Health and Medical Administration Commons^™

Clinical Practice Workflow Implementation For The Improvement Of Diabetic Metric Compliance, Sugosh Anur, Sohil Khanna, Alison Mancuso, Alexander Kowalski

Rowan-Virtua Research Day

Recent guidance suggests the management of screen-detected diabetes can be optimized using multifactorial interventions to improve overall disease burden, patient outcomes, and cost-savings. We explored preventive diabetic care and implemented interventions to increase recommended testing compliance among patients with Type II Diabetes Mellitus. This study employed a multi-faceted approach beginning with the distribution of surveys to patients in the Stratford Family Medicine Office in order to gauge their health literacy level pertaining to Diabetes management. Patient electronic medical records were evaluated to determine baseline levels for all laboratory values. Data analysis was completed using Statistical Package for the Social Sciences …

Factors That Influence The Decision To Get Vaccinated Against Covid-19, Rhea Bhargava, Meghan H. Foos, Brandy M. Gotti, Alexandra L. Mulvenna, Taylor O. Smith, Danielle Cooley, Venkateswar Venkataman

Rowan-Virtua Research Day

Since the start of the COVID-19 pandemic and the launch of the vaccine, healthcare workers have been encouraging people to get vaccinated to prevent the spread of the virus. However, there is a significant number of people who are vaccine hesitant, or uncertain about receiving the COVID-19 vaccine and its booster. Vaccine hesitancy represents a state of opportunity to make positive change; therefore, it is crucial for healthcare workers to identify those who are in this population. When factors contributing to the vaccine hesitancy, including gender, age, ethnicity, education level, and income were studied, it was found that women, those …

Gestational Diabetes Among The South Asian Diaspora In The United States Of America: A Scoping Review, Anudeep Deevi, Mariam Sharobeem, Gabrianna Andrews, Rahul Ubrani, Venkateswar Venkataraman

Rowan-Virtua Research Day

Aim: The scoping review was conducted to review the current knowledge base regarding gestational diabetes mellitus (GDM) among South Asians in the United States. In addition, the review was meant to identify any gaps in knowledge, specifically about the current care received by South Asians as well as the associated adverse health outcomes.

Methods: A systematic search of PubMed, Web of Science, Embase, and Scopus was conducted. Key words ""gestational diabetes South Asians in the United States" were used as search terms. Search was restricted to U.S. articles published on or after 01/01/2013 with key words. Articles were screened by …

Improvements In Cardiac Auscultation Utilizing Multisensory Learning In Medical Students: A Preliminary Study, Harrison Patrizio, Riley Phyu, Bum Kim, Nils V. Brolis

Rowan-Virtua Research Day

Objective: To explore interweaving visual, auditory, and tactical stimulus into traditional education methods to improve cardiac auscultation teaching outcomes.

Methods: A pilot randomized controlled trial was conducted at our institution’s simulation center with 32 first year medical students from a single medical institution. Participants were randomly divided into two groups, and completed an educational module on identifying and understanding the pathophysiology of five common cardiac sounds. Participants in the control group (n=16) utilized traditional education methods, while the interventional group (n=16) incorporated visual, auditory, and tactical stimuli. Afterwards, participants listened to randomly selected cardiac sounds and competency data was collected …

The Effectiveness Of Examination Table Cleaning Protocols In Osteopathic Family Medicine Offices, Riley Phyu, Harrison A. Patrizio, Thomas Boyle, Todd Schachter

Rowan-Virtua Research Day

Contaminated environmental surfaces are responsible for acquisition of healthcare associated infections. In 2002 there were approximately 1.7 million healthcare associated infections, resulting in about 99,000 annual deaths. Appropriate disinfection of environmentally contaminated surfaces are required to reduce transmission of pathogens. Adenosine triphosphate (ATP) bioluminescence is being used in hospital settings to audit the cleanliness in the hospital settings. However, there is a paucity of literature in different healthcare settings outside of hospital settings. This may unintentionally result in a more relaxed cleaning protocol in outpatient settings.

Objective: To assess the effectiveness of disinfecting protocol in osteopathic family medicine offices using …

Improving Diabetic Retinopathy Screening Practices With Qi Methodology In Family Medicine Offices, Rea Isaac, Anne Jones

Rowan-Virtua Research Day

Early detection and treatment of diabetic retinopathy (DR) is crucial in preventing vision loss and blindness in vulnerable diabetics. With around 7.7 million patients having DR, and the target population being 20 -75 years old, the potential for improving their quality of life is substantial (WHO, 2022). Despite the importance of timely and routine eye exams, 45% of diabetic patients do not complete an exam despite physicians recommendations (Lu, 2014). This project aims to standardize eye exams, improve process flow, and improve patient understanding of the urgency of timely and comprehensive eye exams for DR. Multiple PDSA cycles and QI …

