Department of Surgery & Perioperative Care: Annual Report 2021 by DellMedSchool

ANNUAL REPORT 2020-2021

DEPARTMENT OF SURGERY AND PERIOPERATIVE CARE

MISSION & VISION

Welcome From the Chair When we began writing and organizing this second edition of our annual report while the pandemic swirled around us, we feared we would have little new to report. Of course, as the report came together, it was apparent how our learners, faculty and staff persevered through this most unusual year that further contributed to our mission of revolutionizing how people get and stay health. Our clinical, educational, and research programs continue to grow at a rapid pace, consistent with the overall growth of the Dell Medical School at UT Austin and the Austin community in general. We look back on milestones like the opening of the UT Health Austin Ambulatory Surgery Center with pride, and we recognize the impact that our new abdominal transplant program will have on our community.

Revolutionizing How People Get & Stay Healthy • Improving health in the community as a

model for the nation.

• Evolving new models of person

centered, multidisciplinary care that

reward value.

• Accelerating innovation and research to

improve health.

• Educating leaders who transform

health care.

• Redesigning the academic health

We look forward to another productive year ahead, and hope you enjoy reading about some of the highlights from the past year.

environment to better serve society.

A vital, inclusive health ecosystem: • Vital: Vigorous, animated, full of life and

energy, dynamic

• Inclusive: Open to everyone • Ecosystem: The complex of a

Kevin Bozic, M.D., MBA Chair, Department of Surgery and Perioperative Care Dell Medical School

community and its environment

functioning as a system

WHAT’S INSIDE 3

Educating Future Leaders

15 Clinical Care 27 Research Programs 33 Commitment to Diversity, Equity and Inclusion 34 Impact of Philanthropy

SURGERY AND PERIOPERATIVE CARE AT A GLANCE

Divisions

Residency Programs

Total Residents

(General Surgery, Emergency Medicine, Orthopaedic Surgery)

85%

Electives and Acting Internships

Fellowships

Increase in Unique Donors

DIVISION LEADERSHIP ACUTE CARE SURGERY Carlos VR Brown, M.D.

ORTHOPAEDIC SURGERY Karl Koenig, M.D., MS

ANESTHESIA AND PERIOPERATIVE MEDICINE Thomas Vetter, M.D., MPH

PEDIATRIC SURGERY Nilda Garcia, M.D.

CARDIOTHORACIC SURGERY Charles Fraser, Jr., M.D. EMERGENCY MEDICINE Nicholas Steinour, M.D. MINIMALLY INVASIVE SURGERY John Uecker, M.D., Interim

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SURGICAL ONCOLOGY Declan Fleming, M.D.

HEALTH PROFESSIONAL SPECIALISTS

REGULAR FACULTY

196

AFFILIATE FACULTY

SURGICAL SUBSPECIALTIES Stuart Wolf, M.D. TRANSPLANT SURGERY Nicole Turgeon, M.D.

Faculty by Designation

DEPARTMENT LEADERSHIP

Faculty by Specialty # of Faculty

Division Acute Care Surgery

Anesthesia and Perioperative Medicine

Cardiothoracic Surgery

Emergency Medicine

Minimally Invasive Surgery

Orthopaedic Surgery

Pediatric Surgery

Surgical Oncology

Surgical Subspecialties

Transplant

Total

Kevin Bozic, M.D., MBA DEPARTMENT CHAIR

Kimberly Brown, M.D. ASSOCIATE CHAIR OF EDUCATION

277 Alex Haynes, M.D., MPH ASSOCIATE CHAIR OF INVESTIGATION AND DISCOVERY

15%

PROFESSORS

57 %

ASSISTANT PROFESSORS

28%

Stuart Wolf, M.D. ASSOCIATE CHAIR OF CLINICAL INTEGRATION AND OPERATIONS

ASSOCIATE PROFESSORS

Regular Faculty Jeremy Marshall, MHA SENIOR DIRECTOR OF OPERATIONS AND STRATEGY 3

EDUCATING FUTURE LEADERS

“

Medical education does not exist to provide students with a way of making a living, but to ensure the health of the community.” — RUDOLF VIRCHOW

Education continues to grow, thrive and innovate in the Department of Surgery and Perioperative Care. Sixteen of our medical student graduates from the Class of 2021 entered competitive residencies in specialties within our department. Dell Med’s signature curriculum Advancing Care Transformation is now part of all residency programs, fostering leadership development and care transformation efforts across clinical programs. Our faculty members continue to model lifelong learning, including two of our junior faculty who participated in the Dell Medical School Junior Faculty Leadership Program, where they learned from McCombs School of Business leaders and alongside our Dell Med students. Measuring outcomes and iterating care to drive better outcomes that matter to patients are practices that keep growing throughout the clinical environment, allowing students, residents and faculty members to learn from our own clinical experiences.

Kimberly Brown, M.D., FACS ASSOCIATE CHAIR OF EDUCATION

EDUCATING FUTURE LEADERS

UNDERGRADUATE MEDICAL EDUCATION COVID RESPONSE The COVID-19 pandemic affected virtually every person in the world, including medical students and residents. Dell Med leadership sent students home from their clinical rotations in mid-March 2020, which disrupted clerkships, electives, ICU rotations and acting internships. The education team responded by first making sure students were all safe and healthy, followed by creating plans for finishing coursework and making up clinical experiences. All students in the Class of 2020 were able to complete their graduation requirements, and clerkship students made up lost clinical time during the summer and holidays. Many of the students helped

the Austin community through contact tracing and other volunteer efforts. The emergency medicine residents were right on the front line of COVID-19, caring for patients throughout the pandemic while working to keep themselves and their care teams safe. General surgery and orthopaedic surgery residents shifted workflows when elective cases were suspended, working in shifts to care for patients with emergency surgical needs and minimizing the number of residents in the hospital at any given time.

Pedro Teixeira, M.D., helps a student with vascular anastomosis training at the surgical skills lab. Photos by Shannon Southerland.

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Adapting to 2020 COVID-19 changed medical education in an instant. With hands-on simulation no longer possible because of COVID restrictions, for example, the emergency medicine clerkship for second-year medical students needed to rapidly adapt the curriculum. Sara Scott, M.D., the clerkship’s director, worked with the IT department at The University of Texas at Austin to have simulation software installed on a home laptop to allow for projection of patient monitor data over Zoom. She also incorporated online simulation resources, such as the Virtual Resus Room, which is an interactive, collaborative approach to online simulation education, to add realism to virtual cases. These adaptations allowed simulation education to continue in the emergency medicine clerkship despite the social distancing restrictions of the 2020-21 academic year.

