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https://www.readbyqxmd.com/read/29215378/developing-resident-sensitive-quality-measures-a-model-from-pediatric-emergency-medicine
#1
Daniel J Schumacher, Eric S Holmboe, Cees van der Vleuten, Jamiu O Busari, Carol Carraccio
PURPOSE: To begin closing the gap with respect to quality measures available for use among residents, the authors sought to identify and develop resident-sensitive quality measures (RSQMs) for use in the pediatric emergency department (PED) setting. METHOD: In May 2016, the authors reviewed National Quality Measures Clearinghouse (NQMC) measures to identify resident-sensitive measures. To create additional measures focused on common, acute illnesses (acute asthma exacerbation, bronchiolitis, closed head injury [CHI]) in the PED, the authors used a nominal group technique (NGT) and Delphi process from September to December 2016...
December 5, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29214627/a-12-month-descriptive-analysis-of-emergency-intubations-at-brooke-army-medical-center-a-national-emergency-airway-registry-study
#2
Michael D April, Steven G Schauer, Calvin A Brown Rd, Patrick C Ng, Jessie Fernandez, Andrea E Fantegrossi, Joseph K Maddry, Shane Summers, Daniel J Sessions, Robert M Barnwell, Mark Antonacci
Emergency airway management is a critical skill for military healthcare providers. Our goal was to describe the Emergency Department (ED) intubations at Brooke Army Medical Center (BAMC) over a 12-month period. MATERIAL AND METHODS: Physicians performing endotracheal intubations in the BAMC ED complete data collection forms for each intubation event as part of the National Emergency Airway Registry, including patient demographics, intubation techniques, success and failure rates, adverse events, and patient disposition...
October 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/29209996/understanding-ownership-of-patient-care-a%C3%A2-dual-site-qualitative-study-of-faculty-and-residents-from-medicine-and-psychiatry
#3
Deborah S Cowley, Jesse D Markman, Jennifer A Best, Erica L Greenberg, Michael J Grodesky, Suzanne B Murray, Kelli A Corning, Mitchell R Levy, William E Greenberg
INTRODUCTION: With changes in duty hours and supervision requirements, educators have raised concerns about erosion of patient care ownership by resident physicians. However, the definition of ownership is unclear. This qualitative study investigated definitions of ownership in medicine and psychiatry faculty and residents. METHODS: The authors distributed an anonymous online survey regarding definitions of ownership to faculty and residents at the psychiatry and internal medicine residency programs at the University of Washington and the Harvard Longwood psychiatry residency and conducted a qualitative analysis of free-text responses to identify emergent themes...
December 5, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/29209788/-reform-of-emergency-physician-training-in-austria-finally-up-to-date
#4
REVIEW
H Trimmel, M Baubin, J Kreutziger, G Frank, G Prause
During the last 20 years Austrian prehospital emergency medical services (EMS) have significantly improved. The structure and organization of Austrian EMS comply with European standards but training requirements for prehospital EMS physicians are insufficient when compared with other countries. Although some EMS systems follow the German or Swiss postgraduate training concepts, the legal requirements in Austria defining the scope of mandatory training for physicians in the prehospital setting are only minimal...
December 5, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29208032/junior-rounds-an-educational-initiative-to-improve-role-transitions-for-junior-residents
#5
Richard Dunbar-Yaffe, Wayne L Gold, Peter E Wu
OBJECTIVE: At our institution, Morning Report focuses mostly on diagnostic reasoning. This makes it a challenge for first-year residents to learn to manage common on-call emergencies, such as hyperkalemia. We sought to improve their preparedness for the transitions they would encounter: from medical student to physician at the beginning of the academic year, and from junior resident to senior resident toward the end. In response to feedback, we developed the Junior Rounds curriculum: a weekly session focused on the approach to commonly encountered on-call emergencies and internal medicine referrals...
December 6, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29202696/rosc-rates-and-live-discharge-rates-after-cardiopulmonary-resuscitation-by-different-cpr-teams-a-retrospective-cohort-study
#6
Tak Kyu Oh, Young Mi Park, Sang-Hwan Do, Jung-Won Hwang, In-Ae Song
BACKGROUND: Previous studies have reported that the quality of cardiopulmonary resuscitation (CPR) is closely associated with patient outcomes. The aim of this study was to compare patient CPR outcomes across resident, emergency medicine, and rapid response teams. METHODS: The records of patients who underwent CPR at the Seoul National University Bundang Hospital from January 1, 2013 to December 31, 2016 were analyzed retrospectively. Return of spontaneous circulation, 10- and 30-day survival, and live discharge after return of spontaneous circulation were compared across patients treated by the three CPR teams...
December 4, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29194855/regarding-wellness-and-burnout-initiatives-in-emergency-medicine
#7
Ravi Katari
The recent outpouring of scholarly and open-access content on resident wellness and occupational satisfaction with regards to Emergency Medicine (EM) has been an inspiration and welcome development. ACEP Wellness Week, EMRA Wellness Committee, the recently established ALiEM Wellness Think Tank are a handful of several great examples of the professional community coming together to address the challenging reality of burnout in EM. Indeed, that EM is uniquely affected among other specialties has been extensively documented to an impressive degree...
