues from tuition return to support the BSGP program and to expand the class size (June 05).
• Advertise post-doc positions on the central postdoctoral website managed by the Research Education Office in the Office of Research and prepare a step-by-step instruction sheet for recruiting post docs (March 05).
• Submit one new training grant (Dec 05).

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

• Convene two disease-focused meetings to facilitate research collaborations between basic science, outcomes/community-based and clinical faculty (Dec 05).
• Identify five new grant initiatives through the Strategic Research Planning Committee (SRPC) that will increase funding by aligning grant applications with areas of identified research strength (Dec 05).

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

• Establish a Research Practice Organization (RPO) that provides overarching guidance on themes such as use of IDC funds, maximizing the federally mandated F&A rate by capturing all research-related cost, organization and function of pre- and post-award, etc (June 05).
• Lead efforts through the RP0 to streamline the grants and contracts submission, contract completion and grants accounting through the Controller’s office and compliance monitoring committees, by completing a Website that directs faculty in understanding the grant application process, reducing faculty and staff efforts in pre-award processes, decreasing the time between grant award and account set-up and decreasing the time required for approvals for CDAs, MTAs, COI issues and CTAs. (September 30, 2005).
• Enhance quality of grant submissions through investigator workshops (June 05).
• Expand clinical-faculty research training (e.g., GCRC Clinical Scholars) and Academic Affairs-sponsored mentoring programs to prepare faculty to conduct clinical research at a competitive level (Aug 05).

3.5 Develop an institutional reward system for faculty participating in multidisciplinary research

• Establish departmental and individual incentives for faculty to conduct clinical and health outcomes research – e.g., IDC return and release time (Dec 05).
• Develop new financial incentives for departments, department chairs and faculty to encourage team science (Dec 05).
• Recognize interdisciplinary activities in the faculty activity database (FAD) and work with departments to clearly document these activities for tenure and promotion decisions (June 05).

3.6 To be successful in obtaining funding for big-research initiatives through partnering within UNM, and with other universities and state institutions

• Convene a thematic meeting (e.g., focused on a specific grant opportunity) with targeted scientists from UNM and a research partner institution to discuss common interests and capabilities and facilitate collaborative research initiatives around the identified grant opportunity (Dec 05).

3.7 To 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 (Aug 05).
• Develop a NARCH-Native-American Scientific Community Advisory Board (June 05).
• Organize an Albuquerque Area Indian Health Service IRB in conjunction with the UNM-SOM HRRC (Aug 05).
• Increase the number of Native American researchers through special mentoring and development programs (Dec 05).

3.8 To increase the commercialization of intellectual property (IP).

• To 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 to increase faculty involvement to achieve those targets (June 05).

ADMINISTRATION

4.1 The SOM will 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.

• Assure that Clinician Educator Policies have been revised so that they are aligned with the tenure/promotion policies in the Faculty Handbook.
• Changes to both the Clinician educator and tenure policies for notification of negative third year review and notification within tenure track of negative reviews have been approved by the COC. Wording of the policies is to be completed by 28 January 2005 to allow three weeks review by the faculty before a vote at the February General faculty meeting. Creation of a template of the path of review for both CE and tenure track will be placed on the web by 24 February 2005 to allow a more transparent description of the processes.

4.2 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. A plan will be developed in collaboration with UNMHSC Human Resources Dept. to be submitted to Dean Roth by June 1, 2005.
  • Submit a full report in December of 2005 documenting the changes in promotion of URM and women to SOM staff positions of 10 or higher. This report will be produced in collaboration with UNMHSC HR
• Faculty
  • UNM School of Medicine has made much progress in the recruitment and retention of URM faculty and is among the national leaders in the area of URM faculty by maintaining double the national average – (SOM is at 10%). This has been made possible by the Center of Excellence Grant awarded continuously to the SOM from 1996 to 2004. Drs. Padilla and Gomez will resubmit the Center of Excellence Grant to HRSA for funding in January 2005.
  • Contact all potential faculty who are being invited to interview with the SOM in order to address the issues of diversity. We will offer to assist them in meeting groups within UNM or the community who represent the multiple levels of diversity that exist within our community. The purpose will be to enhance their understanding of the level of support available if they were to join our faculty. These contacts will begin by January 2005. Success will be measured by demonstrating that more than 50% of potential faculty has been contacted.
  • The UNMSOM Center of Excellence will function as a clearinghouse for additional fellowship and training opportunities for junior faculty at the SOM, as well as maintain a database of funding opportunities (while tracking the outcomes on an annual basis) by December 2005.

