Medicine and Health Sciences Commons^™

An Organization-Wide Service Improvement Approach, Jennifer Jasmine Arfaa, Phd, Mhsa, Cynthia Line, Phd, Nora Kramer, Msn, Rn, Karen Montoro, Rn, Richard D. Blob,, Maria Francesco, Jaime Stazi, Rn, Elisabeth Kunkel, Md, Susan Krekun, Md, Lizanne Mason, Rn, Kathy Evans, Rn, Lorraine Weikel, Rn, Ann D. Clark, Ms, Otr/L, Ray Wisniewski, Teresa Heavens

Department of Nursing papers and presentations

APPROACH TO PROBLEM SOLVING

High priority index questions from HCAHPS and Press Ganey surveys, including overall ratings, communication with RNs and MDs, hospital environment and response to concerns and complaints, were targeted for improvement. These high priority indices served as the basis for redesigning Patient Services using a multi-faceted approach to improve patients’ experiences.

At Thomas Jefferson University Hospital (TJUH), high performance on the Patient Experiences of Care Survey has been driven by a successful multi-tiered approach to patient services:

·Hospital leadership guided and implemented new approaches to ensure excellence in patient services is an ever-present and obtainable goal

·Physician …

Cardiac Risk Factors And Risk Scores Vs Cardiac Computed Tomography Angiography: A Prospective Cohort Study For Triage Of Ed Patients With Acute Chest Pain., Ethan J Halpern, Jacob P Deutsch, Maria M Hannaway, Adrian T Estepa, Anand S Kenia, Kenneth J Neuburger, David C Levin

Department of Radiology Faculty Papers

OBJECTIVE: The objective of the study is to evaluate cardiac risk factors and risk scores for prediction of coronary artery disease (CAD) and adverse outcomes in an emergency department (ED) population judged to be at low to intermediate risk for acute coronary syndrome.

METHODS: Informed consent was obtained from consecutive ED patients who presented with chest pain and were evaluated with coronary computed tomography angiography (cCTA). Cardiac risk factors, clinical presentation, electrocardiogram, and laboratory studies were recorded; the Thrombolysis in Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) scores were tabulated. Coronary computed tomography angiography findings were …

Consistent Surgeon Evaluations Of Three-Dimensional Rendering Of Pet/Ct Scans Of The Abdomen Of A Patient With A Ductal Pancreatic Mass., Matthew E Wampole, John C Kairys, Edith P Mitchell, Martha L Ankeny, Mathew L Thakur, Eric Wickstrom

Department of Biochemistry and Molecular Biology Faculty Papers

Two-dimensional (2D) positron emission tomography (PET) and computed tomography (CT) are used for diagnosis and evaluation of cancer patients, requiring surgeons to look through multiple planar images to comprehend the tumor and surrounding tissues. We hypothesized that experienced surgeons would consistently evaluate three-dimensional (3D) presentation of CT images overlaid with PET images when preparing for a procedure. We recruited six Jefferson surgeons to evaluate the accuracy, usefulness, and applicability of 3D renderings of the organs surrounding a malignant pancreas prior to surgery. PET/CT and contrast-enhanced CT abdominal scans of a patient with a ductal pancreatic mass were segmented into 3D …

Body Mri Artifacts In Clinical Practice: A Physicist's And Radiologist's Perspective., Martin J Graves, Donald Mitchell

Department of Radiology Faculty Papers

The high information content of MRI exams brings with it unintended effects, which we call artifacts. The purpose of this review is to promote understanding of these artifacts, so they can be prevented or properly interpreted to optimize diagnostic effectiveness. We begin by addressing static magnetic field uniformity, which is essential for many techniques, such as fat saturation. Eddy currents, resulting from imperfect gradient pulses, are especially problematic for new techniques that depend on high performance gradient switching. Nonuniformity of the transmit radiofrequency system constitutes another source of artifacts, which are increasingly important as magnetic field strength increases. Defects in …

Marine-Lenhart Harboring Papillary Thyroid Cancer, Brian Y. Chou, Md, Sharon Segal, Do, Edmund A. Pribitkin, Md, Jeffery L. Miller, Md

Department of Otolaryngology - Head and Neck Surgery Presentations and Grand Rounds

Introduction

Graves' disease with functioning nodules is referred to as Marine-Lenhart Syndrome. Only 2.7% of the patients with Graves’disease have concomitant functioning nodules.¹ Thyroid scintigraphy often definitively confirms the diagnosis. However, in addition to a hyperfunctioning (i.e. "hot") nodule, the thyroid scan may reveal isofunctioning (i.e. "warm"), and or a nonfuntioning (i.e. "cold") nodule as compared to the normal surrounding thyroid. Since hyperfuntioning nodules rarely harbor malignancy, if one is found that corresponds to the nodule in question, no cytologic evaluation is usually necessary.² Conversely, the majority of all nonfunctioning nodules may be benign or less frequently malignant, …

Department Of Radiology-Annual Executive Summary Report-July 1, 2012 To June 30, 2013, Vijay M. Rao, Md

Department of Radiology Administrative Documents and Reports

86 page Department of Radiology Annual Executive Summary Report, July 1, 2012 to June 30, 2013, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.

