UT Health San Antonio receives funding from the UT System to expand sites of care

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The University of Texas System Board of Regents on Nov. 14 approved $80 million from the Permanent University Fund (PUF) Bond Proceeds for UT Health San Antonio to expand its sites of care, including the construction of a multispecialty/research hospital in San Antonio.

While still in the early planning phase, this expansion will transform patient care in multiple sub-specialties with the critical integration of advanced medical research from San Antonio’s leading academic health organization. The hospital facility will integrate exceptional patient care with robust clinical research to more comprehensively care for the unique health needs of San Antonio’s diverse community.

UT Health San Antonio President William L. Henrich, M.D., MACP

As such, the new facility will be a unique addition to San Antonio’s hospital environment. Having increased access to the newest drugs and surgical devices in hundreds of clinical trials provides an extraordinary opportunity for patients to receive the most innovative health care without leaving the city.

In this effort, UT Health San Antonio will maintain its essential collaboration with its primary clinical and teaching partner, University Health System (UHS), as the two organizations continually look for ways to work together for Bexar County and surrounding areas to provide the best possible health outcomes. While specific details are yet to be defined, this expansion of innovative health care service with these strong partners is an unprecedented opportunity to positively impact community health.

UT Health San Antonio intends to pay for the clinical expansion with a combination of funds from current clinical operations, debt and charitable donations, as well as the PUF distribution.

“We are proud to be at the forefront of innovation with a new facility that will support the extraordinary work of our doctors, nurses and other health care providers, including our significant research community,” said William L. Henrich, M.D., MACP, president of UT Health San Antonio. “These funds and a new facility represent a welcome and needed investment in San Antonio. It is beneficial not only for patients, but also for the educational, research and highly specialized patient care services that our university provides through five schools, including medicine, dentistry, nursing, health professions and biomedical sciences.

“It is also a demonstration of The University of Texas fulfilling its mission of advancing health to serve Texans and the world,” Dr. Henrich added. “I am incredibly grateful to the UT System Board of Regents, Chancellor James Milliken, Executive Vice Chancellor for Health Affairs John Zerwas, M.D., and the entire leadership team of the UT System for their partnership to advance health care in San Antonio and beyond.”

 

 

Even low-stress surgery can be fatal for frail patients, study finds

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The threshold for when to perform elective surgery in a frail patient may be much higher than previously thought, according to new research coauthored by Paula Shireman, M.D., M.S., M.B.A., of UT Health San Antonio. The journal JAMA Surgery published the findings Nov. 13.

The retrospective study of 432,828 patients treated in veterans hospitals between 2010 and 2014 found that frail patients were more likely to die within 30, 90 and 180 days after surgery than non-frail patients. This was true even after low-stress surgical procedures such as cystoscopy (scope of the bladder) and moderate-stress procedures such as laparoscopic cholecystectomy (minimally invasive gallbladder removal). The 30-day mortality rate among frail patients after a low-stress procedure was 1.55%. For frail patients who underwent a moderate-stress surgery, it was 5.13%. These rates are higher than the 1% mortality rate often used to define high-risk surgery, the authors wrote.

Dr. Shireman, a professor of surgery and practicing vascular surgeon in the Long School of Medicine at UT Health San Antonio and the South Texas Veterans Health Care System, said the study offers guidance to surgeons, patients and families about whether a frail patient should undergo surgery, particularly elective procedures.

“Elective cases — that’s really where the take-home message of this study is,” Dr. Shireman said. “If a frail patient shows up in an emergency situation, it’s different. But what about elective cases? Do you do the surgery? Is it in a patient’s best interest?”

The frail are more vulnerable

Frailty is a clinical syndrome marked by slow walking speed, weak grip, poor balance, exhaustion and low physical activity. Frail individuals have increased vulnerability to events such as falls and disability. Multiple studies in the veterans affairs (VA) system and academic medical centers have demonstrated that frail patients have higher rates of complications and mortality; however, these studies have focused on higher-risk surgical procedures.

“Surgeons are better at looking at patients and saying, ‘I think you’re too frail to survive a really stressful surgery,’ and we don’t operate on them because we have a pretty good sense that they will have a bad outcome,” Dr. Shireman said. “But maybe we don’t use that same lens when it’s a much less stressful surgery.”

Perhaps frail individuals have better things to do with their remaining time than recovering from an elective surgery. “There is no right or wrong answer,” Dr. Shireman said. “Two patients, given the exact same scenario, could choose entirely opposite directions. Our approach has to be patient-centered.”

