Medicine and Health Sciences Commons^™

Burnout And Health Scores Among Residency Programs As An Indicator Of Wellness, Hannah Manzi, Jon Halling, Nayda Parisio Poldiak, Suzanne Perkins

HCA Healthcare Journal of Medicine

Background

With long hours, significant responsibilities, and a heavy workload, residency can be an incredibly stressful experience. The aim of our study was to assess the impact of residency on mental health and wellness. A secondary aim was to determine if the post-graduate year (PGY) of the different residents impacted their mental health or ability to cope with the stressors of residency.

Methods

Residents in anesthesiology, family medicine, internal medicine, and surgery were invited to complete a survey. The first portion of the survey had residents rank their mental health on a scale from 1 to 5. There was also …

Lifestyle Medicine For The Health Care Worker, Workplace, And Community Well-Being: A Butterfly Effect, Karina Doucet, Nicholas D'Angelo

HCA Healthcare Journal of Medicine

Burnout is a prevalent and expensive problem in the US, and the National Plan For Health Workforce Well-Being included a goal to institutionalize well-being as a long-term value. Lifestyle Medicine (LM), an evidence-based practice using behavioral interventions to treat, prevent, and reverse certain chronic conditions, can achieve this goal. Implementing small changes in the workplace that support lifestyle medicine has a butterfly effect on both workplace and community well-being. Furthermore, the health of health care workers (HCWs) and patients improves, and health care costs decrease. This can be done with LM wellness programs or LM training for HCWs. LM wellness …

Opioid-Related Emergency Department Visits Before And During Covid-19: Association With Community-Level Factors, Timothy F. Page, Weiwei Chen, François Sainfort, Julie A. Jacko

HCA Healthcare Journal of Medicine

Background

The purpose of the study was to investigate the relationship between community-level variables and emergency department (ED) visit rates before and during COVID-19. The focus was on opioid-related ED visits. Despite large declines in overall ED visits during COVID-19, opioid-related visits increased. While visits for avoidable conditions decreased, the opposite was true for opioid-related visits.

Methods

We combined data from Florida EDs with community-level variables from the 2020 American Community Survey. The outcome measures of the study were quarterly ZIP code tabulation-area-level ED visit rates for opioid-related ED visits as well as visit rates for all other causes. Associations …

A Quality Improvement Study On Increasing Rates Of Lung Cancer Screening, Arpit Arora, Crystal Bharat, Sophia Zia, Pooja Paunikar, Dana Simpson

South Atlantic Division GME Research Day 2024

No abstract provided.

The Utility Of Cologuard In A Real-World Community Setting, Abhinav K. Rao, Shivam Kalra, Danny Tran, Angeli Patel, Ibrahim Al-Saadi, Levi C. Diggins, Ian Whitaker, Shannon Kang, Kunaal Patel, Eyad Gharaibeh, Ali Khalifa, Don C. Rockey, Brett Van Leer-Greensberg

South Atlantic Division GME Research Day 2024

No abstract provided.

Primary Care Physician Supply And Population Health Outcomes In Florida, 2010-2019, Maxwell E. Droznin, Julia Fashner

HCA Healthcare Journal of Medicine

Background

Primary care physicians play vital roles in the prevention and management of chronic disease. With increasing rates of chronic disease and a national primary care physician shortage, the role that primary care physician supply has on health outcomes in Florida is not well understood. The objective of this study was to investigate the relationship between primary care physician supply (PCPS) and population health outcomes of obesity, life expectancy, coronary artery disease hospitalization, and death rate as reported by county in the state of Florida for the years 2010, 2013, 2016, and 2019.

Methods

This was a retrospective, cross-sectional study. …

Who Left The Hospital Against Medical Advice During The Early Covid-19 Pandemic?, Bryan Werner, Se Won Lee

HCA Healthcare Journal of Medicine

Background

Patients leaving against medical advice (AMA) presents a challenge to hospitals as they try to manage costs and improve patient outcomes in an ever-increasing competitive market. Investigating AMA discharges that occurred during the early COVID-19 pandemic presents a unique opportunity to better understand this phenomenon and be better prepared for the future.

Methods

This retrospective analysis of 34 379 patients from a nationwide private healthcare system across 20 states analyzed patients during the early stages of the pandemic who chose to leave against medical advice (AMA) after being admitted with COVID-19 infection and identified several patient characteristics associated with …

Hepatitis B Virus Screening In Asian Immigrants: Community-Based Campaign To Increase Screening And Linkage To Care, Aziza Win

South Atlantic Division GME Research Day 2023

No abstract provided.

Effects Of Free Physical Fitness On Bmi, Kaviya Sathyakumar, Hira Hussain, Lizbeth Zambrano, Amisa Patel, Amber Patel, Stephanie Anderson

North Florida Division GME Research Day 2023

No abstract provided.

