Interprofessional Education Commons^™

Incorporating Home Visits In A Primary Care Residency Clinic: The Patient And Physician Experience, Mary Caitlin St. Clair, Jessica J. F. Kram, Glenda Sundberg

Journal of Patient-Centered Research and Reviews

Purpose: Home visits, once a popular but now uncommon form of health care delivery, are on the rise. Few studies have focused on the value the experience brings to resident physicians and their patients.

Methods: A 6-month pilot was conducted with 11 residents who participated in 32 home visits with 11 patients. Patient and resident experiences were captured through a survey following the home visits.

Results: In all, 100% of patients and a majority of residents were very interested in being a part of and incorporating future home visits, respectively. Every patient in the survey said that the visits resulted …

Implementation Of An Evidence-Based, Electronic Clinical Algorithm To Improve Screening, Evaluation, And Referral Of College Students For Depressive Symptoms And An Evaluation Of Differences Based On Sexual Orientation And Gender Identity Data, Chris Webb

Graduate Theses, Dissertations, and Capstones

The purpose of this project was to improve the screening, evaluation, and referral of college students (LGBTQ+/Heterosexual) for depressive symptoms through the implementation of an evidence-based, electronic clinical algorithm. There is evidence in the literature indicating that there are increased mental health disparities among college students and the LGBTQ+ population. The prevalence of depressive symptoms among university students is higher than the general population, requiring university student health centers to implement enhanced screenings for depressive symptoms and identification of depression predictors. Prior to implementation of this project, a student health clinic in the Southeastern part of the United States used …

Intensive Care To Intermediate Care Bridge Program, Natasha Bartlett, Sally Langerak, Lindsey Lucas, Jonathan Archibald, Tayla Robbins, Miranda Thompson, Patrice Tetu, Calla Hastings, Megan Garland, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Amy Sparks

Operations Transformation

To deliver the highest quality of care across the continuum, a large academic tertiary medical center envisioned a project that would provide an internal source of cross trained nurses for their medical intensive care unit (SCU2) and their medical intermediate care unit (R4/IMC/AVU). The hope for this program was to improve communication and collaboration between nurses and enhance the care that they provide to patients and their families.

A highly qualified team of nurses was established to create a performance improvement project. The overall goal of this endeavor was to build a more collaborative relationship between the units and ultimately …

Retrospective Evaluation Of Weight Loss In Maine Medical Center Cancer Institute (Mmcci) Patients Receiving Radiation Treatment For Head And Neck Cancer, Julian Johnson, David Debartolo-Stone, Jessica Moore, Ruth Hanselman, Stephen Tyzik, Suneela Nayak, Amy Sparks

Operations Transformation

Treatment for head and neck cancer often results in weight loss as a side effect. One option to mitigate this weight loss is placement of a percutaneous endoscopic gastrostomy (PEG) tube placement. Radiation oncologists at a academic tertiary medical center discuss the option of PEG placement during patient consultation.

A retrospective evaluation of weight loss in patients receiving radiation was conducted over a two-year period. The goal of this data collection was to create a standard for oncology consultations regarding PEG tube placement.

Baseline metrics and a root cause analysis drove subsequent data collection steps. After analyzing the raw data, …

Increasing First Case On Time Starts In An Ambulatory Surgery Center, Diane Fecteau, Shannan Reid, Sydney Green, Ruth Hanselman, Suneela Nayak, Stephen Tyzik, Amy Sparks

Operations Transformation

In an ambulatory surgical center, first case on-time starts directly affects the patient experience. In addition, in order to treat as many patients as possible, delays of first case on-time starts negatively impacts the rest of scheduled surgical patients and increases staff overtime expenditures. An ambulatory surgical team within a large urban health care system initiated a performance improvement initiative to enhance the patient experience, increase staff accountability and care team well-being.

The goal of this project was to start 70% or more first cases on time. Baseline metrics demonstrated that patients and surgeons were the largest cause of delay. …

Race-Based Trauma Care Training For Veteran’S Health Administration Nurse Practitioners, Vanessa Loyd

Dissertations

Abstract

Problem: Trauma informed care has become a priority for persons exposed to psychological, physiological, emotional consequences as a result of traumatic experiences. Veterans are from different cultures, including gender, race, religion, sexual orientation and other social groups. The Veterans Health Administration (VHA) is responsible for the health of this culturally diverse patient population. Healthcare providers without any prior military experience may experience difficulty obtaining an accurate history and physical exam due to the military’s cross-cultural environment. The project aim was to increase confidence and competence in race-based trauma care by incorporating training into a new acute care fellowship …

Optimizing Intraprofessional Communication At Patient Handover, Allison Crabtree

Doctor of Nursing Practice Projects

This performance improvement project aimed to increase the communication competency of nurses during intraprofessional interactions at patient handover. An educational program focused on optimizing communication among nurses was implemented in a community-based, not-for-profit, rural hospital. The course was designed to incorporate a variety of instructional strategies to meet learner needs. Consistency and standardization of the patient handover process was a central theme. Topics of the course focused on the use of a standardized communication tool, the relationship of communication on patient safety, the importance of clear and effective communication, the role of the nurse as gatekeeper and facilitator of patient-specific …

Time-Out In Madrid: Considering The Role Of Time-Outs In Clinical Practice, Colin T. Phillips

Journal of Maine Medical Center

No abstract provided.

