scholarly journals Collaborative Comanagement Between Neurohospitalists and Internal Medicine Hospitalists Decreases Provider Costs and Enhances Satisfaction With Neurology Care at an Academic Medical Center

2017 ◽  
Vol 8 (2) ◽  
pp. 74-81
Author(s):  
James G. Greene
Keyword(s):  
Positive Impact ◽  
Medical Center ◽  
Academic Medical Center ◽  
Hospital Medicine ◽  
Professional Services ◽  
Care Model ◽  
Future Health ◽  
Medical Centers ◽  
Academic Medical ◽  
Potential Benefits

Background and Purpose: The majority of academic medical centers are moving to a neurohospitalist model of care for hospital neurology coverage. Potential benefits over a more traditional academic model of patient care include greater expertise in acute neurologic disease, increased efficiency, and improved availability to patients, providers, and learners. Despite these perceived advantages, switching to a neurohospitalist model can come at substantial financial cost, so finding ways to maximize the positive impact of a limited number of neurohospitalists is very important to the future health of academic neurology departments. Over the past 7 years, we have implemented a model for inpatient neurological care based on an intimate collaborative relationship between the neurology and hospital medicine services at our main academic hospital. Our goal was to optimize the value of care by decreasing cost while improving quality. Methods: Cost and revenue associated with professional services was evaluated on a yearly basis. As part of ongoing quality improvement efforts, yearly surveys were administered to referring providers during the transition to a collaborative care model in which NHs and medicine hospitalists comanage neurology inpatients. Results: Net operating loss was dramatically decreased upon transition to the new care model. Concomitantly, there was a robust positive impact on perception of overall quality, timeliness, and communication skills of neurology services. Conclusions: Collaborative comanagement is an effective strategy to improve overall satisfaction with neurology services at a tertiary academic medical center while maintaining financial viability.

scholarly journals Defining Potential Overutilization of Physical Therapy Consults on Hospital Medicine Services

2021 ◽  
Author(s):  
Maylyn Martinez ◽  
Matthew Cerasale ◽  
Mahnoor Baig ◽  
Claire Dugan ◽  
Marla Robinson ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Positive Impact ◽  
Medical Center ◽  
Academic Medical Center ◽  
Hospital Medicine ◽  
High Mobility ◽  
Academic Medical ◽  
Risk Patients ◽  
Therapy Services ◽  
Activity Measure

Appropriate use of inpatient physical therapy services is important for preventing hospital-associated disability (HAD). We assessed potential overutilization of physical therapy consults on hospital medicine services using the Activity Measure-Post Acute Care (AM-PAC) score. Our sample included 3592 unique admissions (mean age, 66 years; 48% women) at a large academic medical center. Based on an AM-PAC cutoff of >43.63 (raw score, 18) in patients who were discharged to home, 38% of physical therapy consults were considered “potential overutilization.” Combined with age <65 years, 18% of consults remained “potential overutilization.” After adjustment for age, sex, and length of stay, patients admitted with high mobility scores were 5.38 times more likely to be discharged to home (95% CI, 4.36-2.89) compared with those with low mobility scores. Being more judicious with physical therapy consults and reserving skilled therapy for at-risk patients could help prevent HAD while also having a positive impact on healthcare systems.

scholarly journals Coronavirus Disease 2019 (COVID-19) Clinical Trial Oversight at a Major Academic Medical Center: Approach of Michigan Medicine

2020 ◽  
Vol 71 (16) ◽  
pp. 2187-2190 ◽  
Author(s):  
Kayte Spector-Bagdady ◽  
Peter D R Higgins ◽  
Keith D Aaronson ◽  
Judy Birk ◽  
Kevin R Flaherty ◽  
...  
Keyword(s):  
Media Coverage ◽  
Medical Center ◽  
Academic Medical Center ◽  
Research Integrity ◽  
Research Issues ◽  
Randomized Controlled Clinical Trials ◽  
Subject Recruitment ◽  
Medical Centers ◽  
Academic Medical ◽  
Trial Oversight

Abstract Clinicians, eager to offer the best care in the absence of guiding data, have provided patients with coronavirus disease 2019 (COVID-19) diverse clinical interventions. This usage has led to perceptions of efficacy of some interventions that, while receiving media coverage, lack robust evidence. Moving forward, randomized controlled clinical trials are necessary to ensure that clinicians can treat patients effectively during this outbreak and the next. To do so, academic medical centers must address 2 key research issues: (1) how to effectively and efficiently determine which trials have the best chance of benefiting current and future patients and (2) how to establish a transparent and ethical process for subject recruitment while maintaining research integrity and without overburdening patients or staff. We share here the current methods used by Michigan Medicine to address these issues.

