Medicine and Health Sciences Commons^™

Strengthening Safety Culture By Leveraging The Daily Management System, Suneela Nayak, Mark Parker, Erin Graydon Baker, Amy Sparks, Ruth Hanselman, Stephen Tyzik, Sydney Green

Operations Transformation

STRENGTHENING SAFETY CULTURE BY LEVERAGING THE DAILY MANAGEMENT SYSTEM

There is abundant evidence that links a strong culture of safety with improved patient and staff experience. However, there has been no clear avenue identified as to how to achieve this metric.

A team in a large academic tertiary teaching hospital set about leveraging their daily managing system (DMS) to attain improvement in their institution’s safety. The goals of this quality improvement project were to use DMS to identify and report safety concerns and increase frontline team knowledge and comfort with reporting safety concerns during Gemba walks.

A root cause analysis …

Improving The Workflow And Partnership Between Registration And Clinical Staff In An Outpatient Urgent Care Center, Melissa Fairfield, Bailey Eells, Faye Collins, Joyce Cornish, Stephen Tyzik, Joy Moody, Wendy Osgood, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

An outpatient urgent care unit was experiencing challenges in balancing the need to register patients and delivering care in the timeliest manner as possible. Upon examination, it was found that delays were being experienced in patient triage and discharge that resulted in low patient satisfaction scores.

A team of providers was established to review all process steps and a quality improvement project was created to attain a goal of 100% of the time discharge would not be delayed due to incomplete registration.

Baseline metrics demonstrated current numbers of delayed discharges, median time from door to triage as well as door …

Treating Substance Use Disorders: Enhancing Attendance At The Weekly Inpatient Medication Assisted Treatment Group, Devon Gillis, Jayne Weisberg, Dena Whitesell, Amy Mcauliffe, Amy Sparks, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

Operations Transformation

At a large academic tertiary medical center, an Integrated Medication Assisted Treatment (IMAT) program has been established for those medically stable inpatients with an addiction diagnosis. Over a four month period, this program had experienced a decline in attendance and a quality improvement project was initiated is to better understand the barriers to attendance and institute a process that would reverse the decline.

A goal was established to improve attendance by medically stable patients that have consented to participate to a minimum of 50%.

A root cause analysis outlined numerous causes for low attendance and several countermeasures were established to …

Facilitating Earlier Discharges To Decrease Avoidable Patient Days And Improve Flow For An Acute And Intermediate Care Unit, Natasha Bartlett

Operations Transformation

No abstract provided.

Reduction Of Catheter Associated Urinary Tract Infections (Cauti) In A Critical Care Setting, Deborah Jackson, Lindsey Lucas, Shawn Taylor, Jonathan Archibald, Stephen Tyzik, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

Urinary tract infections (UTIs) are the most common type of healthcare associated infections. Seventy five percent are related to indwelling urinary catheters. These infections come with increased morbidity and mortality risk. A team of intensive care providers at a large academic tertiary medical center initiated a quality improvement project to reduce the number of CAUTIs.

Baseline data established the total number of catheter days and CAUTIs by month. A subsequent root cause analysis was completed and several counter measures were developed to include a KPI implementation to track that all intensive care providers are educated in CAUTI and creation of …

A Coaching And Team Performance Evaluation Model To Build Capacity For High-Impact Lean Improvement, Ruth Hanselman, Mark Parker, Suneela Nayak, Stephen Tyzik, Amy Sparks

Operations Transformation

There is abundant evidence that links a strong culture of safety with improved patient and staff experience. However, there has been no clear avenue identified as to how to achieve this metric.

A team in a large academic tertiary teaching hospital set about leveraging their daily managing system (DMS) to attain improvement in their institution’s safety. The goals of this quality improvement project were to use DMS to identify and report safety concerns and increase frontline team knowledge and comfort with reporting safety concerns during Gemba walks.

