A Report to the KUMC Community

Since I became Executive Dean of the University of Kansas School of Medicine (SOM) on August 1, 2002, and then Executive Vice Chancellor of the University of Kansas Medical Center (KUMC) on January 1, 2005, I have been honored to work with thousands of people here at the medical center and throughout the community who have dedicated themselves to raising the educational and scientific profile of our institution.

Over the past decade, thanks to this hard work, KUMC has experience extraordinary growth. As the medical center enters its next phase of growth, spurred by thoughtful strategic planning and other efforts to increase our efficiency and realize bold new aspirations, it is a good time to take note of all we have accomplished together. What follows is a report on the status of my original long-term goals from 2002, more specifically covering the last five years from July 1, 2006. I will also outline major goals for the future.

Original goals

In 2002, we had several major goals:

1. Implement a new curriculum for SOM.

• Done, new curriculum started for first-year students in fall of 2006.

2. Build new medical office building for physician practices.

• Done, groundbreaking July of 2009, opening July of 2011.

3. Obtain NCI designation for KU cancer program, first as a clinical center and then as a comprehensive cancer center at five-year renewal.

• Application for clinical designation was submitted on September 22, 2011.

4. Build the research enterprise, especially clinical and translational research.

• Research grant funding grew from $69 million in 2005 to $100 million in 2010.
• The SOM's ranking based on NIH funding has gone from 75^th to 60^th of among all 124 public and private medical schools since 2006. We are now 32nd among public medical schools.
• KUMC received its first grant to support our General Clinical Research Center in 2005 and in June of 2011 we received a Clinical Translational Science Award of $20 million over five years to support additional growth for this type of research.
• In August 2011, KUMC was awarded a five-year, $6 million NIH grant to become one of 29 institutions nationally designated as Alzheimer's Disease Centers.
• In October, KUMC was among the inaugural 25 national sites to participate in the newly created Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT).

5. Build a strong relationship with KU Hospital and negotiate a new affiliation agreement.

• Our affiliation agreement was renegotiated and went into effect October 1, 2007. The relationship is working well with three partners: the physician group (University of Kansas Physicians, UKP), KUMC, and KU Hospital (KUH). One major outcome of the affiliation agreement is growth in hospital support for the university. When I started as Dean in 2002, hospital support was $10 million; that number had doubled, to $20 million, by 2006. In the last five years it has quadrupled and is now more than $100 million.

• We have completed joint strategic planning, and are working on a master facility plan and a realignment of the clinical enterprise. Our goals are to streamline decision making, simplify the organization, reduce costs through merging of business processes and improve transparency and collaboration around investments in programs. These efforts will set the stage for future growth and prepare us for the implementation of federal health care reform and accountable care organizations.

Milestones

In the last decade, the full-time faculty at KUMC has grown from 739 in 2001 to 1123 in 2011. We have recruited 24 of 28 department chairs and 12 of 14 center/ institute directors. In addition, we have created six departments and eight centers/institutes. Other areas of overall growth at KUMC include:

• KUMC has increased the number of students in health professions programs (the figures below are based on a three-year average of enrollment and graduation):
  • The number of nursing graduates (Bachelor of Science in Nursing, RN to BSN completion, Master of Science in Nursing, PhD in Nursing, Doctor of Nursing Practice) has increased from 182 to 235 (29%)
  • The number of School of Allied Health graduates (Bachelor of Science, MA/MS, Master of Occupational Therapy, PhD in Rehabilitation Science or Therapeutic Science, Doctor of Physical Therapy and Doctor of Audiology) has increased from 178 to 211 (19%)
  • The number of Masters of Public Health and Masters of Health Services Administration graduates has increased from 43 to 52 (21%)
  • The number of School of Medicine PhD graduates has increased from 12 to 18 (33%)
• Total KUMC research funding has grown from $81 million to $119 million since 2006 (47%).
• Total KUMC NIH funding has increased from $50 million to $67 million since 2006 (34%).
• Professional fee revenue from the physician practice has more than doubled, from $86 million to $214 million since 2005.
• KUEA fundraising on behalf of KUMC has almost doubled from $21.6 million in FY2007 to $41 million in FY 2011.
• Thirty-six new endowed chairs have been added since 2002. We now have 64 total.
• Student satisfaction scores have shown dramatic improvement thanks to significant efforts by Dorothy Knoll, our recently retired Dean of Students. In just one of many measures showing positive results, students reporting that they felt "a sense of community at KUMC" rose from 63 percent in 2003 to 81 percent in 2011.

The accomplishments outlined above are the result of many people working toward the same goals. The success of our program development was due to significant efforts internally as well as externally with our community partners.

