Medical Education Commons^™

Conference Proceedings: Aurora Scientific Day 2017

Journal of Patient-Centered Research and Reviews

This supplement includes select abstracts presented at the 43rd Annual Aurora Scientific Day research symposium on May 24, 2017. Aurora Scientific Day hosts a forum for original research conducted by faculty, fellows, residents, and other allied health professionals affiliated with Aurora Health Care, an integrated health system headquartered in Milwaukee, Wisconsin.

Quality Improvement Study For Postpartum Hypertension Readmissions, Molly K. Lepic, Sara M. Stanenas, Carla J. Kelly, Deborah Simpson, Jeffrey A. Stearns

Journal of Patient-Centered Research and Reviews

Background: Hospital readmission rates are a focus of the Centers for Medicare and Medicaid Services. This was identified as a system opportunity to improve health care quality and patient education in order to reduce preventable readmissions. In 2009, 27% of obstetric readmissions were due to hypertensive disease, and preventable readmissions regarding hypertension are flagged as an area for quality improvement in our health care system. There is limited evidence on specific management of postpartum hypertension.

Purpose: Identify risk factors in our community and reduce postpartum readmissions for hypertension within our hospital.

Methods: We performed a retrospective chart review from November …

Positive Impact On Patient Satisfaction And Caregiver Identification Using Team Facecards: A Quality Improvement Study, Nicole M. Martin, Khalil Odeh, Lamya Boujelbane, Marvi V. Rijhwani, Susan Olet, Aijaz Noor, Colleen Nichols, Richard Battiola

Journal of Patient-Centered Research and Reviews

Background: Patients satisfaction is an increasingly important metric in measuring the quality of care that hospitals and physicians provide. It can be difficult for patients to remember their providers and their roles, all of which may potentially impact a patient’s overall satisfaction.

Purpose: To see if giving facecards with pictures and names of caregivers and description of roles improved patient satisfaction and identification of care team members.

Methods: Team facecards were designed and distributed to the patients during the interventional period of the study. Patients’ identification of team members, the role of each physician and overall satisfaction was measured using …

Push For Progress Inspired Improved Outcomes, Jacob L. Bidwell

Journal of Patient-Centered Research and Reviews

The author and issue editor describes the changing faces of health care as well as movements undertaken by U.S. health systems over the last two decades to improve the treatment and documented outcomes of minority or impoverished patients and to understand the impact of cultural differences on patient care. While much progress has been made, achieving health equity will require the continued efforts of many working toward this goal.

Health Care Disparities Knowledge, Attitudes, And Behaviors In Resident Physicians, Rebecca Hammarlund, Diana Hamer, Kathleen Crapanzano, Rachel Bernard, Carine Nzodom, Courtney James, Angie Johnson, Diane Kirby, Laura Hetzler, Chris Woodward, Jesse Sulzer, Lauren Rabalais, Laurinda Calongne

Journal of Patient-Centered Research and Reviews

Purpose: Health care disparities are an important but sometimes underrepresented topic in graduate medical education. In this study we measured the impact of educational and behavioral interventions on resident knowledge about and attitudes toward health care disparities.

Methods: Faculty from 6 residency programs designed and presented an hour-long educational intervention to emphasize the importance of and increase resident knowledge about health care disparities. Selected residents then helped design a month-long behavioral intervention to engage their peers in conversations about disparities with patients. Surveys were administered pre- and post-educational intervention as well as post-behavioral intervention in order to measure the impact …

Improving Obstetrics In Family Medicine Residency Clinics: A Quality Improvement Study, Garima Chawla, Jessica J.F. Kram, Bonnie Bobot, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Background: Prenatal care/deliveries within our family medicine clinics have declined, perhaps because patients are unaware that our clinics provide these services. With lower volumes, clinicians may feel less comfortable with current skills/knowledge of obstetric (OB) care.

Purpose: Increase family medicine clinic OB numbers, patient awareness, and clinician comfort/knowledge in OB.

Methods: English-facile patients (18–50 years), residents and faculty at Aurora family medicine residency clinics were included. Patients were provided preintervention surveys upon check-in. Residents/faculty were surveyed via Survey Monkey. Changes made based on initial survey results were: 1) increasing systemwide awareness that our caregivers provide OB care, through fliers at …

Identifying And Targeting Age-Related Colorectal Cancer Screening Rate Disparities In Family Medicine Residency Clinics, Jonathan J. Blaza, Jasmine R. Wiley, Matthew Gill, Alonzo Jalan, Will Lehmann, Deborah Simpson, Jeffrey A. Stearns

Journal of Patient-Centered Research and Reviews

Background: Health care systems continuously seek to improve patient care through population-level analysis of clinical quality metrics and patient characteristics to identify disparities in care. Nationally, disparities in colorectal cancer (CRC) screening rates have been identified with lower screening rates reported for patients who are uninsured and/or lower socioeconomic status, African American/black, Asian, and non-English-speaking Hispanic patients. No age-related CRC screening rate disparities with associated interventions have been reported.