Table of Contents

Chairman, Vice Chairmen 1

Divisions and Directors 1

Committees and Chairmen 1

Radiology Department Faculty Rank 2

Faculty with Secondary Appointments 3

Clinical Divisions 4

Radiology Residents and Fellows 5

Department Organizational Chart 6

Department Administration Chart 7

State of the Department 8

Appendix I: Publications

Journal Articles 24

Books and Book Chapters 30

Abstracts 31

Appendix II: Formal Scientific Presentations 43

Appendix III: Honors, Editorial Activities, Service to Regional or National Organizations …

Delayed Appearance Of Aortic Pseudoaneurysm, Melanie Kinkler, Deborah Rodgers, Traci B. Fox, Ms, Rt(R), Rdms, Rvt

Department of Radiologic Sciences Faculty Papers

A pseudoaneurysm off of the abdominal aorta is an extremely rare, yet potentially fatal, diagnosis following trauma to the abdomen. This case describes a delayed complication following spinal surgery.

Carotid Artery Aneurysm: A Case Study, Ashley Ashley Kanefsky, Rdms, Jessica Mcgettigan, Traci B. Fox, Ms, Rt(R), Rdms, Rvt

Department of Radiologic Sciences Faculty Papers

A 60 year old male arrived at the emergency department after losing consciousness. CT showed he demonstrated a right hemispheric embolic stroke with a middle cerebral artery distribution. Upon further investigation, the patient was found to have a right common carotid artery aneurysm that extended about 1 cm from the carotid bifurcation into the internal carotid artery. The patient underwent carotid artery reconstruction with the use of his right great saphenous vein.

This case demonstrates an unusual form of cerebral embolization due to a internal carotid artery aneurysm.

Assessment Of Early Tumor Response To Cytotoxic Chemotherapy With Dynamic Contrast-Enhanced Ultrasound In Human Breast Cancer Xenografts., Jian-Wei Wang, Wei Zheng, Ji-Bin Liu, Yao Chen, Long-Hui Cao, Rong-Zhen Luo, An-Hua Li, Jian-Hua Zhou

Department of Radiology Faculty Papers

There is a strong need to assess early tumor response to chemotherapy in order to avoid adverse effects from unnecessary chemotherapy and allow early transition to second-line therapy. This study was to quantify tumor perfusion changes with dynamic contrast-enhanced ultrasound (CEUS) in the evaluation of early tumor response to cytotoxic chemotherapy. Sixty nude mice bearing with MCF-7 breast cancer were administrated with either adriamycin or sterile saline. CEUS was performed on days 0, 2, 4 and 6 of the treatment, in which time-signal intensity (SI) curves were obtained from the intratumoral and depth-matched liver parenchyma. Four perfusion parameters including peak …

Early Results Of Prostate Cancer Radiation Therapy: An Analysis With Emphasis On Research Strategies To Improve Treatment Delivery And Outcomes., Kosj Yamoah, Kwamena Beecham, Sarah E Hegarty, Terry Hyslop, Timothy Showalter, Joel Yarney

Department of Radiation Oncology Faculty Papers

ABSTRACT: BACKGROUND: There is scant data regarding disease presentation and treatment response among black men living in Africa. In this study we evaluate disease presentation and early clinical outcomes among Ghanaian men with prostate cancer treated with external beam radiotherapy (EBRT). METHODS: A total of 379 men with prostate cancer were referred to the National Center for Radiotherapy, Ghana from 2003 to 2009. Data were collected regarding patient-and tumor-related factors such as age, prostate specific antigen (PSA), Gleason score (GS), clinical stage (T), and use of androgen deprivation therapy (ADT). For patients who received EBRT, freedom from biochemical failure (FFbF) …

Retro-Aortic Left Renal Vein, Joann Aichroth, Rdms, Traci B. Fox, Ms, Rt(R), Rdms, Rvt

Department of Radiologic Sciences Faculty Papers

The term retro-aortic left renal vein (RLRV) is defined as the left renal vein coursing posterior to the abdominal aorta. RLRV is an uncommon condition in which the left renal vein passes posterior to the abdominal aorta and anterior to the vertebrae. RLRV may lead to left renal vein hypertension (LRVH) syndrome, which is also known as Nutcracker syndrome. Nutcracker syndrome (NCS) is a condition in which the left renal vein is compressed causing hypertension of the vessel. RLRV and Nutcracker syndrome are vascular anomalies considered to be of clinical importance especially during surgical procedures of the renal vasculature.