GRADUATES PURSUING SURGICAL SPECIALTIES ORTHOPAEDIC SURGERY: • • •

at The University of Texas at Austin

GENERAL SURGERY: • • • •

The Growth Year Zach Timmons, Class of 2021, is in the emergency medicine residency program at UT Houston. For his signature “Growth Year” project during his third year at Dell Med, he decided to pursue the entrepreneur-in-residence program that gives medical students the opportunity to pursue an independent project either on their own or in collaboration with other teams in Austin, with the goal of giving students the skill set and experience to innovate on health through business. Early in his education at Dell Med, Timmons became passionate about addressing food insecurity in the community, a problem that affects 170,000 people in Austin. As a medical student, he was aware of the multitude of physical and mental complications poor nutrition can cause, which led him to co-found Good Apple, an Austin-based produce delivery service that provides a box of produce to a family facing food insecurity for every box of produce the company sells. The service has been a great success and recently received a $275,000 grant from Twitter CEO Jack Dorsey to continue funding their work.

Sanjiv Gopalkrishnan, M.D., Houston Methodist Hospital Harrison Miner, M.D., University of Oklahoma College of Medicine Laura Bashour, M.D., Dell Medical School

•

Frank Buchanan, M.D., Oregon Health & Science University School of Medicine Emmalie Berkovsky, M.D., University of Arizona College of Medicine Charlotte Heron, M.D., University of Colorado School of Medicine Lee Fuentes, M.D., Dell Medical School at The University of Texas at Austin Praveen Satarasinghe, M.D., Drexel University College of Medicine

EMERGENCY MEDICINE: • • • • •

Hannah Rosenthal, M.D., Creighton University School of Medicine Jameson Tieman, M.D., University of Miami, Jackson Health System Zack Timmons, M.D., University of Texas Medical School at Houston Kayla Nussbaum, M.D., Indiana University School of Medicine Emily Leede, M.D., University of Texas Medical School at Houston

UROLOGY: • •

Hannah Kay, M.D., University of North Carolina School of Medicine Pooja Srikanth, M.D., University of Minnesota Medical School

ANESTHESIA: •

Alex Wright, M.D., Stanford Medicine

EDUCATING FUTURE LEADERS

Zack Timmons, M.D., Good Apple’s co-founder, loads produce boxes for delivery

Laura Bashour, M.D., a member of Dell Med’s Class of 2021, obtained a Master of Arts in Design focused on Design in Health during her third year — a unique opportunity for medical students that is a key part of Dell Med’s Leading EDGE curriculum. The program brings together Dell Medical School, the UT Austin School of Creative Technologies, and Dell Med’s Design institute for Health to focus on identifying health system needs and implementing how systems change to design thinking. Design thinking is an iterative process that incorporates the stakeholder in the design of a solution to an identified problem. This collaborative process aims to develop solutions that are more easily adoptable for stakeholders. From this program, Bashour hoped to gain insight on the process and barriers involved in taking an idea and transforming it to an end product. Bashour participated in three separate projects: working with the Austin State Hospital to develop a security system; a Bill & Melinda Gates Foundation vaccine distribution project; and designing the UT Health Austin COVID19 drive-through testing sites. Bashour is excited to continue her education at Dell Medical School in the Orthopaedic Surgery Residency. She looks forward to being a part of a team that encourages growing physicians to transform the health care 8 | 2021 ANNUAL REPORT

system through excellence in surgical training and learn alongside mentors such as AJ Johnson, M.D., who actively advocate for diversity within the field of orthopaedic surgery. For her third-year research distinction project, Charlotte Heron, Class of 2021, analyzed data from the Texas Cancer Registry to understand how it could be used for predictive models that inform shared decision-making in cancer treatment. Through this work, Heron uncovered disparities in missing data between insured and uninsured patients, as well as significant differences in cancer outcomes between these groups. This project built on her prior experience working for an electronic health record company, giving her insights into how data quality starts from the moment information is captured in a system all the way through to how it is analyzed to drive change.

30% OF DELL MED’S CLASS OF 2021 MATCHED INTO DEPARTMENTAL SPECIALTIES FOR RESIDENCY

GRADUATE MEDICAL EDUCATION Emergency Medicine Services Fellowship The new Emergency Medicine Services Fellowship welcomed inaugural fellow Melissa Miller, M.D., in July 2021. Miller completed her emergency medicine residency at UT Austin in 2021 and is looking forward to working with the team at Austin-Travis County Emergency Medical Services led by affiliate faculty member and fellowship program director Mark Escott, M.D., and assistant program director Jason Pickett, M.D. As a female physician in a male-dominated specialty, Miller understands that diversifying emergency medicine raises the standards of care for all patients; she won the Health Equity Award at the department’s 4th Annual Research Symposium for her presentation titled: “Are there gender or racial disparities in EMS-administered sedation among patients in police custody?”

Residency Programs • General Surgery Residency • Categorical • Preliminary • Emergency Medicine Residency • Orthopaedic Surgery Residency Fellowships • Orthopaedic Value-Based Care Fellowship • Emergency Medicine Services Fellowship • Craniofacial & Pediatric Plastic Surgery Fellowship • The Joseph Miles Abell Jr., M.D., Clinical Fellowship in Orthopaedic Surgery

Emergency medicine resident and inaugural emergency medicine services fellow receives the 4th Annual Department of Surgery and Perioperative Care Equity Award.

https://www.acepnow.com/article/emergency-medicine-workforce-needs-women-physicians/

EDUCATING FUTURE LEADERS

Emergency Medicine Residency • Chris Wyatt, M.D. FACEP, Interim Program Director • Meghal Mehta, M.D. FACEP, PGY-2 Assistant Program Director • Shawn Wassmuth, M.D. FACEP, PGY-3 Assistant Program Director The Emergency Medicine Residency faced unprecedented challenges this past year, caring for patients on the front lines of COVID-19 in an environment that changed almost daily while trying to keep themselves and their families healthy. This group of physicians demonstrated extraordinary resilience and camaraderie in the face of so many unknowns and always put the needs of the patients first. During the severe winter storm experienced by Central Texas in February 2021, the few EM residents who had power and water hosted their fellow residents who lost power and water in their homes for days, and spouses with reliable transportation shuttled residents to and from the hospital safely, ensuring that all shifts were covered. Woody Green, M.D., PGY-1, worked for nine years as a paramedic with Austin-Travis County EMS before beginning medical school. He had always dreamed of being a doctor but wasn’t sure how to make it work. He was drawn to emergency medicine for its variety and intensity, but he felt clinically stifled as a paramedic, wanting to know and do more than his role allowed. The idea of medical school kept coming back year after year, but after Green’s daughter was born in 2012, he came to the realization that he couldn’t support her in going after her dreams if he didn’t model chasing his own. Green graduated in the inaugural class of Dell Med M.D.s and decided to stay with the Dell Med family by attending the Emergency Medicine Residency. Not only was Green grateful to have been able to keep his family in their established community during the COVID-19 pandemic, the EM Residency was 10 | 2021 ANNUAL REPORT

the perfect fit for his career goals. He completed a distinction in Design in Health during his time as a Dell Med undergraduate, with a focus on working with health care entities and using design principles to solve problems. Pursuing Dell Med’s unique Advancing Care Transformation curriculum as a resident felt like the next step in that journey. While not certain yet about the specifics of his distinction project, Green hopes to work on improved handoffs of Emergency Room patients back to the outpatient resources that care for them long term. Green is grateful for the EM Residency faculty and their support in helping him transition from a medical student to his new role as a physician, and he is looking forward to furthering his growth as an emergency medicine physician.

