Download the health of Wisconsin

Talk about
the health
of Wisconsin
Annual Report 2006
table of contents
A message from our leaders .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
A vibrant academic health center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Heart care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Cancer care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Stroke care .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Critical care .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Community benefit .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Transforming care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Redefining a school .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Primary care and prevention .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Building for the future .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
A statewide resource .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Credits
Produced by UW Health Marketing and Public Affairs
Editor.............................................................................................................................................................................Beth Fultz
Graphic Design...................................................................................................................................................... Angie Fadness
Contributors......................................................................................... Juli Aulik, Kari Brotzman, Lisa Brunette, Renae Buchheim,
Aaron Conklin, Linda Dietrich, Doug Feingold, Michael Felber, Dian Land,
Tim LeMonds, Cathy Mike, Ken Pelatzke, Kathy Schultz, Diane Stojanovich, Beth Zaher
Photography............................................................ Alan Craig, Michael Lemberger, Andy Manis, Tom McInvaille (pp. 4, 6, 8, 10),
Jeff Miller/University Communications (p. 21), David Nevala, Bob Rashid
Talk about
the health of Wisconsin
A
t UW Health, talking about the health of Wisconsin is something
we do every day. Conversations about our state’s health take
place at our home base in Madison and with colleagues throughout
the state. They happen in hospitals and clinics, in classrooms and
boardrooms, in research laboratories and outreach programs,
between doctors and patients, students and teachers, within research
teams and care teams, between investigators and the people affected
by their research.
In a climate of open discussion and debate, we tackle knotty problems
such as access to health services and health insurance, and the
economics of modern health care. Listening and talking about
Robert Golden, MD
Dean, University of Wisconsin School of
Medicine and Public Health; Vice Chancellor
for Medical Affairs, UW-Madison
prevention and treatment of disease, about the health needs of our
population as a whole and the vulnerabilities and strengths of particular
groups, we gain understanding and direction. From these conversations
come plans that lead to world-class patient care, stimulating
educational programs and exciting new knowledge about medical
science.
This annual report is part of our ongoing conversation. In its pages,
you’ll learn how UW Health is addressing the most serious health
concerns of our state­­—heart disease, cancer, stroke and unintentional
injury. These health threats claim the largest numbers of our citizens’
lives and cost our state the most in terms of health care dollars spent
and lost productivity. They also offer the greatest opportunity for
improvement if we can harness our knowledge, focus our educational
Jeffrey Grossman, MD
President and CEO, University of Wisconsin
Medical Foundation; Senior Associate Dean
for Clinical Affairs, UW School of Medicine
and Public Health
efforts and bring appropriate, cost-effective treatment to those who
need it.
Finally, it’s significant that this is the first time UW Health has
published a single annual report on the combined activities of our three
organizations. The choice is appropriate since our efforts to address the
health care needs of the state are inextricably intertwined. The report
reflects our deepening commitment to work closely together, share
resources and seek synergies. Already we are engaged in the next
round of conversations, as we pursue our shared mission to provide
the finest possible programs of health education, research, patient care
Donna Sollenberger
President and CEO, University of Wisconsin
Hospital and Clinics
and community service to Wisconsin residents. ■
Talk about
a vibrant academic
health center
From left to right: The UW Health Sciences Learning Center; The UW Clinical Science Center which houses UW Hospital and Clinics, UW Children’s Hospital and the
UW Paul P. Carbone Comprehensive Cancer Center; and one of the UW Medical Foundation’s 30 community-based clinics throughout South Central Wisconsin.
B
y definition, an academic health center is a vibrant and collaborative environment, composed of multiple entities, each with
its own strong identity, united by a shared mission of patient care, education, research and community service. When it
comes to vibrancy and collaboration, UW Health stands out.
Situated on the western edge of the UW-Madison campus, the health sciences complex is a rapidly growing, continually evolving hub
of activity. With a timeless view of scenic Lake Mendota, it radiates determination to give its historic legacy new meaning in the 21st
century. Each organization within the enterprise brings valuable strengths to the table—the UW School of Medicine and Public Health
with its core missions of education and basic, translational clinical and population research; UW Medical Foundation with nearly
1,000 dedicated physicians in 98 specialties; and UW Hospital and Clinics, the health care setting where unique skill, knowledge and
compassion meet patients seeking care. Together, they focus their combined efforts on heart disease, cancer, stroke, unintentional
injury and a host of other urgent health issues facing our state. This report describes a year of that concerted effort to improve the
health of Wisconsin and beyond.
UW School of Medicine and Public Health
A colorful mural clearly marks the location of the
Walker’s Point Clinic on the Milwaukee Clinical
Campus of the UW School of Medicine and
Public Health.
When the UW School of Medicine and Public Health celebrates its centennial in
2007—it was founded in 1907 as a two-year preclinical program—it will, within
the preceding five years, have almost completely rebuilt itself. Already enjoying
the state-of-the-art library and classrooms of the Health Sciences Learning
Center, which opened in 2004, the school this year made significant headway
on construction of the equally impressive Interdisciplinary Research Complex
located immediately adjacent. Those projects alone have brought the SMPH
roaring into the 21st century with facilities to rival any other health sciences
campus in the country. In addition, the school this year not only changed its
name but expanded its fundamental purpose to reflect a new emphasis on the
health of populations and the prevention of disease. With affiliated campuses
in Milwaukee, Marshfield and La Crosse and with family medicine residency
programs in seven communities, the school reflects the diversity of the state and
offers students the best of both urban and rural medicine experiences.
UW Hospital and Clinics
Safe, high-quality, patient-centered care is the
hallmark of UW Hospital and Clinics.
UW Health again this year garnered national recognition for quality, safety and
service. For the second consecutive year, UW Hospital and Clinics—staffed by
the faculty physicians of UW Health­—ranked among the top ten hospitals in
the country in the University HealthSystem Consortium’s national benchmarking
study of quality and safety. UWHC also was cited among the Leapfrog Group’s
50 Top Hospitals and among US News and World Report’s list of “America’s Best
Hospitals.” Thanks to its heart and vascular care program, UWHC was also named
among Solucient’s 100 Top Hospitals—Cardiovascular Benchmarks for Success.
And, with high-level performance for quality and safety, and inpatient satisfaction
scores that continue to reach above the 90th percentile, it’s no surprise that
UWHC again received the region’s Consumer Choice award from the National
Research Corporation. All of this has been achieved while continuing on time
and on budget with the opening of the hospital’s spacious new emergency
department and construction of the new American Family Children’s Hospital,
scheduled to open in August 2007.
Celebrating 10 Years
UW Medical Foundation
The year 2006 marked the 10th anniversary of the formation of UW Medical
Foundation. In that critical first decade, UW physicians transformed themselves
from an informal federation of 14 departmental partnerships into the largest
multispecialty medical group in Wisconsin and one of the largest in the nation.
Today UWMF’s nearly 1,000 physicians treat patients at more than 30 locations
throughout South Central Wisconsin. As the physician faculty at UW Hospital
and Clinics, they bring world-class knowledge and excellence in specialty care
to residents of the region. Foundation physicians also provide care at Madison’s
strong community hospitals—125 of them in multiple specialties at Meriter
Hospital and nearly 40 family medicine specialists at St. Mary’s Hospital.
