Medicine and Health Sciences Commons^™

Looking Beyond The Traditional: Integrating A New Curriculum Design Into An Immersion Practicum Evaluation Tool, Denise Brown, Msn, Rnc-Ob, Kathleen D. Black, Phd, Rnc-Ob, Maureen Fitzgerald, Msn, Rnc-Nic, Tara Flood, Msn, Cbc, Maureen Kane, Msn, Rn, Cen, Laura Roettger, Msn, Cpnp-Pc

College of Nursing Posters

Abstract

Changes in health care delivery and recent reports from the Institute of Medicine (IOM, 2010) call for nurse educators to reconstruct the way they prepare nursing students for practice in the 21st century. Health care delivery continues to shift from the acute care to outpatient and transitional settings, therefore faculty must assure that graduates are prepared to practice in those environments. In order to address these changes, the Jefferson College of Nursing at Thomas Jefferson University embarked on a mission to redesign their undergraduate curriculum. The new clinical courses, now referred to as Immersion Practicums, were designed to allow …

Occupational Therapy And People Living With Scoliosis And Undermineralized Bones, Curran Smith, Ids, Katie Ramin, Ots

Program of Industrial Design Posters

Poster highlights work with 7 year old boy Brendan. Created Prone Pillow which can be used as a back rest. It also features a handle for carrying and a removable cover.

Fungal Infections From Human And Animal Contact, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Fungal infections in humans resulting from human or animal contact are relatively uncommon, but they include a significant proportion of dermatophyte infections. Some of the most commonly encountered diseases of the integument are dermatomycoses. Human or animal contact may be the source of all types of tinea infections, occasional candidal infections, and some other types of superficial or deep fungal infections. This narrative review focuses on the epidemiology, clinical features, diagnosis and treatment of anthropophilic dermatophyte infections primarily found in North America. Other human-acquired and zoonotic fungal infections also are discussed in brief.

Socioeconomic Status And Stroke Outcome, Sophia Dang, Jonathan C. Li, Kimon Bekelis, Md, Stavropoula Tjoumakaris, Md

Sigma Xi Student Research Day

Introduction

• International studies find socioeconomic status (SES) to be predictive of functional impairment after stroke.^1,2
• Lower socioeconomic status (LSE) is associated with increased severity of stroke onset, higher incidence of risk factors, and worse outcomes.³
• We sought to confirm the predictive significance of SES on acute ischemic stroke patient outcomes at a large urban, U.S. stroke center.

Pre-Admission Blood Pressure And Outcome In A Large Telestroke Cohort, Elias Atallah, Md, Kimon Bekelis, Md, Nohra Chalouhi, Md, Hasan Saad, Md, Sophia Dang, Jonathan C Li, Ayan Kumar, Bs, Justin Turpin, Randa R. Barsoom, Stavropoula Tjoumakaris, Md, David Hasan, Md, Jl, Robert H. Rosenwasswer Md, Pascal Jabbour, Md

Sigma Xi Student Research Day

Introduction

• 55% of Americans live within 60 miles of a primary stroke center.
• Telestroke (TS) units shorten treatment delivery times (e.g. rt-PA) and reduce permanent neurologic sequelae.^1,2
• TS units provide tele-consults with neurovascular specialists experienced in medical and surgical treatment of acute ischemic stroke (AIS).
• Maintenance of systolic blood pressure (SBP) > 140mmHg is recommended in AIS management. SBP < 140mmHg is independently predictive of poor neurologic outcome.³

• We analyzed all patients with AIS symptoms transported to Thomas Jefferson University Hospital (TJUH), via JeffSTAT EMS ground vehicles or helicopters, to verify efficiency of the TS system and the prognostic value of vital sign-monitoring throughout the transportation process.

Eosinophilic Heart Disease: A Case Report And Review Of Literature (Poster)., Ghulam Akbar Md, Fnu Vikram, Ronald S. Freudenberger Md, Matthew W. Martinez Md

Department of Medicine

No abstract provided.

Multiple Myeloma Vaccination Patterns In A Large Health System: A Pilot Study, Andinet Alemu, Maharaj Singh, Chris Blumberg, John O. Richards, Martin K. Oaks, Michael A. Thompson

Journal of Patient-Centered Research and Reviews

Purpose

Common reasons for hospitalization and death in patients with multiple myeloma (MM) are infections. As patients with MM are living longer and are treated with immunomodulatory drugs, there is a need to immunize against vaccine-preventable diseases and ultimately determine the efficacy of these vaccines. We evaluated vaccination practice patterns in MM patients at our health system using electronic medical records and data analytics.

