University of Iowa Health Care Annual Report 2020

UNIVERS IT Y OF IOWA HEA LTH C ARE

2020 ANNUAL REPORT

OUR MISSION

OUR VISION

Changing medicine. Changing lives.®

To be a destination academic medical center for Iowa and the world.

UNIVERSITY OF IOWA HEALTH CARE IS IOWA’S ONLY COMPREHENSIVE ACADEMIC HEALTH SYSTEM. IT INCLUDES:

UI Hospitals & Clinics, which includes UI Stead Family Children’s Hospital

UI Roy J. and Lucille A. Carver College of Medicine

UI Physicians

THROUGH COMMUNICATION, COORDINATION, AND TEAMWORK, UI HEALTH CARE:

Educates and trains the next generation of physicians and health care professionals

Fosters collaborations with health systems and providers across Iowa and the region

Provides life-changing primary and specialty care and expertise to patients, families, and communities

Conducts research that advances biomedical science, leading to improved treatments and therapies

On the cover, from left: Brandy Faybik, RN, staff nurse at UI Stead Family Children’s Hospital; Rhanda Darville, MD, fellow physician in pediatric gastroenterology; Stanley Perlman, MD, PhD, professor of microbiology and immunology

OUR VALUES Innovation. Collaboration.

Accountability. Respect. Excellence.

HIGHLIGHTS FROM 2020:

“We Stand Together,” a statement that symbolizes our resiliency and response to the COVID-19 pandemic and galvanizes our organization, our community, and our state

Hundreds of UI Health Care faculty, staff, and students participate in “White Coats for Black Lives,” a national, medical student-led observance calling for racial equality and social justice in medicine and communities nationwide

A yearlong sesquicentennial celebration for the Roy J. and Lucille A. Carver College of Medicine marks 150 years of medicine on the UI campus

The Sesquicentennial Distinguished Lecture by David Skorton, MD, president and CEO of the Association of American Medical Colleges, former president of the UI, and former faculty member in the Carver College of Medicine

The opening of the 40-bed UI Health Network Rehabilitation Hospital in Coralville, Iowa

David Skorton, MD

UNIVE RSIT Y OF IOWA HE ALTH CARE | 2020 ANNUAL R EP ORT |

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COVID-19

MARCH n n

It was a year unlike any other. n

Altered by a coronavirus pandemic that brought more than 81 million cases worldwide, including 19.2 million cases in the U.S. and 275,000 cases in Iowa, the year 2020 reshaped the way University of Iowa Health Care pursued its tripartite mission of medical education, research, and patient care.

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First patient with COVID-19 is admitted to UI Hospitals & Clinics.

Video visits are offered for patients who may have COVID-19; suspected patients are directed to a special Respiratory Illness Clinic.

The UI suspends in-person instruction and moves to virtual learning.

Visitor restrictions are implemented, and screenings begin at facility entrances.

Elective and non-urgent surgeries and clinical outreach services are suspended; ambulatory clinics are postponed or transitioned to virtual visits.

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UI scientists cease or curtail research activities.

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Medical student clinical rotations are suspended.

APRIL n

The year was extraordinary in terms of the preparation and changes required to care for patients with COVID-19 in addition to those with other health care needs. It was disruptive in that traditional ways of conducting research or teaching students and trainees were modified. It was remarkable in that every person associated with UI Health Care rose to the challenge—for their colleagues, their families and communities, and their fellow Iowans. And it was hopeful in that vaccines arrived in December, signaling the beginning of the end of the pandemic.

UI Health Care hospitalists launch the Home Treatment Team, which provides follow-up calls and “virtual hospital” kits for COVID-19 patients.

MAY n

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Elective surgical procedures resume on a gradual basis at UI Hospitals & Clinics.

Limited clinical trials and basic science research resumes on campus.

JUNE n

Many challenges still remain, but there is hope and renewed optimism. As we did throughout 2020, we will continue to work together to change medicine and change lives in Iowa and beyond.

Brooks Jackson, MD, MBA Vice President for Medical Affairs and the Tyrone D. Artz Dean, Carver College of Medicine

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Third- and fourth-year medical students resume their core clinical clerkships and clinical clerkship electives.

First- and second-year students continue to learn primarily via virtual instruction.

