Development of Electronic Medical Record-Based “Rounds Report” Results in Improved Resident Efficiency, More Time for Direct Patient Care and Education, and Less Resident Duty Hour Violations

2016 ◽  
Vol 82 (9) ◽  
pp. 853-859 ◽  
Author(s):  
Phillip B. Ham ◽  
Toby Anderton ◽  
Ryan Gallaher ◽  
Mike Hyrman ◽  
Erika Simmerman ◽  
...  
Keyword(s):  
Patient Care ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Academic Medical Centers ◽  
Educational Activity ◽  
Direct Patient Care ◽  
Activity Time ◽  
Medical Centers ◽  
Academic Medical ◽  
American Board Of Surgery

Surgeons frequently report frustration and loss of efficiency with electronic medical record (EMR) systems. Together, surgery residents and a programmer at Augusta University created a rounds report (RR) summarizing 24 hours of vitals, intake/output, labs, and other values for each inpatient that were previously transcribed by hand. The objective of this study was to evaluate the RR's effect on surgery residents. Surgery residents were queried to assess the RR's impact. Outcome measures were time spent preparing for rounds, direct patient care time, educational activity time, rates of incorrect/incomplete data on rounds, and rate of duty hour violations. Hospital wide, 17,200 RRs were generated in the 1-month study. Twenty-three surgery residents participated. Time spent preparing for rounds decreased per floor patient (15.6 ± 3.0 vs 6.0 ± 1.2, P < 0.0001) and per intensive care unit patient (19.9 ± 2.9 vs 7.5 ± 1.2 P < 0.0001). The work day spent in direct patient care increased from 45.1 ± 5.6 to 54.0 ± 5.7 per cent ( P = 0.0044). Educational activity time increased from 35.2 ± 5.4 to 54.7 ± 7.1 minutes per resident per day ( P = 0.0004). Reported duty hour violations decreased 58 per cent ( P < 0.0001). American Board of Surgery in Training exam scores trended up, and estimates of departmental annual financial savings range from $66,598 to $273,141 per year. Significant improvements occur with surgeon designed EMR tools like the RR. Hospitals and EMR companies should pair interested surgeons with health information technology developers to facilitate EMR enhancements. Improvements like RRs can have broad ranging, multidisciplinary impact and should be standard in all EMRs used for inpatient care at academic medical centers.

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.

scholarly journals Guiding Academic Clinician Educators at Research-Intensive Institutions: a Framework for Chairs, Chiefs, and Mentors

2021 ◽  
Author(s):  
Anna Chang ◽  
Brian S. Schwartz ◽  
Elizabeth Harleman ◽  
Meshell Johnson ◽  
Louise C. Walter ◽  
...  
Keyword(s):  
Patient Care ◽  
Career Success ◽  
Department Chairs ◽  
Academic Medical Centers ◽  
High Quality ◽  
Quality Patient Care ◽  
Medical Centers ◽  
Clinician Educator ◽  
Academic Medical ◽  
Clinician Educators

AbstractDepartment chairs and division chiefs at research-intensive academic medical centers often find mentoring clinician educators challenging. These faculty constitute the majority of academic physicians. Supporting excellent clinician educators is key to ensuring high-quality patient care and developing tomorrow’s physicians. Little has been written for leaders on strategies to advance academic clinician educators’ career success. We present a framework to guide chairs, chiefs, and mentors seeking to address clinician educator retention and satisfaction in academic medical centers.

Challenges of privatizing academic medical centers in Saudi Arabia and appropriate strategies for implementation

2020 ◽  
Vol 25 (1) ◽  
pp. 68-77 ◽  
Author(s):  
Ahmed Al Kuwaiti ◽  
Fahd A. Al Muhanna
Keyword(s):  
Medical Education ◽  
Saudi Arabia ◽  
Patient Care ◽  
Public Hospitals ◽  
Academic Medical Centers ◽  
Healthcare Sector ◽  
Content Type ◽  
Medical Centers ◽  
Academic Medical ◽  
The Government

PurposeA crisis in the financial sustainability of the public healthcare sector often compels governments to consider privatization. The purpose of this paper is to summarize various strategies to overcome the challenges facing the privatization of academic medical centers (AMCs) in Saudi Arabia.Design/methodology/approachIn this paper, the authors discuss the challenges faced in privatizing AMCs in delivering their core functions such as patient care, medical education and research. Further, the appropriate strategies are listed to overcome these challenges in privatization of AMCs.FindingsThe authors described the benefits of privatization that include a reduction in the financial burden on government healthcare expenditure, quick decision making and creation of new financial models to improve healthcare services. On the other hand, the profit motive of private management could create pressure on patients and may divert AMCs from their primary objectives. Therefore, it is imperative for the government to develop and implement appropriate strategies that balance the benefits of privatizing AMCs with eliminating the negative impact of privatization on patient care, medical education and research.Originality/valueThough AMCs privatization is currently feasible in Saudi Arabia, appropriate strategies are essential to overcome the challenges of its implementation. The government should frame a uniform rules and regulations prior to privatizing public hospitals so that it will fulfill the purpose in an efficient manner.

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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