Utilization and impact on fellowship training of non-physician advanced practice providers in intensive care units of academic medical centers: a survey of critical care program directors

2014 ◽  
Vol 29 (1) ◽  
pp. 112-115 ◽  
Author(s):  
Aaron M. Joffe ◽  
Stephen M. Pastores ◽  
Linda L. Maerz ◽  
Piyush Mathur ◽  
Steven J. Lisco
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Care Program ◽  
Program Directors ◽  
Fellowship Training ◽  
Academic Medical Centers ◽  
Advanced Practice ◽  
Medical Centers ◽  
Academic Medical

scholarly journals Survey of the Use of Corticosteroids Among Neonatal Intensive Care Units for the Prevention or Treatment of Bronchopulmonary Dysplasia

2005 ◽  
Vol 10 (2) ◽  
pp. 90-99
Author(s):  
Kalen B. Porter ◽  
Sandra S. Garner
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Bronchopulmonary Dysplasia ◽  
Neonatal Intensive Care ◽  
Inhaled Corticosteroids ◽  
Academic Medical Centers ◽  
Neonatal Intensive Care Units ◽  
Medical Centers ◽  
Systemic Corticosteroids ◽  
Academic Medical

OBJECTIVE To survey neonatal intensive care units (NICUs) at academic medical centers to determine the current use of inhaled and systemic corticosteroids for the prevention or treatment of bronchopulmonary dysplasia (BPD). METHODS A survey was developed to evaluate aspects of systemic and inhaled corticosteroid use in neonates. Eighty academic medical centers with neonatal/perinatal medicine fellowship programs were surveyed. Neonatology fellows or NICU clinical pharmacists with direct patient care activities responded via telephone, fax or e-mail. RESULTS Fifty-three institutions responded to the survey (66.3% response rate). Twenty-nine percent of respondents (n = 15) use corticosteroids for prevention of BPD. Systemic corticosteroids are used by 6% of respondents (n = 3) and inhaled corticosteroids are used by 14% of respondents (n = 7) for prevention. Ten percent of respondents (n = 5) use either systemic or inhaled corticosteroids for prevention. Eighty-eight percent of respondents (n = 45) use corticosteroids for treatment of BPD. Systemic corticosteroids are used by 10% of respondents (n = 5) and inhaled corticosteroids are used by 10% of respondents (n = 5) for treatment. Sixty-nine percent of respondents (n = 35) use either systemic or inhaled corticosteroids for treatment. There was a wide variability in drug, dose, titration, taper, administration, and duration of therapy reported. CONCLUSIONS These results indicate that systemic and inhaled corticosteroids are commonly used by practitioners for the prevention or treatment of BPD despite a recommendation against the routine use of systemic corticosteroids by the American Academy of Pediatrics' (AAP) Committee on Fetus and Newborn and the Canadian Paediatric Society's Fetus and Newborn Committee from February 2002.

scholarly journals Changes in Pharmacy Residency Training Design Between 2012 and 2017: A Perspective of Academic Medical Centers

2017 ◽  
Vol 53 (2) ◽  
pp. 113-120 ◽  
Author(s):  
Anne Krasniak ◽  
William Darko ◽  
Christopher D. Miller ◽  
Robert Seabury ◽  
Luke A. Probst
Keyword(s):  
Residency Program ◽  
Pharmacy Practice ◽  
Program Directors ◽  
Fellowship Training ◽  
Academic Medical Centers ◽  
Survey Period ◽  
Residency Programs ◽  
Medical Centers ◽  
Academic Medical ◽  
Residency Program Directors

Purpose:The role of health-system pharmacists continues to expand, and this area of pharmacy practice increasingly requires augmented baseline training. It is unclear how Post Graduate Year 1 (PGY-1) pharmacy residencies may be changing to meet these needs.The objectives of our survey were to describe PGY-1 pharmacy residency program design among academic medical centers, characterize program changes enacted over 5-year period, and describe career paths among PGY-1 pharmacy residency graduates. Methods: A 32-item questionnaire was developed independently, which was reviewed and validated by 4 residency program directors. The survey was uploaded to an online survey tool and sent electronically to residency program directors of 109 Vizient academic medical centers with PGY-1 pharmacy residency programs. Residency program directors were identified from a list of Vizient-participating hospitals. The survey was re-sent at 2-week intervals on 4 occasions to improve response rates. SPSS version 23.0 was used to analyze the data. Results: Overall, 49 (45%) of hospitals responded to the survey. Survey responses showed statistically significant increases over the 5-year survey period in the following areas: the number of PGY-1 resident positions offered ( P = .001), percent of time spent on teaching experiences ( P = .001), and percentage of PGY-1 residents pursuing PGY-2 or fellowship training ( P = .026). Conclusion: We found that PGY-1 pharmacy residency programs at Vizient academic medical centers have undergone limited changes over the 5-year survey period and substantial variation exists between program designs. The most common change to program design was an increase in the percentage of time residents spend on teaching experiences. There was an increase in residents pursuing PGY-2 or fellowship training, which may suggest a shift toward increased specialization in clinical pharmacy practice or may reflect changes in the availability of job opportunities.