UI Health Care becomes the first health system in Iowa, and one of the first in the nation, to establish a dedicated, post-COVID-19 Respiratory Illness Follow-Up Clinic.

JULY n

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UN IV E R S IT Y O F IO WA HEALTH C AR E | 2 0 20 ANNUAL R EPORT

More than 1,400 UI Health Care staff nurses complete cross-training to respond to future surges in COVID-19 cases.

Clinical trials for the Pfizer-BioNTech vaccine for COVID-19 begin at Iowa, with UI Health Care researchers participating as part of a national, multicenter study.

AUGUST n

COVID-19 TOTALS AT UI HOSPITALS & CLINICS

A combination of in-person classes and virtual learning marks the start of the fall 2020 semester.

THROUGH DEC. 31, 2020:

1,235

SEPTEMBER n

COVID-19 cases increase in Iowa, following the start of fall courses on university and college campuses and the opening of community school districts across the state.

ADULT INPATIENTS

70

NOVEMBER n

PEDIATRIC INPATIENTS

Phase I of a plan to respond to a continued surge in COVID-19 patients begins with an expansion of ICU beds; increased coronavirus testing capabilities; additional staff to respond to increases in patient call volumes; and adjustment of surgical and clinical procedures.

575 PATIENTS TRANSFERRED FROM OTHER HOSPITALS

DECEMBER n

n

Vaccinations begin for UI Health Care staff following the arrival of the Pfizer-BioNTech COVID-19 vaccine.

Deactivation of the Phase I surge plan begins, marking the beginning of a gradual return to pre-pandemic patient care services.

87,195 TELEHEALTH SCREENINGS

112,244 RESPIRATORY ILLNESS CLINIC VISITS

Allison Wynes, DNP, ARNP, ACNP-BC, advanced practice provider in the Medical Intensive Care Unit

UNIVE RSIT Y OF IOWA HE ALTH CARE | 2020 ANN UAL R EP ORT |

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MEDICAL EDUCATION AND TRAINING Changing the future of health care through innovation, integration, and individualization

152 153 152 153 66 FIRST-YEAR MD STUDENTS

GRADUATING MD STUDENTS WHO

(2020-21 ACADEMIC YEAR)

PARTICIPATED IN THE NATIONAL

RESIDENCY MATCHING PROGRAM

70% 48% 41% 32%

(SPRING 2020) Iowa residents

female students

are graduates of Iowa’s public universities

are an ethnic minority or underrepresented in medicine

51%

chose primary care specialties for residency training

28%

matched with residency programs in Iowa

21%

matched with UI Hospitals & Clinics

EDUCATION/TRAINING PROGRAMS NATIONALLY RANKED BY U.S.

NEWS & WORLD REPORT (“BEST GRADUATE SCHOOLS 2021”)

#1 #4

Physician assistant Physical therapy

#15

Family medicine

#20

Primary care

#29

Internal medicine

#34

Research

6 REGIONAL MEDICAL EDUCATION CENTERS ACROSS IOWA

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UN IV E R S IT Y O F IO WA HEALTH C AR E | 2 0 20 ANNUAL R EPORT

1,371 FACULTY MEMBERS

605 MEDICAL STUDENTS

73 PHYSICIAN ASSISTANT STUDENTS

129 PHYSICAL THERAPY STUDENTS

779 RESIDENTS, FELLOWS, AND DENTISTS IN TRAINING

300+ GRADUATE STUDENTS

As in-person classes and students’ clinical rotations were suspended in March 2020 due to the coronavirus pandemic, preparations were underway for alternative learning opportunities.

With start of the fall 2020-21 academic year, small-group classes for pre-clinical students were held in person, while largegroup lectures were conducted virtually.

Clinical clerkships returned to in-person activities, while the interview cycle for prospective students transitioned to an online platform.

Pictured above: Joyce Wahba, fourth-yer medical student. Pictured on opposite page, from left: Donna D’Alessandro, MD, professor of pediatrics; Nolan Mattingly, second-year medical student; and Michael Haugsdal, MD, clinical assistant professor of obstetrics and gynecology, with fourth-year medical students Anne Nora and Michael Klemme.

