Medicine and Health Sciences Commons^™

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …

Engaging Chief Medical Officers To Improve Multidisciplinary Rounds, Gregory Mccormack, Pranav C. Mehta

HCA Healthcare Journal of Medicine

Background

Multidisciplinary rounds (MDRs), a model of care in which multiple members of the care team, representing different disciplines, come together to discuss the care of a patient in real-time. MDRs are a valuable tool for clinical teams to improve patient length of stay (LOS), reduce healthcare-associated infections, and increase care coordination. HCA Healthcare’s data science and performance improvement teams created a data visualization tool called Next-gen Analytics for Treatment and Efficiency (NATE) Tempo to support care teams in managing rounds and barriers.

Methods

A pilot implementation of MDRs using the NATE Tempo tool was initiated in 10 hospitals, accompanied …

Describing And Predicting Trajectories Of Healthcare Utilization Among Older Adults Presenting To An Emergency Department Using The Interrai Emergency Department Screener, Matthew B. Downer, Kristina Kokorelias, Andrew P. Costa, Don Melady, Samir K. Sinha

Journal of Geriatric Emergency Medicine

Introduction: Although older adults visit emergency departments (EDs) more than any other age group, the trajectories of healthcare utilization older adults experience post-ED are not well described. Further, whether rapid ED assessment tools can predict trajectories and discharge destinations remains unclear.

Methods: Older adults (≥65 years) who presented to an ED at a large Canadian urban academic hospital were recruited (January 2018-April 2019). The interRAI ED Screener (EDS) was completed on presentation. Patients were categorized by EDS risk score (1/2=low, 3/4=moderate, 5/6=high) and had their discharge destinations tracked. Patients admitted to hospital were tracked until their final discharge destination. …

From Bedside To Boardroom: Inspiring Nurses Through Storytelling, Dr. Tricia Kassab

Transform

from bedside to boardroom: Inspiring Nurses through storytelling

The key to understanding how nurse executives use stories to lead organizations resides in a deeper examination of the type of stories told to create transformational change. The story of nurse Kassab and how she started from bedside to boardroom highlights the importance of using stories to effect changes. Nurse leaders need to connect with staff personally and forge strong relationships with teams, especially during times of stress. This article reviewed how nurse leaders set the tone of organizational cultures using a transformational leadership style to inspire, energize and influence the nursing …

Evaluation Of A Community Based Teaching Hospital’S Geriatric Emergency Medicine Initiative, Josette Hartnett, Isabel Muronzi-Belfon, Suzanne J. Rose

Journal of Geriatric Emergency Medicine

INTRODUCTION: To accommodate the complex healthcare needs of the rising geriatric population, Stamford Hospital’s (SH) emergency department (ED) began a Geriatric Emergency Medicine Initiative (GEMI) in 2018 to improve our ED environment, practices, and focused assessments for our community-dwelling older adults.

METHODS: This retrospective program evaluation describes SH’s novel ED processes for at-risk older adults and compares GEMI and non-GEMI assessed patient outcomes using aggregate frequencies on throughput metrics such as length of stay (LOS), 72 hour and 30-day re-admission rates, and other outcomes of interest. Chi-square tests and group t-tests were used for all analyses with a p-value of …

New Dentists’ Most-Asked Legal Questions, Dan Schulte Jd

The Journal of the Michigan Dental Association

This feature addresses new dentists' most frequently asked legal questions, offering concise answers to guide them. Topics include licensing requirements, dental record maintenance, accommodations for hearing-impaired and non-English proficient patients, the enforceability of covenants not to compete, the necessity of written employment agreements, responding to bad dental work, reporting suspected abuse, prescribing drugs to friends and family, contract terms with dental plans, and handling suspected employee theft. The article emphasizes the importance of understanding legal aspects to navigate a dental career successfully.

