The technology that caregivers, educators, and researchers at the U.Va. Health System have at their disposal is impressive in its complexity and power. But ultimately the ability to offer high-quality care to patients in the U.Va. community and in the Commonwealth is due to the dedication, energy, and expertise of the 6,000 Health System employees.

The outstanding performance of Health System employees is the reason that U.S. News & World Report ranks the School of Medicine twenty-third in the nation for research-intensive medical schools and the School of Nursing nineteenth. These individuals are why the U.Va. Medical Center once again was named one of the top 100 cardiovascular hospitals in the nation, and why many of our specialties — such as neurosciences, digestive health, and endocrinology — are consistently ranked among the best in the nation. The contributions of U.Va.'s health care personnel are also the reason the Medical Center achieved Magnet Recognition from the American Nurses Credentialing Center, a mark of nursing excellence bestowed on just 5 percent of U.S. hospitals.

Collective Success

A number of achievements serve to highlight the quality of the professionals the Health System attracts. Many Health System employees attain recognition from the most prestigious professional organizations in their fields. For instance, Pamela Cipriano, chief clinical officer and chief nursing officer at the Medical Center, was one of just thirteen nurses across the country to receive the Distinguished Member Award from the American Nurses Association.

R. Edward Howell, vice president and CEO of the U.Va. Medical Center, was recognized for his leadership in advocating for community health care and hospital services. He received a Partnership for Action Grassroots Champion Award from the American Hospital Association, in partnership with the Virginia Hospital & Healthcare Association. Mr. Howell and his team at the Medical Center have spent the last several years focused on advocacy.

Others are recognized for their sustained commitment to education. Neurosurgeon John Jane received the 2008 Parker J. Palmer Courage to Teach Award from the Accreditation Council for Graduate Medical Education. During his tenure at U.Va., Dr. Jane has trained fifty-five neurosurgeons, sixteen of whom are now chairs of their own neurosurgery departments. Dr. John Kattwinkel, the Charles Fuller Professor of Neonatology, was named a recipient of a 2008 Outstanding Faculty Award, administered by the State Council of Higher Education for Virginia.

Nursing professor Suzanne Burns (Nursing '85, '88) received one of the first Flame of Excellence Awards from the American Association of Critical-Care Nurses honoring teaching and clinical excellence at the regional and national levels. Her colleague, Reba Moyer Childress (Nursing '79, '91), assistant professor of nursing, was named a fellow of the American Academy of Nurse Practitioners, while Sarah Farrell (Nursing '81, '83), associate dean for academic programs and chief technology officer for the School of Nursing, was elected president of the Virginia Association of Colleges of Nursing.

U.Va. Health System faculty members were also honored for their contributions to research. Dr. Anindya Dutta, the Harry Flood Byrd, Jr., Professor of Biochemistry; and William R. Pearson, professor of biochemistry and molecular genetics, were named fellows of the American Association for the Advancement of Science. Dr. Dutta was honored for his investigations of processes that lead to genomic instability in cancer cells, while Professor Pearson is highly regarded as the codeveloper of FASTA, a software package with programs for searching protein and DNA databases.

This level of individual excellence places the Health System at the forefront of health care. This year, 160 University of Virginia physicians were named to the list of "Best Doctors in America," the result of a comprehensive peer-review survey. This total reflects an increase of thirty-five more U.Va. physicians since the last survey. Doctors included in the list are among the top 3 percent to 5 percent in their specialties.

New Leadership in Medical and Nursing Education

Strong, visionary medical educators can influence generations of students and inspire their colleagues. The Health System is fortunate to have found superb leaders to serve as new deans of the Schools of Medicine and Nursing.

Dr. Steven T. DeKosky

Dorrie K. Fontaine

Dr. Steven T. DeKosky, an international leader in Alzheimer's disease research, is the new vice president and dean of the School of Medicine. He is charged with developing patient-centered models of care and establishing U.Va. as a translational research center.

This appointment represents a homecoming for Dr. DeKosky. He completed a postdoctoral fellowship in neurochemistry at U.Va.'s Clinical Neuroscience Research Center, and his first academic appointment was in the Department of Neurology. He succeeds Dr. Sharon L. Hostler, the McLemore Birdsong Professor of Pediatrics, who assumed the post in May 2007 as interim vice president and dean.

