November 2010

November 2010

Welcome to the November 2010 edition of Round Table.

Roundtable Header

Welcome to the November edition of Round Table.

Many years ago, Ford adopted the slogan “Quality is Job 1.” I feel it is appropriate for the Health System to borrow this phrase as we move into a new era of healthcare, where improving clinical quality is our number one priority. This is not just a Health System goal. Clinical quality is now a University goal. Mr. Howell and I are now co-chairing the Quality subcommittee of the Medical Center Operating Board, with accountability to and support from President Sullivan. She realizes, as do Mr. Howell and I, that we must become a national leader in academic medicine with regard to clinical quality.

Toward that end, we have improved our overall adjusted mortality index from 1.2 to 0.96 over the past four quarters. This is a truly significant accomplishment. However, we must do better. The goal for the entire Health System is to be in the top quartile (0.6) for our mortality index when compared to the 101 medical centers in the University Health Consortium. Our initial goal for 2012 is to be better than the median (0.8).

Is that too ambitious? No. In the past we have looked at individual areas for quality improvement. Today, we are looking at our entire clinical operation to recognize where we are excelling, where we are doing well but could improve, and where we need to focus additional attention and resources. Let me assure you, if the need for additional resources is identified, we will provide them.

Several people have commented that they feel that they provide quality care and efforts to "improve quality" are derogatory of their efforts. This is not at all the purpose or the implication of our renewed quality efforts.

Modern academic medical centers are complicated places delivering complex, multidisciplinary care. Systems must be developed, and evolve, to provide safe, high-quality care to patients. A quick review of today’s quality metrics illustrates that coordinated systems are necessary to provide care with the lowest risks of mortality and adverse outcomes.

We have identified six strategic quality imperatives for 2011. They are as follows:

  • Remove obstacles to safe care;
  • Improve communication among caregivers;
  • Escalate and intervene, early, for acute changes in patient condition;
  • Balance education and patient safety;
  • Regiment safe practice;
  • Decrease variation in practice.

All clinical faculty and staff will receive more detailed information about the six imperatives. For those faculty and staff who are not involved in clinical care, there is much you can do to improve clinical quality. I encourage you to engage with your colleagues and think about how you can support the Health System imperatives. Quality improvement will have a monthly place in the Round Table and a heightened profile in all Health System communications. For all of us, quality will indeed be Job One.

In this issue of Round Table, we celebrate honors for Richard L. Guerrant, MD, and Karen Rheuban, MD, review some details of our CTSA application,

highlight the CVC campaign, and celebrate our employees of the month: Brenda Loving of the Division of Infectious Diseases and Amy Harris of the Division of Gastroenterology and Hepatology.


Steven T. DeKosky, MD

Center for Global Health Director Richard L. Guerrant, MD, Receives 2010 Thomas Jefferson Award

Congratulations to Dr. Richard L. Guerrant on receiving the highest honor bestowed upon a faculty member at the University of Virginia! Dr. Guerrant was presented with the 2010 Thomas Jefferson Award for his excellence in scholarship at the Fall Convocation.

Dr. Guerrant, the Thomas H. Hunter Professor of Medicine and the Director of the Center for Global Health, has charted a career of which Mr. Jefferson would approve. This “simple diarrhea doc,” as he humbly refers to himself, has led international efforts to prevent the tragic deaths of nearly 2 million children each year from gastrointestinal pathogens. For more than 40 years he has trained generations of physicians and scientists at UVA and across the globe to help children in the world’s poorest nations.

Dr. Guerrant's research focuses on the recognition, diagnosis, pathogenesis, impact, treatment and control of enteric infections and their consequences. "Dick's research has addressed multiple aspects of this problem, from basic science studies of the mechanisms of action of bacterial toxins that cause diarrhea, to seminal work in Brazil demonstrating not only the mortality but the long-term morbidity from diarrhea," wrote Dr. James P. Nataro, Benjamin Armistead Shepherd Professor and chair of the Department of Pediatrics.

He has collaborated with UVA scientists whose work led to three Nobel prizes and with whom he has coauthored 16 scientific papers. He was elected to the Institute of Medicine of the National Academy of Sciences in 2003.

Dr. Guerrant is currently leading a $30 million, eight-site project on "Malnutrition as an Enteric Disease," supported by the Bill and Melinda Gates Foundation. His longest-standing NIH grant promoting international collaboration in infectious diseases has just received the top score for its unprecedented fifth cycle of funding over the next five years. All told, his research awards bring more than $5 million per year to the University.

Across Grounds, colleagues from schools as diverse as the College of Arts & Sciences, the McIntire School of Commerce and the schools of Engineering and Applied Science, Nursing and Architecture wrote of Dr. Guerrant's cross-disciplinary work and interests. "Dick is deeply committed to intellectual exchange beyond the boundaries of discipline and profession," Brantley Womack, Cumming Professor of Foreign Affairs in the College of Arts & Sciences, wrote.

