Medicine and Health Sciences Commons^™

Hannaford Center For Safety, Innovation & Simulation 2023 Annual Report, Mainehealth

Annual Reports

In this 2023 Annual Report, you will see that combination of cutting-edge technology, a talented team, and the shared drive to improve health care for patients makes the Sim Center a fantastic resource for our system.

Optimizing Psychological Safety: Using A Focus Group To Acquire Perspectives From Standardized Patients Who Identify As Lgbtq+, Brandy Brown, Rachel Kupferman, Bethany Rocheleau, Christine Mallar, Karissa Hannifan, Beth Gray, Victoria Hayes, Leah Mallory

Journal of Maine Medical Center

Introduction: Gender and sexual minority (lesbian, gay, bisexual, transgender, questioning; LGBTQ+) patients report poor health care experiences, partly because health care providers are not trained to meet their needs. Simulation can help learners practice competencies related to diversity, equity, and inclusion, but there are psychological safety considerations when recruiting standardized patients (SPs). Our objective was to incorporate the expertise of members of the LGBTQ+ community in our SP pool as we developed related curriculum.

Methods: All SPs were invited to participate in a focus group if they identified as LGBTQ+ and wanted to contribute. Content experts developed a focus group …

Improving Inclusive Communication: Pilot Results From A Simulation-Based Learning Opportunity To Practice Taking A Sexual Health History, Rachel Kupferman, Beth Gray, Bethany Rocheleau, Christine Mallar, Karissa Hannifan, Victoria Hayes, Leah Mallory, Brandy Brown

Journal of Maine Medical Center

Introduction: Sexual and gender minority (lesbian, gay, bisexual, transgender, questioning; LGBTQ+) patients experience health care inequities. Simulation using standardized patients (SPs) is an effective tool for communication-based training. To promote equitable practice, we created an experiential learning opportunity for residents to practice inclusive communication and improve their comfort in caring for LGBTQ+ patients while maintaining the psychological safety of SPs.

Methods: Our interdisciplinary team explored relevant simulation curricula, conducted a focus group with LGBTQ+ SPs, created a didactic presentation, and designed and implemented a simulated case. Family medicine residents participated in the training and completed pre- and post-training surveys rating …

Developing An Interprofessional Community Psychiatry Rotation Using An Assertive Community Treatment Team Model: A Preliminary Evaluation, Ruth Frydman

Journal of Maine Medical Center

Introduction: There is a shortage of psychiatric providers trained to work in community settings with people with serious mental illness (SMI) and associated comorbidities. We designed an innovative psychiatry rotation and curriculum for psychiatry residents and other learners.

Methods: The rotation incorporates working with our Assertive Community Treatment team and includes home visits, assertive outreach, and visits in other community settings. It was designed to improve learners’ confidence in their understanding and skill set for working with and treating people with SMI in the community on an interprofessional (IP) team. This pilot quality improvement project evaluated psychiatry resident responses to …

The Academy At Mite Report Of Activities 2022, Mmc Institute For Teaching Excellence

Journal of Maine Medical Center

No abstract provided.

Simulation-Based Resuscitative Transesophageal Echocardiography Training For Emergency Medicine Residents, August Felix, Andrew Fried, Jessica Hathaway, Tania D. Strout

Costas T. Lambrew Research Retreat 2023

Introduction: Resuscitative TEE is an emerging tool in the cardiac arrest tool-box, and can improve outcomes in OHCA.

• Identifies reversible causes

• Decreases time off chest

• Evaluates compression efficacy

• Improves assessment during pulse-checks

• Simulation training can prepare EM residents to obtain and interpret TEE views on a live patient.

How To Address Health Misinformation? Using Focus Groups To Understand The Experience And Needs Of Interprofessional Undergraduate Health Professionals, Leah Mallory, Jennifer Hayman, Shelley Cohen Konrad, Linda H. Chaudron, Christine Mallar, Grace Price, Brendan Prast, Julia Safarik

Costas T. Lambrew Research Retreat 2023

The Problem of Health Misinformation Students from six different health professions share ideas

Access To Pediatric Type 1 Diabetes Care In Montana, James C. Bohnhoff, Michael Kohut Phd, Chelsea Bodnar, Elizabeth A. Jacobs

Costas T. Lambrew Research Retreat 2023

Introduction: Management of Type 1 Diabetes (T1D) requires significant family effort and specialty support. We aimed to understand how living in a rural state impacts families’ experiences during and after diagnosis.

Befast Assessment In A Rural Community Hospital – The Birch Study, Caroline Knight, Eileen Hawkins, Hilary Merrifield, Laura Stein, Robert Stein

Costas T. Lambrew Research Retreat 2023

Background: There are known regional disparities in treatment rates with thrombolysis and thrombectomy for acute ischemic stroke. BEFAST has been implemented in acute stroke protocols to aid in recognition of signs of stroke, but its utility in a rural ED is not well known.