A root cause analysis identified 5 areas for improvement and several countermeasures were …

Implementation Of Trauma Service Guideline For The Use Of Phenobarbital In The Management Of The Non-Icu Trauma Patient At Risk Or Experiencing Severe Alcohol Withdrawal, Joseph Rappold, Julianne Ontengco, Stephen Tyzik, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

The trauma service in a large academic tertiary medical center admits a large proportion of patients with the secondary diagnosis of alcohol use disorder. Given the successful use of phenobarbital in the critical care unit for withdrawal prophylaxis and treatment of acute withdrawal, a quality improvement project was established to create and implement guidelines for the non ICU patient.

A root cause analysis demonstrated several issues to include inconsistent clinical decision documentation. As a result, several countermeasures were initiated to address the various issues.

Post implementation of countermeasures, a decrease in the amount of severe alcohol withdrawal as well as …

Evaluation Of Epas1 Variants For Association With Bovine Congestive Heart Failure [Version 1; Peer Review: 2 Approved], Michael P. Heaton, Adam S. Bassett, Katherine J. Whitman, Greta M. Krafsur, Sang M. Lee, Jaden M. Carlson, Halden J. Clark, Helen R. Smith, Madeline C. Pelster, Veronica Basnayake, Dale M. Grotelueschen, B. Vander Ley

School of Veterinary and Biomedical Sciences: Faculty Publications

Background: Bovine congestive heart failure (BCHF) has become increasingly prevalent in feedlot cattle in the Western Great Plains of North America. BCHF is an untreatable complex condition involving pulmonary hypertension that culminates in right ventricular failure and death. A protein variant of hypoxia-inducible factor 2 alpha (HIF2α, encoded by the endothelial PAS domain-containing protein 1 gene, EPAS1) was previously reported to be associated with pulmonary hypertension at altitudes exceeding 2,000 m. Our aim was to evaluate EPAS1 haplotypes for association with BCHF in feedlot cattle raised at moderate altitudes (1,200 m).

Methods: Paired samples of clinical cases and unaffected controls …

Yearly Trend Of Acute Venous Thromboembolism In Patients Admitted With Heart Failure In The United States., Sijan Basnet, Rashmi Dhital, Biswaraj Tharu, Dilli Ram Poudel, Anthony Donato

Reading Hospital Internal Medicine Residency

Introduction: Heart failure (HF) patients are at risk for venous thromboembolism (VTE) during the hospital stay. We aim to study the recent trend of deep vein thrombosis (DVT), pulmonary embolism (PE), and VTE in heart failure patients from years 2000-2013. Methods: We utilized the National (Nationwide) Inpatient Sample database and selected non-pregnant patients over the age of 18 years for this purpose. We selected HF, DVT, PE, and VTE based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). We used STATA for analysis. Results: We noted an increase in prevalence of DVT, PE and composite …

Factors Leading To Meconium Aspiration Syndrome In Term- And Post-Term Neonates, Saroop Chand, Aamna Salman, Razia Mustafa Abbassi, Abdul Rehman Siyal, Fayaz Ahmed Memon, Abdul Lateef Leghari, Ashmal Sami Kabani, Sajid Ali

Department of Pathology and Laboratory Medicine

Background:
Meconium aspiration syndrome (MAS) is considered a major cause of respiratory morbidity. It is a common issue encountered in the delivery room and newborn nursery. There is a need to identify the factors that lead to MAS to develop strategies to screen such patients at an early stage to decrease the mortality and morbidity. The objective of this study was to determine the factors leading to MAS in neonates delivered at ≥37 weeks of gestational age.
Methods:
A cross-sectional study was conducted through non-probability consecutive sampling technique at Liaquat University Hospital, Hyderabad from August 2016 to February 2017. All …

Ranolazine Decreases Weekly Anginal Episodes In Patients With Chronic Stable Angina And Type 2 Diabetes, Hisham Kaddurah

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on the meaningful difference between statistical and clinical significance.