Incrasing The Rate Of Pneumococcal Vaccination In Patients Over 65, Ubaldo Gonzalez Morales, Muna Alhusban, Chelsea Guan, Natalia Cavin, Humeyra Dogan, Liliana Franco Moreira, Ashwini Komarla, Allison Ferrara

North Florida Division GME Research Day 2023

No abstract provided.

Dementia Screening At Hope Clinic, Kang-Lin Tsai, Wolf Frances, Elizabeth Suniega

Gulf Coast Division GME Research Day 2023

No abstract provided.

Hpv Vaccination In Florida: Where We Are, Where We Need To Be And How To Get There, Thanuja Neerukonda, Alexandra Witt, Neeharika Makani, Dhruv Patel

West Florida Division GME Research Day 2023

No abstract provided.

Unearthing Historical Trauma To Advance Health Equity For Survivors Of Human Trafficking, Sandy Woo-Cater

HCA Healthcare Journal of Medicine

In the last decade, the public health field has grown a strong interest in responding to issues related to human trafficking. This specific concentration in healthcare has made efforts to ensure this work includes culturally appropriate tools to serve patients. While curricula to guide health professionals in areas such as cultural competency, cultural responsiveness, or cultural humility exist, historical trauma is not often integrated in the understanding of health outcomes for patients experiencing human trafficking. This paper asserts that advancing health equity for these patients necessitates a deeper historical perspective.

Care Alert Program In Chronic Recurrent Ed Utilizing Patients, Kaitlyn Phelps, Jonathan Bryan, Jonathan Leggett, Erica Gibbons, Brian Griggs

HCA Healthcare Journal of Medicine

The Care Alert program is designed to help navigate encounters with patient populations that are high utilizers of emergency department (ED) resources. These populations often have chronic medical conditions, have a poor understanding of their conditions, are unfamiliar with the EDs’ role in the management of these conditions, and commonly lack outpatient resources. The Care Alert program intends to address the needs of this challenging patient population by designing individualized care plans that are approved through a multidisciplinary committee. Data from this study showed a 37% decrease in ED visits and a 47% decrease in hospitalizations during the initial 8 …

The Impact Of Covid-19 In The Latinx Community, Laura Pedraza, Ricardo Villela, Vikki Kamatgi, Kaitlyn Cocuzzo, Ricardo Correa, Miriam Zylberglait Lisigurski

HCA Healthcare Journal of Medicine

The COVID-19 pandemic has intensified the existing health and social disparities that affect minority groups in the United States (US), including the Latinx community. This situation has been reflected in many aspects of health, including increased morbi-mortality and reduced adherence to medical and scientific recommendations. Limited access to health care, financial challenges, migrant status, and health literacy, or lack thereof, have all hampered the Latinx community's ability to seek aid quickly and to be tested or treated effectively for this disease. This pandemic has shown that the Latinx community's socioeconomic status correlates with greater mortality rates when compared to other …

Is There A Bias Toward Unvaccinated Covid-19 Patients?, Abbas B. Jama, Anwar Khedr, Hisham Mushtaq, Nitesh K. Jain, Thoyaja Koritala, Syed Anjum Khan

HCA Healthcare Journal of Medicine

With more than 22% of the United States still not vaccinated for COVID-19, we are trying to shed some light on whether there is any bias when treating unvaccinated COVID-19 patients. We highlight several reports where some individuals or organizations displayed possible bias, whether implicit or explicit. We examine the legal and ethical implications of these biases and offer a general overview of how to tackle them.

A Call To Action: Preventing Opioid And Substance Abuse In South Florida Youth, Julie A. Jacko, Katherine P. Cohen, Cathaerina Appadoo, Arkene S. Levy, Timothy F. Page, Michael J. Parker, Solina Pierre-Gilles, Francois Sainfort

HCA Healthcare Journal of Medicine

The opioid crisis poses a substantial threat to youth throughout the nation. This crisis has been exacerbated by the COVID-19 pandemic, reversing some of the positive national trends in the fight against the opioid epidemic. Some risk factors for youth opioid use have been identified nationally. The South Florida tri-county region of Miami-Dade, Broward and Palm Beach is a culturally distinct region which may not follow national trends and likely has unique risk and protective factors. To address the concerning spike in youth opioid use in South Florida, a community coalition was formed to identify factors unique to South Florida …

Effect Of An Electronic Order Set On Newborn Hepatitis B Immunization Rates, Daniel Pedersen, Angelina Rodriguez, Olu Oyesanmi, Heather Schramm, Michael King

