ࡱ> %` 8Abjbj"x"x ;b@@8v^^^8L4,"8(```$hћ#"##ћ``K&&&#|8``&#&&ODQ` H^F$[P&0,P$LQQ,Jw0& /ћћp&j,####$D School of Medicine Executive Committee Meeting Minutes May 19, 2009 Present: Bob Anderson, Bill Betz, Terri Carrothers, Bob DAmbrosia, Steve Daniels, Frank deGruy, Chip Dodd, Vikram Durairaj, Rob Feinstein, Laurie Gaspar, Ron Gibbs, Don Gilden, Fred Grover, Tom Henthorn, Ben Honigman, Herman Jenkins, Mark Johnston, Richard Johnston, Richard Krugman, Steven Lowenstein, Claude Selitrennikoff (for Wendy Macklin), Naresh Mandava, Lilly Marks, Dennis Matthews, Tom Meyer, Bob Murphy, David Norris, Chip Ridgway, Jim Spencer, Ann Thor, Cheryl Welch, Moritz Ziegler, Jan Bodin (Staff) Guests: Angela Wishon, Sharon Shear, Chris Nyquist, Bill Maniatis, Doug Jones, Pam Welkner, Randall Meacham, Tom Beresford Proxy: Kevin Lillehei proxy to Herman Jenkins Colleen Conry (past president of Faculty Senate) proxy to Frank deGruy John Cambier voted on the ED Department status issue via signed ballot prior to the meeting Approval of the Minutes - Minutes from the April 21, 2009 meeting were unanimously approved by electronic vote following the meeting. Deans Updates - A listing of search, affiliation and institutional updates was included at Attachment 2 in the agenda packet. Discussion Items Deans Comments - Dean Krugman added TCH Pediatric Surgery Sub-Specialty Cost Center to todays discussion items. The final candidates for OB-GYN will be here on their 2nd round interviews this week and next. The Pharmacology chair candidates are beginning to be scheduled. There are 6 Cancer Center Director candidates - 2 have completed their interviews and 4 more are scheduled - hopeful completion of this round of interviews is the end of June. Three Neurology candidates are being scheduled for interviews. Budget update - This year, we lost another $2.8M from the $15.1M state appropriation. The regents voted another 5.9% tuition increase and that added to the stimulus package dollars will put our budget only slightly higher (~$65,000) than last year. Lilly Marks commented that a key factor to remember is that we have had an overall 19% cut in state funding. That 19% represents $2.8M. This year $1.5M of the FY 09-10 cut, will be backfilled by stimulus dollars, but will remain a hole 2 years from now when the stimulus dollars go away. Asked where the $1M that UPI has on hold will fit into the budget scenario, the Dean responded that that will be a discussion for a meeting later this summer. Alumni Relations - Associate Dean for Alumni Relations Bill Maniatis thanked the group for the opportunity to visit with them. He is a Denver native, SOM alum and currently practices as a urologist in the community. He outlined his plan for a new beginning of alumni relations by improving relationships with students, housestaff and faculty. The observation was made that housestaff and students are not treated well by some, including those at affiliate institutions and because of that students and residents are disinclined to engage once they leave the institution. It is Dr. Maniatis goal to build relationships such that students and post docs will become inclined to engage. He invited those present to send their suggestions to  HYPERLINK "mailto:William.Maniatis@ucdenver.edu" William.Maniatis@ucdenver.edu. Department Status for Emergency Medicine - Dr. Doug Jones, Chair of the committee to review the petition for department status was invited to answer any questions regarding the committees deliberations. Two of the questions that came out of last months meeting were answered in the documents submitted at Attachment 5 of todays agenda packet. Dean Krugman began the discussion by asking if the committee had explored how academic appointments would be handled where there is no academic enrichment funding. Dr. Jones indicated that the committee had discussed only whether or not that issue was in the purview of the committee to determine. They concluded that the issue would likely be debated and reviewed on its merits as the occasions arose and that likely it would be at the Deans prerogative. Dr. Honigman said that the CEO of DHHA was not in favor of a carve out but was willing to contribute to a combined fund. The CEO of UCH was also in favor of a combined fund. Asked about the number of primary faculty and the amount of grant funding, Dr. Honigman replied that there are 24 tenure-eligible faculty at the University and 16 additional employed by DHHA. The grant funding is currently between $2.5M and $3M but there would likely be a steep increase were department status to be approved. Asked if space allocations had been discussed, Dean Krugman indicated that no discussions had taken place regarding space. He indicated that a timeframe for a chair search was not clear, but when it did begin that