Medicine and Health Sciences Commons^™

Initial Response To The Opioid Crisis: Availability Of Buprenorphine And Warm Handoff In The Ed, Lauren Selame, Md, Benjamin H. Slovis, Md, Ma, Theodore Christopher, Md, Facep, Kory S. London, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Background:

• The United States is in the midst of an opioid crisis.
• The Centers for Disease Control and Prevention has cited Emergency Departments (ED) as important centers for treatment and referral, including medication assisted treatment (MAT), which has been shown to be superior to motivational interviewing and referral alone.1,2
• While direct linkage to outpatient programs via the ED may be an opportunity to better serve this population, data on such “warm handoff” interventions are sparse.

Objective: We initiated an ED opioid use disorder (OUD) pathway, which aimed to initiate buprenorphine therapy and perform warm handoff directly into the community for …

Improving Postoperative Handoffs In The Neuro-Intensive Care Unit, Richard F. Schmidt, Md, Andrew Mendelson, Md, Sonia Gill, Md, Nicole Hollup, Crnp, Matthew Vibbert, Md, Coleen Vernick, Md, Giuliana Labella, Msn, Marie Wilson, Msn, Caitlin Harley, Msn, Maryanne Mccarrin, Msn, Jack Jallo, Md, Rebecca Jaffe, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Introduction

• Transitions of care represent a major source of medical errors, patient morbidity/mortality, and increased healthcare waste.
• 2018 CLER report indicated largely unfavorable responses toward handoffs and care transitions for perioperative services and neurointensive care.
• Use of the IPASS handoff tool is associated with up to 30% reduction in adverse events and 23% reduction in medical errors.
• Implementation of IPASS for postoperative handoffs in the SICU resulted in improved organization, safety, and communication.

It Takes A Village: Developing An Airway Management Bundle To Standardize Emergent Intubation Processes In The Emergency Department, James Sacca, Md, Daniel Casey Kim, Md, Dimitri Papanagnou, Md, Mph, Edd(C)

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Problem Definition

Airway management is at the core of emergent patient care. Emergent intubations in the Emergency Department (ED) at Thomas Jefferson University Hospital (TJUH) have been noted by staff to be variable and not standardized. Staff have also described that equipment tends to be difficult to locate during intubations.

There is no objective data to confirm these claims. Furthermore, there is no bundle in place to guide emergent intubations in the ED.

Our team sought immediate actions to improve ED airway processes.

Improving Diabetic Retinopathy Screening In A Large Ambulatory Practice, Erica Li, Md, Rebecca Simon, Md, Michael Weissberger, Md, Jennifer Moyer, Md, Rachel Ehrman-Dupre, Md, Andrew Rabovsky, Md, Simon Newsom, Md, Pooja Padgaonkar, Md, Julita Mienko, Md, Sarah Hirsh, Md, Geoffrey Mills, Md, Phd

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Aim 1: To increase the percentage of JFMA diabetic patients with up-to-date retinopathy screening to 60% by April 1, 2019.

Aim 2: To increase the utilization of an in-office portable retinal scanner by identifying current barriers to its use and developing a standardized workflow to overcome these barriers.

Outcome measure: The percentage of adult diabetic patients with a JFMA provider listed as the PCP who have been seen in the Jefferson health system within the last 24 months, who had retinopathy screening once in the last 24 months.

Process measure: The number of retinal scans completed each week.

Does Specific Labelling Of Chest Radiographs To Confirm The Position Of Peripherally Inserted Central Venous Catheters Decrease Turn Around Time?, Patrick Lee, Md, Maansi R. Parekh, Md, Paras Lakhani, Md, Achala Donuru, Md, Baskaran Sundaram, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Objectives

The primary objective of the current study was to decrease the turnaround time (TAT) of PICC CXRs. TAT was defined as the time from completion of the study to finalization of the report by the interpreting radiologist.

Implementation Of Standardized Discharge Instructions, Caitlin Hodge, Md, Quyngdiem Lam, Md, Luis A. Mejia, Md, Orlando C. Kirton, Md, Facs, Mccm, Fccp, Mba, Robert Josloff, Md, Kristin Noonan, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Introduction

Previously, same-day surgical discharge instructions were handwritten by residents on generic fill-in-the-blank forms leading to inconsistent discharge instructions. Residents started an initiative to create these standardized discharge instructions. These instructions were designed to improve documentation for post-operative instructions as well as enhance overall patient safety in an attempt to eliminate miscommunications with patients.