UNIVE RSIT Y OF IOWA HE ALTH CARE | 2020 ANN UAL R EP ORT |

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RESEARCH AND DISCOVERY Changing medicine through multidisciplinary biomedical science, leading to new understanding, new collaborations, and new treatments

12

MEMBERS OF THE NATIONAL ACADEMY OF MEDICINE

335

NATIONAL ACADEMY OF SCIENCES

177

TOTAL NIH GRANTS

$245.6M

2

MEMBERS OF THE

RESEARCH PROJECT (R01) GRANTS

21

national ranking in NIH funding among public medical schools

43

national ranking in NIH funding

IN EXTERNAL RESEARCH FUNDING IN FY 2020

$138.7M IN NIH FUNDING

$232.2M IN FY19 $224.2M IN FY18

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HOWARD HUGHES MEDICAL INSTITUTE INVESTIGATORS

The drive to provide safe, effective vaccines against COVID-19 brought unprecedented levels of collaboration and urgency in vaccine development, testing, and approval. In July 2020, UI Health Care investigators began participating in the clinical trial for the Pfizer-BioNTech vaccine, enrolling approximately 270 of the more than 43,000 study participants worldwide. As 2020 drew to a close, UI Health Care researchers joined the clinical trial for a new COVID-19 vaccine produced by Novavax.

Pictured: Michael Russell, PharmD, staff member in the Vaccine Research Office.

30+ MAJOR RESEARCH CENTERS, INSTITUTES, AND PROGRAMS, INCLUDING: ■

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Abboud Cardiovascular Research Center Carver Family Center for Macular Degeneration Center for Auditory Regeneration and Deafness Cystic Fibrosis Research Center Fraternal Order of Eagles Diabetes Research Center Helen C. Levitt Center for Viral Pathogenesis and Disease Holden Comprehensive Cancer Center Institute for Clinical and Translational Science Institute for Vision Research Iowa Institute of Human Genetics Iowa Neuroscience Institute Pappajohn Biomedical Institute Wellstone Muscular Dystrophy Cooperative Research Center

UNIVE RSIT Y OF IOWA HE ALTH CARE | 2020 ANN UAL R EP ORT |

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9

ADULT AND PEDIATRIC CARE SPECIALTIES RANKED

BY U.S. NEWS & WORLD

REPORT (“BEST HOSPITALS”

AND “BEST CHILDREN’S HOSPITALS,” 2020-21)

#6

Ophthalmology

#7

Ear, Nose, and Throat

#32

Neonatology

#34

Gynecology

#37

Pediatric Orthopedics

#38

Pediatric Diabetes and Endocrinology

#41

Cancer

#42

Pediatric Nephrology

#49

Pediatric Neurology and Neurosurgery

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UN IV E R S IT Y O F IO WA HEALTH C AR E | 2 0 20 ANNUAL R EPORT

PATIENT CARE AND SERVICE Changing lives through comprehensive, compassionate care

SERVING PATIENTS FROM ALL OF IOWA’S 99 COUNTIES

860

INPATIENT BEDS, INCLUDING 190 PEDIATRIC BEDS AT UI STEAD FAMILY CHILDREN’S HOSPITAL

10,747 In early March 2020, as the first cases of COVID-19 were confirmed in Iowa, preparations were already underway in anticipation of patients with COVID-19.

UI Hospitals & Clinics epidemiologists had been monitoring the global spread of the novel coronavirus for weeks.

Numerous safety measures—including refresher training on best clinical practices, acquisition and conservation of personal protective equipment, and planning for surges in inpatient and outpatient cases—were put into place.

A specially designated respiratory illness clinic, which offered pre-clinic video visits for patients suspected of having COVID-19, was established.

Hospital visitor restrictions and health screenings (including temperature and symptom checks) also were implemented. With the arrival of the first patients with COVID-19—and as more patients with COVID-19 arrived at our facilities, many of whom were transferred from other hospitals across Iowa—our medical teams were ready to safely provide the care patients needed.

Pictured: Kim Staffey, MD, cardiologist and clinical associate professor of internal medicine.

