Warfarin Management Using Point-of-Care Testing in a University-Based Internal Medicine Resident Clinic

2012 ◽  
Vol 344 (4) ◽  
pp. 289-293 ◽  
Author(s):  
Marcus Smith ◽  
Sarah Grace ◽  
Michael S. Bronze ◽  
Rhett Jackson ◽  
Donald Harrison ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Point Of Care ◽  
Internal Medicine Resident ◽  
Point Of Care Testing ◽  
Medicine Resident

Pharmacogenomics education and perceptions: is there a gap between internal medicine resident and attending physicians?

2021 ◽  
Author(s):  
Carolyn R Rohrer Vitek ◽  
Jyothsna Giri ◽  
Pedro J Caraballo ◽  
Timothy B Curry ◽  
Wayne T Nicholson
Keyword(s):  
Internal Medicine ◽  
Point Of Care ◽  
Internal Medicine Resident ◽  
Current Clinical Practice ◽  
Medicine Resident ◽  
Resident Physicians ◽  
Internal Medicine Residents ◽  
Care Gaps ◽  
Attending Physicians ◽  
Do So

Aim: To determine if differences in self-reported pharmacogenomics knowledge, skills and perceptions exist between internal medicine residents and attending physicians. Materials & methods: Forty-six internal medicine residents and 54 attending physicians completed surveys. Thirteen participated in focus groups to explore themes emerging from the surveys. Results: Resident physicians reported a greater amount of pharmacogenomics training compared with attending physicians (48 vs 13%, p < 0.00012). No differences were found in self-reported knowledge, skills and perceptions. Conclusion: Both groups expressed pharmacogenomics was relevant to their current clinical practice; they should be able to provide information to patients and use to guide prescribing, but lacked sufficient education to be able to do so effectively. Practical approaches are needed to teach pharmacogenomics concepts and address point-of-care gaps.

Drug Alert Experience and Salience during Medical Residency at Two Healthcare Institutions

2021 ◽  
Vol 12 (02) ◽  
pp. 355-361
Author(s):  
Kinjal Gadhiya ◽  
Edgar Zamora ◽  
Salim M. Saiyed ◽  
David Friedlander ◽  
David C. Kaelber
Keyword(s):  
Internal Medicine ◽  
Residency Training ◽  
Medical Center ◽  
Internal Medicine Resident ◽  
Clinical Decision ◽  
University Of Pennsylvania ◽  
Teaching Hospitals ◽  
Medicine Resident ◽  
Internal Medicine Residents ◽  
The University

Abstract Background Drug alerts are clinical decision support tools intended to prevent medication misadministration. In teaching hospitals, residents encounter the majority of the drug alerts while learning under variable workloads and responsibilities that may have an impact on drug-alert response rates. Objectives This study was aimed to explore drug-alert experience and salience among postgraduate year 1 (PGY-1), postgraduate year 2 (PGY-2), and postgraduate year 3 (PGY-3) internal medicine resident physicians at two different institutions. Methods Drug-alert information was queried from the electronic health record (EHR) for 47 internal medicine residents at the University of Pennsylvania Medical Center (UPMC) Pinnacle in Pennsylvania, and 79 internal medicine residents at the MetroHealth System (MHS) in Ohio from December 2018 through February 2019. Salience was defined as the percentage of drug alerts resulting in removal or modification of the triggering order. Comparisons were made across institutions, residency training year, and alert burden. Results A total of 126 residents were exposed to 52,624 alerts over a 3-month period. UPMC Pinnacle had 15,574 alerts with 47 residents and MHS had 37,050 alerts with 79 residents. At MHS, salience was 8.6% which was lower than UPMC Pinnacle with 15%. The relatively lower salience (42% lower) at MHS corresponded to a greater number of alerts-per-resident (41% higher) compared with UPMC Pinnacle. Overall, salience was 11.6% for PGY-1, 10.5% for PGY-2, and 8.9% for PGY-3 residents. Conclusion Our results are suggestive of long-term drug-alert desensitization during progressive residency training. A higher number of alerts-per-resident correlating with a lower salience suggests alert fatigue; however, other factors should also be considered including differences in workload and culture.

scholarly journals Military Internal Medicine Resident Decision to Apply to Fellowship and Extend Military Commitment

2018 ◽  
Vol 183 (7-8) ◽  
pp. e299-e303 ◽  
Author(s):  
Alice E Barsoumian ◽  
Joshua D Hartzell ◽  
Erin M Bonura ◽  
Roseanne A Ressner ◽  
Timothy J Whitman ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Internal Medicine Resident ◽  
Medicine Resident

scholarly journals EMR-based handoff tool improves completeness of internal medicine residents’ handoffs

