April 2013

April 2013

Welcome to the April 2013 edition of the Round Table.

Roundtable Header

Welcome to the April edition of the Round Table!

Last month I had the pleasure of celebrating Match Day with the students of the Class of 2013. This class of 145 students had 141 matches to residency programs across the country, with four students deferring their residency to do research or to pursue a Master of Public Health degree. Twenty-five of our graduates will remain at UVA to complete their training.

This was a wonderful day, filled with excitement and pre-envelope-opening jitters. Every member of the graduating class was given an orange T-shirt that read "Keep Calm and Match On." And match they did! This was an outstanding class, and there were many matches to prestigious residencies across 32 states and Washington, DC. The most matches went to internal medicine (23), pediatrics (19), anesthesiology (14), family practice (9), and orthopaedics and psychiatry (8 each).

As the Class of 2013 moves on to their residencies and their professional careers, I wish them luck. I would also like to thank the faculty and staff for your commitment to these students. Advising, educating, and shepherding them through the last four years — and seeing their elation as they matched to residency programs — is a testament to your dedication and hard work!

While on the topic of education and hard work: we have some of our own cut out for us. The Liaison Committee for Medical Education (LCME), the accrediting authority for medical schools in the U.S. and Canada, will arrive to conduct their survey from October 5-8, 2014. In preparation for their arrival, we are kicking off the institutional self-study on June 10, 2013. To date, more than 150 faculty, staff, and students have been appointed to subcommittees to analyze and assess all aspects of the medical school and its programs. We have also invited University leaders and deans, faculty from across Grounds, and alumni to serve on an executive committee, which added approximately 30 participants to the self-study. Barnett Nathan, MD, is serving as faculty chair of the institutional self-study. Both Match Day and the LCME visit are reminders that we must maintain our teaching excellence in graduate and medical training.

Thank you to the LCME steering committee — Chair Randolph Canterbury, MD, Senior Associate Dean for Education; Barnett Nathan, MD, Associate Professor of Neurology; Brad Haws, CEO, UVA Physicians Group, Senior Associate Dean and Chief Administrative Officer, UVA School of Medicine; and Lesley Thomas, JD, Assistant Dean for Medical Education — for keeping us focused on this important project. Additionally, I would like to thank all who are involved in preparing us for the October 2014 visit.

I would also like to take this opportunity to update you on an upcoming leadership transition. Nancy E. Dunlap, MD, has been appointed to be the next Dean of the School of Medicine. A pulmonologist, Dr. Dunlap is currently the physician-in-residence with the National Governors Association Center for Best Practices in Washington, D.C. She will arrive on May 1 to start transitioning into the role, and officially assume decanal duties August 1, 2013.


Steven T. DeKosky, MD, FAAN, FACP


Documenting Restraints: Face-to-Face LIP Evaluation in Patient Record

Regardless of the type of restraint (behavioral vs. nonbehavioral), a licensed independent practitioner (LIP) order is required when restraints are first applied to a patient. Additionally, a face-to-face assessment of need is required by the LIP:

For Behavioral Restraints or Seclusion: A face-to-face assessment must occur within one hour after restraints are initially applied or the order renewed.

For Nonbehavioral Restraints: A face-to-face assessment must occur within 24 hours after restraints are initially applied or the order renewed.

The face-to-face assessment must be documented in the patient medical record progress note. Although a restraint is a time-limited order, restraints should be removed as soon as the patient’s behavior warrants — even if the order time limit has not expired. After removing restraints, if patient behavior requires restraints to be reapplied, a new order (with new face-to-face evaluation) must be completed.

Updated Guideline: Adult Code 12 Roles

The Medical Emergency Response Committee has updated the Adult Code 12 guideline to provide guidance to clinicians regarding role expectations during a cardiac arrest event. The University of Virginia Health System has adopted team resuscitation concepts, developed by the American Heart Association, which aim to optimize roles and responsibilities and maximize outcomes via well-defined functioning team resuscitation. Please review the updated "Adult Code 12 Role" guideline to be sure you are aware of your role and responsibility in the event of a cardiac arrest.

