Medicine and Health Sciences Commons^™

Increasing Effectiveness Of The Surgical Airway Response System: Introduction Of The Otolaryngology Airway Pager, Quality Improvement Project Of The Pgy-2 Class, Erin Reilly, Md, Lauren Galinat, Md, Ryan Rimmer, Md, Gregory Epps, Md, Nikolaus Hjelm, Md

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

Introduction:

The need for an Otolaryngology airway pager is based on several external and internal factors. The current communication pathway for emergent airways at our institution is well established but often misinterpreted. The protocol is outlined in Figure 1. The priority to reach out to other departments is based on their availability of an attending in house overnight. Furthermore, there is often a delay in contacting the Otolaryngology department. Our service has multiple pagers to accommodate for each of our inpatient teams, which can be confusing for other services. One of the driving events for this project was an incident …

Philadelphia Drug Monitoring Program And Compliance With Department Of Health Requirements, Paniz Heidari, Do, William Wieczorek, Md, Jayassree Iyer, Md, Denise Pineda-Fortin, Md, Elizabeth Liveright, Md

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

Objectives:

With this newly instituted mandate, we found that many of the resident did not have access to the PDMP query site. Our initial goal is to have 100% of residents have log-in access to the PDMP site. Our long-term goals involve increasing the query of the PDMP website by OB-GYN residents prior to prescribing narcotic pain medication.

There are several changes that we can make to result in improvement of our initial goal including: identifying residents that require access, working with program coordinator to identify gaps in their PDMP application, and assisting in providing DOH with any additional documentation …

Increasing Ultrasound-Guided Thyroid Biopsy Yield, T. Conor Mckee, Md, Christopher G. Roth, Md, Ms-Hqs

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

Objectives: Conduct Plan-Do-Study-Act (PDSA) performance improvement project to improve thyroid biopsy yield
Short Term>reduce unsuccessful biopsies by 50% Long-Term>eliminate unsuccessful biopsies

Improving Proficiency In Central Venous Catheter Insertion: Standardized Simulation Based Training For Internal Medicine House Staff, John Madara, Md, Christoph Hutchinson, Md, Ma, Frances Mae West, Md, Ms

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

Objectives:

The objectives of this study are to assess residents' pre-workshop ability and comfort with CVC placement, undergo a standardized online didactic and hands-on clinical training simulation workshop, and subsequently undergo a proficiency test using simulation models to assess competency. The goal of a standardized training module is to create a universal approach to CVC placement in our institution and improve comfort and technical ability of house staff. We hypothesize that this will reduce complications and improve patient care and safety.

Quality Review Of Irradiated Cellular Blood Product Orders, Matthew Grzywinski, Vandy Ly, Md

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

Objectives:

Our goal is to educate house staff on the indications for irradiated blood products. We hope to reduce the number of inappropriate irradiation orders to less than 50% of the total orders for irradiated blood products and to be followed up over time.

Addressing Barriers To Breast Cancer Screening: Where To Intervene To Increase Mammogram Completion Rates, Jennifer Laporta, Md, Robert J. Mcclowry, Md, Elizabeth "Mackie" Talley, Md, Lionel Mcintosh, Md, Allison Rague, Md, Claire Thesing, Md, Amy Leshner, Md, Gillian Love, Md, Daniel Sizemore, Md, Patrick Mcmanus, Md

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

Methods:

Study sought to determine if an intervention would aid in increasing mammogram screening rates in the Jefferson Family Medicine Associates practice.

Consolidation Of P2y12 Testing While Maintaining Quality And Turnaround Time, Geetha Jagannathan, Mbbs, Jerald Z. Gong, Md

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

Objective:

To consolidate the test performed at 2 different locations at 1, thereby improving cost effectiveness while maintaining quality and result turnaround time.

Does Physician Education Of Alternative Therapies For Obstructive Sleep Apnea Improve Utilization?, Colin Huntley, Md

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

Methods:

We conducted a retrospective chart review of patients in the Jefferson Sleep Disorder Center (JSDC) consisting of 2 cohorts of patients. The first was a group of patients undergoing PSG in March, 2014 prior to institution of the UAS program. The second was a cohort of patients undergoing PSG in July 2016 after institution of the UAS program, positive initial results, readily available literature in the JSDC, and a physician in-service including details of the procedure and outcome, quality of life, and complication rate data.

We collected demographic and PSG data. We then reviewed the electronic medical record and …

Standardized Consent Forms For Surgical Procedures: An Intervention To Improve The Resident-Led Informed Consent Process, C. Hodge, N. Sich, T. Olszewski, A. Rogers, R. Josloff, K. Noonan

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

Objectives and Goals:

To provide high quality, consistent consent forms for common surgical procedures and improve resident workflow by creating and implementing standardized printed consents for common surgical procedures.