Purpose: Determine and address CRC screening disparities in care provided to eligible patients > 50 years old in two primary care residency clinics.

Methods: Retrospective analysis using REAL-G (race, ethnicity, age, preferred …

College Students, Experiences On Smart Phone Technology Usage: A Qualitative Content Analysis Study, Fatemeh Jafarzadeh-Kenarsari, Parand Pourghane

The Qualitative Report

Besides many benefits of the cell phone technology, numerous arguments are raised on the different and important negative effects of such a technology. This qualitative content analysis study explored the common usages of smart phone technology, its challenges, and benefits among Iranian college students. Participants were 32 bachelor degree students who were recruited using purposive sampling method with maximum variation. Data were collected through 11 individual semi-structured interviews and 3 focus group discussions (5-8 students in each group). Data analysis was done based on a conventional content analysis approach. Data analysis resulted in 3 main themes and 12 sub-themes. The …

Developing A Mobile Application: Improving Health Care Students’ Ability To Communicate, Kiersten Walters, Ilya Rybakov, Patricia L. Darbishire

Purdue Journal of Service-Learning and International Engagement

The purpose of this project was to develop, pilot, assess, and describe a new interdisciplinary, game-based phone application. The application is intended to help health care students better communicate medication and medical terminology to their patients and to other health care providers and insurance companies. This IRB-approved project called “PharmPhrase” was developed using an application-development software program. The pilot involved multiple groups of competing teams composed of volunteer pharmacy students in their first professional years who were randomly assigned into teams of three to five. The PharmPhrase user explains a randomly generated medical term to team members based on assumptions …

Increasing Fitness Engagement Among Ohiohealth Employees, Kristen Goins

Masters Theses/Capstone Projects

This presentation focuses on how to increase fitness engagement among the employees of a large medical facility.

Palliative Players: Project Development And Initial Implementation, Eliza Eager

Muskie School Capstones and Dissertations

The Palliative Players are screened and trained hospice volunteers who provide a low-cost, sustainable, role-playing resource for use teaching communication skills to healthcare workers who discuss serious illness with patients and their families. The Palliative Players project was conceived and developed in early 2017 by Dr. Lauren Michalakes, Medical Director of Palliative Care at Coastal Healthcare Alliance (CHA); Sarah Dwelley, RN; Flic Shooter, Director of Hospice Volunteers of Waldo County (HVOWC); and Eliza Eager, Project Coordinator; to provide believable, emotive simulated patients (SPs) for role-play in workshops teaching healthcare workers communication tools and skills for use in conversations with patients …

Las Condiciones De Vida De Los Usuarios Adultos Mayores Del Hospital Makewe / The Living Conditions Of Elderly Users Of Makewe Hospital, Taylor Selembo

Independent Study Project (ISP) Collection

Life conditions are a fundamental aspect of the health of senior citizens, as these are the factors that determine their quality of life and capacity to satisfy their needs. Life conditions are dependent on the particular social, political, economic, and geographic context of the region. This study intends to answer the following question: How are the life conditions of senior citizens belonging to Hospital Makewe, located in the IX region of Chile? This quali-quantitative study utilized observation, surveys (n = 40) and interviews (n = 15) in order to accomplish the main objective. The main objective was to describe senior …

Opening A Student-Run Pro Bono Occupational Therapy Pediatric Clinic, Anne H. Zachry

Faculty Presentations

This presentation described the opening of a student-run pro bono pediatric therapy clinic that provides services to children/families who are economically disadvantaged. The benefits of participation for students and clients were reviewed, and fund-raising and the development of a mission statement were discussed.

A Validated Measure For Fertility Awareness: An Essential Step Toward Informed Reproductive Decision-Making, Brennan Peterson

Marriage and Family Therapy Faculty Articles and Research

"The efforts by Kudesia and colleagues (1) to create and validate a fertility awareness survey is a vital development in the field of reproductive health care. The 29-item Fertility and Infertility Treatment Knowledge Score (FIT-KS) was created to measure fertility awareness and infertility treatment knowledge in the general population and among medical trainees. Using a combination of existing questionnaires, consultation with specialists in test construction, and clinical recommendations of an expert panel of 15 reproductive endocrinologists, the FIT-KS is the first of its kind in the United States. The authors should be commended for their foresight and attempts to address …

Web Resources For Physician Wellness, Elizabeth C. Lawrence

Office of Physician and Student Wellness (OPSW)

A current listing of websites, TED talks, and podcasts related to physician wellness and resiliency.

