Transcript Slide 1

Training a New Generation
of Healthcare Providers
August 2007
Virginia Healthcare Reform Commission

Goal: Access to quality healthcare that is safe
and affordable

Governor’s Charge: “…look for creative ways to
further improve the delivery of healthcare to
Virginians.”
Source: Office of the Governor, “Governor Kaine Creates Healthcare Reform Commission.” Press Release, August 6, 2006.

VCU’s Response: Build an integrated “training
hub” for medical students, residents, physicians,
and other healthcare providers to serve
communities across Virginia.
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Medical Education & Clinical Simulation
Building, Phase I

MSB 1
New 200,000 gsf facility to be
built on A.D. Williams site
(corner of 12th and Marshall
Streets)
- 150,000 gross square
feet (gsf) of dedicated
E&G space
- 50,000 gsf of additional
research space

Proposed building as viewed from East Marshall Street
Estimated Cost:
$ 70.0 million GF
$ 88.6 million NGF
$158.6 million total
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Location will be critical.
 Current site of A.D.
Williams provides a
central location with
access to:
- Existing Educational
and Research
Space
- Hospital Facilities
- Massey Cancer
Center
 Allows for future
growth on West
Hospital site
New facility will fully utilize space and accommodate large training spaces not
feasible in A.D. Williams.
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Building tomorrow’s workforce
 With the new Medical Education and Clinical
Simulation Building, VCU could increase medical
school enrollments from 730 students to 1,000 over
time.
Source: Governor’s Healthcare Reform Commission, Workforce Workgroup Recommendation Presentation, May 2007.
 Time is of the essence.
- Recent studies in Virginia suggest that current enrollment
projections will not be sufficient to meet anticipated physician
demand.
- Because it takes 7-10 years post-baccalaureate to educate a
doctor, today’s decisions impact patient care well into the
next decade.
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The foundation has been laid
 At 730 students, VCU has the largest medical school in the Commonwealth.
 With our existing medical school infrastructure (e.g., large, well established, basic
science and clinical faculty, dedicated teaching hospital and clinics, and active
accreditation status), VCU could grow the student body up to 1,000.
 The School would be able to accommodate the related operating costs without any
additional operating support beyond the projected increases in tuition revenue and
the anticipated state support for medical education provided through the current
base adequacy guidelines.
 With its existing, preeminent faculty, the Commonwealth is assured that the
students added to the medical school class in Virginia would be attending one of
the top medical schools in the country
 With its Inova-Fairfax partnership, VCU has expertise in establishing a fullyaccredited regional campus.
- VCU is exploring opportunities to train medical students in high demand areas
throughout the state.
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VCUHS provides on-going support
 Health system funding has been essential to the
success of medical education and physician training
programs. Between 2003-2007, the VCU Health
System contributed:
- $43M from MCV Hospitals for faculty teaching residents;
- $20M from MCV Physicians toward faculty for teaching
medical students and residents;
- $57M from MCV Hospitals, MCV Physicians and Virginia
Premier to the School of Medicine for new faculty
recruitment; and
- $13M for teaching students in pharmacy, nursing, and other
health professions.
 In total, VCUHS has contributed $133 million over
five years.
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Integrating medical education
Today’s Approach
A New Approach
Compartmentalized, teaching
activities and accreditation
Interns and
Residents
2 years basic health sciences
2 years clinical skills
M.D. degree
Typically 1-3 years (or more)
Practicing physician
Medical
Students
Practicing
Physicians
Continuing education
Reaccredidation
VCU seeks a coordinated approach
that integrates medical education
across all levels and across
multiple healthcare professions.
Other Healthcare Providers
(e.g., nurses, pharmacists, dentists)
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Growing residency programs...
 Medical school education and residency training are
integrally linked.
- Residents in training are often the “first line” teachers
for medical school students.
 As more students complete their medical degrees,
additional residency opportunities will be needed in
order to impact physician supply.
 As VCU expands its medical school enrollment, the
University’s goal is to increase affiliated residency
slots at the same rate.
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…Through regional partnerships.
 Through a combination of VCUHS and Universitysponsored residency programs, VCU is exploring
opportunities to create up to 250 residency slots.
- VCU’s partnership with Inova provides an important
entry point to the Northern Virginia region.
- VCU’s relationships with its 5 Family Practice
programs (Riverside, Hanover County, Chesterfield,
Inova, Winchester) provide additional opportunities to
develop affiliated residency programs throughout the
Commonwealth.
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Addressing pipeline issues
 K-16 preparation
- VCU already plays an active role in cultivating Virginia’s future healthcare
providers. Successful programs include: Project Inquisitive Minds, Youthwork
Health Occupations Institute, Jump rope to Stethoscope, and Week in Scrubs.
- A new $1.5 million grant from the Howard Hughes Medical Institute to enrich the
undergraduate life sciences curriculum.
 Creating “practice networks”
- Because of the disjointed nature of medical education, students are often
encouraged to seek professional opportunities out of state.
- By tracking students into a network of residencies – particularly in primary
care -- and providing on-going educational support throughout physicians’
professional lives, VCU will attract and retain a greater number of
physicians.
- Through continuing education that focuses not only on updates in medicine,
but also on new regulatory and practice management issues, VCU will
improve Virginia’s business climate for physicians and extend their
functional work lives.