These consents will be used by residents consenting patients in the ED or inpatient setting.

Consents shall include standardized procedure descriptions, risks and benefits of the procedure, and alternative treatment option descriptions, risks and benefits

Use Of Standardized Patient Scenarios To Train Medical Assistants In An Ambulatory Rehabilitation Medicine Clinic, Lawrence Asprec, Md, Ashley Depadua, Md, Sarah Durante, Md, Nicholas Freedman, Do, Andy Olsen, Do, H. Kelly O' Donnell, Do

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

Objectives:

To improve the efficiency of our outpatient Rehabilitation Medicine clinic without sacrificing high value/quality patient care.

To clarify the responsibilities of the MA and identify areas of redundancy in the rooming process.

To demonstrate the utility of in-situ simulation for MA training.

To reduce the time it takes for MAs to complete all assigned tasks to 10 minutes or less per encounter in at least 50% of patient encounters within two months from the time of intervention.

To potentially highlight other areas in which to improve clinic efficiency and overall patient satisfaction (e.g. front desk registration process, resident and …

How Good Are We At Determining Risk? Quantifying The Accuracy Of Clinician Determined Risk For Vte Prophylaxis, Katerina Dukleska, Md, Adam P. Johnson, Md, Mph, Tyler M. Bauer, Myles Dworkin, Johanna Beck, Kamini D. Patel, Rn, Geno J. Merli, Md, Scott W. Cowan, Md

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

Objectives:

Create and validate a simple tool for concurrent audits of risk stratification, compliance and documentation

Evaluate accuracy of clinician risk stratification and prophylatic ordering practice compared with a standardized Caprini RAM across different assigned risk categories

Provide recommendations for EPIC VTE Prophylaxis CDS Development

Improving The Patient Colonoscopy Prep Experience, Natalie Cosgrove, Md, Andrew Dargan, Md, Raja K. Dhanekula, Md, Gloria Francis, Md, Komal Gandhi, Md, Andrew Kistler, Md, Mark Malamood, Md, Bolin Niu, Md, Sheela S. Reddy, Md, Apeksha Shah, Md, Christina Tofani, Md, Andrew Zabolotsky, Md, Robert Cohen, Md, Stephanie M. Moleski, Md, Jorge Prieto, Md

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

AIM:

To improve patient prep compliance, prep quality, and an overall better experience by designing a prep specific website that will address the most common prep questions and concerns

Once launched, the website address will be placed on printed colonoscopy prep instructions and stated on the after hours GI clinic voicemail as an additional patient resource

A Quality Improvement Project To Reduce The Wait Time For Initial Appointment In An Urban Outpatient Sleep Center, Anasua Chakraborty, Md, Ritu G. Grewal, Md

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

Project Aim:

In this study we aimed to see if replacing one face to face follow up visit after sleep study with a phone call by a trained office staff will

-decrease the total number of follow up office visits, thus decreasing health care cost

-increase the number of new patients seen during the 6 month follow up period

-Did not decrease patient compliance.

Risk Factor Analysis For 30-Day Readmission Rates Of Newly Tracheostomized Children, Jenna Briddel, Md, Abigail Strang, Md, Jessica Levi, Md, Patrick Barth, Md, Aaron Chidekel, Md, Udayan Shah, Md

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

Objectives:

Pediatric patients undergo tracheostomy for a variety of reasons; however, medical complexity is common among these patients. Although tracheostomy may help to facilitate discharge, these patients may be at increased risk for hospital readmission. The purpose of this study was to evaluate our institutional rate of 30-day readmission for patients discharged with new tracheostomies and to identify risk factors associated with readmission.

Study Design:

A retrospective cohort study was conducted for all pediatric patients ages 0-18 years with new tracheostomies at our institution over a 36-month period.

Methods:

A chart review was performed for all newly tracheostomizedchildren from 2013 …

A Video-Based Educational Intervention For Providers Regarding Colorectal Cancer Screening, Zoe Agoos, Md, Bryan Botti, Md, Laura Emerson, Md, Angela Silverman, Md, Mph, Lori Atkinson, Md, Danielle Dang, Md, Mph, Elizabeth Collins, Md, Erica Li, Md, Rebecca Simon, Md, Michael Weissberger, Md, Geoffrey Mills, Md, Phd

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

Methods:

Email sent to providers asking them to complete a 7 question survey regarding knowledge and self-reported comfort in screening for colorectal cancer using a shared decision-making approach.