Refugee-Centered Medical Home:A New Approach To Care At The University Of Louisville Global Health Center, Rahel Bosson, Ruth M. Carrico, Anupama Raghuram, Paula Peyrani, William A. Mattingly, Rebecca Ford, Stephen P. Furmanek, Julio A. Ramirez

Journal of Refugee & Global Health

Refugees arrive to the United States with a full spectrum of health conditions, many of which involve intense case management requiring significant financial investments and use of healthcare resources. Kentucky receives more than 3,000 new refugees each year and ranked 10th in the nation for numbers of new arrivals resettled during 2015. These refugees arrive from diverse countries representing different cultures and speaking different languages. In addition, they arrive with diverse health conditions and medical needs. The aims of this paper are to share experiences from the University of Louisville Global Health Center regarding conceptualization, implementation and evaluation of a …

Aligning Opioid Prescribing Pathways, Andrea Lai, Outpatient Pharmacy, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

There is a drug epidemic sweeping the State of Maine and it continues to worsen each passing year. In 2017, the Maine legislature passed Public Law Chapter 488 to strengthen the controlled substance prescription monitoring program. An outpatient pharmacy, located in a large acute care hospital, created a performance improvement project to clarify opioid prescription and resolve any non-compliance with Chapter 488.

After a root cause analysis, several KPIs were established to include tracking the number of phone calls made by pharmacists to non-compliant providers to clarify scripts, provide one on one education and ultimately resolve non-compliance. Repeat offenders were …

Effective Methods For Domestic Violence Screening In The Emergency Department, Megan Bryan

Grace Peterson Nursing Research Colloquium

Abstract

Background: The CDC reports that one in four women and one in ten men will experience some form of domestic violence in their lifetime that will have either a short-term or long-term impact on their well-being. Often the first place these victims are seen where they can receive help is the emergency department. Objectives: The goal of this systematic integrative literature review was to explore existing literature on domestic violence screening methods used in the emergency department and determine which methods prove most effective. Concurrently, this review examined the barriers to effective domestic violence screening and how nursing education …

Improving Access And Utilization Of Data To Support Research And Programs Intended To Eliminate Disparities And Promote Health Equity, Rosaly Correa-De-Araujo

Journal of Health Disparities Research and Practice

Numerous Federal initiatives are addressing health and health care disparities. The ultimate goal is to achieve “a nation free of disparities in health and health care.” Social determinants of health remain mostly responsible for health/health care disparities among population groups within and between countries. In the United States, there is little evidence that disparities associated with such determinants are decreasing, with only 10% of those associated with race/ethnicity and income having demonstrated improvement in recent years. A variety of data sources are available from the Federal and private sectors to support research on disparities, but no single national survey seems …

Bibliography Of Physician Wellness Resources, Elizabeth C. Lawrence

Office of Physician and Student Wellness (OPSW)

Current list of articles and books on physician wellness.

Implementation Of The National Asthma Guidelines In A Residential Pediatric Clinic, Patricia A. Foster-Staples

Dissertations

Abstract

Purpose: Foster care children admitted to residential facilities are a unique and vulnerable group, many presenting with undiagnosed or poorly managed asthma. The alarming rate of residents admitted to a particular residential primary care clinic with a diagnosis of asthma led to the project question: “Based on record reviews, does staff education about the importance of utilizing the national guidelines for asthma education influence the implementation of such guidelines in a residential pediatric clinic?” The purpose of this quality improvement project was to implement a systematic process to influence practice change. The project was conducted over a period …

Unm Gme Resources - July 2017, Elizabeth C. Lawrence

Office of Physician and Student Wellness (OPSW)

No abstract provided.

Vitamin C To Decrease The Effects Of Smoking In Pregnancy On Infant Lung Function (Vcsip): Rationale, Design, And Methods Of A Randomized, Controlled Trial Of Vitamin C Supplementation In Pregnancy For The Primary Prevention Of Effects Of In Utero Tobacco Smoke Exposure On Infant Lung Function And Respiratory Health, Cindy T. Mcevoy, Kristin F. Milner, Ashley J. Scherman, Diane G. Schilling, Christina J. Tiller, Brittany Vuylsteke, Lyndsey E. Shorey-Kendrick, Eliot R. Spindel, Robert Schuff, Julie Mitchell, Dawn Peters, Jill Metz, David Haas, Keith Jackson, Robert S. Tepper, Cynthia D. Morris

OHSU-PSU School of Public Health Faculty Publications and Presentations

Despite strong anti-smoking efforts, at least 12% of American women cannot quit smoking when pregnant resulting in > 450,000 smoke-exposed infants born yearly. Smoking during pregnancy is the largest preventable cause of childhood respiratory illness including wheezing and asthma. Recent studies have shown a protective effect of vitamin C supplementation on the lung function of offspring exposed to in utero smoke in a non-human primate model and an initial human trial. Vitamin C to Decrease the Effects of Smoking in Pregnancy on Infant Lung Function (VCSIP) is a randomized, double-blind, placebo-controlled trial to evaluate pulmonary function at 3 months of age …

