Medical Education Commons^™

Thyroid Hormone-Clearing Deiodinase 3 Protects From Cranio- Encephalic And Cardiac Congenital Abnormalities, Arturo Hernandez, M Elena Martinez, Ilka Pinz, Marilena Preda, Thomas Gridley

Costas T. Lambrew Research Retreat 2021

Implications: Transient overexposure to TH during development may contribute to idiopathic congenital syndromes in humans (cleft palate, hydrocephalus, cardiac and Chiari malformations, others)

Tusm–Mmc Maine Track: Undergraduate Medical Education Teaching Partnership 2021, Maine Medical Center

Annual Reports

2021 Program Report

Improving Safety Using Hfmea And Insitu Simulation Prior To Initiating Contrast Mri Studies In An Ambulatory Setting, Micheline Chipman, Todd Dadaleares, Heather Beaulieu, Leah Mallory

Costas T. Lambrew Research Retreat 2021

The objective of this event was to test a new system for emergency response to MRI contrast reactions by ensuring staff familiarity with emergency equipment and a newly drafted emergency response protocols, and to mitigate any LST identified.

Dietary Patterns And Pfas Plasma Concentrations In Childhood: Project Viva, Usa, Shravanthi M. Seshasayee, Sheryl L. Rifas-Shiman, Jorge E. Chavarro, Jenny L. Carwile, Antonia M. Calafat, Sharon K. Sagiv, Emily Oken, Abby F. Fleisch

Costas T. Lambrew Research Retreat 2021

Children who adhered to a dietary pattern of primarily packaged foods and fish had higher plasma concentrations of select PFAS, reflective of food intake and/or correlated lifestyle factors.

Development Of Maine Ongoing Outreach Simulation Education (Moose), A Novel Telesimulation Program, To Improve Neonatal Resuscitation In A Rural Community Hospital, Allison Zanno, Misty Melendi, Micheline Chipman, Jeffrey Holmes, Alexa Craig, Samantha Piro, Anna Gilbert, Sarah Gabrielson, Leah Mallory, Anya Culter, Mary Ottolini

Costas T. Lambrew Research Retreat 2021

Objective- To implement monthly neonatal resuscitation telesimulation team training sessions in a rural community hospital delivery room that is feasible, sustainable, and replicable at other sites.

Plasma Concentrations Of Per- And Polyfluoroalkyl Substances And Body Composition From Mid-Childhood To Early Adolescence, Jaclyn Janis, Sheryl Rifas-Shiman, Shravanthi M. Seshasayee, Clifford J Rosen, Abby F Fleisch, Sharon Sagiv, Emily Oken

Costas T. Lambrew Research Retreat 2021

BACKGROUND

• Per- and polyfluoroalkyl substances (PFAS) may alter body composition by lowering anabolic hormones and increasing inflammation.

Prior studies have found positive, inverse, and null associations of PFAS concentrations with adiposity among children and adolescents.

Few studies have examined associations of PFAS concentrations with changes in body composition longitudinally.

No study has examined the association of PFAS plasma concentrations with lean mass.

Naloxone Co-Prescribing Across A Large Health System: A Quality Improvement Project, Marc D. Kimball, Sarah Hemphill, Kristen Silvia

Costas T. Lambrew Research Retreat 2021

Introduction:

• Naloxone availability and administration saves lives

• The CDC recommends naloxone co-prescribing for patients with OUD and other eligibility criteria

• Maine Medical Center’s baseline was found to be 6% in one clinic. This held true across the entire MaineHealth system.

Notch Signaling Regulates Perivascular Adipose Tissue (Pvat) Function During Diet-Induced Obesity, C Yang, A Harrington, L Ryzhova, L Liaw

Costas T. Lambrew Research Retreat 2021

Objectives:

-To test the hypothesis that canonical Notch signaling influence vascular function by regulating PVAT-derived vascular relaxation factors.

-To determine how overexpression of Notch signaling or loss of the key Notch signaling component influence PVAT function.

