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Meet The Board: A Jaqi Rountable, Ashley Gregory

Journal of Accreditation and Quality Improvement in Medical Education

This roundtable introduces readers to the founding members of the Journal of Accreditation and Quality Improvement in Medical Education's editorial board. Through their reflections, readers will gain insight into the experiences, interests, and aspirations that collectively inform the journal's mission and strategic direction.

Mission Seemingly Impossible: Student Satisfaction With Time For Self-Directed Learning, Sara Bradley, Robyn Bockrath, Mara Johnson, Celia Laird O'Brien

Journal of Accreditation and Quality Improvement in Medical Education

Background. Medical schools accredited by the Liaison Committee on Medical Education (LCME) are often required to demonstrate improvement on accreditation elements in a relatively short amount of time. In October 2021, the LCME cited our institution as Unsatisfactory for the self-directed learning (SDL) element after 21.3% of second-year medical (M2) students reported dissatisfaction with unscheduled time for SDL. The LCME required us to demonstrate improvement in a status update due December 2022. In this paper, we describe a rapid continuous quality improvement (CQI) approach that successfully increased student satisfaction and achieved full compliance within 1 year.

Methods. We employed a …

Uncovering The Genetic Landscape Of Pediatric Hearing Loss Along The Texas–Mexico Border, Desiree Lanehart, Michelle Gray, Roberta Sierra, Camille Maldonado, Daniel Brooks, Hongzheng Dai, Aaly Rahimtoola, Sandy Magallan, Alberto Allegre, Lori Berry

School of Medicine Publications

Children in Health Professional Shortage Areas (HPSAs), including the US border regions, experience delays in the diagnosis of hereditary hearing loss (HL), driven primarily by limited access to specialized genetic services. Although approximately 60% of congenital HL has a genetic etiology, many affected children in these communities remain undiagnosed, delaying timely intervention. Project GIVE is an NIH-funded virtual genomics program that expands access to genome sequencing (GS) for children with undiagnosed multisystemic conditions along the Texas–Mexico border in the Rio Grande Valley (RGV) and El Paso regions of Texas, USA. Children (0–18 years) with suspected rare diseases were referred by …

Unlocking Affixes In The Esl Community College Classroom: The Language Of Law, Science, And Technology, Patricia George-Hunter Edd

Journal of English Learner Education

Since vocabulary plays a significant role in second language acquisition, expansive vocabulary targets should be set and pursued. This paper explores the results of introducing affixes to develop vocabulary and increase motivation for beginner to intermediate-level English language learners (ELLs) pursuing academic disciplines in law, science, and technology at a New York City community college. Participants included 23 ELLs with diverse linguistic, educational, and sociocultural backgrounds enrolled in an online synchronous Integrative Language Seminar (ILS) designed to develop all areas of English language proficiency. Pre‑, post‑, delayed tests, questionnaires, and post‑intervention interviews were conducted and analyzed to establish the language …

Effects Of Differentiated Physical Education Learning On Physical Fitness And Active Lifestyle Among Junior High School Students: A Quasi-Experimental Study, Asep Akbaruddin, Sumbara Hambali, Wahyu Saputra, Mochamad Fajar Permana

Indonesian Journal of Research in Physical Education, Sport, and Health

Background: Low levels of physical fitness and physical activity among junior high school students remain a significant concern in physical education. Differentiated instruction offers a potentially effective approach by tailoring learning activities, levels of difficulty, and instructional experiences to students’ readiness, interests, and abilities. Objective: This study aimed to investigate the effects of differentiated physical education instruction on physical fitness and active lifestyles among junior high school students. Methods: A quantitative approach employing a quasi-experimental, nonequivalent control-group design was adopted. A total of 90 junior high school students participated in the study, with 45 assigned to the experimental group and …

Participatory Research With People With Aphasia: Frameworks, Examples, And Implementation Guidance, Jacqueline J. Hinckley, Katie A. Strong, Brent Archer, Lauren Bislick, Suma R. Devanga, Amy E. R. Engelhoven, Anthony Pak-Hin Kong