With physicians at all Madison hospitals and in dozens of communities, UWMF
has been at the center of health care collaborations such as Wisconsin Dialysis
and the Madison Surgery Center. Through these partnerships among UW Hospital
and Clinics, UW Medical Foundation and Meriter Hospital, UW Health has been
able to reduce duplication of services, increase efficiency and improve access to
care for the community as a whole.
UW Health’s new Odana Atrium is redesigning
the full spectrum of primary care practice from
wellness efforts to chronic disease management.
Interior wood, stone and soothing colors of
nature create a healing environment.
Gary Cockerman (front row, third from left) is surrounded by emergency department staff who helped speed him to UW Hospital and Clinics for heart attack care
last July. Front row, left to right: Ann Kovnesky, Shawn Biwer, Cockerman, Wade Woeltle. Back row left to right: Carol Christianson, Jeff Steinke and Charles Happel.
From lab to bedside
Our work at the UW Cardiovascular
Research Center takes results from
discoveries at the molecular level and
brings them to the patient’s bedside in
the form of more effective treatments.
Take, for example, the cell line
developed collaboratively by a UW
Richard L. Moss, PhD, director,
UW Cardiovascular Research
Center; professor and chair,
department of physiology
cardiologist and a physiologist.
They discovered that when certain
medications are applied to the cell line,
they can produce a deadly arrhythmia. As
a result, some drugs have been removed
from the market nationwide, and we
have provided a standard for the industry
in screening drugs for arrhythmogenic
activity.
Usually we think of knowledge moving
from the laboratory to patient care, but
learning flows both ways. At our center,
basic research is more effective because
of our close collaboration with clinical
colleagues.
Talk about
heart care
Faster heart care for rural patients
L
ast July, after waterskiing near his weekend home in Lake
Mills, Wis., 64-year-old Gary Cockerman began sweating
and experiencing chest pain. An ambulance rushed him to Fort
Memorial Hospital in Fort Atkinson, Wis., where emergency room staff
recognized a heart attack. Following a new protocol, they called
a 24-hour hotline at UW Hospital and Clinics to activate both
Med Flight helicopter transport and the cardiac catheterization lab.
Staff at Fort had Cockerman ready when Med Flight arrived, and
when it touched down back in Madison, UWHC staff were waiting to
open his blocked artery.
Amy Schoenoff, RN, cardiothoracic surgery,
UW Hospital and Clinics
Patient-centered design
This clockwork rapid response is part of the Level One Heart Attack
This past year, I was asked to help
Program UW Hospital and Clinics began in 2004 and officially
develop the new cardiothoracic
launched in March 2006. A team effort by Med Flight, regional hospital
inpatient unit at UW Hospital and Clinics.
emergency departments and UW Hospital’s heart and vascular team,
Our goal in the design was to bring all
the Level One program focuses on reducing transport time for patients
the aspects of care that a patient needs to
who need coronary angioplasty to open blocked arteries and restore
blood flow to the heart.
the patient, instead of having the patient
travel to different parts of the hospital.
As nurses, physicians and other
“As soon as a patient is identified as having a blockage, emergency
clinicians, we attended many meetings
departments call the hotline in UW Hospital’s Access Center to get
and experimented with mock-ups to
things rolling,” explains Darren Bean, MD, a UW Health emergency
test our ideas for the new space. I know
department and Med Flight physician who co-directs the program.
that patients do better with their families
The activation is similar to Med Flight’s response to a trauma scene.
their life, and I recognize how much they
“We don’t know all the specifics about the patient when we leave for
need family close to them. As a nurse I
flight,” says Bean. “But we do know the patient’s outcome is absolutely
believe I offered a unique perspective on
dependent on how quickly blood flow is restored to the starving heart
muscle.”
Critical time is saved by work done before and during the flight.
While Med Flight is en route to their location, the regional emergency
department prepares the patient for transport and gathers information
around them. I see myself as a visitor in
patient and family needs. The end result
is a unit that patients and families really
appreciate. I think the space helps staff
work better together, too. Now the time
we would have spent moving a patient
can be devoted to helping them recover.
that will be needed once they arrive at UW Hospital. During the flight
back, this information is faxed to the UW cath lab. To save additional
time, Med Flight crews give some medications by mouth rather than IV,
making it faster to remove patients from the helicopter upon arrival.
Recommended guidelines call for treatment to open blocked arteries
within two hours, preferably within 90 minutes. Prior to the new Level
One protocols, it took, on average, two hours and forty-seven minutes
for a patient to arrive at UW Hospital from a regional hospital. Today,
the average trip has been reduced to one hour and forty-nine minutes.
Make that one hour, forty-nine minutes, and counting. ■
Milwaukee businessman Todd Lappin (left) underwent treatment from George Wilding, MD and oncology research nurse Jane Straus, RN, BSN in a clinical trial of a
new drug to treat kidney cancer. Two years later, happy with their decision, Lappin and his wife (right) credit the experimental treatment with extending his life.
Bridging research and treatment
Each year since I became a researcher the
percentage of people surviving cancer has
slowly increased. Much of that progress
has come through clinical trials.
At the UW Paul P. Carbone Comprehensive
Cancer Center, we identify possible new
treatments. Phase I clinical trials test these
Dan Mulkerin, MD, medical
oncologist, and assistant professor
of medicine
substances to determine proper doses
and possible side effects. Phase II trials
test how well the drugs treat a specific
kind of cancer. Phase III trials are large,
often worldwide studies that compare
breakthrough treatments to standard ones.
The reasons for joining a clinical trial are
very personal, but outcomes for patients
are often as good as—if not better than
—outcomes of conventional therapy.
Patients also like the chance to help create
new knowledge that may benefit others.
Talk about
cancer care
Tomorrow’s treatments available today
T
odd Lappin, a retired Milwaukee businessman, has proof that
he’s number one in the world. On August 14, 2004, he was
forever recorded as clinical trial patient # 0001 in a worldwide test of
a promising new kidney cancer drug.
This is Lappin’s second experience with kidney cancer. In 1991 his
doctor found tumors in one kidney while treating him for another
condition. The kidney was removed and he was cancer-free until 2004,
when the disease returned.
Faced with the new diagnosis, Lappin did his research. He talked
Patrick Remington, MD, MPH, director,
UW Population Health Institute; and professor
of population health sciences
with his doctor and visited high-profile cancer centers such as M.D.
Waging war on cancer
Anderson and the Dana-Farber Institute. In the end, he chose the UW
One of the core functions of public
Paul P. Carbone Comprehensive Cancer Center.
health is assessment—knowing where we
are now and where we want to be in the
“I learned that kidney cancer is one of the most deadly forms of
future. In 1972, the nation declared
cancer,” he says. “I also learned there were really just two treatments,
“a war on cancer,” and if we hope to
interferon and interleukin-2. Both were likely to make me very sick, and
win, we must continue to invest in efforts
weren’t necessarily effective on my cancer.
not only to wage the fight but to measure
“I had heard about Dr. Wilding from my doctor,” says Lappin. “When I
requires prevention, early detection,
met him and his staff, I knew that UW was about to start a clinical trial
effective treatment and evaluation—and
for kidney cancer. Even the folks at M.D. Anderson asked why I would
evaluation is where the UW Population
come to Texas with Dr. Wilding right in my backyard.”
