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Sample records for academic advising center

  1. Academic Advising and Potential Litigation.

    Science.gov (United States)

    Schubert, Arline F.; Schubert, George W.

    1983-01-01

    Issues in tort and contract law and recent experiences in litigation that influence the academic adviser's responsibility are outlined, including negligence, nondisclosure and misrepresentation, defamation, written and oral contracts, and the adviser as an agent of the institution. Specific areas of adviser vulnerability are noted. (MSE)

  2. Constructivism, Dewey, and Academic Advising

    Science.gov (United States)

    Xyst, Kurt

    2016-01-01

    Many published scholars argue for constructivism as a basis for academic advising theory. However, few have discussed the commensurate ontological assumptions of constructivist thinking. Potential problems with the metaphysical view of the student in contemporary academic advising may be attributable to constructivism. John Dewey's critique of…

  3. Academic Advising and Gender Communication

    Science.gov (United States)

    Nemeth, Sean

    2017-01-01

    Purpose: The purpose of this correlational study was to identify whether there are differences in student satisfaction scores in academic advisement gender pairings in an undergraduate university setting. Methodology: This study was a descriptive correlational research study utilizing archival survey data. The collected data consisted of numeric…

  4. Strengthening Academic Advising by Developing a Normative Theory

    Science.gov (United States)

    Himes, Hilleary A.

    2014-01-01

    Discussions on academic advising theory have centered on application from many disciplines; however, academic advising is unlike any other field, and therefore, theories from other disciplines do not correspond with all of the unique goals of advising: assisting students in understanding the meaning of higher education, supporting students in…

  5. Could Fixing Academic Advising Fix Higher Education?

    Science.gov (United States)

    Hunter, Mary Stuart; White, Eric R.

    2004-01-01

    Academic advising, well developed and appropriately accessed, is perhaps the only structured campus endeavor that can guarantee students sustained interaction with a caring and concerned adult who can help them shape such an experience. Under the guidance of an academic adviser, students can clarify the purposes of their college attendance,…

  6. The Effect of Academic Advising on Academic Performance of ...

    African Journals Online (AJOL)

    Although academic advising in Kenyan universities exists, no research has been done to find out how it impacts on students' educational and career goals. This research aimed at establishing the effect of academic advising on academic performance and the influence of year of study and gender on students' tendency to ...

  7. Academic Advising as Perceived by Business Students

    Science.gov (United States)

    Hsu, Margaretha; Bailey, April E.

    2007-01-01

    Business students' perceptions concerning several academic advising resources are presented. Using a Likert scale, students evaluated resources such as their academic advisor, course instructors, staffs, friends, and parents as well as the university catalog and the Foundations of Business Administration (FBA) course. Selected demographic…

  8. Advising with Understanding: Considering Hermeneutic Theory in Academic Advising

    Science.gov (United States)

    Champlin-Scharff, Sarah

    2010-01-01

    One might say that good advising requires understanding of those being advised. Yet, the way to achieve an accurate understanding of each advisee is unclear. An introduction to the field of hermeneutics, including an outline of Martin Heidegger's notion of human being and existential understanding, is presented to offer advisors a new opportunity…

  9. History of academic advising development in american higher education

    Directory of Open Access Journals (Sweden)

    Abdykhalykova J.E.

    2016-09-01

    Full Text Available the article analyzes the history of the development and establishment of academic advising in the context of US higher education, defines the functions and features of the academic advising in the educational space.

  10. Assessing Student Learning in Academic Advising Using Social Cognitive Theory

    Science.gov (United States)

    Erlich, Richard J.; Russ-Eft, Darlene F.

    2013-01-01

    We investigated whether the social cognitive theory constructs of self-efficacy and self-regulated learning apply to academic advising for measuring student learning outcomes. Community college students (N = 120) participated in an individual academic-advising session. We assessed students' post-intervention self-efficacy in academic planning and…

  11. An Applied Introduction to Qualitative Research Methods in Academic Advising

    Science.gov (United States)

    Hurt, Robert L.; McLaughlin, Eric J.

    2012-01-01

    Academic advising research aids faculty members and advisors in detecting, explaining, and addressing macro-level trends beyond their local campus. It also helps legitimize the professional nature of academic advising, moving it beyond mere prescriptive models that focus on rules and course selection. Due to the erroneous belief that skills in…

  12. Strategies to Enhance Interpersonal Relations in Academic Advising

    Science.gov (United States)

    Hughey, Judy K.

    2011-01-01

    The relationship between interpersonal skills is positively correlated with effective academic advising. Professional academic advisors feel significant pressure to meet a wide array of student needs, increase retention rates, help students in their efforts of academic achievement and career exploration, and support institutions to excel in…

  13. CRIS: A Rule-Based Approach for Customized Academic Advising

    Directory of Open Access Journals (Sweden)

    Chung-Wei Yeh

    2015-04-01

    Full Text Available This study presents a customized academic e-advising service by using rule-based technology to provide each individual learner for recommending courses for college students in Taiwan. Since academic advising for taking courses is mostly by advisors to assist students to achieve educational, career, and personal goals, which made it important in the higher education system. To enhance the counseling effectiveness for advisors to assist students in fitting their professional field and improve their learning experience, we proposed an application system, called CRIS (course recommendation intelligent system. The CRIS consists of six functions: academic profile review, academic interest analysis, career and curriculum matchmaking, recommend courses analysis, department recommend analysis and record assessment. This work provides the solution in three layers, data layer, processing layer and solution layer, via four steps: (1 database design and data transfer, (2 student profile analysis, (3 customized academic advising generation and (4 solution analysis. A comparison of academic score and the combination of individual students' interest in learning and academic achievement satisfaction survey are conducted to test the effectiveness. The experiment result shows that the participating college students considered that the CRIS helpful in their adjustment to the university and it increased their success at the university.

  14. Academic Advising at UNO. Report of the 1991 Student Survey.

    Science.gov (United States)

    Crawford, A. E.

    1991-01-01

    A study was done of student perception of academic advising at the University of Nebraska, Omaha (UNO). The study surveyed 638 students who participated in the early registration process for the Fall 1991 semester. Of those students, 269 were men and 369 were women and 8.3 percent were members of a minority group. The study instrument was the…

  15. Academic and Career Development: Rethinking Advising for Asian American Students

    Science.gov (United States)

    Kodama, Corinne M.; Huynh, Jill

    2017-01-01

    Academic and career development for Asian American students is complicated by cultural influences, interdependence with family, and racial stereotyping. This chapter highlights research, theory, and practice to help educators rethink traditional advising approaches to more appropriately work with Asian American students as they navigate their…

  16. Academic Advising: New Insights for Teaching and Learning in the First Year. The First-Year Experience Monograph Series No. 46. NACADA Monograph Series No. 14

    Science.gov (United States)

    Hunter, Mary Stuart, Ed.; McCalla-Wriggins, Betsy, Ed.; White, Eric R., Ed.

    2007-01-01

    Grounded in the philosophy that academic advising is a robust form of one-on-one teaching, this monograph places advising in a new light, one that brings it to the center of the institutional mission and activity. This monograph challenges all readers to embrace the tremendous potential that academic advising has for educating today's college…

  17. The Effect of Academic Advising on Academic Performance of ...

    African Journals Online (AJOL)

    User

    score was used as an index of their academic performance. The respondents were also asked to provide other general information that assisted in the interpretation of the data. .... Higher Education, 38, 727-742. Cobb, N. J. (2001). The child. California: Mayfield Publishing Company. Vol. 5 (5), Serial No. 22, October, 2011.

  18. The Utilization of a Computer Assisted Guidance System in Academic Advising

    Science.gov (United States)

    Pfautz, Charles Van Vleck

    2010-01-01

    Computer assisted guidance systems may adapt well to various models of academic advising, and they have the ability to address the challenge of meeting the diverse advising needs of community college students without sacrificing the integrity of academic advising (Fowkes & McWhirter, 2007). The purpose of this qualitative case study was to assess…

  19. Academic Advising as a Comprehensive Campus Process. Monograph Series, No. 2.

    Science.gov (United States)

    Glennen, Robert E., Ed.; Vowell, Faye N., Ed.

    The 22 papers of this monograph review academic advising from the perspective of three types of campus activities: administrative support services, academic advising services, and student support services. The papers include: (1) "Obtaining Presidential Support for Advising" (Robert E. Glennen); (2) "Faculty Affairs" (David H. Goldenberg and Steve…

  20. An Overlooked Population in Community College: International Students' (In)Validation Experiences With Academic Advising

    Science.gov (United States)

    Zhang, Yi

    2016-01-01

    Objective: Guided by validation theory, this study aims to better understand the role that academic advising plays in international community college students' adjustment. More specifically, this study investigated how academic advising validates or invalidates their academic and social experiences in a community college context. Method: This…

  1. Quality of Academic Advising at UNO: Results of Student and Faculty Surveys.

    Science.gov (United States)

    ESS Reports, 1988

    1988-01-01

    This report presents the results of a student/faculty survey on the academic advising process at the University of Nebraska at Omaha, and highlights issues in improving the advising process. The survey included 195 recent graduates, 269 existing students, and 207 faculty and professional advisors. The study found that 70.8% of students were…

  2. First-Year Community College Students' Perceptions of and Attitudes toward Intrusive Academic Advising

    Science.gov (United States)

    Donaldson, Paul; McKinney, Lyle; Lee, Mimi; Pino, Diana

    2016-01-01

    For this study, we analyzed the relationship between intrusive academic advising and community college student success. Utilizing a qualitative, single-case study design, we conducted interviews with 12 students who participated in an intrusive advising program at a large, urban community college in Texas. Analysis of the interview data revealed…

  3. The Role of Academic Advising in the Experiences of Undocumented Latina College Students

    Science.gov (United States)

    Franchi-Alfaro, Jessica

    2017-01-01

    This study explored the role of academic advising in the experiences of undocumented Latina college students. The study is predicated on Astin's (1984) theory of student involvement, which discusses academic and social involvement as an important antecedent in the psychosocial and academic development of college students, and its influence on…

  4. Technology and Academic Advising: Student Usage and Preferences

    Science.gov (United States)

    Gaines, Trudi

    2014-01-01

    When both time and financial resources are limited, administrators selectively decide upon proper utilization of current technology and determine whether monies should be expended on new, flashy, and attractive technology realizing that it may not contribute to the advising experience. By obtaining feedback from the students whom the academic…

  5. A Best-Practice Model for Academic Advising of University Biology Majors

    Science.gov (United States)

    Heekin, Jonathan Ralph Calvin

    Biology faculty at an East Coast university believed their undergraduate students were not being well served by the existing academic advising program. The purpose of this mixed methods project study was to evaluate the effectiveness of the academic advising model in a biology department. Guided by system-based organizational theory, a learning organization model, and holistic theory emphasizing an individual's journey of academic and personal growth, an online survey, student focus groups, and faculty interviews were used to collect data, which developed recommendations for improving undergraduate academic advising in the biology department. Using Survey Monkey, 35 surveys were returned. Frequency tables, ANOVAs, and t tests produced the results of the survey. The results of the ANOVAs and t tests indicated statically significant differences (p focus groups. The results from the interviews and focus groups indicated that the role of mentor should remain at the faculty level, guiding students in what they can do with their degrees and discussing options that students may not have considered. The proposed model for academic advising may improve student success rates for undergraduates enrolled in the biology department at the current institution, as well as in science-oriented programs at other institutions, by providing better guidance to those who serve them in academic advising.

  6. Applying Social Cognitive Theory to Academic Advising to Assess Student Learning Outcomes

    Science.gov (United States)

    Erlich, Richard J.; Russ-Eft, Darlene

    2011-01-01

    Review of social cognitive theory constructs of self-efficacy and self-regulated learning is applied to academic advising for the purposes of assessing student learning. A brief overview of the history of student learning outcomes in higher education is followed by an explanation of self-efficacy and self-regulated learning constructs and how they…

  7. The advising alliance for international and domestic graduate students: Measurement invariance and implications for academic stress.

    Science.gov (United States)

    Rice, Kenneth G; Suh, Hanna; Yang, Xiaohui; Choe, Elise; Davis, Don E

    2016-04-01

    We expanded the focus of a prior study of international graduate student advising relationships (Rice et al., 2009) to examine advising experiences of both international and domestic students. International (n = 434) and domestic (n = 387) students completed the Advisory Working Alliance Inventory (AWAI-S; Schlosser & Gelso, 2001) and measures of advising experiences, perceived academic stress, and desire to change advisor. Measurement invariance analyses suggested that a 23-item AWAI-S showed support for scalar invariance. A bifactor structure showed superior fit to the 3-factor model or a second-order factor model for the AWAI-S. International and domestic graduate students did not differ in ratings of general alliance, academic stress, or desire to change advisors. General alliance was strongly related to less academic stress and less desire to change advisors. International students who felt disrespected by their advisors were more likely to be academically stressed than domestic students. Structured mentoring experiences were associated with lower stress and less desire to change, and this effect was similar in both international and domestic students. Overall, results suggested that the current level of measurement, and possibly theory development, regarding the advisory alliance is good at identifying generic satisfaction but weaker at differentiating components of the alliance. (c) 2016 APA, all rights reserved).

