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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.

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

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.

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.

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.

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 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)

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

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.

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 …

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

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

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

Development Of A Codebook For A Prospective Mixed Methods Study Focusing On Experiences Of Mindfulness Intervention In Patients Undergoing Colorectal Surgery, Laura Nicolais, Rebecca Brown, Julie Fitzgibbons, Rachel Farrington

Costas T. Lambrew Research Retreat 2022

Mindfulness is a state of being present with one's thoughts without judgment • Relaxation is a technique to help achieve a state of rest (i.e., physical relaxation) and inner calm (i.e., mental relaxation). • Prior research has shown the many benefits of mindfulness and relaxation practice including improved psychological well-being, stress relief, reduced pain perception, improved sleep, relief of headaches, vomiting; all of which could prove beneficial in the postoperative phase.1 • Measuring the mental and emotional response to a mindfulness intervention in a quantitative manner can be challenging and therefore, a qualitative approach is justified.

Early Warning: Exploring Risk Factors For Hospital Acquired Pressure Injuries Using The Electronic Medical Record, Tricia Foley, Nicole M T Radmore

Costas T. Lambrew Research Retreat 2022

Introduction -Severe Hospital Acquired Pressure Injuries (HAPIs) are, by law, reported to the State of Maine and present a financial burden, as Medicare will not cover costs for these injuries.

Mainehealth As A Partner In The National Covid Cohort Collaborative (N3c), Susan Santangelo, Kimberly Murray, Kathleen M. Fairfield, John Dipalazzo, Ivette Emery, Cliff Rosen

Costas T. Lambrew Research Retreat 2022

N3C is a secure clinical data analytics platform hosted at the NIH that includes vast amounts of data from a large network of he alth care organizations, including MaineHealth , to accelerate advances in COVID 19 research and clinical care.

Recover: Researching Covid To Enhance Recovery, Theresa Roelke, Anne Breggia, Kathryn Brouillette, Ivette Emery, Lauren Moore, Theresa Roelke, Marc Flore, Jacquieline Lapointe, Abigail Arruda, Lyndsey Gower, Teresa Martel, Darlene Peterson, Clifford Rosen

Costas T. Lambrew Research Retreat 2022

HOW WILL RECOVER ACHIEVE ITS GOALS? NIH has selected health care institutions across the nation, including MaineHealth , to conduct this study, which is anticipated to enroll a total of 15,000 participants who have or had SARS CoV 2 infection and 2,680 control participants without a SARS CoV 2 infection.

Improvement Of Family Communication In The Perioperative Environment Utilizing Text Messaging, Sonja Orff, Kristiina Hyrkas

Costas T. Lambrew Research Retreat 2022

Text Messaging Technology Improves Patient Satisfaction for Communication with Nurses in Perioperative Care Unit

Thinking Inside Out: Using A Virtual Platform To Overcome Barriers To Interprofessional Education, Erin Siebers

Costas T. Lambrew Research Retreat 2022

Interprofessional education (IPE) leading to effective communication is critical for patient safety [1] • Barriers to IPE include lack of confidence and lack of experience and opportunities • Barriers are increased in rural states, due to travel and scheduling logistics[2,3] • The pandemic and social distancing restrictions forced rapid transition of an IPE OSCE from an in-person to a virtual event • Our objective was to provide students with an authentic experience similar in quality and value to prior in-person sessions

Implementation Of A Readiness Model For Kidney Transplant Patients, Shelby Mcdonnell, John Vella, Ardyce Peters

Costas T. Lambrew Research Retreat 2022

Increasing Access to Kidney Transplantation: How Decreasing Time in Transplant Evaluation Led to More Timely Eligibility for Organ Offers

Mainehealth Institute For Research: 2022 Year In Review, Mainehealth Institute For Research

Annual Reports

Annual Report

Hannaford Center For Safety, Innovation & Simulation 2022 Annual Report, Maine Medical Center

Annual Reports

• Identified more than 400 latent safety threats across our system
• Provided readiness training for the launching of pediatric ECMO
• Introduced summative block OSCEs for medical students
• Continued rural telesimulation outreach with MOOSE
• Presented or published 15 total abstracts and publications
• Continued development of AR-integration pediatric simulation