Mda Workforce Survey Results Are In: Answers And Opportunities, Eric Knudsen Dds

The Journal of the Michigan Dental Association

This President's Message addresses critical workforce challenges in dentistry based on the Michigan Dental Association's (MDA) recent workforce survey. The survey identifies significant issues such as the shortage of dental professionals, wage stagnation, and the impact of retirement trends on the dental labor market. Findings indicate a need for immediate solutions, leading the MDA to develop initiatives targeting the return of registered dental assistants (RDAs) and registered dental hygienists (RDHs) to the workforce. The survey results emphasize the importance of competitive wages and desirable benefits to attract and retain dental staff. The MDA plans targeted advertising and free job postings …

J Mich Dent Assoc December 2023

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following:

• A cover story on “New Dentists’ Most Asked Legal Questions”
• A case report on “Endodontic Therapy, Crown Amputation, and Soft Tissue Advancement to Treat a Hopeless Tooth”
• A feature “Be a Leader in Your Practice: What’s Your Style?”
• 2023 Author/Title Index to the Journal of the Michigan Dental Association
• News you need, a Guest Editorial and regular …

Dentistry And The Law: Requiring Proof Of Adoption/Retaining Orthodontic Models, Dan Schulte Jd

The Journal of the Michigan Dental Association

In this Dentistry and the Law column, a dentist seeks guidance on handling a situation where racial differences between a child and an accompanying adult raised concerns during an examination, leading the dentist to request proof of adoption. The response clarifies that asking for proof of adoption is not illegal, citing relevant Michigan adoption statutes. The column advises adopting an office policy, emphasizing human trafficking training. Additionally, a dentist inquires about retaining orthodontic models and X-ray films. The answer recommends assuming orthodontic models are part of dental records, subject to a 10-year retention period. Patients can be given their models, …

Be A Leader In Your Practice: What’S Your Style?, William Chase Dds, Maom

The Journal of the Michigan Dental Association

In this Leadership Development feature, the author draws from a wealth of leadership experience in Rotary to explore the importance of leadership in dentistry. Emphasizing the need for self-evaluation through emotional intelligence, the article delves into five key aspects: self-awareness, self-regulation, motivation, empathy, and social skills. The author introduces three leadership styles — Transformational Leadership, Situational Leadership, and Servant Leadership — highlighting their characteristics and benefits. Encouraging readers to adopt diverse leadership styles, the piece underlines the significance of effective leadership in dental practice, community engagement, and organized dentistry.

Promoting Mammography Screenings In African American Women: Media, Church, And Health Providers, Lasonya Little, Debra C. Wallace, K.Jay Poole

Journal of Health Disparities Research and Practice

Due to the underutilization of screening mammography, African American women (AAW) are more likely to experience negative health outcomes after receiving a late-stage breast cancer diagnosis than White Women (WW). The purpose of this article is to examine the roles of the media, health community and the African American church and pastor and their potential impact in AAW screening decisions. Fifteen AAW, ages 45 and older, were invited to participate in a semi-structured interview. Most women agreed the African American pastor and church as well as the health community, and media are an integral part of their lives. Therefore, specific …

Pulmonary Specialist-Supported Health Coaching Delivered By Lay Personnel Improves Receipt Of Quality Care For Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial, Rachel Willard-Grace, Danielle Hessler, Beatrice Huang, Denise Devore, Chris Chirinos, Jessica Wolf, Devon Low, Chris Garvey, Doranne Donesky, Stephanie Tsao, David H. Thom, George Su

Journal of Patient-Centered Research and Reviews

Purpose: Half of people living with chronic obstructive pulmonary disease (COPD) do not receive high-quality, evidenced-based care as described in international guidelines. We conducted secondary data analysis of a previously published study to assess the ability of a model of lay health coaching to improve provision of guideline-based care in a primary care setting.

Methods: As part of a randomized controlled trial, we recruited English- and Spanish-speaking patients with moderate to severe COPD from primary care clinics serving a low-income, predominantly African American population. Participants were randomized to receive usual care or 9 months of health coaching from primary care …

Survey Of Pediatric Critical Care Fellows On Postresuscitation Debriefing, Nicole K. Sather, Lauren E. Zinns, Gillian Brennan, Lily Guo, Nadia Khan, Vinod Havalad

Journal of Patient-Centered Research and Reviews

Purpose: Current guidelines recommend debriefing following medical resuscitations to improve patient outcomes. The goal of this study was to describe national trends in postresuscitation debriefing practices among pediatric critical care medicine (PCCM) fellows to identify potential gaps in fellow education.

Methods: A 13-item survey was distributed to fellows in all 76 ACGME-accredited PCCM programs in the United States in the spring of 2021. The online survey addressed frequency and timing of debriefings following medical resuscitations, whether formal training is provided, which medical professionals are present, and providers’ comfort level leading a debriefing. Results were analyzed using descriptive statistics.