  8. Using Systems Theory to Understand the Identity of Academic Advising: A Case Study

    Science.gov (United States)

    Bridgen, Sean

    2017-01-01

    For decades, advising practitioners and scholars have worked toward developing an identity for advising as a unique field of scholarly inquiry and practice. To date, the identity crisis in advising remains. This study presents an examination and description of the function, purpose, and identity of a university advising system through comparisons…

  9. Fully Integrating Academic Advising with Career Coaching to Increase Student Retention, Graduation Rates and Future Job Satisfaction: An Industry Approach

    Science.gov (United States)

    Tudor, Thomas R.

    2018-01-01

    Higher education institutions in the United States are under increasing pressure to retain and graduate more students. Traditionally, the academic advisor helps students to meet degree graduation requirements and may also do some minor career advising. A new approach is proposed, in which career coaching with industry help becomes just as…

  10. Combining Academic Advising with a Freshman Orientation Course in an Integrated Baccalaureate-Medical Degree Program: Evaluation of the System.

    Science.gov (United States)

    McBeth, Dani L.; Richardson, Susan M.; Cregler, Louis L.; Meyer, Jodie

    2000-01-01

    Evaluated the effects of a freshman seminar incorporating academic advising in an integrated baccalaureate-medical degree program. Found that participating students were more satisfied, and that their biology grades and first-year grade point averages (GPAs) were higher. (EV)

  11. Reinventing the academic health center.

    Science.gov (United States)

    Kirch, Darrell G; Grigsby, R Kevin; Zolko, Wayne W; Moskowitz, Jay; Hefner, David S; Souba, Wiley W; Carubia, Josephine M; Baron, Steven D

    2005-11-01

    Academic health centers have faced well-documented internal and external challenges over the last decade, putting pressure on organizational leaders to develop new strategies to improve performance while simultaneously addressing employee morale, patient satisfaction, educational outcomes, and research growth. In the aftermath of a failed merger, new leaders of The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center encountered a climate of readiness for a transformational change. In a case study of this process, nine critical success factors are described that contributed to significant performance improvement: performing a campus-wide cultural assessment and acting decisively on the results; making values explicit and active in everyday decisions; aligning corporate structure and governance to unify the academic enterprise and health system; aligning the next tier of administrative structure and function; fostering collaboration and accountability-the creation of unified campus teams; articulating a succinct, highly focused, and compelling vision and strategic plan; using the tools of mission-based management to realign resources; focusing leadership recruitment on organizational fit; and "growing your own" through broad-based leadership development. Outcomes assessment data for academic, research, and clinical performance showed significant gains between 2000 and 2004. Organizational transformation as a result of the nine factors is possible in other institutional settings and can facilitate a focus on crucial quality initiatives.

  12. Malpractice Issues in the Academic Medical Center.

    Science.gov (United States)

    Rich, Ben A.

    1986-01-01

    A discussion of legal issues in the academic medical center focuses on standards of care applicable to practitioners, special problems of patient care delivery, and the special status of public academic medical centers. Informed consent to care, relations with affiliated institutions, and private/non-private patient status are also considered.…

  13. Advising International Students in Engineering Programs: Academic Advisors' Perceptions of Intercultural Communication Competence

    Science.gov (United States)

    Zhang, Yi Leaf; Dinh, Trang V.

    2017-01-01

    In recent years, an increasing number of international students have enrolled in engineering programs in U.S. colleges and universities. These students often encounter challenges, and academic advisors play a significant role in international students' academic success. Using a model of intercultural communication competence, we explored attitudes…

  14. Assessing Academic Advising Outcomes Using Social Cognitive Theory: A Validity and Reliability Study

    Science.gov (United States)

    Erlich, Richard J.; Russ-Eft, Darlene F.

    2012-01-01

    The validity and reliability of three instruments, the "Counselor Rubric for Gauging Student Understanding of Academic Planning," micro-analytic questions, and the "Student Survey for Understanding Academic Planning," all based on social cognitive theory, were tested as means to assess self-efficacy and self-regulated learning in college academic…

  15. Academic Specialization and Contemporary University Humanities Centers

    Science.gov (United States)

    Brownley, Martine W.

    2012-01-01

    Given the academic specialization endemic today in humanities disciplines, some of the most important work of humanities centers has become promoting education about the humanities in general. After charting the rise of humanities centers in the US, three characteristics of centers that enable their advancement of larger concerns of the humanities…

  16. Academic advising and student support: Help-seeking behaviors among Saudi dental undergraduate students

    Directory of Open Access Journals (Sweden)

    Asim Al-Ansari

    2015-04-01

    Conclusions: Few students were satisfied with the academic support system. We need to train advisors to help them develop their skills and knowledge and to enable them to provide the support needed by the students.

  17. The Attribution Theory of Learning and Advising Students on Academic Probation

    Science.gov (United States)

    Demetriou, Cynthia

    2011-01-01

    Academic advisors need to be knowledgeable of the ways students learn. To aid advisors in their exploration of learning theories, I provide an overview of the attribution theory of learning, including recent applications of the theory to research in college student learning. An understanding of this theory may help advisors understand student…

  18. The Utility of Liberal Education: Concepts and Arguments for Use in Academic Advising

    Science.gov (United States)

    Rust, Matthew M.

    2011-01-01

    Liberal education remains a mystery to many of the students enrolled in colleges and universities. Academic advisors, standing at the crossroads of the various curricular and cocurricular experiences that make up a student's liberal education, should be prepared to help students recognize the coherence of their education. This article provides…

  19. Academic Medical Centers as digital health catalysts.

    Science.gov (United States)

    DePasse, Jacqueline W; Chen, Connie E; Sawyer, Aenor; Jethwani, Kamal; Sim, Ida

    2014-09-01

    Emerging digital technologies offer enormous potential to improve quality, reduce cost, and increase patient-centeredness in healthcare. Academic Medical Centers (AMCs) play a key role in advancing medical care through cutting-edge medical research, yet traditional models for invention, validation and commercialization at AMCs have been designed around biomedical initiatives, and are less well suited for new digital health technologies. Recently, two large bi-coastal Academic Medical Centers, the University of California, San Francisco (UCSF) through the Center for Digital Health Innovation (CDHI) and Partners Healthcare through the Center for Connected Health (CCH) have launched centers focused on digital health innovation. These centers show great promise but are also subject to significant financial, organizational, and visionary challenges. We explore these AMC initiatives, which share the following characteristics: a focus on academic research methodology; integration of digital technology in educational programming; evolving models to support "clinician innovators"; strategic academic-industry collaboration and emergence of novel revenue models. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Academic medical center libraries on the Web.

    Science.gov (United States)

    Tannery, N H; Wessel, C B

    1998-10-01

    Academic medical center libraries are moving towards publishing electronically, utilizing networked technologies, and creating digital libraries. The catalyst for this movement has been the Web. An analysis of academic medical center library Web pages was undertaken to assess the information created and communicated in early 1997. A summary of present uses and suggestions for future applications is provided. A method for evaluating and describing the content of library Web sites was designed. The evaluation included categorizing basic information such as description and access to library services, access to commercial databases, and use of interactive forms. The main goal of the evaluation was to assess original resources produced by these libraries.

  1. Academic Advising for Student Success: A System of Shared Responsibility. ASHE-ERIC Higher Education Report No. 3, 1991.

    Science.gov (United States)

    Frost, Susan H.

    This monograph examines student advising in the higher education setting by focusing on shared responsibility strategies that enhance student motivation and persistence in a diverse student population. In the first two sections, a new concept of advising called developmental advising is described in which the relationship between advisor and…

  2. Developing physician leaders in academic medical centers.

    Science.gov (United States)

    Bachrach, D J

    1997-01-01

    While physicians have historically held positions of leadership in academic medical centers, there is an increasing trend that physicians will not only guide the clinical, curriculum and scientific direction of the institution, but its business direction as well. Physicians are assuming a greater role in business decision making and are found at the negotiating table with leaders from business, insurance and other integrated health care delivery systems. Physicians who lead "strategic business units" within the academic medical center are expected to acquire and demonstrate enhanced business acumen. There is an increasing demand for formal and informal training programs for physicians in academic medical centers in order to better prepare them for their evolving roles and responsibilities. These may include the pursuit of a second degree in business or health care management; intramurally conducted courses in leadership skill development, management, business and finance; or involvement in extramurally prepared and delivered training programs specifically geared toward physicians as conducted at major universities, often in their schools of business or public health. While part one of this series, which appeared in Volume 43, No. 6 of Medical Group Management Journal addressed, "The changing role of physician leaders at academic medical centers," part 2 will examine as a case study the faculty leadership development program at the University of Texas M.D. Anderson Cancer Center. These two articles were prepared by the author from his research into, and the presentation of a thesis entitled. "The importance of leadership training and development for physicians in academic medical centers in an increasingly complex health care environment," prepared for the Credentials Committee of the American College of Healthcare Executives in partial fulfillment of the requirements for Fellowship in this College.*

  3. Academic health centers in competitive markets.

    Science.gov (United States)

    Reuter, J; Gaskin, D

    1997-01-01

    Academic health center (AHC) hospitals and other major teaching hospitals have funded a portion of their academic missions through patient care revenues. Using all-payer state discharge data, this DataWatch presents information on how these institutions are being affected by market changes. Although AHCs are not as successful as other hospitals are in attracting managed care patients, competitive pressures had not eroded AHCs' financial status as of 1994. However, increasing enrollment in managed care and potential changes in both Medicare and Medicaid suggest that pressure on the financing of these institutions' social missions will continue to grow over time.

  4. Expanding the Advising Team.

    Science.gov (United States)

    Glennen, Robert E.; And Others

    1989-01-01

    The process and results of team building by Emporia State University's centralized advising center are examined from the perspectives of president, enrollment management, centralized advising, and faculty. The effort demonstrates that administrative, state, and team commitment can produce positive results in freshman retention, higher graduation…

  5. SurfScholar an advising service to attract international students to get entire academic degrees in Portugal’s most dynamic Surf-City: Lisbon.

    OpenAIRE

    Einstein, Simon Adrian

    2016-01-01

    The following text is a business plan for SurfScholar - an advising service to attract international students to get entire academic degrees in Portugal’s most dynamic Surf-City: Lisbon. SurfScholar is presented as a viable business concept with environmental, economic and socio-cultural sustainability as guiding principles. For a variety of reasons, Lisbon is becoming an increasingly popular destination for international student mobility. Additionally, Lisbon and its surroundi...

  6. Coordinated Management of Academic Health Centers.

    Science.gov (United States)

    Balser, Jeffrey R; Stead, William W

    2017-01-01

    Academic health centers (AHCs) are the nation's primary resource for healthcare discovery, innovation, and training. US healthcare revenue growth has declined sharply since 2009, and is forecast to remain well below historic levels for the foreseeable future. As the cost of education and research at nearly all AHCs is heavily subsidized through large transfers from clinical care margins, our institutions face a mounting crisis. Choices centering on how to increase the cost-effectiveness of the AHC enterprise require unprecedented levels of alignment to preserve an environment that nurtures creativity. Management processes require governance models that clarify decision rights while harnessing the talents and the intellectual capital of a large, diverse enterprise to nimbly address unfamiliar organizational challenges. This paper describes key leadership tactics aimed at propelling AHCs along this journey - one that requires from all leaders a commitment to resilience, optimism, and willingness to embrace change.

  7. Improving student-perceived benefit of academic advising within education of occupational and physical therapy in the United States: a quality improvement initiative

    Directory of Open Access Journals (Sweden)

    Lisa J. Barnes

    2017-03-01

    Full Text Available Academic advising is a key role for faculty in the educational process of health professionals; however, the best practice of effective academic advising for occupational and physical therapy students has not been identified in the current literature. The purpose of this quality improvement initiative was to assess and improve the faculty/student advisor/advisee process within occupational and physical therapy programs within a school of allied health professions in the United States in 2015. A quality improvement initiative utilizing quantitative and qualitative information was gathered via survey focused on the assessment and improvement of an advisor/advisee process. The overall initiative utilized an adaptive iterative design incorporating the plan-do-study-act model which included a three-step process over a one year time frame utilizing 2 cohorts, the first with 80 students and the second with 88 students. Baseline data were gathered prior to initiating the new process. A pilot was conducted and assessed during the first semester of the occupational and physical therapy programs. Final information was gathered after one full academic year with final comparisons made to baseline. Defining an effective advisory program with an established framework led to improved awareness and participation by students and faculty. Early initiation of the process combined with increased frequency of interaction led to improved student satisfaction. Based on student perceptions, programmatic policies were initiated to promote advisory meetings early and often to establish a positive relationship. The policies focus on academic advising as one of proactivity in which the advisor serves as a portal which the student may access leading to a more successful academic experience.

  8. Building Blocks for Academic Papers Graduate Writing Center Workshop [video

    OpenAIRE

    Naval Postgraduate School; Naval Postgraduate School (U.S.)

    2015-01-01

    Naval Postgraduate School, Graduate Writing Center Workshop, Building Blocks for Academic Papers. Presented by George Lober, MA, Senior Lecturer, Department of Defense Analysis, Naval Postgraduate School.