Emergency Physician Involvement in Hospital Preparedness: A National Survey of Academic Medical Centers

2020 ◽  
pp. 1-4
Author(s):  
Kevin M. Ryan ◽  
Sina Mostaghimi ◽  
Julianne Dugas ◽  
Eric Goralnick
Keyword(s):  
United States ◽  
Emergency Medicine ◽  
Emergency Preparedness ◽  
Response Rate ◽  
Medical Center ◽  
Academic Medical Center ◽  
The United States ◽  
Academic Medical Centers ◽  
Medical Centers ◽  
Academic Medical

ABSTRACT Objectives: The aim of this study was to determine the involvement of emergency medicine physicians at academic medical centers across the United States as well as their background training, roles in the hospital, and compensation if applicable for time dedicated to preparedness. Methods: A structured survey was delivered by means of email to 109 Chairs of Emergency Medicine across the United States at academic medical centers. Unique email links were provided to track response rate and entered into REDCap database. Descriptive statistics were obtained, including roles in emergency preparedness, training, and compensation. Results: Forty-four of the 109 participants responded, resulting in a response rate of 40.4%. The majority held an administrative role in emergency preparedness. Formal training for the position (participants could select more than 1) included various avenues of education such as emergency medical services fellowship or in-person or online courses. Of the participants, most (93.18%) strongly agreed that it was important to have a physician with expertise in disaster medicine assisting with preparedness. Conclusions: The majority of responding academic medical center participants have taken an active role in hospital emergency preparedness. Education for the roles varied though, often consisted of courses from emergency management agencies. Volunteering their time for compensation was noted by 27.5%.

scholarly journals Learning Experiences Within Infectious Diseases Pharmacy Residency Programs in the United States: A Cross-Sectional Survey

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Jonathan C Cho ◽  
Matthew P Crotty ◽  
Wesley D Kufel ◽  
Elias B Chahine ◽  
Amelia K Sofjan ◽  
...  
Keyword(s):  
United States ◽  
Infectious Diseases ◽  
Medical Center ◽  
Academic Medical Center ◽  
Travel Medicine ◽  
The United States ◽  
Cross Sectional ◽  
Residency Programs ◽  
Medical Centers ◽  
Academic Medical

Abstract Background Pharmacists with residency training in infectious diseases (ID) optimize antimicrobial therapy outcomes in patients and support antimicrobial stewardship (AS) programs. Although most ID residencies are accredited and assessed by certain standards, the degree to which these programs are similar is not known. Methods A 19-item, cross-sectional, multicentered, electronic survey was distributed via e-mail to pharmacy residency program directors (RPDs) of all 101 second-year postgraduate (PGY-2) ID residency programs in the United States. Results Survey responses were collected from 71 RPDs (70.3%); 64.8% were associated with an academic medical center and 97.2% focused primarily in adult ID. Rotations in the microbiology laboratory, adult AS, and adult ID consult were required in 98.6% of residency programs. Only 28.2% of responding programs required pediatric AS and pediatric ID consult rotations. Programs at academic medical centers were more likely to offer immunocompromised host ID consult (P = .003), pediatric ID consult (P = .006), and hospital epidemiology (P = .047) rotations but less frequently offered outpatient AS (P = .003), viral hepatitis clinics (P = .001), and travel medicine clinics (P = .007) rotations compared to programs at nonacademic medical centers. Residents were frequently involved in AS committees (97.2%), pharmacokinetic dosing of antimicrobials (83.1%), precepting pharmacy trainees (80.3%), and performing research projects (91.5%). Conclusions The PGY-2 ID pharmacy residency programs demonstrated consistency in required adult ID consult, antimicrobial management activities, committee service, and teaching and research opportunities. Pediatric experiences were less common. The PGY-2 ID residency programs prepare pharmacists to become antimicrobial stewards for adult patients.