Methods

This institutional review board-approved study retrospectively reviewed patients with MM who visited the health system from May 2012 to May 2014. Data collected included demographics, influenza vaccination (FV) and pneumonia vaccination (PV) history, hospitalization episodes …

Models For Predicting Incident Delirium In Hospitalized Older Adults: A Systematic Review, Sundeep Kalimisetty, Wajih Askar, Brenda Fay, Ariba Khan

Journal of Patient-Centered Research and Reviews

Purpose

The purpose of this systematic review is to summarize the reported risk prediction models and identify the most prevalent factors for incident delirium in older inpatient populations (age ≥ 65 years). In the future, these risk factors could be used to develop a delirium risk prediction model in the electronic health record that can be used by the Hospital Elder Life Program to reduce the incidence of delirium.

Methods

A medical librarian customized and conducted a search strategy for all published articles on delirium prediction models using an array of electronic databases and specific inclusion and exclusion criteria. Then, …

Health Care Transitions For Adolescents And Young Adults With Special Health Care Needs: Where Are We Now?, Nicole Mubanga, Dennis J. Baumgardner, Jessica J. F. Kram

Journal of Patient-Centered Research and Reviews

Eventually, all adolescents must “graduate” from pediatric-oriented to adult-oriented health care. This transition, most often occurring during young adulthood, is especially important for adolescents with special health care needs and involves not only primary care physicians, but also both pediatric and adult subspecialists. Several studies support the benefit of transitional programs for adolescents and young adults with special health care needs. Additionally, the American Academy of Pediatrics named transitional care as one of its top priorities. However, transitional programs have yet to become an established norm among hospitals and providers, specifically outside of children’s hospitals. This topic synopsis aims to …

Deaf Access To Healthcare, Jennifer L. Yates

Senior Honors Theses

Modern medical professionals strive to provide culturally competent care; however, Deaf[1] culture remains overlooked. Common language and experience draw deaf individuals together as a cultural group. Ignorance about Deaf culture perpetuates barriers to holistic care in the medical setting. Deaf patients receive misdiagnoses, delayed treatment, and privacy breaches. Deaf culture understandably avoids healthcare and is characterized by numerous health disparities as a result. Obstacles hindering Deaf access to healthcare are directly opposed to the intended therapeutic relationship and holistic care. Increased awareness of Deaf culture is required to improve the Deaf’s access to healthcare.

[1] The word deaf should …

The Mechanism Of Sex Trafficking And What You Can Do About It, Benjamin J. Huebner

Senior Honors Theses

Awareness for sex trafficking is on a steady incline. Many organizations and events help to raise awareness for sex trafficking and often collect money to combat the issue. However, the unfortunate reality is that the public has gained a non-functional awareness of the issue. The public knows about the problem, they know that the number affected is astronomical, and they know that it is ugly, but they know of no tangible way to work toward the solution. Nothing is wrong with donating to an organization that is working to resolve the issue, but people need to be made aware of …

Aspergillus Fumigatus Trehalose-Regulatory Subunit Homolog Moonlights To Mediate Cell Wall Homeostasis Through Modulation Of Chitin Synthase Activity, Arsa Thammahong, Alayna K. Caffrey-Card, Sourabh Dhingra, Joshua J. Obar, Robert Cramer

Dartmouth Scholarship

Trehalose biosynthesis is found in fungi but not humans. Proteins involved in trehalose biosynthesis are essential for fungal pathogen virulence in humans and plants through multiple mechanisms. Loss of canonical trehalose biosynthesis genes in the human pathogen Aspergillus fumigatus significantly alters cell wall structure and integrity, though the mechanistic link between these virulence-associated pathways remains enigmatic. Here we characterize genes, called tslAand tslB, which encode proteins that contain domains similar to those corresponding to trehalose-6-phosphate phosphatase but lack critical catalytic residues for phosphatase activity. Loss of tslA reduces trehalose content in both conidia and mycelia, impairs cell wall …

