scholarly journals Marketing the Research Missions of Academic Medical Centers: Why Messages Blurring Lines Between Clinical Care and Research Are Bad for both Business and Ethics

2019 ◽  
Vol 28 (3) ◽  
pp. 468-475 ◽  
Author(s):  
MARK YARBOROUGH ◽  
TIMOTHY HOUK ◽  
SARAH TINKER PERRAULT ◽  
YAEL SCHENKER ◽  
RICHARD R. SHARP
Keyword(s):  
Science Communication ◽  
Clinical Care ◽  
Research Integrity ◽  
Informed Consent Process ◽  
Ethical Analysis ◽  
Academic Medical Centers ◽  
Therapeutic Misconception ◽  
The Public ◽  
Medical Centers ◽  
Academic Medical

Abstract:Academic Medical Centers (AMCs) offer patient care and perform research. Increasingly, AMCs advertise to the public in order to garner income that can support these dual missions. In what follows, we raise concerns about the ways that advertising blurs important distinctions between them. Such blurring is detrimental to AMC efforts to fulfill critically important ethical responsibilities pertaining both to science communication and clinical research, because marketing campaigns can employ hype that weakens research integrity and contributes to therapeutic misconception and misestimation, undermining the informed consent process that is essential to the ethical conduct of research. We offer ethical analysis of common advertising practices that justify these concerns. We also suggest the need for a deliberative body convened by the Association of American Medical Colleges and others to develop a set of voluntary guidelines that AMCs can use to avoid in the future, the problems found in many current AMC advertising practices.

scholarly journals Implementing Resident Team Assistant Programs at Academic Medical Centers: Lessons Learned

2020 ◽  
Vol 12 (6) ◽  
pp. 769-772
Author(s):  
Ryosuke Takei ◽  
George Dalembert ◽  
Jeanine Ronan ◽  
Nicole Washington ◽  
Stuti Tank ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Clinical Care ◽  
Lessons Learned ◽  
Academic Medical Centers ◽  
Institutional Goals ◽  
Medical Centers ◽  
Academic Medical ◽  
Medical Teams ◽  
Administrative Task ◽  
Administrative Tasks

ABSTRACT Background Excessive inpatient administrative tasks can lead to adverse consequences for residents and their patients. Furthermore, this burden has been linked to depersonalization, a major component of physician burnout. Objective To describe the development, implementation, feasibility, acceptability, and early outcomes of Resident Team Assistant (RTA) programs. Methods Three large academic medical centers created RTA programs in which administrative assistants are incorporated into inpatient medical teams. First steps included a needs assessment and driver diagram creation to identify key issues and to solidify goals. Program directors were assigned, and RTAs were hired, trained, and incorporated into inpatient teams at each institution (2003, 2016, 2018). Program leadership and institutional stakeholders met regularly to discuss development and quality assurance. Surveys and direct interviews were performed to evaluate impact and acceptability. Institutional goals in accordance to RTAs tasks were also investigated. Results Resident surveys and interviews have shown acceptability with RTAs completing a large percentage of resident administrative tasks while promoting time spent in direct clinical care and job satisfaction. Hospital-specific improvements have included increase in referring physician communication rate and decrease in work hour violations. The programs have maintained high feasibility and sustainability with a relatively low time commitment from leadership and cost for the institutions. Conclusions The RTA programs at the 3 institutions have continued to be sustained over time with perceived improvements in administrative task burden and job satisfaction for the residents. They have maintained high acceptability and feasibility in terms of effort and costs for the hospitals.

