scholarly journals Implementation of the GSA KAER Toolkit in a Large Clinic System: Workflow Modifications and EMR Tools

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 347-347
Author(s):  
Barak Gaster ◽  
Basia Belza ◽  
Monica Zigman Suchsland ◽  
Judit Illes ◽  
Benjamin Olivari ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Interdisciplinary Teams ◽  
Scope Of Practice ◽  
Community Resources ◽  
Red Flags ◽  
Medical Assistants ◽  
Primary Care Clinics ◽  
Patient Health ◽  
Patient Service ◽  
The University

Abstract We implemented the KAER toolkit in the University of Washington primary care clinics. In this session we share the workflows implemented to promote the KAER model and share the tools we developed within EPIC, the system's electronic medical record (EMR). We collaborated with clinic staff to develop interdisciplinary workflows including: training patient service representatives, social workers, nurses, and medical assistants (MAs) about 'red flags;' training medical assistants to complete the Patient Health Questionnaire (PHQ-9) and Montreal Cognitive Assessment (MoCA); and assuring they are appropriately entered into flowsheets in EPIC. We created a checklist (EPIC 'SmartPhrase') and educated the clinics' interdisciplinary teams to utilize it within their scope of practice. Additionally, we created an order set (EPIC 'SmartSet') of commonly ordered tests and referrals to expedite evaluation of patients with suspected cognitive impairment. Lastly, we created a direct link from our EMR to our website containing community resources.

Combining the Love of Art, Science, Business and Medicine to Innovate and Enhance Patient Health. Highlights from the 7th Annual Leaders in Medicine Symposium of the Cummings School of Medicine, Calgary, AB

2018 ◽  
pp. E51-E54
Author(s):  
Jennifer Beatty ◽  
Michael Peplowski ◽  
Noreen Singh ◽  
Craig Beers ◽  
Evan M Beck ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Clinical Care ◽  
Clinical Problem ◽  
Faculty Members ◽  
Guest Speaker ◽  
School Of Medicine ◽  
University Of Calgary ◽  
Patient Health ◽  
The University ◽  
Care Costs

The Leader in Medicine (LIM) Program of the Cumming School of Medicine, University of Calgary, hosted its 7th Annual LIM Research Symposium on October 30, 2015 and participation grew once again, with a total of six oral and 99 posters presentations! Over 45 of our Faculty members also participated in the symposium. This year’s LIM Symposium theme was “Innovations in Medicine” and the invited guest speaker was our own Dr. Breanne Everett (MD/MBA). She completed her residency in plastic surgery at University of Calgary and holds both a medical degree and an MBA from the University of Calgary. In her inspiring talk, entitled “Marrying Business and Medicine: Toe-ing a Fine Line”, she described how she dealt with a clinical problem (diabetic foot ulcers), came up with an innovation that optimized patient care, started her own company and delivered her product to market to enhance the health of the community. She clearly illustrated how to complete the full circle, from identifying a clinical problem to developing and providing a solution that both enhances clinical care and patient health as well as reduces health care costs and hospital admissions. The research symposium was an outstanding success and the abstracts are included in companion article in CIM.

Finding the path of least resistance: Locally adapting the MITIGATE toolkit in emergency departments and urgent care centers

2021 ◽  
pp. 1-3
Author(s):  
Joanne Huang ◽  
Zahra Kassamali Escobar ◽  
Todd S. Bouchard ◽  
Jose Mari G. Lansang ◽  
Rupali Jain ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Antimicrobial Stewardship ◽  
Emergency Departments ◽  
Urgent Care ◽  
Complex Data ◽  
University Of Washington ◽  
Primary Care Clinics ◽  
Urgent Care Centers ◽  
The University

Abstract The MITIGATE toolkit was developed to assist urgent care and emergency departments in the development of antimicrobial stewardship programs. At the University of Washington, we adopted the MITIGATE toolkit in 10 urgent care centers, 9 primary care clinics, and 1 emergency department. We encountered and overcame challenges: a complex data build, choosing feasible outcomes to measure, issues with accurate coding, and maintaining positive stewardship relationships. Herein, we discuss solutions to challenges we encountered to provide guidance for those considering using this toolkit.

scholarly journals Innovative Partnership Between Primary Care, AAA, and Academia Connects 4Ms and Social Determinants of Health

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 107-107
Author(s):  
Suzanne Leahy ◽  
Katie Ehlman ◽  
Lisa Maish ◽  
Brad Conrad ◽  
Jillian Hall ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Health System ◽  
Preliminary Evaluation ◽  
Language And Literacy ◽  
Community Based ◽  
Primary Care Clinics ◽  
College Of Nursing ◽  
Value Based Care ◽  
The University