2018 ◽  
Vol 7 (3) ◽  
pp. e000188 ◽  
Author(s):  
Rebecca L Tisdale ◽  
Zac Eggers ◽  
Lisa Shieh
Keyword(s):  
Internal Medicine ◽  
Medical Center ◽  
Internal Medicine Resident ◽  
Objective Data ◽  
Code Status ◽  
Medicine Resident ◽  
Communication Breakdown ◽  
Internal Medicine Residents ◽  
Action List ◽  
Identical Fashion

BackgroundThe majority of adverse events in healthcare involve communication breakdown. Physician-to-physician handoffs are particularly prone to communication errors, yet have been shown to be more complete when systematised according to a standardised bundle. Interventions that improve thoroughness of handoffs have not been widely studied.AimTo measure the effect of an electronic medical record (EMR)-based handoff tool on handoff completeness.InterventionThis EMR-based handoff tool included a radio button prompting users to classify patients as stable, a ‘watcher’ or unstable. It automatically pulled in EMR data on the patient’s 24-hour vitals, common lab tests and code status. Finally, it provided text boxes labelled ‘Active Issues’, ‘Action List (To-Dos)’ and ‘If/Then’ to fill in.Implementation and evaluationWritten handoffs from general and specialty (haematology, oncology, cardiology) Internal Medicine resident-run inpatient wards were evaluated on a randomly chosen representative sample of days in April and May 2015 at Stanford University Medical Center, focusing on a predefined set of content elements. The intervention was then implemented in June 2015 with postintervention data collected in an identical fashion in August to September 2016.ResultsHandoff completeness improved significantly (p<0.0001). Improvement in inclusion of illness severity was notable for its magnitude and its importance in establishing a consistent mental model of a patient. Elements that automatically pulled in data and those prompting users to actively fill in data both improved.ConclusionA simple EMR-based handoff tool providing a mix of frameworks for completion and automatic pull-in of objective data improved handoff completeness. This suggests that EMR-based interventions may be effective at improving handoffs, possibly leading to fewer medical errors and better patient care.

A new perspective: from internal medicine resident to oncologist

2018 ◽  
Vol 19 (11) ◽  
pp. 1433
Author(s):  
Adam Yuh Lin ◽  
Sheetal Kircher
Keyword(s):  
Internal Medicine ◽  
Internal Medicine Resident ◽  
Medicine Resident ◽  
New Perspective

Implementation of point-of-care testing in a general internal medicine practice: A confirmation study

2017 ◽  
Vol 473 ◽  
pp. 71-74 ◽  
Author(s):  
Elizabeth-Lee Lewandrowski ◽  
Sunu Yeh ◽  
Jason Baron ◽  
J. Benjamin Crocker ◽  
Kent Lewandrowski
Keyword(s):  
Internal Medicine ◽  
General Internal Medicine ◽  
Point Of Care ◽  
Point Of Care Testing ◽  
General Internal ◽  
General Internal Medicine Practice

scholarly journals Educational Conference Scheduling, Patient Discharge Time, and Resident Satisfaction

2014 ◽  
Vol 6 (3) ◽  
pp. 574-576 ◽  
Author(s):  
Steffanie Campbell ◽  
Matthew Campbell ◽  
Chirayu Shah ◽  
Alexander M. Djuricich
Keyword(s):  
Internal Medicine ◽  
Medical Patient ◽  
Patient Discharge ◽  
Internal Medicine Resident ◽  
Case Conference ◽  
Morning Report ◽  
Discharge Time ◽  
Medicine Resident ◽  
Medicine Service ◽  
Internal Medicine Residents

Abstract Background Limits on resident duty hours instituted in 2003 and 2011 have compressed medical resident daily workload. Despite this compression, residents must gain competence to practice medicine without supervision. Objective We sought to determine whether moving the time our educational conference is scheduled affects the time when patient discharges are completed on an internal medicine teaching service. Methods The study was conducted at a county hospital within a large internal medicine residency program. During the 4-month study period, the morning report conference for internal medicine residents was shifted from 8:30 am to 2 pm. Patient discharge times, defined as the time the discharge order set was signed, were obtained for the service via the electronic health record. The outcomes measured were patient discharge time variation and internal medicine resident preference for conference time. Results Survey response rate was 82% (42 of 51). Of the residents who responded, 64% (27 of 42) preferred the 8:30 am report time, and 74% (31 of 42) felt the 8:30 am time was also better for education and timing of teaching rounds. There was no difference in discharge times for 2999 patients on the medicine teaching service, whether educational case conference morning report occurred at 8:30 am or at 2 pm. Conclusions Medical patient average discharge time was not influenced by time of educational conference. Factors other than the timing of educational conference appear to influence hospital discharge times on an inpatient internal medicine service.

Sign in / Sign up

Export Citation Format

Share Document