HCA Healthcare Journal of Medicine

Objective

Hepatitis B is an infectious deoxyribonucleic acid virus which can cause significant morbidity and mortality. There is no current definitive treatment, however in the United States immunization is widely available. A paper published by the Advisory Committee on Immunization Practices/Centers for Disease Control (ACIP/CDC) in 2018 made updated recommendations regarding vaccination practices in the United States. The most notable change made was that all healthy newborns weighing ≥2000 g with a negative hepatitis B-status mother should receive hepatitis B immunization within 24 hours of birth. This quality improvement project studied the effect of the electronic medical record newborn admission …

Informing Strategy To Ensure Detection: Perceptions Of Coronavirus Testing In A Southeastern U.S. Urban Homeless Population, Colleen Bell, Theodore Bosi, Barbara L. Gracious

HCA Healthcare Journal of Medicine

Introduction: Attitudes of those in the homeless population toward testing, particularly during a pandemic, are critical to understand, so that they and their communities may be safely triaged and protected. Homeless persons are more likely to be exposed during viral epidemics, and have greater vulnerability for more severe viral illness, due to greater medical comorbidities. The literature reflects a dearth of published papers describing the perceptions, interest, and motivations of homeless people to seek or receive viral testing, despite their status as a high-risk population.

Methods: A quality improvement project consisting of a cross-sectional survey took place at 8 SARS-CoV-2 …

Neuropsychiatric Presentation Of Covid-19: A Case Report Of Disinhibition In An Acute Sars-Cov-2 Infection, I. Jack Abramson, Kristy A. Fisher, Clara V. Alvarez, Jacqueline Horan Fisher

HCA Healthcare Journal of Medicine

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) viral infection is notable for a high degree of symptom diversity. Emerging evidence suggests viral invasion of the central nervous system; therefore, serious neurological and psychiatric manifestations are anticipated. We present the case of a 67-year-old male physician with a history of stable Bipolar Disorder for decades, hospitalized for persistent COVID-19 symptoms with documented positive serology, who presented with new and acute onset neuropsychiatric symptoms of disinhibition proximate the viral infection. We postulate neuroinvasion as the putative origin of the patient’s psychiatric instability. Further investigation is needed to expand upon our understanding of the …

Adverse Childhood Experiences As Predictors Of Perceived Health: Assessing The Ace Pyramid Model Using Multiple-Mediation, Phillip Hughes, Tabitha L. Ostrout

HCA Healthcare Journal of Medicine

Background: Adverse Childhood Experiences (ACEs) have been shown to contribute to a litany of mental and physical health problems, including several chronic diseases and death, via a model known as the ACE pyramid. Many of the results of ACEs in the ACE pyramid are known contributors to poor perceived health, which has significant health implications. Despite these results, a possible link between ACEs and perceived health has not been examined to date. Based on the temporal order of the ACE pyramid, we believe any relationship between ACEs and perceived health will be mediated by other components of the model.

Methods: …

Geriatrics In Clinical Practice And Beyond: Brain Health, The Sixth Vital Sign?, Nannette Hoffman

HCA Healthcare Journal of Medicine

Brain health in middle age and geriatric patients will take on greater importance for health care practitioners in our aging society. This article discusses various approaches clinicians can use for their patients to promote and improve brain health. These are generally the same lifestyle adoptions for cerebrovascular disease and cardiovascular disease prevention: weight management, exercise, and blood pressure and cholesterol lowering. Social stimulation and cognitive activities may also be important for the elderly.

The Other Epidemic, Bruce Deighton

HCA Healthcare Journal of Medicine

The epidemic level of opioid abuse in the U.S. population continues to present a major challenge to our society and to the medical profession. Medical education has a significant role in improving screening, diagnosis, appropriate treatment and management of opioid use disorder. Addressing the problem of overprescribing opioids through physician education, surveillance and opioid management has resulted in significant improvement, translating to fewer overdose deaths from prescription opioids. Graduate medical education can increase access to care by training more addiction medicine specialists, and training other physicians to prescribe buprenorphine and provide access to medically assisted care.

Effect Of An Electronic Order Set On Newborn Hepatitis B Immunization Rates, Daniel Pedersen, Angelina Rodriguez, Michael King, Heather Schramm

West Florida Division GME Research Day 2020

No abstract provided.

Transitioning To Value-Based Diabetes Care: A Call For Action Derived From Primary Care Providers In South Florida, Francois Sainfort, Julie A. Jacko, Johannes Vieweg

HCA Healthcare Journal of Medicine

Background: In Florida, 2.4 million people have diabetes and 5.8 million are pre-diabetic. Not only has the prevalence of diabetes doubled over the past 20 years from 5.2 in 1992 to 11.2 in 2014, but the Centers for Disease Control and Prevention expects 1 out of every 3 adults will have diabetes by the year 2050. In addition, in every year since 1996, Florida well exceeds the national levels in terms of prevalence of diabetes, and the gap is getting wider. A study was conducted to gather information from key physician stakeholders as to how to address unmet needs of …