Shedding Light On The Off-Hours Coverage Gap In Radiology: Improving Turnaround Times And Critical Results Reporting, Gilda Boroumand, Md, Jaydev K. Dave, Phd, Ms, Christopher G. Roth, Md, Ms-Hqs

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

Objective:

Devise a plan to optimize off-hours faculty and trainee staffing within the Department of Radiology

Measure the magnitude of patient safety gains in terms of report turnaround times (TAT) and critical results communication times (CRC)

Beat To Beat: Implementing A Tailored Literature Review E-Newsletter For A Multidisciplinary Subspecialty Group, Shashank Behere, Md, Steven Ritz, Md

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

Objective:

To increase availability and exposure to recent, relevant, reliable literature from a range of sources, for a multidisciplinary cardiac center, by creating an e-newsletter summarizing articles of interest.

Maintaining Continuity In A Resident Run Clinic-Impact Of The 6+2 Scheduling., Odunayo Banjoko, Md, Doron Schneider, Md, Rachel Ramirez, Md

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

Objective:

The aim of this study was to evaluate the continuity of care with regards to follow up with the same team (and optimally same resident) 1 year prior to implementing the 6+2 scheduling block and 1 year post schedule block change.

It's Midnight. Do You Know How Your Patient Is Doing?, W. Alswalmeen, Md, K. Foley, Md, K. Noonan, Md, R. Josloff, Md

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

Transitions of care are vulnerable points in patient care. With the volume of information transferred, quality of care and patient safety are at risk. Numerous attempts at standardization of transitions of care have been utilized; however no consensus regarding the optimal method has been reached. We developed a “watcher” model in addition to standard end of shift sign out. Patients at risk were identified by the day team and seen overnight by a senior and junior surgery resident, along with a nursing representative: either a bedside RN or nursing supervisor. We hypothesized that these midnight rounds could proactively identify patient …

Ambulation Protocols Leading To Decreased Postoperative Complications And Hospital Stay, T. Olszewski, K. Noonan, H. Gold, G. Kelly, E. Youseef

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

Background:

In the postoperative course, patients are routinely encouraged to ambulate as frequently as possible. Typically in the hospital this can become burdensome to the staff and often becomes low priority. Patients are also not aware of the frequency and quality of the ambulation that is sufficient in the postoperative period. At present, patients on the surgical floor who are completely independent and without any devices (eg. Oxygen, nasogastric tubes, chest tubes) are freely able to ambulate at will although there is no reliable way to track this progress. Other patients with devices are limited to waiting for nursing or …

Contact Precautions-How Patient Centered Are They?, Eloho Edosio, Md

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

Method:

The data collecting tool was a questionnaire that consisted of 11 questions structured to measure satisfaction with the quality of education provided before CP was implemented and also to evaluate overall satisfaction with the quality of health care provided by the hospital. A trial run was performed before it was administered to patients in the study group. The study group consisted of patients on CP from April till May 2017.

Implementation Of A Standardized Handoff System For A General Surgery Residency Program, E. M. Caparosa, A. M. Brown, J. Stern, G. Chevrollier, V. M. Kucherov, S. G. Woodward, S. W. Cowan

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

Introduction:

The I-PASS Handoff Bundle is an evidence based standardized set of educational materials designed to decrease handoff failures in patient care.

Two of every three "sentinel events", the most serious events reported to the Joint Commission, are due to failures of communication, including miscommunication during patient care handoffs.

Implementation of the I-PASS method results in decreased medical errors and preventable adverse events

There are few studies that evaluate this validated method in the context of a General Surgery resident program

We aim to implement the I-PASS system into the transition of care process for General Surgery residents at our …

Quantifying Patient Reported And Documented Compliance With Adjuncts To Venous Thromboembolism Prophylaxis, Tyler M. Bauer, Md, Katerina Dukleska, Md, Adam P. Johnson, Md, Mph, Johanna Beck, Myles Dworkin, Kamini D. Patel, Rn, Geno J Merli, Md, Scott W. Cowan, Md

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

Objectives:

1. Measure patient compliance with pharmacologic, mechanical and ambulatory prophylactic measures.

2. Evaluate for agreement between nursing documentation and patient reported compliance with mechanical and ambulatory prophylactic measures.