The clinical trial, explains Dr. George Wilding, director of the Carbone
progress. Having a balanced portfolio
Health Institute plays a critical role.
Our primary way of judging our success
against cancer is reduction in the age-
Cancer Center and Lappin’s oncologist, is a Phase III trial of a drug
adjusted death rate from the disease
that targets the blood supply feeding growing tumors. Many similar
among Wisconsin residents. It’s not
drugs are under study, and clinical trials will determine which are most
progress to be improving treatment when
effective.
people are still getting cancer at the same
The treatment Lappin is receiving has improved his long-term
that means fewer people are getting
prognosis. “From the beginning,” he says, “there was dramatic
cancer, and those who do are living
reduction in the size of the tumors. I know the drug I’m taking is not
longer, healthier lives.
rate. When we see the death rate decline,
‘curing’ my cancer. It’s an ongoing process, like treating diabetes; I’ll
be doing this the rest of my life.” Lappin still likes the odds.
“We heard Dr. Wilding at an event last spring. He spoke of two kidney
cancer patients—a 22-year-old young woman he treated several years
ago and me. The young woman lived eight months with her cancer.
I’ve been here more than two years. I can’t help but think how sad it is
that she never had the opportunity I’ve had. To me, the clinical trial has
made all the difference.” ■
Jamie Dixon visits with neurointerventional radiologist Beverly Aagaard Kienitz, MD, whose expert intervention interrupted a stroke in progress and spared Dixon
potentially devastating brain damage.
From research to prevention
Smoking is the leading preventable
cause of heart disease, responsible
for more than 100,000 U.S. deaths
each year. That’s why so much of our
current federally funded research at the
UW Center for Tobacco Research and
Intervention focuses on understanding
the cardiovascular effects of smoking and
Michael Fiore, MD, MPH, director,
UW Center for Tobacco Research
and Intervention; and professor of
medicine
finding the best treatments for smokers
with various physical and psychological
profiles.
Our center is unique because we apply
our research in the real world through
our statewide outreach program,
cessation clinics and special programs
like “You Can Quit.” This effort, which
provides quit-smoking medications and
counseling to all employees of UW
Hospital and Clinics and UW Medical
Foundation, has been enormously
successful, reaching hundreds of
employees in just its first year.
Talk about
stroke care
Deep in the brain, damage control
S
troke kills more than 3,000 Wisconsin residents every year and
severely disables thousands more. Amazingly, Jamie Dixon isn’t
one of them.
At home with her children on a spring afternoon, 27-year-old Jamie
suddenly found herself unable to button her baby boy’s outfit. Soon,
her right side went numb and she couldn’t move. Found by a visiting
neighbor, she was rushed to a community hospital, then transferred to
University of Wisconsin Hospital and Clinics.
On arrival, her situation looked bleak: Her upper arm was paralyzed,
and she had a facial droop, weakness in her right leg and trouble
forming and understanding words. Even worse, she was beyond the
“therapeutic window” of three hours, when it’s considered safe to give
intravenous clot-dissolving drugs to restore blood flow to the brain.
Fortunately, Douglas Dulli, MD, the stroke specialist on call, knew
that UW Hospital offered another option—sophisticated magneticresonance imaging to see how much of Jamie’s brain was damaged
and how much might be saved if medication were given through the
Kelly Traeger, fourth-year student,
UW School of Medicine and Public Health.
Hands-on learning
Last spring as a third-year medical
student, I was on the front lines of
care for patients with stroke, head
injury, chronic pain and many other
neurological disorders. Standing beside
me were the UW Health physicians
who lead the neuroscience clerkship
required of all UW School of Medicine
and Public Health students. In that
arteries instead of the veins. Dulli paged interventional neuroradiologist
comprehensive course, I learned from
Beverly Aagaard Kienitz, MD. Following stroke-team protocol, they met
expert neurologists, neurosurgeons and
at “the magnet”—the MRI machine, where scans revealed a small area
rehabilitation medicine specialists who
of permanent damage and a larger area at risk but still salvageable.
are also dedicated educators. As students,
“This is why MR imaging is so important,” Aagaard Kienitz says. “It told
inpatient rounds and in outpatient clinics.
us that if we didn’t open the vessels, Jamie could lose the entire left
We learned how to obtain thorough
side of her brain. This was a young mother. We decided to go all-out.”
patient histories, conduct neurological
Using X-ray guidance, Aagaard Kienitz inserted a catheter to deliver
initiate surgical management plans and
clot-dissolving medications deep in the arteries of Jamie’s brain. Next,
construct multi-faceted rehabilitation
she deployed a tiny device to break up any remnants of the blockage.
plans. For me, the highlight of the course
Suspicion that the clot had formed elsewhere was confirmed when
cardiologists found and closed an opening in her heart.
After a week of rehabilitation, Jamie went home to continue recovery.
Today, her speech is fluent, her gait steady and sure. She is raising two
children and active in her husband’s business. Occasional clumsiness
we actively participated with them on
examinations, create treatment strategies,
was the time we spent “on call.” For
these cases, we assessed patients prior to
the establishment of a diagnosis, which
required us to apply all the skills we had
learned in the course’s daily scheduled
activities.
on her right side is the only sign of a potentially devastating stroke.
“This is why we’re in medicine,” says Aagaard Kienitz. “To give these
children back their mother and this husband his wife. I am so thrilled at
Jamie’s recovery.” ■
Charlie Thole holds the basketball he was playing with the day Med Flight transported him to UW Hospital and Clinics for life-saving emergency surgery. At left is
his Brodhead physician, Kevin Bluemel, MD, and MedFlight crew members (left to right): Bruce Lindsay, MD; Ken Heller, RN and Jason Quisling, Pilot.
A place to rely on
I felt such relief when the doors opened
to University of Wisconsin Hospital’s
new emergency room. My partner
and I were bringing in a one-year-old
baby with a serious heart problem. I
Dan Williams, emergency medical
technician
10
The new ED is impressive­—state-of-theart, yet warm and calming. It’s part of the
area’s only Level One trauma center with
dozens of specialists always available
on-site. Patients know they’re in a worldclass facility.
remember thinking about the incredible
On days like today with this tiny child,
responsibility we had and what this little
you see first-hand the level of expertise
girl must mean to somebody.
and comprehensiveness of care UW
Hospital is able to provide, and you
realize there’s nothing they can’t handle.
Talk about
critical care
Angels and a first-rate emergency team on his side
W
hen 11-year-old Charlie Thole went to school on May 12, the
only thing on his mind was finishing fifth grade. He couldn’t
know that before the day was over, his life would hang in the balance
as medical professionals made decisions crucial to his survival.
