The Kansas University Hospital is in the midst of growth. During the past 15 years, the hospital has grown to more than 600 beds, maintaining full occupancy, and with it, the ID program has grown. KUH has opened a heart hospital, established a cancer institute, achieved NCI designation, expanded the bone marrow transplant program to over 200 BMT's annually, established a liver transplant unit and performed more than 100 OLT's each year, established a spine and orthopedic surgery referral center accepting all types of bone and joint infections, and formed an active center for lung disease including cystic fibrosis and pulmonary hypertension. In addition, the hospital has expanded to eleven ICUs that focus on all areas of medical, surgical, transplant, trauma, cardiac, burn, neurologic and neurosurgical issues. To accomodate patients with infections associated with these expansions, the ID faculty has grown to 11 members and the fellowship program has been expanded to six fellows. The overall growth has expanded the need for ID consultants in each of these units, and in the entire hospital. Infection Prevention is staffed with four nurse clinicians, the OPAT (out-patient antibiotic therapy) program has three nurses and follows 200 patients daily, and the antibiotic stewardship program is staffed with dedicated ID PharmDs working with our staff.
To accomodate the out-patients, KU has opened a new, adjacent, medical office building where fellows and faculty see OPAT patients, post hospital follow-ups, consultations referred from private physicians and persons living with HIV and other immune compromised individuals.
Due to the tremendous growth of infections that ID is requested to evaluate and monitor, we now have six teams rounding daily in the hospital participating in seeing 70-90 follow-up patients and 10-20 new consultations. In addition, two ID teams staff the ambulatory clinics daily.
Another strength of the fellowship program is the depth of our teaching program. Four days each week, we have teaching programs which cover all aspects of education in which a fellow needs to become prepared to be able to move into clinical practice or be a member of a teaching/research faculty. In these sessions, we discuss clinical cases, review articles from the literature, design and plan strategy for our research publications and presentations, and review essential topics to educate learners including faculty and fellows. We have interdisciplinary grand rounds, BMT quarterly grand rounds, monthly antibiotic stewardship conferences, monthly infection control conferences and twice weekly microbiology lab rounds.
ID fellows rotate to the Kansas City Veterans Administration Medical Center and to a private practice tertiary referral hospital called Research Medical Center. In each of these, ID fellows are mentored by former fellows of this program as well as other highly talented educators.
ID fellows have opportunity to take course work in the KU MPH program if they so desire. Fellows are trained in giving presentations, including selection of appropriate cases, preparation of slides, targeting key issues for presentation and discussion, and preparing follow-up case reports and case series for publication. Fellows are expected to select a faculty advisor and to take time off of the clinical rotations to do clinical research. Here they are guided to prepare and submit manuscripts for presentation. Usually, the majority of KU ID fellows elect to take this area of training and prepare presentations for regional and national meetings.
Faculty in the program have a diverse background, having trained at Yale, Mayo, Vanderbilt, Texas, Columbia and from our own program. This clearly strengthens the program in all areas of infectious diseases. Several faculty members have completed the MPH degree. Others are certified in transplant infections, clinical research methods, and basic research.
Recently, there have been physicians training in this program from 10 countries in addition to fellows from the US. We are proud of our record showing that all fellows who have completed this program for the past 25 years have passed boards and have become fully certified in ID. Fellows from the program have accepted positions throughout the country, internationally, in academia and in private practice.
What is the future for this program and its growth potential associated with the University Hospital? The KUH will complete a rehabilitation hospital and associated LTACH in July 2014. Then, work will begin on a new oncology inpatient facility. Thus the potential for growth the Infectious Diseases training and practice continues here in Kansas CIty.