"As part of Iowa's only comprehensive academic medical center, our teams of multidisciplinary specialists are advancing the frontiers of medicine in new and unprecedented ways. Together, we share a passionate commitment for providing all our patients with today's best and most innovative care."

—Paul Rothman, MD

One principle stands above all others at University of Iowa Hospitals and Clinics.

Patients and their families come first. Always.

This commitment provides the foundation upon which the hospital's strategic plan for years 2006 through 2010 is built. It is the core value that drives our unique team-oriented patient care environment of innovative care, scientific inquiry, and biomedical discovery.

Working together as multi-disciplinary partners, our physician scientists inspire and challenge each other to find even better ways to treat patients with illness, disease, and injury.

"We pride ourselves on our ability to develop and refine innovative ideas," explains Paul Rothman, MD, a designated strategic plan "champion" for innovative care. "This leadership role not only supports the most advanced technologies and techniques for patient care, but also includes the use of well-known performance improvement models to enhance our care environment."

The goal is simple and clear: People must feel "The Iowa Difference" every step of the way.

Innovative care "champion" Paul Rothman, MD

An incubator for creative thinking.

Leaders in Innovation

A revolutionary new 4-D (four dimensional) radiation treatment system provides a great example of how University of Iowa Hospitals and Clinics is a world leader in developing patient care technologies.

In fact, UI Hospitals and Clinics is the first hospital in Iowa, and one of the first in the nation, to use this highly advanced technology, which takes the traditional three-dimensions of cancer imaging—width, height, and depth—and adds a crucial fourth dimension—time.

"Adding the dimension of time makes it possible to precisely direct radiation at a moving organ without risking damage to nearby healthy tissue," explains John Bayouth, PhD, director of physics in the Department of Radiation Oncology.

"What we get," adds radiation oncologist John Buatti, MD, "is not just a series of static images of the moving tumor, but rather a frame-by-frame ‘movie' laying out the location of the tumor during every second of the patient's breathing cycle."

Sudershan Bhatia, MD

University of Iowa Hospitals and Clinics is the first hospital in Iowa, and one of the first in the nation, to use 4-dimensional technology, which makes it possible to precisely direct radiation at a moving organ without risking damage to nearby healthy tissue. It's one more tool at the disposal of radiation oncologist Sudershan Bhatia, MD.

"I had heard about this new technique (for treating lung cancer) and I was willing to try it. It was a wonderful option to have. The procedure itself was very simple and I had no pain at all. The care I got was first-rate—marvelous."

—Lorraine Young

Lorraine Young, 87, was one of the first patients at the Holden Comprehensive Cancer Center at The University of Iowa to benefit from 4-D treatment.

Young came to UI Hospitals and Clinics after doctors in Dubuque, Iowa, diagnosed a malignant tumor on her lower right lung.

"The procedure was very simple and I had no pain at all," she says.

Better yet, a follow-up examination provided the best possible news.

"We found no evidence of the tumor and her prognosis is very good," says radiation oncologist Sudershan Bhatia, MD. "We don't expect any more problems."

Cancer patient Lorraine Young of Dubuque, Iowa, was one of the first patients at UI Hospitals and Clinics to benefit from 4-D treatment.

Sparking New Ideas

Academic medical centers like UI Hospitals and Clinics provide a unique environment for health care innovation because they house some of the nation's most respected experts in patient care, research, and education.

Working together in collaborative, multi-disciplinary teams, these experts inspire and challenge each other to improve on old patient care ideas and develop new ones.

"We truly have an inspiring and exciting atmosphere—a perfect incubator for innovation and creative thinking," says radiation oncologist John Buatti, MD.

This means UI physician scientists will continue to focus on making improvements as they introduce new technologies like 4-D cancer therapy.

"As colleagues in academic medicine," Buatti says, "we share a deep passion for developing and improving techniques and technologies that truly make a difference for patients.

"To me, this speaks to the heart of what is good. The University is a place for ideas, free interchange, and a commitment to make the world a better place."

Physician Chief of Staff Eva Tsalikian, MD, adds that UI Hospitals and Clinics represents a visionary investment in innovation and hope for a better future.

"We believe serious inquiry, teaching, and collaboration work hand-in-glove to improve human health," he says. "As an academic medical center, we are uniquely committed to the notion of sharing today's health care advances with future generations."

This enormous responsibility requires a sophisticated array of world-class technologies, a comprehensive infrastructure, and teams of physician scientists committed to innovative thinking and biomedical discovery.

Recruiting Innovative Experts

To keep the spark of innovative care alive and vibrant, UI Hospitals and Clinics takes special pride in partnering with the UI Roy J. and Lucille A. Carver College of Medicine in attracting and retaining some of the world's most innovative physicians.

