Curricular Development and Implementation of a Longitudinal Integrative Medicine Education Experience for Trainees and Health-Care Professionals at an Academic Medical Center

A growing number of patients and consumers are seeking integrative medicine (IM) approaches as a result of increasing complex medical needs and a greater emphasis on prevention and health promotion. Health-care professionals need to have knowledge of the evidence-based IM resources that are safe and available to patients. Medical institutions have acknowledged the need for education and training in various IM modalities and whole-health approaches in medical curricula. There is a strong need to develop and incorporate well-structured IM curricula across all levels of learning and practice within medicine. This article provides an example of the development, implementation, impact, and assessment of IM education curricula across all learner levels at a large academic medical center.

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Self-Perceived End-of-Life Care Competencies of Health-Care Providers at a Large Academic Medical Center

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909118779917 ◽

2018 ◽

Vol 35 (11) ◽

pp. 1409-1416 ◽

Cited By ~ 11

Author(s):

Marcos Montagnini ◽

Heather M. Smith ◽

Deborah M. Price ◽

Bidisha Ghosh ◽

Linda Strodtman

Keyword(s):

Health Care ◽

End Of Life ◽

Health Care Providers ◽

Health Care Professionals ◽

Medical Center ◽

Academic Medical Center ◽

Hospitalized Patients ◽

Care Providers ◽

Academic Medical ◽

Eol Care

Background: In the United States, most deaths occur in hospitals, with approximately 25% of hospitalized patients having palliative care needs. Therefore, the provision of good end-of-life (EOL) care to these patients is a priority. However, research assessing staff preparedness for the provision of EOL care to hospitalized patients is lacking. Objective: To assess health-care professionals’ self-perceived competencies regarding the provision of EOL care in hospitalized patients. Methods: Descriptive study of self-perceived EOL care competencies among health-care professionals. The study instrument (End-of-Life Questionnaire) contains 28 questions assessing knowledge, attitudes, and behaviors related to the provision of EOL care. Health-care professionals (nursing, medicine, social work, psychology, physical, occupational and respiratory therapist, and spiritual care) at a large academic medical center participated in the study. Means were calculated for each item, and comparisons of mean scores were conducted via t tests. Analysis of variance was used to identify differences among groups. Results: A total of 1197 questionnaires was completed. The greatest self-perceived competency was in providing emotional support for patients/families, and the least self-perceived competency was in providing continuity of care. When compared to nurses, physicians had higher scores on EOL care attitudes, behaviors, and communication. Physicians and nurses had higher scores on most subscales than other health-care providers. Conclusions: Differences in self-perceived EOL care competencies were identified among disciplines, particularly between physicians and nurses. The results provide evidence for assessing health-care providers to identify their specific training needs before implementing educational programs on EOL care.

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Rapid prototyping and clinical testing of a reusable face shield for health care workers responding to the COVID-19 pandemic

10.1101/2020.04.11.20061960 ◽

2020 ◽

Author(s):

Arash Mostaghimi ◽

M.-J. Antonini ◽

Deborah Plana ◽

Philip D. Anderson ◽

Brandon Beller ◽

...

Keyword(s):

Health Care ◽

Health Care Professionals ◽

Medical Center ◽

Academic Medical Center ◽

Clinical Settings ◽

Hospital Administrators ◽

Incident Command ◽

Academic Medical ◽

Survey Results ◽

Materials Used

AbstractDue to supply chain disruption, the COVID-19 pandemic has caused severe shortages in personal protective equipment (PPE) for health care professionals. Local fabrication based on 3D printing is one way to address this challenge, particularly in the case of simple products such as protective face shields. As a consequence, many public domain designs for face shields have become available. No clear path exists, however, for introducing a locally fabricated and unapproved product into a clinical setting. In a US health care setting, face shields are regulated by the Food and Drug Administration (FDA); similar policies exist in other countries. We describe a research protocol under which rapid iteration on an existing design, coupled with clinical feedback and real-world testing in an emergency department, allowed a face shield to be implemented by the members of the incident command team at a major academic medical center. We describe our design and testing process and provide an overview of regulatory considerations associated with fabrication and testing of face shields and related products. All designs, materials used, testing protocols, and survey results are reported in full to facilitate the execution of similar face shield efforts in other clinical settings. Our work serves as a case study for development of a robust local response to pandemics and other health care emergencies, with implications for healthcare professionals, hospital administrators, regulatory agencies and concerned citizens.