That morning, Charlie was playing basketball at Orfordville Elementary
School in Rock County, Wis. Trying to get open for a pass, he was
accidentally elbowed by a schoolmate just above his left ear. From that
moment, the clock was ticking.
“He went to the school office very lethargic,” says Charlie’s dad, Aaron
Thole. “He had trouble walking. Thankfully I was home when the school
called and we got Charlie to our family doctor in Brodhead right away.”
Nan Peterson, RN, MS, Madison Area Safe
Kids Coalition coordinator; and clinical nurse
specialist, UW Children’s Hospital
Giving safety a boost
Nothing is more heartbreaking to
Kevin Bluemel, MD, the Tholes’ family physician at Mercy Brodhead
me than seeing a child harmed or
Medical Center, knew right away that Charlie’s condition was serious.
killed in an unintentional­—and
preventable—injury. As the former
“He was confused,” Bluemel recalls. “His pulse was in the 30s, his
nurse manager of the pediatric intensive
blood pressure was low, and it was hard to keep him awake. I called
care unit at UW Children’s Hospital,
UW Hospital for emergency help, and at one point, I pulled his dad
the number of tragedies I saw first-
aside and said, ‘He isn’t looking good; get your wife here right away.’”
hand inspired me to help save kids and
families from such devastation.
Braving windy conditions, UW Med Flight flew to Brodhead, landing in
Through education on proper car seat
an open field across the road from the clinic. As the helicopter made
installation, use of bicycle helmets, tips to
the 25-minute return flight, caregivers at UW Children’s Hospital
prevent furniture from falling on toddlers
prepared for Charlie’s arrival. His mom and dad drove, arriving just
and many other initiatives, the Madison
seconds before their son was rushed into the operating room.
Area Safe Kids Coalition* has made a
About halfway into the two-hour surgery, pediatric neurosurgeon
coordinator, I’m proud of the work we’ve
Bermans Iskandar, MD, emerged with the six words Charlie’s parents
done to advocate on behalf of children
desperately wanted to hear.
and build awareness among parents
“Charlie is going to be alright,” he assured them, then explained that
fulfilling was the role we played in seeing
the injury had caused life-threatening bleeding between the head and
a new Wisconsin booster seat law take
skull. To stop the bleeding, he removed a small portion of Charlie’s
effect in 2006, requiring youngsters up to
skull—nothing that should prevent a complete recovery.
difference since its creation in 1996. As its
about injury prevention. Especially
age 8 (instead of 4) to use a booster seat
when riding in a motor vehicle.
“This condition is often fatal,” says Iskandar. “The injury does not
have to be extensive. All that is required is a small skull fracture that
injures an underlying blood vessel.” If operated on promptly, however,
complete recovery with no neurological deficits is usually possible.
* UW Children’s Hospital is the lead agency for
the Madison Area Safe Kids Coalition, which also
includes representatives from public health, law
enforcement, fire departments, state consumer
protection agencies and others.
Back in Brodhead, everyone at the family medicine clinic is elated with
Charlie’s recovery. “He’s a great kid,” Bluemel says. “He really had
angels watching over him.” ■
11
Talk about
community benefit
Bringing health care and education to the communities we serve
UW
Health’s community service commitment encompasses charity care, direct charitable giving to address the health
needs of the communities we serve, and employee giving and volunteerism to benefit a wide variety of charitable
organizations. Much of our effort is directed to local programs for underserved residents, such as Access Community Health
Center and the MEDIC program that hosts six Madison clinics where faculty-supervised medical students treat underserved and
uninsured patients on a walk-in basis. With the statewide reach of the UW School of Medicine and Public Health, UW Health
community programs also reach into the heart of Milwaukee and into rural areas throughout the state. Significant additional
support goes to local, state and national organizations dedicated to health education and research.
Caption here
Access Community Health Centers
Working at Access Community Health Centers is perfect for Ken Loving, MD. “It’s
the reason I went to medical school,” he says. “I love the way the job allows me
to combine the science of being a physician with interaction on a daily basis with
people in the community who have trouble accessing the health system.”
As a federally qualified health center, ACHC is mandated to provide care for
people who cannot overcome economic, cultural, educational and numerous
other barriers. Located in the heart of Madison’s most underserved communities,
the center’s two locations bring care to the groups who need it most.
This year ACHC served 8,000 men, women and children from Dane County. One
third were under 18, and more than half were uninsured. UW Health continues
to be an important source of support, enabling the organization in 2005 to open
its second location, the William T. Evjue Clinic on Madison’s east side. Already,
in July 2006, ACHC broke ground to add medical and dental exam rooms at that
location to serve more of the city’s underserved and uninsured residents.
UW Health support helps Access Community
Health Centers make a difference in the lives of
thousands of Madison residents each year.
UW Health teams hoof it to fight heart disease
For the last five years UW Health has been a corporate sponsor for the annual
Heart Walk, sponsored each October by the American Heart Association. Rain or
shine, enthusiastic teams of walkers don bright red team T-shirts and get moving
to support heart health. This year’s brigade put nearly $24,000 in the coffers that
will support heart research in the coming year.
Teams from UW Health raised nearly $24,000 at
this year’s Heart Walk.
12
MEDIC volunteers make a difference
Joel Thomas Adler, president of the UW School of Medicine and Public Health’s
MEDIC outreach program, speaks fondly of the time he helped a man with an
injured shoulder.
“He understood very little English and couldn’t afford time away from his three
manual labor jobs,” Adler says, “but we taught him some exercises and provided
medication.”
Adler and dozens of other first- and second-year UW SMPH students volunteer
at six free clinics throughout Madison as part of the MEDIC program. Three are
weekly clinics that treat mainly acute health problems, while three others focus
more on prevention, education and mental health assistance. Together, they treat
approximately 1,200 patients each year, nearly all of whom lack health insurance.
MEDIC clinics are staffed entirely by volunteers, including not only students,
but physicians, residents and an array of health professionals. Not content to
simply provide health care, MEDIC also engages the community through literacy
activities, participation in health fairs and other community-based activities. The
program offers students a unique opportunity to gain valuable clinical experience
while serving those who would not otherwise have access to health care.
Brian Hotujec (left), a first-year medical student,
listens while Dr. Quinn Pack (right), a UW
internal medicine resident, talks to a patient.
Teen fitness program targets childhood obesity epidemic
Carlos, a Madison teenager, accomplished more in a year as part of the UW Pediatric Fitness Program than many people
do in a lifetime. Through an innovative approach aimed at reducing childhood obesity, he was able to begin working out,
cut down on sports drinks, increase his milk and calcium intake, and, most important, eat breakfast. Through the unique
teen fitness regimen that combines education and fun to help kids from 5-18, he has grown stronger and added muscle in
his chest, upper body and legs.
“He made the choice,” says his mom Kathryn Bush. “He set the goal, and he’s been able to do it. This program works so
much better because it’s something he really wants to do.”
Wisconsin health is global health
Madison’s Latino population is among the fasting growing in the country,
and Hmong and Native American communities contribute richly to the state’s
makeup. Each group approaches health and healthcare in slightly different
ways. “Wisconsin health is global health,” says Cynthia Haq, MD, director of
UW Madison’s new Center for Global Health. To be most effective, today’s
health professionals increasingly need a better understanding of the cultures and
peoples of the world, she says. Through her own experiences in Uganda, Haq
learned about the profound impact of social and cultural factors in health and
health care.
