Document 6421

Board of Regents Chancellor

NSHE Health Sciences Program Enrollment Medicine 235 Medical Students 263 Residents/Fellows 152 Basic Science Grad. Students

Public Health 453 Students

Health Professions 4,022 Students

Fall 2008 Statistics

Nursing 5,564 Students

NSHE Health-Science Enrollment 15,313 Students

ALL Dental Health 1,021 Students

Mental Health/ Chemical Dependency/ Social Work 3,603 Students

The Opportunity: Many Opportunities for Promoting Internal Collaboration, Integration and Program Enhancement The health care related AA degree and certificate programs at the two year colleges include: College of Southern Nevada (CSN) • Env. Health & Safety (AAS/CA) • Developmental Services Tech (CC) • Mental Health Services Tech (CC) • Mental Health Services (AAS/CA) • Deaf Studies/Interpreter (AAS/CA) • Surgical Technology (AAS)/CA • Cardiorespiratory Services (AAS) • Pharmacy Technician (CA) • Paramedic Medicine (AAS/CA) • Medical Office Assistant (CA) • Medical Office Practice/Coding (CC) • Medical Transcription (CA) • Medical Laboratory Technology (AAS) • Medical Laboratory Assistant (CA) • Emergency Med. Technology (CC) • Health Information Technology (AAS) • Dental Hygiene (AS/BS) • Dental Assisting (CA) • Massage Specialist (CA/CC) • Diagnostic Medical Sonography (AAS) • Nursing (AAS) • Occupational Therapy Assistant (AAS) • Physical Therapist Assistant (AAS) • Ophthalmic Technology (AAS) • Radiation Therapy Technology (AAS) • Veterinary Technology (AS/CA) • Phlebotomy (CC)

CSN cont’d • Psychology (AA) • Biological Sciences (AS)

Truckee Meadows • EMT (Cert) • Radiologic Tech (AAS) • Paramedic (Cert) • Dietary Tech/Nutrition (AS) • Nursing (AAS/Cert) • Dental Assistant (AAS) • Dental Hygiene (AS) • Dev. Disability Tech (AS) • Substance Abuse Counselor (AS) • Mental Health Services (AAS) • Mental Health Technician (AS) • Medical Imaging Technology (Cert) • Psychology (AA) • Veterinary Technology (AS/Cert)

Great Basin • Nursing Assistant (CNA) • Nursing, (AS, RN to BSN) • Radiology Technology (AAS) • Emergency Medical Services • Substance Abuse (CA) • Medical Transcription (CA) • Diagnostic Medical Sonography (CA) • Human Services (AAS) • Ultrasound (CA)

Western Nevada College • Phlebotomy (CC) • Nursing Assistant (CC) • Nursing (AAS) • Deaf Studies (AA) • American Sign Language (CA) • Surgical Technician (CA) • Biological Sciences (AS) • Emergency Medical Services (CC)

The Opportunity: Many Opportunities for Promoting Internal Collaboration, Integration and Program Enhancement The health care related programs at the four year colleges/universities include: UNLV UNLV (cont’d) UNR • Nursing (BSN, MS, PhD) • Social Work • Nursing (BSN, MS) • Clinical Laboratory Sciences • Radiologic Technology • Health Ecology • Health Physics • Sports Injury Management • Social Work (BS, MSW) • Kinesiology • Athletic Training • Speech Pathology • Nuclear Medicine • Fitness & Sports Management • Audiology • Nutrition Sciences • Health Education • Nutrition • Dentistry • Counseling • Veterinary Science • Pediatric Dentistry • Counselor Education • Psychology • Orthodontics Residency • Biotechnology • Environmental Science & Health • Human Services • Addiction Studies (Cert) • Human Development & • Human Services Counseling • Family Nurse Practitioner (Cert) Family Studies • Gerontology (Cert) • Marriage & Family Therapy (Cert) • Public Health • Biomedical Engineering • Nursing Education (Cert) • Social Psychology • Crisis and Emergency • Biotechnology Management • Biomedical Engineering • Exercise Physiology • Health Physics • Health Promotion • Health Sciences • Health Care Administration • Physical Therapy • Psychology • Public Health • Radiochemistry • Comprehensive Medical Imaging

UNR (cont’d)

UNSOM • Residencies: family medicine, internal medicine, pediatrics, emergency medicine, OB/GYN, plastic surgery, general surgery, psychiatry • Fellowships: child/adolescent psychiatry, geriatrics, hospice & palliative medicine, surgical critical care, acute care surgery, sports medicine, medical oncology, family medicine obstetrics, hand & microsurgery, trauma surgery, orthopedic trauma • MD/PhD • MD/MPH • MD/MBA • BS/MD Nevada State College • Nursing (BS) • Speech Pathology (BS/MA) • Biology/Health Promotion concentration (BS) • Psychology (BA/BS) • Occupational Sci. (BS)

NSHE Health Sciences System (HSS) Mission Promoting an Internal Promoting Promoting Promoting Collaboration Development Efficiency & External and a and Program Effectiveness Collaboration Systems Growth Approach

