Commentary: A Call to Leadership: The Role of the Academic Medical Center in Driving Sustainable Health System Improvement Through Performance Measurement

Boelen A, Platvoet-ter Schiphorst MC, van Rooijen N, Wiersinga WM. Selective macrophage depletion in the liver does not prevent the development of the sick euthyroid syndrome in the mouse. Eur J Endocrinol 1996;134:513–8. ISSN 0804–4643 A decreased serum triiodothyronine (T3) level is one of the main characteristics of the sick euthyroid syndrome, caused mainly by a decreased 5′-deiodination of thyroxine (T4) in the liver. Cytokines have been implicated in the pathogenesis of the changes in thyroid hormone metabolism during illness. We therefore investigated the role of cytokines produced by the liver macrophages (Kupffer cells) in the development of the sick euthyroid syndrome, which was induced in mice by a single injection of bacterial endotoxin (lipopolysaccharide) or by 24-h starvation. Experiments were carried out with or without previous selective depletion of liver macrophages by intravenous administration of liposome-encapsulated dichloromethylene diphosphonate. Relative to saline-injected pair-fed controls, the administration of lipopolysaccharide caused a decrease of serum T3 and T4 and liver 5′-deiodinase mRNA. Selective depletion of liver macrophages did not affect these changes. Starvation for 24 h decreased serum T3 and T4, associated with a slight decrease of liver 5′-deiodinase mRNA. There were no differences between macrophage-depleted and non-depleted animals in this respect. In summary, selective depletion of liver macrophages did not affect the decrease in serum T3, T4 or liver 5′-deiodinase mRNA induced by lipopolysaccharide or 24-h starvation in mice. We conclude that cytokines produced by Kupffer cells are not involved in the pathogenesis of the sick euthyroid syndrome in this experimental model. A Boelen, Department of Endocrinology, F5-171 Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

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Creating a Longitudinal Integrated Clerkship with Mutual Benefits for an Academic Medical Center and a Community Health System

The Permanente Journal ◽

10.7812/tpp/13-137 ◽

2014 ◽

Vol 18 (2) ◽

pp. 50-56 ◽

Cited By ~ 21

Author(s):

Ann Poncelet

Keyword(s):

Health System ◽

Community Health ◽

Medical Center ◽

Academic Medical Center ◽

Academic Medical ◽

Longitudinal Integrated Clerkship

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Fertility navigators in female oncofertility care in an academic medical center: a qualitative evaluation

Supportive Care in Cancer ◽

10.1007/s00520-020-05412-1 ◽

2020 ◽

Vol 28 (12) ◽

pp. 5733-5741 ◽

Cited By ~ 1

Author(s):

M. van den Berg ◽

S. Nadesapillai ◽

D. D. M. Braat ◽

R. P. M. G. Hermens ◽

C. C. M. Beerendonk

Keyword(s):

Fertility Preservation ◽

Medical Center ◽

Academic Medical Center ◽

Qualitative Evaluation ◽

Added Value ◽

Personal Care ◽

Academic Medical ◽

Supportive Role ◽

Female Fertility Preservation

Abstract Purpose To explore patients’ and professionals’ experiences with fertility navigators in female oncofertility care. Methods Semi-structured in-depth interviews were conducted with nine female cancer patients and six healthcare professionals to explore their experiences. They were recruited from an academic medical center (referral clinic for female fertility preservation care). Data were analyzed using the concepts of grounded theory. Results Patients were satisfied about the supportive role of the fertility navigator in their fertility preservation process: fertility navigators added value as they became “familiar faces” and provided information, emotional support, personal care, and served as patients’ primary contact person. The fertility navigators had a pleasant collaboration with professionals and supported professionals by taking over tasks. To improve the role of fertility navigators, it was suggested that they should always be present in fertility preservation counseling, and attention should be paid to their availability to improve continuity of care. Conclusion Fertility navigators provide personal care, improve satisfaction in patients in their oncofertility process, and support professionals. The overview of issues that need to be addressed when assigning fertility navigators in female oncofertility care combined with the improvement suggestions could be used by other centers when considering implementing fertility navigators.

