The Momentum Continues in 2012

As stated in our Strategic Plan (http://forwardtogether.health.ufl.edu/), our vision for UF&Shands is that:

“Together we strive to create unstoppable momentum toward the goal of improving individual and community health through discovery, clinical and translational science and technology, exceptional education, and patient-centered, innovative, high-quality health care.”

The work that you have done since this statement was published in May 2010 has contributed toward achieving this vision in a progressive manner, year by year. 2012 will be a year in which we gain further momentum toward becoming “unstoppable.” This is our vision as we move Forward Together.

The key strategic elements of this vision have been previously articulated on this Page. They are:

We have made considerable progress in each of these areas. If 2012 is to be a year of accelerated momentum, we need to focus actively on those things that will be the key catalysts — patient-care quality, GatorAdvantage and self-insurance, facility openings and upgrades, research productivity, philanthropy and new curricula. As well, we need to work hard to defeat or mitigate key threats — i.e., state and federal legislative actions that may significantly impair our education and safety net missions.

Patient Care Quality: Quality is Job 1. This is the centerpiece of the entire strategic plan. As our quality of care has improved, so has the excitement about our education and clinical missions. Thanks to the efforts of faculty and staff throughout every component of our ambulatory and inpatient service, in both Gainesville and Jacksonville, we have made substantial progress in our safety and quality scores based on University HealthSystem Consortium (UHC) metrics. For the upcoming year, we have identified a number of specific goals.

In Gainesville we are focusing on three Big Aims: reducing harm, improving the patient experience and reducing variation in care. We are working to lessen harm by reducing hospital mortality through optimization of our adult and pediatric early warning systems and improving sepsis care. In addition, we are implementing new processes to reduce harm through improved surgical safety briefings in our operating rooms. We are also focusing on improving the patient experience through numerous initiatives including hourly rounding, improving pain management and the I Promise campaign. Finally, we are working on ways to reduce variation in care provided to our patients through increased use of order sets and protocols through the implementation of EPIC.

In Jacksonville, we will focus on three major initiatives with the overarching goal of advancing Shands Jacksonville into the UHC four-star rating. First and requiring the broadest effort will be reducing the readmission rate from the current 13.4% to the target benchmark of 10.3%. The second initiative is to improve patient satisfaction as measured by Hospital Consumer Assessment of Healthcare and Provider Systems (HCAHPS). Our final goal is to improve the Agency for Healthcare Research and Quality’s composite indicator for patient safety incidents from the 25th percentile to the 75th percentile.

GatorAdvantage: This is about Gators taking care of Gators. We have made substantial improvements in improving access and customer service in the GatorAdvantage program, but we need to reach out even more to our colleagues and co-workers at UF and at Shands, and provide them with great service and our expert, compassionate care. When we gain the confidence of a sufficient number of faculty and staff in our UF&Shands community, word-of-mouth will grow, a tipping point will be reached, and the momentum will grow.

Self-insured health plan: The University of Florida is requesting the ability to create a self-insured health plan during the current legislative session. Self-insurance extends the idea of GatorAdvantage to a health plan that will emphasize prevention, wellness and evidence-based practice. If we obtain approval, what self-insurance means is that all premiums will come to UF rather than an insurance company, and UF will pay medical claims on behalf of its employees through a third-party administrator. It gives us, collectively, the flexibility to take responsibility for our health plan and to take responsibility for our health.

Clinical facilities-Gainesville: In July, we will open UF&Shands Family Medicine at Main, a University of Florida Physicians (UFP) practice in a new 25,000-square-foot building that will serve the primary care needs for the Gainesville community and for GatorAdvantage patients. Toward the end of the calendar year, we will also open UF&Shands at Springhill, a 110,000-square-foot building on 39th Avenue near I-75. This will be a state-of-the-art UFP multispecialty facility that will include a variety of specialty services including dermatology, neurology, psychiatry, women’s health including in vitro fertilization, and chronic pain evaluation and treatment. At Shands at UF, a new GI endoscopy suite will be constructed in the Cancer Hospital, a new welcome and triage unit will be constructed for Labor and Delivery and a new lobby for the Shands Hospital for Children will be created.

Clinical facilities-Jacksonville: The new year will start with the roll-out of the EPIC system on the campus beginning on January 21st. This will be an exciting time as we move forward to launch the system in the inpatient environment. Development in North Jacksonville will get underway now that the state has granted preliminary approval of the Shands Jacksonville North Certificate of Need. UF&Shands Jacksonville is busily preparing for full development of the site. Plans to develop the last unused space at the Emerson Street complex for ambulatory services are currently underway. Additional UF services will be announced in the coming weeks as the complex continues to serve patients on the Southside. On the main campus, the newly renovated 8 North unit, which features all private rooms, will come online in February. It is the first renovation to be completed with the use of the EPIC system fully integrated into the plan. In August, the new outpatient VA Clinic will open next door to the campus. Once this occurs, the VA will leave behind nearly 50,000 square feet of space at Shands Jacksonville. Plans are underway to renovate and convert this space to further enhance community access services.