Woody Green, M.D., PGY-1, EM Distinction Resident and former paramedic

General Surgery Residency • Carlos V.R. Brown, M.D., FACS Program Director • Tatiana Cardenas, M.D., FACS Associate Program Director Residents in the General Surgery Program are often juggling far more than just their residency and clinical duties. No one this year is a better example than one of the fourth-year general surgery residents, Kristofor Olson, M.D., Ph.D. On the heels of welcoming his first child with his wife, Tara, in the past year, Olson was accepted to be the Brennan Visiting Resident at Memorial Sloan Kettering Cancer

Emergency Medicine 2021 residency graduation

Center. Olson sees his acceptance into this prestigious and highly sought-after program as the next step in his journey to becoming a surgeon scientist focusing on surgical oncology. On the research front, Olson published a letter in The New England Journal of Medicine this year titled “Penetrating Injuries from ‘Less Lethal’ Beanbag Munitions,” after the center’s clinical experience with these patients during the protests after the murder of George Floyd. Olson plans to apply for a surgical oncology fellowship, inspired by his belief in the “value in seeing the way things are done at different institutions, both in taking care of cancer patients and seeing how systems function, especially at a

Kristofor Olson, M.D., Ph.D. Photo by Shannon Southerland

high-volume institution.” He credits the Dell Med General Surgery Residency with allowing him the surgical volume and autonomy that helped him develop a robust clinical skill set and the confidence to safely care for patients. Olson also appreciates the support he received from the program to be able to navigate becoming a new parent, while providing quality clinical care, and publishing critical data in the most prestigious journal in the world. The department is excited to see where Olson’s dedication, grit and resilience lead him next!

Advancing Care Transformation Advancing Care Transformation is a signature Dell Med program that provides selected residents with an opportunity to engage in a nontraditional, interdisciplinary learning experience in health systems science. One of the rising chief residents in general surgery, Sabino Lara, M.D., was one of the first Dell Med residents to enroll in the program. The rigorous curriculum allowed him to work with leaders in the medical field to improve the current health care system with the goal of providing more efficient value-based care. He was able to collaborate with the Design Institute for Health and learn about the process of designing programs with the patient 11

CLINICAL CARE EDUCATING FUTURE LEADERS

General surgery chief residents, class of 2021: Andrew Harding, M.D.; Melanie Bobbs, M.D.; Joshua Crosby, M.D. Photo Shannon Southerland

in mind. In addition to that, he was able to go to the C-suite and see what it takes to run a hospital, a behind-the-scenes look that most residents don’t get to see. During his internship, Lara cared for diabetic patients undergoing lower extremity amputations with a fragmented and variable approach to care. To help solve this problem, Lara worked with the Division of Vascular Surgery to help establish a diabetic foot infection clinical pathway and limb salvage program. This new program works as a multidisciplinary integrated practice unit to better organize and coordinate care for patients with 12 | 2021 ANNUAL REPORT

diabetic foot wounds. Lara has worked to expand the program’s catchment area with a focus on informing primary care providers in Central Texas about the limb salvage program. Furthermore, he is working to develop educational materials to distribute to diabetic patients in the region, so they better understand their disease and opportunities to improve their outcomes. At the completion of his General Surgery Residency in the summer of 2022, Lara will be continuing his surgical education while pursuing a Plastic Surgery Fellowship at the University of Southern California.

Orthopaedic Surgery Residency •

•

Anthony “AJ’ Johnson, M.D., FAOA, FACS, FAAOS Program Director Austin Hill, M.D., MPH, FAAOS Associate Program Director

Bioskills Lab The Orthopaedic Surgery Residency is proud to announce the creation of the UT Austin Orthopaedic Surgery Residency’s Cadaveric Bioskills, Surgical Simulation, and Surgical Anatomy Curriculum. As an example of the real-world application of the unique leadership program, this curriculum was developed by James “JD” Spearman, M.D., inaugural academic chief

resident, with the oversight of Hilton Gottschalk, M.D. as faculty adviser. Structured as a progressive learning and teaching experience, the curriculum helps residents develop competency in basic surgical skills, surgical anatomy, surgical approaches and operative techniques. Residents undergo technical skill assessments by faculty members in a lower risk environment, gain exposure to orthopaedic implants and systems prior to the operating room, and learn to build professional relationships with industry representatives. As the curriculum progresses, residents have opportunities to improve as “residents as teachers” as they solidify their own learning by teaching the more junior residents.

Chase Romere, M.D., has his “horns up” while participating in the newly created UT Austin Orthopaedic Surgery Residency Cadaveric Bioskills, Surgical Simulation, and Surgical Anatomy Curriculum, along with fellow participants David Bruni, M.D., Mitch Rohrback, M.D., and JD Spearman, M.D., MBA. (Participants listed left to right.)

EDUCATING FUTURE LEADERS

Bimonthly cadaveric bioskills labs with adjunctive virtual simulation surgery stations rotate through the breadth of orthopaedic training, including trauma, sports medicine, hand, shoulder/elbow, total joints, foot and ankle, and spine. A full complement of curricular materials accompanies each session, including a review that outlines surgical approaches, relevant surgical anatomy, implant to be used and technique guide, and relevant literature. Spearman and the orthopaedic residency team have received overall positive feedback, and they have opened lanes for feedback of how labs can be improved further. The leadership skills Spearman is

gaining, in his role as the academic chief-resident, aim to provide real-world skills residents need to be innovative and groundbreaking physicians. The residency program looks forward to partnering with One World Surgery – Holy Family Surgery Center in Tegucigalpa, Honduras, for a six-week international elective. All PGY-4 residents will be offered the chance to attend the elective in person, but even those not attending will receive the Spanish-language training and FEMA Emergency Response Courses, and they will attend the program’s Humanitarian Mission didactic with interesting case presentations from Honduras.

One World Surgery – Holy Family Surgery Center, Tegucigalpa, Honduras. Pictured: Orthopaedic Residency Director, AJ Johnson, M.D., and local site director Merlin Antunez, M.D. 14 | 2021 ANNUAL REPORT

Elizabeth Duckworth, M.D., MBA, PGY-1, participated in three interdisciplinary collaborations with the Biomedical Engineering program at the UT Cockrell School of Engineering. These projects span the entire academic year and are a gateway for learners, both at Dell Med and at Cockrell, to work more closely with relevant faculty members and gain real-world exposure to the relationship between biomedical engineering and medicine. Duckworth has found these projects to create exciting opportunities and is grateful for the unique focus Dell Med places on multidisciplinary relationships, both within Dell Med and in the UT community as a whole, especially given the support needed from diverse faculty, saying, “It’s worth stating that all of these projects required financial buy-in from faculty who came up with the ideas, and I just want to say that I’m grateful to the faculty members in the department, more broadly, for supporting this kind of project and encouraging us to spend both time and put money where their mouth is in terms of encouraging these multidisciplinary projects. I think it’s a cool opportunity to get involved with a different type of research than what we traditionally do both in medical school and residency.”