Analysis Of Implementing Best Practices For Co-Prescribing Naloxone In Your Agency Online Cme Training Module Via Pre- And Post- Knowledge Assessment., Alicia Podwojniak, Arvind Venkataraman, Richard Jermyn

Rowan-Virtua Research Day

The opioid epidemic poses substantial risk to society. Providers must ensure that their patients understand the uses and risks of both opioids and naloxone. One way to analyze this concept is via metacognition. This refers to a person’s knowledge about cognitive phenomena, and thus it regulates self-awareness abilities in decision making, such as planning and evaluating. It is not only important for providers to have knowledge on best practices, but also to have self-awareness, and confidence in their decision making to ensure optimal patient outcomes. True-false confidence weighted scoring can be utilized, whereby various levels of confidence are assessed from …

Focused Pocus: Cardiopulmonary Curriculum For Internal Medicine Residents, Daniel Tran, Krunalkumar Patel, Shivani Dalal, Umang Patel, Troy Randle

Rowan-Virtua Research Day

Problem Statement: Point-of-care ultrasound (POCUS) is currently not a required core competency in internal medicine (IM) residency despite its inherent benefits, and many hospitalists are not equipped to confidently acquire nor interpret basic ultrasound images.

Background: POCUS is used at the bedside by physicians to answer directed clinical questions to help guide patient management. During the COVID-19 pandemic, the use of ultrasound for quick, accurate diagnosis of life-threatening pathology has been instrumental in early detection of acute cardiopulmonary failure, monitoring treatment response, and minimizing nosocomial spread. We aimed to determine interest in learning POCUS, confidence level, self-rated proficiency, and perceived …

Robotic Cholecystectomy Versus Laparoscopic Cholecystectomy: A Modern Analysis Of Outcomes And Efficiency, Samuel Durham, Aziz Sadiq

Rowan-Virtua Research Day

Introduction/Purpose

Laparoscopic cholecystectomy was first performed in the United States in 1982, and by 1992 it became standard practice. The first robotic cholecystectomy was performed in 1997, yet it still has not been widely accepted as the standard of care. Many research papers early on in the development of robotic-assisted surgery concluded that robotically removing gallbladders would be more costly and less time efficient. We aim to compare the costs and operative time between laparoscopic and robotic cholecystectomy.

Methods

A study was performed on patients who underwent an elective robotic cholecystectomy over one year by a single primary surgeon. Operative …

Patient Perception Of The Semantics Of Medical Students Am I A “Medical Student” Or A “Student Doctor”, Brianna Nghiem, Samantha Plasner

Rowan-Virtua Research Day

Patients may perceive medical students differently depending on one of two titles that are traditionally used in clinical settings: “medical student” or “student doctor.” Previous studies have indicated that patient understanding of the medical hierarchy is poor and that a misunderstanding of the role of providers has been found to adversely affect patient satisfaction. To further understand this relationship, this study investigates differences in patient perceptions of the terms “medical student” and “student doctor" in university-affiliated and private family practices. Awareness of patient preferences can help guide the student’s clinical behaviors.

Barriers To Doula Use In New Jersey After 2021 Medicaid Coverage Expansion, June Solow, Aashna Reddy, Natali Sharma, Jonathan Lewis

Rowan-Virtua Research Day

Background: Doulas are trained non-clinical professionals that provide continuous support to a pregnant mother from the prenatal to postpartum period. Presence of a doula has been shown to benefit both mother and newborn health.

Purpose: To determine what prevents doula utilization in New Jersey.

Methods: A review of the current literature about doulas, mothers, clinicians, and legislation in other states was conducted. This included qualitative and quantitative data gathered in the United States.

Results: The most significant barrier from both the mother’s and doula’s perspectives is cost. Besides cost, diversity and number of doulas is low. A major barrier to …

Assessing The Need For Mental Health Screenings In A Student-Run Free Clinic And A Family Medicine Office, Sahil Parikh, Emily Forester, Alisha Basak, Jennifer Walpow, Rebecca Chae, Sahiba Gill, Tara Pellegrino

Rowan-Virtua Research Day

Background: The US Preventive Services Task Force provides strong evidence that early screening helps identify depression in primary care settings, promotes intervention, and facilitates treatment. The Rowan Community Health Clinic (RCHC) in Lindenwold, NJ is a student-run free clinic who serves patients regardless of patient gender, race, income or insurance status. This study aims to determine if there is a need to build internal infrastructure at RCHC for depression and anxiety management.

Methods: This is an IRB-approved study that began in June 2021. Data was collected from Rowan Community Health Center and Rowan Family Medicine patients. Patients were administered mental …

Does Accountability Affect Adherence To Moisturizer Treatment In Atopic Patients With Xerosis?, Stuti Prajapati, Christina Kontzias, Steven Feldman

Rowan-Virtua Research Day

Introduction: Xerosis is common in atopic dermatitis (AD). Adherence depends on factors such as complexity of treatments, disease understanding and accountability. Accountability is a psychobehavioral construct, referring to the expectation that one must be responsible for their actions or inactions.

