Medicine and Health Sciences Commons^™

Getting Engaged: Efforts To Increase Housestaff Event Reporting, Adam P. Johnson, Md, Mph, Ruben Rhoades, Md, Allison Greco, Md, Caitlyn Sidrane, Mph, Bracken Babula, Md, Rebecca C. Jaffe, Md

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

Background:

Residents traditionally are under-engaged in event reporting through institutional channels.

The ACGME Clinical Learning Environment Review prioritizes this issue, and is establishing national benchmarks.

In 2015 the Housestaff Quality and Safety Leadership Council selected Increasing Error Reporting as their clinical quality initiative.

Got Diabetes? With Us, You'll Have Complete Diabetic Care, Mansi Shah*, Md, Hasmik Minasyan*, Md, Alison Liss*, Md, John Caruson, Md, Loren Chen, Md, Albert Lee, Md

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

AIM:

By April 2016, we aim to improve Complete Diabetic Care of Thursday JHAP Clinic's patients with diabetes by 50%.

* These authors contributed equally

Appropriate Utilization Of Diabetic Diets For Inpatients, Neha Agarwal, Md, Tasha Kouvatsos, Md

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

AIM:

To increase the number of diabetic patients that are ordered a diabetic diet at time of admission

So that blood sugars may be better controlled throughout admission with decreased usage of CDI

Taking The "E" Out Of Night "Mare" Rotation: Uncloaking Ghost Admissions Via Teletracking And Reducing Paper Fatigue, Ramya Punati, Md, Jaehee Kim, Md, Rebecca C. Jaffe, Md, Lakshimi Ravindran, Md, Bracken Babula, Md

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

Goal:

To improve communication at admission for patients admitted from non-ED locations so that patient care delays are minimized and provider frustration decreases.

Easy Identification Of Missed Dvt Prophylaxis-A Chance For Intervention, Kinjal Parikh, Md, Shuwei Wang, Md, Kimberly Conway, Rn, Rebecca C. Jaffe, Md

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

Goal:

"To minimize the number of missed or refused medications for inpatients so that adverse patient events such as PE or DVT are prevented"

SMART AIM: Within 3 months of initiating an EMR based electronic identification system for refused and missed medications, we will decrease the rate at which DVT prophylaxis was ordered however not eventually administered by 50%.

Improving Influenza Vaccination Rates And Understanding Reasons For Patient Refusal At Jefferson Hospital Ambulatory Practice, Daniel Brandt, Md, Ashley Butland, Md, Kevin Kwak, Md, Joseph Yoo, Md, Albert Lee, Md, Susan West, Md

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

AIM:

Improve influenza vaccination rates for eligible patients at the Jefferson Hospital Ambulatory Practice to levels above the national average of 43.6% between October 2015 and March 2016 with universal screening and improved documentation.

To characterize reasons for patients who did not receive vaccination.

Using A Swift Score Guided Time Out To Reduce Medical Icu Readmission Rates, Justin Herman, Md, Andrew Dargan, Md, John Madara, Md, Michael Baram, Md, Bharat K. Awsare, M.D., Fccp

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

AIM:

For patients admitted to the medical ICU over an additional period of 17 months, our goal is to reduce the rate of ICU readmissions within 72 hours of transfer out of the ICU to less than 2%. This will as a result reduce the costs of care, length of stay, and in-hospital mortality rates for these patients.

Understanding And Improving Patient Arrival Rates At An Urban Ambulatory Medicine Resident Clinic, Teresa Lee, Md, Shuwei Wang, Md, Susan Truong, Md, Albert Lee, Md

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

AIMS:

To improve the arrival rate of patients at the Jefferson Hospital Ambulatory Practice (JHAP) by 10% over a 10-month period from July-April 2016 using a combination of additional reminder calls and targeted summaries from physicians.

Improving Influenza Vaccination Rates In The Hiv Population At An Academic Clinic, Anusha G. Govinda, Md, Anita Modi, Md, Emma Biegacki, Bryan Hess, Md

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

AIM:

Performance measure: Percentage of HIV-infected patients with documentation of influenza vaccination in Allscripts.

Numerator: Number of HIV-infected patients who have obtained an influenza vaccine during influenza season.