To view the new guideline, please visit: www.healthsystem.virginia.edu/docs/manuals/guidelines/cpgguidelines/02-clinical-practice-guidelines/2.047-2.047-code-12-roles/at_download/currentfile

Eight UVA Dialysis Sites Earn 5-Diamond Status

Congratulations to UVA Dialysis for an outstanding job in renewing their 5-Diamond Patient Safety status. For the third year in a row, all eight of our units — University of Virginia Kidney Center, UVA Altavista Dialysis, UVA Amherst Dialysis, UVA Augusta Dialysis, UVA Lynchburg Dialysis, UVA Orange Dialysis, UVA Page Dialysis, and UVA Zion Cross Roads Dialysis — achieved this rating, the highest available.

The 5-Diamond Patient Safety Program helps dialysis facilities increase awareness, and promote and build a culture of patient safety. There are 139 facilities in Virginia, and only 21 of them made 5-Diamond status — eight of the 21 are UVA sites! These types of efforts are an important step in realizing our clinical strategy and exemplify the commitment our dedicated staff and care providers have toward patient safety.

Richard Santen, MD, Elected President of The Endocrine Society

Congratulations to Richard J. Santen, MD, Professor of Medicine, Endocrinology and Metabolism! Dr. Santen has been elected the President-Elect of the Endocrine Society. The Endocrine Society, founded in 1916 as The Association for the Study of Internal Secretions, is the world’s oldest, largest, and most prestigious organization devoted to research of hormones and the clinical practice of endocrinology. It has more than 14,000 members from over 85 countries. Dr. Santen will assume this role at the Society’s Annual Meeting this June, and will become President of the Society in June of 2014.

Dr. Santen is the third president of the Endocrine Society from UVA in recent years — Peggy Shupnik, PhD, Professor of Medicine, Senior Associate Dean for Research, was president from 2007 to 2008, and Robert Carey, MD, Professor of Medicine, Dean, Emeritus, and University Professor, was president of the society from 2008 to 2009. Also, John C. Marshall, MD, PhD, Professor of Medicine, Endocrinology and Metabolism, is the current Secretary-Treasurer, an executive position in the society. Only two other institutions (Massachusetts General Hospital and Northwestern University) have had more than three faculty members serve as president of the society.

Dr. Santen was elected for his significant contribution to and leadership in the global advancement of research, education, and patient care in endocrinology. Congratulations, Dr. Santen!

Register Now: Appreciative Practices in Health Care Conference

The first Appreciative Practices in Health Care conference will run June 13-15 here at the University of Virginia, with joint sponsorship by the UVA Center for Appreciative Practice, the UVA Office of Continuing Medical Education, and the Corporation for Positive Change. The conference will highlight Appreciative Inquiry (AI) and the underlying principles rooted in positive and social psychology and will demonstrate their application to interprofessional teamwork, patient care, and the individual. This interactive symposium features Diana Whitney, PhD, an internationally recognized expert in the field of AI, and the faculty of the UVA Center for Appreciative Practice, who have emerged as leaders in this field. The format includes panel discussions, teaching presentations and skill-building activities over four interrelated half-day sessions.

Registration is open to all healthcare providers, administrators and members of healthcare teams who wish to learn about the applications of Appreciative Inquiry and its principles in their work environments. For full conference details and to register, please visit www.cmevillage.com and click on "Conferences and Symposia.” The conference has been accredited for 15.5 AMA PRA Category 1 creditsTM.

Please contact Katharine Schlag, CME Program Planner, with questions at kas3b@virginia.edu. Eligible UVA Academic Division employees may wish to consider use of the University Education Benefits Program to assist with the conference registration fee. For more information, visit www.hr.virginia.edu/go/ed-benefit.

James Browne, MD, Honored as Emerging Leader in Orthopaedic Surgery

Congratulations to James Browne, MD, Assistant Professor Orthopaedic Surgery! He has been chosen by Orthopedics Today as one of the emerging leaders among orthopaedic surgeons. A committee of eight orthopaedic experts selected the honorees. Dr. Browne was recognized at a reception in Chicago on March 20. As a part of “Leaders in Total Joint Replacement: Generation Next,” Dr. Browne also participated in a poster session detailing the techniques and technologies used in his procedures. Of the 40 honorees of the evening’s events, Dr. Browne was awarded a spot among the top six winners.


Brian Wispelwey, MD, Awarded AOA – Anne L. Brodie Teacher’s Teacher Award

Please join me in congratulating Brian Wispelwey, MD, Professor of Medicine, for winning the 2013 Alpha Omega Alpha – Anne L. Brodie Teacher’s Teacher Award. This is a medical education faculty-mentoring award that recognizes University of Virginia School of Medicine faculty who model excellence in the mentoring of clinical faculty educators. Dr. Wispelwey has previously received many awards for his personal teaching. He received the Teacher's Teacher award for his dedication and commitment to mentoring residents and faculty to become the next generation of inspiring teachers. In what was a very competitive year, with many wonderful and qualified candidates, Dr. Wispelwey stood out for his long service teaching the core faculty of the ICM/POM II course, and the Teach the Teacher Workshop for residents. Many have been inspired to become clinical teachers by his towering example.

