Medical Education Commons^™

Implementation And Evaluation Of A Resident Pediatric Complex Care Education Series, Calivin Schaffer, Danielle Doctor, Amy Buczkowski, Bonnie Lynne Boomsma, Logan Murray

Costas T. Lambrew Research Retreat 2025

Children with medical complexity have significant chronic health problems that affect multiple organ systems and result in functional limitations, high health care need or utilization, and often dependence on medical technology. Addressing their needs requires optimizing care within the medical home and medical neighborhood.

Expanding Library Services At Pen Bay Medical Center, Christina Kratzman Ma, Mi

MaineHealth Maine Medical Center

No abstract provided.

Pbpa Creating Pathways To Ensure Patients Are Using Their Inhaled Medications Effectively, Suzan Michelle Collins, Heather Blake, Chandler Blodgett, Sue Vermette, Martine Eon

Operations Transformation

Problem: Patients do not consistently know how to prepare, use and/or clean their inhalers effectively.

Impact: When patients do not consistently know how to prepare, use and/or clean their inhalers effectively they are in fact, not receiving the benefit from their prescribed medication.

They experience poor patient outcomes and overall poor patient experience.

• Increased calls to provider offices for unresolved, worsening symptoms and/or complications. (Thrush, hoarseness, cardiac symptoms etc.)
• Increased same day office visits.
• Patient crowding in Urgent Care and/or Emergency Department.
• Hospital Admissions.
• Increase in emotional and financial stress from missing school and/or work.
• Increase in referrals to specialists …

Let’S Go! 2022-2023 Educational Programs: Developing A Standardized Obesity Medicine Curriculum Through A Realist Evaluation, Isaac Stickney, Peter Amann, Victoria Rogers, Austin Steward, Kayla Bronzo, Alec Luro, Robert Bing-You

Journal of Maine Medical Center

Problem: Obesity is linked to more than 200 chronic conditions, lower quality of life, and worse outcomes for patients. Let’s Go! is a community engagement initiative that works with communities to create environments that support healthy behaviors that impact obesity. Let’s Go! provides educational programming for all medical learners and providers throughout Maine and Carroll County, New Hampshire. The goal of Let’s Go! is to address the health outcomes of obesity and the stigma associated with it, including its impact on patients’ mental health and clinicians’ unconscious biases.

Approach: We used a realist evaluation, a framework in which the social …

Ultrasound Guided Piv Insertion Implementation, Blake Hotchkiss, Beth O'Donnell, Miles Merwin, Billie Jo Senecal, Ronica Smith, Eric Alan, Bryan Tavary, Chelsea Harkins, Taylor Archard, Leslie Geissinger, Lauren Remington

Operations Transformation

Observed high number of unsuccessful peripheral IV insertion attempts. This increases waste (cost and time) and decreases patient satisfaction.

Creating Capacity To Accommodate Additional Cardiac Catheterization Procedures, Kristin Anthony

Operations Transformation

Patient access to diagnostic outpatient (OP) cardiac catheterization is limited by a perceived lack of capacity. Outpatient cardiac cath pts flow through the ACU for pre/post procedure care. Current schedule limits pts that may be scheduled through the ACU to two OP procedures/day. Cardiologists request the ability to schedule beyond the two procedures/day allowed. Significant variation in pre/postoperative care orders exist amongst cardiologists resulting in variability in length of stay. Cardiac procedures are booked either as 60/90/120 minutes – Epic case averaging technology is not active in the cath lab. As a result, the case minutes in the cath lab …

Approach To Pivie In Pediatrics: Standardization For Early Detection, Jamie Green, Jill Gregory, Elizabeth Murphy, Jessica Miller, Nicole Manchester, Frank Harris, Meaghan Wildes, Cecilia Inman, Jenn Paradis, Faye Weir

Operations Transformation

PIVIE (Peripheral Intravenous Infiltration & Extravasation) can have devastating effects, especially in the pediatric population. The condition may disrupt vasculature severe enough for permanent skin and tissue loss that can lead to impaired limb function due to severe scarring. Problem: No standardized process existed either to prevent or review these events at Barbara Bush Children’s Hospital at Maine Medical Center prior to the study. PIVIEs were measured through the event reporting platform and only severe PIVIEs were being documented in this report. All infiltrations (1-4 on the infiltration scale) should be measured for accurate benchmarking. Occurrences in the electronic medical …

Transition To Adult Care For Bleeding Disorders: Building A Multidisciplinary Tool, Leslie Larson, Ekaterina Funk, Dana Grass, Felicia Munster, Eric Larsen, Louise Baca, Glen Roy, Sara Artinyan