Tevar Should Be Considered In Select Patients With Uncomplicated Stanford Type B Aortic Dissection, Mordechai G. Sadowsky

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Nienaber CA, Kische S, Rousseau H, et al. Endovascular repair of type B aortic dissection: long-term results of the randomized investigation of stent grafts in aortic dissection trial. Circ Cardiovasc Interv, 2013;6(4):407-16. doi: 10.1161/circinterventions.113.000463.

Conference 2020: Wednesday 2nd And Thursday 3rd Of September, 2020, Sue Jones

HUCBMS: Heads of University Centres of Biomedical Sciences

No abstract provided.

Future Challenges And Opportunities In Teaching And Research For Biomedical Sciences, Gerry Mckenna

HUCBMS: Heads of University Centres of Biomedical Sciences

No abstract provided.

Supporting Recent Advances In The Enhancement Of Teaching And Learning, Theresa Maguire

HUCBMS: Heads of University Centres of Biomedical Sciences

No abstract provided.

Hong Kong Rae 2020: Perspective From A Department Hosting Two Healthcare Disciplines, Shea-Ping Yip

HUCBMS: Heads of University Centres of Biomedical Sciences

No abstract provided.

Update On The Research Assessment Framework 2021, Yvonne Barnett

HUCBMS: Heads of University Centres of Biomedical Sciences

No abstract provided.

Widening Participation And Access: Maximising And Capturing The Impact Of University Interventsions, Andrew Bengry

HUCBMS: Heads of University Centres of Biomedical Sciences

No abstract provided.

Open Research: The Imperative Of Working Together To Make This Happen, Liam Earney

HUCBMS: Heads of University Centres of Biomedical Sciences

No abstract provided.

Promotion Of Research And Its Economic Impact In Ireland, Mark Ferguson

HUCBMS: Heads of University Centres of Biomedical Sciences

No abstract provided.

The Cost Of The Culturati: Studying The Neighborhood Stability Impact Of Cultural District Designations, Prakash Mishra

Dartmouth Undergraduate Journal of Politics, Economics and World Affairs

The decision to declare a district for a specific cause is a critical policy decision; making an area an official office park or designated cultural site means it will attract specific types of residents and businesses and require specific amenities. This paper reviews the impact of designating a cultural district as a place-based policy, specifically by developing a measure of neighborhood stability and applying a stress test of neighborhood stability in cultural districts during the Great Recession. The model underpining the neighborhood stability measure is an optimal stopping time model which frames neighborhood rents as a Brownian motion with drift. …

Volume I | Issue Ii | 2019.Pdf, Dujpew Editorial Board

Dartmouth Undergraduate Journal of Politics, Economics and World Affairs

No abstract provided.

Masthead 2019, Dujpew Editorial Board

Dartmouth Undergraduate Journal of Politics, Economics and World Affairs

No abstract provided.

Letter From The Editor 2019, Dujpew Editorial Board

Dartmouth Undergraduate Journal of Politics, Economics and World Affairs

No abstract provided.

A Cross Sectional Study Evaluating Psychosocial Job Stress And Health Risk In Emergency Department Nurses, Rupkatha Bardhan, Karen Heaton, Melissa Davis, Peter Chen, Dale A. Dickinson, Claudiu T. Lungu

Faculty & Staff Research and Creative Activity

Nurses experience psychosocial work stress that may negatively affect physical and mental health over time. In this cross-sectional study we investigated prevalence of job stress and oxidative stress in nurses, and determined if significant relationships exist between higher job stress scores and demographic factors and working conditions. Emergency department nurses (n = 42) were recruited from a University Hospital following Institutional Review Board approval. Job stress indicators, effort–reward ratio and overcommitment were evaluated from survey questionnaires using the effort–reward imbalance model, and associations with age, sex, body mass index, and working conditions were measured by logistic regression analysis. Oxidative stress …

Map7 Prevents Axonal Branch Retraction By Creating A Stable Microtubule Boundary To Rescue Polymerization., Stephen R. Tymanskyj, Le Ma