On one of several trips to Uganda, Cynthia Haq,
MD, director of the UW Global Health Program
met with a local healer.
Furthermore, thanks to the way people—and diseases—now travel from continent
to continent in mere hours, Wisconsin is hardly immune to dangerous new health
threats. “We now have a single world in terms of health,” Haq says.
The new center sponsors global health courses on campus and educational
programs abroad, facilitates global health research by encouraging networking
among UW-Madison faculty and staff, and promotes worldwide partnerships and
exchanges resulting in lasting impacts both here and abroad.
13
Look what’s parked on Main Street
For many Wisconsin children, limited transportation and lack of access make it
difficult to get to the dentist. UW Health’s solution? Bring the dentists to the kids!
To reach youngsters in 12 counties in southern and southwestern Wisconsin,
UW Children’s Hospital dentists and hygienists staff the Ronald McDonald Care
Mobile for eight months during the year. The 40-foot, 26,000-pound traveling
dental office holds a laboratory, reception area, medical records and two patient
exam rooms. Inside the enormous vehicle, staff provide x-rays, dental cleanings
and fluoride applications. Through the combined sponsorship of UW Children’s
Hospital and Ronald McDonald Charities, the Care Mobile enables many children
without insurance to receive treatment at no cost.
The Ronald McDonald Care Mobile takes dental
care access on the road.
In another move to expand access to dental care, UW Health played an
instrumental role in enabling dental hygienists to bill Medicaid for preventive
services. According to a recent survey, almost half of Wisconsin children
attending schools with a higher percentage of low-income students have
untreated decay, which leads to difficulty in eating, sleeping, learning and proper
nutrition. Recognizing the serious implications of the problem, UW Health
leaders strongly supported a Medicaid rule change, which has allowed dental
professionals to provide more preventive care to these children.
Ronald McDonald Care Mobile Statistics
Number of clinic days provided: 449
Number of children treated: 2,569
Number of clinic visits provided: 6,184
Value of services: $1,265,055
Number of exams, x-rays: 6,158
Number of cleanings: 5,609
Number of fillings, stainless steel crowns: 7,378
Number of extractions: 1,073
(NOTE: The totals above are derived from the programs inception, which began in January, 2003.)
Grant supports outreach to Allied Drive
July 2006 saw the kickoff of Reaching Out for Health and Wellness on Allied Drive, a student-led initiative to expand
outreach programming by the Community Service Programs Office of the UW School of Medicine and Public Health. UW
SMPH was one of eight recipients nationwide in the Caring for Community grant program of the American Association of
Medical Colleges (AAMC). Supported by the Pfizer Medical Humanities Initiative, the grant will provide the school with
$30,000 over four years. Susan Skochelak, MD, MPH, associate dean for academic affairs, is the principle investigator for
the grant, and is supplying matching funds to support program activities over the next four years.
The grant provides funding for service projects initiated, developed and administered by medical students in collaboration
with existing community agencies. Medical students and other volunteers will use door-to-door interviews, neighborhood
programs, community dinners, health fairs and festivals to conduct health-related needs assessments and provide targeted
health education to residents. The Allied Wellness Center, Inc., established in July 2004 to address the holistic health needs
of the Allied/Belmar/Dunn’s Marsh neighborhood, will serve as the community partner for the initiatives.
14
Community Organizations Receiving Financial Support from UW Health in FY06
100 Black Men of Madison
Access Community Health Center
ABC for Health
African Association of Madison
AIDS Network
All City Swim Meet
Alzheimer’s Association
American Cancer Society
American Diabetes Association
American Heart Association
American Lung Association of Wisconsin
American Red Cross
American Red Cross – Badger Chapter
American Society of Health Economists
AMIGOS-Madison Chapter
Arthritis Foundation
American Society of Preventive Oncology
Association of Fundraising Professionals
Attic Angels
Bayview Foundation Inc.
Crohn’s and Colitis Foundation of
American – Wisconsin Chapter
Centro Hispano of Dane County
Children’s Health Alliance of Wisconsin
City of Columbus Playground Equipment
Colonial Club
Columbus Crop Walk
Combat Blindness Foundation
Community Shares of Wisconsin
Cross Plains Stingray Swim Team
Cross Plains World Fair
Cystic Fibrosis Foundation
Dane County Coalition
Dane County Department of Human
Services
Dane County Immunization Coalition
DeForest Annual Celebration
DeForest Area EMS
Domestic Abuse Intervention Services
Downtown Madison Inc.
Beaver Dam Lake Days
East Madison/Monona Coalition of
the Aging
Beaver Dam Music Review
Easter Seals Wisconsin (Camp Waubek)
Big Brothers Big Sisters
ElderCare of Wisconsin
Black Belt America
Elm Lawn PTO
Brain Injury Association of Wisconsin
Exchange Center for Prevention of
Child Abuse
Breast Cancer Recovery Foundation
Building Wisconsin Inc.
Camp Shalom
Capital Candlelighters
Family Support & Resource Center
Fishing Has No Boundaries
Fitchburg Days
Fitchburg Farmers Market Kids Days
Food Allergy & Anaphylaxis Network
Fort Memorial Hospital Foundation
Forward Wisconsin
Friends of McFarland Library
Friends of the Waisman Center
Friends of UWHC
Girls on the Run
Glaciers Edge Council of the Boy Scouts
Greater Madison Convention and
Visitor Bureau
Habitat for Humanity
Health Professional Mentoring Program
HospiceCare
Interfaith Hospitality Network
Judith Chester Scholarship Fund
Junction Ridge Neighborhood Association
Juvenile Diabetes Research Foundation
LaFollette High School
Latino Health Council
LeRoy Butler Breast Cancer Awareness
Leukemia and Lymphoma Society
Lighten Up
Family Centers, Inc.
Lincoln Elementary School
Family Connections of Wisconsin
Literacy Leadership, Inc.
Family Service
Lupus Foundation
(continued on page 16)
15
Madison Area Down Syndrome
Association
Madison Area Literacy Council
Madison Children’s Museum
Madison Community Foundation
Madison Metropolitan School District
Madison Opera
Madison Parks Foundation
Madison West High School
March of Dimes
Mark Maida Memorial Run
MATC Foundation
McFarland Family Festival
McFarland Fire Department
McFarland Firecracker 500
United Cerebral Palsy
Palmyra Eagle Project Graduation
United Way of Dane County
Pediatric Research Foundation
Urban League of Greater Madison
Prevent Blindness Wisconsin
UW Health Innovations Program
Rape Crisis Center
UW School of Nursing
Redline Club
UW Spirit Squad
Respite Center
Verona Hometown Days
Richland Hospital Foundation
Verona Little League
Ronald McDonald House
Waunafest
RSVP of Dane County
WHA Foundation
Safe Community Coalition
Wisconsin Alliance for Fire Safety
Safe Harbor
Wisconsin Coalition Against Domestic
Violence
Salvation Army
Scholarships
Second Harvest Foodbank
Wisconsin Council on Children and
Families
Shelley Grover Foundation
Wisconsin Employer Support of the Guard
and Reserve
Shillelagh Foundation
Wisconsin Medical Society Foundation
Shrine Circus
Wisconsin Sports Development Corp.