The Qualitative Report

Participatory research (PR) improves the meaningfulness and efficiency of research and reduces the research-to-practice gap, because it includes the lived experience of those who are affected by the research in the planning, execution, and dissemination of the research. Communication disabilities, like aphasia due to stroke, or communication differences impact the way in which meaningful research collaborations can take place. The purpose of this paper is to describe the ethics, challenges, and opportunities for involving people with aphasia as collaborators in research. We highlight specific examples of PR projects undertaken by community member teams composed of researchers, clinicians, people with aphasia, …

Implementation Of A Preventative Screen To Detect Heartworm Disease In Local Mosquito Populations, Ava Hurley, Emma Weissmeier, Lucy Corten, Jayden Ockert, Jackson Greenwold-Claiborne, Addison Levitz, Carson Mickey, Alexandra Bonner, Paul E. Richardson

Journal of the South Carolina Academy of Science

Heartworm disease, caused by the parasite Dirofilaria immitis, affects thousands of mammalian pets across the nation annually and is increasingly spreading. Various mammalian pets including dogs, cats, ferrets, and horses are affected by the disease, and currently dogs are the only mammalian pets with an approved treatment. This study aims to implement a preventative approach to combating the disease by utilizing a PCR-based screen to detect D. immitis in mosquito populations. Five key objectives were established in this study: refine a preventative screen to detect heartworm DNA in mosquitoes, implement the preventative screen through partnerships with local animal shelters, …

Development Of Genomic Detection Techniques Of Aquatic Pathogens To Aid In Disaster Relief After Hurricanes, Ana Rose Johnson-Redmon, Abigail F. Turka, Rylie Masterson, Paul E. Richardson

Journal of the South Carolina Academy of Science

Extreme weather events such as hurricanes, tropical storms, and flooding can introduce microbial contaminants into freshwater systems through stormwater runoff, animal waste, and damaged or overwhelmed wastewater infrastructure. Rapid detection of waterborne pathogens is important for environmental monitoring and public health response, especially in coastal regions vulnerable to hurricane-related flooding. This study developed and refined a polymerase chain reaction (PCR)-based environmental DNA detection technique to identify aquatic pathogens in freshwater systems. Water samples were collected from four freshwater sites, including three man-made ponds and one drainage ditch, during the Fall 2025 and Spring 2026 semesters. Target organisms include Giardia, Cyclospora, …

Investigating The Prevalence Of Human Papilloma Virus In A College-Aged Sample Group And Its Link To Sexual Behaviors And Attitudes, Gabriela Lewczyk, Eva Pollak, Phoebe Stryker, Samantha Hickey, Emily Moyer, Katelyn Ambrose, Alexander Knight, Rahjai Thomas, Adriana Burk, Paul E. Richardson

Journal of the South Carolina Academy of Science

Human Papilloma Virus (HPV) is the most common sexually transmitted infection (STI) in the United States, infecting up to 75% of sexually active individuals, with a prevalence rising significantly around age nineteen for oral and genital infections. Because the virus infects epithelial cells and is transmitted primarily through skin-to-skin contact, it is found mainly in the cervix, oral cavity, and on/within ones’ skin. While most of the 200+ HPV subtypes are benign and tend to self-clear within six months to two years, twelve of these strains are classified as high-risk oncogenic strains that drive malignant progression. Furthermore, HPV is linked …

Development Of A Molecular Screen For Community-Based Hookworm Detection, Emma Weissmeier, Ava Hurley, Jackson Greenwold-Claiborne, Morgan Deeringer, Paul E. Richardson

Journal of the South Carolina Academy of Science

Hookworm disease, caused by Ancylostoma duodenale and Necator americanus, is a soil-transmitted infection affecting over 700 million people worldwide. Transmission occurs through direct skin contact with contaminated soil, leading to health consequences including iron-deficiency anemia, malnutrition, and long-term developmental impacts. The CCU Disease Hunters program developed a PCR-based environmental screen to detect hookworm DNA in soil samples before transmission reaches human or animal hosts. Initiated in response to a request from All 4 Paws Animal Rescue, this project established protocols for soil collection, DNA extraction, and molecular identification of hookworm using the cytochrome c oxidase (COI) and cytochrome b (COB) …

Vol7iss5, Hca Healthcare

HCA Healthcare Journal of Medicine Covers

Cover for Volume 7 Issue 5 of the HCA Healthcare Journal of Medicine.

