Forward Together: Three Years of Progress

For several weeks now you’ve been hearing about The Big Picture. Thousands of you have visited the site at http://thebigpicture.ufhealth.org to check out dozens of images from around UF&Shands that capture the spirit of camaraderie you share as we work across our teaching, research and patient care missions to provide the best possible outcomes for our patients, animal and human.

In many ways, that spirit has been an outgrowth of the shared vision we set forth in our strategic plan, which debuted on May 20, 2010, nearly three years ago. This plan, the result of 10 months of concerted effort by our deans, center and institute directors, and hospital CEOs, provided a prescient roadmap that has put us on the right path. We have accomplished a great deal since then. On May 20, 2013, the third anniversary of our strategic plan, we will celebrate our progress to date and share exciting plans for the future.

The thriving collaboration between the University of Florida Health Science Center and Shands HealthCare does not simply benefit our patients and our communities. Our faculty and staff are working together like never before — sharing ideas and resources, building relationships and new programs, supporting each other’s efforts and the vision of our joint institutions.

We’ve collected a few of their stories below; as you will see, UF&Shands partnerships are evident throughout our centers, institutes and colleges. Whether large or small, it’s collaborations like these that exemplify our mission of Forward Together and keep us moving toward the future.

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Andy Kerwin, M.D., Division Chief, Acute Care Surgery, UF College of Medicine-Jacksonville Lynne Sheffer, B.S.N, R.N., Nurse Manager, TraumaOne, Shands Jacksonville

TraumaOne, the state’s first (and northeast Florida and southeast Georgia’s only) Level I trauma program, is known as one of the best in the country. Its founders are recognized for setting the standards in trauma care. For more than 30 years, UF faculty and Shands Jacksonville staff have worked hand in hand to care for patients that other hospitals cannot.

Since 2010, Dr. Andy Kerwin and Lynn Sheffer have led specially trained teams in the trauma center and surgical intensive care unit. Lynne, a 25-year veteran at Shands Jacksonville, and Dr. Kerwin, who has been with the College of Medicine for 12 years, have developed a relationship built on collaboration, respect and appreciation for one another’s expertise.

“It would be hard to find someone more passionate than Lynn is about providing quality care. We have a lot of great people here, and she is a great leader of the trauma nursing staff, a reflection of their talents. I feel fortunate to work side by side with her,” says Dr. Kerwin.

After hearing his words, Sheffer responded by saying, “That's very kind of Andy, but he’s one of the key reasons our trauma center and intensive care unit save so many lives. It’s hard to tell sometimes because he’s so humble, but I would trust him and his team to care for the people closest to me. Hopefully we’ll continue to work with each other to maintain and improve our care here.”

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Randy Graff, Director of Educational Technology, Health Science Center, UF Dwayne Callahan, Systems Engineer, Information Services, Shands at UF

Academic Health Center IT Training, offered through the information technology department, provides a learning environment for UF&Shands faculty and staff. Free workshops are offered multiple times a week in the AHC IT Training Room for those who want to learn computer programs such as Excel and Photoshop. The room offers 15 student stations and a teacher workstation with a projector, an interactive whiteboard and an audiovisual system — and it’s only getting better.

Thanks to a collaborative UF&Shands team led by Randy Graff and Dwayne Callahan, the room and its equipment received a makeover this month. First, each computer was replaced with an energy-efficient version that takes up less space. The new projector and a larger interactive whiteboard are easier for instructors to use. Callahan spearheaded the biggest change, however, by installing virtual desktops on all the computers — thereby making them more secure, consistent and easy to update. Now whenever the computers reboot, they revert to their original settings, making them immediately user-ready from the first minute of class.

“It’s Dwayne’s expertise that made the switch to the virtual desktop service be successful,” said Graff. “Every trainer can now walk into the room and everything is ready for them. He’s hands on — no detail was too small for him to address. I couldn’t have done it without him.” Collaborating with Graff was a great experience, Callahan said. “His insight and knowledge were invaluable. I feel that working together was the key to this project’s success.”

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Leilanie Merrill, Administrative Assistant, Office of Development/GatorMed Concierge Program, UF Robbie Davis, Access Center Coordinator, Patient Access Center, Shands at UF

As the administrative assistant to Mary Ann Kiely, the associate vice president for development for the UF Health Science Center and vice president for development for Shands HealthCare, Leilanie Merrill works seamlessly in both the UF and Shands worlds.