Abstract Nationally, there is a growing focus on addressing geriatric care in primary care settings. HRSA’s Geriatric Workforce Enhancement Program (GWEP) has called for academic and health system partners to develop a reciprocal, innovative, cross-sector partnership that includes primary care sites and community-based agencies serving older adults. Through the University of Southern Indiana’s GWEP, the College of Nursing and Health Professions, the Deaconess Health System, three primary care clinics, and two Area Agencies on Aging (AAA) have joined to transform the healthcare of older adults regionally, including rural residents in the 12-county area. Core to the project is a value-based care model that “embeds” AAA care managers in primary care clinics. Preliminary evaluation indicates early success in improving the healthcare of older adults at one primary clinic, where clinical teams have referred 64 older adult patients to the AAA care manager. Among these 64 patients, 80% were connected to supplemental, community-based health services; 22% to programs addressing housing and transportation; and, nearly 10% to a range of other services (e.g., job training; language and literacy; and technology). In addition to presenting limited data on referred patients and referral outcomes, the presentation will share copies of the AAA referral log, to illustrate how resources were categorized by SDOH and added to support integration of the 4Ms.

scholarly journals AB1192 THE UNDERWORLD OF DEPRESSIVE SYMPTOMS IN RHEUMATIC DISEASES: OVERLOOKED, UNRECOGNIZED OR UNPERCEIVED?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1886.2-1887
Author(s):  
F. Ingegnoli ◽  
T. Schioppo ◽  
T. Ubiali ◽  
V. Bollati ◽  
S. Ostuzzi ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Rheumatic Diseases ◽  
Real Life ◽  
Severe Depression ◽  
Mild Depression ◽  
Cross Sectional ◽  
Online Study ◽  
Social Burden ◽  
Patient Health ◽  
The University

Background:The concomitant presence of depressive symptoms and rheumatic diseases (RDs) impose a considerable economic and social burden on the communities as they are associated with numerous deleterious outcomes such as increased mortality, work disability, higher disease activity and worsening physical function, higher pain levels and fatigue. Despite growing interest on depressive symptoms burden in RDs, current patient perception on this topic is unknown.Objectives:Italian patients with RDs were invited to participate in an online study gauging the presence and the perception of depressive symptoms using the Patient Health Questionnaire (PHQ-9).Methods:This was a cross-sectional no-profit online study to screen the presence and the perception of depressive symptoms in RDs patients. All participants gave their consent to complete the PHQ-9 and they were not remunerated. Completion was voluntary and anonymous. The PHQ-9 rates the frequency of symptoms over the past 2 weeks on a 0-3 Likert-type scale. It contains the following items: anhedonia, depressed mood, trouble sleeping, feeling tired, change inappetite, guilt or worthlessness, trouble concentrating, feeling slowed down or restless, and suicidal thoughts. Patients were stratified as: <4 not depressed, 5-9 sub-clinical or mild depression, 10-14 moderate depression, 15-19 moderately severe depression and 20-27 severe depression. The survey was disseminated by ALOMAR (Lombard Association for Rheumatic Diseases) between June and October 2019.Results:192 patients took part in the study: 170 female with median age 50 years. Among respondents only 35 (18.2%) were not depressed. Depression was sub-clinical or mild in 68 (35.4%), moderate in 42 (21.9%), moderately severe in 30 (15.6%), and severe in 17 (8.9%). 16 (8.3%) of respondents declared to have depressive symptoms and 7 of 16 were under psychiatric therapy.Moreover, patients were grouped according to diagnosis.124 respondents had inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis). 23 (18.5%) were not depressed. Depression was sub-clinical or mild in 41 (33%), moderate in 26 (21%), moderately severe in 21 (17%), and severe in 13 (10.5%). Among them, 8 (6.5%) declared to have depressive symptoms depressed and 3 of 8 were under psychiatric therapy.49 respondents had a connective tissue disease or vasculitis. 11 (22.5%) were not depressed. Depression was sub-clinical or mild in 19 (38.8%), moderate in 13 (26.5%), moderately severe in 2 (4%), and severe in 4 (8.2%). Among them, 3 (6%) declared to have depressive symptoms and 1 of 6 were under psychiatric therapy.19 respondents had other rheumatic diseases. 1 (5.3%) was not depressed. Depression was sub-clinical or mild in 8 (42.1%), moderate in 3 (15.8%), moderately severe in 7 (36.8%). Among them, 5 (26.3%) declared to be depressed and 3 of 5 were under psychiatric therapy.Conclusion:Our study confirmed that the overall real-life burden of depressive symptoms is relevant in all RDs. At the same time, these results highlighted that depressive symptoms are overlook by physicians and unperceived by patients since fewer that half of respondents (46.4%) had a clinical depression (PHQ-9>10). These results suggested that screening for depression should form part of the routine clinical assessment of RD patients.Acknowledgments:We thank the Lombard Association of Rheumatic Diseases (ALOMAR) for its contribution to design and disseminate the survey, the group that sustain systemic sclerosis (GILS), and the IT service of the University of Milan.Disclosure of Interests:Francesca Ingegnoli: None declared, Tommaso Schioppo: None declared, Tania Ubiali: None declared, Valentina Bollati: None declared, Silvia Ostuzzi: None declared, Massimiliano Buoli: None declared, Roberto Caporali Consultant of: AbbVie; Gilead Sciences, Inc.; Lilly; Merck Sharp & Dohme; Celgene; Bristol-Myers Squibb; Pfizer; UCB, Speakers bureau: Abbvie; Bristol-Myers Squibb; Celgene; Lilly; Gilead Sciences, Inc; MSD; Pfizer; Roche; UCB