December 1, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29177177/does-intradisciplinary-conflict-influence-to-outcomes-of-emergency-medicine-residency-program-a-mixed-methods-study
#8
Mohammadreza Maleki, Seyyed Meysam Mousavi, Mina Anjomshoa, Nasrin Shaarbafchizadeh, Zeinab Naimi Taleghani
Objective: To explore impact of emergency medicine residency program on patient waiting times in emergency department (ED) and determine the associated factors. Methods: A two-phased sequential exploratory mixed-methods approach was used. The first phase was comprised of retrospective before-after design of ED encounters for a 3-month period, six months before and six months after the introduction of an emergency medicine residency program in an Iranian teaching hospital...
October 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29175310/no-more-code-black-intervention-to-improve-inpatient-flow-at-a-large-public-hospital
#9
Charles E Coffey, Valda Carter, Eric Wei, Douglas Hutcheon, John P Gruen, Annie Anonas-Ternate, Rebecca Sandoval, Annie Marquez, Laura Sarff, Brad Spellberg
Code Black is a documentary movie, and now television series, whose name derives from a term used to describe critical hospital overcrowding resulting in dangerously inadequate patient flow. The Los Angeles County + University of Southern California (LAC+USC) Medical Center is a large, urban, public hospital with a long history of spending substantial amounts of time in Code Black-indeed the movie was created by a former Emergency Medicine resident at LAC+USC Medical Center. To change years of inadequate inpatient flow, we implemented time-limited cardiac monitoring criteria and empowered existing staff to enforce admission and downgrade criteria for our telemetry, step-down care unit, and intensive care units...
November 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29168974/heeadsss-up-pediatric-residents-confidence-and-practice-in-adolescent-health-care-before-and-after-mandatory-adolescent-medicine-rotations-in-thailand
#10
Rosawan S Areemit, Boonying Manaboriboon, Supinya In-Iw, Jiraporn Arunakul, Wirote Areekul
Background The field of adolescent medicine is an emerging area of specialization in Thailand. Adolescent medicine was made a mandatory rotation in general pediatric residency training programs for the class of 2013. Objective This study aims to explore the difference in pediatric residents' confidence and the frequency in providing aspects of care to adolescents. Subjects Participants included two groups of pediatric residents; the former curriculum group (FCG) in 2012 and the mandatory curriculum group (MCG) in 2015...
November 23, 2017: International Journal of Adolescent Medicine and Health
https://www.readbyqxmd.com/read/29166354/smoothing-the-transition-points-in-canadian-medical-education
#11
Nick Busing, Jay Rosenfield, Kamal Rungta, Matt Raegele, Andrew Warren, Bruce Wright, Mark Walton, Ivy Oandasan, Anthony Sanfilippo, Anurag Saxena
In 2010 the Association of Faculties of Medicine of Canada, Collège des médecins du Québec, College of Family Physicians of Canada, and the Royal College of Physicians and Surgeons of Canada launched The Future of Medical Education in Canada Postgraduate (FMEC PG) Project to examine postgraduate medical education (PGME) in Canada and make recommendations for improvement. One recommendation that emerged concerns the transitions learners experience across the undergraduate medical education-PGME-practice continuum...
November 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29159555/use-of-a-hands-free-instantaneous-closed-loop-communication-device-improves-perception-of-communication-and-workflow-integration-in-an-academic-teaching-hospital-a-pilot-study
#12
Daniel Z Fang, Teja Patil, Ilana Belitskaya-Levy, Marianne Yeung, Keith Posley, Nazima Allaudeen
Efficient and effective communication between providers is critical to quality patient care within a hospital system. Hands free communication devices (HFCD) allow instantaneous, closed-loop communication between physicians and other members of a multidisciplinary team, providing a communication advantage over traditional pager systems. HFCD have been shown to decrease emergency room interruptions, improve nursing communication, improve speed of information flow, and eliminate health care waste. We evaluated the integration of an HFCD with an existing alphanumeric paging system on an acute inpatient medicine service...
November 17, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29141123/improving-mental-health-training-for-primary-care-residents-a-resident-led-educational-intervention
#13
Peter J Ureste, Tammy L Duong, Andreea L Seritan, Ana-Maria Iosif, Donald M Hilty
Objective: Psychiatric training in family medicine residency programs is necessary but not always sufficient. A brief educational intervention was designed to help improve family medicine residents' knowledge, comfort, and attitudes in delivering mental health care. Methods: A 6-hour didactic curriculum was taught by 2 psychiatry residents to family medicine residents between February and April 2015. Preintervention and postintervention surveys assessed participant demographics, knowledge, comfort levels, and attitudes regarding treating patients with psychiatric illness...
November 2, 2017: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/29131347/critical-care-ultrasound-a-national-survey-across-specialties
#14
Jeffrey R Stowell, Ross Kessler, Resa E Lewiss, Igor Barjaktarevic, Bikash Bhattarai, Napatkamon Ayutyanont, John L Kendall
PURPOSE: Management of the critically ill patient requires rapid assessment and differentiation. Point-of-care ultrasound (POCUS) improves diagnostic accuracy and guides resuscitation. This study sought to describe the use of critical care related POCUS amongst different specialties. METHODS: This study was conducted as an online 18-question survey. Survey questions queried respondent demographics, preferences for POCUS use, and barriers to implementation. RESULTS: 2735 recipients received and viewed the survey with 416 (15...