THE BIOMEDICAL ENGINEERING SENIOR DESIGN TEAM

UT Biomedical Engineering students complete a design project for Elizabeth Duckworth, M.D., MBA, and assistant professor Matthew Ellington, M.D

CLINICAL CARE The clinical mission of the Department of Surgery and Perioperative Care is to develop and maintain a multifaceted clinical care program that engages all components of health care delivery — providers, health systems, financial entities and social systems — in a coordinated effort to provide integrated and patient-centered care that delivers value to patients. The delivery of clinical care is organized around ten clinical divisions. Some divisions have a specific focus, such as the Division of Transplant Surgery, while others encompass wide-ranging efforts, such as the Division of Surgical Specialties. The clinical care associated with the department is delivered in a variety of settings, including the clinics of UT Health Austin (the clinical enterprise of Dell Medical School), community-based clinical organizations, and facilities of the partner hospital system Ascension Seton.

Stuart Wolf, M.D.,FACS ASSOCIATE CHAIR OF CLINICAL OPERATIONS AND INTEGRATION

CLINICAL CARE

Strategic Clinical Goal Every year, the department’s Leadership Council sets strategic goals in various domains. The FY2022 goal for the clinical domain is “Build and disseminate systems to measure and improve value.” Its key deliverable is a playbook to support development of data tracking tools and dashboards across the department’s clinical programs, and measure the impact of the data tracking tools and dashboards. Project co-leads Nicole Turgeon, M.D., FACS, and Stuart Wolf, M.D., FACS, have interviewed leaders of department clinical programs and Ascension Seton about the current state of dashboards, barriers to optimal use of dashboards and desired future state. The council will use this information to help prepare and socialize the playbook document.

Figure: Average Length of Stay (Operation to Discharge)

Winter Storm Uri During the historic winter storms that left many Austinites without power and water in February 2021, department faculty members set up the UT Health Austin Ambulatory Surgery Center as a makeshift shelter. Employees at Dell Seton Medical Center at The University of Texas who could not safely make it home were given a safe, warm place to stay until conditions improved. This effort was recognized by UT Austin President Jay Hartzell and the university community at large as a great example of Longhorns helping Longhorns. Working together and supporting colleagues was a story repeated across the bridge at Dell Seton. The emergency medicine faculty, many of whom stayed at 18 | 2021 ANNUAL REPORT

the hospital for days to cover for those who could not safely make their shifts, were battling frozen pipes, loss of power and an influx of patients suffering injuries related to the storms.

UT Health Austin blanketed by the historic winter storms.

Ambulatory Surgery Center The UT Health Austin Ambulatory Surgery Center opened in early 2020, and the first operation was performed in September 2020. In the following months, the center gained accreditation by the Accreditation Association for Ambulatory Health Care, Centers for Medicare & Medicaid Services, and the Texas Health and Human Services Commission. The center is multispecialty: As of May 31, 2021, procedures had been performed by 20 physicians in seven service lines (gynecology, surgical oncology, ophthalmology, orthopaedics, urology, gastroenterology and plastic surgery). The center recently began to offer more advanced procedures such as major laparoscopic surgery and imaging-directed cancer surgery. Plans for expansion include new service lines, a total joint program and offering overnight stays after selected procedures.

UT Health Austin opens the new Ambulatory Surgery Center

Acute Care Surgery • Carlos V.R. Brown, M.D., FACS Division Chief The Division of Acute Care Surgery is excited to begin developing its Surgical Critical Care fellowship. The program will be led by Marc Trust, M.D., and the inaugural fellow will start in August of 2023. This will provide surgeons with advanced training in the care of critically ill and injured patients with a vast array of acute, life-threatening conditions. Fellows will be trained in multisystem stabilization of pathophysiologic changes resulting from insults such as trauma, burns, sepsis and perioperative complications, to name a few. Housed primarily at Dell Seton Medical Center at The University of Texas, in addition to training in the surgical intensive care unit, fellows will be offered experiences from robust operative services such as acute care surgery, burns, and other growing programs such as vascular and transplant surgery.

Trauma surgeon and assistant professor Marc Trust, M.D.

Along with the excellent clinical training, the curriculum will highlight Value-Based care principles, and incorporate the Master of Science in Health Care Transformation into the fellowship. This program is offered by the Value Institute for Health and Care, a unique collaboration between Dell Medical School and the McCombs School of Business and provides students with the knowledge and guidance to increase health care value. Fellows would complete the training program with all the necessary skills and tools to make a meaningful impact throughout their careers.

Anesthesia and Perioperative Medicine • Thomas Vetter, M.D., MPH Division Chief • Erik Pronske, M.D. Assistant Division Chief During the COVID-19 pandemic, attending anesthesiologists at U.S. Anesthesia Partners-Texas (Central) (formerly, Capitol Anesthesia Association) have made a major contribution to the collaborative efforts at the network of Ascension Seton hospitals in managing the surge of critically ill patients in Greater Austin and Central Texas. Many of these attending anesthesiologists are faculty members in the Division of Anesthesia and Perioperative Medicine. Their efforts reflect not only a tremendous professionalism but also the vital additional roles anesthesiologists can play in health care. The Perioperative Surgical Home (PSH) is an innovative program that seamlessly coordinates and integrates care for the patient through every phase of the surgical experience – from preoperative, intraoperative, postoperative to post-discharge from the hospital. The innovative, hybrid Perioperative Surgical Home model is a coalition among Ascension Texas, USAP-Texas (Central), SOUND and Dell Medical School. Perioperative Surgical Home clinics are currently located at four Ascension Seton hospitals in Central Texas, with 19

CLINICAL CARE a fifth clinic to be opened soon at the Dell Seton Medical Center at UT Austin. In collaboration with her surgical, hospitalist, and nursing colleagues, Marissa Mery, M.D., is working to better understand the sequelae and consequences of critical injury and illness, including functional outcomes, cognition and financial stress. Her goals are not only to better understand these long-term adverse outcomes in surgical patients, but also to develop strategies to mitigate them, thus allowing surviving, post-ICU patients to lead fuller lives.

PEDIATRIC CARDIOVASCULAR ANESTHESIOLOGY TEAM

Erin Gottlieb, M.D., MHCM

Anthony Zapata, M.D.