Denominator: Total number of HIV-infected patients at the Jefferson Infectious Disease (ID) Clinic

Patient exclusions: Those who are allergic to eggs or have had allergic reactions to the influenza vaccine in the past

Goal: "75% of HIV-infected patients at the Jefferson ID clinic will be vaccinated against influenza and documented in Allscripts during influenza season"

Medication Errors And Hospital Admissions, A Tale Of Woe, Allison Greco, Md, René Daniel, Md, Raymond Janowski, Md, Bracken Babula, Md

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

Goal for Improvement:

To improve proper medication regimens for patients as they transition between healthcare settings

So that patients achieve improved outcomes and reduced hospital admissions caused by medication errors

SMART aim is to decrease teh number of discrepancies between discharge medication lists and pill bottles or blister packs produced at one-week follow up with Jefferson PCP by 10% within six months.

Transgender Patients' Experiences Of Discrimination At Mental Health Clinics, Corrine Ann Stocking

Dissertations and Theses

The transgender population is makes up about 0.3% of the U.S. population (Gates 2011). The term transgender is both an identity and an umbrella term used to describe people who do not adhere to traditional gender norms (Institute of Medicine 2011). Transgender people experience many barriers to services, negative health outcomes, and discrimination (Fredrikson-Goldsen et al. 2013; Institute of Medicine 2011; Eliason et al. 2009; Hendricks & Testa 2012). Mental health clinics are an important site for understanding transgender peoples' experiences due to being a gatekeeper for other medical services and their role in helping transpeople with issues surrounding coming …

"An Imperfect Personal Journey": University Names 37 Wellness Ambassadors, Becky St. Clair

Andrews Agenda: Campus News

No abstract provided.

Learning Needs Assessment Of Crna Clinical Instructors, Karen Kapanke

College of Science and Health Theses and Dissertations

Clinical instruction in nurse anesthesia often involves Certified Registered Nurse Anesthetists 'teaching as they were taught', lacking a current curricular framework or training in clinical education. This gap between classroom and clinical setting is well documented in the literature. While studies concur formal educational programs for clinical instructors are lacking, very few needs assessments based on current evidence exist.

Relational Frame Theory: Implications For Training Perspective-Taking And Empathy In Children With High Functioning Autism, Lyssa Haase

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Perspective-taking involves the ability to shift one's visual-spatial and affective stance relative to contextual cues. Empathy responses leading to socio-emotional reciprocity depend intimately on perspective-taking processes. Deficits in perspective-taking have been widely documented in individuals with Autism Spectrum Disorders (ASD), and are commonly regarded to underlie impaired interpersonal functioning in this population. The most widely used frameworks for understanding ASD derive from a cognitive science program called Theory of Mind (ToM), and from an applied behavior analytic program based on Operant Theory (OT). Recent research interest has centered on a contemporary contextual behavior analytic approach to perspective taking drawing upon …

A Survey Of Tuberculosis Infection Control Practices At The Nih/Niaid/Daids-Supported Clinical Trial Sites In Low And Middle Income Countries., Catherine Godfrey, Gail Tauscher, Sally Hunsberger, Melissa Austin, Lesley Scott, Jeffrey T. Schouten, Anne F. Luetkemeyer, Constance Benson, Robert Coombs, Susan Swindells

Journal Articles: Infectious Diseases

BACKGROUND: Health care associated transmission of Mycobacterium tuberculosis (TB) is well described. A previous survey of infection control (IC) practices at clinical research sites in low and middle income countries (LMIC) funded by the National Institute of Allergy and Infectious Diseases (NIAID) conducting HIV research identified issues with respiratory IC practices. A guideline for TB IC based on international recommendations was developed and promulgated. This paper reports on adherence to the guideline at sites conducting or planning to conduct TB studies with the intention of supporting improvement.

METHODS: A survey was developed that assessed IC activities in three domains: facility …

A Behavioural Account Of Mobile Gambling, Richard James, Richard Tunney, Claire O'Malley

International Conference on Gambling & Risk Taking

Mobile gambling is an emerging market in which there is evidence that some gamblers are introduced to gambling through their mobile device, and that mobile gambling does not ‘cannibalise’ participation with other forms of gambling. There is a concern that mobile gamblers face distinct risks from other forms of gambling, particularly for harmful behaviours. This paper presentation outlines a behavioural account of mobile gambling that combines both the learned characteristics of problem gambling with how individuals interact with their mobile devices. This hypothesizes that the extended gaps between plays or sessions potentially attracts extended play, even in the face of …

