That was the year that was: Celebrating our achievements in 2011

Welcome to 2012, OTSP readers! As we approached the New Year, whether you were taking a well-deserved holiday or continuing to work on your research or serve the needs of our patients, no doubt you took time to reflect on the year that has just passed and to think about your personal resolutions and professional goals for the year ahead.

What does turning the page on a new year mean to you? And what does it mean for UF&Shands? I would argue that for our academic health center, the idea of “out with the old, in with the new” doesn’t fit. Rather, we build on progress from one year to the next. In this spirit, here is a celebration of our achievements in 2011, as recounted by our HSC college deans and center/institute directors, and by our hospital CEOs. In the next issue of OTSP, I will set out some key goals for UF&Shands for 2012.

COLLEGE OF DENTISTRY

• Research: Despite an extremely challenging environment for research funding, we maintained our national ranking as fifth among all dental institutions in the United States for NIH research funding through the National Institute of Dental and Craniofacial Research. We also received official designation as a research center by the State of Florida and by the Office of Institutional Research for The Southeast Center for Research to Reduce Disparities in Oral Health.
• Education: We created two new administrative units, the Department of Restorative Dental Sciences and the School for Advanced Dental Sciences. These changes will better prepare DMD and dental specialty students for dental practice, and to support interdisciplinary clinically oriented research.
• Patient care: This past year, we deployed a new clinical management software system that includes an electronic dental record. The new software’s data collection ability also enhances our ability to continue to improve quality processes including timeliness and appropriateness of care. Our dental program under GatorAdvantage was expanded to include discounts for certain specialties, and the response of UF&Shands employees to our full range of dental services was gratifying. Our Gator Advantage contact number is 352-273-7954 and Gator Perks for dental services can be found at http://www.hr.ufl.edu/benefits/gatorperks/default.asp#uf

COLLEGE OF MEDICINE

• Research: Faculty in the UF College of Medicine (COM) generated a 16% year-over-year growth in NIH funded research, ONE OF the largest PERCENTAGE increases nationally among medical schools. The COM continues to attract and retain the nation’s best scientific minds and academic leaders, like Drs. Robert Hromas, Michael Clare-Salzler, Linda Cottler, Mark Scarborough, Scott Rivkees, and Vladimir Vincek, who began as chairs of Medicine, Pathology, Epidemiology, Orthopedics, Pediatrics, and Dermatology (a new department in the COM), respectively, and Dr. George Drusano, who joined UF and will bring his emerging infections research group to the new UF research facility at Lake Nona in Orlando when construction finishes later in 2012.
• Education: A major reform of the medical education curriculum was initiated, which quickly identified the need for new educational facilities to implement fully. A major leadership gift was received from Class of 1960 alumni Dr. Jim Free and his wife Carole, which enables the COM to move forward in designing and creating the a new medical education building, and within it, to create a new Center for Primary Care Education and Innovation. Dr. Ralph Rice was appointed Director of the UF School of Physician Assistant (PA) Studies, and working with VA Associate Chief of Staff for Education, Dr. Josepha Choeng and many VA colleagues, successfully competed for funding to create an innovative PA Residency Program at the Malcolm Randall VA Medical Center, one of just six such programs in the nation.
• Patient Care: Unwavering focus on patient safety and quality of care by COM faculty helped propel Shands@UF forward to a 4-star rating in quality performance by the University Healthcare Consortium. The patient safety component score was 12th best in the nation. University of Florida Physicians, the college’s faculty practice, began construction on a new family medicine facility on Main Street, a new multi-specialty office building at the Springhill northwest campus near I-75 and NW 39th Avenue, and renovations to create a new Florida Recovery Center campus at Williston Road and SW13th Street. Additional open access programs were added to the practice, such as OrthoCare After Hours at the Orthopaedic & Sports Medicine Institute on SW 34th Street and Hull Road.