20 | 2021 ANNUAL REPORT

Under the direction of Garrett Scales, M.D., the faculty in the Division of Anesthesia and Perioperative Medicine continues to provide the MS2 and MS4 students at Dell Medical School with outstanding clinical teaching and learning. Most of the faculty members are clinically practicing, so they have a practical, real-world perspective on anesthesiology, which the medical students greatly appreciate. An advanced MS4 elective in anesthesiology will be offered starting in July 2022. This advanced elective will provide those students planning to pursue an anesthesiology residency with an intensive, in-depth experience in the specialty. Erik Pronske, M.D., assistant chief of anesthesia and perioperative medicine, along with Thomas Vetter, M.D., MPH, chief of anesthesia and perioperative medicine, have developed a roster of outstanding opportunities for the division’s affiliate faculty members to engage in a variety of pragmatic scholarly activities. The broad scope of these scholarly activities spans clinical care, education, research and healthscape (the places where people live, learn, work and play): the four pillars of the Dell Medical School and the Department of Surgery and Perioperative Care. Pediatric cardiovascular anesthesiologists in the Texas Center for Pediatric and Congenital Heart Disease (TCPCHD) led by Chief of Pediatric Cardiac Anesthesiology Erin Gottlieb, M.D., MHCM, have been expanding their program to meet the needs of patients in Central Texas and beyond. With the center now providing expanded services including heart transplant, Gottlieb and assistant professor Anthony Zapata, M.D., look forward to assistance from additional specialized anesthesiologists to complement these new services in the coming year.

Clinical Innovation and Design In the 2020/2021 school year, the Texas Center for Pediatric and Congenital Heart Disease partnered with the Clinical Innovation and Design program, a nine-month team-based program for the students at Dell Med School and UT’s Cockrell School of Engineering. Shelly Sakiyama-Elbert, Ph.D., chair of biomedical engineering at the Cockrell School of Engineering, and Carlos Mery, M.D., MPH, the director of health transformation and design in congenital heart disease, are the director and co-director for the program that serves as a distinction or M.D./Master in Science in Engineering dual degree for third-year medical students and fulfills course work for fifth-year undergraduate students seeking a dual degree (B.S. in Biomedical Engineering/M.S. in Engineering). Zaria Jackson, Dell Children’s first Berlin Heart pump recipient, with her mother, Olivia Gunthrie.

Cardiothoracic Surgery • Charles D. Fraser, Jr., M.D. Division Chief The division had several exciting firsts during the past year after beginning its pediatric heart transplant program. The program performed the first pediatric heart transplant in Austin in October 2020 in an 18-year-old patient. Also in January 2021, baby Zaria Grace Jackson became the first child to receive a Berlin Heart pump while she awaited a heart transplant, which was performed in March. In addition, the division recruited Ziyad Binsalamah, M.D., surgical director of pediatric heart transplantation and mechanical circulatory support for the program.

The program culminated on May 10, 2021, when students Hayley Meier (M.S. Biomedical Engineering), Morgan F. Gaither (Dell Med/M.S. Biomedical Engineering), Kayli Kallina (Dell Med/Distinction) and Raghave Upadhyaya (M.S. Computational Science, Engineering, and Applied Mathematics) presented their clinical immersion, design thinking and prototyping experience to a group of guests and panelists who are experts in

Clinical Innovation and Design Program Team at their May 2021 Symposium.

CLINICAL CARE the field of innovation and design with medical devices. Tom Krummel, M.D., Van Truskett, Ph.D., and John Uecker, M.D., generously volunteered their time, suggestions and tough questions to help this team think about the next steps in device development and “to-market” concepts.

Emergency Medicine • Nicholas Steinour, M.D., FACEP Division Chief The Emergency Medicine (EM) team faced some unusual challenges this past year. Although overall hospital admissions were up, the emergency department saw volumes well below traditional pre-COVID numbers. This, along with concerns from residents about the amount of patient exposure they were getting, and the nature of the teaching as attendings were providing direct patient care and feedback from former residents about graduation and being unprepared to work with Advanced Practice Providers, integral to Emergency Department (ED) functioning in many places, prompted some updates to the ED staffing model. The team adjusted attending staffing to fit national averages of productivity in terms of patients/hour; moved from pod staffing to team staffing so that each attending has a team that includes APPs, interns, and upper-level residents; and rewrote the resident schedule for more consistent staffing across the department. This caused attending productivity to increase by over 40%. Residents, previously seeing about 30% of ED patients registered at Dell Seton, saw about 80% of patient encounters. Despite increases in productivity, the enhanced resident coverage allowed attendings to have more time to teach. They reported feeling less pressured during many of their shifts and accomplished more patient care with the same amount of pressure. Residents reported that they saw more patients, participated in more procedures, and received better 22 | 2021 ANNUAL REPORT

comprehensive teaching throughout the day.

Minimally Invasive Surgery • John Uecker, M.D., FACS Interim Division Chief The Minimally Invasive Surgery Division is excited to announce the new Digestive Health Institute, a clinical partnership between UT Health Austin and Ascension Seton. Digestive Health combines GI surgery, gastroenterology, integrated behavioral health experts, dieticians and medical researchers into a single integrated practice unit (IPU) to provide comprehensive and truly integrated care. The Digestive Health team, led by medical director and Dell Medical School’s chief of gastroenterology and hepatology, Deepak Agrawal, M.D., MPH, and surgical director F. Paul “Tripp” Buckley, M.D., has the ability to provide the most advanced treatments available to patients in Central Texas and beyond with a focus on patient-centered outcomes, cuttingedge research, and medical education. With over 10 M.D.s, five PAs/NPs, dieticians, social workers, an ostomy nurse, two complete esophageal labs, EndoFlip, PillCam, Fibroscan, CellVizio, and an on-site imaging center, Digestive Health embodies multidisciplinary, specialized care in a single location with the focus on patients from Texas and beyond.

Orthopaedic Surgery • Karl Koenig, M.D., M.S., FAOA, FAAOS, FAAHKS Division Chief • Brannan Smoot, M.D., Assistant Division Chief

Immersion Program in Value-Based Health Care Due to travel restrictions resulting from the pandemic, the Immersion Program in ValueBased Health Care transitioned from on-site to virtual. Individuals from across the nation were able to attend the program, and with a room of providers, payors and policy advocates, it was

ORTHOPAEDIC SURGERY RETREAT

Guests in the Immersion Program in Value-Based Health Care participate in a discussion with David Ring, M.D., Ph.D., on comprehensive care of musculoskeletal symptoms.

no surprise to see lively discussion about the stakeholder requirements to change the health care landscape. A new addition to the program was a cost and pricing workshop, which included a case to introduce participants to time-driven activity-based costing. Other sessions included a presentation on patient-reported outcome measures, and how to approach contracting for value-based health care. This two-day program is offered quarterly, and inquiries can be sent to dellmedsurgery@austin.utexas.edu.

The Orthopaedic Surgery Division hosted its 2020 divisional retreat as a hybrid meeting, hosting faculty members both in person and virtually. This was the first hybrid meeting hosted not only by the department, but at Dell Medical School since the COVID-19 pandemic began. The division was able to experience much needed in-person camaraderie, received a full report on the state of the residency by Anthony “AJ” Johnson, M.D., and Austin Hill, M.D., worked in small groups to share teaching challenges and successes, and worked together to establish goals for the division during the next year. The hybrid model was very successful, with 32 faculty attending between the in-person and virtual options, as well as two resident representatives, paving the way for innovation in how the future of meetings will look in a post-pandemic world, both for the department and for the rest of Dell Med

Value-Based Health Care Award The department is proud to announce that the UT Health Austin MSK Institute won the Value-Based Healthcare Center Europe 2021 Patient Outcomes Award in acknowledgment of the high-value, teambased “Whole Person Care” and education for patients with joint pain, including the underserved and vulnerable local community, financed by a bundle payment. The institute was selected from over 60 nominations for this international recognition and is a groundbreaking example of what integrated practice units and value-based health care can achieve.