HOSPITAL STAFF

1,076

3,184

759

physicians and dentists

nurses

resident and fellow physicians

1,039,681 32,872

CLINIC VISITS

PATIENT ADMISSIONS

32,807

151,815

554

major surgical operations

minor surgical procedures

organ and tissue transplants

50,468

EMERGENCY DEPARTMENT VISITS

UNIVE RSIT Y OF IOWA HE ALTH CARE | 2020 ANN UAL R EP ORT |

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NURSING, CARE COORDINATION, REHABILITATION

8

ADULT AND PEDIATRIC UNITS RECOGNIZED WITH GOLD OR SILVER BEACON AWARDS FOR EXCELLENCE™ FROM THE AMERICAN ASSOCIATION OF CRITICAL-CARE NURSES

17 ACTIVE NURSE-LED RESEARCH STUDIES

25 PUBLICATIONS

47

88

333

ACTIVE NURSE-LED EVIDENCE-BASED PRACTICE PROJECTS

ORAL AND POSTER PRESENTATIONS TO REGIONAL, NATIONAL, OR INTERNATIONAL AUDIENCES

CONTINUING EDUCATION EVENTS

800+

4,639+

5,500+

CITATIONS AND 8,400+ REQUESTS FROM 54 COUNTRIES FOR THE IOWA MODEL OF EVIDENCE-BASED PRACTICE

ADULT AND PEDIATRIC VENTILATOR INITIATIONS

EMPLOYEES

130,000+ INPATIENT AND OUTPATIENT PHYSICAL AND OCCUPATIONAL THERAPY CONSULTS EACH MONTH

10 |

EXPERIENCED NURSE FELLOWSHIP PROGRAM, ACCREDITED BY ANCC PRACTICE TRANSITION ACCREDITATION PROGRAM IN 2020

1st

accredited program in Iowa

6th accredited program in the world

UN IV E R S IT Y O F IO WA HEALTH C AR E | 2 0 20 ANNUAL R EPORT

Early in 2020, the critical demand for flexible staffing to meet emerging patient care needs in the midst of a pandemic was recognized. Nurses and social workers shifted to establish a home care team to coordinate communication and care services. The care team, including nurses, nursing assistants, physical therapists, occupational therapists, respiratory therapists, respiratory assistants, advanced practice providers and many others, expanded their skills and training through online courses, simulation labs, and cross-training to different care settings. This proactive preparation was critical for successful implementation of surge plans to meet fluctuating patient volumes and patient care needs.

Pictured at right: Nick Klein, BSN, RN, CCRN, staff nurse in the Medical Intensive Care Unit.

Pictured at left: Cynthia West, LISW, OSW-C, social worker in the Holden Comprehensive Cancer Center.

THERAPIES, RESPIRATORY CARE

4

consecutive Magnet® designations for nursing excellence from the American Nurses Credentialing Center

UNIVE RSIT Y OF IOWA HE ALTH CARE | 2020 ANN UAL R EP ORT |

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OUTREACH AND ENGAGEMENT Changing lives through service to Iowans and their communities

1,585

155

5,010

CARVER COLLEGE OF MEDICINE

IN-PERSON AND 31 VIRTUAL PROGRAMS IN

PEOPLE FROM 83 COUNTIES

ALUMNI PRACTICE IN 78

STEM EDUCATION, ADULT-BASED COMMUNITY

PARTICIPATED IN CONTINUING

OF IOWA’S 99 COUNTIES

EDUCATION, AND PROVIDER RELATIONS

MEDICAL EDUCATION PROGRAMS

CONTENT DELIVERED IN FY 2020

$352,000,000+ IN COMMUNITY BENEFIT SERVICES AND PROGRAMS

864,000+

PEOPLE SERVED BY COMMUNITY BENEFIT PROGRAMS AND SERVICES

79 10 13 12 |

ADULT SPECIALTY CARE CLINICS IN 18 IOWA COMMUNITIES

PEDIATRIC SPECIALTY CARE CLINICS IN 8 IOWA COMMUNITIES

IOWA COMMUNITIES HAVE CHILD HEALTH SPECIALTY CLINICS

TELEMEDICINE SITES ACROSS IOWA: 14

UI locations

13

Child Health Specialty Clinic centers

7

UI outreach clinic locations

15

non-UI locations

UN IV E R S IT Y O F IO WA HEALTH C AR E | 2 0 20 ANNUAL R EPORT

9,011 STUDENTS FROM 191 IOWA SCHOOLS TOOK PART IN 157 ON-CAMPUS, VIRTUAL, AND SCHOOL-HOSTED UI HEALTH CARE STEM (SCIENCE, TECHNOLOGY, ENGINEERING, AND MATH) PROGRAMS IN FY 2020