  9. Patient-centered measurement at an academic medical center.

    Science.gov (United States)

    Gooding, T D; Newcomb, L; Mertens, K

    1999-07-01

    Harborview Medical Center (Seattle, Wash) has collected patient data on operations since 1988 and has participated in the University HealthSystem Consortium's (UHC; Oak Brook, III) patient satisfaction measurement program since 1996. The patient feedback program is intended to provide data suitable for the quality improvement process and benchmark Harborview's performance against that of other academic medical centers (AMCs). The Picker Institute Adult Inpatient survey's seven dimensions of care are used to disseminate the patient data and focus the action plans. The areas with the largest problem scores and the highest correlation with overall satisfaction are identified, and then specific actions are devised to address those areas. For example, patient satisfaction data collected in May 1997 led the quality council to highlight information and education as an area for improvement for both inpatients and outpatients. Patients reported that they often got answers they could not understand. Also, they did not always get enough information at discharge to feel comfortable about going home. A Discharge/Transition Center CQI (continuous quality improvement) team was charged with developing a discharge/transition process that ensures continuity of care for patients as they move throughout the system. In addition, a hospitalwide Patient and Family Information team has been working on improving information delivery by developing both patient-friendly processes and useful educational materials. Harborview will continue to gather feedback through not only more targeted, specific surveys but also focus groups, which have been conducted around specific issues such as diabetes care, clinical pathways, pain management, and teen health.

  10. Assessing the Academic Medical Center as a Supportive Learning Community

    Science.gov (United States)

    Gannon, Sam C.

    2011-01-01

    Academic medical centers are well-known for their emphasis on teaching, research and public service; however, like most large, bureaucratic organizations, they oftentimes suffer from an inability to learn as an organization. The role of the research administrator in the academic medical center has grown over time as the profession itself has…

  11. The Impact of Intrusive Advising on Academic Self Efficacy Beliefs in First-Year Students in Higher Education

    Science.gov (United States)

    Miller, Lauren Kemner

    2010-01-01

    First-year retention rates have seen minimal gains as high numbers of first-year students are leaving college due to insufficient academic skills and inability to adjust to the academic and social life of college. Programs that provide strategies to improve the transition from high school to college and that help develop skills to facilitate…

  12. A Web-Based EFL Writing Environment as a Bridge between Academic Advisers and Junior Researchers: A Pilot Study

    Science.gov (United States)

    Reynolds, Barry Lee

    2013-01-01

    In the age of "publish or perish," publishing academic journal articles is a must, not only for professors but also for graduate students in Taiwan. Increasingly, Taiwanese research universities are requiring masters and PhD students to write theses and dissertations in English, with an added caveat for PhD students to publish two or…

  13. Psychology's Future in Medical Schools and Academic Health Care Centers.

    Science.gov (United States)

    Sheridan, Edward P.

    1999-01-01

    Discusses the history of psychology's development and growth in medical centers, its current status, and some goals for the future of psychology in medical schools and academic health care centers. Explores issues related to the education and training of psychologists. (SLD)

  14. Lessons learned: mobile device encryption in the academic medical center.

    Science.gov (United States)

    Kusche, Kristopher P

    2009-01-01

    The academic medical center is faced with the unique challenge of meeting the multi-faceted needs of both a modern healthcare organization and an academic institution, The need for security to protect patient information must be balanced by the academic freedoms expected in the college setting. The Albany Medical Center, consisting of the Albany Medical College and the Albany Medical Center Hospital, was challenged with implementing a solution that would preserve the availability, integrity and confidentiality of business, patient and research data stored on mobile devices. To solve this problem, Albany Medical Center implemented a mobile encryption suite across the enterprise. Such an implementation comes with complexities, from performance across multiple generations of computers and operating systems, to diversity of application use mode and end user adoption, all of which requires thoughtful policy and standards creation, understanding of regulations, and a willingness and ability to work through such diverse needs.

  15. Food for thought? Potential conflicts of interest in academic experts advising government and charities on dietary policies.

    Science.gov (United States)

    Newton, Alex; Lloyd-Williams, Ffion; Bromley, Helen; Capewell, Simon

    2016-08-05

    A conflict of interest (CoI) can occur between public duty and private interest, in which a public official's private-capacity interest could improperly influence the performance of their official duties and responsibilities. The most tangible and commonly considered CoI are financial. However, CoI can also arise due to other types of influence including interpersonal relationships, career progression, or ideology. CoI thus exist in academia, business, government and non-governmental organisations. However, public knowledge of CoI is currently limited due to a lack of information. The mechanisms of managing potential conflicts of interest also remain unclear due to a lack of guidelines. We therefore examined the independence of academic experts and how well potential CoI are identified and addressed in four government and non-governmental organisations in the UK responsible for the development of food policy. Policy analysis. We developed an analytical framework to explore CoI in high-level UK food policy advice, using four case studies. Two government policy-making bodies: Department of Health 'Obesity Review Group' (ORG), 'Scientific Advisory Committee on Nutrition' (SACN) and two charities: 'Action on Sugar' (AoS), & 'Heart of Mersey' (HoM). Information was obtained from publicly available sources and declarations. We developed a five point ordinal scale based upon the ideology of the Nolan Principles of Public Life. Group members were individually categorised on the ordinal ConScale from "0", (complete independence from the food and drink industry) to "4", (employed by the food and drink industry or a representative organisation). CoI involving various industries have long been evident in policy making, academia and clinical practice. Suggested approaches for managing CoI could be categorised as "deny", "describe", or "diminish". Declared CoI were common in the ORG and SACN. 4 out of 28 ORG members were direct industry employees. In SACN 11 out of 17 members

  16. Academic health centers and society: an ethical reflection.

    Science.gov (United States)

    Pellegrino, E D

    1999-08-01

    Academic health centers--which combine university, medical school, and hospital--exist to satisfy universal human needs and thus are by definition instruments of social purpose. Their core mission is threefold: to provide medical knowledge that can help relieve and prevent illness and suffering, to supply practitioners able to apply that knowledge wisely, and to serve as sites where optimal use of medical knowledge can be demonstrated and investigated. Maintaining a balance between core mission and responsiveness to social trends is a delicate exercise. Overly close accommodation to such trends can endanger the core mission, as has occurred in the United States with regard to managed care. Society and academic health centers have mutual obligations. Obligations of society include giving academic health centers financial and other support and allowing them sufficient freedom to pursue their mission; obligations of academic medical centers include accepting greater scrutiny by society and providing social criticism on matters relating to health. A task for the future is to discern how academic health centers can be responsive to social needs without being totally subservient to societal desires.

  17. Development of a longitudinal integrated clerkship at an academic medical center.

    Science.gov (United States)

    Poncelet, Ann; Bokser, Seth; Calton, Brook; Hauer, Karen E; Kirsch, Heidi; Jones, Tracey; Lai, Cindy J; Mazotti, Lindsay; Shore, William; Teherani, Arianne; Tong, Lowell; Wamsley, Maria; Robertson, Patricia

    2011-04-04

    In 2005, medical educators at the University of California, San Francisco (UCSF), began developing the Parnassus Integrated Student Clinical Experiences (PISCES) program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants' career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center.

  18. Development of a longitudinal integrated clerkship at an academic medical center

    Directory of Open Access Journals (Sweden)

    Ann Poncelet

    2011-04-01

    Full Text Available In 2005, medical educators at the University of California, San Francisco (UCSF, began developing the Parnassus Integrated Student Clinical Experiences (PISCES program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants’ career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center.

  19. Food for thought? Potential conflicts of interest in academic experts advising government and charities on dietary policies

    Directory of Open Access Journals (Sweden)

    Alex Newton

    2016-08-01

    Full Text Available Abstract Background A conflict of interest (CoI can occur between public duty and private interest, in which a public official’s private-capacity interest could improperly influence the performance of their official duties and responsibilities. The most tangible and commonly considered CoI are financial. However, CoI can also arise due to other types of influence including interpersonal relationships, career progression, or ideology. CoI thus exist in academia, business, government and non-governmental organisations. However, public knowledge of CoI is currently limited due to a lack of information. The mechanisms of managing potential conflicts of interest also remain unclear due to a lack of guidelines. We therefore examined the independence of academic experts and how well potential CoI are identified and addressed in four government and non-governmental organisations in the UK responsible for the development of food policy. Methods Policy analysis. We developed an analytical framework to explore CoI in high-level UK food policy advice, using four case studies. Two government policy-making bodies: Department of Health ‘Obesity Review Group’ (ORG, ‘Scientific Advisory Committee on Nutrition’ (SACN and two charities: ‘Action on Sugar’ (AoS, & ‘Heart of Mersey’ (HoM. Information was obtained from publicly available sources and declarations. We developed a five point ordinal scale based upon the ideology of the Nolan Principles of Public Life. Group members were individually categorised on the ordinal ConScale from “0”, (complete independence from the food and drink industry to “4”, (employed by the food and drink industry or a representative organisation. Results CoI involving various industries have long been evident in policy making, academia and clinical practice. Suggested approaches for managing CoI could be categorised as “deny”, “describe”, or “diminish”. Declared CoI were common in the ORG and SACN

  20. 5 strategies for improving performance of academic medical centers.

    Science.gov (United States)

    Valletta, Robert M; Harkness, Alicia

    2013-06-01

    Academic medical centers should consider five strategies for becoming more cost-efficient and profitable as reforms are implemented: Make faculty responsible for cost and quality. Explore opportunities to collaborate with community hospitals. Extend care and education beyond the walls of the organization, employing technology and innovative teaching practices. Maximize healthcare IT investment by sharing data-rich patient records with other medical centers and research institutes. Align research with business strategy.

  1. Nurturant Ethics and Academic Ideals: Convergence in the Writing Center.

    Science.gov (United States)

    Trachsel, Mary

    1995-01-01

    Examines how and why the American academy has employed the social construct of gender in defining the writing center as a site where caring education is promoted according to a cultural ideal of "women's work." Draws on the author's encounters with feminist philosophy, academic professionalism, psycho-sociolinguistics, and child development…

  2. The Evolving Academic Health Center: Challenges and Opportunities for Psychiatry

    Science.gov (United States)

    Mirin, Steven; Summergrad, Paul

    2011-01-01

    Objective: Regardless of the outcome of current efforts at healthcare reform, the resources that academic health centers need--to provide care for increasingly complex patient populations, support clinical innovation, grow the clinical enterprise, and carry out their research and teaching missions--are in jeopardy. This article examines the value…

  3. Student-reported satisfaction with academic enhancement services at an academic health science center.

    Science.gov (United States)

    Gaughf, Natalie White; Foster, Penni Smith; Williams, Dara A

    2014-01-01

    Although support services are needed to address students' concerns associated with academic demands, there is little research exploring these interventions within health sciences education. The current study examined students' perceptions of academic enhancement services at an academic health science center. Academic enhancement services provided to students included assessment of learning approaches and problems interfering with academic performance. Specific services may have addressed the transition to professional school, study skills assessment and training, time management and organization, testing strategies, clarifying career goals and interests, increasing self-confidence and coping with self-doubt, coping with depression and/or anxiety, stress management, relationship issues, and/or loss and bereavement. All students receiving academic enhancement services received a survey for programmatic improvement at the end of each semester. The online survey was voluntary and anonymous and solicited feedback about the students' experiences. Sixty-three percent of respondents (N = 104; 62% female, 38% male; 62% White, 27% Black/African American, 10% Asian; 2% Hispanic) reported receiving a one-session intervention, while 34% received 2-6 sessions. Eighty-three percent of respondents reported that academic enhancement services improved their situation and 89% reported overall satisfaction. The individual services rated as most helpful addressed time management, study skills training, increasing self-confidence, and testing strategies. It is recommended that health science centers (i) consider providing brief-term academic enhancement services to students addressing time management/organization, study skills, self-confidence, and testing strategies and (ii) engage in empirical investigations of these academic interventions.

  4. Disruptive innovation in academic medical centers: balancing accountable and academic care.

    Science.gov (United States)

    Stein, Daniel; Chen, Christopher; Ackerly, D Clay

    2015-05-01

    Numerous academic medicine leaders have argued that academic referral centers must prepare for the growing importance of accountability-driven payment models by adopting population health initiatives. Although this shift has merit, execution of this strategy will prove significantly more problematic than most observers have appreciated. The authors describe how successful implementation of an accountable care health strategy within a referral academic medical center (AMC) requires navigating a critical tension: The academic referral business model, driven by tertiary-level care, is fundamentally in conflict with population health. Referral AMCs that create successful value-driven population health systems within their organizations will in effect disrupt their own existing tertiary care businesses. The theory of disruptive innovation suggests that balancing the push and pull of academic and accountable care within a single organization is achievable. However, it will require significant shifts in resource allocation and changes in management structure to enable AMCs to make the inherent difficult choices and trade-offs that will ensue. On the basis of the theories of disruptive innovation, the authors present recommendations for how academic health systems can successfully navigate these issues as they transition toward accountability-driven care.

  5. Ambulatory quality improvement in academic medical centers: a changing landscape.

    Science.gov (United States)

    Leas, Brian F; Goldfarb, Neil I; Browne, Robert C; Keroack, Mark; Nash, David B

    2009-01-01

    Efforts to improve the quality of ambulatory care have received tremendous attention as bold new initiatives aimed at influencing the environment of care through financial incentives, public transparency, and information technology rapidly spread. Academic medical centers, which represent a long tradition of excellence and innovation in medical care, might be expected to lead the charge in these new arenas, but motivation for change may be mitigated by the unique complexity and multiple goals of these institutions. A survey conducted in the fall of 2006 examined the early impact of these major new influences on faculty practice plans. Respondents reported that many institutions have begun to develop key components of a quality infrastructure, but much work remains before a robust model emerges at most sites. Some academic medical centers have also embraced pay-for-performance and public reporting efforts, but many are not equipped or eager to engage in these new initiatives.