Is Sepsis Hiding In Plain Sight? Implementation Of An Interprofessional (Ip) Sepsis Simulation To Detect Early Sepsis, Sarah Chang, Amanda Bennett, Anne Dean, Meaghan Anderson, Micheline Chipman

Costas T. Lambrew Research Retreat 2023

Early detection of hospital-acquired sepsis can be challenging. With highly effective IP teams and efficient healthcare systems, sepsis treated quickly can influence morbidity and mortality. This project is aimed at training IP teams in early recognition of sepsis using simulation. Nurses and providers rarely have opportunities to learn together. Simulation followed by an IP debrief is an excellent tool to collaborate for safe patient care.

The Maine Obstetric Medical Simulation (Momsim) Program Identifies And Categorizes Latent Safety Threats Across Rural Hospitals, Jeffrey Holmes, Leah Mallory, Micheline Chipman, Becky Hunt, Sarah Austin, Tracey E. Mcmillan, Emily Watson, Mainehealth

Costas T. Lambrew Research Retreat 2023

Objective: Combine in-situ simulation with an HFMEA framework to identify and categorize common system wide LST and opportunities to improve patient safety

Improving Pubmed For The Novice At The Expense Of The Expert: Surveying Librarians 3 Years Post-New Pubmed, Tim Kenny Mls, Heather Kemp Mlis

Maine Medical Center

Background: In 2019 PubMed, the publically accessible search interface for the MEDLINE database underwent a user interface update and overhaul. MEDLINE is the primary component of PubMed, a literature database developed and maintained by the NLM National Center for Biotechnology Information (NCBI)” (National Library of Medicine, 2022).

Methods: Using a brief web-based survey, comprised of both closed-ended and open-ended questions, health science library professionals provided feedback on the new PubMed.

Weekly Review Of An Academic Checklist To Operationalize Improvements To A Surgical Residency Program, Sean Francois, James Whiting, Kartikey Pandya, Jaswin Sawhney

Journal of Maine Medical Center

Introduction: We report on the use of a weekly academic checklist to monitor proposed improvements to a surgical residency program.

Methods: A single-center, retrospective analysis of residency improvements with an academic checklist of quality initiatives reviewed weekly at morbidity and mortality conferences. The positive response rate for each of the 11 items were reviewed. Trends of positive responses during the year were reviewed. The effectiveness of the checklist was also assessed with 2 internal surveys completed by faculty and residents.

Results: Over 15 months, the checklist was reviewed 46 times. The rate of a positive response for items varied from …

Using Hierarchy Of Needs To Build Care Team Engagement, Cathy Palleschi, Katherine Skroski, Sam Canonico, Hailey Frager, Mary Beeaker, Suneela Nayak, Natalia Johnson, Rebecca Brookes

Operational Transformation

Cardiology Intensive Care & Cardiovascular Interventional Care teams provide superb care to critically ill cardiac patients at Maine Medical Center. Covid Pandemic revealed the importance of caregiver physical and mental health wellbeing, as well as engagement in order to continue to provide outstanding care to patients. Leadership devised innovative ways to improve team engagement and ensure that care team members' needs are met.

Equipping Health Professions Educators To Better Address Medical Misinformation, Brian G. Southwell, Andrea Anderson, Anne Berry, Kamilah Weems, Lisa Howley, Cristina Pelin, Maya Vasser, Michael Cassara, Marie C. Petrizzo, Samara Ginzburg, Renee Mcleod-Sordjan, Joseph Weiner, Lexie Morales, Mark Saunders, Emiri Uchiyama, Laura Fothergill, Deborah Sherman, Rebecca L. Toonkel, Alison M. Vargovich, Nicholas M. Fusco, Kelly Foltz-Ramos, Jessica Kruger, William Prescott Jr, Jennifer Hayman, Shelley Cohen Konrad, Linda H. Chaudron, Christine Mallar, Grace Price, Brendan Prast, Julia Safarik, Leah Mallory, Aashna Sunderrajan, Sara Serritella, Nicole L. Pierce, Olabisi Falana, Eve Bloomgarden, Shika Jain, Lisa Mordell, Vineet Arora

Maine Medical Center

As part of a cooperative agreement with the US Centers for Disease Control and Prevention (Federal Award Identification Number [FAIN]: NU50CK000586), the Association of American Medical Colleges (AAMC) began a strategic initiative in 2022 both to increase confidence in COVID-19 vaccines and to address medical misinformation and mistrust through education in health professions contexts. Specifically, the AAMC solicited proposals for integrating competency-based, interprofessional strategies to mitigate health misinformation into new or existing curricula. Five Health Professions Education Curricular Innovations subgrantees received support from the AAMC in 2022 and reflected on the implementation of their ideas in a series of meetings …