Dr. Gregory Townsend, MD, Associate Professor of Medicine, wrote in his nominating letter, “If the UVA medical faculty were to have to put the educational 'raising' of young faculty members in the hands of one person, there could be no better choice than Dr. Wispelwey. … I have had numerous discussions with [Dr. Wispelwey] regarding how best to teach medicine, and his passion and dedication have inspired me to sharpen my own diagnostic and management skills so that I can be the most effective teacher that I can be." Congratulations, Dr. Wispelwey!

Conference: "Administrative Leadership in a VUCA World"

The inaugural Administrative Leadership Conference will be take place in Newcomb Hall May 7-8, 2013. The theme of the conference is “Administrative Leadership in a VUCA World.” The acronym VUCA highlights the unstable and rapidly changing environment in which the School of Medicine's administrative leaders work every day — a world of Volatility, Uncertainty, Complexity, and Ambiguity. The challenges such an environment places on our faculty and staff as well as unit leaders across the Health System are well known.

Sponsored by the SOM’s Office of Organizational Learning & Development, the conference is intended for UPG and SOM administrative leaders and is intended to foster networking and collaboration; communicate policies, practices, and expectations; share best practices; encourage innovation and creativity; and enhance leadership skills.

Conference participants will have learning and development opportunities in six core tracks: financial management, human resources management, information management, leadership, operations, and research administration.

Registration is flexible: Participants can sign up for the entire conference or choose to attend only a few sessions. Information on the content of each session, presenters, and registration instructions will be available soon. Until then, please contact Troy Buer (tsb5t2@virginia.edu) or Anne Williams (aw8p@virginia.edu) for more information.

National Healthcare Decisions Day Raises Awareness

April 16 is the sixth annual National Healthcare Decisions Day, a day to help raise awareness about the importance of advance care planning. Making decisions far in advance about end-of-life care and clearly determining who makes care decisions is important for family, friends, and healthcare providers. There will be a display from April 16-18 in the Hospital Cafeteria, and staff will be available to provide information about Advance Directives. There will also be related displays on trauma, organ donation, bereavement, and a signed proclamation stating our commitment to this effort. For more information on National Healthcare Decisions Day, visit nhdd.org.

Hepatology 2013: Conference of Liver Disease and Transplantation

The 8th UVA Annual Conference of Liver Disease and Transplantation, Hepatology 2013: Management of Cirrhotic Patients, will be held on Saturday, May 4, 2013, at the Omni Hotel. Sponsored by the Office of Continuing Medical Education and the University of Virginia School of Medicine, this course is designed to provide general and community-based gastroenterology physicians; general, internal medicine and family medicine physicians; physician's assistants; and nurse practitioners an opportunity to learn about and discuss the advances in the diagnosis and treatment of patients with liver disease and liver transplantation.

This year's course, directed by Abdullah M. S. Al-Osaimi, MD, Associate Professor of Medicine and Surgery, Medical Director of Liver Transplantation, will provide sessions that will provide an update on viral hepatitis B and C treatment; emerging epidemic of nonalcoholic fatty liver disease; liver transplant process and donor liver transplant process; immunosuppressive medications and their complications during post-liver transplantation; and decompensated cirrhotics and care of hospitalized cirrhotic patients.

To register, go to www.cmevillage.com and click on "Conferences and Symposia." For more information, please contact Ladi Carr, PhD, Faculty CME Coordinator, Office of Continuing Medical Education, at ladicarr@virginia.edu.