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Integration of an Academic Medical Center and a Large Health System: Implications for Pharmacy

Hospital Pharmacy ◽

10.1177/0018578718823735 ◽

2019 ◽

Vol 54 (3) ◽

pp. 170-174

Author(s):

Brian L. Erstad ◽

Tina Aramaki ◽

Kurt Weibel

Keyword(s):

Health System ◽

Health Systems ◽

Integration Method ◽

Medical Center ◽

Academic Medical Center ◽

Lessons Learned ◽

Faculty Members ◽

Pharmacy Services ◽

Academic Medical ◽

High Level

Objective: To provide lessons learned for colleges of pharmacy and large health systems that are contemplating or in the process of undergoing integration. Method: This report describes the merger of an academic medical center and large health system with a focus on the implications of the merger for pharmacy from the perspectives of both a college of pharmacy and a health system’s pharmacy services. Results: Overarching pharmacy issues to consider include having an administrator from the college of pharmacy directly involved in the merger negotiation discussions, having at least one high-level administrator from the college of pharmacy and one high-level pharmacy administrator from the health system involved in ongoing discussions about implications of the merger and changes that are likely to affect teaching, research, and clinical service activities, having focused discussions between college and health system pharmacy administrators on the implications of the merger on experiential and research-related activities, and anticipating concerns by clinical faculty members affected by the merger. Conclusion: The integration of a college of pharmacy and a large health system during the acquisition of an academic medical center can be challenging for both organizations, but appropriate pre- and post-merger discussions between college and health system pharmacy administrators that include a strategic planning component can assuage concerns and problems that are likely to arise, increasing the likelihood of a mutually beneficial collaboration.

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Patient Safety Trilogy: Perspectives from Clinical Engineering

Biomedical Instrumentation & Technology ◽

10.2345/0899-8205-47.2.137 ◽

2013 ◽

Vol 47 (2) ◽

pp. 137-142 ◽

Cited By ~ 3

Author(s):

Izabella Gieras ◽

Paul Sherman ◽

Dennis Minsent

Keyword(s):

Patient Safety ◽

Medical Center ◽

Academic Medical Center ◽

Clinical Engineering ◽

Veterans Health ◽

Health Administration ◽

Healthcare Technology ◽

Academic Medical ◽

Clinical Engineers

This article examines the role a clinical engineering or healthcare technology management (HTM) department can play in promoting patient safety from three different perspectives: a community hospital, a national government health system, and an academic medical center. After a general overview, Izabella Gieras from Huntington Hospital in Pasadena, CA, leads off by examining the growing role of human factors in healthcare technology, and describing how her facility uses clinical simulations in medical equipment evaluations. A section by Paul Sherman follows, examining patient safety initiatives from the perspective of the Veterans Health Administration with a focus on hazard alerts and recalls. Dennis Minsent from Oregon Health & Science University writes about patient safety from an academic healthcare perspective, and details how clinical engineers can engage in multidisciplinary safety opportunities.

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The Procedure Coordinator: A Resident-Driven Initiative to Increase Opportunity for Inpatient Procedures

Journal of Graduate Medical Education ◽

10.4300/jgme-d-18-00399.1 ◽

2018 ◽

Vol 10 (5) ◽

pp. 583-586 ◽

Cited By ~ 2

Author(s):

Matthew Gorgone ◽

Brian McNichols ◽

Valerie J. Lang ◽

William Novak ◽

Alec B. O'Connor

Keyword(s):

Medical Center ◽

Academic Medical Center ◽

Medical Providers ◽

Procedural Training ◽

Academic Medical ◽

Attending Physician ◽

Attending Physicians ◽

The Impact ◽

Training Opportunities

ABSTRACT Background Training residents to become competent in common bedside procedures can be challenging. Some hospitals have attending physician–led procedure teams with oversight of all procedures to improve procedural training, but these teams require significant resources to establish and maintain. Objective We sought to improve resident procedural training by implementing a resident-run procedure team without routine attending involvement. Methods We created the role of a resident procedure coordinator (RPC). Interested residents on less time-intensive rotations voluntarily served as RPC. Medical providers in the hospital contacted the RPC through a designated pager when a bedside procedure was needed. A structured credentialing process, using direct observation and a procedure-specific checklist, was developed to determine residents' competence for completing procedures independently. Checklists were developed by the residency program and approved by institutional subspecialists. The service was implemented in June 2016 at an 850-bed academic medical center with 70 internal medicine and 32 medicine-pediatrics residents. The procedure service functioned without routine attending involvement. The impact was evaluated through resident procedure logs and surveys of residents and attending physicians. Results Compared with preimplementation procedure logs, there were substantial increases postimplementation in resident-performed procedures and the number of residents credentialed in paracenteses, thoracenteses, and lumbar punctures. Fifty-nine of 102 (58%) residents responded to the survey, with 42 (71%) reporting the initiative increased their ability to obtain procedural experience. Thirty-one of 36 (86%) attending respondents reported preferentially using the service. Conclusions The RPC model increased resident procedural training opportunities using a structured sign-off process and an operationalized service.

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