“I had to learn how to support a Shands executive,” said Merrill, a UF employee supporting a Shands supervisor. “I have to work within both sides.” Although a UF employee, Merrill now works with the Shands finance and purchasing systems and shares an office with both UF and Shands development officers.

Additionally, Merrill assists with the GatorMed Concierge Program and works closely with Robbie Davis, a Shands employee who is the access center coordinator at the Patient Access Center. The GatorMed program provides access to UF&Shands physicians and provides personal assistance to members of the President’s Council, which is UF’s leadership giving society.

“Robbie is amazing,” Merrill said. “If I need something for a patient, Robbie makes it happen.” Davis and Merrill work together on a daily basis on how to best arrange clinic outpatient appointments for GatorMed members and make sure they and their families have a comfortable visit. “Leilanie and I work really hand in hand,” Davis said. “It’s kind of like we are the right hand and the left hand. We have to have that because that’s how we take care of our patients.”

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Bill Sommer, Videoconference Operations Manager, Shands Jacksonville Nelson Keefer, Media Technician, Communications, UF College of Medicine -Jacksonville

Shands Jacksonville and University of Florida staff members work together to coordinate the Jacksonville campus’ audio/visual services and improve their overall capabilities. The coordinated efforts of Bill Sommer (Shands Jax) and Nelson Keefer (UF Jax) are instrumental in providing administrators, physicians, nurses and various departments with the resources they need to fulfill all of our missions.

There are more than 18 classrooms, boardrooms, auditoriums and other venues on the Jacksonville campus. On any given day, there are 50 to 75 meetings taking place. Add Research Day, graduations, employee forums, campuswide celebrations and other large-scale events, and the significance of their combined efforts is quite evident.

Keefer and Sommer continually look to one another for guidance and assistance, and along with others in their respective departments, they have formed a strong team.

“I’ve worked at Shands for the past 13 years, and though we’ve always tried to work together to meet the growing needs of our organization, I can honestly say that in the past few years, we’ve really come together to find solutions,” Keefer said. “Bill is one of the main reasons. He’s a guy who’s always willing to work together for both sides of our organization. We’ve always sought his opinion. Bill and his co-worker Clara Lindley are always there to answer questions, and we do the same. It’s a great working relationship, and it’s only getting better.”

Sommer expresses the same sentiment: "Nelson's right. I've been here 12 years and as time has gone on, we've come closer together, my department and the media center at Shands. When we need something, they're always willing to help, and the same goes for me and Clara. It's a good feeling to know you're working on the same team with a great group of people. That attitude comes from the top of our organization. We now try to look at ourselves as one big family."

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Rossana Passaniti, Media Relations Coordinator, Shands at UF Marilee Griffin, Communications Coordinator, UF

The tight-knit collaborative nature of UF&Shands partnerships is particularly strong among newer employees working in integrated departments such as UF&Shands Communications. A case in point is the dynamic duo of Marilee Griffin and Rossana Passaniti, two news media coordinators employed by Shands Health Care and the UF Health Science Center, respectively.

Griffin joined the communications team last year, shortly after Shands Marketing and Public Relations merged with the Health Science Center’s News and Communications department. Her responsibilities include working closely with UF faculty and staff to share the latest research and clinical news with audiences outside and throughout the academic health system.

Passaniti, who worked in communications at the UF Health Science Center in the ’90s, rejoined the media team as a Shands employee this past January and, among other things, is responsible for connecting reporters with appropriate sources for stories centered on patient care and hospital operations. Passaniti and Griffin work together to complete these often-overlapping tasks and share in efforts to highlight UF&Shands’ achievements and manage media coverage.

“There really are no boundaries or dividing lines in finding the best stories,” said Passaniti. “By working together, the two of us accomplish much more than we possibly could working by ourselves.”

They’re part of a new ‘UF&Shands generation’ that doesn’t pay much attention to who’s employed by Shands and who’s employed by UF, Griffin said. “Our jobs are so interconnected that we rely on each other constantly.”

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Sherrilene Classen, Ph.D., M.P.H., I-MAP, Director, UF College of Public Health and Health Professions Patty Helsel, Manager, Shands Rehab Center at Magnolia Parke

Shands at Magnolia Parke Driving Rehabilitation Services and UF’s Institute for Mobility, Activity and Participation, or I-MAP, joined forces in 2011 to establish what directors say is the first program where clinical driving rehabilitation services are delivered in direct association with current research.