A New Project Echo Focused On Clinical Research In Development By The Nne-Ctr, Ivette Emery, Kerri Barton, Meredith Oestreicher, Neil Korsen, Irwin Brodsky

Costas T. Lambrew Research Retreat 2021

I diagram presented for the project by the NNE-CTR

A Period Seroprevalence (Sars-Cov-2) Survey In Mhccn Cancer Healthcare Workers (Hcws) Providing Patient Care During The Height Of The Outbreak: A Registry Study (Initial Progress), Jill Prescott, Caroline Knight, Erin Hobart, Jamie Saunders, Kimberly Caron, Sandra Neptune, Patty Brown, Lisa Lemire, Anne Breggia, Susan L. Guierin-Staples, Lee Lucas, Paul Han, Rachit Kumar, Robert Carlson, Scot Remick

Costas T. Lambrew Research Retreat 2021

Introduction: There is little information on the basic epidemiologic and serologic profile(s) of the novel SARSCoV- 2 coronavirus especially in HCWs employed in rural settings. We embarked on a period seroprevalence study in the MaineHealth Cancer Network (MHCCN) to document Covid-19 exposure in our rural cancer care workforce. Our fundamental hypothesis is that despite implementing procedures to safeguard patients and the use of appropriate PPE in the care of known source patients/PUIs in both the inpatient and outpatient cancer care settings a small, but not insignificant number of cancer care providers (hereafter referred to as cancer HCWs) will have evidence …

Hannaford Center For Safety, Innovation & Simulation 2021 Annual Report, Maine Medical Center

Annual Reports

In this 2021 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.

2019 Mite Annual Report

Journal of Maine Medical Center

No abstract provided.

Lessons From An Evidence-Based Medicine Exploration: When Transparency And Sensitivity (Analyses) Can Change The Take-Home Message, Nadi N. Kaonga, Toby Fitzgerald

Journal of Maine Medical Center

No abstract provided.

Development Of A Certificate In Healthcare Improvement For Inter-Professional Teams, Kathleen M. Fairfield, Hannah R. Martin, Peter W. Bates, Erin M. Graydon-Baker, Mark G. Parker, Jordan S. Peck, Debra A. Rothenberg, Ghassan A. Saleh, Isaac Z. Stickney, John Tooker, Robert L. Trowbridge, John E. Wennberg

Journal of Maine Medical Center

Introduction

To address gaps in care team improvement-science education and connect geographically dispersed learners, we created a healthcare improvement certificate program, now completing the third program year, for inter-professional (IP) healthcare teams, including third year medical students.

Methods

This hybrid learning program consists of five modules: Learning Healthcare Systems, Improvement Science, Patient Safety and Diagnostic Error, Population Health and Health Equity and Leading Change. The curricular materials are comprised of focused readings, concise videos, faculty-moderated discussion boards, weekly synchronous calls of participants with faculty, and a longitudinal improvement project. The faculty are content experts, and worked with a curricular designer …

Building A Peer Reviewer Community Of Practice, Victoria Hayes Md, Robert Bing-You Md, Med, Mba, Wendy Craig Phd

Journal of Maine Medical Center

Introduction: Scholarly peer review is the cornerstone for maintaining quality and relevance in the medical literature. Few programs that support peer-reviewer training have been described.

Methods: We developed a 2-pronged approach to support peer-reviewer training at our institution. This approach included a formal online course that offered a certificate of completion and an informal group manuscript peer review (GMPR) meeting held monthly.

Results: A total of 13 participants completed the online course in the first 2 years (2017-2018). Nineteen enrolled in the third year. The GMPR met regularly over 3 years and reviewed 26 manuscripts. Typical attendance has been 8-10 …

“When I Let Go Of What I Am, I Become What I Might Be.” Lao Tzu, Robert Bing-You

Journal of Maine Medical Center

No abstract provided.

A Modified Sir Model Equivalent To A Generalized Logistic Model, With Standard Logistic Approximations, David E Clark, Jordan S Peck, Gavin Welch

Costas T. Lambrew Research Retreat 2021

No abstract provided.

Tusm Faculty Appointments And Promotions 2019

Journal of Maine Medical Center

No abstract provided.

Reviewer Acknowledgement 2019

Journal of Maine Medical Center

No abstract provided.

Introducing An Adult Adhd Toolkit For Application In Collaborative Care, C. Jason Mallo

Journal of Maine Medical Center

Introduction: While providers in collaborative care have been challenged to respond to rising patient complaints about attention deficit hyperactivity disorder (ADHD) in adulthood, institutional guidance has been lacking or insufficient. To address this issue, an Adult ADHD Toolkit was created to be used by providers spanning primary care and psychiatry. This article reviews how the toolkit was developed, its contents, and future directions.

