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.

Nevada System of Higher Education efforts
◦ What has been done
NSHE
University of Nevada School of Medicine
Celebrating 40 years: 1969 to 2009




319 full-time faculty
73 part-time faculty
157 classified staff
About 800 volunteer faculty
Who We Are: Students,
Residents and Fellows



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

College of Osteophatic Medicine
◦ Class size 135


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

Professional education for rural Nevada
◦ 70 courses annually; more than 1,050 participants
at 18 rural sites

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.

Resources

Center for Molecular Medicine
◦ 100,000 square foot state-of-the-art research
building

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


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

Adding training programs in neurology,
otorhinolaryngology, gastroenterology and
pathology


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

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


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

Great Basin College
◦ RN – AAS
◦ RN – BSN
◦


Truckee Meadows
Community College
◦ RN – AAS
Western Nevada College
◦ LPN
◦ RN – AAS
36

Several new RN training programs have been developed in Nevada
over the past several years
◦ Touro University




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

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”





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


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:

Nevada State College,
UNLV, UNR

State-of-the-art labs,
seminar rooms and smart
classrooms

31,500 square feet

Sharing of resources

Training side by side


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

In addition to educational benefits NSHE
provides direct benefits to Nevadans through
direct clinical services


Direct Care Provided:
$16,607,962
Supervised Indirect Clinical
Care While Pursuing Degree:
2,047,076 hrs



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
`