Operations Transformation

Youth with chronic illnesses often have poorer health outcomes after transitioning to adult care. Maine Health Bleeding Disorders is a Health Resources and Services Administration (HRSA) grant funded Hemophilia Treatment Center (HTC) that serves patients with congenital bleeding disorders. We provide multidisciplinary specialty care throughout the lifespan which includes pediatric and adult hematologists, family nurse practitioners, nurses, physical therapists, social worker, dietitian, genetic counselor, and research coordinator. In 2022, HRSA mandated all federally funded HTCs increase by 25 percent from baseline the number of individuals ages 12 to 26 years seen in a comprehensive clinic that have a health care …

Hannaford Center For Safety, Innovation & Simulation 2023 Annual Report, Mainehealth

Annual Reports

In this 2023 Annual Report, you will see that combination of cutting-edge technology, a talented team, and the shared drive to improve health care for patients makes the Sim Center a fantastic resource for our system.

Optimizing Psychological Safety: Using A Focus Group To Acquire Perspectives From Standardized Patients Who Identify As Lgbtq+, Brandy Brown, Rachel Kupferman, Bethany Rocheleau, Christine Mallar, Karissa Hannifan, Beth Gray, Victoria Hayes, Leah Mallory

Journal of Maine Medical Center

Introduction: Gender and sexual minority (lesbian, gay, bisexual, transgender, questioning; LGBTQ+) patients report poor health care experiences, partly because health care providers are not trained to meet their needs. Simulation can help learners practice competencies related to diversity, equity, and inclusion, but there are psychological safety considerations when recruiting standardized patients (SPs). Our objective was to incorporate the expertise of members of the LGBTQ+ community in our SP pool as we developed related curriculum.

Methods: All SPs were invited to participate in a focus group if they identified as LGBTQ+ and wanted to contribute. Content experts developed a focus group …

Improving Inclusive Communication: Pilot Results From A Simulation-Based Learning Opportunity To Practice Taking A Sexual Health History, Rachel Kupferman, Beth Gray, Bethany Rocheleau, Christine Mallar, Karissa Hannifan, Victoria Hayes, Leah Mallory, Brandy Brown

Journal of Maine Medical Center

Introduction: Sexual and gender minority (lesbian, gay, bisexual, transgender, questioning; LGBTQ+) patients experience health care inequities. Simulation using standardized patients (SPs) is an effective tool for communication-based training. To promote equitable practice, we created an experiential learning opportunity for residents to practice inclusive communication and improve their comfort in caring for LGBTQ+ patients while maintaining the psychological safety of SPs.

Methods: Our interdisciplinary team explored relevant simulation curricula, conducted a focus group with LGBTQ+ SPs, created a didactic presentation, and designed and implemented a simulated case. Family medicine residents participated in the training and completed pre- and post-training surveys rating …

Developing An Interprofessional Community Psychiatry Rotation Using An Assertive Community Treatment Team Model: A Preliminary Evaluation, Ruth Frydman

Journal of Maine Medical Center

Introduction: There is a shortage of psychiatric providers trained to work in community settings with people with serious mental illness (SMI) and associated comorbidities. We designed an innovative psychiatry rotation and curriculum for psychiatry residents and other learners.

Methods: The rotation incorporates working with our Assertive Community Treatment team and includes home visits, assertive outreach, and visits in other community settings. It was designed to improve learners’ confidence in their understanding and skill set for working with and treating people with SMI in the community on an interprofessional (IP) team. This pilot quality improvement project evaluated psychiatry resident responses to …

The Academy At Mite Report Of Activities 2022, Mmc Institute For Teaching Excellence

Journal of Maine Medical Center

No abstract provided.

Improving Pubmed For The Novice At The Expense Of The Expert: Surveying Librarians 3 Years Post-New Pubmed, Tim Kenny Mls, Heather Kemp Mlis

MaineHealth Maine Medical Center

Background: In 2019 PubMed, the publically accessible search interface for the MEDLINE database underwent a user interface update and overhaul. MEDLINE is the primary component of PubMed, a literature database developed and maintained by the NLM National Center for Biotechnology Information (NCBI)” (National Library of Medicine, 2022).

Methods: Using a brief web-based survey, comprised of both closed-ended and open-ended questions, health science library professionals provided feedback on the new PubMed.

Is Sepsis Hiding In Plain Sight? Implementation Of An Interprofessional (Ip) Sepsis Simulation To Detect Early Sepsis, Sarah Chang, Amanda Bennett, Anne Dean, Meaghan Anderson, Micheline Chipman

Costas T. Lambrew Research Retreat 2023

Early detection of hospital-acquired sepsis can be challenging. With highly effective IP teams and efficient healthcare systems, sepsis treated quickly can influence morbidity and mortality. This project is aimed at training IP teams in early recognition of sepsis using simulation. Nurses and providers rarely have opportunities to learn together. Simulation followed by an IP debrief is an excellent tool to collaborate for safe patient care.