The Rapid Increase Of Digital Resources And Research Used At The Maine Medical Center Library And The Nation: Since The Beginning Of The Covid 19 Pandemic, Maegan L. Halica

Maine Medical Center

Health science resources have increasingly become accessible to researchers, health care professionals, and health scientists. With the current technology available in the healthcare settings affiliated with all MaineHealth, authors of various publications can share their knowledge with others across the globe. The COVID 19 pandemic created a situation that not only increased the need for technological communication and accessibility at a rapid pace, but the situation also created an alternative outlet for those in a medical library to utilize needed information pertaining to their position through the crisis of the pandemic.

Implementing Uniform Curriculum To Increase Efficiency And Access To Simulation, Christine Mallar, Bethany Rocheleau, Shelly Chipman, Mike Shepherd, Erin Siebers

Costas T. Lambrew Research Retreat 2022

• Using Standardized Patients (SPs) is effective in improving communication skills.

• Conducting SP training can be cost prohibitive in terms of time and labor.

• Demands of current curriculum created a need for an innovative and more efficient approach to meet new CLER requirement.

Code Blue! When A Simulation Isn’T A Simulation Anymore, Bethany Rocheleau, Christine Mallar, Shelly Chipman, Leah Mallory, Mike Shepherd, Erin Siebers, Susan Lane, Tracie Knight

Costas T. Lambrew Research Retreat 2022

Objectives:

• To identify and remediate gaps responding to a medical emergency during a simulated event.

• To provide a safe working environment for standardized patients and clinical staff.

Factors Associated With Chronic Hepatitis C Direct-Acting Antiviral Prescriptions In Maine, Colin T. Waters, Anya K. Cutler, Kinna Thakarar, Kathleen Fairfield

Costas T. Lambrew Research Retreat 2022

Introduction -2.5 to 4.7 million people in the United States have active Hepatitis C (HCV) infections. •Chronic HCV infection is linked to substantial morbidity including cirrhosis and liver failure. •Oral direct-acting antivirals (DAA) yield sustained virologic response in 90 to 95% of individuals. •Many patients eligible for DAA therapy have not received treatment.

A Multicenter Pilot Study To Evaluate The Effect Of Evoo On Lipid Parameters, Caroline Knight, Ralph Hamill, Katherine Brady, Stacia Kozidis

Costas T. Lambrew Research Retreat 2022

Purpose:

The purpose of this multi-center, double-blinded pilot study was to determine if EVOO has a positive effect on HDL cholesterol levels and anti-inflammatory markers for subjects diagnosed with CVD and to determine if the polyphenol concentration is proportional to those effects. Subjects completed consecutive 28-day periods (with a 14- day washout between) in which they will either consume the low polyphenol EVOO daily or the high polyphenol EVOO. In a double-blinded manner, each subject was his or her own control with a 14-day washout between study periods. HDL levels and other parameters were be measured after each period of …

A Period Seroprevalence(Sars-Cov-2) Survey In Mhccn Cancer Healthcare Workers (Hcws) Providing Patient Care During The Height Of The Outbreak: A Registry Study (Second Year Progress), Caroline Knight, Jill Prescott, Jill Hobart, Jamie Saunders, Kimberly Caron, Sandra Neptune, Patty Brown, Kyla Sturtevant, Sean Eller, Lisa Lemire, Anne Breggia, Susan L. Guerin-Staples, Lee Lucas, Paul Han, Rachit Kumar, Johnson Liu, Robert Carlson, Scot Remick

Costas T. Lambrew Research Retreat 2022

In December 2019, emergence of a new coronavirus in Wuhan, China heralded the onset of a global pandemic (aka Covid-19) that is well into its third year. At the outset, the initial first wave of the alpha variant in 2020 had less impact on our state and HCWs. In December 2020, Covid-19 vaccinations became available. By fall and winter 2021-2022, the delta and subsequent omicron variants nearly overwhelmed Maine healthcare systems and work force. In June 2020, we embarked on a period seroprevalencestudy in the MaineHealthCancer Network (MHCCN) to document Covid-19 exposure in our rural cancer care workforce. Enrollment continues …

Anesthesia Non-Technical Skills In The Operating Room Clinical Learning Environment (Orcle), Denham S Ward

Costas T. Lambrew Research Retreat 2022

Anesthesia non-technical skills (ANTS) are critically important to patient safety in the operating room. The purpose of this study was to examine the global experience of ANTS in the clinical learning environment of the operating room (OR). Our goal is to answer the research question: “How are ANTS perceived by residents early in their training in the ORCLE?” Ultimately, we wish to use this information to inform curricula to teach ANTS in daily clinical practice.