Clinical Research Grant Program: Awardees & New RFA

Last fall we announced the Clinical Research Grant Program, a five-year, $35 million investment in clinical research here at UVA. It met with an outstanding response, garnering 95 preproposals, out of which five were ultimately selected for funding. The titles and principal investigators awarded are:

  • MRI Features Of Mild Traumatic Brain Injury In Student Athletes (Jason Druzgal, MD)
  • Novel Lesioning Strategies for Treatment of Parkinson's Disease and Other Movement Disorders (Jeff Elias, MD)
  • A Clinical Sequencing Program To Direct Treatment Of Relapsed Pediatric Cancers (Ira Hall, PhD)
  • Identification of Microvascular Disease in Patients with Angina (Chris Kramer, MD)
  • Genetic Characterization of Atheroprotective B-1 Cells from Patients with Coronary Artery Disease (CAD): Defining the Pathway to Novel Treatments for Cardiovascular Disease Prevention (Coleen McNamara, MD; Angela Taylor, MD)


Last month, Ronald B. Turner, MD, Professor of Pediatrics, Associate Dean for Clinical Research, sent out a request for applications (RFA) for the next round of funding from the Health System Clinical Research Grant Program. The RFA has been modified slightly to provide more information about the types of proposals that will be funded by this program. Preliminary applications will be due by April 15. For more details, please visit: www.medicine.virginia.edu/research/offices/clinical-research/news-and-highlights/clinical-research-support-grants

We look forward to seeing your innovative proposals for this next round of funding.

Smart Phones as HIV Weapon Receives National Attention

An innovative plan developed at the School of Medicine to use smart phones to improve care for people recently diagnosed with HIV in rural Virginia has gained national attention. Last month a release went out, detailing the Positive Links program and its support from the AIDS United Foundation, and it was highlighted under the "National News" header in the Centers for Disease Control news update for HIV/Hepatitis/STD/TB Prevention. ( content.govdelivery.com/bulletins/gd/USCDCNPIN-6e641b#61189) Congratulations to Rebecca Dillingham, MD, MPH, Director, Center for Global Health, Division of Infectious Disease and International Health, and her team for developing this new application and program!

You can read the full release, "Smart Phones Become Weapon Against HIV"

Caution Regarding Carryforward on Federal Grants

With sequestration now impacting federal grant-making agencies, investigators are cautioned not to permit a large unexpended balance to accrue on a federal grant unless there are extraordinary reasons for doing so. In particular, the National Institutes of Health (NIH) is scrutinizing unspent balances greater than 25% of a given year's funding. Barring sufficient justification, NIH likely will use unspent balances as offsets against the next year's funding.

Internal Research Funding Mechanisms at the School of Medicine — Active and Upcoming

In addition to the recent solicitation of proposals for shared research equipment ( www.medicine.virginia.edu/research/offices/research/home/Shared%20Equipment%20Request%20Spring%202013.docx), the School of Medicine will be soliciting proposals for the following internal programs this spring:

Thelma R. Swortzel Collaborative Research Award. This program provides support for innovative research collaborations in the areas of ear, eye, heart, or cancer. Its goal is to support collaborative, translational research that addresses unmet clinical needs and leads to improvements in health care.

Annette Lightner Research Award. This program supports medical research in rheumatology, autoimmune diseases, and rheumatoid arthritis (with particular interest in dermatomyositis). Research on diabetes will not be funded by this program.

Henry Rose Carter Research Award. This program provides support for innovative research related to malaria or other public health problems.

You can expect to receive these solicitations over the next several weeks.

MSSRP Program Seeks Projects & Preceptors

The School of Medicine (SOM) Office for Research is soliciting projects for the Medical Student Summer Research Program (MSSRP). The program is restricted to rising second-year UVA medical students. Research projects will run for seven weeks. The total stipend is $2,800, though SOM can provide limited cofunding — up to $1,000 for one student per preceptor — if preceptor need is documented; SOM pays Summer Session fees for all participating students.

The large number of returning preceptors is a testimonial to the productivity of these students. A detailed program description can be found at www.medicine.virginia.edu/research/offices/research/for-students-and-postdocs/medical-student-research-programs-at-uva.html.

If you wish to participate in the program, please complete the 2013 Preceptor Form (see above link), after which students will contact you directly. To complete the approval process, student and preceptor must complete the online student form on that same site.

If you have any questions about the MSSRP, feel free to contact Dr. Steven Wasserman at ssw3an@virginia.edu.


Take Time to Honor Your Faculty

A wonderful way to honor your faculty is by nominating them for recognition and awards. Listed below are five upcoming awards, to be given to faculty who bring excellence to our institution:

Dean’s Clinical Excellence Award

Dean’s Excellence in Teaching Award

Dean’s Excellence in Faculty Research Awards

Robert J. Kadner Award for Outstanding Graduate Teaching

David A. Harrison Distinguished Educator Award

For deadlines, information on eligibility, and criteria, please follow the above links. If you have questions, please contact Ashley Ayers at ala5t@virginia.edu.