  6. Decline of clinical research in academic medical centers.

    Science.gov (United States)

    Meador, Kimford J

    2015-09-29

    Marked changes in US medical school funding began in the 1960s with progressively increasing revenues from clinical services. The growth of clinical revenues slowed in the mid-1990s, creating a funding crisis for US academic health care centers, who responded by having their faculty increase their clinical duties at the expense of research activities. Surveys document the resultant stresses on the academic clinician researcher. The NIH provides greater funding for basic and translational research than for clinical research, and the new Patient-Centered Outcomes Research Institute is inadequately funded to address the scope of needed clinical research. An increasing portion of clinical research is funded by industry, which leaves many important clinical issues unaddressed. There is an inadequate supply of skilled clinical researchers and a lack of external support for clinical research. The impact on the academic environment in university medical centers is especially severe on young faculty, who have a shrinking potential to achieve successful academic careers. National health care research funding policies should encourage the right balance of life-science investigations. Medical universities need to improve and highlight education on clinical research for students, residents, fellows, and young faculty. Medical universities also need to provide appropriate incentives for clinical research. Without training to ensure an adequate supply of skilled clinical researchers and a method to adequately fund clinical research, discoveries from basic and translational research cannot be clinically tested and affect patient care. Thus, many clinical problems will continue to be evaluated and treated with inadequate or even absent evidence-based knowledge. © 2015 American Academy of Neurology.

  7. Publications in academic medical centers: technology-facilitated culture clash.

    Science.gov (United States)

    Berner, Eta S

    2014-05-01

    Academic culture has a set of norms, expectations, and values that are sometimes tacit and sometimes very explicit. In medical school and other health professions educational settings, probably the most common norm includes placing a high value on peer-reviewed research publications, which are seen as the major evidence of scholarly productivity. Other features of academic culture include encouraging junior faculty and graduate students to share their research results at professional conferences and lecturing with slides as a major way to convey information. Major values that faculty share with journal editors include responsible conduct of research and proper attribution of others' words and ideas. Medical school faculty also value technology and are often quick to embrace technological advances that can assist them in their teaching and research. This article addresses the effects of technology on three aspects of academic culture: education, presentations at professional meetings, and research publications.The technologies discussed include online instruction, dissemination of conference proceedings on the Internet, plagiarism-detection software, and new technologies deployed by the National Center for Biotechnology Information, the home of PubMed. The author describes how the ease of deploying new technologies without faculty changing their norms and behavior in the areas of teaching and research can lead to conflicts of values among key stakeholders in the academic medical community, including faculty, journal editors, and professional associations. The implications of these conflicts and strategies for managing them are discussed.

  8. Building diversity in a complex academic health center.

    Science.gov (United States)

    South-Paul, Jeannette E; Roth, Loren; Davis, Paula K; Chen, Terence; Roman, Anna; Murrell, Audrey; Pettigrew, Chenits; Castleberry-Singleton, Candi; Schuman, Joel

    2013-09-01

    For 30 years, the many diversity-related health sciences programs targeting the University of Pittsburgh undergraduate campus, school of medicine, schools of the health sciences, clinical practice plan, and medical center were run independently and remained separate within the academic health center (AHC). This lack of coordination hampered their overall effectiveness in promoting diversity and inclusion. In 2007, a group of faculty and administrators from the university and the medical center recognized the need to improve institutional diversity and to better address local health disparities. In this article, the authors describe the process of linking the efforts of these institutions in a way that would be successful locally and applicable to other academic environments. First, they engaged an independent consultant to conduct a study of the AHC's diversity climate, interviewing current and former faculty and trainees to define the problem and identify areas for improvement. Next, they created the Physician Inclusion Council to address the findings of this study and to coordinate future efforts with institutional leaders. Finally, they formed four working committees to address (1) communications and outreach, (2) cultural competency, (3) recruitment, and (4) mentoring and retention. These committees oversaw the strategic development and implementation of all diversity and inclusion efforts. Together these steps led to structural changes within the AHC and the improved allocation of resources that have positioned the University of Pittsburgh to achieve not only diversity but also inclusion and to continue to address the health disparities in the Pittsburgh community.

  9. Integrating pediatric hospitalists in the academic health science center: practice and perceptions in a Canadian center.

    Science.gov (United States)

    Mahant, Sanjay; Mekky, Magda; Parkin, Patricia

    2010-04-01

    The integration of hospitalists in academic settings has been identified as a challenge to the hospitalist movement. The Division of Pediatric Medicine, Hospital for Sick Children, Toronto, was established in 1981, providing a rich resource to examine this field in the academic context and inform academic program development. To explore the characteristics, practice, perceptions, and contributions of pediatric hospital medicine in an academic health science center (AHSC). A cross-sectional survey of physicians attending on the pediatric medicine inpatient unit (PMIU) (n = 20). Clinical activity included attending on the PMIU, consultation and comanagement outside the PMIU, and outpatient care of "hospital intense" patients. There was a high level of engagement in research, education, and quality improvement activities. Perceived advantages to a career as a hospitalist included: working in a team; generalist approach to care; stability relative to community practice; intellectually stimulating and rewarding work; and growing area for scholarship. Perceived disadvantages to a career as a hospitalist included: burnout; recognition and respect; and lack of long-term relationships with patients. Themes regarding barriers to establishing a career as a hospitalist in an AHSC were as follows: burnout; time and skills to develop an academic niche; balance between clinical and academic priorities; and system for career advancement. The contributions of pediatric hospitalists to the academic mission were diverse. Fellowship training, faculty development, and balance between time allocated to direct patient care and academic pursuits should be defined. This will help ensure career development, viability, and realization of excellence in the academic context. (c) 2010 Society of Hospital Medicine.

  10. Residency Surgical Training at an Independent Academic Medical Center.

    Science.gov (United States)

    Jones, Jeremiah; Sidwell, Richard A

    2016-02-01

    Independent academic medical centers have been training surgeons for more than a century; this environment is distinct from university or military programs. There are several advantages to training at a community program, including a supportive learning environment with camaraderie between residents and faculty, early and broad operative experience, and improved graduate confidence. Community programs also face challenges, such as resident recruitment and faculty engagement. With the workforce needs for general surgeons, independent training programs will continue to play an integral role. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Finessing the Academic and Social-Emotional Balance: A Revised Developmental Advising Model for Students with Learning Disabilities or AD/HD

    Science.gov (United States)

    Ryser, Jeannine; Alden, Peg

    2005-01-01

    Advisor perceptions of and responses to the social and emotional needs of college students with learning disabilities (LDs) and attention deficit/hyperactivity disorder (AD/HD) are studied. Through a mixed-method approach of surveys and focus groups, four themes emerged: social-emotional issues that students present in the advising relationship;…

  12. Commentary: Institutes versus traditional administrative academic health center structures.

    Science.gov (United States)

    Karpf, Michael; Lofgren, Richard

    2012-05-01

    In the Point-Counterpoint section of this issue, Kastor discusses the pros and cons of a new, institute-based administrative structure that was developed at the Cleveland Clinic in 2008, ostensibly to improve the quality and efficiency of patient care. The real issue underlying this organizational transformation is not whether the institute model is better than the traditional model; instead, the issue is whether the traditional academic health center (AHC) structure is viable or whether it must evolve. The traditional academic model, in which the department and chair retain a great deal of autonomy and authority, and in which decision-making processes are legislative in nature, is too tedious and laborious to effectively compete in today's health care market. The current health care market is demanding greater efficiencies, lower costs, and thus greater integration, as well as more transparency and accountability. Improvements in both quality and efficiency will demand coordination and integration. Focusing on quality and efficiency requires organizational structures that facilitate cohesion and teamwork, and traditional organizational models will not suffice. These new structures must and will replace the loose amalgamation of the traditional AHC to develop the focus and cohesion to address the pressures of an evolving health care system. Because these new structures should lead to more successful clinical enterprises, they will, in fact, support the traditional academic missions of research and education more successfully than traditional organizational models can.

  13. Developing Leaders: Implementation of a Peer Advising Program for a Public Health Sciences Undergraduate Program

    Directory of Open Access Journals (Sweden)

    Megan eGriffin

    2015-01-01

    Full Text Available Peer advising is an integral part of our undergraduate advising system in the Public Health Sciences major at the University of Massachusetts Amherst. The program was developed in 2009 to address the advising needs of a rapidly growing major that went from 25 to over 530 majors between 2007 and 2014. Each year, 9-12 top performing upper-level students are chosen through an intensive application process. A major goal of the program is to provide curriculum and career guidance to students in the major and empower students in their academic and professional pursuits. The year-long program involves several components, including: staffing the drop-in advising center, attending training seminars, developing and presenting workshops for students, meeting prospective students and families, evaluating ways to improve the program, and collaborating on self-directed projects. The peer advisors also provide program staff insight into the needs and perspectives of students in the major. In turn, peer advisors gain valuable leadership and communication skills, and learn strategies for improving student success. The Peer Advising Program builds community and fosters personal and professional development for the peer advisors. In this paper, we will discuss the undergraduate peer advising model, the benefits and challenges of the program, and lessons learned. Several methods were used to understand the perceived benefits and challenges of the program and experiences of students who utilized the Peer Advising Center. The data for this evaluation were drawn from three sources: 1 archival records from the Peer Advising Center; 2 feedback from peer advisors who completed the year-long internship; and 3 a survey of students who utilized the Peer Advising Center. Results of this preliminary evaluation indicate that peer advisors gain valuable skills that they can carry into their professional world. The program is also a way to engage students in building community

  14. Virginia Tech named national Center of Academic Excellence in Information Assurance Education

    OpenAIRE

    Micale, Barbara L.

    2005-01-01

    Virginia Tech has been designated as a national Center of Academic Excellence in Information Assurance Education (CAEIAE) for academic years 2005-2008 by the National Security Agency (NSA) and Department of Homeland Security (DHS).

  15. Succession planning in an academic medical center nursing service.

    Science.gov (United States)

    Barginere, Cynthia; Franco, Samantha; Wallace, Lynne

    2013-01-01

    Succession planning is of strategic importance in any industry. It ensures the smooth transition from leader to leader and the ability of the organization to maintain the forward momentum as well as meet its operational and financial goals. Health care and nursing are no exception. In the complex and challenging world of health care today, leadership is critical to an organization's success and leadership succession is a key strategy used to ensure continuity of leadership and development of talent from within the organization. At Rush University Medical Center, a 667-bed academic medical center providing tertiary care to adults and children, the need for a focus on succession planning for the nursing leadership team is apparent as key leaders come to the end of their careers and consider retirement. It has become apparent that to secure the legacy and continue the extraordinary history of nursing excellence, care must be taken to grow talent from within and take the opportunity to leverage the mentoring opportunities before the retirement of many key leaders. To ensure a smooth leadership transition, nursing leadership and human resources partner at Rush University Medical Center to implement a systematic approach to leadership succession planning.

  16. Leadership in Academic Health Centers: Transactional and Transformational Leadership.

    Science.gov (United States)

    Smith, Patrick O

    2015-12-01

    Leadership is a crucial component to the success of academic health science centers (AHCs) within the shifting U.S. healthcare environment. Leadership talent acquisition and development within AHCs is immature and approaches to leadership and its evolution will be inevitable to refine operations to accomplish the critical missions of clinical service delivery, the medical education continuum, and innovations toward discovery. To reach higher organizational outcomes in AHCs requires a reflection on what leadership approaches are in place and how they can better support these missions. Transactional leadership approaches are traditionally used in AHCs and this commentary suggests that movement toward a transformational approach is a performance improvement opportunity for AHC leaders. This commentary describes the transactional and transformational approaches, how they complement each other, and how to access the transformational approach. Drawing on behavioral sciences, suggestions are made on how a transactional leader can change her cognitions to align with the four dimensions of the transformational leadership approach.

  17. Changing structure to improve function: one academic health center's experience.

    Science.gov (United States)

    Alexander, B; Davis, L; Kohler, P O

    1997-04-01

    Academic health centers (AHCs) have been under siege for the past few years, with decreased federal and state funding for educational and research programs and increasing competition in the health care marketplace. In addition, many AHCs are burdened with the bureaucratic red tape of large educational institutions, which makes agility in responding to a demanding health care market difficult. The authors describe the response to these threats by Oregon Health Sciences University (OHSU), an approach that has been different from those of most similar institutions. OHSU chose to change its structure from being part of the state system of higher education to being an independent public corporation. The authors outline the political process of building widespread support for the legislation passed in 1995, the key features of the restructuring, the challenges faced before and after the transition to a public corporation, and lessons learned in this metamorphosis to a new form.

  18. [Academic procrastination in clients of a psychotherapeutic student counselling center].