November 13, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29128036/an-inexpensive-esophageal-balloon-tamponade-trainer
#15
Timothy P Young, Heather M Kuntz, Bradley Alice, Jon Roper, Mike Kiemeney
BACKGROUND: Emergency medicine practitioners must be able to perform rare, life-saving procedures. One such example is esophageal balloon tamponade, which is complex, fraught with complications, and difficult to demonstrate and practice. DISCUSSION: We constructed a simple, inexpensive model esophagus and stomach that we attached to a mannequin, allowing emergency medicine residents to visualize and practice esophageal balloon tamponade device placement. CONCLUSION: Our esophageal balloon tamponade model was easy to construct and allowed demonstration, conceptual visualization, and simulated performance of the procedure...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29122279/stem-cell-based-bone-regeneration-in-diseased-microenvironments-challenges-and-solutions
#16
Bing-Dong Sui, Cheng-Hu Hu, An-Qi Liu, Chen-Xi Zheng, Kun Xuan, Yan Jin
Restoration of extensive bone loss and defects remain as an unfulfilled challenge in modern medicine. Given the critical contributions to bone homeostasis and diseases, mesenchymal stem cells (MSCs) have shown great promise to jumpstart and facilitate bone healing, with immense regenerative potential in both pharmacology-based endogenous MSC rescue/mobilization in skeletal diseases and emerging application of MSC transplantation in bone tissue engineering and cytotherapy. However, efficacy of MSC-based bone regeneration was not always achieved; particularly, fulfillment of MSC-mediated bone healing in diseased microenvironments of host comorbidities remains as a major challenge...
October 30, 2017: Biomaterials
https://www.readbyqxmd.com/read/29119470/failure-to-flow-an-exploration-of-learning-and-teaching-in-busy-multi-patient-environments-using-an-interpretive-description-method
#17
Teresa M Chan, Kenneth Van Dewark, Jonathan Sherbino, Alan Schwartz, Geoff Norman, Matthew Lineberry
INTRODUCTION: As patient volumes continue to increase, more attention must be paid to skills that foster efficiency without sacrificing patient safety. The emergency department is a fertile ground for examining leadership and management skills, especially those that concern prioritization in multi-patient environments. We sought to understand the needs of emergency physicians (EPs) and emergency medicine junior trainees with regards to teaching and learning about how best to handle busy, multi-patient environments...
November 8, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/29117094/a-novel-task-trainer-for-penile-corpus-cavernosa-aspiration
#18
Amber S Ruest, Leila P Getto, Jenna M Fredette, Amy Cherico, Mia A Papas, Jason T Nomura
INTRODUCTION: Priapism is a rare yet time sensitive emergency with potentially significant morbidity. A novel task trainer was developed for corpus cavernosa aspiration and phenylephrine injection. The primary aim of this study was to assess model realism and usefulness for emergency medicine resident procedural education. Secondarily, an assessment of comfort level with the procedure before and after intervention was performed. METHODS: A priapism model containing corpus cavernosa and spongiosum analogs was constructed...
November 8, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29114347/examining-critical-factors-affecting-graduate-retention-from-an-emergency-training-program-in-addis-ababa-ethiopia-a-qualitative-study-of-stakeholder-perspectives
#19
Meredith Kuipers, Amira Eapen, Joel Lockwood, Sara Berman, Samuel Vaillancourt, James Maskalyk, Aklilu Azazh, Megan Landes
Background: In Ethiopia, improvement and innovation of the emergency care system is hindered by lack of specialist doctors trained in emergency medicine, underdeveloped emergency care infrastructure, and resource limitations. Our aim was to examine the critical factors affecting retention of graduates from the Addis Ababa University (AAU) post-graduate emergency medicine (EM) training program within the Ethiopian health care system. Methods: One post-graduate trainee and one program manager from the AAU and the University of Toronto (UT) partnership conducted qualitative interviews with current AAU EM residents and stakeholders in Ethiopian EM...
April 2017: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/29114341/tackling-challenges-of-global-health-electives-resident-experiences-of-a-structured-and-supervised-medicine-elective-within-an-existing-global-health-partnership
#20
Michelle Tubman, James Maskalyk, David Mackinnon, Raghu Venugopal, Elayna Fremes, Lisa M Puchalski Ritchie, Aklilu Azazh, Megan Landes
Background: The Toronto-Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM) deploys teaching teams of Canadian EM faculty to Addis Ababa to deliver a longitudinal residency curriculum. Canadian trainees participate in these teams as a formally structured and supervised elective in global health (GH) and EM, which has been designed to enhance the strength of GH electives and address key challenges highlighted in the literature. Methods: The purpose of this qualitative study was to identify, describe, and evaluate strengths and weaknesses of this elective in relation to its purposeful structure...
April 2017: Canadian Medical Education Journal
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