4.3 The SOM will work to enhance its Development Office activities and results.

• Develop a pilot program with four departments creating a “Development Staff Representative” to work with departments to create a development program for those departments.

4.4 The SOM will support the development and growth of strategic programs, centers, 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.

• Support continued development of the CRTC to achieve NCI designation in 2005/2006.
• Support development and success of the Institute for Ethics and the ethics programs through four educational initiatives that will have been successfully implemented or enhanced by the end of CY05:
  • The Joan Gibson Health Care Ethics Certificate Program
  • The Jack and Donna Rust Project on Ethics and Professionalism at the Bedside: Ethics, Law and Medicine Forum
  • The Jack and Donna Rust Community Outreach Program
• Support development and success of the Center for Native American Health
  • By December 2005 develop a strong formal structure for CNAH.
  • By December 2005 establish an HSC American Indian Student Support Service.
  • By December 2005 establish with CRTC a CHR intervention program to provide cancer education and prevention programs to native communities.
  • In collaboration with UNMHSLIC create by December 2005 a database inventory of all HSC research & non-research projects involving NM Native Americans.
  • Determine tribally driven research priorities through a NM Tribal Research Conference to be held Spring/Summer 2005.
• Support development and success of the Institute for Public Health
  • By December 2005, the IPH will have generated a strategic road map that broadly connects the SOM to the needs of New Mexico. The roadmap will have had review within the SOM and with external partners sufficient to achieve acceptance and use. The roadmap will be used to develop curricula, guide research, and inform planning in health and healthcare for New Mexico.
• Support development and success of the Oral Health Institute
  • The SOM will assure by January 2005, the selection of an interim OHI Director.
  • By May 2005 the Internal Executive Committee will be formed and a three-year business plan for the OHI completed.
  • By June 2005, the co directors of the Residency and the Masters in Dental Hygiene programs will conduct first year evaluations of the expanded education programs and submit a combined report.
• Create coherent structure for Biostatistics faculty and programs

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

• Staff
  • Support and participate in “Pathways to Success” mentorship pilot program developed by HSC Human Resource Department.
• Faculty
  • Develop plan for expanding mentoring assignments for new physician leaders to receive support and guidance from existing leaders.
  • Will work with the Committee of Chairs to develop mentoring assignments for all new leaders who are assuming new assignments at the divisional, center and institute level. This objective will be completed by July, 2005.
  • Will work with the senior leadership of the HSC to develop and implement a mentoring program for physician leaders who are assuming roles within the clinical enterprise. This objective will be implemented by July, 2005.
• Develop and implement Physician Leadership Workshops to address new clinical enterprise assignments. This will be developed with the HSC leadership and will be implemented by October, 2005.
• Develop education for staff and faculty in group process management, continuous improvement and project management. This will be implemented with UNM Hospital personnel by October, 2005.

4.6 The SOM will improve existing databases so that integration of financial and productivity data will support strategic decision making in real time.

• The SOM shall improve and stabilize it’s financial position:
  • Achieve financial results for FY 2005 that are as good or better than the projected “negative net margin” of $2,059,000.
  • Create a realistic financial plan for FY 2006 showing a positive net margin.
• The SOM, in conjunction with University Hospital and the Health Sciences Center, shall improve data-driven decision making by developing integrated clinical financial reports at an enterprise level.