COLLEGE OF MEDICINE – JACKSONVILLE

• Recruitment: New faculty appointments made a significant impact on the campus over the past year. After an extensive national search, the new Dean of the College of Medicine – Jacksonville and Associate Senior Vice President for Health Affairs was appointed. Dan Wilson, MD, PhD will join the organization early in 2012. In addition, Robert Levy MD, PhD, the new Chair of Neurosurgery, and Nipa Shah, MD, the new Chair of Community and Family Medicine, have joined the faculty this year.
• Medical Homes: The 21 offices of the Jacksonville based UF primary care network have been designated as Medical Homes by the National Committee on Quality Assurance (NCQA). The UF network is the first academic practice in Florida to achieve this designation and the only primary care network in Jacksonville to be recognized. UF faculty at these locations demonstrate the highest level of patient-centered care when benchmarked by the NCQA.
• Caring Communications: A community-based curriculum focused on enhancing the listening skills of clinicians has now been taught to nearly 772 physicians, nurses and administrators on the Jacksonville campus. This model has enhanced the patient and the provider experience. A perfect complement to the “I Promise” campaign, this program provides skills and tools to clinicians as they interact with our patients.

COLLEGE OF NURSING

• Clinical: Archer Family Health Care (AFHC), the UF College of Nursing’s comprehensive, nurse-managed health center, celebrated its 10th anniversary in 2011. The clinic also initiated a state-of-the-art practice management and electronic health record system, made possible through a collaborative agreement with the Alliance of Chicago. AFHC is a nationally recognized model partnering with a local community to expand access to high-quality care for the underserved. About 80 percent of AFHC patients have incomes below 200 percent of federal poverty guidelines, and more than half have no health insurance. In 2011 the clinic had over 6,000 patient visits — more than six times the number of visits the center had during its first year of operation.
• Research: Carmen Rodriguez, PhD, ARNP, College of Nursing assistant professor, received a $1 million grant from the National Institutes of Health to develop a speech-generating device for patients who cannot speak. The NIH Phase 2 Small Business Innovation Research program will support the development of “GatorVoice,” a device to help suddenly speechless hospital patients communicate their needs.
• Education: The College of Nursing implemented a completely revised Bachelor of Science in Nursing curriculum, which now reflects the most current national standards and emphasizes the Institute of Medicine’s competencies including evidence-based practice, systems leadership, prevention/population health, inter-professional teamwork and patient safety/quality. The first class in this new curriculum graduated in December, 2011.

COLLEGE OF PHARMACY

• Endowed Professorship in Hospital Safety: Bob Crisafi, Ph.D., and his wife, Barbara, donated $1 million to the college to create a chair in the department of pharmaceutical outcomes and policy to look at how medication is administered in a hospital and to create systems that will prevent medication errors. The gift established an endowed chair at the College of Pharmacy that will work in conjunction with Shands HealthCare to generate new studies and processes to further reduce drug errors at hospitals. The goal is to improve patient safety not just at Shands but also at hospitals throughout the U.S.
• UF Research & Academic Center in Orlando: A leading scientist in clinical pharmacology at the Food and Drug Administration has taken a new academic role at the UF College of Pharmacy to improve drug development and create tools and approaches to make sure new products are safe, effective and within FDA-regulated standards. Lawrence J. Lesko, Ph.D., is leading the college’s new pharmacometrics and systems pharmacology initiative at the UF Research and Academic Center, now under construction in Orlando. With plans to add several faculty researchers and a dozen graduate students and postdoctoral fellows, the program will provide a vital pipeline in training the next generation of scientists skilled in drug-modeling simulation, translational science and drug regulatory affairs.
• Marine Natural Products: Hendrik Luesch, Ph.D., an associate professor of medicinal chemistry at UF’s College of Pharmacy, took a generally lethal byproduct of marine cyanobacteria and made it more specifically toxic — to cancer cells. More lab work is required before a drug based on apratoxin can be tested in patients with colon cancer, but Luesch believes apratoxin S4 is the first candidate to show the needed tumor selectivity, antitumor effects and potency to be effective. The UF Research Opportunity Fund and the Bankhead-Coley Cancer Research Program supported the study. Earlier in the year, Luesch also published an additional potential benefit for his Largazole compound in treating serious fractures, osteoporosis and other bone diseases.