Firing Up Instead Of Burning Out: Tales From The Front Line Of The Cake Committee, Britainy Stephens, Msw, Lsw, Lora Rhodes, Msw, Lsw, Alison Petok, Msw, Lcsw, Gregory Garber, Msw, Lcsw

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

This presentation will focus on an underutilized model of supportive care that can help bring back some of the human moments that can often be lost in delivering supportive oncology care. Handling the often complicated issues that arise in oncology care can take a toll on social workers and our oncology co-workers in other disciplines. In oncology care, especially in an outpatient setting, social workers often fulfill the role of emotional support not just for our patients but also for other oncology professionals. Though we are not employed to act as such, we dually assume the position of therapist and …

Gathering Qualitative Feedback And Demonstrating Value For An Institutional Repository (Ir), Daniel G. Kipnis, Msi

Academic Commons and Scott Memorial Library Staff Papers and Presentations

Objective:

To gather qualitative feedback demonstrating value for assets discovered in institutional repository from researchers across the globe.

Poster presented at 117th Medical Library Association Annual Conference in Seattle, Washington.

Health Sciences Libraries To The Rescue: Bolstering The Library's Role With Repository And Publishing Services, Daniel G. Kipnis, Msi

Academic Commons and Scott Memorial Library Staff Papers and Presentations

Panel discussion sponsored by Bepress showcasing repositories and how they can increase the visibility and relevance of the health sciences library by providing crucial services. Attendees will come away with a concrete sense of how they can identify needs on campus, reach out to various stakeholders, and get support from strategic partners.

Inside Out, Spring 2017

Inside Out

Contents:

Abstract Anatomy: The Strength Within, Jordyn Brooke Tumas, Front Cover

Lower East Side, Caroline Christianson, Inside Cover

Untitled, Alex Rowan, 1

Daytime Figure Study, Chen Zhou, 2

Amyloids, Malika Madhava, 3

Dirty Dishes, Daisy Zhang, 4

Topography, Prachi Priyam, 5

Glass Wall, South Street, Sanket Patkak, 5

Our home is open, Julie Christensen, 6

Hands, Katie Shen, 7

Balance, Anna Melnick, 8

Consequence, Anitha Ahmed, 9

Woman with White Carnation, Katie Sommers, 10

pocketbooks, Anthony K. Vu, 10

Miniatures, Holly Rankin, 11

Savory Poem, Anya Platt, 11

Rememberance, Anya Platt, 12

Paper Doll, Daisy Zhang, 13

Miniatures, Holly Rankin …

Inside Out, Spring 2016

Inside Out

Contents:

Untitled, Amanda Breem, Front Cover

Stockholm Underground, David Chou, Inside Front Cover

Portrait of a Woman, Chen Zhou, Opposite Page

The Happy Prince, Yuhang Zhou, 1

Feeling Limited, Amy Tressan, 2

Winged Scapula, Daisy Zhang, 3

Untitled, Kathryn Tuazon, 4

Cooking with Papa in Ramadan, Anitha Ahmed, 6

Not Sure Where I'm Going, Jessica Gatt, 6

Salt Marsh, Jessica Gatt, 7

Bite your liquor, not your tongue, Daisy Zhang, 8

Dr. Frank N. Furter, Kathryn Tuazon, 9

Calm, Jessica Gatt, 10

River Basin, Jessica Gatt, 11

Thoracic Vertebra, Holly Rankin, 12

Scapula 2, Holly Rankin, 13

The Kacha Bazaar, …

Effect Of Oral Iron Repletion On Exercise Capacity In Patients With Heart Failure With Reduced Ejection Fraction And Iron Deficiency: The Ironout Hf Randomized Clinical Trial., Gregory D Lewis, Rajeev Malhotra, Adrian F Hernandez, Steven E Mcnulty, Andrew Smith, G Michael Felker, W H Wilson Tang, Shane J Larue, Margaret M Redfield, Marc J Semigran, Michael M Givertz, Peter Van Buren, David J Whellan, Kevin J Anstrom, Monica R Shah, Patrice Desvigne-Nickens, Javed Butler, Eugene Braunwald

Department of Medicine Faculty Papers

Importance: Iron deficiency is present in approximately 50% of patients with heart failure with reduced left ventricular ejection fraction (HFrEF) and is an independent predictor of reduced functional capacity and mortality. However, the efficacy of inexpensive readily available oral iron supplementation in heart failure is unknown.

Objective: To test whether therapy with oral iron improves peak exercise capacity in patients with HFrEF and iron deficiency.

Design, Setting, and Participants: Phase 2, double-blind, placebo-controlled randomized clinical trial of patients with HFrEF (

Interventions: Oral iron polysaccharide (n = 111) or placebo (n = 114), 150 mg twice daily for 16 weeks. …

Download Entire Issue: Collaborative Healthcare: Interprofessional Practice, Education And Evaluation (Jcipe), Volume 8, Number 1, 2017

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Download Entire Issue: Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE), Volume 8, Number 1, 2017