scholarly journals Automatic ID Consultation for Inpatients With COVID-19: Point, Counterpoint, and a Single-Center Experience

2020 ◽  
Vol 7 (10) ◽  
Author(s):  
Cynthia T Nguyen ◽  
Gregory Olson ◽  
Mai T Pho ◽  
Alison K Lew ◽  
David Pitrak ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Single Center Experience ◽  
Academic Medical ◽  
Clinician Satisfaction ◽  
Potential Benefits ◽  
Infectious Diseases Consultation ◽  
The Impact

Abstract There are many unknowns with regard to COVID-19 clinical management, including the role of Infectious Diseases Consultation (IDC). As hospitalizations for COVID-19 continue, hospitals are assessing how to optimally and efficiently manage COVID-19 inpatients. Typically, primary teams must determine when IDC is appropriate, and ID clinicians provide consultation upon request of the primary team. IDC has been shown to be beneficial for many conditions; however, the impact of IDC for COVID-19 is unknown. Herein, we discuss the potential benefits and pitfalls of automatic IDC for COVID-19 inpatients. Important considerations include the quality of care provided, allocation and optimization of resources, and clinician satisfaction. Finally, we describe how automatic IDC changed throughout the COVID-19 pandemic at a single academic medical center.

scholarly journals An Academic Medical Center’s Learners’ Perceptions of Health Disparities

PRiMER ◽  
2018 ◽  
Vol 2 ◽  
Author(s):  
Joyce E. Balls-Berry ◽  
Eddie Greene ◽  
Jennifer McCormick ◽  
Onelis Quirindongo-Cedeno ◽  
Karen Weavers ◽  
...  
Keyword(s):  
Health Disparities ◽  
Health Care Providers ◽  
Medical Center ◽  
Academic Medical Center ◽  
Care Providers ◽  
Unequal Treatment ◽  
Medical Centers ◽  
Academic Medical ◽  
Significant Difference ◽  
Patient Groups

Introduction: Lack of health equity ultimately leads to unequal treatment of diverse patients and contributes to the growing disparities seen in national health. Academic medical centers should consider providing health care providers and biomedical researchers training on how to identify and address health disparities. Methods: The authors led an introductory health disparities course for graduate students and research and clinical fellows at an academic medical center in the Midwest. We compared pre/postcourse assessments to determine changes in learners’ perceptions and knowledge of health disparities using an unpaired analysis to permit inclusion of responses provided only at baseline. Results: Sixty-two learners completed preassessment, with 56 completing the postassessment (90%). In the postcourse assessment, learners reported an increase in knowledge of disparities and had changes in their perceptions of health disparities linked to treatment of different patient groups based on demographic characteristics. There was a statistically significant difference in learners’ perceptions of how patients are treated based on gender identity (P=0.02) and sexual orientation (P=0.04). Conclusions: The results detail how an academic medical center can provide training on health disparities for diverse learners. This study underscores the influence of health disparities from the perspective of learners who conduct biomedical research and patient care. This course serves a model for introductory-level health disparities courses.

Good IT Requires Good Communication

2013 ◽  
pp. 122-125
Author(s):  
Charles H Andrus ◽  
Mark Gaynor
Keyword(s):  
Medical School ◽  
Medical Center ◽  
Academic Support ◽  
Academic Medical Center ◽  
Support Staff ◽  
Good Communication ◽  
Medical Centers ◽  
Academic Medical ◽  
Organizational Differences

Electronic Medical Records (EMR) in academic medical centers often have additional complexity to them due to structural and organizational differences. Often the hospital operates independent of the medical school such as the physicians often work for the medical school, while the nurses and other ancillary departments work for the hospital. Such differences require special consideration when making changes to an EMR. The case study concerns an academic medical center where there are two ways to access the EMR. One methodology is to use a clinical computer on clinical floors within the hospital. A second methodology is the use of Citrix servers to access the EMR. Due to organizational differences, the EMR users access the system via two separate sets of Citrix servers. The hospital’s support staff controls one set of Citrix servers and the academic support staff controls the other set. Physicians and mid-level providers utilize the academic Citrix servers, but nursing and other ancillary departments use the hospital’s Citrix servers. With the servers controlled by separate teams, careful coordination is needed to ensure uniformity across the servers for a consistent user experience.

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