COLLEGE OF PUBLIC HEALTH AND HEALTH PROFESSIONS

• The number of degrees awarded by the College of Public Health and Health Professions (PHHP) in academic year 2010-2011 increased by 26% to 667, including 326 bachelors, 175 masters, and 166 doctoral degrees, and the College inaugurated a new PhD program in public health with concentrations in environmental and global health, and social and behavioral science.
• PHHP’s extramural research funding increased by 9% to $19 million, and the College ranked 18th in NIH funding among the 49 accredited schools of public health.
• Two new departments (Epidemiology and Biostatistics) that reside simultaneously in PHHP and in the College of Medicine were launched successfully, and an internationally renowned scholar, Linda B. Cottler, PhD, MPH, was recruited as the founding chair of the Department of Epidemiology.

COLLEGE OF VETERINARY MEDICINE

• Personnel: This past year, in addition to numerous faculty hires to improve our research, clinical and educational productivity, the College of Veterinary Medicine made several important leadership appointments: Dr. Dana Zimmel was appointed Chief of Staff for the veterinary hospitals. She is an equine internist with a special interest in hospital leadership. Dr. Paul Cooke was recruited from University of Illinois as Chair of Veterinary Physiological Sciences. Dr. Rowan Milner, a veterinary oncologist, was appointed Chair of Small Animal Clinical Sciences.
• Veterinary students: Enrollment was increased from 100 to 112 for the class entering Fall of 2012. Performance of the graduates of 2011 was stellar: 100% of them passed the licensing board examination and 100% of them have been employed as veterinarians. To accommodate the increased class size, we constructed a new 160 seat state of the art auditorium, and renovated several teaching and clinical areas.
• Clinical Services: We have implemented new initiatives in our new Small Animal Hospital with a focus on excellence in patient care, an exceptional client experience, and improved services to referring veterinarians. Specialty services have been adjusted and or expanded; results for 2011 indicate increases in both caseload and revenue.

CANCER CENTER

• Research: Jianrong Lu, PhD, and his team have shown that chromatin insulator-binding factor (CTCF) binds to VEGF, a powerful angiogenic factor and regulates angiogenesis. This discovery has implications for a number of angiogenesis dependant diseases, and in particular should help us better control tumor growth and metastases. David Reisman, MD, PhD, and his team have identified two polymorphic sites on the BRM tumor suppressor gene associated with smoking related lung cancer. They have also discovered agents that can demethylate BRM potentially leading to reversal of the enhanced cancer risk for smokers. Sadasivan Vidyasagar, MD, PhD, and his team have identified a nutrient beverage that corrects for the mucosal transport abnormalities following radiation or chemotherapy. The patented and licensed invention, termed Enterade, should be available in the Spring.
• UF Proton Therapy Institute:
  • Pediatric proton therapy led by Drs. Indelicato, Mendenhall, and Marcus has started the nation’s first pediatric proton fellowship, and has become the principal destination for patients from Canada’s Princess Margaret Hospital, the British Health Service, St. Jude's Children’s Hospital and attracts children from Australia, South America, and throughout the world.
  • UF Proton Therapy Institute has now treated nearly 3000 men with prostate cancer boasting a near perfect local control rate and a markedly lower rate of side effects compared to standard radiation. Potency rates in particular are substantially better than standard radiation and to nerve sparing surgery reported in the Journal of the American Medical Association (JAMA).
  • Exploring the potential for the high linear energy transfer (LET) matrix of the proton beam to augment radiation inducible tumor autoimmunity are recently funded grants in lung cancer (Dr. Hoppe) and sarcoma (Dr. Indelicato). The goal is to improve tumor control using proton treatment and to provide a vaccine-like, tumor-specific, autoimmunity.
• Our stereotactic body radiosurgery program, aimed at comprehensive treatment of patients with metastatic disease, is off to a great start, with 50 patients treated last year. Our physician residents, lead by Robert Amdur, MD, distinguished themselves again in 2011 by producing the second highest number of peer reviewed papers in the country. A multidisciplinary team of physicians, led by Stephen Grobmyer, MD, in the Department of Surgery, succeeded in making our program a National Center of Excellence in Breast Cancer. The 18 month evaluation process includes 27 standards for treating women diagnosed with breast disease. UF&Shands is one of only six such programs in the State.

CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTE

• Personalized Medicine Program: In the summer of 2011, the UF Clinical and Translational Science Institute (CTSI) launched its Personalized Medicine Program with funding from two federal grants. The NCRR awarded a one-year CTSA administrative supplement of $499,920 to create the program at UF and replicate it at Stanford University. In addition, the National Institute of General Medical Sciences, as the lead institute for the NIH Pharmacogenomics Research Network, awarded UF a four-year grant of $351,600 in support of collaboration with five other institutions to collectively gather data on the experience of launching personalized medicine programs.
• Building Statewide and National Research Infrastructure: Important programs and services have been launched in 2011 that will markedly improve clinical and translational research opportunities for UF clinical and translational researchers:
  • Health Impacts for Florida: UF-Florida State University (FSU) Community Research Collaboration: UF received an NIH grant of $472,675 that will help expand a UF-FSU partnership establishing a statewide network to connect communities with teams of clinical scientists, physicians and physicians-in-training. Initial projects will assess and monitor mild traumatic brain injury and health risk behaviors among youth.
  • HealthStreet: Led by Dr. Linda Cottler, chair of the UF Department of Epidemiology and co-director of the CTSI Community Engagement and Research Program, HealthStreet has a team of community health workers who go out into the community to interview Alachua County residents about their health concerns and connect them to opportunities to participate in research as well as medical and social services.
  • Hepatitis C Therapeutic Registry and Research Network (HCV TARGET): Led jointly by the University of Florida and the University of North Carolina at Chapel Hill, HCV-TARGET leverages resources from academia, the NIH and the pharmaceutical industry. To date, it includes 25 CTSA-affiliated institutions and 25 community practices in 16 states and Puerto Rico. UF serves as the Clinical Coordinating Center and will oversee the network’s contractual and administrative processes as well as house the network’s serum samples in the UF CTSI Biorepository. In addition to improving care for HCV patients across the country, HCV-TARGET serves as a model for developing national CTSA-based networks that provide a more efficient infrastructure for clinical trials.
• Integrated Data Repository, Research Related Consent, and Biorepository Project: The academic health center is creating an Integrated Data Repository (IDR) of clinical and research data to facilitate research at UF. The IDR is a joint effort of the colleges, the major institutes, and UF&Shands IT. In parallel with this effort, the CTSI has also developed a state-of-the-art Biorepository that operates in conjunction with the UF Processing Laboratory and the Molecular Pathology & Immunology Core.

EMERGING PATHOGENS INSTITUTE

During 2011, Emerging Pathogens Institute (EPI) continued to build interdisciplinary research capacity in emerging pathogens and infectious diseases, further enhancing UF’s reputation as a top national and international center for research in this area.