Mortality Per 100,000 Population Nevada U.S. Nevada State Rank

• • • • • •

Heart Disease Cancer Stroke Death by Firearm Suicide All Causes

242.1 199.2 59.0 16.0 19.2 824.0

211.2 201.8 51.7 10.0 10.4 776.0

38 32 40 47 50 31

Sources: National Center for Health Statistics, National Vital Statistics, 2006, 2007 Data (Published 2008)

Nevada’s Health Indicators NV RANKING 43 49 48 50 51*

HEALTH CARE FINANCING AND EXPENDITURES Population uninsured Children uninsured Public health funding Adults enrolled in Medicaid Children enrolled in Medicaid

NV RANKING 46 50 47 46 46 46

HEALTH CARE WORKFORCE Primary care physicians (per 100,000) Registered nurses (per 100,000) Dentists (per 100,000) Psychiatrists (per 100,000) Rate of residents in core and specialty programs (per 100,000) Paramedics

NV RANKING 45 46 38 51* 50 47 40 50

HEALTH CARE ACCESS AND CAPACITY Community hospital beds (per 100,000) Geographic disparity of health outcomes (as a differential percentage) Persons lacking access to primary care Adults with a usual source of care Children with a medical home Adults who visited a doctor in the past two years Adults who visited a dental clinic in the past year Children who received medical and dental preventive care

NV RANKING 38 50 45

HEALTH CARE QUALITY Mortality rate of cases amenable to health care (per 100,000) Medicare readmissions after 30 days (of admissions) Medicare patients who gave a best rating for health care received in past year Hospital patients who received recommended care for acute myocardial infarction, congestive heart failure, or pneumonia Adult diabetics who received recommended preventive care

45 46 NV RANKING 39 50

MATERNAL & CHILD HEALTH Mothers receiving late or no prenatal care Children immunized

NV RANKING 1 (worst) 40 41 NV RANKING 41 48 42 31 50 51 *

MINORITY HEALTH DISPARITIES Diabetes death rate among Blacks (per 100,000) Preterm births among Hispanics Preterm births among Blacks HEALTH & WELL-BEING Years of life lost due to premature death (per 100,000) Age-adjusted death rate by suicide (per 100,000) Heart disease death rate (per 100,000) Breast cancer death rate (per 100,000 women) Colorectal cancer death rate (per 100,000) Adults reporting poor mental health

Nevada’s Health Ranking

Source: America’s Health Rankings, United Health Foundation, 2008

 Nevada

ranks lower for health determinants than for health outcomes, indicating that overall healthiness may decline over time.

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Nevada System of Higher Education efforts ◦ What has been done

NSHE University of Nevada School of Medicine

Celebrating 40 years: 1969 to 2009

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319 full-time faculty 73 part-time faculty 157 classified staff About 800 volunteer faculty

Who We Are: Students, Residents and Fellows 

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235 medical students 151 basic science graduate students 263 residents and fellows

Medicine  Increased medical student class size from 52 to 62  Increased Graduate Medical Education (GME) trainees from 222 to 280  Increased faculty from 272 to 300

Western Schools of Medicine: class sizes

160 140 120 100 80 60 40 20 0

144

82 62

80

UNSOM (1969) U. Arizona (1964) U. Utah (1942) U. N. Mexico (1961)

class size

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College of Osteophatic Medicine ◦ Class size 135

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New combined degree programs: M.D./M.P.H., M.D./Ph.D., M.D./MBA and B.S./M.D. The B.S./M.D. accelerated path began at University of Nevada, Reno in 2008 and will start at University of Nevada Las Vegas in fall 2010

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Professional education for rural Nevada ◦ 70 courses annually; more than 1,050 participants at 18 rural sites

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Telemedicine ◦ 12 clinical specialties across 49 rural sites ◦ 240 patients seen remotely since Jan. 2008

In 2010 the University of Nevada School of Medicine was recently named as a top 10 allopathic medical school contributing the most to the pipeline of family physicians. This honor, awarded by the American Academy of Physicians The University of Nevada School of Medicine graduated 15.8 percent of its students who chose to enter family medicine over the last three years.

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Resources

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Center for Molecular Medicine ◦ 100,000 square foot state-of-the-art research building

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Health Sciences Education Building ◦ 50,000 square foot building for inter-disciplinary health sciences students education

UNSOM has the capital facilities to expand the class to 100 but resources are needed to support the necessary faculty/staff

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Eight residencies: family medicine, internal medicine, pediatrics, emergency medicine, OB/GYN, plastic surgery, general surgery, psychiatry Eight fellowships: child/adolescent psychiatry, geriatrics, palliative medicine, surgical critical care, acute care surgery, sports medicine, FM OB/GYN, medical oncology

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Adding training programs in neurology, otorhinolaryngology, gastroenterology and pathology

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UNSOM’s current model is a distributed model with slightly over half of graduate medical education provided at University Medical Center in Las Vegas. Additional GME relationships include ◦ VA Medical Center: ◦ Renown in Reno: ◦ Sunrise in Las Vegas:

Internal Medicine, Family Medicine, Psychiatry, Surgery Internal Medicine, Family Medicine, Psychiatry Pediatrics

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The Western States GME programs

Sources :ACGME, AOA

Western States and Universities: GME Residencies

Western States and Universities: GME Fellowships

◦ Local  Partnership with hospital and health care facilities

◦ State  Funding for GME

◦ Federal  Medical Residency Caps

Nursing Statistics

Nursing Statistics

Nursing Statistics

NSHE Nursing Programs

NSHE has nursing programs in each educational unit and offers a full range of nursing programs including

In Southern Nevada: 

UNLV ◦ RN – BSN ◦ RN to BSN ◦ MSN ◦ Doctorate

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College of Southern Nevada ◦ LPN ◦ RN – AAS Nevada State College ◦ RN – BSN ◦ RN to BSN

35

NSHE has nursing programs in each educational unit and offers a full range of nursing programs including

In Northern Nevada: 

UNR ◦ RN – BSN ◦ RN to BSN ◦ MSN

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Great Basin College ◦ RN – AAS ◦ RN – BSN ◦

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Truckee Meadows Community College ◦ RN – AAS Western Nevada College ◦ LPN ◦ RN – AAS

36

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Several new RN training programs have been developed in Nevada over the past several years ◦ Touro University

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BSN RN-BSN MSN Doctorate in Nursing Practice

◦ Apollo College - Associate of Applied Science in Nursing (ADN Degree) ◦ National University - Associate of Science in Nursing (ASN Degree) ◦ Kaplan College - LPN program ◦ University of Southern Nevada - BSN Source: Nevada State Board of Nursing website, accessed May 30, 2010.

Nursing  In 2006 NSHE programs doubled the enrollment in undergraduate nursing

Nursing: NSHE Enrollment NSHE Nursing Degrees Number of Graduates

Program

07/08

PHD - UNLV

2

MSN-UNLV

38

MSN-UNR

17

BSN-NSC

98

BSN-UNLV

136

BSN-UNR

107

BSN-GBC

3

AAS-CSN

170

AAS-GBC

15

AAS-TMCC

64

AAS-WNC

49

LPN-CSN

25

LPN-WNC

1

TOTAL Source: NSHE Data Warehouse & IPEDS

725

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NSHE’s doubling of nursing enrollment between 2000 and 2005 and development of private nursing schools, have resulted in a significant increase in the number of Nevada nursing graduates Graduates from Nevada Nursing Programs 900

800

795 734

741

2005/2006

2006/2007

700

600

788 In 08-09 (approx. 84% are from NSHE programs)

505

500

400 360

356 300

312

328

319

2000/2001

2001/2002

336

278

200

100

0 1997/98

1998/99

1999/2000

2002/2003

2003/2004

2004/2005

2007/2008

Sources: Nevada State Board of Nursing, Annual Report 2007-2008

Nevada’s neighboring states have significant shortages of nursing professionals, suggesting that there is limited opportunity to attract nurses from surrounding states to Nevada

Registered Nurses Per 100,000 California 638 Utah 630 New Mexico 579 Nevada 572 Arizona 546 National Average

State Rank 46 47 48 49 50

824

Source: Kaiser State Health Facts, accessed May 5, 2009; 2007 data from Bureau of Labor Statistics and U.S. Census Bureau

Nursing Growth: Critical Elements Clinical Training Capacity

Nursing Enrollment

Qualified Student Pipeline

Recruitment of Nurses from Health Care Facilities

Nursing Grads Passing NCLEX

Nurses Practicing in Nevada

Increasing Pass Rate Increases Nurses Adapted from NHA issue brief “Nurse Shortage 2008”

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System-wide Nursing Collaboration Implementation of common application process Establishment of common admission requirements for all NSHE pre-licensure nursing programs Development of common student graduate survey Extension of articulation agreements amongst NSHE programs

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Joint Public Health PhD Program (UNLV and UNR approved December 2008) Joint Doctor in Nursing Practice (DNP) Program (UNLV and UNR approved December 2009)

Shadow Lane Campus:

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Nevada State College, UNLV, UNR

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State-of-the-art labs, seminar rooms and smart classrooms

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31,500 square feet

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Sharing of resources

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Training side by side

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The Nevada Nursing Education and Practice Alliance (NNEPA) has been formed and has identified a work plan to be executed through three work groups: ◦ Leadership ◦ Education ◦ Work Place Redesign Early projects the group has focused on include: ◦ An electronic student clinical placement system ◦ A standardized student orientation program

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In addition to educational benefits NSHE provides direct benefits to Nevadans through direct clinical services

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Direct Care Provided:

$16,607,962

Supervised Indirect Clinical Care While Pursuing Degree:

2,047,076 hrs

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Nevada is suffering a significant shortage of health care professionals and has poor health indicators These are the results of the inability of the state to keep up with the fast growth in population of the past 20 years The solutions of these problems are complex (and are made more difficult by the current financial situation) and require a multi-strategy approach that will require investment from the state, from the private sector, and establishment of public and private partnerships