negotiations would take place with the chair candidate, just as it does for other department chair searches. In the spirit of transparency, Dr. Bob Anderson asked if Dr. Honigman and Dr. Grover had talked about the historical funds flow between ED and Surgery and whether or not the funds had been equitably adjudicated. Dr. Honigman replied that there had been discussions, but no particular adjudication. Dr. Krugman indicated that documents had been prepared and reviewed at length during the review process. Dr. Grover indicated that $500,000 had been invested in the Altitude Research Center and the recruitment of its faculty and that there would be a clinical tax loss to the surgery department. He also indicted that the Altitude Research Center was a positive. It was reported that over the past 6 years Surgery had invested $1.6M in the Division of Emergency Medicine and that $1.9M had been transferred from ED to the Department of Surgery. Also in the spirit of transparency, and because of its potential impact on the Department of Surgery, Dr. Krugman interjected comments regarding the ongoing discussions at Childrens about the formation of a pediatric surgical sub-specialty cost center. Difficult and, at times, contentious discussions around this cost center have been ongoing for 5-6 months. The TCH Board of Directors Chair, Dean Krugman and Chancellor Wilson met recently and from that meeting thought we should explore a pediatric department of subspecialties similar to a model in play at the University of Texas in Houston. Dr. Krugman reported that once that idea was expressed, it had decompressed a lot of tension. He said an upside would be that there would be a department chair and as part of being a chair, one would be required to work collaboratively with all of the other chairs. A downside would be further fragmentation for the Department of Surgery. For such a thing to happen, TCH would need to follow the schools process for department status in that a group of faculty must get together and petition the school of its desire to form a department; information would need to be gathered for all to review; a review committee would need to be formed; approvals would need to be obtained from SOM Exec and ratified by Faculty Senate. If willing to explore it, its possible that the TCH Board may see the willingness as a move forward. The TCH Board of Directors Chair, the Dean and the Chancellor believe it would be positive to explore. While the department status for ED is in no way tied to the TCH discussions, the impact of this on the Department of Surgery in addition to an ED change would be significant and a review committee for TCH would need to consider it carefully and the impact would need to be studied thoroughly. Dr. Bob Anderson felt that we need to have strong core departments, that the balkanization needed to stop and that a sub-specialty cost center would be favored over a new department. Dr. Steve Lowenstein commented that balkanization implied breaking up common entities into individual areas and that balkanization was not a good metaphor for this situation because there wasnt anything commonly shared within Emergency Medicine and the Department of Surgery. Dr. Lowenstein also pointed out that while Emergency Medicine has rented space from Surgery (and that Dr. Grover had been a gracious landlord), Surgery was never considered a home for ED. He felt that the Division of Emergency Medicine had evolved to a point where it needed to be independent. Dr. Grover said that while he hated to lose Emergency Medicine, department status for it was different than department status for the pediatric cost centers and that the TCH issue worried him some. Dr. Steve Daniels said that the two issues needed to be separated on this vote, and that the messy part of the discussion at Peds does not relate to Emergency Medicine. While both will impact the Department of Surgery, EDs proposal is well formed and concrete while Peds is nebulous. Dr. Krugman agreed that each department proposal will need to be considered on its own merit and that the two were not tied to one another. Dr. Gilden commented that over the past 40 years the neurology specialty evolved to such an extent that it separated from the Department of Medicine and became a department. He believes that Emergency Medicine has also increasingly evolved and that he did not believe that the majority of patients seen in the ER were surgical patients. Dr. Jones summarized that while the report from the review committee does comment on balkanization and funding, they voted unanimously with one recusal that the department met the 4 criteria on which it based its deliberations and recommended academic status. The four criteria include distinct clinical population, distinct medical student