Immunizations And Health Disparities: Immunizations Provided Across A Diverse Population, Jeffery A. Goad, Tania Gregorian

Pharmacy Faculty Articles and Research

"Vaccines help contain the spread of diseases and reduce morbidity and mortality. For any vaccination effort to succeed, vaccine uptake must be widespread across the entire population. However, the US population is very diverse, and there are various groups with different attitudes and beliefs regarding vaccination; this leads to disparities in vaccination rates. The Healthy People initiative, a program managed by Office of Disease Prevention and Health Promotion at the US Department of Health and Human Services HHS that aims to provide Americans with evidence-based, 10-year national objectives for improving their health defines a disparity in health care as 'a …

Therapy Dogs And The Impact On Employees In The Pediatric Medical Setting, Laine Foith

Electronic Theses and Dissertations

More than 40% of nurses reported experiencing significant burnout. Burnout is characterized by disengagement, cynicism, negative views of personal accomplishment and ability, and emotional exhaustion. The healthcare providers that experience burnout can possibly expect a decrease in ability to recognize/report errors, increase of negative feelings toward the patient, and decrease levels of patient satisfaction (Ernest, 2014). One of the ways Schub (2015) suggested to regulate burnout for employees was to provide psychosocial support to colleagues to reduce stress. This study is one of the first attempts to bridge the gap between the unknown correlation between qualitative and quantitative benefits of …

Determining The Knowledge, Attitudes And Beliefs Of Healthcare Providers In Treating Non-Specific Acute And Chronic Back Pain, Stacey L. Kale

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Stacey Kale

Managing back pain has become a public health and clinical challenge (Krein et al., 2016). Incidence of back pain related complaints requiring treatment in the US is estimated at 11.2% of the adult population (Dowell, Haegerich, & Chou, 2016). New research suggests that it is the most common pain problem (Pauline, 2016). It is the third most expensive health disorder and is exceeded only by cancer and heart disease. Many health care providers lack formal pain management education and training thus leaving them at risk for failing to properly manage patients …

Female Circumcision: Attitudes, Knowledge And Beliefs Within The Deaf Community, Morgane Vincent

Undergraduate University Honors Capstones

Female Genital Circumcision (FGC) is a cultural practice by which female genitalia are cut for non-medical purposes. Although the Western world has seen the number of circumcised youth rise, very few studies have been conducted in developed countries. Even fewer are studies on minority groups regarding female circumcision; none explicitly involve deaf people. For this study, 76 deaf or hard of hearing individuals living in the U.S., whose primary means of communication was English or American Sign Language, completed a survey about FGC before and after viewing videos. One video showed an African woman who had experienced FGC, and the …

New Outpatient Experience Survey Design: A Quality Improvement Case Study, Nathan Paluso

Muskie School Capstones and Dissertations

The purpose of this capstone project is to evaluate the implementation process for a new survey methodology introduced by Maine Medical Partners (MMP), by following the Plan-Do-Study-Act (PDSA) quality improvement cycle framework. This new survey has been implemented to collect data on patients’ experiences in the MMP outpatient facilities, and is offered to the patients via iPad at check-out after their appointment. Through observation at MMP practices and MMP staff interviews, strengths and weaknesses of the implementation process have been identified. Evidence-based solutions pertaining to the identified weaknesses have been selected through a literature review and are incorporated in recommendations …

Humor In Medicine: A Literature Review Of Humor’S Potential Therapeutic Value In Health Care, Weston Michael Grant

Psychological Science Undergraduate Honors Theses

Using humor and laughter within the health care field has the potential to be relevant to patients during treatment, to the patient-caregiver relationship, to the subjective well-being of health care providers, and to the environments’ (e.g., work settings) impact on group relationships (e.g., colleagues). A review of the literature examines how the psychological and physiological effects of laughter and humor within the human body impact health and well-being, how humor and laughter improve the patient-practitioner relationship, and if humor and laughter can potentially impact physician burnout. Several possible implications for these findings are discussed, such as professional medical comedians, improvements …

Emergency Preparedness Competencies Among Nurses In Northwest Arkansas, Taylor A. Matlock

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Despite years of training and experience, evidence suggests nurses report wide gaps in emergency competencies and disaster preparedness. Further, nurses report low levels of familiarity in competencies related to planning for disasters, implementing disaster guidelines, and assessing patients exposed to biological and chemical agents. This research sought to establish the self-reported level of emergency preparedness competencies of nurses in Northwest Arkansas, an area that faces a diverse set of potential disasters ranging from nuclear accidents to pandemic disease. Additionally, differences between of the level of preparedness by education level or work specialty were studied. The results are alarming in that …