Smoke Free Wisconsin
Wisconsin Youth Symphony Orchestra
St. Joseph’s Memorial Foundation
Wisconsin Academy of Family Physicians
Stoughton HS Senior Class Bash
Wisconsin Literacy
Stoughton Kiwanis Club
Wisconsin Parkinson’s Association
Stoughton Syttende Mai
Wisconsin Women’s Health Foundation
Student Nurses Association
Women in Focus
National Kidney Foundation of Wisconsin
Sun Prairie Piranhas
Women’s Transit Authority
National Multiple Sclerosis Society
Susan G. Komen Breast Cancer
Foundation
YMCA
McFarland Senior Outreach
Meriter Foundation
Monona Grove Football Booster
Monona Swim and Dive Club
Mt. Horeb Junior Prom
Muscular Dystrophy Association
National Association for the Advancement
of Colored People
National Alliance on Mental Illness
– Madison Branch
National Runaway Switchboard
Nurses Alumni Organization
Oregon Youth Center
Outreach
16
Overseas medical care
Tellurian
Tomorrow’s Hope
Trinity Booster Club
Youth Services of Southern Wisconsin
YWCA of Madison
Pediatric health care and prevention are a major reason for UW Health’s
steadfast support of Access Community Health Center.
During the winter holidays’ Drive to Share, UW Health employees and patients
contribute truckloads of food, toys and other gifts for families in need.
Serving community needs (FY 2006)
UW Health’s overall commitment to the health of the community, including care provided to those without ability to pay and
donations by employees through workplace giving programs, is reflected in the following summary:
Charity care..................................................................................................................................................................... $41,052,300
Contributions to charitable organizations................................................................................................................................ $614,100
Organizations contributed to........................................................................................................................................................... 167
Total initiatives/events sponsored............................................................................................................................................ Over 200
Employee charitable contributions.......................................................................................................................................... $501,500
Number of employees contributing............................................................................................................................................... 1,611
UW Health blood drives and pints contributed.................................................................................................................................. 893
Holiday Drive to Share (first three drives include public participation)
Toys collected through Toys for Tots............................................................................................................................................. 2,400
Families supported through Adopt-a-Family..................................................................................................................................... 166
Meals for Second Harvest Food Bank....................................................................................................................................... 150,000
Friends of UWHC Love Lights
People honored or memorialized.....................................................................................................................................................1,800
Dollars raised.............................................................................................................................................................................$18,000
17
Talk about
transforming care
through science
Patients who have their prostate
glands removed in a traditional
open surgery typically remain in the
hospital an average of two days.
Patients who have the procedure
done using the surgical robot
typically go home the next day and
return to normal activity in as little
as one week.
A surgical robot offers extra hands in the
operating room.
Surgical robotics adds precision,
subtracts recovery time
One of the newest members of the
UW Hospital and Clinics surgery team
stands six feet tall, has four arms and
is named after a famous Italian painter
and inventor. He’s also a robot.
This spring, Steve Bentin, the 62-yearold basketball coach at Madison Area
Technical College, became one of a
growing number of patients to have
his prostate removed with the
Da Vinci® surgical robot, a
technological advancement that
allows surgeons to execute complex
surgeries using minimally-invasive
techniques. Currently, UW Hospital
and Clinics is the only hospital in
the Madison area using robotics in
the operating room, and one of five
medical centers in Wisconsin. While
doctors enjoy the robot’s increased
precision, patients appreciate the
reduced recovery time.
“I’m a major fan of the robot,” says
Bentin, 62. “I actually feel bad telling
some of my friends how good my
surgery was. Instead of spending
weeks sitting around in the backyard
reading books, I was up and walking
around.”
18
Da Vinci® has been in the operating
room at UW Hospital and Clinics
since January 2006, putting the
hospital at the forefront of a
growing national trend. In addition
to prostate removal, UW Health
surgeons are using it to perform
complex heart surgeries, gland
removals, hysterectomies and
cancer staging.
Now the UW Health Transplant
Program offers a desensitization
program in which patients receive
immunosuppressant drugs and
a plasma treatment to remove
rejection-causing antibodies from the
bloodstream. Desensitization cleanses
the blood of harmful antibodies
much the same way as hemodialysis
removes toxins. Immunosuppressant
medications—the same ones patients
take after transplantation—help
prevent the harmful antibodies from
returning. Undergoing the process
prior to transplant allows many
who would otherwise reject their
transplanted kidney, to receive the
new organ successfully.
“This has been a very exciting
development for us,” says Dr. David
Jarrard, a physician with the UW
Paul P. Carbone Cancer Center, and
one of three UW Health urological
surgeons trained to use the robot.
“The cancer outcomes with the
robot are similar to those with open
prostatectomy,” he says. “The big
benefit for patients is the shorter
hospital stay and faster recovery.”
Desensitization helps expand
transplant donor pool
The wait for a new kidney can
be long and arduous for patients
on a lengthy list with other needy
candidates. The picture can be even
more bleak for the 30 percent of
patients considered “sensitized,”
that is, having antibodies against
foreign tissues (such as a new
kidney) that make it harder to find
a compatible living or deceased
donor. These antibodies pose such
a risk that sensitized patients may
wait three to four times longer than
other patients for a compatible
kidney.
Travis, whose kidney transplant succeeded thanks
to a new pre-transplant desensitization process,
and his donor, Sue.
Because the timing of desensitization
is crucial, it’s preferred that candidates
have an identified live donor. Thus
far, the new program has helped
nearly twenty patients overcome
what was once a significant barrier to
transplant.
Islet cell transplant continues to
hold promise
Morning, noon and night, clusters
of special pancreatic cells known as
“islets” regulate the release of insulin
in our bodies, maintaining normal
and innovation
blood sugar levels. Most healthy
people take the process completely
for granted. Those with Type 1
diabetes know what happens
when the process goes off track,
destroying islet cells and robbing
the body of that natural regulation.
Until recently, solid organ
pancreatic transplantation offered
Type 1 diabetics their only hope
of life without daily insulin
injections—and avoidance of the
serious long-term complications
associated with diabetes.
two to three days. Most require
more than one infusion treatment,
and like all transplant patients, they
must continue to take anti-rejection
medications indefinitely.
In the home stretch of the
current round of clinical trials,
UW Hospital has transplanted
eight patients. Three are already
completely insulin free; others
are awaiting a first or additional
procedure.
Says transplant team leader, Dr. Jon
Odorico, “This is truly a major step
forward in diabetes care.”
Artificial rib lets toddler’s lungs
breathe and grow
Julie (left), a Type 1 diabetic and islet cell
transplant recipient, with her transplant
coordinator Nancy.
Now there’s a second alternative.