    Science.gov (United States)

    Jamrozinski, Katja; Kuda, Manfred; Mangholz, Astrid

    2009-01-01

    The start of university education is the beginning of a new phase of life for young adults, which requires significant psychosocial adjustments. Sociobiographical data, clinical symptoms, characteristics of education, work attitude, and career perspectives were gathered from 152 clients by a psychotherapeutic student counselling center to evaluate characteristics of students with and without academic procrastination. The procrastination group comprised heightened numbers of students who had changed universities, and people with suboptimal career prospects and career targets. These subjects were more often male and showed increased incidences of drug- and alcohol problems, as well as a lack of planning of the future. Furthermore, they had larger amounts of their study self-financed. On the basis of these results, concrete recommendations for preventive measures to improve on-time completion of study, and to prevent student drop-out are presented. Georg Thieme Verlag KG Stuttgart-New York.

  19. An Exploration of Preferred Advising Styles at Baptist Affiliated Institutions of Higher Education

    Science.gov (United States)

    Wyatt, Eric L.

    2016-01-01

    The purpose of the current study was to determine if there was congruence between college students' perceptions of their current academic advisor's advising style and their preferred advisor's academic advising style; examine if the relationship between current and preferred advisor's academic advising styles predicted a student's level of…

  20. Supply chain optimization at an academic medical center.

    Science.gov (United States)

    Labuhn, Jonathan; Almeter, Philip; McLaughlin, Christopher; Fields, Philip; Turner, Benjamin

    2017-08-01

    A successful supply chain optimization project that leveraged technology, engineering principles, and a technician workflow redesign in the setting of a growing health system is described. With continued rises in medication costs, medication inventory management is increasingly important. Proper management of central pharmacy inventory and floor-stock inventory in automated dispensing cabinets (ADCs) can be challenging. In an effort to improve control of inventory costs in the central pharmacy of a large academic medical center, the pharmacy department implemented a supply chain optimization project in collaboration with the medical center's inhouse team of experts on process improvement and industrial engineering. The project had 2 main components: (1) upgrading and reconfiguring carousel technology within an expanded central pharmacy footprint to generate accurate floor-stock inventory replenishment reports, which resulted in efficiencies within the medication-use system, and (2) implementing a technician workflow redesign and algorithm to right-size the ADC inventory, which decreased inventory stockouts (i.e., incidents of depletion of medication stock) and improved ADC user satisfaction. Through a multifaceted approach to inventory management, the number of stockouts per month was decreased and ADC inventory was optimized, resulting in a one-time inventory cost savings of $220,500. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  1. Dealing With Deans and Academic Medical Center Leadership

    Science.gov (United States)

    Sanfilippo, Fred; Powell, Deborah; Folberg, Robert; Tykocinski, Mark

    2018-01-01

    The 2017 Association of Pathology Chairs Annual Meeting included a session for department chairs and other department leaders on “how to deal with deans and academic medical center leadership.” The session was focused on discussing ways to foster positive relationships with university, medical school, and health system leaders, and productively address issues and opportunities with them. Presentations and a panel discussion were provided by 4 former pathology chairs who subsequently have served as medical deans and in other leadership positions including university provost, medical center CEO, and health system board chair. There was a strong consensus among the participants on how best to deal with superiors about problems, conflicts, and requests for additional resources and authority. The importance of teamwork and accountability in developing a constructive and collaborative relationship with leaders and peers was discussed in detail. Effectiveness in communication, negotiation, and departmental advocacy were highlighted as important skills. As limited resources and increased regulations have become growing problems for universities and health systems, internal stress and competition have increased. In this rapidly changing environment, advice on how chairs can interact most productively with institutional leaders is becoming increasingly important. PMID:29662949

  2. Making Value-Based Payment Work for Academic Health Centers.

    Science.gov (United States)

    Miller, Harold D

    2015-10-01

    Under fee-for-service payment systems, physicians and hospitals can be financially harmed by delivering higher-quality, more efficient care. The author describes how current "value-based purchasing" initiatives fail to address the underlying problems in fee-for-service payment and can be particularly problematic for academic health centers (AHCs). Bundled payments, warranties, and condition-based payments can correct the problems with fee-for-service payments and enable physicians and hospitals to redesign care delivery without causing financial problems for themselves. However, the author explains several specific actions that are needed to ensure that payment reforms can be a "win-win-win" for patients, purchasers, and AHCs: (1) disconnecting funding for teaching and research from payment for service delivery, (2) providing predictable payment for essential hospital services, (3) improving the quality and efficiency of care at AHCs, and (4) supporting collaborative relationships between AHCs and community providers by allowing each to focus on their unique strengths and by paying AHC specialists to assist community providers in diagnosis and treatment. With appropriate payment reforms and a commitment by AHCs to redesign care delivery, medical education, and research, AHCs could provide the leadership needed to improve care for patients, lower costs for health care purchasers, and maintain the financial viability of both AHCs and community providers.

  3. Governance practices and performance in US academic medical centers.

    Science.gov (United States)

    Szekendi, Marilyn; Prybil, Lawrence; Cohen, Daniel L; Godsey, Beth; Fardo, David W; Cerese, Julie

    2015-01-01

    Recognition of the complex nature of modern health care delivery has led to interest in investigating the ways in which various factors, including governance structures and practices, influence health care quality. In this study, the chief executive officers (CEOs) of US academic medical centers were surveyed to elicit their perceptions of board structures, activities, and attitudes reflecting 6 widely identified governance best practices; the relationship between use of these practices and organizational performance, based on the University HealthSystem Consortium's Quality & Accountability rankings, was assessed. High-performing hospitals showed greater use of all 6 practices, but the strongest evidence supported a focus on board member education and development, the rigorous use of performance measures to guide quality improvement, and systematic board self-assessment processes. All hospitals, even those with the highest quality ratings, had major gaps in their use of best practices for CEO and board assessments. These findings can serve as the basis for developing sound board improvement plans. © The Author(s) 2014.

  4. Cultural Awareness Among Nursing Staff at an Academic Medical Center.

    Science.gov (United States)

    McElroy, Jennifer; Smith-Miller, Cheryl A; Madigan, Catherine K; Li, Yin

    2016-03-01

    The goal is to identify areas for targeted improvement in regard to cultural awareness and competence among nursing staff and in the work environment. Many facilities have initiated programs to facilitate cultural competence development among nursing staff; however, there has been little examination of the effect of these initiatives, assessment of experienced nurses' cultural awareness, or investigation of nurse leader's role in promoting cultural competence in the literature. In this cross-sectional descriptive study, a cultural awareness survey was modified and electronically distributed to all registered nurses and assistive personnel at an academic medical center. The modified survey instrument showed good reliability and validity among the study population. Most nursing staff exhibited a moderate to high level of cultural awareness and held positive opinions about nursing leadership and the work environment with regard to cultural issues. In increasingly diverse work environments, assessing the cultural awareness of nursing staff enables nurse leaders to evaluate efforts in promoting cultural competence and to identify specific areas in which to target staff development efforts and leadership training.

  5. Voriconazole concentration monitoring at an academic medical center.

    Science.gov (United States)

    Sebaaly, Jamielynn C; MacVane, Shawn H; Hassig, Tanna B

    2016-03-01

    Results of a study of the relationship among voriconazole dosages, serum concentrations, adverse effects, and clinical outcomes are presented. A retrospective chart review was conducted that included all patients who had at least one voriconazole concentration drawn between July 1, 2009, and August 15, 2014, at a single academic medical center. The primary outcome was the proportion of patients with initial voriconazole concentrations in the target range. Forty-seven of 88 patients (53%) had an initial voriconazole concentration within the target range, 27% (24 of 88) of patients had a concentration above the range, and 19% (17 of 88) had a concentration below the range. Sixty-seven percent of patients with above-target concentrations had adverse effects. Voriconazole was discontinued in 9% of patients, and dosages were reduced in 11% of patients because of adverse effects. Voriconazole for treatment versus prophylaxis was analyzed in a subgroup, as was obesity and nonobesity. Twenty-four percent of patients died during their hospital admission, and 14% were not discharged on voriconazole therapy. The within-target group had the highest proportion of patients discharged on voriconazole and the lowest proportion of deaths. A retrospective study in one institution revealed that the first measured voriconazole concentration was within the target range in 53% of patients and that dosage was modified in only 51% of patients whose concentration was outside of that range. The majority of patients with above-target concentrations had an adverse effect, and this result was particularly common in patients with a body mass index of ≥35 kg/m(2). Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  6. Accountable care organization readiness and academic medical centers.

    Science.gov (United States)

    Berkowitz, Scott A; Pahira, Jennifer J

    2014-09-01

    As academic medical centers (AMCs) consider becoming accountable care organizations (ACOs) under Medicare, they must assess their readiness for this transition. Of the 253 Medicare ACOs prior to 2014, 51 (20%) are AMCs. Three critical components of ACO readiness are institutional and ACO structure, leadership, and governance; robust information technology and analytic systems; and care coordination and management to improve care delivery and health at the population level. All of these must be viewed through the lens of unique AMC mission-driven goals.There is clear benefit to developing and maintaining a centralized internal leadership when it comes to driving change within an ACO, yet there is also the need for broad stakeholder involvement. Other important structural features are an extensive primary care foundation; concomitant operation of a managed care plan or risk-bearing entity; or maintaining a close relationship with post-acute-care or skilled nursing facilities, which provide valuable expertise in coordinating care across the continuum. ACOs also require comprehensive and integrated data and analytic systems that provide meaningful population data to inform care teams in real time, promote quality improvement, and monitor spending trends. AMCs will require proven care coordination and management strategies within a population health framework and deployment of an innovative workforce.AMC core functions of providing high-quality subspecialty and primary care, generating new knowledge, and training future health care leaders can be well aligned with a transition to an ACO model. Further study of results from Medicare-related ACO programs and commercial ACOs will help define best practices.

  7. Academic Centers and/as Industrial Consortia: US Microelectronics Research 1976-2016

    NARCIS (Netherlands)

    Mody, Cyrus C.M.

    2017-01-01

    In the U.S., in the late 1970s and early 1980s, academic research centers that were tightly linked to the semiconductor industry began to proliferate – at exactly the same time as the first academic start-up companies in biotech, and slightly before the first U.S. industrial semiconductor research

  8. Performing Research at University Centers for Academic Development--An Explorative Case Study in Sweden

    Science.gov (United States)

    Stigmar, Martin; Edgren, Gudrun

    2017-01-01

    The aim is to explore the absence or presence of, and motives for, research at centers for academic development and to problematize the research situation among academic developers. Boyer's and Healey's theories are used as lenses for the analysis based on the questionnaires that were used for data collection. The conclusion is that research is a…

  9. A Person-Centered Investigation of Academic Motivation and Its Correlates in High School

    Science.gov (United States)

    Wormington, Stephanie V.; Corpus, Jennifer Henderlong; Anderson, Kristen G.

    2012-01-01

    This study used a person-centered approach to identify naturally occurring combinations of intrinsic motivation and controlled forms of extrinsic motivation (i.e., introjected and external regulation) and their correlates in an academic context. 1061 high school students completed measures of academic motivation, performance, and school-related…

  10. A Way to Approach the Strategic Decisions Facing Academic Health Centers.

    Science.gov (United States)

    Capper, Stuart A.; Fargason, Crayton A., Jr.

    1996-01-01

    Three models of strategic management for academic health centers are detailed: the traditional model, which will become rare; a revised traditional model that offers "boutique" clinical services, biomedical research, and medical education; and the academic services model, focusing on competitive primary and secondary clinical services, health…

  11. Closing the Gap: Merging Student Affairs, Advising and Registration

    Science.gov (United States)

    Goomas, David T.

    2012-01-01

    In a pilot study at El Centro College, an urban college in the Dallas County Community College District, students in a new-to-college educational framework class were offered an intervention intended to enhance the academic advising process. The intervention consisted of in-class career services advising, degree selection, degree planning, course…

  12. Annual Report of the Operation Research Center for Academic Year 2000

    National Research Council Canada - National Science Library

    Davis, Mark

    2000-01-01

    ...) the integration of new technologies into the academic program. By being fully engaged in current Army issues, the Operations Research Center assures that systems engineering education at West Point remains current and relevant...

  13. Academic Career Selection and Retention in Radiation Oncology: The Joint Center for Radiation Therapy Experience

    International Nuclear Information System (INIS)

    Balboni, Tracy A.; Chen, M.-H.; Harris, Jay R.; Recht, Abram; Stevenson, Mary Ann; D'Amico, Anthony V.

    2007-01-01

    Purpose: The United States healthcare system has witnessed declining reimbursement and increasing documentation requirements for longer than 10 years. These have decreased the time available to academic faculty for teaching and mentorship. The impact of these changes on the career choices of residents is unknown. The purpose of this report was to determine whether changes have occurred during the past decade in the proportion of radiation oncology trainees from a single institution entering and staying in academic medicine. Methods and Materials: We performed a review of the resident employment experience of Harvard Joint Center for Radiation Therapy residents graduating during 13 recent consecutive years (n = 48 residents). The outcomes analyzed were the initial selection of an academic vs. nonacademic career and career changes during the first 3 years after graduation. Results: Of the 48 residents, 65% pursued an academic career immediately after graduation, and 44% remained in academics at the last follow-up, after a median of 6 years. A later graduation year was associated with a decrease in the proportion of graduates immediately entering academic medicine (odds ratio, 0.78; 95% confidence interval, 0.65-0.94). However, the retention rate at 3 years of those who did immediately enter academics increased with a later graduation year (p = 0.03). Conclusion: During a period marked by notable changes in the academic healthcare environment, the proportion of graduating Harvard Joint Center for Radiation Therapy residents pursuing academic careers has been declining; however, despite this decline, the retention rates in academia have increased

  14. Finding Your Voice: Talent Development Centers and the Academic Talent Search

    Science.gov (United States)

    Rushneck, Amy S.