Dorrie K. Fontaine, a specialist in addressing the needs of critically ill patients, was appointed dean of the School of Nursing. Her research focuses on comfort for critically ill patients, pain relief, and family presence at end of life. While at the University of California, San Francisco, she also established a reputation for promoting interprofessional education across health care disciplines. Another of Dean Fontaine's key interests is promoting healthy work environments for nurses and hospital colleagues. She served as president of the American Association of Critical-Care Nurses, the largest specialty nursing organization in the world, in 2003�04. Dean Fontaine succeeds Jeanette Lancaster, the University's longest-tenured dean and among the longest-tenured deans of nursing in the nation, who has stepped down after nineteen years of service.

This year, the School of Nursing officially dedicated the newly completed Claude Moore Nursing Education Building, and the School of Medicine broke ground on the Claude Moore Medical Education Building. Both schools are also expanding their programs in clinical simulation, one of the most powerful health care teaching models in practice today.

Advancements in Medical and Nursing Care

Because U.Va. medical and nursing faculty members serve at an academic medical center, they are able to make essential connections between patient care and scientific and technological progress. And these faculty members have the opportunity not simply to make new treatments available to patients but to play a role in their development.

The Health System is committed to funding advanced technology. As a result, U.Va. physicians are often among the first to gain access to this new medical technology and specialized equipment. This year, physicians from the Health System were the first in the nation to use the Artis zeego imaging system from Siemens Healthcare. This new machine's robotic arm technology makes it possible to visualize internal organs clearly from perspectives that could never be gained otherwise. U.Va. physicians first used the system to guide a liver shunt precisely into place and are now leading the way in exploring its benefits for patients with different imaging and treatment needs.

Many high-tech interventions are only available to patients who can come to Health System facilities for care. Through the Office of Telemedicine, the Health System is involved in a multifaceted effort to use technology to reach out to people in rural areas of the state and to provide routine and follow-up care in their communities. The office received $2.7 million in funding from the Federal Communications Commission for a Rural Health Care Pilot Program that gives outlying health care facilities broadband access to experts and equipment at leading medical institutions. When these networks are in place, doctors will be able to transmit patient records, video files, and other images for diagnosis and ongoing care.

The office is also a partner in the new Virginia Acute Stroke Telehealth network, which is funded by a $1.3 million grant from the national Office of Rural Health Policy. Its goal is to decrease Virginia's stroke mortality rates — among the nation's highest — and boost the number of stroke patients who receive clot-busting medication within hours of experiencing stroke symptoms.

Research from Cells to Society

Basic science research at the cellular and molecular level provides the critical foundation for advances in medical care. In a recent article published in Science, Todd Stukenberg, associate professor of biochemistry and molecular genetics, explained why a single protein — the Aurora-B kinase — plays such an important role in guiding the process of cell division. Professor Stukenberg and his colleagues investigated the activation of Aurora-B and found that there are at least two independent mechanisms to activate Aurora-B that depend on the kinase's location on the chromosome. This discovery sets the stage for research into new chemotherapies that could interrupt cell division in tumors with limited side effects.

Other examples of basic research conducted at the U.Va. Health System have even more direct application for treatment. Dr. William Petri (Graduate Arts and Sciences '80, Medicine '82), the Wade Hampton Frost Professor of Epidemiology and chief of the Division of Infectious Diseases and International Health, discovered a protein used by the Entamoeba histolytica, a parasite that causes diarrhea and malnutrition and kills nearly 100,000 people a year, to undermine the body's immune mechanism. Inhibiting this protein might clear this infection.

Some Health System researchers are investigating treatments that could be adopted in months. In clinical trials conducted at the University, Dr. Bankole Johnson, the Alumni Professor of Psychiatric Medicine and chair of the Department of Psychiatry and Neurobehavioral Sciences, demonstrated that topiramate, an existing therapeutic medication, not only decreases heavy drinking but also diminishes the extensive harm alcohol dependence causes to physical organs, such as the heart and liver, as well as damage to an individual's psychosocial well-being that decreases quality of life. Findings from the clinical trials provide evidence that may lead the FDA to approve topiramate for alcohol dependence.