Two Tech Updates: SysAid and GraphPad Prism

The School of Medicine is currently rolling out a new Help Desk Management System called SysAid. SysAid gives both our IT support and end users a powerful tool that will speed up service-call resolution. It also provides a way to manage and track those service calls.

SysAid simplifies communication between the end user and the support technician by giving them an easy-to-use web interface for submitting IT-related requests. End users are automatically kept up to date on the progress of their request. SysAid also provides detailed inventory management and a remote tool that will enable our IT support team to solve many service calls remotely, thereby saving time and increasing productivity. With powerful support tools, a built-in knowledgebase, and detailed inventory tracking, the School of Medicine will see improvements in all aspects of its IT support.

The initial rollout will be completed by the first week of April. The departments covered during this phase are: Surgery, Neurology, Otolaryngology, Urology, Dean's office, Microbiology, Cell Biology, Biochemistry & Molecular Genetics, Neuroscience, Cell Signaling, Core Facilities, and the Myles H. Thaler Center for AIDS and Human Retrovirus Research. We will be working to incorporate SysAid into other School of Medicine Departments later this year.

Also, we would also like to let you know that the School of Medicine has many licenses left for GraphPad Prism, a software tool that assists in analyzing, graphing, and presenting scientific data. The license cost is only $60 per year.

Please contact David Stewart, Desktop Support Manager, at dls3kx@virginia.edu for more information on either of these items.

COI Training for Investigators on PHS Awards

Last April, the School of Medicine aligned the financial disclosure requirements in its conflict of interest (COI) policy with the new Public Health Service (PHS) COI policy, which became effective in August 2012. An additional requirement of the federal policy is mandatory COI training for Investigators. (This is defined by the PHS as "the project director or principal investigator and any other person, regardless of title or position, who is responsible for the design, conduct, or reporting of research funded by the PHS, or proposed for such funding, which may include, for example, collaborators or consultants.") Investigators who transfer PHS funding to UVA must be retrained immediately, regardless of whether they had received COI training at their prior institution. The University is using the Collaborative Institutional Training Initiative (CITI) online system to fulfill this requirement.

If you currently are receiving or expect to receive PHS funding or a sub-award derived from PHS funding, you must complete the CITI COI training at https://www.citiprogram.org/Default.asp. We have posted instructions for completing CITI training at http://www.medicine.virginia.edu/research/offices/research/home/instructions-for-CITI-COI.html. Principal Investigators on PHS awards and sub-awards derived from PHS funding must ensure that all investigators on their project(s) also have taken the training.

Please note that PHS policy requires that investigators be retrained at least every four years. We will include a reminder of this training requirement in the annual request for financial disclosures, which will be sent to faculty in April.

Also note that under PHS policy, you may not spend any funds until you have completed this training. The University will not issue a PTAEO (Project, Staff, Award, Expenditure Type, and Organization) for a new award until all investigators on the project have complied with this requirement.

Employee of the Month: Elizabeth Molina

Elizabeth Molina, Director of Finance, Radiology, was recognized for her ability to foster a collaborative spirit while restructuring work processes and functions within the Department of Radiology. She received multiple nominations acknowledging her efforts to create a work environment that is conducive to customer service and team spirit while streamlining the workflow. In addition, Liz helped to organize two financial retreats for the department where it reviews the national, regional, local, and departmental economics related to our healthcare, research, and educational missions.

In his nomination, Alan Matsumoto, MD, Professor and Chair of Radiology and Medical Imaging, recognized Liz's extraordinary contributions, including providing new quarterly funding reports to allow him to track revenues and expenses for the research mission. He says, "As Chair, I now have a much better idea of what studies are closed, what costs need reconciliation, what residual indirects are available to re-invest into our research mission, while helping the [Office of Sponsored Programs] keep their records more up-to-date with deficits being reconciled in a more timely fashion."

Many thanks to Liz for her dedication to her team, the Department of Radiology, and the University of Virginia.

Save the Date: State of the School Address: May 16, 2013

I would like to remind you that the next School of Medicine General Faculty Meeting and State of the School address will be held Thursday, May 16, at 5 p.m. in the Claude Moore Medical Education Building (3rd Floor, Room 3110). The agenda will include research, education, and clinical updates. The faculty will also be voting on graduation of the 4th-year students, as well as on a revision to the School of Medicine bylaws. Please join me at a reception immediately following our meeting. I look forward to seeing all of you.