Methods: A workgroup of providers from different backgrounds devised materials for the toolkit by reviewing adult ADHD literature and clinical consensus.

Discussion: The toolkit addresses common dilemmas encountered in the evaluation and management of adult ADHD, and …

Changes In Hospital Utilization By Individuals Experiencing Homelessness After Engaging With Interdisciplinary, Low-Barrier Healthcare Services In Portland, Maine, Sarah Hemphill Ba, Adam Normandin Md, Ms, Debra Rothenberg Md, Phd

Journal of Maine Medical Center

Introduction: The Maine Medical Center Preble Street Learning Collaborative (PSLC) aims to couple medical education with addressing the unmet healthcare needs of those experiencing homelessness in Portland, Maine. The PSLC provides low-barrier medical, psychiatric, dental, and case management services to all-comers and is co-located near many of the city’s social services. The purpose of this study was to evaluate the impact of the PSLC in its first 19 months by describing demographic characteristics and patterns in hospital utilization of patients served by the PSLC.

Methods: We performed a retrospective chart review of 888 patients with one or more …

Virtual Coaching And Deliberate Practice To Enhance Medical Students' Clinical Reasoning During Oral Case Presentations, Nicole Akar-Ghibril Md, Cristina Carter Md, Gabrina Dixon Md, Med, Ellen Goldman Med, Mba, Mary C. Ottolini Md, Mph, Med

Journal of Maine Medical Center

ABSTRACT:

Introduction

Oral case presentations (OP) provide an opportunity for medical students to practice clinical reasoning and communication skills, and for faculty to provide assessment. Specific teaching strategies are needed to improve students’ OP skills.

Objective

To compare the effectiveness of Virtual Coaching (VC) to Small Group (SG) discussion or Traditional Feedback (TF/control) in improving clinical reasoning during OP, using a validated PBEAR (Problem Representation, Background Evidence, Analysis, Recommendation) tool.

Design/Methods

Students from two medical schools were randomly assigned to three groups during their inpatient pediatric clerkship. All completed an eLearning module about using illness scripts to promote clinical reasoning …

Time To Bring Curiosity Back Into The Practice Of Medicine, Robert Bing-You

Journal of Maine Medical Center

No abstract provided.

Improving Patient Experience And Education By Leveraging Technology, Cathy Palleschi, Wendy Osgood, Mark Parker, Cecilia Inman, Alicia Russell, Eileen Shanahan, Erin Pappal

Operations Transformation

It is estimated that 65% of the population are visual learners. With that in mind, a team of cardiac nurses in a large academic tertiary hospital developed a quality improvement project to hopefully improve patient engagement as well the patients’ perception that the nurses explained things in a manner that they could understand.

Baseline patient survey scores for the question, “Nurses Explained Things In A Way That I Understand”, were under the 75^thpercentile for a period of 9 months. A root cause analysis was conducted and it demonstrated numerous reasons for this score.

Several countermeasures were instituted to …

Development Of Mechanical Ventilator Educational Brochure For Patients/Families, Cathy Palleschi, Wendy Osgood, Mark Parker

Operations Transformation

Patients on mechanical ventilation often have no memory of events while being ventilated. In addition, families during this time, are often overwhelmed and unable to retain information provided to them by caregivers.

In attempt to address these issues, a team of care providers in an tertiary academic hospital established a goal to create a mechanical educational brochure with the goal to reduce associated anxiety and improve overall understanding of information provided.

As part of a clinical transformation project, a root cause analysis was conducted and a number of countermeasures were initiated. Some of these included a survey to capture feedback …

Improving Patient Flow By Increasing Early Discharges On A Mother & Baby Unit, Faye Weir, Joy Moody, Kathleen Cyr, Cathy Palleschi, Stephen Tyzik, Joseph East, Heidi Morin, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

Discharging patients early in the day has many advantages amongst which is increased bed availability. However, the experience in a large academic tertiary medical center demonstrated that most discharges occurred early to mid afternoon. A care team on a mother /baby unit established a quality improvement project to increase the number of discharges by 11AM and streamline key discharge planning activities.

A root cause analysis identified multiple barriers to attaining he established goals. To address these barriers, a multi prong approach was instituted to include a discharge education KPI for all unit staff.

Data collection post countermeasure implementation demonstrated some …

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 …

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 …