This infusion of talent and leadership contributes to better patient care, visionary new ideas in medical research, and a vigorous program of medical education.

It also makes UI Hospitals and Clinics unique in providing the people of Iowa with around-the-clock access to world-class specialists from every medical discipline.

During the past fiscal year alone, the hospital and college have recruited additional experts in such fields as cardiac electrophysiology, heart failure, endoscopic transnasal brain surgery, hepatology, brachytherapy, and pancreas transplantation.

Among those appointed to leadership positions were:

• Mark Anderson, MD, PhD, chair of cardiology who is especially focused on developing new therapies for treating patients with cardiac arrhythmias.
• Harold Burkhart, MD, new director of the extracorporeal membrane oxygenation (ECMO) for premature newborns and continuing as director of pediatric cardiothoracic transplantation.
• Keith Carter, MD, head of Ophthalmology and Visual Sciences, whose expertise includes reconstructive surgery, oculoplastic surgery, and eye orbit.
• Frances Johnson, MD, medical director of the UI Heart and Vascular Center cardiomyopathy treatment program, who is leading an expansion of heart failure services and helping guide the heart transplantation program.
• Jonathan Klein, MD, medical director of the University of Iowa Children's Hospital Neonatal Intensive Care Unit. Klein's expertise includes high-frequency ventilation, nitric oxide therapy, surfactant replacement therapy, and persistent pulmonary hypertension in newborns.
• Bruce Luxon, MD, PhD, director ofgastroenterology-hepatology, an expert in liver diseases and the medical management of patients awaiting liver transplantation.
• Thomas Scholz, MD, University of Iowa Children's Hospital director of pediatric cardiology, whose expertise includes non-invasive assessment of cardiac anatomy and function.
• Jeffrey Segar, MD, University of Iowa Children's Hospital director of neonatology, an expert in the regulation of fluid and electrolyte homeostasis in newborns, and cardiovascular function in children.
• Michael Todd, MD, head of Anesthesia, an expert in anesthesia for neurological patients.
• Ronald Weigel, MD, PhD, head of Surgery, whose research focus includes the role of genes and hormones in breast cancer. Weigel holds four patents related to breast cancer research.

Heart specialists Frances Johnson, MD, Barry Cabuay, MD, and Larry Mossman, RN, challenge each other to develop new and better ideas for patient care.

Innovative Emergency Care

Driven by the urgent nature of trauma, injury, and illness, the Emergency Treatment Center stands on the front lines of innovative patient care at UI Hospitals and Clinics. Patients and family members often arrive in a state of anxiety and concern.

So it was last year for Kim Heller of Elkader, Iowa.

Kim's husband, Tim, required highly specialized emergency care. UI neurosurgeons had years before implanted a shunt to control hydrocephalus, an abnormal buildup of fluid in the brain. Now the shunt had become clogged and repairs were needed or Tim would die—a terrifying thought to Kim and her parents as they drove Tim to the Emergency Treatment Center.

Fighting back tears, Kim recalls her state of mind: "We imagined it would be like the ‘ER' program on TV. We pretty much expected to see the full gamut of craziness."

Instead, Tim quickly and efficiently received the best, most advanced neurosurgical care in an environment of calm professionalism.

"They were exceptionally well organized," Kim says. "Tim received a very thorough pre-surgical evaluation and we were informed in detail what the next steps would be. We arrived at 10:30 p.m. and he was in neurosurgery by midnight."

Since then, Tim has recovered and is again leading a normal, healthy life.

As a caseworker for an agency serving elderly people, Kim admits to be being very hard to please. In fact, she looked hard to find something wrong during the visit.

"I know where to look for the ‘dirt,'" she says. "It wasn't there."

A National Leader

The Heller family's experiences reflect an environment where innovative techniques and technologies are enhanced by a commitment to continuing improvement.

Eric Dickson, MD, who directs the Department of Emergency Medicine, notes that UI Hospitals and Clinics not only boasts some of the nation's best and most advanced emergency care, but also some of the most efficient.

"We have gone to great lengths to improve our clinical outcomes by using some of today's best formal process improvements," Dickson says, citing collaborative efforts with the hospital's Department of Operations and the Iowa Business Council.

These initiatives have used performance improvement models for quality patient care. Tools of this type, while common in many industries, are new to health care.

"We are among the nation's first emergency departments to apply them in a health care setting," Dickson says.

The results have been spectacular, as reflected in a double digit reduction in emergency room and clinic wait times and increased patient satisfaction.

"We must be willing to look at things from the patient's perspective," Dickson says. "If it were me lying there on that table, what would I expect?"

Kim and Tim Heller of Elkader, Iowa, appreciate how meaningful a performance-oriented environment can be.