A Strategy for the Future

The College of Community Health Sciences began a strategic planning process in fall 2012 to develop a five-year plan that builds on the College’s deep roots in primary care and family medicine education while responding to the changing health care needs of communities.   

A plan was developed during an intensive nine-month process, in consultation with the firm CFAR Inc. and guided by a Core Team and Steering Committee that included College faculty, clinical staff, administrators, alumni, community leaders and others.

The goal was to create a shared vision of how best to achieve the College’s mission of primary care, education and research in a health care environment that is shifting from reactive and illness care to prevention, and to develop a road map for how the College can achieve that vision.

Now the College is transitioning the work ostrategic planning into the work oimplementation.

“This is the beginning of a journey,” says Dean Richard Streiffer, MD.

The College’s previous mission statement focused on providing “the physicians and expertise needed for accessible, high-quality and compassionate health care for the citizens oAlabama … with a special emphasis on rural areas.” Since its founding in 1972, more than 400 family physicians have completed the College’s residency, with 50 percent
practicing in Alabama and halfofthose in rural areas. The College’s medical student program steers graduates into primary care specialties at a rate more than twice the national average, and its award-winning rural pipeline program has placed nearly 50 doctors into rural practice.    

Today, the mission is not just producing doctors but improving the health ofAlabama’s population, coupled with community engagement and social accountability.

“The strategic plan is intended to be a living, breathing document that guides the work of the College,” Streiffer says. “The strategic plan, and the initiatives that comprise it, will ultimately be integrated into the everyday work of the College.” 

The strategic planning process began with individual interviews ofCollege faculty, staffand alumni, and stakeholders across The University ofAlabama and the community. Focus groups were conducted with residents and medical students. Based on the results, a survey was developed and administered to College faculty and staff, select faculty of UA and the University of Alabama School of Medicine, residents, medical students, alumni and community members.  

More than 350 respondents completed the survey, including all College faculty. Survey results, coupled with an in-depth analysis of the College, were used to create strategic options that were the centerpiece of a strategic planning retreat and used to shape the College’s strategic plan. The all-day retreat was held in March 2013, and the 100 plus attendees hashed through various strategic planning options.   

“Engaging as many people and their thinking as possible, and really welcoming their input, was vital to developing a meaningful strategic plan,” Streiffer says.

The planning process was undertaken with the expert assistance ofCFAR consultants Jessica Geiben Lynn and Christopher Hugill. From offices in Philadelphia and Boston, CFAR serves clients across a range of industries worldwide, including health care, life sciences, higher education, nonprofits and family and closely held enterprises. The firm’s approach combines an understanding of business with insights into the human systems that make up organizations.

The College’s plan contains four strategic priorities: build on the strong foundation of the Family Medicine Residency; provide an innovative and community-oriented undergraduate medical education experience; transform the clinical enterprise to deliver exceptional patient-centered care; and foster a passion for scholarly pursuit in line with the College’s mission. Four Strategic Action Teams, or StATs, were formed and charged with implementing each priority. Here are highlights of work completed by the StATs in 2013:

The Residency StAT created a curriculum committee and a marketing plan to improve residency recruiting. A clinical rotation in emergency medicine was added, and an emergency medicine fellowship for primary care physicians is under consideration. Work is underway to add community medicine, dermatology and practice management experience for residents. The College’s Department of Family Medicine added five new faculty who are working closely with residents.

The Medical Student StAT is implementing the Tuscaloosa Longitudinal Community Curriculum, which will give third-year medical students an opportunity to live and train in communities under the supervision of practicing primary care physicians, be involved in the comprehensive care of patients over time and to have long-term relationships with patients’ physicians.

The Clinical StAT is advancing a patient-centered medical home (PCMH) model of care within University Medical Center, which the College operates. A PCMH provides a team-based approach to comprehensive patient care. Led by a physician and including such health professionals as nurses, social workers, psychiatrists, nutritionists and pharmacists, the PCMH organizes primary care to emphasize coordination and preventive care.

The Scholarship StAT is working to create a passion for research at the College. A monthly lecture series began in February 2014 featuring College and University faculty who present their research. The College participates in a research breakfast program with other colleges on campus to share research and find ways to collaborate. A Summer Scientific Writing Workshop is planned for College faculty. 