CLINICAL CARE

Pediatric Surgery • Nilda Garcia, M.D., FACS Division Chief • Jessica Naiditch, M.D., FACS, FAAP Assistant Division Chief

Pectus Excavatum and Carinatum Program The Pediatric Surgery Team expanded several key clinical programs this year at Dell Children’s Medical Center. Under the leadership of Erich Grethel, M.D., FACS, the team established a new multidisciplinary pectus excavatum and carinatum program to provide the best care of patients with chest wall deformities. The team took the model of Enhanced Recovery After Surgery (ERAS) techniques that have improved surgical outcomes in other procedures and developed a pectus pathway to improve postoperative pain control, encourage early mobility, and decrease hospital length of stay in pectus patients, optimizing care before, during and after surgery. Advancement in surgical techniques and pain control at Dell Children’s Medical Center has decreased the amount of time patients stay in the hospital after surgery and have improved comfort, even with less need for pain medications in the hospital and after discharge.

Pediatric Bowel Management Program Ankur Rana, M.D., leads the Pediatric Bowel Management Program for children with severe constipation and/or fecal incontinence. Causes include congenital conditions, constipation and issues with muscle weakness or injury. This multidisciplinary program brings together more than five subspecialties to improve quality of life and self-esteem for patients through predictable bowel movements.

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The cochlea is a hollow, spiral-shaped bone found in the inner ear that plays a key role in the sense of hearing and participates in the process of auditory transduction. Sound waves are transduced into electrical impulses that the brain can interpret as individual frequencies of sound.

Hearing Center Under the leadership of Corrie Roehm, M.D., FAAP, the Hearing Center is the only pediatric multidisciplinary hearing center in Central Texas. The center offers advanced pediatric hearing services including cochlear implants and comprehensive care for children with hearing impairment to improve communication and connection for patients, both with their families and the world around them. The unique care team approach includes otolaryngology, audiology, speech therapy, social work and psychology. The center is focused on whole person care and helping families better understand the process and feel empowered in their decision making. The team plans to expand their services throughout other locations in Austin, offering increased access for patients in the community.

Surgical Oncology • Richard Fleming, M.D., FACS Division Chief In March 2020, the Surgical Oncology Division opened UT Health Austin‘s newest subspecialty clinic, the Complex General Surgical Oncology Clinic. This clinic, led by medical director and division member Alex Haynes, M.D., and staffed by Haynes; Kimberly Brown, M.D.; Declan Fleming, M.D.; and Diana Mendoza, PA-C, helps to address the needs of adult patients affected by a wide variety of cancers including melanoma and sarcoma, liver, pancreas, esophagus, gastric, colon and rectal cancers, as well as neuroendocrine tumors. The team partners with colleagues in the Livestrong Cancer Institutes at UT Health Austin, which includes specialists in medical oncology, nutrition, genetic counselling, psychiatry, social work, symptom management and wellness to provide advanced, comprehensive, whole-person care.

Alex Haynes, M.D., is ready to perform surgery in the Ambulatory Surgery Center.

In addition to direct patient care, team members continue to serve in leadership roles in the comprehensive multidisciplinary Cancer Treatment Planning Conferences for breast cancer, cutaneous malignancies, hepatobiliary and gastrointestinal cancers led by Livestrong Cancer Institutes, Ascension Seton and ARA Diagnostic Imaging Group, helping to review and develop advanced, coordinated plans of care for patients affected by these cancers.

Kinesiology and Health Education in the College of Education, the Department of Nutritional Sciences in the College of Natural Sciences, and the School of Nursing this next year.

Finally, research around the use of prehabilitation, or the focus on better equipping patients to recover and thrive after their surgical procedures, is ongoing. The work employs smartphone technology to better assist in monitoring and improving patient recovery after complex surgical procedures. Researchers are working to initiate a clinical trial partnering with members of the Department of

• Plastic Surgery

Surgical Subspecialties • Stuart Wolf, M.D., FACS Division Chief

Areas of focus: • Otolaryngology • Urology Most of the 15 surgeons in the plastic surgery division of the Surgical Subspecialties division play a substantial role in resident and student education. The most exciting development during the past 25

CLINICAL CARE

year is the formation and evolution of the Austin Plastic Surgery Research Group, which began as a collaboration between a few attending physicians and students interested in plastic surgery. In less than a year, the group has gained dozens of members and research projects. There is a multilevel student leadership structure that ensures perpetuation of the group and ongoing projects. Research was mostly clinical at first but is evolving to include some basic research projects and systems research. Productivity has been very gratifying, with multiple presentations at national and local meetings, and numerous papers published and in the pipeline. The urology section of the Division of Surgical Subspecialties was proud to welcome a new team member in 2020 with the recruitment of Aaron Laviana, M.D., MBA. Laviana is a urologic oncologist who specializes in bladder cancer, kidney cancer, prostate cancer, testicular cancer, penile cancer, complex kidney surgery and robotic surgery. Laviana has a particular interest in health economics and systems engineering and utilized his MBA to further investigate and improve upon the operational side of medicine. Laviana is pivotal in orchestrating the initiation and expansion of multiple cancer-related treatment protocols and integrating evidence-based medicine into clinical pathways. A notable accomplishment of the otolaryngology section of the Division of Surgical Subspecialties was solving the challenge of providing safe tracheotomy care to patients suffering from severe COVID-19 infections. The faculty members remain

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New urologic oncologist and assistant professor Aaron Laviana, M.D.

very engaged in teaching medical students through popular two- and four-week elective rotations. With the clinical diversity among faculty members, these rotations are customized to the interests of each student. Finally, the otolaryngology faculty members host a workshop that teaches shared decision-making in surgery through a dual role-playing exercise, in which students act as patient and physician in various scenarios, during the second-year surgery clerkship.

Dell Seton Medical Center Surgery Team

Transplant Surgery • Nicole Turgeon, M.D., FACS Division Chief The Transplant Program, led by Nicole Turgeon, M.D., FACS, had a busy year ramping up for launching programs at both Dell Children’s Medical Center and Dell Seton Medical Center. Dell Children’s Kartik Pillutla, M.D., is the medical director for the pediatric program, and the adult program has hired Medical Director Brian Lee, M.D. Both programs recently received approval on their UNOS applications. The programs continue to build out their teams through several recruitment and hiring initiatives. In the coming year, the programs are looking forward to officially opening and are on schedule to begin offering transplant services in fall 2021.

Adult Transplant Medical Director Brian Lee, M.D.

RESEARCH PROGRAMS Despite the extraordinary events of the past year, the Department of Surgery and Perioperative Care’s research efforts continue to grow. With the addition of new faculty members, the extramural funding portfolio has expanded and diversified, and the department continues to hone its focus on highly clinically relevant research, supporting the missions of the department, Dell Medical School and The University of Texas at Austin.