Rationale And Design Of An Endocrinology Education Program For Primary Care In Maine: Initiation Of Mainehealth Endo Echo Maine, Irwin Brodsky, Joan Ingram, Stacy O'Brien, Tho Ngo, Charles T. Winchell

Journal of Maine Medical Center

Introduction: Population health and quality of care initiatives for the management of common endocrine disorders often include algorithmic and protocol-driven workflows in primary care practices. Endo ECHO is a division of Project ECHO at University of New Mexico that engages primary care clinicians in didactic presentations and case discussions to augment conceptual (experiential, nuanced) rather than algorithmic (rote) learning.

Research Design and Methods: MaineHealth Endo ECHO was designed using the Project ECHO model. Project ECHO® is an interactive learning opportunity that uses video conferencing to connect specialty and primary care to share best practices for delivering care. Using …

Safe Care For Seizure Patients On An Epilepsy Monitoring Unit, Deborah Bachand, Lauri Wilson, Rachel Caiola, Lynne Keller, Megan Selvitelli, Mary Jo Farley, Jennifer O'Neill, Sara Shrock, Hannah Plummer, Sally Prokey, Amy Sparks, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

Operations Transformation

Seizure patients admitted to an Epilepsy Monitoring Unit located within an academic tertiary medical center have a high potential to impact patient safety. As a result, a unit based team identified a need for a higher level of training for both their staff and float companions to ensure safe and standardized care for this group of patients.

The goal of this quality improvement project was to create an educational tool that would assist 100% of staff in better recognizing and responding to seizures. Baseline metrics and root cause analysis demonstrated a lack of consistent information being taught, a poorly identified …

Patient And Student Experience On An Interprofessional Hotspotting Team, Steven Elsesser, Md, Elizabeth Feeney, Bsn, Katherine Petty, Spt, Kevin Shaloo, Spt, Nancy Tang, Pharmd

JCIPE Posters

The purpose of the Student Hotspotting initiative is to identify these individuals, understand their barriers and intervene by:

• Connecting them with community resources
• Improving coordination and communication between both providers and the patient
• Empowering these individuals to better manage their health

Our patient (DW) lives in a close-knit, 4-generation household that just welcomed their newest member: a black-and-white kitten

DW is a 61 year-old female who recently received orthotopic heart transplant. Her comorbidities include sleep apnea, GERD, OA, chronic pain syndrome, COPD and a history of a CVA

We identified 3 main barriers to address with DW

• Transportation difficulties
• Management …

Bridging The Gaps: Team 6 Hotspotting Experience, Sean O'Sullivan, Rebecca Schuck, Sean Tonnesen, Gabrielle Sallade, Emily Osisek, Avninder Ubhi

JCIPE Posters

Healthcare spending in the U.S. reached $3.5 trillion in 20171. Half of this spending was due to only 5% of patients. Hotspotting is the practice of identifying high-utilizing patients and providing them ancillary care. Supporting such patients with nutrition information, care coordination, clinician communication, health education, and treatment adherence coaching benefits the patients, clinicians, and healthcare system. The Jefferson Interprofessional Student Hotspotting Program places students of different educational programs into teams to identify high-utilizing patients and provide them individualized and holistic care. It is an intimate longitudinal clinical experience for students and an opportunity to improve the health of complex …

Interprofessional Student Hotspotting: Impact Of Federally Qualified Health Centers (Fqhc) On Complex Patients, Alexis Amendola, Pallavi Chary, Andrew Day, Graziella Holland, Michelle Murray, Jesse Simpson

JCIPE Posters

Individuals with complex health and social needs drive much of the total cost of care, accounting for nearly 50% of annual costs. Studies show that patients’ use of community health centers is associated with lower health care costs, less frequent use of emergency departments, and fewer preventable hospitalizations, compared to patients who do not use the health centers. Federally qualified health centers (FQHCs) provide patients with medical homes where they can build ongoing, personal relationships with treatment teams, resulting in continuous, comprehensive and integrated care.