Farber Institute for Neuroscience Faculty Papers

Complex neural circuits are built from axonal branches that allow each neuron to connect with multiple targets. During development, maturation of nascent branches depends on stabilization of newly assembled or transported microtubules, which are thought to be regulated by microtubule-associated proteins (MAPs). However, because many known MAPs inhibit branch formation, it is not clear which MAP is responsible for regulating microtubule stability during branch development. Here, we show that MAP7, a less-well understood MAP that is localized to branch junctions, provides a key molecular mechanism to regulate microtubule stability during branch formation. In developing rodent sensory neurons of mixed sex, …

Effect Of 3-Dimensional Virtual Reality Models For Surgical Planning Of Robotic-Assisted Partial Nephrectomy On Surgical Outcomes: A Randomized Clinical Trial., Joseph D Shirk, David D Thiel, Eric M Wallen, Jennifer M Linehan, Wesley M White, Ketan K Badani, James R Porter

Articles, Abstracts, and Reports

Importance: Planning complex operations such as robotic-assisted partial nephrectomy requires surgeons to review 2-dimensional computed tomography or magnetic resonance images to understand 3-dimensional (3-D), patient-specific anatomy.

Objective: To determine surgical outcomes for robotic-assisted partial nephrectomy when surgeons reviewed 3-D virtual reality (VR) models during operative planning.

Design, Setting, and Participants: A single-blind randomized clinical trial was performed. Ninety-two patients undergoing robotic-assisted partial nephrectomy performed by 1 of 11 surgeons at 6 large teaching hospitals were prospectively enrolled and randomized. Enrollment and data collection occurred from October 2017 through December 2018, and data analysis was performed from December 2018 through March …

A Comparison Of Opioid Abuse Screening Tools Of Detection Of High Risk Patients In The Inpatient Setting, Grace Gu Md, Albert Cheng Md, Darren Rahaman Md, Shyh-Jeun Wang Md, Maureen Strohm Md, Napatkamon Ayutyanont

Family Medicine

• The United States is currently experiencing an opioid epidemic, which claims 115 lives daily by overdose.
• Tools for identifying patients at increased risk for abuse include: Screener and Opioid Assessment for Patients with Pain (SOAPP-R) and Opioid Risk Tool (ORT).
• However, data is lacking for the comparison of the two most commonly used opioid screen tools (SOAPP-R and ORT).
• We are comparing the effectiveness of these screening tools for patients being discharged from the hospital who have no "red flags" for abuse.

Young, Kathleen Louise "Kay" (Fa 1327), Manuscripts & Folklife Archives

Folklife Archives Finding Aids

Finding aid and full-text scan of paper (Click on “Additional Files” below) for Folklife Archives Project 1327. Student folk studies project titled “Ginseng: A Treasured Kentucky Herb That Goes to China” about the business of buying and selling ginseng in Grayson County, Kentucky and the growing and harvesting of ginseng in Simpson County, Kentucky. Photos include the growing stages of the ginseng plant, the harvesting process, and the informants.

Irisin Functions To Inhibit Malignant Growth Of Human Pancreatic Cancer Cells Via Downregulation Of The Pi3k/Akt Signaling Pathway., Deguo Zhang, Ping Zhang, Luan Li, Nan Tang, Fei Huang, Xianguo Kong, Xueying Tan, Guangjun Shi

Department of Medicine Faculty Papers

Introduction: Irisin is a newly identified cytokine that has gained increasing attention because of its potential therapeutic applications in metabolic diseases and human cancers. Recently, accumulating evidence indicates that irisin plays an important role in the development and metastasis of various tumors. The aim of this study was to evaluate the effects and underlying mechanisms of irisin on malignant growth of pancreatic cancer cells.

Materials and methods: The anti-proliferative effect of irisin was examined using the CCK-8 assay. Irisin-induced apoptosis was determined by the annexin V-FITC/PI staining assay. The effects of irisin on cell migration and invasion were assessed using …