Results: A …

A Clear, Succinct Research Question Portends The Rest Of The Story, Jessica J. F. Kram, Lisa Sullivan Vedder, Brenda Fay, Deborah Simpson

Journal of Patient-Centered Research and Reviews

The goal of any research manuscript is to convey the story of a systematic answer to an important question in the field. A clear, succinct research or study question is what provides the storyline that connects all the sections of a manuscript. One of the most common strategies to developing a meaningful research question is the FINER approach, which encompasses five standards to determine the quality of a question: feasible, interesting, novel, ethical, and relevant. Using the FINER approach can provide the guidepost for all design and reporting decisions. This editorial recommends creating a study protocol aimed at answering your …

Conference Proceedings: Select Abstracts Presented At 2023 Advocate Aurora Scientific Day

Journal of Patient-Centered Research and Reviews

This abstract supplement includes findings presented at the 49th annual Advocate Aurora Scientific Day on May 24, 2023. The Scientific Day symposium provides a virtual forum for the sharing of preliminary results from research and case studies conducted by faculty, fellows, residents, and other health professionals associated with Illinois-based Advocate Health Care and Wisconsin-based Aurora Health Care.

A Helping Hand Out Of The River: Refugee Perspectives For Provider Engagement, Brian L. Isakson, Elizabeth R. Stein, Alexandra Olson, Destiny Waggoner, Jill Holtz, Sara Ali, Suha Amer, Martin Ndayisenga

Journal of Patient-Centered Research and Reviews

Purpose: A growing number of refugee groups are seeking care within the U.S. health care system for medical, psychological, and social needs. Research is limited in understanding refugee-specific conceptualizations of helping relationships and provider characteristics that improve interactions in health systems. This study aimed to identify provider characteristics that facilitate engagement and helpfulness in a refugee-specific population from refugee participant voices to inform future practices of health care clinics.

Methods: Semi-structured interviews with refugee participants were conducted to assess 1) experiences moving on from difficult experiences, 2) engagement with the health system, and 3) provider characteristics that facilitated engagement and …

Assessing Medication Self-Management Challenges And Self-Efficacy During Emergency Department Medication Reconciliation: An Evidence-Based Quality Improvement Project, Mitchel Erickson, Jyu-Lin Chen, Yoonmee Joo, Stephanie Rogers, Thomas Hoffman, Claire Bainbridge

Journal of Geriatric Emergency Medicine

Abstract

Background

Older adult patients (≥65) accessing emergency departments (ED) represent a significant demographic. Recidivism secondary to adverse drug events (ADE) ranges between 6-24% and levels of prescribed medication non-adherence is common among older adults. The ED pharmacist medication reconciliation workflow may mitigate self-management challenges in real time and reduce medication-related harm while potentially impacting recidivism, medication adherence, and patient self-efficacy. The purposes of this evidence-based project were to (1) evaluate the impact of a modified Medication Management for Deficiencies in the Elderly (MedMalDE) intervention on Self-Efficacy for Appropriate Medication Use (SEAMS) and 30-day return to care and (2) identify …

Depression And Anxiety Of Care Partners During The Emergency Department Visit Of Older Adults With Cognitive Impairment, Nancy Glober, Anthony Perkins, Joshua Chodosh, Karen Connor, Sujuan Gao, Frank Messina, Malaz Boustani, Soo Borson, Nicole R. Fowler

Journal of Geriatric Emergency Medicine

Background: Older adults with cognitive impairment (CI) are more likely to visit the emergency department (ED) than those without CI. They are also more likely to suffer poor outcomes after an ED visit. Family and friends who serve as care partners contribute significant time and resources to the care of these patients and may need particular attention to their emotional needs during and after the ED encounter. In this study, we examined the association between patient and care partner characteristics on care partner depression and anxiety at the time of the ED visit.

Methods: Baseline data from 640 patient-care partner …

Risk Assessment In Discharge Process Using Pfmea Tool In A Multi-Specialty Hospital, Shalini ., Kanakavalli K. Kundury, H. Basavana Gowdappa

International Journal of Health and Allied Sciences

Introduction: ‘Quality’ is an inseparable component of healthcare. It focuses not only on care parameters but also in identifying the potential failures/ risks associated with the care process; thereby addressing them pro-actively before the occurrence of the loss. There are several quality tools available such as Process Failure Mode Effect Analysis (PFMEA) that helps in analyzing a process for identification of possible failures. This helps to find ways to avoid the occurrence of the failure or have a strategy to eliminate or minimize the risk. Thus, the current study was undertaken on identifying the risks involved in the discharge process …