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Health Care Expenditures for University and Academic Medical Center Employees Enrolled in a Pilot Workplace Health Partner Intervention

Journal of Occupational and Environmental Medicine ◽

10.1097/jom.0000000000000488 ◽

2015 ◽

Vol 57 (8) ◽

pp. 897-903 ◽

Cited By ~ 1

Author(s):

Kenton J. Johnston ◽

Jason M. Hockenberry ◽

Kimberly J. Rask ◽

Lynn Cunningham ◽

Kenneth L. Brigham ◽

...

Keyword(s):

Health Care ◽

Medical Center ◽

Academic Medical Center ◽

Health Care Expenditures ◽

Workplace Health ◽

Academic Medical

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The Experience of Providing Physical Therapy in a Changing Health Care Environment

Physical Therapy ◽

10.1093/ptj/82.7.648 ◽

2002 ◽

Vol 82 (7) ◽

pp. 648-657 ◽

Cited By ~ 21

Author(s):

Rosemary Blau ◽

Sarah Bolus ◽

Terrence Carolan ◽

Daniel Kramer ◽

Elizabeth Mahoney ◽

...

Keyword(s):

Health Care ◽

Work Environment ◽

Health Care Professionals ◽

Phenomenological Study ◽

Physical Therapists ◽

Medical Center ◽

Systemic Change ◽

Academic Medical Center ◽

Health Care Environment ◽

Care Environment

Abstract Background and Purpose. The changes in the health care environment during the last decade have had an impact on the roles and responsibilities of all health care professionals. The purpose of this phenomenological study was to describe the experience of staff physical therapists during a time of systemic change within a large urban academic medical center. Subjects and Methods. Participants were 5 physical therapists working in various clinical settings within the medical center. The participants were interviewed and asked the question “Over the past 4 years, there have been major changes in your work environment. What has it been like for you working as a clinician during this time of change?” Interviews were recorded, transcribed, and analyzed to find thematic patterns of responses. Results. Four common themes emerged in which participants described experiencing loss of control, stress, discontent, and disheartenment. A fifth theme showed that despite these negative feelings, participants were able to “find the silver lining” in their daily work lives (ie, they were able to find positive aspects of their professional lives despite the perceived unpleasant changes with which they had to cope). Discussion and Conclusion. This study provides insight into the experiences of a group of staff physical therapists during a time of systemic change in their work environment. Although the themes reflect largely unsettling and negative experiences, there seems to be an underlying ability to find affirmative aspects of work.

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Implementation of an Interdisciplinary, Team-Based Complex Care Support Health Care Model at an Academic Medical Center: Impact on Health Care Utilization and Quality of Life

PLoS ONE ◽

10.1371/journal.pone.0148096 ◽

2016 ◽

Vol 11 (2) ◽

pp. e0148096 ◽

Cited By ~ 29

Author(s):

Christine Ritchie ◽

Robin Andersen ◽

Jessica Eng ◽

Sarah K. Garrigues ◽

Gina Intinarelli ◽

...

Keyword(s):

Health Care ◽

Medical Center ◽

Academic Medical Center ◽

Interdisciplinary Team ◽

Care Utilization ◽

Complex Care ◽

Care Model ◽

Academic Medical ◽

Care Support

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Intravenous Immune Globulin Stewardship Program at a Tertiary Academic Medical Center

Annals of Pharmacotherapy ◽

10.1177/1060028016673071 ◽

2016 ◽

Vol 51 (2) ◽

pp. 135-139 ◽

Cited By ~ 4

Author(s):

Megan A. Rocchio ◽

James W. Schurr ◽

Aaron P. Hussey ◽

Paul M. Szumita

Keyword(s):

