Major organizational and curriculum changes are under way at Kansas University Medical Center in Kansas City, Kan.
Simplified, the goal boils down to four words: More primary care physicians.
That's what Daniel Hollander is striving for with one of several changes he's implementing as the new dean of the medical school at the Kansas University Medical Center in Kansas City, Kan.
"Across the country and in the state we have a great need for primary care physicians," said Hollander, who came to his new post in February from the University of California at Irvine.
Meanwhile, Eleanor Sullivan, dean of KUMC's School of Nursing, said she's working on several new programs, including one to help turn out top nursing administrators.
The program combines a doctoral degree in nursing with a master's degree in business administration from KU's business school.
"There are only a few of these programs in the country. We are really expecting great things of graduates from these programs," Sullivan said. "They are going to be the leaders in nursing and health well into the next century."
Hollander said the faculty is working on a grant proposal for $15 million from the Kansas Health Foundation to implement a major emphasis on primary care.
"What this will allow us to do is to switch about 55 residency slots from the specialities to primary care," he said.
The result will be to educate more primary care medical students and increase the number of primary care residents.
It will also help provide more relief for primary care physicians already practicing in the state, especially in rural and under-served urban areas, Hollander said. Those physicians, because of their location and isolation, have trouble getting time off to improve their education, he said.
"The Legislature has been very helpful in this direction and has allocated some additional funds to implement primary care activities," he said.
Enrollment at the school is continuing at 175 new students each year, he said.
He said many more new students will be going into primary care. And he hopes to place about half of those in primary care in rural and under-served areas.
The emphasis on primary care is one of several changes he has worked toward since coming to KUMC, he said.
"We have looked very comprehensively at the entire school and its function. And together with the faculty we have decided on very major changes at the medical school," Hollander said.
- Curriculum. Hollander has asked the faculty's education council to revise the curriculum to emphasize self-learning and introduce clinical medicine into the curriculum earlier. The council also has been asked to emphasize lectures and small group discussions.
Organization. The school of medicine has functioned as 16 separate practice organizations based in the individual clinical departments. He said a committee of chairs of the various practices and hospital representatives will combine them into a unified practice group that will make billing and care more comprehensive.
"There will be only one bill, once scheduler, one collection area, one promotion," he said. "We will be creating a Mayo Clinic-type of environment with total unification of all of our practice environments. What this will result in is a a more efficient, more competitive and more patient-friendly operation."
The Mayo Clinic is a world renowned hospital in Rochester, Minn.
- Outreach. Hollander said he is also working to forge ties with Kansas City area hospitals and those in the western regions of the state. "We're basically going out to the state and telling hospitals that we're here for them for educational purposes," he said. He said they hope to form an electronic mail network with the hospitals throughout the state, using the Internet and interactive television.
The big change in the school of nursing is the new combined nursing doctorate/MBA program, nursing dean Sullivan said.
Those who go through the program could land positions such as the chief nurse of a major medical center or a health care system, she said.
Those going through the program would leave with a background in economics management, human resource management and organizational structures and behavior, as well as having completed a significant research project in nursing administration, Sullivan said.
Of about 10 new students taken into the nursing doctoral program, two or three will probably enter the combined program, she said.
Sullivan said one of the nursing school's goals is to continue on its research track.
"We just hit about $2 million in external funding this year, which is double what our goal was for the year," she said. The research grants came largely from the National Institutes of Health.
"It's an all-time record for the school. We're going to continue to support faculty research efforts," she said.
The school is also moving ahead with a cultural diversity program. Graduate students who finish their master's degrees in clinical nursing are eligible to become clinical faculty members and, in return, agree to serve on the faculty for two years.
Three minority students are on the faculty this year and two more will enter the program in the upcoming year, so in a few years the minority representation on the faculty will be increased by five.
She said the school is also moving into faculty practice and contract with various health organizations and agencies who want health care services for their students or employees.
"In this time of change in the health care system, it's an opportunity for us to demonstrate how advance practice nurses can meet the tremendous needs for primary health care in the community," she said. "And at the the same time, these sites serve as learning laboratories for our students."
She said the school is finding that enrollment demand is extremely high -- it has 43 applicants for every opening. Each year the school takes 150 undergraduate students. There are 300 students in the undergraduate program, 250 master's students and 30 doctoral students.
The school's master's program is bursting at the seams, particularly the nurse practitioner program, she said.
That program, a collaborative program with Wichita State University and Fort Hays State University, uses interactive television so students in Wichita and Hays don't have to come to Kansas City for classes, she said.