Simulation-Based Resuscitative Transesophageal Echocardiography Training For Emergency Medicine Residents, August Felix, Andrew Fried, Jessica Hathaway, Tania D. Strout

Costas T. Lambrew Research Retreat 2023

Introduction: Resuscitative TEE is an emerging tool in the cardiac arrest tool-box, and can improve outcomes in OHCA.

• Identifies reversible causes

• Decreases time off chest

• Evaluates compression efficacy

• Improves assessment during pulse-checks

• Simulation training can prepare EM residents to obtain and interpret TEE views on a live patient.

Access To Pediatric Type 1 Diabetes Care In Montana, James C. Bohnhoff, Michael Kohut Phd, Chelsea Bodnar, Elizabeth A. Jacobs

Costas T. Lambrew Research Retreat 2023

Introduction: Management of Type 1 Diabetes (T1D) requires significant family effort and specialty support. We aimed to understand how living in a rural state impacts families’ experiences during and after diagnosis.

The Maine Obstetric Medical Simulation (Momsim) Program Identifies And Categorizes Latent Safety Threats Across Rural Hospitals, Jeffrey Holmes, Leah Mallory, Micheline Chipman, Becky Hunt, Sarah Austin, Tracey E. Mcmillan, Emily Watson, Mainehealth

Costas T. Lambrew Research Retreat 2023

Objective: Combine in-situ simulation with an HFMEA framework to identify and categorize common system wide LST and opportunities to improve patient safety

Befast Assessment In A Rural Community Hospital – The Birch Study, Caroline Knight, Eileen Hawkins, Hilary Merrifield, Laura Stein, Robert Stein

Costas T. Lambrew Research Retreat 2023

Background: There are known regional disparities in treatment rates with thrombolysis and thrombectomy for acute ischemic stroke. BEFAST has been implemented in acute stroke protocols to aid in recognition of signs of stroke, but its utility in a rural ED is not well known.

How To Address Health Misinformation? Using Focus Groups To Understand The Experience And Needs Of Interprofessional Undergraduate Health Professionals, Leah Mallory, Jennifer Hayman, Shelley Cohen Konrad, Linda H. Chaudron, Christine Mallar, Grace Price, Brendan Prast, Julia Safarik

Costas T. Lambrew Research Retreat 2023

The Problem of Health Misinformation Students from six different health professions share ideas

Weekly Review Of An Academic Checklist To Operationalize Improvements To A Surgical Residency Program, Sean Francois, James Whiting, Kartikey Pandya, Jaswin Sawhney

Journal of Maine Medical Center

Introduction: We report on the use of a weekly academic checklist to monitor proposed improvements to a surgical residency program.

Methods: A single-center, retrospective analysis of residency improvements with an academic checklist of quality initiatives reviewed weekly at morbidity and mortality conferences. The positive response rate for each of the 11 items were reviewed. Trends of positive responses during the year were reviewed. The effectiveness of the checklist was also assessed with 2 internal surveys completed by faculty and residents.

Results: Over 15 months, the checklist was reviewed 46 times. The rate of a positive response for items varied from …

Using Hierarchy Of Needs To Build Care Team Engagement, Cathy Palleschi, Katherine Skroski, Sam Canonico, Hailey Frager, Mary Beeaker, Suneela Nayak, Natalia Johnson, Rebecca Brookes

Operations Transformation

Cardiology Intensive Care & Cardiovascular Interventional Care teams provide superb care to critically ill cardiac patients at Maine Medical Center. Covid Pandemic revealed the importance of caregiver physical and mental health wellbeing, as well as engagement in order to continue to provide outstanding care to patients. Leadership devised innovative ways to improve team engagement and ensure that care team members' needs are met.

Equipping Health Professions Educators To Better Address Medical Misinformation, Brian G. Southwell, Andrea Anderson, Anne Berry, Kamilah Weems, Lisa Howley, Cristina Pelin, Maya Vasser, Michael Cassara, Marie C. Petrizzo, Samara Ginzburg, Renee Mcleod-Sordjan, Joseph Weiner, Lexie Morales, Mark Saunders, Emiri Uchiyama, Laura Fothergill, Deborah Sherman, Rebecca L. Toonkel, Alison M. Vargovich, Nicholas M. Fusco, Kelly Foltz-Ramos, Jessica Kruger, William Prescott Jr, Jennifer Hayman, Shelley Cohen Konrad, Linda H. Chaudron, Christine Mallar, Grace Price, Brendan Prast, Julia Safarik, Leah Mallory, Aashna Sunderrajan, Sara Serritella, Nicole L. Pierce, Olabisi Falana, Eve Bloomgarden, Shika Jain, Lisa Mordell, Vineet Arora