• EPI helped facilitate the recruitment of seven new faculty members, including faculty in the Colleges of Public Health and Health Professions, Medicine, Veterinary Medicine, Agriculture, and Liberal Arts and Sciences. Of particular note was the recruitment of the Ira Longini group from University of Washington, Seattle, to the new PHHP/COM Department of Biostatistics; Dr. Longini and colleagues bring to UF some of the best investigators in the country in mathematical modeling of influenza and cholera transmission, and assessment of vaccine efficacy (including a project just funded by the Gates Foundation to evaluate global dengue vaccine efficacy).
• At a translational/community level, the school-located influenza immunization program in Alachua County, a joint effort of the Alachua County Health Department, the Alachua School System, and EPI-affiliated investigators in the Colleges of Medicine, Nursing, and Public Health and Health Professions, was recognized as the best influenza immunization program in the country at the AMA/CDC-sponsored National Vaccine Summit in San Diego.
• Internationally, EPI investigators were involved in a series of studies ranging from use of nighttime satellite light images to assess seasonal measles fluctuations in Niger (published in Science by Tatem and colleagues), to modeling of cholera transmission in Zimbabwe (PNAS, Mukandavire, Smith, & Morris), ecologic niche modeling of Bacillus anthracis in Kazakhstan (BMC Ecology, Blackburn and colleagues), and assessment of subclinical avian influenza virus infections among rural Thai villagers (Clinical Infectious Diseases, Gray and colleagues). In conjunction with PHHP, EPI was also instrumental in the establishment of a new, state-of-the-art UF microbiology laboratory in Haiti, which will serve as the basis for a series of ongoing NIH- and DOD-funded EPI research projects in the Gressier region.

GENETICS INSTITUTE

• Research: Several UF Genetics Institute scientists received major multi-investigator research grants. Laura Ranum was awarded a PO1 (program project) grant from NINDS and a special 5-year award from the Keck Foundation for studies of human neurogenetics; Wilfred Vermerris received a 4-year $5 million award from the US Department of Agriculture for study of sustainable production of next generation sweet sorghums; and Martin Cohn, who received a UO1 center grant from the National Institute of Diabetes, Digestive and Kidney Diseases for study of the development of human genitalia.
• Education: In 2006, UFGI initiated a PhD program in Genetics and Genomics, one of the very few graduate programs at UF which transcends normal college boundaries. This year the first two students graduated; Yan Ren remained at UF to do a postdoctoral fellowship and Tong Lin accepted a research position as a statistical analyst at St. Jude’s Children’s Hospital in Memphis, Tennessee.
• Service: Every year the Genetics Institute sponsors the Florida Genetics Symposium. The keynote speaker this year was Nobel laureate Carol Greider from Johns Hopkins, who delivered the keynote address on “The role of telomers in human health” to a standing room only audience.

Florida Genetics was coupled this past year with an art exhibit related to genetics created by students from the College of Fine Arts.

INSTITUTE ON AGING

• It was very gratifying that our NIH construction grant for a 40,000 sq. ft. Institute on Aging building was expanded by 80,000 sq. ft. to accommodate other UF clinical and translational science programs, including the CTSI headquarters, the General Clinical Research Center, the Department of Biostatistics and Department of Epidemiology, and several specific research projects. The groundbreaking and initiation of construction of this new building was certainly a highlight of the year and will serve UF well for decades to come.
• The competitive renewal application for our Claude D. Pepper Center for Older Americans Independence received a fundable top priority score. This is testimony to the internationally-recognized achievements that have been accomplished by our faculty and staff in the first funding period. We are very proud of our NIH-funded Pepper Center, which is one of only 15 such Centers nationally, and the only one in the Southeast.
• Completed research participant recruitment ahead of schedule of over 1,600 older sedentary adults in the “LIFE” study to assess whether lifestyle interventions can prevent major mobility disability.

MCKNIGHT BRAIN INSTITUTE

• A new structure of governance for the Evelyn F. and William L. McKnight Brain Institute (MBI) was established in 2011 by creating the MBI Steering Committee, which has focused on modernizing the MBI strategic mission. The MBI’s new vision will be closely interactive with the Neuromedicine Interdiciplinary Clinical and Academic Program (NICAP). These changes generated forward momentum based on the collaborative leadership of the Departments of Neuroscience, Neurology, Psychiatry and Neurosurgery, the Institute on Aging, the Center for Translational Research on Neurodegenerative Disease (CTRND) and the Age Related Memory Loss (ARML) Program.
• The MBI renovated several areas in 2011 to improve it research environment. The DeWeese Auditorium and other conference facilities have been updated to next generation audio/video systems and other cosmetic improvements. The MBI lobby was renovated to present a more reception-friendly atmosphere and initial impression of the Institute. Additionally, renovation of the patient access facility for the 3T MRI has been completed within the AMRIS (Advanced Magnetic Resonance Imaging and Spectroscopy Facility) to accommodate with patients’ needs.
• The MBI made considerable progress in the past year in improving its utilization of funds. The MBI significantly reduced administrative and core facilities overhead allowing for a greater percentage of MBI funds to help sponsor research. This has enabled the MBI to grant three faculty start-up packages and establish complimentary funds toward the recent Lillian Wells Foundation gift for 2012 to support brain tumor research in the Department of Neurosurgery. The Brain and Spinal Cord Injury Research Trust Fund from the State of Florida was used to fund eight multi-PI collaborative grant applications to increase NIH-funded research projects. The fund from McKnight Brain Research Foundation was used to support the initiation of three new research projects that advance the Foundation’s mission, in addition to ongoing research in the Age-related Memory Loss Program.