Charting And Checking For Suicidality In A Family Medicine Residency Clinic, Bridget Murphy, Stacy Ogbeide

Journal of Human Services Scholarship and Interprofessional Collaboration

Suicide is a leading cause of death in the United States, and many individuals who die by suicide are likely to have seen a primary care physician (PCP) within the month of their death. Thus, the goal of this quality improvement (QI) project was to examine suicidality documentation practices of interprofessional clinicians within a Family Medicine residency clinic, thus providing rationale for continued research and a template for other clinics to emulate. The QI project used the Plan-Do-Study-Act cycle to survey 28 Family Medicine residents, faculty, and trainees for the Plan stage of the cycle in 2022 and assessed their …

Informed Consent In Surgical Practice With Patients’ Experiences: A Cross-Sectional Study, Seda Kumru, Pakize Yiğit, Meryem Demirtaş, Hüseyin Fındık

Patient Experience Journal

This study aims to evaluate patients' experiences and perspectives regarding informed consent in surgical practice. Data for this cross-sectional study were collected from 276 patients using a questionnaire developed by Falagas et al. Descriptive statistics were employed for all questions. Statistical tests such as the Mann-Whitney U test, Kruskal-Wallis test, and Spearman's rank correlation analysis were performed, and Cohen's effect sizes were reported. IBM SPSS 23.0 was used for all analyses, and p<0.05 was considered statistically significant. A high score on both The Delivered Information Index and The Patient-Physician Index represents a positive informed consent process. Among the participants, 65.2% indicated that they understood all parts of the consent form. Of all patients, 92.8% reported that information about the specific surgical procedure was provided by physicians. However, 47.5% of the patients reported that they did not feel comfortable with their surgeons. The mean score of the Delivered Information Index was 5.63 (2.38). The mean patient-physician relationship score was 14.38 (3.31). There was a moderate positive correlation between the delivered information index and the patient-physician relationship (r=0.50; p<0.001). In addition, there was a moderate positive correlation between the delivered information index and the time spent on the informed consent process, as well as between the patient-physician relationship and the time spent on the informed consent process (r=0.52; r=0.40, respectively). The study emphasized the lack of communication between patients and physicians, the limitation of information on treatment risks, adverse effects, and alternative treatment options.

Experience Framework

This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/).

• Access other PXJ articles related to …

Coaching And Laissez-Faire Leadership Styles, Michelle C. Dziurgot Dds

The Journal of the Michigan Dental Association

Editor Dr. Michelle C. Dziurgot discusses the differences between coaching and laissez-faire leadership styles in dentistry. Coaching leaders motivate and educate their team members, fostering collaboration and improvement. In contrast, laissez-faire leaders take a more hands-off approach, allowing team members to make decisions independently. The author, a dentist, describes how she combines both styles in her practice, emphasizing the importance of educating and coaching team members while allowing them to take ownership of their roles. The editorial highlights the need for patient engagement in oral health care and the importance of coaching patients to take an active role in their …

Dentistry And The Law: Problems With Referral Incentives Explained, Dan Schulte Jd

The Journal of the Michigan Dental Association

Incorporating referral incentives in dentistry, like gift cards or raffles, can present ethical and legal issues. The MDA's ethical rule 4.E prohibits rebates or fee splitting, extending to any referral source, including patients. Gift cards may be perceived as rebates. Raffle tickets are less problematic, but only the winner gains something of value. State law (MCL 333.16221) deems fee division unethical. For insurance and dental plan agreements, check for clauses mandating specific fee schedules and discouraging referral fees to ensure compliance. Federal laws might also apply if incentives are used for Medicaid or Medicare patients.