Research facilities: The Academic and Research Building at Lake Nona is proceeding on schedule and should be open by summer. This is an extraordinary facility that will include educational space for the College of Pharmacy, specialized clinical and laboratory research space for the colleges of Medicine and Pharmacy and space for clinical trials for the Institute on Aging. Construction on the Clinical and Translational Research Building is underway. This will house the Institute on Aging, the Clinical and Translational Science Institute (CTSI) headquarters, the General Clinical Research Unit, the Department of Epidemiology and the Department of Biostatistics and several specific clinical research programs.

Research productivity: The opening of the Academic and Research Building in Lake Nona is exciting, but even more exciting is that two groups of faculty investigators will move into the building — one focused on clinical pharmacometrics and systems pharmacology, and the other on developing methods to fight drug-resistant microbes, both by drug development of new antibiotics and by suppression of resistant microbes. Overall research productivity throughout the health science center will be enhanced by improved infrastructure related to our CTSI. Specific goals for the year include: 1) development of a statewide biomedical research collaboration network involving UF&Shands, Florida State University, and emerging partners in Orlando and Tampa; 2) creation of new consent processes for research use of tissue and data in clinical settings to support various transformational initiatives; 3) design and deliver consulting services to improve the recruitment and retention of research subjects; 4) build our biorepository to provide scalable, cost-recovery services for major research programs, integrated with sample processing and the developing metabolomics center; 5) implement the enterprise-wide Integrated Data Repository for clinical and research use, along with data flows from Epic, laboratory, biorepository and additional strategic information resources; and 6) create a Master’s degree program in Biomedical Informatics.

Philanthropy: Funding from the state for our educational and research programs is expected to be flat or declining in the next few years. Philanthropy becomes more important than ever to fill in the gaps and spark growth. Despite the economic downturn, cash gifts (including cash payments on pledges) to the colleges and hospitals that comprise UF&Shands increased from $41 million in FY10 to $58 million in FY11. This shows that our donors are excited about developments at UF&Shands and wish to support our efforts. For FY12, our goal is to continue this substantial show of support, with a focus on major gifts and building development programs in all of the units that comprise UF&Shands.

New curricula: The goal of interprofessional education is to train health professionals to provide collaborative care that is high quality, safe, and patient centered. During the coming academic year, an expansion of the current interprofessional curriculum will take place, with students from multiple colleges learning together in teams. Newly developed half-day sessions will address patient safety and quality of care, health systems and health disparities, professional ethics and health care roles. All the sessions will include aspects of communication skills and team building. Multidisciplinary conferences during clinical rotations are also being developed, with an emphasis on patient safety and quality.

State and federal legislative actions: The Governor’s budget proposal includes over $2 billion in cuts to Medicaid hospital payments statewide. The hospital industry is actively working to push back against drastic Medicaid cuts harmful to our patients, providers, and communities. We will remain engaged in the legislative process as the House and Senate Committees develop and reconcile their budget proposals in the next few months. In Washington, D.C., 2012 will bring more funding threats to our academic missions. Medicare Graduate Medical Education payments and NIH research grants are particularly vulnerable to cuts. We will work persistently to mitigate any federal funding reductions and to prevent a 27% reduction in Medicare physician rates.

Finally, 2012 will bring a changing of the guard in the leadership of the College of Medicine-Jacksonville. As announced last September, after an incredible 40 years of faculty service and college leadership, Dr. Robert Nuss will be retiring from his position as vice president for health affairs, Jacksonville, and dean of the College of Medicine, Jacksonville. Under Dr. Nuss’s strong leadership, the Jacksonville campus has grown substantially and thrived, and he leaves a legacy of mentorship, commitment to excellence and organizational savvy. Taking up this critical role at a critical time will be Daniel R. Wilson, MD, PhD, who comes to us from Creighton University where he was chairman of the department of psychiatry for the past 11 years. Dr. Wilson was chosen for his demonstrated record of achievement, his international reputation and sustained academic and administrative excellence. He is excited to be here and we are excited that he decided to join the UF&Shands family.

Wishing you all a year of personal and professional momentum and growth,

Forward Together,

David S. Guzick, M.D., Ph.D. Senior Vice President, Health Affairs President, UF&Shands Health System