Before the coronavirus pandemic halted in-person learning programs in fiscal year 2020, UI Health Care STEM Education had hosted 144 on-campus and off-campus programs for Iowa K-12 students. When inperson sessions stopped, online opportunities arose. UI Health Care STEM Education hosted 13 virtual programs, which generated over 71,500 virtual program views and 2,200 page views on a new STEM resources webpage.

Pictured: Brittaney Sharp, MSN, RN, CNOR, nursing practice leader in the Main Operating Room, leads a handson activity during a Girls Go STEM event.

UNIVE RSIT Y OF IOWA HE ALTH CARE | 2020 ANN UAL R EP ORT |

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PHILANTHROPY Changing medicine through generous commitments to our people and our programs

$91,000,000 IN PHILANTHROPIC SUPPORT TO UI HEALTH CARE IN FY 2020 THROUGH THE UI CENTER FOR ADVANCEMENT

30,925 PHILANTHROPIC GIFTS TO UI HEALTH CARE

27,538 PHILANTHROPIC CONTRIBUTORS TO UI HEALTH CARE

In addition to philanthropic gifts through the UI Center for Advancement, in-kind donations have been a steady, and much-appreciated, means of support for UI Health Care in its response to the coronavirus pandemic. From mid-March through the end of December 2020, nearly 98,000 items—face shields, surgical masks, N95 respirators, medical gloves and gowns, handmade face coverings, and more—have been donated by businesses, organizations, and individuals from across Iowa and around the country.

SOURCE OF GIFTS FY 2020 ALUMNUS (ALL AREAS) CORPORATIONS FOUNDATIONS NON-ALUMNUS ORGANIZATIONS OTHER

$32,812,234 $10,356,531 $12,707,120 $24,136,570 $11,017,800 $228

UNIVE RSIT Y OF IOWA HE ALTH CARE | 2020 ANNUAL R EP ORT |

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CONSOLIDATED FINANCIAL INFORMATION Fiscal year 2020 (July 1, 2019 through June 30, 2020) enterprise revenue and expenses.

FISCAL YEAR 2020 REVENUE

TOTAL $2,734,312,187

PATIENT CARE

$2,229,631,178

EXTRAMURAL FUNDING

$237,869,736

OTHER OPERATING REVENUE

$187,051,042

GENERAL EDUCATION FUNDS

$77,381,485

STATE APPROPRIATIONS TOTAL

$2,378,746 $2,734,312,187

FISCAL YEAR 2020 EXPENSES PERSONNEL

TOTAL $2,623,747,744

$1,481,776,636

SUPPLIES

$606,913,611

LICENSES, FEES & OTHER OPERATING EXPENSES

$161,978,141

DEPRECIATION AND AMORTIZATION

$112,775,695

REPAIRS & MAINTENANCE

$105,377,416

SERVICES (INSURANCE) OCCUPANCY, BILLING & OVERHEAD (ADMIN & MEDICAL) TOTAL

$28,899,184 $126,027,061 $2,623,747,744

FISCAL YEAR 2020 PERSONNEL EXPENSES FACULTY

TOTAL $1,481,776,637

SEIU

$367,869,082

P&S

$376,290,632

MERIT

$188,178,157

RESIDENTS, FELLOWS AND POST DOC

$77,535,311

OTHER TOTAL

$53,795,033

TOTAL

16 |

$418,108,422

UN IV E R S IT Y O F IO WA HEALTH C AR E | 2 0 20 ANNUAL R EPORT

$1,481,776,637

UNIVERSITY OF IOWA HEALTH CARE 2020 ANNUAL REPORT Produced by University of Iowa Health Care Marketing and Communications. All rights reserved. No part of this publication may be reproduced or transmitted in any way without written permission: Marketing and Communications University of Iowa Health Care 200 Hawkins Drive, W319 GH Iowa City, Iowa 52242

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CHANGING MEDICINE. CHANGING LIVES.®

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