Objective: We sought to assess whether interventions expected to improve accountability would be associated with improved adherence to xerosis treatment.

Method: This is a prospective study of 30 patients diagnosed with xerosis . Patients were given moisturizer with an electronic monitor to record adherence and asked to apply it once daily for three months. Subjects were randomized into one of …

Barriers To Dermatological Care In Patients Who Received Extensive Mohs Surgery - An In-Depth Qualitative Analysis, Stuti Prajapati, Mallory Zaino, Christina Kontzias, Laura Doerfler, Steven R. Feldman

Rowan-Virtua Research Day

Background: Dermatological care needs to be accessible for the elderly, but they face prominent challenges contributing to delays in diagnosis and treatment. Prolonged management of may lead to widespread cutaneous malignancies, necessitating extensive Mohs surgery.

Objective: To identify areas for early intervention in the geriatric population who have undergone extensive Mohs surgery.

Methods: We performed a qualitative study on 10 patients 65 years and older (68-91) from Atrium Health Wake Forest Baptist dermatology clinics between December 2022 and February 2023, who had extensive Mohs surgery (3 or more layers removed).

Results: Three major areas for potential intervention for cutaneous carcinoma …

Stimulant Prescriptions For Adhd Treatment In Children, Victoria Murray, Miranda Reed, Sonya Priven, Dan Rios, Jan Widerman

Rowan-Virtua Research Day

ADHD has become a much more common neurobehavioral disorder in the US, but access to both psychotherapy and medication remains limited, exacerbating socioeconomic disparities in multiple life domains, including education, employment, and substance use disorder. Equity in access to care is an opportunity to substantially improve care.

Brief Review: Patient Pill Splitting. What Is The Appropriate Advice To Provide Patients In The Emergency Department?, Mohammad Rattu, James Espinosa, Gabriel Meister, Alan Lucerna

Rowan-Virtua Research Day

A number of patients have inquired about the practice of pill splitting. Cutting or splitting of pills can be used by patients to create an intermediate dose or to save on money where a higher dose is priced at relatively the same cost as a lower dose. In this review we discuss a number of issues related to medication safety and table splitting.

Brief Review: Low Frequency Event Charts (G-Charts) In Healthcare, James Espinosa, David Ho, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

The ability to determine if a change in a system is actually an improvement—or worsening in function—is one of the essential desiderata of quality improvement efforts. There are many ways to look at the issue. A special problem occurs when the event being studied is low frequency by nature. By way of example, patient falls in a given hospital or division of a hospital may occur in a way that is low frequency—yet each event is important. Process engineering has developed an approach to low frequency events. Part of this approach may involve specialized charts that look at the “time-between-events”—as …

End Of Life Symptom Management In The Emergency Department, Alice Chang, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

The Emergency Department is at times the only place patients can turn to for symptom relief. In an aging population, this means that more patients are presenting to the ED towards the end of life (EOL). Emergency medicine (EM) prides itself as a specialty that handles disease-directed treatment for a variety of acute conditions. In contrast, palliative care (PC) is focused on improving the quality of life (QOL). It has become essential for EM physicians to care for patients who are not seeking life-sustaining measures, but instead quality of life interventions. Patients with serious illness, even hospice patients, present to …

Breaking Down Barriers: Investigating Structural And Systemic Factors That Contribute To Covid-19 Disparities In African American Communities In New Jersey, Fazal Choudhary, Suraj Pothineni

Rowan-Virtua Research Day

Background: The COVID-19 pandemic has affected the lives of millions of Americans; however, minority communities have been hit the hardest as infection rates continue to sky rocket and new variants arise. As of October 5, 2021, the CDC reports that African Americans make up a similar share of cases relative to the overall population, at about 12%, but have a significantly higher rate of deaths compared to the population, at approximately14%. African American communities are being disproportionately affected because of higher incidence of chronic diseases, inadequate access to health care, and poorer living and working conditions, which increases their vulnerability …

The Efficacy Of Osteopathic Manipulative Treatment In Reducing Pain Medication Usage In Chronic Pain Patients: A Brief Literature Review, Catherine Alapatt, Kinjal Shah

Rowan-Virtua Research Day

Chronic pain is one of the most common complaints for adult patients. Chronic pain almost always includes a pharmacological approach which can involve opioids and non opioids. Non-pharmacological approaches are less commonly used by patients with chronic pain, despite the significant misuse of opioids in the treatment of chronic pain. There is a need for nonpharmacological therapies in the treatment of chronic pain patients to lessen the misuse of opioids. One underused form of nonpharmacological therapy for chronic pain is OMT. There have been several studies demonstrating OMT to be effective in treating chronic pain conditions. In addition, there is …