Cost Savings And Efficiency Realized Decreasing Orders For Type And Crossmatching, Susan Garruto, Msha, Msn, Bsn, Rn, Aprn, Cnor, Rnfa, Katy Loos, Msn, Bsn, Rn, Acagnp, Rae Fierro, Rn, Cnor, Rnfa

Department of Neurosurgery Posters

Background

• Thomas Jefferson University Hospital (TJUH) is a Tertiary, Level 1Trauma Center and the Regional Spinal Cord Injury Center of the Delaware Valley with 900+ beds

• C/T Ratio is the ratio of RBC units cross matched for potential transfusion to the number of units actually transfused

• The American Association of Blood Banks (AABB) recommendation for C/T ratio is < 2

• TJUH blood bank, on periodic review by AABB and the College of American Pathologists (CAP) was cited as deficient in C/T ratio quality indicators

• Cost to cross match RBC units is on average $71 with the charge …

An Experience Of Practitioners Navigating The Role Of Patient/Caregiver, Susan M. Shaw, Rain Lamdin

Patient Experience Journal

This journey involved one of us having (repeat) intraspinal surgery in a country far from home but of a similar culture and with the same first language. The carer travelled across the world to be present during the hospital stay. We kept a journal during our admission, and following discharge realised there were significant differences between how we had documented our experience and the record presented in the clinical notes. The particular examples we present illustrate the relationships, rules and issues that we navigated. We share our experience in the form of moments from our journal, some of them alongside …

The Evolution And Integration Of A Patient-Centric Mapping Tool (Patient Journey Value Mapping) In Continuous Quality Improvement, Alison Tothy, Sunitha K. Sastry, Heather M. Limper, Paul Suett, Mary Kate Springman, Susan M. Murphy

Patient Experience Journal

The need to improve a healthcare system that too frequently fails to deliver benefits of care, even resulting in harm to patients, has been well established. The resulting era of quality improvement has aimed to improve the delivery of care by increasing quality while reducing cost. One approach to improving how healthcare is delivered is the application of Lean management strategies. Despite widespread investment in Lean approaches to improve healthcare delivery, evidence supports a deficiency of this approach to improve patient satisfaction with care. Identifiable operational tension between quality improvement efforts designed to streamline care processes and those targeting improvement …

Reconnecting The Mind And Body: A Pilot Study Of Developing Compassion For Persistent Pain, Sarah L. Parry Dr, Zoey Malpus Dr

Patient Experience Journal

As an alternative to the more typical cognitive behavioural approach to pain management, a novel pain management group based on the principles of compassionate mind training was developed for a particular sub-group of patients. Participants were patients of a community pain clinic, who were invited to participate in this alternative approach to pain management. The eight-week Compassion in Pain Groups included psychoeducation around persistent pain, the underlying principles of compassionate mind training, practical exercises such as diaphragmatic breathing, followed by a series of compassionate imagery exercises and group discussions. Both quantitative and qualitative analyses were undertaken to gain further insights …

The Impact Of Queue-Controlled Modified Open Access Scheduling On No-Show Rate In A Community Mental Health Child Psychiatry Med Check Clinic: A Pilot Study, Timothy Lesaca Md

Patient Experience Journal

No-shows in child and adolescent psychiatry are a particularly concerning phenomenon that have ramifications beyond productivity and mental health outcomes. One might contend that children have a fundamental right to health care, and the failure to address the no-show phenomenon passively impedes that human right. In this study, a queue-controlled modified open access scheduling model (QCMOAS) was compared to a traditional scheduling model for the incidence of no-shows in a community mental health child psychiatric med check clinic. A six month period of QCMOAS was compared to the preceding six months of traditional scheduling and the six month period exactly …

Experiences Of Communication Barriers Between Physicians And Immigrant Patients: A Systematic Review And Thematic Synthesis, Salim Ahmed, Sonya Lee, Nusrat Shommu, Nahid Rumana, Tanvir Turin

Patient Experience Journal

Frequent immigration of peoples from outside often challenges various systems of any country; healthcare sector is the most confronted one. One of the most prominent reasons for this confrontation is communication gap between physicians and immigrant patients. In this systematic narrative review, we studied existing literature on physician-immigrant patient communication. We systematically searched the repositories of literature and followed some criteria to select literature. We selected 32 literatures for information extraction. Three themes emerged from the synthesis: Physicians’ viewpoint about communication barrier with their immigrant patients, Immigrant patients’ viewpoint about the communication barrier with their physicians, and Interpreter as a …