Additionally, addressing these individuals' needs and decreasing costs requires interprofessional teams to engage with communities …

Interprofessional Student Hotspotting Learning Collaborative: A Student Initiative To Together Help Patients In Tangible And Intangible Ways, Kristin Brannon, Saskia Levy-Sheon, Michael Murphy, Megan Rankel, Caroline Christianson, Carly Alexander, Tejash Patel, Mariana Kuperman, Md, Leigh Ann Hewston, Pt, Dpt, Med, Ceeaa

JCIPE Posters

The Interprofessional Student Hotspotting Learning Collaborative brings together a team of students who work closely with individual patients with complex medical histories who are “super-utilizers” of health care resources.

Our goals:

• Provide a targeted, patient-centered approach to patient care
• Learn about our patient’s health from their perspective and develop a plan based on the patient’s goals and perceived needs
• Minimize misuse and miscommunication that had previously hindered the patient healthcare experience.
• Bring unique perspectives from each of our respective disciplines to improve upon inefficiencies in care
• Our team consisted of students from the colleges of Occupational Therapy, Physical Therapy, Nursing, …

Interprofessional Perspectives: Challenges & Lessons Learned From Participation In The Student Hotspotting Program, Alex Faus, Bs, Jennifer Newman, Ba, Stephanie Quist, Bm, John Ra, Bs, Madeline Runyen, Ba, Kelsie Wilhelm, Bsfs

JCIPE Posters

By participating in the Student Hotspotting Program, students learned that:

• Coordinating the care of a complex patient requires an interprofessional team
• Hotspotting interventions can often be complicated by uncontrollable circumstances
• Building trust is key to working with patients who may be hesitant to engage with the healthcare system
• Successful interprofessional healthcare teams are characterized by specific attributes
• As future healthcare practitioners, we can apply these lessons into our own interprofessional interactions to optimize our treatment plans for complex patients

An Overview And An Experience Of Hotspotting, Adam Myer, Allyson Psillos, Brianna Brown, Anne Bono, Stephen Kern, Phd, Otr/L, Faota, Jamie Smith, Michele Zawora, Md

JCIPE Posters

United States Healthcare Dilemma

In the United States, a large proportion of healthcare resources and costs are utilized by a small percentage of the population.

• Approximately 25% of the United States healthcare costs are incurred by 1 percent of the population, while 5% are of healthcare costs are incurred by 50% of the population. The small percentage of the individuals who consume large amounts of resources has led to the term “super-utilizers.”
• These patients usually have complex and hard-to-manage conditions, as well as socioeconomic barriers to care, which frequently lead to potentially avoidable emergency department and hospital admissions and complications. …

Student Hotspotting: A Novel Dynamic For Learners And Patients, Richard Jeffries, Lydia Glick, Katherine O'Rourke, Mi Bui, Jennifer Morelli, Katherine Cambareri, Florencia Campbell, Miranda Aragon, Tracey Vause-Earland

JCIPE Posters

About the Student Hotspotting Program:

A team of interdisciplinary students working with patients with complex medical and social needs

Identify "super-utilizers" of the healthcare system

• These patients frequently use the Emergency Department as primary source of medical care
• A "super-utilizer" of the ED is costly to the patient and system

Goals:

• Build relationships
• Identify needs and goals
• Provide support to navigate healthcare system and increase independence

Listen To Us: Dad-Endorsed Strategies For Ehdi Professionals, Holly F. Pedersen Dr., Jerusha Olthoff

Journal of Early Hearing Detection and Intervention

While fathers play an increasingly important role in today’s families, there is an imbalance of research regarding fathers of children with disabilities compared to mothers. Modest research with mothers of children who are deaf/hard of hearing exists; however, very limited research is available specific to fathers of that population. With the advent of newborn hearing screening, the number of children who have hearing loss being identified within the first six months of life has significantly increased. Thus, the number of fathers participating in EHDI services has also increased. Seeking to answer the question, What do fathers’ experiences in the early …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Using Short Message (Sms) To Deliver Appointment Reminders And Reduce No-Show Rates: An Evidence-Based Practice Project, Fernando Serrano

Doctor of Nursing Practice Final Manuscripts

Background/Objectives: Missed appointments (MAs) are correlated with reduced treatment efficacy, increased financial burden on medical institutions, and early treatment terminations for therapy (DeFife, Conklin, Smith, & Poole, 2010). MAs occur for a variety of reasons including, but not limited to severity of illness, financial/geographic constraints, and forgetting the appointment (Filippidou, Lingwood, & Mirza, 2014). Appointment compliance within outpatient mental health clinics has a wide variance with some clinics reporting MAs ranging from 15% to 50% (Car, Gurol-Urganci, de Jongh, Vodopivec-Jamsek, & Atun, 2013).

With decreasing costs and a subsequent massive increase in mobile phone technology use by the general population, …