Safer Together: One Purpose, One Future, Tara Haines

HCA Healthcare Journal of Medicine

This art quilt is based on the theme that working together creates a safer future for our patients. The patient is at the center and is surrounded by the care team to help them navigate towards health and better outcomes. Our student nurse is on the left with angel wings, supported by their professor, the patient, the care team, and their nurse, all guided by Florence Nightingale's lamp over the often uneven path towards a safer future

Trust As Public Health Infrastructure: Advancing Health Care Safety Through Risk Communication And Community Engagement, Karanvir Bhinder, Sahibpreet Bhinder

HCA Healthcare Journal of Medicine

Background

Preparedness frameworks traditionally emphasize surveillance, laboratory capacity, clinical care and logistics. However, recent public health emergencies have demonstrated that even technically sound interventions may fail when trust is weak, communication is fragmented or misinformation undermines public confidence. Risk communication and community engagement (RCCE) is therefore increasingly recognized as an important component of effective outbreak response.

Perspective

Evidence from COVID-19, Ebola and other public health emergencies demonstrates that trust, communication and community engagement influence adherence to public health guidance, vaccine acceptance, healthcare utilization and the implementation of evidence-based interventions. Despite this, RCCE is frequently operationalized as a support function rather …

Advanced Practice Provider-Physician Collaboration And Medical Staff Governance: A Framework For Patient Safety, Nicolas Testa, Kaysha Hervey, Cynthia Borum

HCA Healthcare Journal of Medicine

The growth of advanced practice providers (APPs) is occurring in parallel with persistent and projected physician shortages. One important solution and increasingly visible response to these workforce challenges is the expanding role of APPs. Strong physician-APP partnerships can help distribute workload, improve access, and support sustainable practice with the delivery of safe, quality patient care. The future of clinical care will depend on effective APP-physician collaboration grounded in sound credentialing, clearly defined supervision and practice expectations, and robust medical staff monitoring programs. We describe the governance and oversight processes in a large health care system to assess and support APP …

From Hired To Hands-On-Deck Status: Solving Delays In Health Care Hiring Processes And Supporting Workforce Safety Across A Large For-Profit Health System, Cynthia Skeens

HCA Healthcare Journal of Medicine

Background

During and after the COVID-19 pandemic, health care staffing shortages and onboarding inefficiencies, specifically delays in employee health clearance, prolonged time to hire, and threatened workplace and patient safety.

Methods

An employee health onboarding workflow at a large health care organization was redesigned across 3 domains: people, process, and technology. Interventions included workflow standardization, elimination of non–value-added steps, optimized tuberculosis screening, increased appointment capacity, and technology integration (electronic health record [EHR]documentation, centralized scheduling and communication, and completion of pre-visit forms). Following a pilot from May to December 2022, the workflow was expanded organization-wide with a structured rollout and ongoing …

Promoting Safety In Alcohol Withdrawal Syndrome: A Proactive Nursing Process Framework, Julie Anne C. Comia, Elizabeth Card

HCA Healthcare Journal of Medicine

Background

Alcohol withdrawal syndrome (AWS) is a potentially life-threatening response to the abrupt cessation or reduction of heavy, prolonged alcohol use. Untreated, it can progress to delirium tremens (DT), a medical emergency historically associated with mortality as high as 40%. Agitation and hallucinations during withdrawal also pose safety risks to the health care team in addition to the patient. Because deterioration follows a predictable course, timely nursing recognition and intervention are central to protecting both the patient and the care team from avoidable harm. The evidence-based framework is intended as an educational tool to help nurses anticipate and avoid harm; …

A Conceptual Framework For Clinical Quality Oversight In Telehealth-Enabled Home-Based Urgent Care, Taylor Spencer, Jason P. Williams

HCA Healthcare Journal of Medicine

Background

Home-based urgent care serving frail older adults should aspire to high-quality clinical care with optimal patient outcomes. However, monitoring and ensuring this quality can be challenging. For example, telemedicine and value-based frameworks introduce substantial complexity to clinical quality monitoring.