“Joining our clinical driving program here at Shands Rehab Center at Magnolia Parke together with the driving research program of the University of Florida makes us even stronger in the delivery of patient care,” said Patty Helsel, O.T.R./L., C.K.T.P. “Working together puts the evidenced-based research in our clinic so we are receiving cutting-edge information as it is obtained.”

The UF&Shands Driving Rehabilitation Services program offers occupational therapy and driver evaluation assessments for older adults and people who have conditions that may affect their ability to drive. They also offer intervention plans and driver training to help individuals drive more safely or use community transportation alternatives independently if they cannot or choose not to drive.

I-MAP scientists have been developing safe driving behavior measures for older adults, as well as prediction models for driving performance in teens with autism spectrum disorders and attention deficit hyperactivity disorder and for people with traumatic brain injury, epilepsy and Parkinson’s disease.

“We are working shoulder-to-shoulder with clinical driver rehabilitation specialists in order to ‘infuse’ evidence into practice,” said Sherrilene Classen, an associate professor of occupational therapy.

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Mark Bleiweis, M.D., Professor of Surgery and Director, UF Congenital Heart Center Josh Campbell, B.S.N., R.N., C.C.R.N., Pediatric Intensive Care Unit, Shands Hospital for Children

The Berlin Heart ventricular assist device program at the UF Congenital Heart Center and Shands Hospital for Children at UF save the lives of pediatric patients in severe heart failure. In 2006, under the direction of pediatric cardiac surgeon Mark Bleiweis, UF&Shands was the first in Florida to use the Berlin Heart, an external pump specifically designed for children whose hearts cannot pump enough blood through their bodies. Since then, UF&Shands has used the device 16 times as a bridge to transplant. In most cases, children who were on the Berlin Heart would not have lived long enough without it to receive their new hearts. The UF&Shands pediatric transplant survival rates exceed expected and national survival rates.

Josh Campbell, a nurse at Shands for the past 14 years, said Bleiweis is intimately involved in every aspect of each patient’s care. “Dr. Bleiweis is very passionate about his patients and the care we provide them,” Campbell said. The program requires an interdisciplinary collaboration among physicians, nurses and pharmacy staff, as well as respiratory, physical and occupational therapists, and others, he said.

“We treat the patient as a whole, and one thing affects another. The cohesiveness of the treatment team affects outcomes, and we have good outcomes.” Bleiweis, who joined UF in 2006, agreed. “You’ve got to have an active clinical team and a supportive medical center,” Bleiweis said. “We’re a seamless group of people taking care of the sickest patients. This kind of program can only be done well at places like UF&Shands, where we have the best and brightest faculty and hospital staff.”

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Elise Martin, Manager, Patient Access Center Surgery Supervisor, Shands at UF Pam Clevenger, R.N., Triage Nurse, Department of Surgery, UF College of Medicine

In May 2012, UF Physician’s new Patient Access Center opened to improve service for patients and referring physicians. The Patient Access Center improves access for patient care including appointment scheduling, prescription refills, test results, medical questions and other needs with a focus on patient-centered hospitality.

UF’s department of surgery now has a coordinator for each surgery service line, such as acute care surgery, pediatric surgery and vascular surgery. The department of surgery has been working in collaboration with the access center to provide expedited patient scheduling access within 48 hours. In addition, the relationship between the access center and the department of surgery triage nurse allows for immediate nursing assistance with urgent health care concerns.

Elise Martin and Pam Clevenger work closely to create efficient, timely and enhanced patient-centered care. The relationship between the Patient Access Center and the UF department of surgery triage nurse provides seamless patient care, said Martin. The center initially handles the patient call and directly transfers the patient to the triage nurse, who takes over when urgent medical concerns need to be addressed.

“The patients are transferred on as if we are sitting next to each other,” Martin said. “We have eliminated the running around, trying to find a nurse to take an urgent call and made it a better patient experience. Several of the patients, though repeat callers, have no idea we are in two different locations.” As the triage nurse for the department of surgery, Clevenger works very closely with the Patient Access Center. “Working together, we are able to ensure that our patient’s questions and concerns are handled quickly with care, concern and compassion,” she said.