Though still experimental, islet
cell transplantation continues to
offer promise and, for the right
individuals, several potential
advantages over conventional
pancreas transplant. Islet cells are
extracted from the donor pancreas
and infused intravenously into the
portal vein of the recipient’s liver.
Unlike pancreas transplantation, a
major surgical procedure requiring
two to three months of recovery
time, the surgical process for islet
cell infusion takes only about two
hours. Patients can go home in 24
to 72 hours and back to work in
Traditional spinal fusion surgery
is an effective treatment for adults
with spinal curvatures, but usually
a poor solution for younger
patients. “The non-expanding metal
rods and screws stop the spine
from getting worse, but they also
essentially stop it from growing,”
says UW Health pediatric surgeon
Kenneth Noonan. “That’s not a
huge problem when you’re older
and done growing, but it is when
you’re two.”
Noonan and a UW Children’s
hospital colleague, Aimen Shaaban,
have become the first pediatric
surgical team in Wisconsin to
use an implantable, expandable
metal device that offers spinal
treatment that can grow with
a child. Known as a Vertical
Expandable Prosthetic Titanium
Rib (VEPTR), the device helps
straighten the spine and separate
the ribs so the lungs can grow and
fill with enough air to breathe. The
artificial rib is lengthened every
4 to 6 months to accommodate
the growth of the child. Noonan
Two-year-old Kate, just two days after UW
Health surgeons implanted an expandable
titanium rib to correct a severe spinal curvature
and Shaaban’s first patient was a
two-year-old girl from Stevens Point,
Wis., with severe scoliosis secondary
to a rare congenital syndrome. She
received the implant under an FDA
Humanitarian Device Exemption
(HDE), created solely to benefit
patients with rare conditions. Without
the corrective surgery, she would
likely have developed serious and
potentially fatal breathing problems
due to inhibited lung growth.
“Thanks to VEPTR, she’ll be able to
maintain her lung function so she
can have a normal lifespan,” says Dr.
Shaaban. Prior to development of the
UW VEPTR team, only seven centers
in the United States were performing
the procedure.
19
Talk about
redefining a school
Change and continuity
into existing courses. The end result
will be physicians who are better able
to focus on prevention; understand
social, cultural and behavioral
influences on health; relate to diverse
groups of patients; and function more
effectively within the current health
care system.
The past year has been a time of
major change at the University of
Wisconsin School of Medicine and
Public Health. The school’s new
name, now more comprehensive than
simply the University of Wisconsin
Medical School, is the clearest
indication that something is different.
A long time coming, the name change
reflects a fundamental transformation
for the school, an innovative move
representing the most promising
approach to dealing with an array
of challenging health problems in
Wisconsin—from childhood obesity
that devolves into diabetes to tobacco
addiction that predisposes smokers to
cancer to hip-shattering falls among
the elderly.
The change integrates traditional
medicine, which generally focuses
on individual patients from
molecular, cellular and organ-system
perspectives, with public health,
which concentrates on disease
prevention and health promotion
in groups of people ranging from
neighborhoods to the “global village.”
The school is steadily incorporating
public health into all of its major
missions.
20
Wisconsin Partnership funds
rural health initiative
New degree program signals
importance
The Master in Public Health (MPH)
degree program was created to
respond to a critical nationwide
need for public health workers
trained to deal with issues such as
bioterrorism, e-coli infections, West
Nile Virus and other immerging
infectious diseases. Now in
its second year, the year-long
MPH provides multidisciplinary
public health education and
training to current and future
health professionals. The popular
new program is enhancing and
expanding the state’s public health
workforce, preparing people to
serve in government agencies,
academic settings and the private
health sector.
Curriculum infused with new
emphasis
To ensure that public health
training evolves across all four
years of the standard MD degree
curriculum, school leaders have
created Innovations in Medical
Education. The four new faculty
curriculum developers who have
been hired for this major program
are carefully weaving extensive new
material on public health, cultural
competence and professionalism
The Wisconsin Partnership Program
has played a crucial role in the
creation and growth of both of
these new programs. Stemming from
Blue Cross/Blue Shield’s conversion
from a non-profit to a for-profit
corporation, the WPP allocates and
disburses proceeds from investments
on the approximately $300 million
that has been transferred to the
school. The WPP’s broad goal is to
improve the health of all people in
the Badger State by distributing funds
to community organizations, training
public health practitioners and
supporting creative education and
research programs.
Funding from the WPP has also been
essential to the Wisconsin Academy
for Rural Health, a new MD program
that will train physicians to work
in small towns in rural areas of the
state where the health care needs of
farm families, Native American and
Hmong communities and others are
badly under-met. The WARM program
will run parallel to the standard MD
program, and use the school’s two
rural clinical campuses—Marshfield
Clinic in central Wisconsin and
Gundersen Clinic in western
La Crosse—plus one in Green Bay
as regional hubs. From there it will
extend to a network of smaller
outlying hospitals and clinics, where
the bulk of students’ training in the
third and fourth years will take place.
By 2015, a total of 25 new MDs
will be prepared to live and
practice in rural Wisconsin. The
program, to begin in Fall 2007, will
complement the intensive urban
clinical experience the school
has offered third- and fourth-year
medical students at its Milwaukee
Clinical Campus for decades. Here
students train alongside physicians
in busy inner-city clinics that draw
ethnically diverse patients from
nearby neighborhoods.
The WARM program will rely
heavily on the volunteer physicians
who serve in the school’s longrunning Preceptorship Program.
Created in 1926, the program has
served for years as a national
model of clinical training that
supplements classroom instruction.
Volunteer physicians have
generously opened their offices
and practices scattered throughout
Wisconsin to fourth-year medical
students for the six- to eight-week
preceptorship clinical experiences.
sciences, and biostatistics and
medical informatics. At the same
time the school is encouraging
and supporting researchers in all
departments to use epidemiology,
informatics and the social and
behavioral sciences to examine,
whenever possible, public health
issues of concern in Wisconsin.
One exciting new public health
research project that began recently
at the school is the Survey of the
Health of Wisconsin. This program,
funded by the WPP, is creating
a mechanism to collect data on
the many factors—biological,
behavioral and environmental—
that influence the health of
Wisconsinites. Extensive data from
approximately 1,000 residents who
are representative of the state’s
entire population will influence
statewide health services research,
community-based prevention and
treatment trials and, ultimately,
future health priorities.
Translational research, to be featured
in the Interdisciplinary Research
Complex that is under construction,
will be a focus for years to come, and
clinical investigations will remain a
hallmark of the institution.
Similarly, the school will always be
committed to training students to be
physicians who are firmly grounded
in the basic sciences and comfortably
competent in the clinic. But physicians
and researchers of the immediate
future must learn to examine and
understand all the factors—biological,
behavioral, genetic, environmental and
social—affecting human health. School
leaders are convinced that this novel
combination of new perspectives,
knowledge and tools—one that
uniquely integrates medicine and
public health—has the best chance of
making the biggest impact on health
in Wisconsin.
SMPH researchers, widely
recognized for their strength in the
basic sciences, will consistently
strive for discoveries relating to
cardiovascular disease, cancer and
neuroscience, and they will eagerly
seek to make advances in new
areas relating to stem cells, imaging
science and molecular medicine.