Ready, Set, And Go Back: The Role Of The Judiciary In Brazil’S Bingo Ban, Luiza Jobim Llm, Toni Williams

International Conference on Gambling & Risk Taking

Brazil, the host of the 2014 World Cup and the 2016 Olympics, is known for strong competitive traditions in sports and games. It is also one of only three G-20 countries (together with Saudi Arabia and Indonesia) that currently bans non-state provision of gambling products. Bingo was a notable exception to this prohibition, after enabling legislation was enacted in 1993, with the intention that proceeds would help fund national sports development. The game quickly became very popular but there were persistent questions about, and contestations over, the capacity of the regulatory framework to control the dual risks of exploitation of …

Problem Gambling Prevalence And Risk Factors Among Older Adults, Nigel E. Turner Ph.D., John Mccready, Robert Mann Ph.D., Mark Van Der Maas, Hayley Hamilton, Tracy Schrans

International Conference on Gambling & Risk Taking

Reports on the results of a study that interview older adults at casinos and racetrack slot machine venues (racinos) in Ontario. The study used an intercept survey employing cluster sampling methods to obtain a random sample of 2,103 Ontario older adults (aged 55 and older) gambling at seven sites across the province. Older adults exiting the gaming floor were randomly selected to be invited to participate in an interview / survey, which required about 15-20 minutes of their time. Participants provided information about their own gambling behavior and gambling-related problems, attitudes toward gambling, gambling and gambling problems in their community, …

Voice Your Health -- Determining Elementary School Students Perceived "Hinders" And "Helpers" To Leading A Healthy Lifestyle, Mindy Stewart

Ursidae: The Undergraduate Research Journal at the University of Northern Colorado

Research demonstrates that the quality of a person’s diet as well as the level of physical activity greatly influences the likelihood of that person being overweight. Healthful life habits are formed during childhood. Childhood overweight and obesity increase the risk of hyperlipidemia, hypertension, insulin resistance, and respiratory problems. Due to the serious problems associated with these disease states, it is critical to prevent or decrease the rate of childhood overweight and obesity. This project sought to discover the barriers children perceive are preventing them from being healthy and what they believe is healthy. The goal of the project was to …

Profiling At-Risk Gamblers, Tapio Jaakkola, Kari Vuorinen, Mirka Smolej

International Conference on Gambling & Risk Taking

The majority of gambling research has been concentrating on problem gambling and on the association between gambling behavior, game design and gambling harm. Much less attention has been directed at recreational gambling or on players that do not suffer from any gambling related problems. However, when it comes to preventing gambling harm we should also target those at risk as well those who are gambling moderately.

As a part of a project on prevention of adult gambling harm we did a study of at-risk gamblers in order to recognize and to define the socio-economic background of our target group. Prior …

Responsible Consumption Of Gambling: Results From A Survey Of Experts, Nerilee Hing, Alex M.T. Russell

International Conference on Gambling & Risk Taking

Consumers are now advised to “gamble responsibly” and to adopt a range of responsible gambling (RG) consumption strategies, such as setting time and expenditure limits, taking frequent breaks, and balancing gambling with other activities. However, it is unclear whether RG consumption strategies are aimed at non-problem and low-risk gamblers as a harm prevention strategy, higher-risk gamblers as a harm minimization strategy, or problem gamblers as a means to address their gambling problem. Indeed, conceptual developments in RG consumption are in their infancy and agreed definitions, principles, goals and behaviors are lacking.

This paper presents findings from an expert survey conducted …

Measuring Market Saturation In The U.S. Casino Industry: An Analytical And Empirical Analysis, Clyde W. Barrow, Alan P. Meister, David R. Borges

International Conference on Gambling & Risk Taking

The national and regional economies in the U.S. remain on a slow growth trajectory, while the casino gaming industry has seen a rapid and ongoing expansion. Consequently, states, Native American tribes, and gaming operators have increasingly shifted their attention from gaming expansion to the problems of regional competition, cannibalization, market maturation, and market saturation. The question of “market saturation” has become a salient point of public policy debate and a topic that is now frequently raised in the industry and media. This paper analyzes the concept of saturation in the context of casino gaming markets and compares several metrics for …

Gambling Warning Messages: The Impact Of Winning And Losing On Message Reception Across A Gambling Episode, Rory A. Pfund, Meredith K. Ginley, Samuel C. Peter, James P. Whelan, Andrew W. Meyers

International Conference on Gambling & Risk Taking

Warning messages prevent and modify risk-taking behaviors. When controlling the outcome of each wager, studies suggest such messages can increase a player’s knowledge about gambling-specific risks, modify their gambling-related cognitive distortions, and even change play. The present study takes the next step by asking if the reception of the warning message is influenced by the player’s experience of winning or losing.