Immune Globulin ◽

Medical Center ◽

Academic Medical Center ◽

Intravenous Immune Globulin ◽

Solid Organ ◽

Organ Rejection ◽

Guideline Compliance ◽

Stewardship Program ◽

Academic Medical ◽

Number Of Patients

Background: In October 2010, a pharmacist-driven stewardship program was implemented at the Brigham and Women’s Hospital to ensure continued adherence to the prescribing guideline, focusing on indications for intravenous immune globulin (IVIG) use and dosing per ideal body weight. Objective: The primary objective was to describe an IVIG stewardship program at a tertiary academic medical center. Methods: This was a prospective, observational study from January 2013 through December 2014. All patients ordered to receive IVIG during the defined study period were included. The intervention assessed describes a pharmacist-driven IVIG stewardship program for medication approval. The primary end point was guideline compliance based on indication, dose, dosing weight, and frequency. Secondary end points included the number of patients receiving IVIG, indications, orders discontinued as a result of guideline nonadherence, and total amount dispensed. Results: A total of 418 patients were identified during the study time frame. The top indications were: hypogammaglobulinemia in bone marrow transplantation and hematological malignancy (50.7%), acute solid organ rejection (11.8%), and immune thrombocytopenia with bleeding (10.1%). In all, 12 patients (2.9%) received IVIG for an indication nonadherent with the IVIG prescribing guideline; 9 patients (2.2%) and 2 patients (0.5%), respectively, received a different dose or frequency per the prescribed indication; and 12 orders (2.9%) for indications nonadherent to the guideline were discontinued. A total of 26 033 g of IVIG were dispensed during the study period. Conclusions: An IVIG stewardship program, including an institution-specific prescribing guideline and a pharmacist-driven stewardship program, may ensure guideline compliance for appropriateness of indication and dose at an academic medical center.

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Returns to Operating Room After Neurosurgical Procedures in a Tertiary Care Academic Medical Center: Implications for Health Care Policy and Quality Improvement

Neurosurgery ◽

10.1093/neuros/nyy429 ◽

2018 ◽

Vol 84 (6) ◽

pp. E392-E401

Author(s):

Panagiotis Kerezoudis ◽

Amy E Glasgow ◽

Mohammed Ali Alvi ◽

Robert J Spinner ◽

Fredric B Meyer ◽

...

Keyword(s):

Health Care ◽

Quality Improvement ◽

Operating Room ◽

Health Care Policy ◽

Medical Center ◽

Academic Medical Center ◽

Tertiary Care ◽

Neurosurgical Procedures ◽

Care Policy ◽

Academic Medical

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Supporting health care workers during the COVID-19 pandemic: Mental health support initiatives and lessons learned from an academic medical center.

Psychological Trauma Theory Research Practice and Policy ◽

10.1037/tra0000893 ◽

2020 ◽

Vol 12 (S1) ◽

pp. S168-S170 ◽

Cited By ~ 2

Author(s):

Adam Gonzalez ◽

Cynthia Cervoni ◽

Megan Lochner ◽

Jessica Marangio ◽

Colleen Stanley ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Health Care Workers ◽

Medical Center ◽

Academic Medical Center ◽

Lessons Learned ◽

Academic Medical ◽

Care Workers ◽

Mental Health Support ◽

Health Support

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Evaluation of inpatient cancer pain management at an academic medical center.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.34_suppl.128 ◽

2012 ◽

Vol 30 (34_suppl) ◽

pp. 128-128

Author(s):

Michael Mearis ◽

Joseph Shega ◽

Randall Knoebel

Keyword(s):

Pain Management ◽

Cancer Pain ◽

Medical Center ◽

Academic Medical Center ◽

Cancer Pain Management ◽

Nccn Guidelines ◽

Academic Medical ◽

Number Of Patients ◽

Increased Risk ◽

Cancer Network

128 Background: The National Comprehensive Cancer Network (NCCN) guidelines on cancer pain management were developed to direct pain assessment and management. The purpose of this study was to assess whether adherence to guidelines was associated with improved outcomes. Methods: One-hundred and nine patients admitted to the inpatient hematology oncology service that received at least one dose of morphine, oxycodone, or hydromorphone were evaluated and allocated into groups based on adherence to the NCCN guidelines. Safety and achievement of analgesia (pain score ≤ 4) at 24-hours after opioid initiation were compared between the two groups. A multivariate analysis was performed to identify predictors of opioid regimens non-adherent to guidelines. Results: Sixty-four percent of patients were initiated on regimens adherent to the NCCN guidelines. 63% of patients initiated on regimens adherent to NCCN guidelines reached the endpoint of analgesia at 24 hours compared to 41% of those who were not (p = 0.028). Adverse events were infrequent (p > 0.5). Opioid tolerance was the variable most predictive of being initiated on regimens non-adherent to guideline recommendations (OR 3.1, 95% confidence interval 1.24-7.82). Conclusions: A significant number of patients presenting with cancer pain are initiated on regimens non-adherent to NCCN guidelines, leading to reduced attainment of adequate analgesia. Opioid tolerant patients are at an increased risk of inadequate analgesia, and should be identified and initiated on proper pain regimens taking home opioid usage into consideration.

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