Improving Screening For Diabetic Retinopathy In An Ambulatory Resident Clinic, R. Benson Jones, Guy Katz, Jon Zaid, Navdeep Sangha, Rebecca Davis

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Introduction

While 60% of Americans with diabetes are screened for diabetic retinopathy, the residents in the Jefferson Internal Medicine Associates (JIMA) ambulatory clinic had a lower screening rate (roughly 50%).(1) Our project aimed to increase that screening rate.

Scanning For Qi: Resident And Sonographer Driven Improvement Of Radiology Resident Ultrasound Technique, Brian Blumhof, Md, Corinne Wessner, Bs, Rdms, Rvt, Kristen Mcclure, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Objective

The aim of this structural QI project is to improve the educational ultrasound curriculum , thus improving overall resident confidence and technical ability in acquiring diagnostic quality sonographic images.

Comparing resident confidence levels and performance against their initial benchmarks as well as against yearly cohorts, we plan to create a long standing addition to the radiology residency at Jefferson, with plans to include additional ultrasound examinations as the curriculum becomes more robust.

Stakeholders include not only the radiology residency, which would benefit from improved resident education and knowledge, but also the hospital and ultimately patients, who stand to benefit …

Evaluation Of A Text-Based Event Reporting Process On Resident Event Reporting Rates, R. B. Jones, C. L. Devin, D. Chalikonda, B. Menachem, R. Kanesa-Thasan, K. Klinger, B. Babula, R. Jaffe

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Background

Voluntary event reporting is crucial to identify problem areas in healthcare. At TJUH, resident reporting from July to February during FY19 represented 2% of all report, compared to nursing who accounted for 77% of reports. Resident physicians witness events but do not report them due to cumbersome reporting platform, absence of feedback about reports, lack of reinforcement on how and what to report, and a mindset of not wanting to cause trouble (1,2). Our project aimed to lower the barrier of high administrative reporting burden for residents to report events by creating a HIPAA-compliant, mobile event reporting system.

Getting Rid Of Stupid Stuff (Gross) Committee: Residents Dedicated To Streamlining Epic-Related Workflow, Nkosi H. Alvarez, Md, Christina L. Jacovides, Md, Brian M. Till, Md, Walker Lyons, Md, Keyur Patel, Md, Richard Zheng, Md, Adam Johnson, Md, John Kairys, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Objectives

• Identify specific mechanisms for submitting and implementing improvements to the Epic environment
• Standardize high-use order sets
• Incorporate high-value modular components into existing order sets
• Create new order sets to streamline resident workflows
• Improve communication between stakeholders

Optimizing Resident Clinic Efficiency Through Process Flow Analysis, Michael Abendroth, Md, Mba, Saumya Copparam, Md, Qiang Zhang, Phd, Rose Costello, Ma, Tara Uhler, Md, Robert Bailey, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Abstract

Introduction: Clinic process inefficiencies cause lengthy visit and wait times, which frustrate patients and providers and limit clinic capacity

Objective: To identify process inefficiencies and assess process flow interventions

Methods: Prospective, consecutive series of resident clinic visits over a 3-week period after transferring refraction from tech to resident. Personnel recorded the time spent waiting for and undergoing each clinic process. The clinic also piloted a “Fast Track” from registration to resident for appropriate established patients.

Results: Patients spent 53% of the visit waiting, primarily for the tech. Transferring refraction from tech to resident decreased the wait for tech …

Reducing Double Chest Ct And Unnecesary Radiation: A Quality Improvement Project, Stephan S. Leung, Md, Mansi R. Parekh, Md, Achala Donuru, Md, Paras C. Lakhani, Md, Christopher G. Roth, Md, Baskaran Sundaram, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Objectives

To analyze the variables resulting in double chest CTs being ordered and performed, with the aim to reduce the amount of ordered double chest CTs at Thomas Jefferson University Hospital.

Getting To The Source: Safety Findings In Cervical Cancer Screening Using External Lab Databases, Miranda Aragon, Md, Sunny Lai, Md, Mph, Geoffrey Mills, Md, Phd

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Objective

To investigate the feasibility of using external lab databases to locate Pap smear results completed at outside clinics.