In a laboratory study, participants were randomly assigned to a winning or losing gambling experience where they either viewed periodic warning messages or not. Using a mixed model analysis, the influence of the warning messages was related to players’ …

Prolonged Morphine Exposure Induces Increased Firm Adhesion In An In Vitro Model Of The Blood-Brain Barrier., Marianne Strazza, Vanessa Pirrone, Brian Wigdahl, Will Dampier, Wei Lin, Rui Feng, Monique E Maubert, Babette Weksler, Ignacio A Romero, Pierre-Olivier Couraud, Michael R Nonnemacher

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

The blood-brain barrier (BBB) has been defined as a critically important protective barrier that is involved in providing essential biologic, physiologic, and immunologic separation between the central nervous system (CNS) and the periphery. Insults to the BBB can cause overall barrier damage or deregulation of the careful homeostasis maintained between the periphery and the CNS. These insults can, therefore, yield numerous phenotypes including increased overall permeability, interendothelial gap formation, alterations in cytokine and chemokine secretion, and accelerated cellular passage. The current studies expose the human brain microvascular endothelial cell line, hCMEC/D3, to prolonged morphine exposure and aim to uncover the …

Medical Student And Resident Foley Catheterization Training Program To Decrease Post-Operative Catheter Associated Urinary Tract Infections, Peter J. Altshuler, Adam P. Johnson, Md, Mph, Danica Giugliano, Md, Gerald A. Isenberg, Md, Scott W. Cowan, Md

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

Objective:

Determine whether a more comprehensive medical student urinary catherer training curriculum can be successful in decreasing post-operative CAUTI rates in general and vascular surgery patient populations.

Primary target:

Reduce post-operative UTI rates by 0.5% over 6 months

Secondary targets:

Achieve 100% medical student confidence in Foley catheter placement, understanding indications and contraindications to urinary catheterization.

Improve objective performance of urinary catheterization skills as determined by objective clinical skills exam (OSCE) scores.

Screening For Venous Thromboembolism In Asymptomatic Trauma Patients: Effective In High Risk Patients, Seth Stake, Bs, Adam Wallace, Bs, Deepika Koganti, Md, Pgy-4, Adam P. Johnson, Md, Mph, Joshua A. Marks, Md, Scott W. Cowan, Md, Murray Cohen, Md

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

Hypothesis:

Through data analysis of a large cohort of trauma patients, a clinically applicable protocol can be developed based on various predisposing factors for VTE in asymptomatic patients. By isolating the factors that make these patients high risk for VTE, we can effectively lower the incidence of PE in hospitalized trauma patients.

Preventing Sports Injuries, Chris Fagerness

Staff Work

"It may be beneficial to participate in a variety of athletic activities during the year, however it is important to take rest periods between athletic seasons."

Posting about strength and conditioning for athletes­­­­­­­­ from In All Things - an online hub committed to the claim that the life, death, and resurrection of Jesus Christ has implications for the entire world.

http://inallthings.org/preventing-sports-injuries/

Exploring The Opioid Epidemic: Barriers To Adequate Patient Care, Laurie Geddes

Nursing Capstones

No abstract provided.

Analyzing Patient Satisfaction And Improved Physician-Patient Communication Using Introductory Brochures, Raza A. Hasan, Md, Lily Ackermann, Md

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

AIM:

Assess how the use of introductory brochures added to patient satisfaction at time of discharge. Also, assess whether the brochure helped foster improved physician-patient communication.

Remote Hospitals And Hospital Value Based Purchasing, Nicole Adams

Nursing ETDs

The purpose of this study is to identify remote hospitals and then assess their performance in the first three years of the Hospital Value Based Purchasing program. A definition for remote hospital was created using clinical outcome literature and travel time. The hospitals were then identified as those hospitals more than 60 minutes driving time from the next nearest hospital by using geographic information systems software (n = 127). The remote hospitals payment adjustments and raw quality scores were be compared with non-remote hospitals. Remote hospitals have done well in the first three years improving their payments over time. However, …