Applying an existing treatment to a different area of medicine often proves successful. Dr. Adam Katz, associate professor of plastic surgery, will study the use of fat grafting for wounds and severe burns as part of an effort of the Armed Forces Institute of Regenerative Medicine (AFIRM), a multimillion-dollar initiative launched by the Department of Defense to develop clinical therapies using regenerative medicine to treat battlefield injuries. This fat-grafting procedure currently performed all over the world for cosmetic purposes might also improve wound healing and limb function for soldiers who are severely hurt and scarred.

Some studies have impact much closer to home. A nursing study led by operating room nurse and researcher Eric Blum underscored the importance of providing regular communication to families of patients undergoing surgery. With the documented findings in place, new policies can be put in practice to ensure that such conversations take place.

Space for research continues to be a priority. This year saw the opening of the new Sheridan G. Snyder Translational Research Building; the Carter-Harrison Research Building is scheduled for completion early next year. Still, at a time when the budget of the National Institutes of Health is being cut, Health System researchers continue to be successful in attracting funding. This year, nine Health System researchers were awarded a total of $10 million over three years from the U.Va. Tobacco Research Program to advance the study of diseases associated with smoking. The program was created in 2007 following a gift from Philip Morris USA. Other major grants include those below.

• Dr. R. Ariel Gomez, the Robert J. Roberts Professor of Pediatrics, received a Method to Extend Research in Time award from the National Heart, Lung, and Blood Institute to further his study of renin cells in the kidneys. The award covers an initial five-year period ($1.9 million) and is renewable for an additional five years of support.
• Dr. Richard Guerrant (Medicine '68), the Thomas Harrison Hunter Professor of International Medicine and founder of U.Va.'s Center for Global Health, received a $3.6 million grant from the National Institute of Allergy and Infectious Diseases to develop a new approach to treat the Clostridium difficile, a major cause of diarrhea that has become increasingly resistant to antibiotics.
• Dr. Eric Houpt, the Harrison Distinguished Teaching Professor of Medicine, will use a $2.6 million grant from National Institute of Allergy and Infectious Diseases to develop a single test for more than twenty different food and waterborne pathogens. Dr. Paul Hoffman, professor of medicine, received $2.6 million from the institute to create a single treatment to prevent infection from a variety of pathogens.
• Kim Innes, assistant professor of research in the School of Nursing and adjunct assistant professor in the Department of Physical Medicine and Rehabilitation, was awarded a five-year, $585,070 grant from the National Center for Complementary and Alternative Medicine to investigate yoga for the prevention and management of cardiovascular disease and related chronic, insulin-resistant conditions.
• With a $1.8 million grant from the National Heart, Lung, and Blood Institute and the National Institute of Neurological Disorders and Stroke, the Health System will establish a consortium of seven medical centers to evaluate best procedures in cardiothoracic surgery. Dr. Irving L. Kron, the S. Hurt Watts Professor of Surgery and chair of the Department of Surgery; and Dr. Karen C. Johnston (Graduate School of Arts and Sciences '99), the Harrison Distinguished Teaching Professor of Neurology and chair of the Department of Neurology, are leading this initiative.
• Kathryn Laughon (Nursing '98, '99), assistant professor of nursing, received a two-year NIH grant, providing $275,000 a year, to test an interactive health communication application as a way of providing information and support to the guardians of children who survived intraparental homicide.
• Kevin Lee, the Harrison Foundation Professor of Neuroscience and chair of the Department of Neuroscience, received an $890,000 grant from the National Institute of Neurological Disorders and Stroke to test a new treatment for stroke that delivers oxygen and glucose to brain cells cut off by a blood clot.
• Richard J. Price, associate professor of biomedical engineering, received a $300,000 three-year grant from the Hartwell Foundation to further his research on an innovative method to treat pediatric brain tumors.
• Dr. Benjamin W. Purow, assistant professor of neurology, was awarded a five-year, $375,000 Early Career Physician-Scientist award from the Howard Hughes Medical Institute for his work studying glioma, the most common and lethal brain tumor.
• Ann Gill Taylor (Nursing '63, Curry '75), the Betty Norman Norris Professor of Nursing and director of the Center for the Study of Complementary and Alternative Medicine, received a five-year, $673,299 Academic Career Award from the National Center for Complementary and Alternative Medicine to build leadership skills in complementary and alternative medicine research.