Critical Care Organizations in Academic Medical Centers in North America

2015 ◽  
Vol 43 (10) ◽  
pp. 2239-2244 ◽  
Author(s):  
Stephen M. Pastores ◽  
Neil A. Halpern ◽  
John M. Oropello ◽  
Natalie Kostelecky ◽  
Vladimir Kvetan
Keyword(s):  
Critical Care ◽  
North America ◽  
Academic Medical Centers ◽  
Medical Centers ◽  
Academic Medical

scholarly journals 2540. Targeting ID Education for Advanced Practice Providers: A Growing Learning Group in Academic Medical Centers

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S883-S883
Author(s):  
Matthew S L Lee ◽  
Wendy Stead
Keyword(s):  
Patient Care ◽  
Educational Intervention ◽  
Educational Background ◽  
Educational Opportunities ◽  
Academic Medical Centers ◽  
Online Video ◽  
Advanced Practice ◽  
Post Intervention ◽  
Medical Centers ◽  
Academic Medical

Abstract Background Advanced Practice Providers (APPs), including nurse practitioners (NPs) and physician assistants (PAs), increasingly provide patient care in inpatient settings at academic medical centers. However, little is known about their medical education. We sought to describe current APP educational experiences at our institution and to implement and evaluate an educational intervention aimed at decreasing inappropriate antimicrobial use for asymptomatic bacteriuria (ASB) amongst this group. Methods 33 inpatient-based APPs participated in the educational intervention consisting of in-person sessions and an online video reviewing diagnosis and management of ASB. Pre- and post-intervention surveys assessed knowledge before and after the intervention. Surveys also assessed APP’s educational background, opportunities, and barriers. Results 17 APPs completed the pre-intervention survey. 59% estimated less than 10 hours of antimicrobial education during their training. 88% reported that the majority of their current learning is independent. All APPs reported desiring more educational opportunities. 76% felt current opportunities are designed for medical students or housestaff. Commonly reported barriers included patient care, rounding obligations, and lack of protected time. 8 APPs attended the in-person sessions and there were 21 views of the online video. 10 APPs completed the post-intervention survey. All reported interest in similar sessions in the future. 70% planned to prescribe fewer antimicrobials for ASB; however, the same number also reported “Attending or fellow decision” as the main barrier to decreasing prescriptions. Mean knowledge scores significantly increased after the intervention from 2.5 to 4.125 (P < 0.05). Conclusion APPs within an academic medical center have unique educational backgrounds and needs. APPs identified current educational opportunities as student/resident directed and incompatible with their work schedules. More APPs utilized the video session than attended in-person lectures. This intervention improved immediate knowledge acquisition; however, retention and impact on clinical outcomes are still being evaluated. Disclosures All authors: No reported disclosures.

A LOGIT MODEL FOR THE EFFECT OF TELECARDIOLOGY ON ACUTE NEWBORN TRANSFERS

2001 ◽  
Vol 17 (2) ◽  
pp. 244-249 ◽  
Author(s):  
Mark C. Rendina ◽  
Noel Carrasco ◽  
Brian Wood ◽  
Andrew Cameron ◽  
Carl Bose
Keyword(s):  
Intensive Care ◽  
Logit Model ◽  
Neonatal Intensive Care ◽  
Newborn Infants ◽  
The United States ◽  
Academic Medical Centers ◽  
Hospital Charges ◽  
Medical Centers ◽  
Academic Medical ◽  
Level 3

The deregionalization of neonatal intensive care in the United States has shifted the site of care for many newborn infants away from academic medical centers where subspecialty support is available.Objective: To investigate the effect of immediate echocardiogram interpretation via telemedicine on rates of neonatal transfer to academic medical centers.Methods: A logit model was developed to predict the probability of transfer from two regional level 3 neonatal intensive care units to academic medical centers. One of these units implemented a telecardiology program and the other acted as a comparison institution with on-site cardiology expertise. The telecardiology intervention began 18 months into the 36-month study period.Subjects: Infants (n = 2,142) admitted to neonatal intensive care at either of the two institutions during calendar years 1994 through 1996.Results: A statistically significant reduction in the rate of transfer to academic medical centers was observed. Telecardiology was associated with a 58% reduction of such transfers (p = .001, 95% CI = 30%, 75%). No such reduction was noted at the comparison institution. It is estimated that approximately 30 transfers were eliminated during the study period, resulting in the elimination of approximately $150,000 in hospital charges. In addition, the infants that were transferred after the adoption of telemedicine were more often transferred to their telemedicine partner institution (p < .02).

scholarly journals Hospitalists as Triagists: Description of the Triagist Role across Academic Medical Centers

2019 ◽  
pp. 87-90
Author(s):  
Sadie Trammel Velasquez ◽  
Emily S Wang ◽  
Andrew A White ◽  
Jagriti Chadha ◽  
Michael Mader ◽  
...  
Keyword(s):  
Electronic Communication ◽  
Academic Medical Centers ◽  
Inpatient Service ◽  
Advanced Practice ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Centers ◽  
Academic Medical ◽  
Communication Practices ◽  
Similarities And Differences

From the hospitalist perspective, triaging involves the evaluation of a patient for potential admission to an inpatient service. Although traditionally done by residents, many academic hospitalist groups have assumed the responsibility for triaging. We conducted a cross-sectional survey of 235 adult hospitalists at 10 academic medical centers (AMCs) to describe the similarities and differences in the triagist role and assess the activities and skills associated with the role. Eight AMCs have a defined triagist role; at the others, hospitalists supervise residents/advanced practice providers. The triagist role is generally filled by a faculty physician and shared by all hospitalists. We found significant variability in verbal communication practices (P = .02) and electronic communication practices (P < .0001) between the triagist and the current provider (eg, emergency department, clinic provider), and in the percentage of patients evaluated in person (P < .0001). Communication skills, personal efficiency, and systems knowledge are dominant themes of attributes of an effective triagist.

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