    2012-01-01

    Talent Development Centers are just one of many tools every family, teacher, and gifted advocate should have in their tool box. To understand the importance of Talent Development Centers, it is essential to also understand the Academic Talent Search Program. Talent Search participants who obtain scores comparable to college-bound high school…

  15. Organizing multidisciplinary care for children with neuromuscular diseases at the Academic Medical Center, Amsterdam : CASE STUDY

    NARCIS (Netherlands)

    Kortbeek, Nikky; van der Velde, M.F.; Litvak, Nelli Vladimirovna

    2017-01-01

    The Academic Medical Center (AMC) in Amsterdam, The Netherlands, recently opened the ‘Children’s Muscle Center Amsterdam’ (CMCA). The CMCA diagnoses and treats children with neuromuscular diseases. The patients with such diseases require care from a variety of clinicians. Through the establishment

  16. Africa Center for Strategic Studies Senior Leader Seminar. Academic Summary

    National Research Council Canada - National Science Library

    1999-01-01

    From October 31 to November 12, 1999, 115 civilian and military officials from Africa, Europe, and the United States participated in the inaugural Senior Leader Seminar of the Africa Center for Strategic Studies (ACSS) in Dakar, Senegal...

  17. Which Emotional Profiles Exhibit the Best Learning Outcomes? A Person-Centered Analysis of Students' Academic Emotions

    Science.gov (United States)

    Ganotice, Fraide A., Jr.; Datu, Jesus Alfonso D.; King, Ronnel B.

    2016-01-01

    Previous studies on academic emotions have mostly used variable-centered approaches. Although these studies have elucidated the relationships between academic emotions and key academic outcomes, they cannot identify naturally-occurring groups of students defined by distinct academic emotion profiles. In this study, we adopted a person-centered…

  18. A midwifery-led in-hospital birth center within an academic medical center: successes and challenges.

    Science.gov (United States)

    Perdion, Karen; Lesser, Rebecca; Hirsch, Jennifer; Barger, Mary; Kelly, Thomas F; Moore, Thomas R; Lacoursiere, D Yvette

    2013-01-01

    The University of California San Diego Community Women's Health Program (CWHP) has emerged as a successful and sustainable coexistence model of women's healthcare. The cornerstone of this midwifery practice is California's only in-hospital birth center. Located within the medical center, this unique and physically separate birth center has been the site for more than 4000 births. With 10% cesarean delivery and 98% breast-feeding rates, it is an exceptional example of low-intervention care. Integrating this previously freestanding birth center into an academic center has brought trials of mistrust and ineffectual communication. Education, consistent leadership, and development of multidisciplinary guidelines aided in overcoming these challenges. This collaborative model provides a structure in which residents learn to be respectful consultants and appreciate differences in medical practice. The CWHP and its Birth Center illustrates that through persistence and flexibility a collaborative model of maternity services can flourish and not only positively influence new families but also future generations of providers.

  19. UN legal advisers meet

    International Nuclear Information System (INIS)

    1969-01-01

    Legal Advisers from twelve international organizations belonging to the United Nations Organization's family met at the Agency's Headquarters in Vienna on 19 and 20 May to discuss legal problems of common administrative interest. The meeting was held on the initiative of the Agency while the UN Conference on the Law of Treaties was taking place in Vienna during April and May. With Mr. Constantin A. Stavropoulos, Under-Secretary, Legal Counsel of the United Nations, as chairman, this was the second meeting of Legal Advisers since 1954. The following organizations were represented: Food and Agriculture Organization of the United Nations, International Atomic Energy Agency, International Bank for Reconstruction and Development, International Civil Aviation Organization, International Labour Organisation, Inter-Governmental Maritime Consultative Organization, International Monetary Fund, International Telecommunication Union, United Nations, United Nations Educational, Scientific and Cultural Organization, United Nations Industrial Development Organization, World Health Organization. Topics discussed included the recruitment of legal staff and possible exchange of staff between organizations; competence and procedure of internal appeals committees, experience with cases before the Administrative Tribunals and evaluation of their judgments; experience with Staff Credit Unions; privileges and immunities of international organizations; headquarters and host government agreements; and patent policies of international organizations. Consultations will continue through correspondence and further meetings. (author)

  20. Integrative medicine at academic health centers: a survey of clinicians' educational backgrounds and practices.

    Science.gov (United States)

    Ehrlich, Gillian; Callender, Travis; Gaster, Barak

    2013-05-01

    Integrative medicine is a relatively new field that seeks to combine conventional and nonconventional approaches to patient care. Many academic health centers have now established integrative medicine clinics, yet little is known about the clinicians who practice at them. We used a nationwide survey to characterize the backgrounds, clinical practices, and involvement in research and education of clinicians who practice integrative medicine at academic health centers. Participants included clinicians (MDs, DOs, PAs, and nurse practitioners) who practice at 30 different integrative medicine clinics that are affiliated with academic health centers. Completed surveys from 136 of 162 clinicians were received (84% response rate). The integrative therapies that clinicians most often reported providing themselves were breathing exercises (66%), herbal medicine prescribing (61%), meditation (44%), and functional medicine (34%). The integrative therapies that clinicians most often referred their patients for were acupuncture (96%), massage (92%), yoga (85%), and meditation (79%). Respondents reported spending a mean of 20% of their time training medical students, and 63% had participated in research in the past year. This survey provides the first national assessment of clinicians practicing integrative medicine at academic health centers. These clinicians use a wide variety of complementary and alternative therapies and appear involved in the research and education missions of their academic health centers.

  1. Sustaining the edge: factors influencing strategy selection in academic health centers.

    Science.gov (United States)

    Walsh, Anne M; Szabat, Kathryn

    2002-01-01

    Competition within the acute care sector as well as increased penetration by managed care organizations has influenced the structure and role of academic health centers during the past decade. The market factors confronting academic health centers are not dissimilar from conditions that confront other organizations competing in mature industries characterized by declining profitability and intense rivalry for market share. When confronted with intense competition or adverse external events, organizations in other industries have responded to potential threats by forming alliances, developing joint ventures, or merging with another firm to maintain their competitive advantage. Although mergers and acquisitions dominated the strategic landscape in the healthcare industry during the past decade, recent evidence suggests that other types of strategic ventures may offer similar economic and contracting benefits to member organizations. Academic health centers have traditionally been involved in network relationships with multiple partners via their shared technology, collaborative research, and joint educational endeavors. These quasi-organizational relationships appear to have provided a framework for strategic decisions and allowed executives of academic health centers to select strategies that were competitive yet closely aligned with their organizational mission. The analysis of factors that influenced strategy selection by executives of academic health centers suggests a deliberate and methodical approach to achieving market share objectives, expanding managed care contracts, and developing physician networks.

  2. Rice University: Building an Academic Center for Nonprofit Education

    Science.gov (United States)

    Seaworth, Angela

    2012-01-01

    According to the author, the setting for their nonprofit education center was close to ideal: Support from a dean who cares deeply about nonprofit organizations; encouragement from the university and its renewed focus on reaching beyond its walls on the eve of its centennial; and a generous gift from alumni who have been affiliated with the…

  3. Predictors of early faculty attrition at one Academic Medical Center.

    Science.gov (United States)

    Bucklin, Brenda A; Valley, Morgan; Welch, Cheryl; Tran, Zung Vu; Lowenstein, Steven R

    2014-02-10

    Faculty turnover threatens the research, teaching and clinical missions of medical schools. We measured early attrition among newly-hired medical school faculty and identified personal and institutional factors associated with early attrition. This retrospective cohort study identified faculty hired during the 2005-2006 academic year at one school. Three-year attrition rates were measured. A 40-question electronic survey measured demographics, career satisfaction, faculty responsibilities, institutional/departmental support, and reasons for resignation. Odds ratios (ORs) and 95 percent confidence intervals (95% CI) identified variables associated with early attrition. Of 139 faculty, 34% (95% CI = 26-42%) resigned within three years of hire. Attrition was associated with: perceived failure of the Department Chair to foster a climate of teaching, research, and service (OR = 6.03; 95% CI: 1.84, 19.69), inclusiveness, respect, and open communication (OR = 3.21; 95% CI: 1.04, 9.98). Lack of professional development of the faculty member (OR = 3.84; 95% CI: 1.25, 11.81); institutional recognition and support for excellence in teaching (OR = 2.96; 95% CI: 0.78, 11.19) and clinical care (OR = 3.87; 95% CI: 1.04, 14.41); and >50% of professional time devoted to patient care (OR = 3.93; 95% CI: 1.29, 11.93) predicted attrition. Gender, race, ethnicity, academic degree, department type and tenure status did not predict early attrition. Of still-active faculty, an additional 27 (48.2%, 95% CI: 35.8, 61.0) reported considering resignation within the 5 years. In this pilot study, one-third of new faculty resigned within 3 years of hire. Greater awareness of predictors of early attrition may help schools identify threats to faculty career satisfaction and retention.

  4. Physician performance feedback in a Canadian academic center.

    Science.gov (United States)

    Garvin, Dennis; Worthington, James; McGuire, Shaun; Burgetz, Stephanie; Forster, Alan J; Patey, Andrea; Gerin-Lajoie, Caroline; Turnbull, Jeffrey; Roth, Virginia

    2017-10-02

    Purpose This paper aims at the implementation and early evaluation of a comprehensive, formative annual physician performance feedback process in a large academic health-care organization. Design/methodology/approach A mixed methods approach was used to introduce a formative feedback process to provide physicians with comprehensive feedback on performance and to support professional development. This initiative responded to organization-wide engagement surveys through which physicians identified effective performance feedback as a priority. In 2013, physicians primarily affiliated with the organization participated in a performance feedback process, and physician satisfaction and participant perceptions were explored through participant survey responses and physician leader focus groups. Training was required for physician leaders prior to conducting performance feedback discussions. Findings This process was completed by 98 per cent of eligible physicians, and 30 per cent completed an evaluation survey. While physicians endorsed the concept of a formative feedback process, process improvement opportunities were identified. Qualitative analysis revealed the following process improvement themes: simplify the tool, ensure leaders follow process, eliminate redundancies in data collection (through academic or licensing requirements) and provide objective quality metrics. Following physician leader training on performance feedback, 98 per cent of leaders who completed an evaluation questionnaire agreed or strongly agreed that the performance feedback process was useful and that training objectives were met. Originality/value This paper introduces a physician performance feedback model, leadership training approach and first-year implementation outcomes. The results of this study will be useful to health administrators and physician leaders interested in implementing physician performance feedback or improving physician engagement.

  5. Building a Culture of Authentic Partnership: One Academic Health Center Model for Nursing Leadership.

    Science.gov (United States)

    Heath, Janie; Swartz, Colleen

    2017-09-01

    Senior nursing leaders from the University of Kentucky (UK) College of Nursing and UK HealthCare have explored the meaning of an authentic partnership. This article quantifies the tangible benefits and outcomes from this maturing academic nursing and clinical practice partnership. Benefits include inaugural academic nursing participation in health system governance, expanded integration of nursing research programs both in the college and in the health science center, and the development of collaborative strategies to address nursing workforce needs.

  6. A Sustained Partnership between a Haitian Children’s Hospital and North American Academic Medical Centers

    Directory of Open Access Journals (Sweden)

    Michael P. Koster

    2017-05-01

    Full Text Available Global health initiatives from academic medical centers have rapidly proliferated over the last decade. This paper endeavors to describe our 5-year experience as an academic medical collaborative supporting healthcare delivery, medical training, and research at Hôpital Saint Damien-Nos Petits Frères et Soeurs, the only freestanding children’s hospital in Haiti. Descriptions of the history and current activities of our academic medical collaborative, its partnership and communication structure, its evolution to fill the expressed needs of our host site, its funding mechanisms, and its challenges and opportunities for the future are included.

  7. Cyclotron Production of Radionuclides for Nuclear Medicine at Academic Centers

    Science.gov (United States)

    Lapi, Suzanne

    2016-09-01

    The increase in use of radioisotopes for medical imaging has led to the development of new accelerator targetry and separation techniques for isotope production. For example, the development of longer-lived position emitting radionuclides has been explored to allow for nuclear imaging agents based on peptides, antibodies and nanoparticles. These isotopes (64Cu, 89Zr, 86Y) are typically produced via irradiation of solid targets on smaller cyclotrons (10-25 MeV) at academic or hospital based facilities. Recent research has further expanded the toolbox of PET tracers to include additional isotopes such as 52Mn, 55Co, 76Br and others. The smaller scale of these types of facilities can enable the straightforward involvement of students, thus adding to the next generation of nuclear science leaders. Research pertaining to development of robust and larger scale production technologies including solid target systems and remote systems for transport and purification of these isotopes has enabled both preclinical and clinical imaging research for many diseases. In particular, our group has focused on the use of radiolabeled antibodies for imaging of receptor expression in preclinical models and in a clinical trial of metastatic breast cancer patients.