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Keeping more graduates in Virginia
 VCU is committed to working with the state to improve the
retention of medical students and residents who train in Virginia.
- The School of Medicine is increasing its guaranteed
admissions programs. Options currently under consideration
include:
- Dedicating a specific number of admissions to students from
underserved areas of the state; or
- Targeting students with specific interest in primary care;
- Partnering with other colleges and universities in the
Commonwealth to increase the pool of qualified applicants.
- VCU also supports state recommendations to expand loan
forgiveness programs and identify new incentives that will
encourage medical students and residents to practice
medicine in the state.
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Using simulation to improve clinical
skills and patient safety
 Advances in simulation provide new opportunities to:
-
Modernize medical education;
Accelerate residency training;
Extend the careers of practicing physicians; and
Improve patient care while minimizing cost increases
 Over the next several years simulation
will likely become standard part of
medical accreditation standards.
- The American Council of Graduate Medical
Education (ACGME) already requires
surgery residents to be trained through
simulation.
- Simulation has become a mandatory
requirement for practicing anesthesiologist
seeking obtaining their Maintenance of
Certification in Anesthesiology.
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VCU set to lead in simulation…
 Educational applications:
Integrating simulation into the
curriculum is essential to
preparing physicians to provide
care in an increasingly complex
medical environment and work
in teams with other healthcare
professionals.
 R&D: Through its partnerships
with industry in the BioTech
Park, VCU’s Schools of
Medicine and Engineering will
use simulation to advance the
research and development of
new biomedical technologies
and medical treatments for all
Virginians.
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But, why not just renovate?
 Although operationally well-positioned to expand its class size
and transform medical education in the Commonwealth, aging
facilities remain a barrier.
- A.D. Williams, which sits at the heart of the medical center,
illustrates the challenges.
- Built in the 1930s, the facility has serious deficiencies,
including no fire suppression system.
- A.D. Williams cannot be renovated without extensive asbestos
abatement, building and energy code upgrades, and
replacement of mechanical, electrical, and information
technology.
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The options are limited.
 The floor-to-floor height is unworkable. Ceiling heights are too low to
accommodate contemporary heating and air conditioning systems.
Today’s Design
Standard
A.D. Williams
Design
Not enough floor-to-floor height
to fit HVAC, Piping, Lighting
4’-6”
11’-0 ‘
6’-6”
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Modern needs cannot be met.
 Closely spaced columns will
obstruct students’ view of the front
of the room, regardless of the room
configuration or class size.
 With its early 20th century design,
the building cannot support
simulation equipment, educational
technology, or classrooms above 60
students – even with renovations.
 The conventional ductwork
unable to fit minimum plenum
space available. The column
layout impossible for
classroom viewing.
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New construction provides a better
return on investment.
 The cost per square foot to renovate A.D. Williams is 77% of the
cost per square foot to construct a new facility.
- Recent estimates show that the cost to renovate A.D. Williams
structure would be $372 per square foot.
- The cost for new construction on that site would be $483 per square
foot.
 By investing in new construction, the University will gain an
additional 100,000 gsf – doubling the existing space in A.D.
Williams.
 In short, the building’s lack of programmatic flexibility and its
premium location require that A.D. Williams be replaced.
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Promoting economic development
 VCU’s new medical school will serve as the focal point for
developing a comprehensive approach to healthcare in the
Commonwealth.
- With a state-of-the-art educational center, VCU will help local
communities create new jobs in the healthcare industry and
meet the demand for physicians, nurses, oral surgeons,
pharmacists and other health professionals.
- Through community and regional partnerships like Inova,
VCU can raise the skill and competency levels of
healthcare professionals in all regions of the state.
- In partnership with the biotech industry, VCU’s Schools of
Medicine and Engineering can be on the forefront of
discovery in biomedical research and application.
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Leveraging NGF support
 As part of this initiative, Massey Cancer Center will partner with
VCU to support additional research space in the new facility.
- With support from MCC, up to three floors will be dedicated
to research in cancer prevention, diagnosis, and treatment.
 By leveraging almost $90 million NGF, the Commonwealth, in
partnership with VCU, can develop a comprehensive, costeffective approach to meeting future healthcare workforce
needs.
 Under the state’s funding conventions for higher education
facilities, the proposed project would be eligible to receive $115
million GF. With support from private sources, however, VCU’s is
requesting that the state contribute $70 million to this project –
reducing the state’s anticipated contribution by $45 million
GF.
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Meeting Virginia’s needs
 Goal: Access to quality healthcare that is safe and affordable
 Governor’s Charge: “…look for creative ways to further
improve the delivery of healthcare to Virginians.”
 VCU is positioned to respond.
Emerging leader in integrating education across all levels of
training (i.e., students, residents, physicians)
Focused on team-based training and the use of simulation to
improve patient outcomes
Capable of significant enrollment growth at lower cost
Strong community support from Massey Cancer Center
Track record of community outreach and economic
development across the Commonwealth
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