Public health research
complements strong basic and
clinical programs
In the realm of research, the school
is fortifying two departments that
are most closely aligned with
public health: population health
21
Talk about
primary care
The department of family medicine turnaround in childhood immunization
C
hildhood immunizations are one of the few components of well-child care with clear evidence of effectiveness in
reducing illness and death among children. Imagine, then, the alarm bells that sounded for the UW Department of
Family Medicine (DFM) Residency clinics, when a 2002 UW Health study of immunization patterns found DFM clinics to
have the lowest rate of immunization among two-year olds.
The report’s findings brought statewide faculty, residents
and clinic staff together in an effort to improve the
level of care. A statewide quality improvement team
was commissioned to address barriers and oversee the
development and implementation of effective interventions.
Clinical roles, educational content and delivery methods
and all other aspects of care were considered fair
game. Eventual changes included implementation of a
statewide computerized immunization registry (RECIN) and
significant modification of the entire process for childhood
immunization care and resident education.
The result has been a new model of care with greater
standardization and consensus about goals. Most important,
clinics have seen immunization rates improve dramatically
with each measurement cycle. Along with participation in
RECIN, successful interventions have included an increased
role for nurses in caregiver education, and identification of
vaccines needed at all childhood visits, regardless of the
reason for the visit.
Improved communication between clinics and local hospitals
has also helped performance. Physicians involved with
hospital-based prenatal care and delivery include standing
orders for newborn Hepatitis B. Records are forwarded to
Nursing staff now provide the resident or faculty provider
clinics prior to a child’s first visit and entered into RECIN.
with a copy of the immunization history of each child at
At their child’s very first visit, parents receive an up-to-date
every visit. They are assisted by RECIN registry prompts
immunization history and listing of upcoming immunizations
that indicate clearly which doses are due currently, which
and recommended due dates. Parents also receive a new
are overdue and which need to be repeated to ensure
history from the RECIN registry whenever their child’s
proper timing. Using a “no missed opportunity” strategy, the
immunizations are updated, allowing them to stay informed
physician or other provider reviews the history, determines
and partner with their family medicine physician.
the immunization needs for each visit and schedules any
follow-up visits. The registry also produces a monthly report
for providers, which identifies children with delinquent
immunizations. Clinics then send reminder letters and make
nursing follow-up calls.
22
Department of family medicine clinics are now star performers in
childhood immunization.
Careful analysis and attention to detail have paid off! UW
Family Medicine Residency clinics are now the leaders
in immunization practices, with all of the clinics now
performing at or above the 90th percentile, based on
national benchmarks. ■
Talk about
building for the future
American Family Children’s Hospital
Currently under construction alongside University of Wisconsin Hospital and
Clinics, the $78 million American Family Children’s Hospital (AFCH) will soon be
the crown jewel of children’s health care in Wisconsin. Scheduled to open in the
summer of 2007, this world-class health care facility will be dedicated solely to
the care and treatment of children and their families.
As a separate building on the northwest side of UW Hospital and Clinics, AFCH
will offer a fully integrated array of clinical care, academic programs and research
initiatives in a state-of-the-art facility unmatched in the state. Rooms will be twice
the size of those in the current hospital, affording families greater comfort as they
participate in their children’s care.
Patients and families cared for at American
Family Children’s Hospital will know they’re
in a special place.
“American Family Children’s Hospital will offer young patients and their families
a facility on par with the stellar quality of our pediatric physicians, nursing
staff and other caregivers,” says Donna Sollenberger, President and CEO of UW
Hospital and Clinics. “The new space will offer a better healing environment for
youngsters and a less stressful, more comforting experience for families.”
New research complex takes shape on west campus
Designed to encourage unique gatherings of scientists from different disciplines, the UW School of Medicine and Public
Health’s new Interdisciplinary Research Complex is rapidly rising from the ground, adjacent to UW Hospital and Clinics.
With groundbreaking that began in August 2005, the $134 million facility will be constructed in several phases. The first
phase, to be completed in 2008, will consist of two five-story towers atop three-story bases. Cancer research laboratories
will be the anchor tower. Neuroscience and cardiovascular research also will be featured in phase one, as will work on
stem cells and regenerative medicine. In addition, molecular medicine will be a major thrust of research housed in the
new building.
The IRC’s close proximity to the hospital will facilitate translational research in which new scientific discoveries move as
rapidly as possible from research laboratories to clinical care settings.
Taking emergency care to a new level
For 27 years, the UW Hospital and Clinics emergency department (ED) has
provided the highest level of emergency care in the region. On June 6, 2006, it
began a new era as the doors opened on a greatly expanded and completely
remodeled emergency care area.
Visitors quickly notice that the design of the new environment pays close
attention to the needs of patients, including their privacy and confidentiality.
Adult and pediatric patients wait comfortably in separate waiting rooms and
multiple triage rooms offer enhanced privacy as patients are evaluated for care.
All 29 treatment rooms are private and fully equipped to deliver the caliber of
care associated with a Level One trauma center.
UW Hospital’s new emergency room
opened in June 2006.
“We want patients and families to feel welcome from the time they enter our
hospital to the time they leave,” says Adrianne Cisler, director of emergency
services. “The new ED allows for quicker patient diagnosis and the highest level
of care in a safe, comfortable setting.”
23
Talk about
a statewide resource
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U
W Health programs reach to the far corners of the state with quality care, diverse educational programs and research
findings that make a difference in the lives of countless residents:
● UW Health Clinics are located throughout south central Wisconsin.
★ Regional Cancer Centers, affiliated with the UW Paul P. Carbone
Comprehensive Cancer Center, bring world-class cancer care to
residents in seven communities in Wisconsin and northern Illinois.
✪ The principal statewide campus locations of the UW School of
Medicine and Public Health include Madison, La Crosse, Marshfield
and Milwaukee.
● The UW Family Medicine Residency Program has a rich 40year history of training resident physicians in seven Wisconsin
communities.
24
✚ The Generalist Partners Program was among the first in the nation
to involve community-based primary care physicians in teaching
introductory clinical skills to first- and second-year medical
students.
■ The Primary Care Clerkship requirement is fulfilled by medical
students during their third year of medical school.
▲ The Preceptorship program continues hands-on learning for thirdand fourth-year medical students while affording them opportunities
to explore career options and experience in multiple specialties.
★ Longitudinal Rural Rotation Sites are a valuable training ground for
students in the Wisconsin Academy for Rural Medicine program to
address the shortage of physicians in rural areas of the state.
Your contribution can make a difference
Philanthropy is an important source of support for UW Health. Your gift can support innovative
research programs, new facilities and services that directly touch the lives of patients and
families. To learn more about how to contribute, please visit our web site at uwhealth.org or
contact us at 608-263-4545 or toll-free at 800-443-6162.
For more information
Information on all UW Health providers and clinical programs is available on the UW Health web site at uwhealth.org.
To learn more about academic and research programs of the UW School of Medicine and Public Health, please visit online at
med.wisc.edu.
©2007 UW Hospitals and Clinics Authority Board
HA11131-0806P