History of non-physician anaesthesia providers in Papua New Guinea: from heil tultuls to Anaesthetic Scientific Officers

2021 ◽  
pp. 0310057X2110278
Author(s):  
Terence E Loughnan ◽  
Michael G Cooper ◽  
Pauline B Wake ◽  
Harry Aigeeleng
Keyword(s):  
New Zealand ◽  
Papua New Guinea ◽  
New Guinea ◽  
Stages Of Development ◽  
Medical Assistants ◽  
History Of ◽  
The University

The most recent estimates, published in 2016, have indicated that around 70% of anaesthesia providers in Papua New Guinea are non-physician anaesthetic providers and that they administer over 90% of anaesthetics, with a significant number unsupervised by a physician anaesthetist. Papua New Guinea has a physician anaesthetist ratio estimated to be 0.25 per 100,000 population, while Australia and New Zealand have a ratio of 19 physician anaesthetists per 100,000, which is 75 times that of Papua New Guinea. To reach a ratio of seven per 100,000, recommended as the minimum acceptable by the Lancet Commission in 2016, there will need to be over 35 practitioners trained per annum until 2030, at a time when the average annual numbers of recent years are less than three physicians and less than five non-physician anaesthetic providers. We review the development of anaesthesia administered by non-physician indigenous staff and the stages of development from heil tultuls, dokta bois, liklik doktas, native medical assistants, aid post orderlies, and Anaesthetic Technical Officers up to the current Anaesthetic Scientific Officers having attained the Diploma in Anaesthetic Science from the University of Papua New Guinea.

scholarly journals A Pilot Study of a Screening Process for Evaluating the Physical, Mental and Cognitive Health of Senior Physicians

2021 ◽  
Vol 107 (2) ◽  
pp. 33-40
Author(s):  
David E. J. Bazzo ◽  
Patricia Smith ◽  
Elizabeth F. Wenghofer
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Clinical Education ◽  
Cognitive Assessment ◽  
Health Screening ◽  
Health Issues ◽  
Structured Interviews ◽  
Screening Process ◽  
Cognitive Health ◽  
The University

ABSTRACT Physicians are not immune to changes that accompany aging, including decreases in physical and cognitive health and abilities. Many are calling for, or turning to, screening senior physicians for decrements in their ability to provide safe care. Our purpose was to determine the acceptability and feasibility of a pilot screening process, which evaluates the physical, mental and cognitive health of senior physicians. The screening process was developed by the University of California, San Diego, Physician Assessment and Clinical Education Program. The screen included: mental health screening (PHQ-9, GAD-7, and substance abuse screen), cognitive health screening (MicroCog™ and Montreal Cognitive Assessment [MoCA©]) and physical health screening (medical history review and physical examination). Qualitative semi-structured interviews were conducted post-screening. Thirty senior physicians participated in the pilot process, including post-screening interviews. Eight (27%) participants were judged to “require”/“may require” further evaluation after cognitive assessment. No physicians were found to have physical or mental health issues that would prevent them from practicing competently. Interviews revealed that participants felt the screening process was a positive experience that was effective, acceptable, efficient and relevant to their practice. The results of this pilot study indicate that screening physical, mental and cognitive health is considered both feasible and acceptable to senior physicians. This is important as screening the health and cognition of senior physicians is integral to the national discussion related to regulation and patient safety.