SHANDS GAINESVILLE (SHANDS TEACHING HOSPITAL AND CLINICS)

• Together, the College of Medicine and Shands recruited an "outstanding class" in 2011. We believe that bright, successful people want to join teams of other committed professionals. Some of the areas where we recruited national leaders are: Anesthesia Critical Care, Logistics and Supply Chain Management, Transplantation Surgery, Internal Medicine, Surgical Critical Care and Trauma, Case Management, Pediatrics, Cardiac Surgery, Orthopaedics, Internal Audit,Maternal and Fetal Medicine, Addiction Medicine, Clinical Pathology, Quality and Patient Safety Management, Pediatric Urology, Orthopaedic Joint Surgery, Surgical Services Management, Hospital Based Internal Medicine and Pediatric Surgery.
• We were extremely gratified to be recognized for our patient care quality and safety as a 4-star hospital by the University HealthSystem Consortium. This achievement also reflects excellent collaboration between HSC faculty and Shands. A critical component of our quality and safety program is system-wide electronic medical records (EMR). On May 14, we "turned on" the inpatient component of our EMR. While much work remains to be done in its implementation, this is a dramatic milestone in our efforts to enhance patient safety and is built on a foundation established by the earlier implementation of the outpatient EMR by our colleagues in the Faculty Group Practice.
• We invested in new and renewed facilities with the explicit goal of matching our outstanding staff and faculty with contemporary space dedicated to patient care. Some notable examples include: the Shands Hospital for Children Emergency Department, the UF&Shands at Springhill Multi-specialty Practice and the UF&Shands Main Street Family Medicine Center.

SHANDS JACKSONVILLE

• Awards and Accolades: The organization was recognized by two organizations for specific work related to enhanced quality of care. Shands Jacksonville received Magnet designation earlier in the year for its exceptional nursing program and staff. The organization was additionally recognized by the Florida Sterling Council with the inaugural Sustained Excellence Award. This award is a follow-up to the Florida Governor’s Sterling Award which Shands Healthcare received in 2008.
• Stability: The business of managing complex organizations often goes unnoticed unless a significant challenge presents itself. In these difficult economic times, Shands Jacksonville has maintained a level and positive bond and credit rating. In addition, the organization has been recognized by the University Healthcare Consortium (UHC) as having an exceptionally well managed cost structure including leading the nation in supply cost management. Measured against its peers, Shands Jacksonville was ranked 4th out of 117 organizations for its exceptionally low mortality rate. In fact, for its total UHC score, the organization barely missed a four star rating (by .1 on a percentile basis). In developing an independent local Board of Directors, the organization has been successful in recruiting a number of community leaders to serve as Board members. In addition to their expertise, each of these leaders has already used their influence and relationships to help move Shands Jacksonville forward in the community.
• Shands Jacksonville North: The application for a Certificate of Need for Shands Jacksonville North, to be located near the Jacksonville International Airport, was preliminarily approved by the Florida Agency for Healthcare Administration. This occurred only a few weeks ago. The state recognized the significant growth as well as the lack of services available in the area. Project planning is well underway. More exciting news will be shared as development begins.

Forward Together,

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