Purpose

We describe the conceptual framework for a multidimensional quality monitoring program within a national home-based urgent care model.

Framework Description

Medical care was delivered via a multi-state home-based primary, palliative, and urgent care practice serving medically complex Medicare Advantage (MA) populations. Our model of care incorporated distributed clinical and operational teams delivering 24/7 care via telephonic triage, video-enabled encounters, …

Thermal Skin Burns Following Infrared Vein Finder Application In Pediatric Patients: A Report Of 2 Cases And Protocol Revision, Sujata S. Rawlani, Nandini Banad, Jenil Sheth, Raja Narsingrao

HCA Healthcare Journal of Medicine

Background

Peripheral venous cannulation remains a cornerstone of pediatric anesthesia practice. Infrared vein finder devices have gained popularity as aids to improve venous visualization in children with difficult access. However, the thermal hazards associated with certain device types, particularly pocket flashlight-based models, remain underappreciated among clinical staff.

Case Presentation

We report 2 pediatric patients who sustained grade 2 thermal burns at peripheral venous access sites following the use of a pocket flashlight-based infrared vein finder during ophthalmic surgical procedures. The first patient, an 8-month-old girl born at term with appropriate developmental milestones undergoing congenital cataract surgery, developed a ruptured blister …

Assessment Of Hypoglycemia Management In Acute Care Hospitals, Carley Warren, Christina Wing, Chenette Burks, Brooke Schmidt, Adam Hasse

HCA Healthcare Journal of Medicine

Background

Hypoglycemia is a common and potentially preventable complication among hospitalized patients, particularly those receiving insulin or other glucose-lowering therapies. Delayed recognition and inconsistent management can increase adverse outcomes. Although protocols exist, variability in treatment selection and timing may influence the likelihood of returning to normoglycemia. Understanding these patterns is critical to optimizing patient safety in acute care settings.

Methods

This retrospective review evaluated hypoglycemia management in adult inpatients across acute care hospitals within a large health system. Patients were included if they were aged 18 years or older, were hospitalized within the health system, and experienced a hypoglycemic event, …

Yellow Gowns For Fall Prevention: A Quality Improvement Initiative To Enhance Patient Safety, Kimberly Nathan, Obumneke Umerah, Lorenna C. Garcia-Bochas, George A. Helmrich Sr, Nayda Parisio Poldiak, Jilian R. Sansbury

HCA Healthcare Journal of Medicine

Background

Falls, with and without harm, are monitored as a quality metric for inpatient units and are an important component of patient safety. Across the medical-surgical (Med-Surg) units at our facility, fall rates have shown some variability over time, prompting further evaluation of fall-prevention practices and opportunities for improvement. From quarter 1 (Q1) of 2022 through Q2 of 2025, several units reported fall rates ranging between 4.0 and 7.0 falls per 1000 patient days. A review of contributing factors highlighted opportunities to strengthen consistency in fall-prevention practices, enhanced education around alarm use, and improve visibility of patients at higher risk …

Time To Antibiotic Administration In The Treatment Of Sepsis: A Retrospective Cohort Study, Dennis Anthony Cardriche, Grayson Carter, Thomas Matese

HCA Healthcare Journal of Medicine

Background

The 2026 Surviving Sepsis Campaign (SSC) guidelines recommend antimicrobial therapy within 1 hour for probable septic shock, while the Centers for Medicare and Medicaid Services (CMS) mandates a 3-hour window. Current literature presents conflicting evidence on whether these universal time thresholds yield a definitive survival benefit. This study aims to evaluate the real-world impact of delayed antibiotic administration on patient mortality and length of stay (LOS).