Internal efforts

1. We reorganized the medical center's leadership:

• Karen Miller became the Senior Vice Chancellor for Academic and Student Affairs as well as Dean of Allied Health and Nursing.
• The School of Medicine was reorganized to include Senior Associate Deans for Education (Heidi Chumley), Clinical Affairs (Doug Girod) and Finance (Kim Meyer), as well as a Vice Chancellor for Research (Paul Terranova), and a Chief of Staff (Shelly Gebar) who coordinates all of the activities of the office.

2. Also crucial to our successful operations are Jim Pottorff (General Counsel), Stephanie Grinage (Vice President for Medical Development, KU Endowment), Marci Nielsen (Vice Chancellor for Public Policy and Planning until this summer) and Ed Phillips (Vice Chancellor for Administration), until his retirement earlier this year; Steffani Webb, our new Vice Chancellor for Administration, is continuing to make improvements.

3. We attained a full eight years of accreditation by the LCME in 2006. During previous visits, the LCME had identified multiple deficiencies. These were corrected, and this time the LCME identified only one area of concern — the rapid increase in our students' debt; in our most recent letter, received this week, that issue was declared resolved. The LCME had also asked us to report on progress of the Wichita and Salina campuses and it will continue to monitor that, but we do not have to report next year. We now go into our next site visit in October of 2013 with a clean slate

4. We divided the Department of Surgery into five separate departments: general surgery, orthopedic surgery, urology and neurosurgery in 2006, followed by plastic surgery in 2010. Since then, each of these departments has more than doubled in size under the leadership of chairs focused on the needs of each specialty.

5. In an effort to increase the number of physician-scientists trained in the translational research that is integral to the mission of an academic medical center, we have expanded the number of students in our MD/PhD program from three students to 31.

6. Since 2004, the University of Kansas has recruited a total of 95 new faculty to strengthen the cancer research mission and to build capacity for our clinical cancer program. This includes 55 basic science or population-based researchers, 24 clinician researchers, and 16 oncology clinicians. In the last three years, six major leadership positions have been filled.

7. New endowed chairs were established in both the School of Nursing and the School of Health Professions. Four faculty members have now been invested with these chairs.

8. In 2007, our $57.2 million Life Sciences Innovation Center was completed. It was renamed after former Chancellor Hemenway in 2009.

9. In 2010, H. David Wilson was recruited as Dean for the Wichita campus. He has recruited an Associate Dean for Medical Sciences, an Associate Dean for Research, an Associate Dean for Administration, an Associate Dean for Graduate Medical Education, a Chair of Pediatrics, a Chair of Pathology and aChair of Preventive Medicine and Public Health.

10. We have made major improvements to our facilities. The $34 million renovation of the Wahl/Hixon complex is creating state-of-the-art laboratory space; the $6 million Breidenthal renovation will create wet-lab incubator space for bioscience start-up companies; and a $1 million renovation to the Lied Research Building.

11. On the Wichita campus, a 26,000-square-foot addition was built to house a new School of Pharmacy program and to accommodate the expansion of the medical school to a four-year campus.

12. The School of Health Professions has added clinical doctorates and post-professional education programs in physical therapy, audiology and occupational therapy.

13. The School of Nursing now offers its highly regarded PhD program in an entirely online format as well as a clinical doctorate in nursing, which was accredited in 2010.

14. In the fall of 2011, the School of Nursing implemented a new curriculum that reflects a new focus on professionalism and scope of practice in the field of nursing.

15. In April 2011 in Kansas City, we received a full five-year institutional reaccreditation of our residency programs with no deficiencies and with commendation.

External and community efforts

1. In 2004, the Kansas Bioscience Authority (KBA) was established. Since then, we have been a close partner with the KBA, which has committed $50 million to renovate laboratory facilities and hire eminent scholars and rising stars to support our NCI designation application.

2. In 2005, the Greater Kansas City Community Foundation commissioned a Blue Ribbon Task Force to complete a report on how higher education and research could benefit Kansas City. KUMC leadership met with members of the task force, and their report, Time to Get it Right, determined that the region's top priority was to support the growth of life sciences, including the KUMC-led quest for NCI designation. Five years later, a progress report concluded that we had made "great progress" and urged the community to continue supporting our work. In 2007, in concert with this effort, we published our 10-year plan for research growth, The Time is Now.

3. In 2005 and 2006, when Missouri and Kansas voters were asked to consider banning embryonic stem cell research, KUMC leaders gave more than 100 "Stem Cell 101" informational lectures to legislators and the public, explaining the science of embryonic stem cells and the value of this research. The Kansas legislature later rejected a measure that would have criminalized certain types of stem cell research.

4. In 2005, we convened an Advancement Board of community members. This effort gained momentum when the board's strategic plan was ratified in 2008. Later that year members of the board successfully advocated for passage of the Johnson County Research and Education Triangle (JCERT) sales tax (see below). The board has now grown from its original 28 members to 84 active and engaged members. Now it is a major fund- and friend-raising arm for the medical center.