Bringing to Life Baltimore '68: Riots and Rebirth—A How-to Guide

2009 ◽  
Vol 31 (4) ◽  
pp. 13-27
Author(s):  
Jessica I. Elfenbein
Keyword(s):  
Public History ◽  
Community Resources ◽  
National Council ◽  
Collaborative Partnerships ◽  
Civil Unrest ◽  
Anchor Institutions ◽  
State And Local ◽  
The Many ◽  
The University ◽  
American Cities

Abstract This article provides an overview of Baltimore '68: Riots and Rebirth, the multifaceted work led by the University of Baltimore over the course of four years to hear the many voices of our community and to document the varied ways the causes and effects of the civil unrest of April 1968 affected Baltimore and scores of other American cities. Our work, lauded in the national press, received the National Council on Public History's Outstanding Project and the American Association of State and Local History's Award of Merit and 2009 WOW Award. We believe this kind of history, different from popular booster narratives, is a model for public history projects. This article also considers the ways in which universities, as anchor institutions, are increasingly taking the lead in public history and other civic engagement projects. The creative use of university and community resources, including AmeriCorps participation and collaborative partnerships, is also considered.

scholarly journals Bridging Digital Divides: GWEP Pivots to Support Telehealth for Clinical Care and Education

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 476-476
Author(s):  
Lisa Gibbs ◽  
Julie Rousseau ◽  
Sonia Sehgal ◽  
Neika Saville ◽  
Jung-Ah Lee
Keyword(s):  
Older Adults ◽  
Nursing Students ◽  
Clinical Care ◽  
Health Assessment ◽  
Community Resources ◽  
Remote Patient Monitoring ◽  
Phone Calls ◽  
Digital Divides ◽  
Remote Patient ◽  
The University

Abstract Early in the pandemic, the University of California, Irvine (UCI), GWEP pivoted to focus on building telehealth and remote patient monitoring, while supporting team-based interdisciplinary learners. Our Health Assessment Program for Seniors (HAPS) adapted to provide hybrid remote/in-person evaluations with our Geriatric Fellows and Doctor of Nurse Practitioner (DNP) students working alongside our multi-disciplinary team. Learner teams innovatively bridged the digital divide through weekly DNP support phone calls, and the Fellows delivered family conferences through Zoom. In ASSIST, medical students and nursing students gained digital competencies through a phone support system for isolated older adults with friendly weekly check-ins providing referrals to community resources. Another IRB-approved pilot, Healing at Home, diverted patients from the Emergency Room and In-Patient care with a team of ED, Hospitalists, Geriatricians teaching DNP and Fellows telehealth management. GWEP successfully piloted symbiotic learning for both older adults and health profession students through new virtual formats.

scholarly journals Depressive disorders in student population - comparative study conducted in 2007 and 2014

2015 ◽  
Vol 68 (7-8) ◽  
pp. 234-239 ◽  
Author(s):  
Ivana Joksimovic-Knjisa ◽  
Lada Marinkovic ◽  
Natasa Cobrda
Keyword(s):  
Depressive Disorders ◽  
Depressive Symptomatology ◽  
Total Sample ◽  
Female Students ◽  
Student Population ◽  
Suicidal Thoughts ◽  
Patient Health ◽  
Novi Sad ◽  
The University ◽  
Over Time

Introduction. The aim of this study was to determine the frequency of depressive symptomatology and its distinctive manifestations in student population in the interval of 7 years. Material and Methods. A sample of 790 students from the University of Novi Sad was asked questions about depression by means of the Patient Health Questionnaire 9 in 2007 and 2014. Results. The results show that the frequency of depression in student population ranges from 12.4% to 16.5%. Comparing the samples, in 2014 there were more mildly and severely depressed students, while the number of moderately depressed students was significantly lower. Suicidal thoughts were present in about 32% to 45% of depressive students and in about 7% of the total sample. The higher presence of depression was confirmed among female students in both study samples. Conclusion. The percentage of depressed students is stable over time. Symptomatology is very specific and suicidal thoughts are present in a great number of depressed students. Therefore, early diagnosis is essential.

scholarly journals Developing reflective primary teachers: talking science and speaking English as an additional language

2015 ◽  
Vol 17 (2) ◽  
pp. 328
Author(s):  
Gloria Jové Monclus ◽  
Charly Ryan ◽  
Esther Betrián Villas
Keyword(s):  
Primary Education ◽  
Teacher Educators ◽  
Primary Teachers ◽  
Community Resources ◽  
Science Content ◽  
Teaching Plan ◽  
Education Degree ◽  
The University ◽  
English Students

In this article we present a case study in initial education of teachers studying the Primary Education Degree of the University of Lleida. Students prepare a teaching plan for science content linked to community resources, and present it in English. The aim was the students experience "talking science" in English. We focus on the questions: What have we experienced doing this activity in English? Students refer to impotence and frustration at expressing themselves and their ideas in English. While the data shows that there was little focus on science content, they showed the value of the exercise in their development as teachers. They experience ‘otherness’ and connect this to their future roles as teachers in multi-lingual, multi-cultural classrooms. Preparing this case study shows the value of teacher educators reflecting on their practice.

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