Exploring Provider Attitudes Toward Falls Prevention In The Inpatient Setting, Emily Carter Md, Sarah Hallen, Gavin Welch, Nikki Gordon, Mark Parker

Costas T. Lambrew Research Retreat 2022

The rate of falls and falls with injury within Maine Medical Center are rising. •MMC’s InterprofessionalFalls Committee performed a root cause analysis to identify the factors driving this change. •This analysis highlighted the role that nursing and PT/OT’s have on fall prevention and it uncovered the lack of engagement amongst physicians and APPs. •We performed a literature review and found that there were no references identifying specific barriers to inpatient provider engagement; however, in other clinical settings such as the ED and assisted living, barriers to provider falls assessment have been identified. •We utilized the theoretical domains framework (TDF) to …

The Creation Of A Sdot And Its Implementation In The 4th Year Em Clerkship, Lauren Wendell, Evan Gill, Sara Nelson

Costas T. Lambrew Research Retreat 2022

Background •Clinical assessments of EM clerkship students are variable and institution specific. •Direct observation is used in residencies •EM clerkship instituted a student SDOT using a modified National Clinical Assessment Tool for Medical Students in EM (NCAT-EM)

Cytokine Cxcl2 Concentration In The Cerebrospinal Fluid Of Patients With Aneurysmal Subarachnoid Hemorrhage Is Associated With Patient-Reported Headache Pain, Elizabeth Glisic, Joanne T. Dekay, Patricia Lerwick, David J. Gagnon, Richard Riker, Sergey Ryzhov

Costas T. Lambrew Research Retreat 2022

Subarachnoid hemorrhage (SAH) is a severe type of stroke categorized by a sharp, sudden, and persistent headache. The mechanism of headache after SAH is currently poorly understood but the neuro-inflammatory response has been identified as a target in understanding the causes of headache after SAH. A better understanding of this mechanism may lead to identification of molecular targets for therapeutic reduction of headache pain and improving outcomes after SAH. In this study, we collected cerebrospinal fluid (CSF) from patients hospitalized with SAH and conducted a cytokine array to screen for soluble factors involved in SAH-associated headache Introduction

Behavioral Support Checklist Making Mmc More Autism Friendly, Rachel Coffey, Sarah Reynolds

Costas T. Lambrew Research Retreat 2022

Introduction • Patients with Autism Spectrum Disorder and their families report suboptimal medical experiences. • Boston Medical Center championed the “Autism Friendlieness Initiative” through ● Autism Support Checklist ● Provider Training ● Visit Preparation ● Sensory Accommodations

Adolescent And Young Adult (Aya) Cancer Survivorship Survey, Amy Haskins, Christina Holt, Lauren Boehm, Ashley Speckhart

Costas T. Lambrew Research Retreat 2022

Introduction •AYA cancer survivors face unique healthcare challenges following curative therapy •High loss to follow up rate despite importance of survivorship care

Applying The ‘Problem And Solution Trees’ Participatory Method To Design A Public Health Program On Covid 19 Testing For Underserved Populations, Mike Kohut, Elizabeth A Jacobs, Kathleen M Fairfield, G D. Sclar, K Hudak

Costas T. Lambrew Research Retreat 2022

Here we present a case study example of how we applied qualitative research and ‘problem and solution ’trees’( to identity barriers to testing for people who are unhoused

Center For Applied Science And Technology, Robert Carlson, Scot Remick, Lindsey Gower, Sue Lapierre, Anne Breggia, Bob Carlson

Costas T. Lambrew Research Retreat 2022

The journey from basic research to its application in clinical medicine is long and often fragmented. MaineHealth, as the largest healthcare system in Maine, is uniquely situated to create synergies between research and clinical medicine. The new MMCRI Center for Applied Science and Technology is a collaborative effort between the MMC Research Institute (MMCRI) and NorDx, the MaineHealth Diagnostic Laboratory, that provides the infrastructure needed for coordinated integration of MMCRI research core facility instrumentation and data resources with NorDx clinical instrumentation, data resources and support services. The new infrastructure provided by the Center will facilitate and broaden participation in the …

Acquire’Ingscholarly Activity During Residency: An Analysis Of Resident Attitudes Towards Scholarship Before And After A Curricular Intervention, Thomas Q Reynolds, Sarah Gabrielson, Amy Buczkowski, Anya K. Cutler, Gina Trachimowicz

Costas T. Lambrew Research Retreat 2022

ACQUIRE, a curriculum designed to introduce residents to scholarship and support their work, results in improvement in resident perceptions towards scholarly activity at both individual and department levels.