curriculum, distinct ACGME approved residency training program and distinct program for research. Conflict of Interest Limits - At the last meeting, the committee was asked about moving the threshold trigger for reporting from its current threshold of $10,000 to some other level. The group consensus was to move the trigger threshold down to zero, meaning report everything. The questions became how to manage it. Assistant Vice Chancellor for Regulatory Compliance Angela Wishon was invited to sort through the questions that came out of that meeting. AVC Wishon stated that the Office of Regulatory Compliance would manage it all and gear it to the differing levels for each environment. Our threshold trigger point is set at the Campus level and decision to change the current threshold will come from the Chancellor, but feedback from the SOM is important. The ORC is currently compiling information for the next collection cycle and since the SOM is 90% of what their office sees, AVC Wishon seeks our feedback. She reviewed a handout reporting on the schools status of the completion rates for COI reporting. 87% were complete. A list of those reporting and those left to report would be sent to administrators, chairs, center/institute directors and division/section heads later today. The deadline for reporting in this cycle is Friday of this week. The second column on the report titled Original represent faculty and others listed on the protocol for federally funded research. Students dont get the forms automatically unless they are listed on protocols or grants. The COI reporting to date has shown a 48% increase in positive reporting for the SOM which represents double the number of positive disclosures over the last collection period. The VA and TCH will need to report on anything that is sent through the University. AVC Wishon indicated the goal is to use the same collection form for everyone. A straw vote of members was taken today and the consensus was to move the threshold trigger to zero, meaning report everything. CME Report - Associate Dean for Continuing Medical 鶹ý Ron Gibbs provided an update on the CME transition from the traditional style of live courses that used lecture/interactive formats to regional/national audiences that were sometimes venue focused, required extensive event planning, and were commercially supported. Described as a perfect storm, a number of initiatives have combined to propel the transition to CME that now focuses on health care quality gaps, supports maintenance certification and licensure, fosters collaboration for quality improvement and is independent of commercial interests. The UCDSOM CMEs focus is on effective internal RSSs (grand rounds, M&Ms and journal clubs), certification maintenance and performance improvement. Training is being organized by the Center for Advancing Professional Excellence (CAPE). The fee structure has increased from $175/year per OCME RSS event to $500/year which will include up to 3 different RSS events. For live courses, the OCME will arrange a tiered schedule for fees, but some components of event planning will either need to be done at the department level or the department will need to hire an event planner as the OCME is no longer supporting event planning at its previous levels. Dr. Gibbs asked the department chairs to commit their department to the new CME as various Departments have and to seek accreditation for their recurrent educational offerings. He encouraged the faculty and others in their department to attend the advertised CME training courses. Faculty Senate Report - Senate President Vikram Durairaj reported that Lilly Marks presented a brief budget overview and that they had discussed the UPI Member Practice Agreement. Senate voted to send a formal resolution objecting to the closure of the Silver and Gold newspaper and to invite the University President to talk with the Senators about potential options for funding the paper. Sr. Associate Dean Robert Feinstein provided a summary of the Student Promotions committee. Approval Items The 2009 Medical Student Graduation Candidates were unanimously approved. Department Status for Emergency Medicine was approved by vote of 21 in favor, 3 opposed and 0 abstentions. Approval of threshold for Conflict of Interest Reporting: A straw vote was taken and the committee consensus was to move the threshold trigger to zero, meaning to report everything. Executive Session All Senior Clinical Appointment and Promotions Committee actions were approved unanimously. All Faculty Promotions Committee Actions were approved unanimously, including those appointments the FPC did not approve unanimously. All tenure awards were approved unanimously. Adjournment - the meeting adjourned at 9:45 am.     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