Alex B. Haynes, M.D., MPH, FACS ASSOCIATE CHAIR OF INVESTIGATION AND DISCOVERY

RESEARCH PROGRAMS

RESEARCH HIGHLIGHTS PCORI Engagement award Carlos Mery, M.D., MPH, was awarded a PatientCentered Outcomes Research Institute (PCORI) Engagement award for his project titled “Advancing Research in Coronary Anomalies Through Capacity Building and Community Engagement.” The capacity building engagement awards seek to support projects that help communities increase their ability to participate in patient-centered outcomes research and comparative effectiveness research. This two-year award involves collaboration with Boston Children’s Hospital, Children’s Hospital of Philadelphia and Texas Children’s Hospital.

Carlos Mery, M.D., MPH, with a pediatric patient.

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Artificial intelligence-enhanced shared decision making Researchers led by Prakash Jayakumar, M.D., Ph.D., and Kevin Bozic, M.D., MBA, conducted a randomized controlled trial of a new decision aid (“Joint Insights”) for patients considering total knee arthroplasty. The decision aid uses patient-reported outcomes and patients’ demographic and clinical data to generate personalized estimates of their likelihood of benefiting or experiencing risks from the procedure. This report is meant to be used by patients and their clinicians during shared decision-making discussions about the best treatment option for them. In addition to the benefit-risk report, the decision aid includes an education module, values clarification

exercises and a knowledge assessment. The study, published in JAMA Network Open, showed that patients who received the decision aid had higher decision quality, higher levels of shared decision making and satisfaction, and improved functional outcomes compared with patients who received only educational materials. The team received an R21 award from the Agency for Healthcare Research and Quality (AHRQ) to continue this work. The decision aid will be integrated into the electronic health record at Dell Med and rolled out to a second orthopaedic clinic at the UT Health Science Center at San Antonio.

NEW FACULTY The department added several new junior faculty members with research effort during the past year. • Aaron Laviana, M.D., MBA, joined Dell Medical School from Vanderbilt University, where he completed a fellowship in urologic oncology and a Masters of Business Administration. His research interests lie in health economics including the patient economic burden of urologic cancers. • Lucas Ferrer Cardona, M.D., completed a fellowship in vascular surgery at Baylor College of Medicine and spent two years on the faculty at UT San Antonio before joining Dell Med in September 2020. His research interests are in deep vein arterialization and limb salvage.

Prakash Jayakumar, M.D., Ph.D.

• Ziyad Binsalamah, M.D., MSc, joined Dell Med from Baylor College of Medicine, where he completed a congenital heart surgery instructorship. He joined the Texas Center for Pediatric and Congenital Heart Disease, where he is the surgical director of pediatric heart transplantation and mechanical circulatory support. Binsalamah’s academic interests include clinical outcomes research, heart failure and basic science research.

RESEARCH PROGRAMS

“Less lethal” ammunitions study Like much of the nation, Austin saw an outpouring of support for social justice causes during the summer of 2020, and some demonstrators were injured in the large gatherings. Particularly troubling was an influx of injuries associated with "less-lethal" munitions used by law enforcement — colloquially known as "beanbag rounds." Several patients arrived at the emergency department with serious, life-threatening beanbag injuries. Emergency medicine faculty members worked with the Division of Acute Care Surgery and Dell Seton’s trauma service to quickly inventory and catalog these injuries, and to publish a case series in The New England Journal of Medicine that has helped expose the risks associated with using less-lethal munitions in crowd-control settings, describing

penetrating injuries from “less lethal” beanbag munitions.[i] The letter describes the number and nature of injuries sustained by people taking part in protests against racial injustice in Austin who arrived at Dell Seton (the closest Level 1 trauma center to the protests) over two days. The letter describes injuries, treatment and outcomes for 19 patients whose injuries ranged from penetrating soft-tissue injury to skull and facial fractures. The authors concluded that although beanbag rounds are supposed to be “less lethal” munitions that should not cause penetrating injuries, these munitions can cause serious harm and are not appropriate for use in crowd control. Olson KA, Haselden LE, Zaunbrecher RD, et al. Penetrating injuries from “less lethal” beanbag munitions. N Engl J Med 2020;383:1081-1083.

Pictured left to right: Kristofor Olson, M.D., Ph.D., general surgery resident, and Laura Haselden, M.D., emergency medicine resident, are the lead authors of the research paper.

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MS3 RESEARCH DISTINCTION STUDENTS Dell Medical School’s Leading EDGE curriculum allows third-year students the option of completing a Distinction in Discovery and Investigation project. Department of Surgery and Perioperative Care faculty members mentored five of the nine Dell Med third-year medical students who pursued a research distinction for the 2020-21 academic year.

STUDENT: Catherine Dawson

STUDENT: Yousef Nofal

PROJECT: “Utilizing Time-Driven—Activity Based Costing (TD-ABC) to evaluate the pre-operative course, resource utilization, and cost for children undergoing Atrial or Ventricular Septal Defect surgical repairs.”

PROJECT: “Influence of Psychosocial Factors on Changes in Quality of Life Following Laparoscopic Anti-Reflux Surgery.”

MENTOR: Carlos Mery, M.D., MPH (Cardiothoracic Surgery)

MENTOR: F.P. “Tripp” Buckley, M.D., FACS (Minimally Invasive Surgery)

STUDENT: Emilio Ramos

STUDENT: Dayal Rajagopalan

PROJECT: “Comparing the use of Whole Blood vs. Component Blood Therapy in a Massive Transfusion Protocol.”

PROJECT: “Do Surgeons have a Preference for the Biomedical Model of Medicine over the Biopsychosocial Model of Medicine?”

MENTOR: Carlos Brown, M.D., FACS (Acute Care Surgery)

MENTOR: David Ring, M.D., Ph.D. (Orthopaedic Surgery)

STUDENT: Marielle Ngoue PROJECT: “Variation in Sedation between Day and Night time in Ventilated Trauma Patients in the ICU.” MENTOR: Carlos Brown, M.D., FACS (Acute Care Surgery)

RESEARCH PROGRAMS

Annual Research Symposium The department’s 4th Annual Research Symposium was held April 23, 2021. More than 100 people attended the symposium, which was held virtually for the second year in a row. Zara Cooper, M.D., MSc, an acute care surgeon, trauma surgeon and surgical intensivist from Harvard Medical School, attended as a visiting professor. Cooper presented her work on surgical palliative care and then led the question-and-answer sessions after the 22 presentations and 25 narrated e-posters from students, residents and faculty members conducting research. If you missed the symposium, you can view the recording of the abstract presentations and narrated e-posters online.