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Personalized Medicine Program, Clinical and Translational Science Institute, UF&Shands Julie Johnson, Pharm.D., V. Ravi Chandran Professor of Pharmaceutics, UF College of Pharmacy and Director, UF Center for Pharmacogenomics Amanda Elsey, M.H.A., Program Manager, UF Personalized Medicine Program Ben Staley, Pharm.D., Pharmacy Services, Shands at UF

Led by UF pharmacogenomics investigator Julie Johnson, Pharm.D., Ph.D., the Clinical and Translational Science Institute’s Personalized Medicine Program is collaborating across research and clinical enterprises to help health care teams take genetic information into account as a routine part of patient care.

On any given day, the Personalized Medicine Program taps into the expertise of more than 50 faculty and staff, including collaborators from the UF Pathology Laboratories, UF College of Pharmacy, UF CTSI, Shands at UF pharmacy department, Shands at UF interventional cardiology team, and UF&Shands IT, among many others.

In her UF role as program manager, Amanda Elsey keeps the communication flowing and the momentum going among everyone involved. “One of the most interesting things has been the enthusiasm we’ve received on the hospital side for what we’re trying to do,” Elsey said. “Even when there are not straightforward pathways of collaboration, we’ve been able to work together and bring key people to the table to understand how to fit this concept into the everyday clinical workflow.”

One of the groups Elsey interacts with on a daily basis is the Shands clinical pharmacy team, which helps create and oversee the best practice advisories in Epic, the electronic medical records system, that guide physicians and pharmacists on how to act on genetic test results when prescribing specific medications. Ben Staley, Pharm.D., is one of the Shands pharmacists who has been closely involved. “We’ve always heard how genetic testing will change the future of how we use medications,” Staley said. “This has really helped us learn how to use Epic in a creative way to tailor therapy towards the patient.”

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Almut Winterstein, Ph.D., Professor, Department of Pharmaceutical Outcomes and Policy, UF College of Pharmacy Thomas Johns, Pharm.D., Assistant Director, Pharmacy Services, Shands at UF Gigi Lipori, Senior Director for Planning and Analysis, UF&Shands

The UF College of Pharmacy and Shands’ departments of pharmacy services and operational planning and analysis have collaborated on medication safety research and quality improvement for more than a decade.

Research is focused on the types and causes of medication errors in inpatient care, followed by quality improvement initiatives to prevent medication errors and implement best practices surrounding medication use at Shands hospital. “Our collaboration with the College of Pharmacy has guided pivotal improvements in medication safety and continues to show us where our quality improvement resources in the pharmacy should be focused,” Tom Johns said.

Early efforts used data that were often hand-collected, but the implementation of an electronic health record system as well as the Academic Health Center’s commitment to building a comprehensive data warehouse for research and quality improvement, has made great strides. “By leveraging the innovative merging of expansive historical clinical patient data and working in partnership with UF academic health researchers, we have an analytical advantage allowing us to identify quality measures and test solutions in a controlled environment at Shands hospital,” said Gigi Lipori.

The long-standing research program in medication safety in the department of pharmaceutical outcomes and policy combined with clinical expertise in Shands Pharmacy and strong data support from Shands, has resulted in more than $1.5 million dollars of funding for a team led by Almut Winterstein. “Medication therapy in hospitals is complex and offers as many challenges for clinicians as it offers opportunities for researchers,” Winterstein said. “We are fortunate to be in a health care environment where we can contribute to medication safety within our own institutions and simultaneously contribute evidence to a widely recognized national and international research agenda.”

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These examples are compelling in telling the story of increasing alignment between UF and Shands across the large number of programs and support functions that collectively make up our academic health center. Yet they are just a sampling of how the University of Florida and Shands Health Care, two legally distinct entities, have come together as a functionally integrated academic health center. One of the clear signs that our Forward Together plan is working is the growth of UF&Shands — from 19,000 employees in 2010 to about 22,000 today.

At times like these, when accumulating accomplishments set the stage for future plans, it is important to pause, reflect and give recognition. Please join us on May 20, the third anniversary of our strategic plan, when we will celebrate our progress to date and talk about where we’ll head next.

Forward Together,

David S. Guzick, M.D., Ph.D. Senior Vice President, Health Affairs President, UF&Shands Health System