Human Trafficking And Today's Youth, Rachel Whitfield

Presentations

This presentation is designed to help health care providers

• Dispel myths around US domestic trafficking
• Define the different types of human trafficking
• Understand the contributing factors for trafficking
• Understand the effect of pornography on the developing brain
• Recognize risk factors and signs and symptoms of trafficking
• Know how to report human trafficking and where to find local resources

A Community Pharmacy Elective Course Utilizing A Service Development Project To Foster Innovation And Creative Thinking, Danielle Mayer, Pharmd, Bcacp

College of Pharmacy Posters

Course Description

Innovations in Community Pharmacy Practice is a 2-credit hour course offered to pharmacy students in the spring of the third professional year.

Teaching methods

• Group discussions
• Case study activity
• Self-reflection
• Group project

The focus of this course is the evolving role of the community pharmacist in delivering direct patient care services. Students learn the basics of creating a business plan and utilize these principles to create their own business plan for a new or enhanced service that could be implemented at a community pharmacy site. This is a hands-on, project- based course, designed to foster innovation, entrepreneurship, and …

What's Happening: June 3, 2019, Maine Medical Center

What's Happening

No abstract provided.

Week Of June 3, 2019, New York Medical College

InTouch

• The Café Grand Opening Draws a Crowd
• Department of Cell Biology and Anatomy Hosts Annual Research Forum
• College Hosts 9th Annual Paul K. Woolf, M.D., Pediatric Trainee Research Day
• NYMC Observes World Hypertension Day

Newborn Medicine Poster - 2019, Laura Madore Md, Karen Ricci Mph, Jeffrey Shenberger Md

Research and Education Posters

Newborn Medicine Poster - 2019

Nursing Poster - 2019, Rachel K. Walker, Richard Viskochil, Jeanne Gagliarucci, Grace Makari-Judson Md

Research and Education Posters

Nursing Posters - 2019

Pathology Poster - 2019, Anthony Cretara Md, Christopher Otis

Research and Education Posters

Pathology Poster - 2019

Pharmacy Posters - 2019, Adam Pesaturo

Research and Education Posters

Pharmacy Posters - 2019

Surgery Poster - 2019, Gladys Fernandez M.D., David Tashjian Md, Neal Seymour Md, Sheina Theodore Md, Heather Grant Md, Joy Isotti Md

Research and Education Posters

Surgery Poster - 2019

Manufacturing Process Implications On Aerosolized Submicron To Nano-Sized Particles From Respiratory Drug Delivery Devices, Mohammed Ali

Faculty Posters

No abstract provided.

Marta, Marta, Tsos

TSOS Interview Gallery

Marta is a member of the support community for Central American refugees arriving in the southwest US. In this interview, Marta shares her own story of crossing the border at a young age with her daughter and her life in the US. Marta was self-employed for many years and later went on to serve in the US Army in Iraq. For the last 9 months, she and her husband Israel and son Josue have worked tirelessly to help make sure the current refugees arriving are cared for after they are released from detention centers and begin their lives in the …

Med Peds Poster - 2019, Jamie Bowen Md, Mihaela Tiru Md, Benjamin Barnes Md

Research and Education Posters

Med Peds Poster - 2019

Ihdps (Institute For Healthcare Delivery & Population Science) Poster - 2019, Brent Heineman Ba, Sehar Zulfiqar Md, Kerry Spitzer Phd, Mike Moran Ba, Mihaela Stefan Md, Peter Lindenauer

Research and Education Posters

IHDPS (Institute for Healthcare Delivery & Population Science) Poster - 2019

Implications Of Blood Glucose Management With Heart Failure Patients With Type 2 Diabetes In An Acute Care Setting, Jamie Mulick, Mark Romond

All Nursing Boot Camp Posters

No abstract provided.

2016-2018 Retrospective Chart Review:Patients With Substance Use Disorder And Endocarditis, Amartina Dugan, Diane (Helga) Duncan, Sarah King, Tiara Benson

All Nursing Boot Camp Posters

No abstract provided.

Reducing Falls On The Neurovascular Unit, M. Rand Kaller, Isabelle Pisani

All Nursing Boot Camp Posters

No abstract provided.

Psvmc Nursing Reducing Anxiety With The Use Of Aromatherapy Essential Oil Blends In Patients Awaiting Pre-Scheduled Cesarean Section, Amy Engstrom, Erin De La O Cabanas, Minerva Joanne Donato

All Nursing Boot Camp Posters

No abstract provided.