Tuscaloosa Family Medicine Residency

Learn more about the second largest family medicine residency in the nation. TFMR prepares physicians to provide excellent care in family medicine.

Medical Student Education

The College, which also functions as a regional campus of the University of Alabama School of Medicine, offers third and fourth year medical students hands-on experience with patients, dedication of faculty and staff and a vibrant student life. 

Community and Rural Medicine

The College’s Department of Community and Rural Medicine seeks to understand the unique issues rural communities face, how those issues affect the quality of health of rural residents and what can be done to improve health and health outcomes.

Student Health Center

The University of Alabama Student Health Center, which is operated by the College, provides comprehensive patient-centered care designed to meet the health needs of students.

13th Annual Rural Health Conference – Rural Rebound

The 13th annual Rural Health Conference will be held on April 20th, 2012. This year’s topic is Rural Rebound: Emergency Preparedness and Crisis Response. Registration is available now.

40th Anniversary of the College of Community Health Sciences

The College of  Community Health Sciences will be celebrating its 40th anniversary this year. All alumni are encouraged to visit us for an entire weekend of events on April 20th and 21st.

Project Rebound UA Assists Students Affected by Tornado

Originally posted by UA News

The Project Rebound program at The University of Alabama is offering crisis counseling for students impacted by the April 2011 tornadoes.

Project Rebound UA can provide help for students who may be experiencing emotional and other issues resulting from the tornadoes. The program was launched in November in response to the deadly storms and will continue through this June.

The project is funded with a $536,000 grant from the Federal Emergency Management Agency awarded to a partnership of the University’s Institute for Rural Health Research and the Alabama Department of Mental Health.

“Project Rebound UA represents the first time that FEMA has provided funding for an outreach effort focused specifically on a university campus,” said Dr. Melanie Tucker, assistant professor in the Institute for Rural Health Research and the College of Community Health Sciences’ department of community and rural medicine, who is directing the project.

Project Rebound UA crisis counselors Nan Fu, left, and Arlesia Malone provide information about the program to students during the University’s Get on Board Day event earlier this year.

FEMA has currently trained 20 UA graduate students from different areas of study to serve as crisis counselors for individuals and groups of people alike. They can be found across campus daily in locations such as the Ferguson Center, on the Quad and in campus libraries, dormitories and dining facilities. Their goal is to start conversations with students in an effort to gauge their need for further aid, such as community services, medical treatment or mental health assistance.

Disasters cause upheaval in many forms, often resulting in survivors’ loss of security, property, community, health, friends, loved ones and their sense of safety. They can therefore experience increased risk for anxiety, depression, post-traumatic stress disorder and other health conditions.

Rather than offering traditional psychiatric counseling for these issues, the crisis counselors simply listen to students and work to connect them to the resources they might need. They ask students how they are coping and offer them a chance to talk about what they might be going through, reassuring them that what they are feeling is common and part of the recovery process.

It really is unique,” adds Lisa Turley, state director for Project Rebound. “And part of the uniqueness is the way that the student team is reaching out to other students using Twitter, Facebook and texting, which is proving beneficial to students.”

Reports from the team indicate that students are comfortable with social media communication and that it helps lay the groundwork for easier face-to-face communication with the crisis counselors.

“When students see one of the team members on campus, it makes it easier to engage in conversation. The trust level has already been established,” said Turley.

Project Rebound UA also played a role in FEMA’s recent decision to incorporate a texting component to its Distress Help Line. It is currently available to disaster areas in Alabama and Joplin, Mo., where the agency is providing crisis counseling.

“The response the UA team has gotten gave FEMA a much stronger sense of confidence and comfort rolling out that texting piece,” said Turley. “We were thinking texting would be helpful for people who might have a communication disability issue, if they were hard of hearing or deaf. We were surprised at the number of students using texting.”

Turley reports that between Project Rebound UA’s launch in November and the end of January, 167 individual counseling encounters and 2,646 outreach encounters were recorded. FEMA plans to break down those numbers to determine how many of the encounters were via texting and other forms of social media.

“Project Rebound UA began its work at just the right time — when people really needed to talk, and to have that immediate contact, even if it’s a counselor texting back, reaching out, making a connection, being supportive and letting them know there are people who care,” said Turley.