Future studies

Because the study examined a population of veteran patients who were almost all men, further research is needed. Dr. Shireman is the principal investigator of a multisite, National Institutes of Health-funded Collaborative Innovation Award (U01) grant collaborating with research co-author Daniel Hall, M.D., M.Div., M.HSc., of the University of Pittsburgh Medical Center. They will apply the same methods from the current study to health care outcomes data from non-veterans in three civilian health systems. “Our future studies will include higher proportions of female, Hispanic and African American patients, and therefore a much greater racial and ethnic diversity than in the current study,” Dr. Shireman said.

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Reference: “Association of Preoperative Patient Frailty and Operative Stress With Postoperative Mortality,” JAMA Surgery, Shinall, et al.

Funding:  U.S. Department of Veterans Affairs, Veterans Health Administration, National Institute on Aging, National Cancer Institute.

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The University of Texas Health Science Center at San Antonio, now called UT Health San Antonio®, is one of the country’s leading health sciences universities. With missions of teaching, research, healing and community engagement, its schools of medicine, nursing, dentistry, health professions and graduate biomedical sciences have produced 36,500 alumni who are leading change, advancing their fields and renewing hope for patients and their families throughout South Texas and the world. To learn about the many ways “We make lives better®,” visit www.uthscsa.edu.

Employee spotlight: New COO Andrea Marks sets strategy for growth

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By Jennifer Meek

Andrea Marks, COO

Andrea Marks has spent her career managing money, but her most meaningful accomplishment doesn’t have any zeros at the end of it. She’s most proud of raising her two sons into strong-minded and independent young adults, traits she’s demonstrated herself as chief financial officer of UT Health San Antonio for nearly a decade.

Her first job was a hostess at Bonanza buffet. Last month, she became the new chief operating officer at an academic medical center with an operating budget of more than $900 million.

Marks takes the helm as COO when UT Health San Antonio is in the best financial health of her career, the opposite of when she started here 20 years ago. She leads operations during a future of tremendous growth: over $350 million projected in the next five to 10 years.

“I’m excited about the transformative investments we’re making in patient care and research,” Marks said, referring to UT Health’s growth in these missions. “I have purview and responsibility to advance all of our missions; the role of COO is more than just managing the service areas. It’s the challenge of managing the structure and resources to keep up with our growth.”

Marks admits she’s the kind of leader who doesn’t have all the answers. “I respect the expertise of others. I value people’s perspectives. I want to understand,” she said.  “I think I have a great visualization of how problems and opportunities can be solved. It really comes down to execution . . . taking a big idea and turning it into strategy and plans that advance the institution.

“Those who are eager, smart and dedicated can find a way to have a really great career here,” she said. “I’ve seen this organization attract a high caliber of talent. I want to be around that excellence. Here, we’re never satisfied with the status quo.”

Part of why she’s so good at her job is she really likes it. She’s always had a passion for contributing to the community and an excitement about education, two of the missions of UT Health – along with research and patient care. Marks has volunteered on local nonprofit boards at Central Catholic High School and Guardian House, which serves children of divorce and family conflict.

Outside of work, you might find Marks bingeing the Handmaid’s Tale, an edgy dystopian series on Hulu. But more likely you’ll find her at a baseball field. She has a passion for the game after years of watching her sons play in high school and college. Her goal: to watch a baseball game at every major league field in the nation. So far, she’s been to 11 of 30 major league ballparks, a few more than once.

New interprofessional program educates grade school kids about diseases

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The STEM Scholars Program, a new interprofessional program at UT Health San Antonio, unites dental, medical, nursing, graduate and health professions students together to teach lessons at K-12 schools. The first project was teaching lessons about diabetes, cancer and Alzheimer’s at BASIS Primary School to 4th and 5th grade students.

The STEM Scholars Program is funded by a grant from the Student Services Fee Committee to Charlotte Anthony, marketing specialist, Graduate School of Biomedical Sciences, Ramaswamy Sharma, Ph.D., assistant professor, Cell Systems and Anatomy, Long School of Medicine and Irene Chapa, Ph.D., director, Recruitment and Science Outreach.

Links to articles about the lessons:

1st visit article: www.utbiomed.com/diabeteslesson

2nd visit article:www.utbiomed.com/cancerlesson

3rd visit article:www.utbiomed.com/alzheimerlesson

 

Boeing grant to provide training in combat PTSD therapies

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A grant from Boeing Co. will fund scholarships for 200 community mental health providers nationwide to receive low-cost training in the top treatments for military-related post-traumatic stress disorder (PTSD).

Boeing’s $200,000 grant supports the STRONG STAR Training Initiative at UT Health San Antonio, which aims to equip more mental health providers to provide evidence-based treatment for PTSD and in turn increase access to high-quality care. Although hundreds of thousands of military service members and veterans suffer from PTSD, many do not have providers in their local communities who are trained in the leading therapies or in how best to deliver them to combat veterans, which this program provides.