MaineHealth Maine Medical Center

As part of a cooperative agreement with the US Centers for Disease Control and Prevention (Federal Award Identification Number [FAIN]: NU50CK000586), the Association of American Medical Colleges (AAMC) began a strategic initiative in 2022 both to increase confidence in COVID-19 vaccines and to address medical misinformation and mistrust through education in health professions contexts. Specifically, the AAMC solicited proposals for integrating competency-based, interprofessional strategies to mitigate health misinformation into new or existing curricula. Five Health Professions Education Curricular Innovations subgrantees received support from the AAMC in 2022 and reflected on the implementation of their ideas in a series of meetings …

The Rapid Increase Of Digital Resources And Research Used At The Maine Medical Center Library And The Nation: Since The Beginning Of The Covid 19 Pandemic, Maegan L. Halica

MaineHealth Maine Medical Center

Health science resources have increasingly become accessible to researchers, health care professionals, and health scientists. With the current technology available in the healthcare settings affiliated with all MaineHealth, authors of various publications can share their knowledge with others across the globe. The COVID 19 pandemic created a situation that not only increased the need for technological communication and accessibility at a rapid pace, but the situation also created an alternative outlet for those in a medical library to utilize needed information pertaining to their position through the crisis of the pandemic.

Implementing Uniform Curriculum To Increase Efficiency And Access To Simulation, Christine Mallar, Bethany Rocheleau, Shelly Chipman, Mike Shepherd, Erin Siebers

Costas T. Lambrew Research Retreat 2022

• Using Standardized Patients (SPs) is effective in improving communication skills.

• Conducting SP training can be cost prohibitive in terms of time and labor.

• Demands of current curriculum created a need for an innovative and more efficient approach to meet new CLER requirement.

Code Blue! When A Simulation Isn’T A Simulation Anymore, Bethany Rocheleau, Christine Mallar, Shelly Chipman, Leah Mallory, Mike Shepherd, Erin Siebers, Susan Lane, Tracie Knight

Costas T. Lambrew Research Retreat 2022

Objectives:

• To identify and remediate gaps responding to a medical emergency during a simulated event.

• To provide a safe working environment for standardized patients and clinical staff.

Factors Associated With Chronic Hepatitis C Direct-Acting Antiviral Prescriptions In Maine, Colin T. Waters, Anya K. Cutler, Kinna Thakarar, Kathleen Fairfield

Costas T. Lambrew Research Retreat 2022

Introduction -2.5 to 4.7 million people in the United States have active Hepatitis C (HCV) infections. •Chronic HCV infection is linked to substantial morbidity including cirrhosis and liver failure. •Oral direct-acting antivirals (DAA) yield sustained virologic response in 90 to 95% of individuals. •Many patients eligible for DAA therapy have not received treatment.

Acquire’Ingscholarly Activity During Residency: An Analysis Of Resident Attitudes Towards Scholarship Before And After A Curricular Intervention, Thomas Q Reynolds, Sarah Gabrielson, Amy Buczkowski, Anya K. Cutler, Gina Trachimowicz

Costas T. Lambrew Research Retreat 2022

ACQUIRE, a curriculum designed to introduce residents to scholarship and support their work, results in improvement in resident perceptions towards scholarly activity at both individual and department levels.

Cytokine Cxcl2 Concentration In The Cerebrospinal Fluid Of Patients With Aneurysmal Subarachnoid Hemorrhage Is Associated With Patient-Reported Headache Pain, Elizabeth Glisic, Joanne T. Dekay, Patricia Lerwick, David J. Gagnon, Richard Riker, Sergey Ryzhov

Costas T. Lambrew Research Retreat 2022

Subarachnoid hemorrhage (SAH) is a severe type of stroke categorized by a sharp, sudden, and persistent headache. The mechanism of headache after SAH is currently poorly understood but the neuro-inflammatory response has been identified as a target in understanding the causes of headache after SAH. A better understanding of this mechanism may lead to identification of molecular targets for therapeutic reduction of headache pain and improving outcomes after SAH. In this study, we collected cerebrospinal fluid (CSF) from patients hospitalized with SAH and conducted a cytokine array to screen for soluble factors involved in SAH-associated headache Introduction

Applying The ‘Problem And Solution Trees’ Participatory Method To Design A Public Health Program On Covid 19 Testing For Underserved Populations, Mike Kohut, Elizabeth A Jacobs, Kathleen M Fairfield, G D. Sclar, K Hudak

Costas T. Lambrew Research Retreat 2022

Here we present a case study example of how we applied qualitative research and ‘problem and solution ’trees’( to identity barriers to testing for people who are unhoused