Many UA students who may have been impacted by or witnessed the April tornados and their aftermath immediately left Tuscaloosa afterward without counseling, information and access to fellow victims with shared experiences. As a result, there were concerns that students might have a delayed reaction in dealing with the storm that might not emerge until after they returned to Tuscaloosa. Project Rebound UA is working to help make sure that trauma from the tornado does not impact students’ education, health and well-being.

Turley says she was curious why so many students would want to work as crisis counselors and be involved in something that can take such an emotional toll.

“When they told me that they just wanted to help others continue with their recovery, it amazed me. Their dedication to this is just phenomenal,” she said.

She says FEMA plans to use Project Rebound UA as a blueprint for similar outreach efforts at university campuses across the country.

“We’ve found something that works and we’re going to put it out there so people can replicate it on their campuses. We know that we can reach people and reach them effectively.

”For more information about Project Rebound UA, call 205/348-0025, visit www.projectrebound.ua.edu, or find Project Rebound UA on Twitter at Proj_ReboundUA.

Robotic Surgery: A Less Invasive Procedure

Faculty physicians in the College’s Department of Obstetrics and Gynecology and University Medical Center are the first in Tuscaloosa to use robotic surgery to perform hysterectomies and other gynecological procedures. They say the robotic system allows them to operate with more precision and less fatigue, while patients experience improved outcomes, especially in shorter hospital stays, less pain and quicker recovery times.

Marion Reed, MD, an obstetrics and gynecology physician and assistant professor in the department, uses the robotic system for many of the hysterectomies he performs. He says the minimally invasive nature of robotic surgery and the resulting smaller incisions mean that “some of my patients have only had to do this procedure as an out-patient procedure. Others only need to stay in the hospital overnight.” Reed uses the da Vinci robotic system located at DCH Regional Medical Center in Tuscaloosa.

Robotic surgery was first introduced a decade ago by the U.S. military, which wanted surgeons to be able to operate on wounded soldiers on the battlefield without putting themselves at risk. While the military’s efforts were not successful as hoped, the robotic method was picked up by the Sunnyvale, Calif.-based Intuitive Surgical Inc., maker of the da Vinci System.

The da Vinci System consists of a large device with four arms that hover over a patient-side cart and are controlled from a nearby console. Three of the arms are for tools that hold a scalpel, scissors and other surgical instruments and operate through small incisions in the patient’s body; the fourth arm is for an endoscopic camera with two lenses that give the surgeon stereoscopic vision from the console.

The surgeon sits at the console and looks through a viewfinder. With joystick- like controls in each hand, the surgeon manipulates the arms on the robotic system while looking at images captured by the camera on the viewfinder. The robotic arms’ joint-wrist design exceeds the natural range of motion of the human hand, and the view of the patient and the surgical area is magnified up to 10 times through the camera. “Use of this system has tremendously improved surgeon’s dexterity,” Reed says.

Since its introduction, the U.S. Food and Drug Administration has been expanding approval of the use of robotic surgery. Urologists were among the first to use robotic surgery, followed by cardiologists and gynecologists. Today, robotic surgery is used to perform minimally invasive heart, prostate, gynecological and other common operations.

Reed is quick to point out that the robotic system is not a self-driven device, but rather a tool in the hands of the surgeon. He says surgeons must go through special training to use the machines.

While robotic surgery is a natural progression from laparoscopic surgery for hysterectomies, Reed says he uses robotic surgery as an option and not a total replacement of laparoscopic surgery or vaginal hysterectomies.

Laparoscopic surgery is minimally- invasive surgery performed with the help of a telescope-like device that lets the surgeon see inside the abdomen or pelvis. But with laparoscopy, a surgical assistant must hold a camera, and the surgeon operates while standing, using hand-held instruments that have no wrists. The surgeon must also look up and away to a nearby video monitor to see an image of the surgical procedure being captured by the hand-held camera. Reed says with robotic surgery, there is a better view of the patient surgical area as well as more precision and less fatigue.

He acknowledges there is a “mixed reaction” to robotic surgery among surgeons and physicians because surgical procedures using a robotic system can take longer. But he believes that in many cases, the advantages of robotic surgery outweigh the additional time.

“I wish I could have done all my surgeries this way,” he says.

On Rounds – Fall 2011

The fall issue of On Rounds is available now! You can view the online version here.