Congratulations again to Dr. Guerrant for this well deserved honor!

SOM Submits Innovative, Collaborative Clinical and Translational Science Award (CTSA) Application

I am very pleased to inform everyone that we recently submitted what, I believe, is one of the most innovative and collaborative grant proposals I have ever seen. The Clinical and Translational Science Award (CTSA) would create a new center at UVA which will transform how biomedical research is conducted.

The goal of the NIH CTSA program is to create a national consortium of medical research institutions to speed the translation of laboratory discoveries into treatments for patients, to engage communities in clinical research efforts, and to train the next generation of clinical and translational researchers.

We owe great thanks to Dean Emeritus Robert M. Carey, MD, the Harrison Distinguished Professor of Medicine and University Professor, for his leadership in putting together this grant application. It involved a dozen section leaders and many other faculty and staff members to review, propose, and critique their sections. What this group has created is not a School of Medicine project, rather a truly pan-university proposal, which focuses on the strengths of the entire institution.

There are currently 55 CTSA institutions across the country, with plans to fund only 5 more grants. We realize this is going to be the most competitive round for receiving funding. However, given the uniqueness of the proposal, we are confident on it scoring well and are optimistic we will receive funding.

We view the application as UVA’s own roadmap for the future. The exhaustive work done across Grounds sets a course which we will follow for translational research

Thank you to everyone who committed so much of their time and efforts into crafting an outstanding CTSA grant application.

Karen S. Rheuban, MD, Honored with the Rachel Phillips Levy Woman of the Year Award

Congratulations to Dr. Karen S. Rheuban, Senior Associate Dean for Continuing Medical Education and External Affairs, on being named the Rachel Phillips Levy Woman of the Year by the Charlottesville Chapter of Hadassah. The award was established by Charlottesville Hadassah to honor inspirational Jewish-American women. The first award was bestowed on Justice Ruth Bader Ginsburg; the second on Congresswoman Debbie Wasserman Schultz.

Dr. Rheuban has been the driving force behind the expansion of telemedicine services in Virginia. She currently serves as President of the American Telehealth Association. She is also working on the McCormick Observatory Scientific Outreach Committee to build excitement and commitment for the Sciences in the Community, especially among children in the Commonwealth.

Congratulations to Dr. Rheuban!

Help the SOM Continue to Support the Commonwealth of Virginia Campaign (CVC)

Each year the University of Virginia participates in the state-wide Commonwealth of Virginia Campaign (CVC) to direct charitable donations to local state and even national non-profits. This year, the goal for the University is $725,000.

With difficult economic conditions facing our state and the local community this year, we again ask our School of Medicine faculty and staff to support the local health, social service, education and animal rescue programs that serve our community.

The CVC allows us to combine all of our gifts and to help our neighbors in their times of need. You can direct your gift to the organizations of your choice and rest assured no overhead costs will be deducted.

Making a donation is easy. You should have recently received a red envelope with a CVC pledge form. You can fill out the form and return it to your department's CVC coordinator or drop it off at one of three collection sites:

* University Hospital Cafeteria

* Wahoo West Café

* Claude Moore Health Sciences Library

OR: You may also pledge online at CVC, University of Virginia

Special thanks to Family Medicine Chair Sim Galazka, MD, for leading the campaign for the second year in a row and to Karen Rheuban, MD, who will lead next year’s efforts.

Our goal this year is to have 100 percent of our School of Medicine faculty contribute to the CVC. Any contribution you can make is greatly appreciated and will help those in need.

Brenda Loving of Infectious Diseases and Amy Harris of Gastroenterology Named SOM Employees of the Month

Congratulations to Brenda Loving and Amy Harris, our School of Medicine Employees of the Month.

Brenda, a grants specialist in the Division of Infectious Diseases, was nominated for her exemplary organization and communication skills with regard to several successful complex grant submissions.

“Brenda is exceptionally gifted in grants administration and in the ability to work under deadlines with grace, and to work smoothly with others. She extends what our Division is able to accomplish by her abilities and her dedication,” wrote William A. Petri, Jr., MD, PhD, Division Chief for Infectious Diseases.

Amy Harris, Fellowship Coordinator in the Division of Gastroenterology and Hepatology, was nominated for her dedication to the division’s educational program. Her ability to keep the Division functioning without losing sight of patient care and the education of the fellows were cited by her nominators as one of her greatest strengths.

Robert Young, Director of Finance for the Department of Medicine stated, “Amy is a leader among her peers…She is a teacher and a listener, who understands that her involvement and influence creates an environment conducive to learning.”

“Amy provides enormous effort and is always working to solidify our reputation to applicants and the future of our University with the trainees,” commented Dr. Neeral Shah, assistant professor of Medicine

Congratulations again to Brenda and Amy!