5. In the 2006 legislative session, we secured an annual $5 million appropriation from the Kansas legislature to support our NCI designation effort. This appropriation has now continued under three administrations, with governors from both political parties.

6. In November of 2008, Johnson County voters passed the JCERT sales tax, which is generating $5 million annually to support our early phase clinical trials program at a building purchased and donated to us by the Hall Family Foundation. This building will house our drug trials for cancer as well as other trials run by our Frontiers program. It is being renovated now and is scheduled to open in January 2012.

7. The School of Nursing and the School of Health Professions were leading partners in education exchange projects including the Kansas Advanced Practice Collaborative (a statewide program to develop nurse practitioners); NEXUS (a graduate nursing educational exchange program with other schools of nursing nationwide); and the Great Plains IDEA Network (in which we offer courses for the master's in dietetics).

8. KU School of Nursing continues to host the National Database of Nursing Quality Indicators, which compiles and analyzes quality-improvement data from around the country. Five years ago, a few hundred hospitals participated; more than 1,700 are participating in 2011.

9. Dean Wilson has instituted an Advancement Board in Wichita, called 4-Wichita, which includes leading community members and so far it has raised more than $3 million of commitments for that campus.

New goals

Over the next five years, we will continue to work on obtaining NCI designation for the KU Cancer Center, first as a clinical center and then as a comprehensive cancer center at the five-year renewal; building the research enterprise, especially clinical and translational research; and strengthening our relationship with the KU Hospital.

In addition, we now have new goals:

1. Implement the new strategic plan for KUMC that was developed during FY11.

• We have just completed a new strategic plan for KUMC, and are developing an implementation blueprint for the first year of the plan.

2. Expand physician and other health care workforce for Kansas.

• Our Wichita campus expanded to a full four-year program and our Salina campus opened in summer 2011. Eight students started at each campus in July of 2011. In fall of 2012, 28 students will start in Wichita, and further increases will be requested at the next accreditation visit in the fall of 2013.
• Pipeline programs for health professional students will be expanded in Wyandotte County

3. Become the leader in the nation in drug development in an academic setting.

• Since he was recruited from industry in 2005, Scott Weir has developed a model for drug discovery and development between industry, academia, disease philanthropy and other private partners. the Institute for Advancing Medical Innovation (IAMI) was formed and funded by a grant from the Kauffman Foundation and KUEA to encourage entrepreneurship among our faculty, and this year, the program will have six drugs in clinical trials at KUMC that were formulated at KU-Lawrence. Dr. Weir has signed innovative collaborative agreements with the National Institutes of Health and the Leukemia & Lymphoma Society, which will serve as a model for drug-development collaboration.

4. Support and implement all the Frontier programs of the Heartland Institute for Clinical and Translational Research funded by the CTSA grant.

• Already, Frontiers has distributed more than $1 million in pilot study and training grants to investigators from KUMC and our partnering institutions. This includes $168,092 for pre-doctoral training grants, $570,443 for post-doctoral scholar awards, $42,656 for other training awards, $16,000 for mentor awards, and $300,000 for pilot study awards.

5. Develop a School of Public Health at KU, raise $5 million, recruit a dean, and obtain accreditation.

• In 2008, we announced a new Institute for Community and Public Health led by Glen Cox to begin the process for organizing public health programs and gaining support for the future school.
• In early 2011 we received approval from Board of Regents for the new school, did a strategic plan, and will be ready to put in our initial application for accreditation as financial resources are available.

6. Raise $300 million of funding as part of the KU capital campaign.

• During the "silent" phase of the campaign, we have raised $102 million.

7. Finish a KUMC master facility plan and, as part of this project, determine how to fund and build a new Medical Education Building.

• A plan for this is currently being developed and architectural renderings of the building are available.

8. Work with Google to improve the health of Wyandotte County and the state of Kansas.

• In the last several months, Google has announced its plans to install a high-speed fiber pilot project in Kansas City, Kan., and Kansas City, Mo.
• We are currently planning how we can use this network for home-based health care and public school educational programs which will improve health delivery, strengthen the health professions pipeline and enhance overall family health in Wyandotte County.

Summary

These accomplishments began during a healthy economy, but continued during the recent economic crisis. Our state budget was $104 million in FY06, rose to $114 million in FY08 but will be $101 million plus an anticipated $5 million from the Commerce department for cancer for this year, so it has been imperative to reorganize the budget each year to accommodate the recent cuts and all the growth. Despite the difficult financial climate, there is clear and positive momentum at the University of Kansas Medical Center.

It has been a time of great change, which has sometimes been painful. I would like to extend my most profound congratulations and gratitude to everyone who has helped make this extraordinary transformation possible, and I look forward to seeing our continued success as we strive to lift students and society by educating leaders, build healthy communities and make discoveries that will change the world.