Methods

A retrospective cohort study was conducted analyzing 62 153 adult encounters with severe sepsis or septic shock at emergency departments (EDs) between December 31, 2023, and December 31, 2025. Time to first …

A Heuristic Tool To Enable Root Cause Analysis Of Safety Events, William D. Porter, Kianca Joseph, Demitria Stafford, Kurt Larson, John Mier, Michelle Butler-Jackson, Musaddiq Waheed

HCA Healthcare Journal of Medicine

Background

Hospitals routinely collect wide-ranging data related to quality, efficiency, and clinical practice. As part of these efforts, patient safety event data are collected, compiled, and analyzed to drive process improvement.

Methods

We present a novel adaptation and application of the Department of Defense Human Factors Analysis and Classification System (HFACS) as a heuristic tool to improve the conduct of root cause analysis (RCA) sessions that follow serious patient safety events. To assess individual knowledge improvement after reviewing the heuristic tool, a 1-page summary (including a graphical image of the tool) was developed and provided to a convenience sample of …

The Use Of Infra-Red Spectroscopy To Assess Intact Skin Of Various Skin Tones, Mary Lee A. Potter, Stacie Sosa, Charlott Polm, Sherry Campton, Wisam Salameh, Ronnie Klein, Yaniv Cohen

HCA Healthcare Journal of Medicine

Background

Pressure injuries (PI) continue to be a serious medical complication in the acute care setting. Industry leaders advocate for the use of objective technologies to provide accurate and quantifiable skin assessments for all patients across diverse skin tones. The Infra-Red Spectroscopy Scanner (IRSS) is a novel non-invasive decision support system (DSS) electro-optic technology that uses near infra-red spectroscopy to examine and assess physical and chemical changes prior to visual skin breakdown in real-time.

Methods

A 2-phase prospective open-label pilot device study was launched under protocol IRM-02-1123 (USA version 3.0, November 1, 2023). In both Phase 1 and Phase 2, …

Building A Culture Of Safety Through Faculty Mentorship: The Peer Pairing Framework For Clinical Nurse Educators, Clare A. Chambers

HCA Healthcare Journal of Medicine

Background

Clinical nurse educators often transition from bedside practice to clinical education in high-risk settings without structured support. Limited or absent mentorship during this transition may affect educator confidence, student learning outcomes, patient outcomes, and the ability to sustain a culture of safety. Although mentorship is widely recommended in nursing education, implementation strategies remain limited. The Peer Pairing Framework was developed as a staged mentorship approach to support clinical nurse educators and inform a comprehensive mentorship model.

Methods

The Peer Pairing Framework was informed by a voluntary onboarding survey of 914 clinical faculty, of whom 73.52% expressed interest in having …

Critical Care Catalyst: The Impact Of Trauma Nurse Leads On Mortality, Patient Outcomes, And Throughput, Danielle Brady, Jessica L. Brady, Hannah Dice, Parker Hu

HCA Healthcare Journal of Medicine

Background

Trauma is the leading cause of years of life lost in the United States. Dedicated trauma nurse leaders (TNLs) coordinate resuscitation and streamline care, but data evaluating their clinical impact at level I trauma centers are limited. We evaluated the association between a newly implemented dedicated TNL program and patient outcomes.

Methods

This single-center, preimplementation and postimplementation observational study at an urban level I trauma center compared adult tier 1 and tier 2 trauma activations from the pre-TNL period (January 1, 2017, through April 30, 2020) with the post-TNL period (May 1, 2020, through December 31, 2023; 8 dedicated …

Retrospective Exploratory Pre And Post Evaluation Of Waste Anesthetic Gas Scavenging System And Association With Post Anesthesia Care Unit (Pacu) Nurse Health, Jessica Garibay, Dina A. Krenzischek, Ryan Macdonald, Elizabeth Card