  8. The Advising Palaver Hut: Case Study in West African Higher Education

    Science.gov (United States)

    Sy, Jobila Williams

    2017-01-01

    Although international research regarding advising is burgeoning, most of the research on the role of and advantages related to academic advising has been limited to U.S. colleges and universities. This ethnographic case study conducted at a Liberian university examined the organizational culture of advising from student, faculty, and staff…

  9. Social Contingency and Advising Accountability

    Directory of Open Access Journals (Sweden)

    Shinyi Lin

    2016-02-01

    Full Text Available The issue of teaching and learning accountability has been discussed for years. This study focuses specifically on advising accountability of management education to explore how faculty advisors communicate with their student advisees using instant messaging (IM to enhance advising presence primarily based on Tetlock’s social contingency model. The dependent relationships between advisor and advisee are considered a cohort, and their collaboration as a community of practice. Of the 254 graduate students in the college of management, the result reveals that their perception of advising accountability has been casually explained by the antecedents, that is, self-efficacy, advising presence, epistemic engagement, advisor credibility, and their flow experience toward using IM to communicate with their thesis advisors. The research finding validates intervening factors between students’ perception of IM self-efficacy and advising accountability of thesis advisors. The findings, regardless of the limited generalization, provide prescriptive implications that educational practitioners can use to evaluate related issues of advising accountability.

  10. A model for evaluating academic research centers: Case study of the Asian/Pacific Islander Youth Violence Prevention Center.

    Science.gov (United States)

    Nishimura, Stephanie T; Hishinuma, Earl S; Goebert, Deborah A; Onoye, Jane M M; Sugimoto-Matsuda, Jeanelle J

    2018-02-01

    To provide one model for evaluating academic research centers, given their vital role in addressing public health issues. A theoretical framework is described for a comprehensive evaluation plan for research centers. This framework is applied to one specific center by describing the center's Logic Model and Evaluation Plan, including a sample of the center's activities. Formative and summative evaluation information is summarized. In addition, a summary of outcomes is provided: improved practice and policy; reduction of risk factors and increase in protective factors; reduction of interpersonal youth violence in the community; and national prototype for prevention of interpersonal youth violence. Research centers are important mechanisms to advance science and improve people's quality of life. Because of their more infrastructure-intensive and comprehensive approach, they also require substantial resources for success, and thus, also require careful accountability. It is therefore important to comprehensively evaluate these centers. As provided herein, a more systematic and structured approach utilizing logic models, an evaluation plan, and successful processes can provide research centers with a functionally useful method in their evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Nursing schools and academic health centers: toward improved alignment and a synergistic partnership

    Directory of Open Access Journals (Sweden)

    Emami A

    2017-08-01

    Full Text Available Azita Emami,1 Darcy Jaffe,2 Paula Minton-Foltz,3 Grace Parker,4 Susan Manfredi,5 Theresa Braungardt,6 Kelly W Marley,1 Laura Cooley,1 Staishy Bostick Siem7 1University of Washington School of Nursing, Seattle, WA, USA; 2Harborview Medical Center, University of Washington Medicine, Seattle, WA, USA; 3Patient Care Services, Harborview Medical Center, University of Washington Medicine, Seattle, WA, USA; 4University of Washington Medical Center, Seattle, WA, USA; 5Patient Care Services, Northwest Hospital and Medical Center, Seattle, WA, USA; 6Valley Medical Center, Seattle, WA, USA; 7Marketing and Communications, University of Washington School of Nursing, Seattle, WA, USA Abstract: This paper presents the findings from a national survey which the University of Washington conducted among leaders of 32 US academic nursing institutions that are part of academic health centers (AHCs and complements these findings with results from a separate report by the American Association of Colleges of Nursing. While expressing overall satisfaction with their AHC relationships, these leaders find that nursing is often given greater parity in matters of education and research than in mission setting, financial, and governance matters. AHCs are being asked to meet new health care challenges in new ways, starting with the education of health care professionals. AHCs need to be restructured to give nursing full parity if the nation’s and world’s needs for preventive and clinical care are to be best met.Keywords: nursing parity, academic nursing institutions, nurse leaders, institutional alignment

  12. Academic Literacy Instruction for Adolescents: A Guidance Document from the Center on Instruction

    Science.gov (United States)

    Torgesen, Joseph K.; Houston, Debra D.; Rissman, Lila M.; Decker, Susan M.; Roberts, Greg; Vaughn, Sharon; Wexler, Jade; Francis, David J.; Rivera, Mabel O.; Lesaux, Nonie

    2017-01-01

    This document was prepared to assist literacy specialists in the national Regional Comprehensive Center network as they work with states to improve educational policy and practice in the area of adolescent literacy. It comprises three major parts: Part One: "Improving academic literacy instruction for students in grades 4-12." Based on…

  13. 10 Years Later: Lessons Learned from an Academic Multidisciplinary Cosmetic Center

    Directory of Open Access Journals (Sweden)

    Jenny T. Chen, MD

    2017-09-01

    Conclusion:. Although the creation of our academic cosmetic ambulatory surgery center has greatly increased the overall volume of cosmetic surgery performed at the University of Wisconsin, the majority of surgical volume and revenue is reconstructive. As is seen nationwide, minimally invasive cosmetic procedures represent our most rapidly expanding revenue stream.

  14. Crossing the Great Divide: Adoption of New Technologies, Therapeutics and Diagnostics at Academic Medical Centers

    Science.gov (United States)

    DeMonaco, Harold J.; Koski, Greg

    2007-01-01

    The role of new technology in healthcare continues to expand from both the clinical and financial perspectives. Despite the importance of innovation, most academic medical centers do not have a clearly defined process for technology assessment. Recognizing the importance of new drugs, diagnostics and procedures in the care of patients and in the…

  15. Developing physician leaders in academic medical centers. Part 1: Their changing role.

    Science.gov (United States)

    Bachrach, D J

    1996-01-01

    While physicians have historically held positions of leadership in academic medical centers, there is an increasing trend that physicians will not only guide the clinical, curriculum and scientific direction of the institution, but its business direction as well. Physicians are assuming a greater role in business decision making and are found at the negotiating table with leaders from business, insurance and other integrated health care delivery systems. Physicians who lead "strategic business units" within the academic medical center are expected to acquire and demonstrate enhanced business acumen. There is an increasing demand for formal and informal training programs for physicians in academic medical centers in order to better prepare them for their evolving roles and responsibilities. These may include the pursuit of a second degree in business or health care management, intramurally conducted courses in leadership skill development; management, business and finance; or involvement in extramurally prepared and delivered training programs specifically geared toward physicians as conducted at major universities, often in their schools of business or public health. This article article was prepared by the author from research into and presentation of a thesis entitled. "The Importance of Leadership Training And Development For Physicians In Academic Medical Centers In An Increasingly Complex Healthcare Environment, " prepared for the Credentials Committee of the American College of Healthcare Executives in partial fulfillment of the requirements for Fellowship in the College (ACHE). Part 2 will appear in the next issue of the Journal.

  16. Computer Assisted Advising Tool (CAAT).

    Science.gov (United States)

    Matsen, Marie E.

    Lane Community College's Computer Assisted Advising Tool (CAAT) is used by counselors to assist students in developing a plan for the completion of a degree or certificate. CAAT was designed to facilitate student advisement from matriculation to graduation by comparing degree requirements with the courses completed by students. Three major sources…

  17. The Developing Role of Student Advising: An Interview with Charlie Nutt

    Science.gov (United States)

    Harborth, Arlene

    2015-01-01

    Charlie Nutt has been an active member of the National Academic Advising Association (NACADA) since 1991 and currently is the NACADA Executive Director. NACADA promotes and supports quality academic advising in institutions of higher education to enhance the educational development of students. Nutt's current responsibilities as executive director…

  18. Accelerating change: Fostering innovation in healthcare delivery at academic medical centers.

    Science.gov (United States)

    Ostrovsky, Andrey; Barnett, Michael

    2014-03-01

    Academic medical centers (AMCs) have the potential to be leaders in the era of healthcare delivery reform, but most have yet to display a commitment to delivery innovation on par with their commitment to basic research. Several institutional factors impede delivery innovation including the paucity of adequate training in design and implementation of new delivery models and the lack of established pathways for academic career advancement outside of research. This paper proposes two initiatives to jumpstart disruptive innovation at AMCs: an institutional "innovation incubator" program and a clinician-innovator career track coupled with innovation training programs. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Student Advising and Retention Application in Cloud Computing Environment

    Directory of Open Access Journals (Sweden)

    Gurdeep S Hura

    2016-11-01

    Full Text Available  This paper proposes a new user-friendly application enhancing and expanding the current advising services of Gradesfirst currently being used for advising and retention by the Athletic department of UMES with a view to implement new performance activities like mentoring, tutoring, scheduling, and study hall hours into existing tools. This application includes various measurements that can be used to monitor and improve the performance of the students in the Athletic Department of UMES by monitoring students’ weekly study hall hours, and tutoring schedules. It also supervises tutors’ login and logout activities in order to monitor their effectiveness, supervises tutor-tutee interaction, and stores and analyzes the overall academic progress of each student. A dedicated server for providing services will be developed at the local site. The paper has been implemented in three steps. The first step involves the creation of an independent cloud computing environment that provides resources such as database creation, query-based statistical data, performance measures activities, and automated support of performance measures such as advising, mentoring, monitoring and tutoring. The second step involves the creation of an application known as Student Advising and Retention (SAR application in a cloud computing environment. This application has been designed to be a comprehensive database management system which contains relevant data regarding student academic development that supports various strategic advising and monitoring of students. The third step involves the creation of a systematic advising chart and frameworks which help advisors. The paper shows ways of creating the most appropriate advising technique based on the student’s academic needs. The proposed application runs in a Windows-based system. As stated above, the proposed application is expected to enhance and expand the current advising service of Gradesfirst tool. A brief

  20. Readability of Spine-Related Patient Education Materials From Leading Orthopedic Academic Centers.

    Science.gov (United States)

    Ryu, Justine H; Yi, Paul H

    2016-05-01

    Cross-sectional analysis of online spine-related patient education materials from leading academic centers. To assess the readability levels of spine surgery-related patient education materials available on the websites of academic orthopedic surgery departments. The Internet is becoming an increasingly popular resource for patient education. Yet many previous studies have found that Internet-based orthopedic-related patient education materials from subspecialty societies are written at a level too difficult for the average American; however, no prior study has assessed the readability of spine surgery-related patient educational materials from leading academic centers. All spine surgery-related articles from the online patient education libraries of the top five US News & World Report-ranked orthopedic institutions were assessed for readability using the Flesch-Kincaid (FK) readability test. Mean readability levels of articles amongst the five academic institutions and articles were compared. We also determined the number of articles with readability levels at or below the recommended sixth- or eight-grade levels. Intraobserver and interobserver reliability of readability assessment were assessed. A total of 122 articles were reviewed. The mean overall FK grade level was 11.4; the difference in mean FK grade level between each department varied significantly (range, 9.3-13.4; P level at or below the eighth grade level, and only one (0.8%) was at or below the sixth grade level. Intraobserver and interobserver reliability were both excellent (intraclass correlation coefficient of 1 for both). Online patient education materials related to spine from academic orthopedic centers are written at a level too high for the average patient, consistent with spine surgery-related patient education materials provided by the American Academy of Orthopaedic Surgeons and spine subspecialty societies. This study highlights the potential difficulties patients might have in reading

  1. Implementation of a Routine Health Literacy Assessment at an Academic Medical Center.

    Science.gov (United States)

    Warring, Carrie D; Pinkney, Jacqueline R; Delvo-Favre, Elaine D; Rener, Michelle Robinson; Lyon, Jennifer A; Jax, Betty; Alexaitis, Irene; Cassel, Kari; Ealy, Kacy; Hagen, Melanie Gross; Wright, Erin M; Chang, Myron; Radhakrishnan, Nila S; Leverence, Robert R

    2017-11-14

    Limited health literacy is a common but often unrecognized problem associated with poor health outcomes. Well-validated screening tools are available to identify and provide the opportunity to intervene for at-risk patients in a resource-efficient manner. This is a multimethod study describing the implementation of a hospital-wide routine health literacy assessment at an academic medical center initiated by nurses in April 2014 and applied to all adult inpatients. Results were documented in the electronic health record, which then generated care plans and alerts for patients who screened positive. A nursing survey showed good ease of use and adequate patient acceptance of the screening process. Six months after hospital-wide implementation, retrospective chart abstraction of 1,455 patients showed that 84% were screened. We conclude that a routine health literacy assessment can be feasibly and successfully implemented into the nursing workflow and electronic health record of a major academic medical center.