Confronting Conflict: Addressing Institutional Conflicts of Interest in Academic Medical Centers

2010 ◽  
Vol 36 (1) ◽  
pp. 136-187 ◽  
Author(s):  
Bryan A. Liang ◽  
Tim MacKey
Keyword(s):  
Conflicts Of Interest ◽  
Clinical Care ◽  
Study Participant ◽  
Academic Medical Centers ◽  
Public Healthcare ◽  
Federal Grant ◽  
Medical Centers ◽  
Academic Medical ◽  
Commercial Enterprise ◽  
Education Academic

Individual conflicts of interest are rife in healthcare, and substantial attention has been given to address them. Yet a more substantive concern-institutional conflicts of interest (“ICOIs”) in academic medical centers (“AMCs”) engaged in research and clinical care—have yet to garner sufficient attention, despite their higher stakes for patient safety and welfare. ICOIs are standard in AMCs, are virtually unregulated, and have led to patient deaths. Upon review of ICOIs, we find a clear absence of substantive efforts to confront these conflicts. We also assess the Jesse Gelsinger case, which resulted in the death of a study participant exemplifying a deep-seated culture of institutional indifference and complicity in unmanaged conflicts. Federal policy, particularly the Bayh-Dole Act, also creates and promotes ICOIs. Efforts to address ICOIs are narrow or abstract, and do not provide for a systemic infrastructure with effective enforcement mechanisms. Hence, in this paper, we provide a comprehensive proposal to address ICOIs utilizing a “Centralized System” model that would proactively review, manage, approve, and conduct assessments of conflicts, and would have independent power to evaluate and enforce any violations via sanctions. It would also manage any industry funds and pharmaceutical samples and be a condition of participation in public healthcare reimbursement and federal grant funding.The ICOI policy itself would provide for disclosure requirements, separate management of commercial enterprise units from academic units, voluntary remediation of conflicts, and education on ICOIs. Finally, we propose a new model of medical education—academic detailing—in place of current marketing-focused “education.” Using such a system, AMCs can wean themselves from industry reliance and promote a culture of accountability and independence from industry influence. By doing so, clinical research and treatment can return to a focus on patient care, not profits.

Measuring the impact of healthcare indicators on academic medical centers’ scientific production

2021 ◽  
pp. 161-165
Author(s):  
Corrado Cuccurullo ◽  
Luca D’Aniello ◽  
Massimo Aria ◽  
Maria Spano
Keyword(s):  
Research Productivity ◽  
Scientific Activity ◽  
Research Field ◽  
Scientific Production ◽  
Academic Medical Centers ◽  
Fully Integrated ◽  
The Public ◽  
Medical Centers ◽  
Academic Medical ◽  
The Many

The Italian public-owned Academic Medical Centers (AMCs) are hospitals where the activities of scientific research, teaching, and patients care are fully integrated. AMCs have an enormous impact on society and country health. Recently, policymakers and practitioners give more and more great importance to the AMCs’ scientific activity for both welfare and national competitivity. The scientific production and its impact on the research community could be obviously affected by different factors related to the structural and operational characteristics of each AMC. Healthcare institutions could be different for the typology of services that they offer, their geolocation, the presence/absence of Emergency Departments, the number of employees, and so forth. In this sense, our study aims to investigate and determine which are the possible factors impacting the research productivity of AMCs. We develop a model to assess the academic value of AMCs by taking into account these factors and how they are related to healthcare performance, measured in terms of scientific production (e.g. scientific publications) and impact on the research field (e.g. citations). To face this issue, for each of the public AMCs we collect data about research productivity from bibliographic indexing databases (e.g. Web of Science, PubMed) and we retrieve structural information mainly from their official websites. This work has been partially financed by the research project “Leading Change in Academic Medical Centers”, funded by the competitive call for projects V:ALERE 2019. The project aims to provide evidence, advice, and remarks to help the agents of the public health system to address the many challenges that they face.

The Health of the Public Program at the University of Washington: A New Role for Academic Medical Centers

1991 ◽  
Vol 66 (9) ◽  
pp. 499-505 ◽  
Author(s):  
HAROLD I. GOLDBERG ◽  
DIANE P. MARTIN ◽  
DALE B. CHRISTENSEN ◽  
WILLIAM E. NEIGHBOR ◽  
THOMAS S. INUI ◽  
...  
Keyword(s):  
Academic Medical Centers ◽  
University Of Washington ◽  
The Public ◽  
Public Program ◽  
Medical Centers ◽  
Academic Medical ◽  
The University

scholarly journals Overcoming barriers to the adoption and implementation of predictive modeling and machine learning in clinical care: what can we learn from US academic medical centers?