HCA Healthcare Journal of Medicine

Background

The Occupational Safety and Health Administration (OSHA) recognizes the negative health impact of occupational exposure to anesthetic gases in the operating room. As a result, OSHA has implemented regulations, engineering controls, and regular air quality surveillance programs to protect surgical staff. However, immediate postoperative patients exhale waste anesthetic gases (WAGs) into the Post Anesthesia Care Unit (PACU) environment, exposing nurses to occupational health risks, including headaches, fatigue, organ damage, cancer, and reproductive complications. The PACU lacks any regulations or even recognition of this safety issue; in fact, most nurses and leadership are unaware. One potential solution, a scavenging oxygen …

Laboratory Study Of A Waste Anesthetic Gas Mask Scavenging System To Reduce Airborne Pathogen Exposure For Health Care Workers In Post Anesthesia Care Units, Josh Horton, Trevor Lim, Andrew Kanach, John Moenning, James Mcglothlin, Bruce M. Applegate Sr.

HCA Healthcare Journal of Medicine

Introduction

A scavenging oxygen mask system (SOMS) utilizing house vacuum has been demonstrated to significantly reduce exposure of post anesthesia care unit (PACU) health care workers (HCWs) to waste anesthetic gases (WAGs). Therefore, it was proposed that the same system could also be used to protect HCWs in the PACU by reducing Infectious Respiratory Particles (IRPs) spread from patients who may harbor airborne infective pathogens, such as Mycobacterium tuberculosis, certain strains of influenza, and SARS-CoV-2.

Methods

A life-like adult manikin head equipped with a bio-aerosol Collison nebulizer was set up to simulate patients exhausting pathogenic droplets. Further evaluation of …

A Nurse-Driven Escalation In Trauma Team Activation Reduces Mortality Of Injured Patients, Darrell L. Hunt, Yingxian Liu, Jordan S. Rahm, Bailey Segura, Mercedes Huens, Emily Lopez, Esther Krinsky, Joe Spinell, Andrea Palmer

HCA Healthcare Journal of Medicine

Background

There is a dearth of literature examining the clinical outcomes of injured patients who experience physiological deterioration in the emergency department (ED). At our trauma center, injured patients who develop hemodynamic, respiratory, or mental status instability after arrival are retriaged and upgraded to a full trauma team activation (fTA). The purpose of this study was to compare the clinical outcomes of patients with fTA based on prehospital signs and symptoms (initial) versus upgraded fTA patients.

Methods

This was a single-center, retrospective cohort study of injured patients presenting to a tertiary trauma center between June 1, 2022, and June 30, …

Adaptations To Medical Education In A State-Specific Abortion Ban Paradigm, Crystal Duncombe, Anthony Sciuva, Shyamalee A. Ramaraj, Douglas Mcgill, Jilian R. Sansbury, Jennifer Risinger, Nayda Parisio Poldiak, William S. Hart

HCA Healthcare Journal of Medicine

The United States (US) Supreme Court’s overturning of Roe v Wade in 2022 via the decision made in Dobbs v Jackson Women’s Health Organization removed the national protection for doctors to perform abortions and made states able to impose restrictions on this medical procedure. This change immediately affected health care availability in the US, with many states outright banning or effectively banning abortion through gestational limits. Immediate negative effects were reported in populations and locations where maternal health outcomes were already poor, including among Black women and patients living in rural areas. Here we review how the Dobbs decision disrupted …

Making Diagnostic Uncertainty Visible At Intensive Care Unit Transitions: A Narrative Review Of Diagnostic Pause Strategies, Raha West, Ahmed Elhaddad, Behrad Baharlo, Parind Patel

HCA Healthcare Journal of Medicine

Background

Diagnostic error is a significant patient safety issue in critical care. However, it is often difficult to detect during ongoing care. Patients in the Intensive Care Unit (ICU) often have incomplete histories, overlapping symptoms, changing physiology, and concurrent issues. During ICU transitions, patient diagnoses are often reported without clear information on diagnostic confidence, potential alternative diagnoses, pending results, or triggers needing review.

Methods

This clinical narrative review explored diagnostic uncertainty at ICU transitions, specifically those during ICU-to-ward transfers or unplanned escalations to the ICU. A targeted literature search identified studies of adult ICU diagnostic errors, ICU transition safety, ICU-PAUSE …