4TH ANNUAL RESEARCH SYMPOSIUM AWARD WINNERS • Health Equity Award: Melissa Miller, M.D., et al. for “Are there gender or racial disparities in EMS-administered sedation among patients in police custody?” • Value Award: Catherine Dawson et al. for “Evaluating Variation in Preoperative Care for Children Undergoing Atrial or Ventricular Septal Defect Repair” • Best Student Presentation: Eugenia Lin for “Patient-Perceived Involvement in Shared Decision-Making Does Not Align with Provider-rated Involvement” • Best Resident/Postdoc Presentation: Mary Bokenkamp, M.D., for “Agitation in the Trauma Bay as an Early Indicator of Severe Injury and Hemorrhagic Shock” • Best Poster: Simin G. Roward, M.D., for “Does BiPAP Affect Intubation Rates in Trauma Patients with Acute Respiratory Failure?”

Zara Cooper, M.D., MSc, presented research at the department’s 4th Annual Research Symposium.

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COMMITMENT TO DIVERSITY, EQUITY AND INCLUSION The Department of Surgery and Perioperative Care’s Diversity, Equity and Inclusion Committee continues to work on its four focus areas: • Fostering an inclusive culture and environment • Promoting diversity in recruitment and hiring • Using an equity lens in clinical care and research • Creating a structure of accountability and responding to issues and complaints The committee identified a gap in Dell Med and university-wide resources for addressing microaggressions — defined as “brief and commonplace verbal or behavioral indignities that communicate negative attitudes toward marginalized groups” — and created a mechanism for raising concerns and addressing microaggressions featured on the committee’s web presence. The effort is meant to encourage conversation around these types of comments and behaviors, creating opportunities for learning and growth, building a more inclusive culture. Committee members participate in all departmental search committees for new faculty members. Their participation has allowed the department to keep the many values of diverse voices and representation front and center in the hiring process.

Alisha White, M.D. COMMITTEE CHAIR

HEALTHSCAPE Dell Medical School’s fourth pillar, healthscape, seeks to advance innovations that improve health in the landscape of people’s lives. Combined with other mission pillars in clinical care, research and education, the work in the healthscape creates an organizational structure that supports and promotes innovations that advance health outside the clinic using the strengths of an academic medical center. The department seeks to deepen its commitment to — and raise awareness of — its healthscape work in the coming year. Each division is also identifying existing areas that align with the pillar and new opportunities to further develop related work within their division by applying a community lens to the clinical, research and education programs. 35

IMPACT OF PHILANTHROPY

IMPACT OF PHILANTHROPY During the 2020-21 fiscal year, donors invested more than $3.24 million in the Department of Surgery and Perioperative Care in support of the bold work in research, community-focused outreach and clinical care. Now more than ever, philanthropy is propelling the department to great heights.

Some of the earliest supporters, such as Mary Abell and Paula and Thomas Coopwood, planted the seeds for growth. Through the Joseph Miles Abell, Jr., M.D. Clinical Fellowship in Orthopaedic Surgery, passionate young physicians are chosen to join Dell Med to contribute to the growth in orthopaedic care and research. The Dr. Thomas B. Coopwood Service Award for Excellence in Surgery and Perioperative Care allows Dell Med to honor physicians who exemplify service that strengthens the community’s health. These early supporters continue to inspire and fund vital work. The department is grateful to them and to new partners such as the Bass Family Foundation for their transformative philanthropy to the department.

The Bass Family Foundation: 360-Degree care at the Musculoskeletal Institute In March 2021, the Bass Family Foundation made a generous gift of $2.26 million to validate and further develop the department’s unique 360-degree care model to meet patients’ physical, emotional and social needs. Thanks to the Bass family, leaders in the UT Health Austin Musculoskeletal Institute will conduct a three-year study in which researchers will evaluate care and alternative payment models for patients with osteoarthritis to improve patient outcomes based on their individual goals. This gift 36 | 2021 ANNUAL REPORT

will fund new tools and technology and will support personnel, data collection and analysis for the research — helping the department define better value-based models of care with the potential to transform health care policy nationally.

Thomas B. Coopwood Award The department was proud to announce Christopher Ziebell, M.D., FACEP, as the 2020 winner of the Thomas B. Coopwood Service Award. This award is given in honor of the legacy of Thomas B. Coopwood, M.D, who served as the chief of surgery and chief of staff at the University Medical Center Brackenridge and as president of the Travis County Medical Society. Coopwood skillfully and tirelessly cared for thousands of patients and helped train hundreds of surgical residents. Candidates for this award are chosen based on their demonstrated commitment to excellence and leadership in clinical service, education and community service. Ziebell was chosen as the 2020 winner because he intentionally practices on the front line of care for the underserved and underprivileged people of Travis County at the Dell Seton Medical Center at The University of Texas. He is an outstanding educator, not only of trainees but colleagues. He is a tireless advocate for patient care, frequently visiting the Capitol and speaking with public policy officials on behalf of patients, many of whom cannot speak for themselves. He is the change-maker that drove the creation of academic

emergency medicine in Austin and continuously raises the bar for emergency medicine, the point of access to care that the Travis County community depends upon. He is the type of systems thinker who embodies Dell Med’s “rethink” philosophy to health care. The 2020 Award was presented virtually by Kenneth Mattox, M.D., FACS, a Distinguished Service Professor at Baylor College of Medicine and chief of staff and surgeon-in-chief at Ben Taub Hospital. Mattox helped develop the internationally

The 2020 winner of the Thomas B. Coopwood Award, Christopher Ziebell, M.D., FACEP

renowned Ben Taub Hospital Emergency Center and its equally respected trauma center. His reputation as an innovator in trauma care is known worldwide, and he championed indigent care in Houston and trained thousands of doctors, embodying the values of community service and clinical excellence celebrated in the Thomas B. Coopwood Service Award. As he’s announced his retirement this year after 60 years of teaching, research and patient care, the department is proud to have been able to host him and honor his legacy.

Virtual Guest and award presenter Kenneth Mattox, M.D., FACS

IMPACT OF PHILANTHROPY

MAKE YOUR IMPACT Philanthropy to the Department of Surgery and Perioperative Care can come in many different shapes and sizes, but all forms of philanthropy allow the department to continue the important work in treating and caring for the community. The department plays a critical role in realizing Dell Med’s mission: to revolutionize how people get and stay healthy, and the work detailed in this report is a direct result of the researchers, faculty members, physicians, patients, community partners and their passion for changing the world through health care. Please consider joining the family of supporters by making a gift to the department in a way that is most meaningful to you. If you’d like to explore opportunities to get involved, please contact the Office of Development at dellmedgiving@austin.utexas. edu or 512-495-5027.

giving.utexas.edu/surgery21

EDITORIAL TEAM Kate DiMaggio, Senior Editor Dory Thompson Melanie Montoya Jeremy Marshall Lauren Uhler Celeste Campbell

GRAPHIC DESIGN Greg Hitchens

DEPARTMENT OF SURGERY AND PERIOPERATIVE CARE

DELL MEDICAL SCHOOL AT THE UNIVERSITY OF TEXAS AT AUSTIN Health Discovery Building 6.708A 1601 Trinity St., Bldg. B Austin, Texas 78712 512-495-5089 dellmedsurgery@austin.utexas.edu dellmed.utexas.edu/surgery