JAMIA Open ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. 167-172
Author(s):  
Joshua Watson ◽  
Carolyn A Hutyra ◽  
Shayna M Clancy ◽  
Anisha Chandiramani ◽  
Armando Bedoya ◽  
...  
Keyword(s):  
Machine Learning ◽  
Best Practices ◽  
Predictive Modeling ◽  
Clinical Care ◽  
Data Access ◽  
Academic Medical Centers ◽  
Structured Interviews ◽  
Medical Centers ◽  
Adoption And Implementation ◽  
Academic Medical

Abstract There is little known about how academic medical centers (AMCs) in the US develop, implement, and maintain predictive modeling and machine learning (PM and ML) models. We conducted semi-structured interviews with leaders from AMCs to assess their use of PM and ML in clinical care, understand associated challenges, and determine recommended best practices. Each transcribed interview was iteratively coded and reconciled by a minimum of 2 investigators to identify key barriers to and facilitators of PM and ML adoption and implementation in clinical care. Interviews were conducted with 33 individuals from 19 AMCs nationally. AMCs varied greatly in the use of PM and ML within clinical care, from some just beginning to explore their utility to others with multiple models integrated into clinical care. Informants identified 5 key barriers to the adoption and implementation of PM and ML in clinical care: (1) culture and personnel, (2) clinical utility of the PM and ML tool, (3) financing, (4) technology, and (5) data. Recommendation to the informatics community to overcome these barriers included: (1) development of robust evaluation methodologies, (2) partnership with vendors, and (3) development and dissemination of best practices. For institutions developing clinical PM and ML applications, they are advised to: (1) develop appropriate governance, (2) strengthen data access, integrity, and provenance, and (3) adhere to the 5 rights of clinical decision support. This article highlights key challenges of implementing PM and ML in clinical care at AMCs and suggests best practices for development, implementation, and maintenance at these institutions.

Unplanned Reoperation and Implant Revision After Total Wrist Arthroplasty

Hand ◽  
2020 ◽  
pp. 155894471989881 ◽  
Author(s):  
Taylor M. Pong ◽  
Wouter F. van Leeuwen ◽  
Kamil Oflazoglu ◽  
Philip E. Blazar ◽  
Neal Chen
Keyword(s):  
Risk Factors ◽  
Implant Removal ◽  
Academic Medical Centers ◽  
Implant Design ◽  
Factors Associated ◽  
Medical Centers ◽  
Total Wrist Arthroplasty ◽  
Academic Medical ◽  
Related Risk ◽  
Wrist Arthroplasty

Background: Total wrist arthroplasty (TWA) is a treatment option for many debilitating wrist conditions. With recent improvements in implant design, indications for TWA have broadened. However, despite these improvements, there are still complications associated with TWA, such as unplanned reoperation and eventual implant removal. The goal of this study was to identify risk factors for an unplanned reoperation or implant revision after a TWA at 2 academic medical centers between 2002 and 2015. Methods: In this retrospective study, 24 consecutive TWAs were identified using CPT codes. Medical records were manually reviewed to identify demographic, patient- or disease-related, and surgery-related risk factors for reoperation and implant removal after a primary TWA. Results: Forty-six percent of wrists (11 of 24 TWAs performed) had a reoperation after a median of 3.4 years, while 29% (7 of 24) underwent implant revision after a median of 5 years. Two patients had wrist surgery prior to their TWA, both eventually had their implant removed ( P = .08). There were no risk factors associated with reoperation or implant removal. Conclusion: Unplanned reoperation and implant removal after a primary TWA are common. Approximately 1 in 3 wrists are likely to undergo revision surgery. We found no factors associated with reoperation or implant removal; however, prior wrist surgery showed a trend toward risk of implant removal after TWA.

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