Patient Experiences Of Cancer Care: Scoping Review, Future Directions, And Introduction Of A New Data Resource: Surveillance Epidemiology And End Results-Consumer Assessment Of Healthcare Providers And Systems (Seer-Cahps), Michelle A. Mollica, Lisa M. Lines, Michael T. Halpern, Edgardo Ramirez, Nicola Schussler, Matthew Urato, Ashley Wilder Smith, Erin E. Kent

Patient Experience Journal

The shift towards providing high value cancer care has placed increasing importance on patient experiences. This scoping review summarizes patient experience literature, highlights research gaps, and provides future research directions. We then introduce a new resource that links the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) program with the Centers for Medicare and Medicaid Services Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and longitudinal medical claims data. We conducted a scoping review to identify relevant research within the Medicare CAHPS domain that examine factors associated with patient-reported experiences with their cancer care. Gaps indicate a need …

Leadership Development Practices And Patient Satisfaction: An Exploratory Study Of Select U.S. Academic Medical Centers, Chien-Ching Li, Peter Barth, Andrew N. Garman, Matthew M. Anderson, Peter W. Butler

Patient Experience Journal

Interest has been growing among academic medical centers (AMCs) in organization-wide strategies that may improve patient satisfaction. Although leadership development programs have been cited as a potentially useful approach, thus far almost all evidence has come from single-organization case studies. The present study sought to examine potential relationships between leadership development and patient experience across organizations. Data for leadership development practices were obtained from a survey conducted by the National Center for Healthcare Leadership. Patient experience data were obtained from the U.S. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Multivariate analyses (general linear regressions) were performed to examine …

“Quiet At Night”: Reduced Overnight Vital Sign Monitoring Linked To Both Safety And Improvements In Patients’ Perception Of Hospital Sleep Quality, Kevin Stiver, Nandini Sharma, Kayla Geller, Lisa Smith, Julie Stephens, Emile Daoud, Susan Moffatt-Bruce, Ernest Mazzaferri

Patient Experience Journal

Obtaining middle of the night vital signs is disruptive to sleep and not founded on evidence-based medicine. We sought to investigate the perception of quality of sleep and overall satisfaction during a hospital stay between an intervention group where overnight night vital signs were not obtained and a standard of care group where overnight vital signs were obtained every four hours. We also monitored for adverse events in the intervention and standard group. Low-risk observational stay patients with a planned cardiac procedure were eligible for this study. After consent, patients were randomized to the intervention or standard group. Participants were …

An Organisational Study Into The Impact Of Mobile Devices On Clinician And Patient Experience In Auckland, New Zealand, Kelly L. Bohot, Rebecca C. Hammond, Teresa A. Stanbrook

Patient Experience Journal

Mobile technology has potential to improve workflow, patient safety and quality of care, and has been identified as an important enabler of community services. However, little is known about the impact of mobile device use on clinician and patient experiences. Eleven community allied health clinicians were provided with live access to electronic health records, their email and electronic calendar, peer reviewed education and therapy mobile applications via a mobile device. Three data measures were collected over 19-weeks. First, quantitative time and motion data was gathered at baseline and follow-up to enable longitudinal analysis of clinician workflow. Second, a questionnaire consisting …

When One Is Sick And Two Need Help: Caregivers’ Perspectives On The Negative Consequences Of Caring, Ilja Ormel, Susan Law, Courtney Abbott, Mark Yaffe, Marc Saint-Cyr, Kerry Kuluski, Debbie Josephson, Ann C. Macaulay

Patient Experience Journal

Informal or family caregivers contribute significantly to individual care, and to the Canadian healthcare system, yet receive limited support from governments, institutions, and healthcare professionals in recognition of their role, or in response to their health and social care needs – often due to the negative consequences of caregiving. Learning about the diversity of others’ experiences can positively influence personal decision-making, reduce feelings of isolation, as well as promote adjustment to a personal situation. For caregivers, however, few resources exist that provide reliable information on others’ experiences. We collected the narratives of caregivers’ experiences of caring for someone with a …

Patient Perspectives On Quality Family Planning Services In Underserved Areas, Debora Goldberg, Bhakthi Sahgal, Tishra Beeson, Susan F. Wood, Holly Mead, Aliyah Abdul-Wakil, Hallie Stevens, Pinyao Rui, Sara Rosenbaum