Advocacy Spotlight: Important: State Issues Changes To Delegation Of Duties Rules, Neema Katibai Jd

The Journal of the Michigan Dental Association

The Michigan Board of Dentistry has introduced changes to the rules governing the delegation of duties to dental auxiliaries, including the reclassification of "dental assistants" (those not formally trained or licensed) as "unregistered dental auxiliaries" (UDAs). The classification Registered Dental Assistant (RDA) remains. Changes involve the supervision levels for specific tasks and guiding training UDAs for orthodontic duties. Notable changes include allowing UDAs to perform certain orthodontic tasks and expanding their scope of work to include duties such as taking impressions, polishing, and providing nutritional counseling. Dental professionals should know these changes and the supervision required for delegation to UDAs …

Staff Matters: How Can We Be More Creative With Our Benefits?, Jodi Schafer Sphr, Shrm-Scp

The Journal of the Michigan Dental Association

As open enrollment for health benefits approaches, this column discusses creative and cost-effective benefit offerings to attract and retain employees. The focus is on innovative benefits beyond traditional health, life insurance, and retirement plans. Suggestions include pet insurance, paid volunteer time, lunch and learn sessions, and flexible scheduling to accommodate employees' needs, particularly working parents and those with caregiving responsibilities. The importance of seeking employee input in benefit planning is emphasized for discovering practical, employee-desired options.

J Mich Dent Assoc November 2023

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on The University of Michigan's Gordon H. Sindecuse Museum of Dentistry.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, and component news.

This issue also includes two articles reprinted with permission.

• A feature from Ontario Dentist on The Challenge of False Belief: …

Enhancing The Rates Of Advance Directive Documentation To Improve The Quality Of Patient Care, Sydney Sheppard, Katie Salyers, Carolyn Curtis, Adam Franks Franks, Courtney Wellman

Marshall Journal of Medicine

Introduction

Advance Directives (AD) allow patients to maintain autonomy during incapacitation. Patients and their caregivers benefit from these documents in times of crisis. Overcoming barriers to AD completion and documentation can improve patient care quality.

Methods

A retrospective chart review was performed initially, after consolidation of the electronic health record (EHR) and after alteration of the EHR, to evaluate the availability of a patient’s medical power of attorney (MPOA), living will (LW), and code status.

Results

Baseline documentation of MPOA (7.33%), LW (6.00%), and code status (5.33%) within the outpatient EHR was low. After 2 cycles, this improved to 13.10%, …

Nursing Innovation: Improved Perioperative Care With A Redesigned Urological Drape, Olivia Sonneborn, Indra Jolayemi

Journal of Perioperative Nursing

Inventions and innovations have the potential to change lives.¹ Perioperative nurses strive for improved patient care² and are well positioned to develop creative and innovative solutions to clinical challenges faced when caring for patients in the perioperative environment. Fluid leakage during percutaneous nephrolithotomy (PCNL) surgery poses risks to both patients³ and staff. The PCNL drape was developed by a collaborative perioperative team to reduce these risks and improve the quality of care provided to patients.

Exploration Of Burnout, Emotional Thriving, And Emotional Recovery In An Academic Medical Center: A Mixed Methods Quality Improvement Project, Roxana Naderi, Katherine T. Morrison, Zuzanna Czernik, James E. Carter Jr, Katherine N. Dickerman, Alexandra Gallant, Lara Kirkbride-Romeo, Lauren Mcbeth, Angela Keniston, Kristin M. Jensen

Journal of Wellness

Introduction: Healthcare provider burnout, an indicator of wellbeing, impacts patient safety, provider distress, and employee turnover. In this mixed methods, multi-site quality improvement study conductedpandemic, we assessed employee wellbeing in a large clinical department.

Methods: Wellbeing surveys were sent electronically to Department of Medicine clinicians, researchers, administrators, and staff from August-September 2019 assessing perceptions of Burnout, Emotional Thriving (ET), and Emotional Recovery (ER). Qualitative responses were reviewed for themes using mixed inductive-deductive analysis. The initial coding was done by small teams with consensus obtained through large group discussions. This study was IRB-approved as non-human subjects research.

Results: Of the 671 …

Gericared: Feasibility Of A Pilot Program Of A Geriatric Personal Care Attendant Addressing Mentation, Mobility And Matters Most In An Emergency Department Observation Unit, Ilianna Santangelo, Anne Marie Thompson, Aileen Tubridy, Kendra Cull, Bridget Conly, Benjamin A. White, Maura Kennedy

Journal of Geriatric Emergency Medicine

The aging of the population has a significant impact on the health care system, as older adults have higher rates of emergency department (ED) visits and hospitalization, different care needs, and are at higher risk of iatrogenic harm in the hospital setting. In addition, there has recently been a rapid growth in ED observation units (EDOUs), to which older adults are frequently admitted. Recognizing the specific needs of older adults, our EDOU implemented an ‘Up by 10’ program which incorporates key components of delirium prevention programs. We took an iterative approach to the implementation of this program, resulting in a …