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After a year of meetings, deliberations, and focus groups—interrupted by the events of Sept. 11—the four committees of the dean's strategic planning initiative presented their recommendations to Health Sciences faculty and staff at a meeting on June 27. Dr. Gerald Fischbach, executive vice president and dean, set up committees—research, education, patient care, and space—last year to identify Health Sciences' strengths and weaknesses, define goals, and set priorities to reach those goals.

"In the 1990s, Columbia Health Sciences moved from a destitute state to a state when we can plan," Dr. Fischbach said at the meeting's start. "The scope of our effort is enormous but our hope is that research, education, and patient care can all advance together."

Research

Columbia Health Sciences is one of a few U.S. centers that conducts medical, dental, nursing, public health, and basic research. To maintain Columbia's formidable presence in biomedical research, the research committee tried to predict important fields of biomedical research in the next 20 years and assess Columbia's strength in each area. Committee chairman Dr. Thomas Jessell, professor of biochemistry and molecular biophysics, reported the committee felt genomics, bioinformatics, clinical trial design, and chemical biology represent four key biomedical research fields that should be better represented at Columbia. The committee, for example, suggested a new chemical biology institute, where clinical researchers and chemists can interact to understand the molecular basis of disease and develop new therapies. The committee also recommended enhancing our position as one of the world's leading centers in neuroscience and strengthening other fields, including immunology, cancer, cardiology, genetics, and geriatrics. It also supported incentives to promote collaboration throughout the entire university and its campuses. The lack of space for researchers and animals concerned the research committee, too.

Education

Despite the breadth of Columbia Health Sciences education programs—which offer M.D., Ph.D., D.N.Sc., and M.P.H. degrees, among others—education committee chairman Dr. Samuel Silverstein, the John C. Dalton Professor and Chairman of Physiology and Cellular Biophysics, said the committee reached a remarkable consensus. Faculty and student focus groups praised the high quality of Columbia teachers and students, but found little administrative or monetary support for teaching. The committee recommended an education budget, a minimum teaching requirement for faculty, and methods for assessing and rewarding teaching. It did not recommend a separate teaching track.

Lack of space also impairs teaching, Dr. Silverstein said, and the committee recommended the immediate construction of a Clinical Performance Assessment facility. Columbia uses the Mount Sinai School of Medicine performance assessment facility once a year, at great expense, and only for third-year medical students. A state-of-the-art assessment center at Health Sciences could be used throughout a student's medical education and residency to assess performance with standardized patients, and could be expanded with mannequins, simulators, robotics, and virtual technology. In addition, more classrooms, social space, and housing are needed.

Patient Care

Providing the highest quality of care in a compassionate environment is the essence of the mission statement drafted by the executive subcommittee of the patient care committee chaired by Dr. Eric Rose, chairman of surgery and the Morris and Rose Milstein/Johnson & Johnson Professor of Surgery. To achieve the highest quality of care, the committee called for each clinical unit to measure performance and to set up a system to do so in the next three years. To achieve a caring culture, the committee recommended developing a set of values and standards used to educate all staff. The committee recommended hiring within the next year a patient care dean who would implement the plan. A plan to redistribute existing space was another priority.

Space

Each one of the committees concluded that lack and use of space are near emergency status. Though tough choices need to be made with existing space, Dr. Fischbach reported the committee found room to grow. Health Sciences owns 30 acres of land, more than New York University or Cornell, and has covered about half with buildings. The committee, composed of architects, land use planners, and other experts including hospital and university leaders, estimated Health Sciences will need 5 million more square feet of research, clinical, and office space in the next 20 years, in addition to the 7 million square feet already available. The most urgent space need is for outpatient care, and the dean committed to completing an ambulatory care building in five years. However, he also noted the search for space for research and education could not be postponed. In the short term, he said, "we need to review space use in all departments." The committee will also continue to develop a 10- to 20-year plan.

Final copies of the committee's reports will be available at the end of the summer and town meetings will be held to discuss the recommendations.

"Expanding Columbia Health Sciences will be expensive," Dean Fischbach said. "But I am committed to fund raising. I think we're in for a wonderful time."


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