Patient Experience Journal

Ongoing challenges impede efforts to improve the quality of family planning services in underserved communities, which by definition lack sufficient numbers of physicians and other health professionals. Challenges to improving the quality of family planning services include financing difficulties, lack of standards, training deficiencies, as well as little understanding and attention to patient preferences. The objectives of this study were to explore female patients’ preferences for family planning services in underserved areas and to develop a framework to help providers improve patient-centered care. The methodology for this paper included mixed methods research including a survey of women between the ages …

Engaging Rural Residents In Patient-Centered Health Care Research, Michelle Levy, Cheryl Holmes, Amy Mendenhall, Whitney Grube

Patient Experience Journal

Patient engagement is increasingly recognized as a critical component in improving health care. Yet, there remains a gap in our understanding of the intricacies of rural patient engagement in health-related research. This article describes the process of engaging rural patients, caregivers and broader stakeholders to actively participate in an exploratory effort to understand rural perspectives around the patient-centered medical home model. Highlights of the project’s engagement activities demonstrate how giving voice to rural residents can have a significant impact. Lessons learned point to the importance of six factors for successful engagement of rural residents as partners in health care research: …

Evaluating Variables Of Patient Experience And The Correlation With Design, Dyutima Jha, Amy Keller Frye, Jennifer Schlimgen

Patient Experience Journal

The objective of this paper was to understand the variables of patient experience by analyzing recent and relevant evidence and to identify design solutions within the hospital environment that positively impact those variables. A systematic review of literature published from 2008-present was conducted to identify variables that contribute to patient experience benefits. Identified variables were documented and categorized into a design, organizational, and outcome variable matrix. Interviews were conducted with professionals from healthcare institutions, architecture firms and organizations committed to improving the patient experience. Data from healthcare facilities, with high patient experience scores, was also examined to derive effective design …

Increasing Patient Engagement In Healthcare Service Design: A Qualitative Evaluation Of A Co-Design Programme In New Zealand, Lynne Margaret Maher Dr., Brooke Hayward, Patricia Hayward, Chris Walsh Dr

Patient Experience Journal

The Health & Quality Safety Commission New Zealand commissioned Ko Awatea, an innovation and improvement centre, to deliver a co-design programme to nine teams of healthcare providers. The co-design programme was part of Partners in Care, a broader programme developed in 2012 to support and enable patient engagement and participation across the health and disability sector. In the current programme teams received training, guidance and mentorship in Experience Based Design (EBD) methodology through a one day masterclass, seven WebEx sessions, coaching calls, email and through the completion of workbooks. We evaluated the co-design programme to explore the experiences, challenges and …

Patient Experience: The Field And Future, Geoffrey A. Silvera, Courtney N. Haun Mph, Jason A. Wolf Phd

Patient Experience Journal

In an effort to understand the progress and evolution of the field, a self-examination study has been administered to assess contributions to the core knowledge base in the field and to assess the degree to which articles published in Patient Experience Journal (PXJ) addressed the core elements of patient experience outlined in the definition of patient experience as offered by The Beryl Institute. The purpose of this examination is to understand PXJ’s position as a central voice for patient experience scholarship, practice, and knowledge exchange. The findings suggest that the operating definition of the field continues to be suitable and …

Learning And Leading In The Experience Age, Jane Cummings

Patient Experience Journal

A focus on experiences of care helps health systems realize the very transformations they look to achieve. This is because patient experience allows patients, families and carers to define value, enabling healthcare organizations to focus on what matters to them and not simply what is the matter with them. This is what we mean by an ‘experience age’, one in which clear connections are made between the things patients value and the clinical outcomes we look to achieve: where links are drawn between experience, clinical effectiveness, safety and cost in order to provide the very best care for all patients. …

Patient Experience: A Return To Purpose, Jason A. Wolf Phd

Patient Experience Journal

As an opening reflection to Volume 4 of Patient Experience Journal (PXJ), this editorial reviews the progress of the journal and the implications seen both in the evolving healthcare marketplace globally as well as reviews the data on the developing field of patient experience. It reinforces the need for an integrated view of experience as supported by data in the most recent State of Patient Experience research – one encompassing quality, safety, service, cost and population health implications and one driven on an engine of both patient and family engagement and employee/staff engagement. The article offers that healthcare is as …