“Helping veterans with PTSD gain access to evidence-based treatment is critical to their recovery and re-engagement in meaningful life,” said Katy Dondanville, Psy.D., associate professor of psychiatry and behavioral sciences at UT Health San Antonio and director of the STRONG STAR Training Initiative. “The task of developing and maintaining the workforce of veteran-serving community mental health providers is immense and long-term. Boeing’s generous grant will help us make progress toward that goal in 2020.”

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Boeing grant provides low-cost training in combat PTSD therapies to mental health providers nationwide

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Boeing representatives present a $200,000 check to UT Health San Antonio to support the national reach of the STRONG STAR Training Initiative. Pictured are (L-R): Michael Lawson and Tyler Schroeder of Boeing; Alan Peterson, Ph.D., and Katy Dondanville, Psy.D., of UT Health San Antonio and STRONG STAR; Texas State District 119 Rep. Roland Gutierrez; and William Henrich, M.D., MACP, president of UT Health San Antonio.

Media contact: Rosanne Fohn, fohn@uthscsa.edu, (210) 567-3026

SAN ANTONIO (Nov. 11, 2019) – A grant from Boeing Co. will fund scholarships for 200 community mental health providers nationwide to receive low-cost training in the top treatments for military-related post-traumatic stress disorder (PTSD).

Boeing’s $200,000 grant supports the STRONG STAR Training Initiative at UT Health San Antonio, which aims to equip more mental health providers to provide evidence-based treatment for PTSD and in turn increase access to high-quality care. Although hundreds of thousands of military service members and veterans suffer from PTSD, many do not have providers in their local communities who are trained in the leading therapies or in how best to deliver them to combat veterans, which this program provides. The need for such providers is increasing as many service members and veterans seek care outside the military and VA systems due to provider backlogs, lack of VA or military clinics in their communities, or concerns about stigma.

Katy Dondanville, Psy.D., associate professor of psychiatry and behavioral sciences at UT Health San Antonio and director of the STRONG STAR Training Initiative, presents a training workshop to community-based mental health providers on the use of Cognitive Processing Therapy for post-traumatic stress disorder.

“Helping veterans with PTSD gain access to evidence-based treatment is critical to their recovery and re-engagement in meaningful life,” said Katy Dondanville, Psy.D., associate professor of psychiatry and behavioral sciences at UT Health San Antonio and director of the STRONG STAR Training Initiative. “The task of developing and maintaining the workforce of veteran-serving community mental health providers is immense and long-term. Boeing’s generous grant will help us make progress toward that goal in 2020.”

With the scholarship funding, community providers will enroll at a reduced rate in Training Initiative “Learning Communities” that will offer training and consultation over the course of a year, beginning with workshops to be held in early 2020. Providers will be able to choose from Learning Communities that offer training and support in delivering either Prolonged Exposure therapy or Cognitive Processing Therapy, the two leading evidence-based PTSD treatments.

“Our goal is to empower military veterans and their families to succeed in their next mission in life,” said Mike Lawson, senior manager, Boeing Global Engagement. “Partnering with STRONG STAR to expand local access to PTSD treatment will ensure long-term recovery and sustainability of these vital programs.”

The STRONG STAR Training Initiative began in 2017. Through this initiative, UT Health San Antonio faculty share the unparalleled expertise they have gained delivering PTSD treatment to hundreds of military personnel and veterans through clinical trials affiliated with the STRONG STAR Consortium. Besides training in the top research-supported PTSD therapies, the program includes education on how to deliver those therapies in culturally appropriate ways that enhance their appeal to and effectiveness with military service members and veterans.

The program consists of training assignments in advance of the workshops, two days of in-person training, weekly consultation by phone, an online platform of tools for advanced training, program evaluation to determine success and areas for improvement, and consultation with each provider’s organization to develop agency-specific plans for implementation and sustainability. Providers completing the Learning Community requirements are eligible for continuing education credits.

For more information or to inquire about enrollment, please contact the STRONG STAR Training Initiative at training@strongstar.org or visit www.strongstartraining.org

For current news from the UT Health Science Center San Antonio, now called UT Health San Antonio™, please visit our online newsroom, like us on Facebook or follow us on Twitter.

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The University of Texas Health Science Center at San Antonio, now called UT Health San Antonio®, is one of the country’s leading health sciences universities. With missions of teaching, research, healing and community engagement, its schools of medicine, nursing, dentistry, health professions and graduate biomedical sciences have produced 36,500 alumni who are leading change, advancing their fields and renewing hope for patients and their families throughout South Texas and the world. To learn about the many ways “We make lives better®,” visit www.uthscsa.edu.