  2. Strategic planning as a tool for achieving alignment in academic health centers.

    Science.gov (United States)

    Higginbotham, Eve J; Church, Kathryn C

    2012-01-01

    After the passage of the Patient Protection and Affordable Care Act in March 2010, there is an urgent need for medical schools, teaching hospitals, and practice plans to work together seamlessly across a common mission. Although there is agreement that there should be greater coordination of initiatives and resources, there is little guidance in the literature to address the method to achieve the necessary transformation. Traditional approaches to strategic planning often engage a few leaders and produce a set of immeasurable initiatives. A nontraditional approach, consisting of a Whole-Scale (Dannemiller Tyson Associates, Ann Arbor, MI) engagement, appreciative inquiry, and a balanced scorecard can, more rapidly transform an academic health center. Using this nontraditional approach to strategic planning, increased organizational awareness was achieved in a single academic health center. Strategic planning can be an effective tool to achieve alignment, enhance accountability, and a first step in meeting the demands of the new landscape of healthcare.

  3. Strategies for improving attendance at medical grand rounds at an academic medical center.

    Science.gov (United States)

    Mueller, Paul S; Litin, Scott C; Sowden, Monica L; Habermann, Thomas M; LaRusso, Nicholas F

    2003-05-01

    To evaluate, in this before-and-after study, the results of 5 strategies for improving attendance at medical grand rounds at a tertiary care academic medical center. The strategies included (1) using electronic card readers to improve understanding of attendance patterns, (2) conducting yearly needs assessment surveys, (3) developing sessions of topical interest, (4) increasing formal participation by residents and faculty researchers, and (5) enhancing publicity. Attendance at medical grand rounds by Mayo Clinic faculty, fellows, residents, and others was measured by card readers between 1998 and 2001. After implementation of the 5 strategies, the mean +/- SD attendance (as measured by card readers) at medical grand rounds increased 39% from 99.0 +/- 24.6 persons in 1998 to 137.4 +/- 25.2 persons in 2001 (P attendance at medical grand rounds at an academic medical center.

  4. "Innovation" institutes in academic health centers: enhancing value through leadership, education, engagement, and scholarship.

    Science.gov (United States)

    Pines, Jesse M; Farmer, Steven A; Akman, Jeffrey S

    2014-09-01

    In the next decade, the biggest change in medicine in the United States will be the organizational transformation of the delivery system. Organizations-including academic health centers-able to achieve better outcomes for less will be the financial winners as new payment models become more prevalent. For medical educators, the question is how to prepare the next generation of physicians for these changes. One solution is the development of new "innovation" or "value" institutes. Around the nation, many of these new institutes are focused on surmounting barriers to value-based care in academic health centers, educating faculty, house staff, and medical students in discussions of cost-conscious care. Innovation institutes can also lead discussions about how value-based care may impact education in environments where there may be less autonomy and more standardization. Quality metrics will play a larger role at academic health centers as metrics focus more on outcomes than processes. Optimizing outcomes will require that medical educators both learn and teach the principles of patient safety and quality improvement. Innovation institutes can also facilitate cross-institutional discussions to compare data on utilization and outcomes, and share best practices that maximize value. Another barrier to cost-conscious care is defensive medicine, which is highly engrained in U.S. medicine and culture. Innovation institutes may not be able to overcome all the barriers to making medical care more cost-conscious, but they can be critical in enabling academic health centers to optimize their teaching and research missions while remaining financially competitive.

  5. Results of an Institutional LGBT Climate Survey at an Academic Medical Center.

    Science.gov (United States)

    Chester, Sean D; Ehrenfeld, Jesse M; Eckstrand, Kristen L

    2014-12-01

    The purpose of this study was to characterize the climate and culture experienced by lesbian, gay, bisexual, and transgender (LGBT) employees and students at one large academic medical center. An anonymous, online institutional climate survey was used to assess the attitudes and experiences of LGBT employees and students. There were 42 LGBT and 14 non-LGBT survey participants. Results revealed that a surprisingly large percentage of LGBT individuals experienced pressure to remain "closeted" and were harassed despite medical center policies of non-discrimination. Continuing training, inclusive policies and practices, and the development of mechanisms to address LGBT-specific harassment are necessary for improving institutional climate.

  6. 10 Years Later: Lessons Learned from an Academic Multidisciplinary Cosmetic Center.

    Science.gov (United States)

    Chen, Jenny T; Nayar, Harry S; Rao, Venkat K

    2017-09-01

    In 2006, a Centers for Medicare and Medicaid Services-accredited multidisciplinary academic ambulatory surgery center was established with the goal of delivering high-quality, efficient reconstructive, and cosmetic services in an academic setting. We review our decade-long experience since its establishment. Clinical and financial data from 2006 to 2016 are reviewed. All cosmetic procedures, including both minimally invasive and operative cases, are included. Data are compared to nationally published reports. Nearly 3,500 cosmetic surgeries and 10,000 minimally invasive procedures were performed. Compared with national averages, surgical volume in abdominoplasty is high, whereas rhinoplasty and breast augmentation is low. Regarding trend data, breast augmentation volume has decreased by 25%, whereas minimally invasive procedural volume continues to grow and is comparable with national reports. Similarly, where surgical revenue remains steady, minimally invasive revenue has increased significantly. The majority of surgical cases (70%) are reconstructive in nature and insurance-based. Payer mix is 71% private insurance, 18% Medicare and Medicaid, and 11% self-pay. Despite year-over-year revenue increases, net profit in 2015 was $6,120. Rent and anesthesia costs exceed national averages, and employee salary and wages are the highest expenditure. Although the creation of our academic cosmetic ambulatory surgery center has greatly increased the overall volume of cosmetic surgery performed at the University of Wisconsin, the majority of surgical volume and revenue is reconstructive. As is seen nationwide, minimally invasive cosmetic procedures represent our most rapidly expanding revenue stream.

  7. Realizing the vision of leadership development in an academic health center: the Woodruff Leadership Academy.

    Science.gov (United States)

    Korschun, Holly W; Redding, Dennis; Teal, Gary L; Johns, Michael M E

    2007-03-01

    In 2001, senior administrators in Emory University's Woodruff Health Sciences Center (WHSC) designated leadership as the central element of a new strategic plan, believing that an academic health center (AHC) requires excellence in leadership at all organizational levels to carry out the tripartite mission of teaching, research, and patient care. Leadership development in academic medicine presents unique challenges, however, including a wide range of professional roles and diverse operational centers that may be obstacles to unifying a leadership team in the pursuit of a central mission. Many administrators within academic medicine, although highly competent in their areas of expertise, possess limited leadership skills. In 2003, the WHSC created the Woodruff Leadership Academy (WLA) with the goal of developing a cadre of leaders throughout the WHSC with leadership skills relevant to an AHC and, specifically, to the WHSC. The graduates, called Woodruff Fellows, would work with senior leadership to create a shared vision of excellence and to pursue the goal of advancing all WHSC programs into the top rank of AHCs. After the first three years of the WLA, an informal assessment and a formal survey of the 70 fellows who had completed the program indicated that program graduates had embraced enhanced roles and responsibilities, undertaken new cross-disciplinary collaborative relationships, and acquired a renewed enthusiasm and respect for the shared vision of the WHSC.

  8. The economic impact and multiplier effect of a family practice clinic on an academic medical center.

    Science.gov (United States)

    Schneeweiss, R; Ellsbury, K; Hart, L G; Geyman, J P

    1989-07-21

    Academic medical centers are facing the need to expand their primary care referral base in an increasingly competitive medical environment. This study describes the medical care provided during a 1-year period to 6304 patients registered with a family practice clinic located in an academic medical center. The relative distribution of primary care, secondary referrals, inpatient admissions, and their associated costs are presented. The multiplier effect of the primary care clinic on the academic medical center was substantial. For every $1 billed for ambulatory primary care, there was $6.40 billed elsewhere in the system. Each full-time equivalent family physician generated a calculated sum of $784,752 in direct, billed charges for the hospital and $241,276 in professional fees for the other specialty consultants. The cost of supporting a primary care clinic is likely to be more than offset by the revenues generated from the use of hospital and referral services by patients who received care in the primary care setting.

  9. The evolving organizational structure of academic health centers: the case of the University of Florida.

    Science.gov (United States)

    Barrett, Douglas J

    2008-09-01

    The organizational structures of academic health centers (AHCs) vary widely, but they all exist along a continuum of integration--that is, the degree to which the academic and clinical missions operate under a single administrative and governance structure. This author provides a brief overview of the topic of AHC integration, including the pros and cons of more integrated or less integrated models. He then traces the evolution of the University of Florida (UF) Health Science Center, which was created in the 1950s as a fully integrated AHC and which now operates under a more distributed management and governance model. Starting as a completely integrated AHC, UF's Health Science Center reached a time of maximal nonintegration (or dys-integration) in the late 1990s and at the beginning of this decade. Circumstances are now pushing the expanding clinical and academic enterprises to be more together as they face the challenges of market competition, federal research budget constraints, and reengineering clinical operations to reduce costs, enhance access, and improve quality and patient safety. Although formal organizational integration may not be possible or appropriate for any number of legal or political reasons, the author suggests that AHCs should strive for "functional integration" to be successful in the current turbulent environment.

  10. Preparing Academic Medical Centers for the Clinical Learning Environment Review: Alliance of Independent Academic Medical Centers National Initiative IV Outcomes and Evaluation.

    Science.gov (United States)

    Wehbe-Janek, Hania; Markova, Tsveti; Polis, Rachael L; Peters, Marguerite; Liu, Yang

    2016-01-01

    Driven by changes to improve quality in patient care and population health while reducing costs, evolvement of the health system calls for restructuring health professionals' education and aligning it with the healthcare delivery system. In response to these changes, the Accreditation Council for Graduate Medical Education's Clinical Learning Environment Review (CLER) encourages the integration of health system leadership, faculty, and residents in restructuring graduate medical education (GME). Innovative approaches to achieving this restructuring and the CLER objectives are essential. The Alliance of Independent Academic Medical Centers National Initiative (NI) IV provided a multiinstitutional learning collaborative focused on supporting GME redesign. From October 2013 through March 2015, participants conducted relevant projects, attended onsite meetings, and participated in teleconferences and webinars addressing the CLER areas. Participants shared best practices, resources, and experiences. We designed a pre/post descriptive study to examine outcomes. Thirty-three institutions completed NI IV, and at its conclusion, the majority reported greater CLER readiness compared with baseline. Twenty-two (88.0%) institutions reported that NI IV had a great impact on advancing their efforts in the CLER area of their project focus, and 15 (62.5%) reported a great impact in other CLER focus areas. Opportunities to share progress with other teams and the national group meetings were reported to contribute to teams' success. The NI IV learning collaborative prepared institutions for CLER, suggesting successful integration of the clinical and educational enterprises. We propose that national learning collaboratives of GME-sponsoring health systems enable advancement of their education mission, leading ultimately to better healthcare outcomes. This learning model may be generalizable to newfound programs for academic medical centers.

  11. The Role of Plastic Surgery at an Academic Medical Center in the United States.

    Science.gov (United States)

    Pu, Lee L Q; Mirmanesh, Michael

    2017-05-01

    Plastic surgery may have traditionally been labelled as a "less essential" service at many academic medical centers in the United States. The purpose of this study is to evaluate the role of the plastic surgery team as a valuable service at an academic medical center. We performed a 10-year retrospective case review of a single plastic surgeon's case log at 2 academic medical institutions, each with an active plastic surgery training program. Plastic surgical procedures performed in combination with other services and surgical management of complications from nonplastic surgical procedures was evaluated. Plastic surgical procedures performed for all types of reconstruction as a primary service, including breast reconstruction were excluded. The role of the plastic surgery service was evaluated to identify the types of assistance provided, which primary services were involved and what the most common procedures performed were for each service. The type of assistance provided by the plastic surgery service was divided into 2 common categories. The first type involved a concurrent or combined surgical case where the procedure required plastic surgery's participation. The second group included management of complications that occurred on another service, which then required assistance by the plastic surgery team. A total of thirteen primary services were identified as benefitting from involvement with plastic surgery. The most commonly performed reconstructive procedures provided for each service were identified. The plastic surgery team provides invaluable support to other services in a tertiary teaching hospital. Its input allows for more complex surgical procedures to be performed safely and for complications of surgery to be managed successfully. Clearly, plastic surgery plays a critical role at academic medical centers in the United States.

  12. The Effect of Academic Advising on Academic Performance of ...

    African Journals Online (AJOL)

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    adults (Levinson, 1978). Research evidence suggests that there is an empirical link between student mentoring and student retention (Campbell & Cambell, ... Kessler, Brown, & Broman, 1981). Unfortunately, males appear to be reluctant to avail themselves for services even when the helper is a peer rather than some ...

  13. How to Lead the Way Through Complexity, Constraint, and Uncertainty in Academic Health Science Centers.

    Science.gov (United States)

    Lieff, Susan J; Yammarino, Francis J

    2017-05-01

    Academic medicine is in an era of unprecedented and constant change due to fluctuating economies, globalization, emerging technologies, research, and professional and educational mandates. Consequently, academic health science centers (AHSCs) are facing new levels of complexity, constraint, and uncertainty. Currently, AHSC leaders work with competing academic and health service demands and are required to work with and are accountable to a diversity of stakeholders. Given the new challenges and emerging needs, the authors believe the leadership methods and approaches AHSCs have used in the past that led to successes will be insufficient. In this Article, the authors propose that AHSCs will require a unique combination of old and new leadership approaches specifically oriented to the unique complexity of the AHSC context. They initially describe the designer (or hierarchical) and heroic (military and transformational) approaches to leadership and how they have been applied in AHSCs. While these well-researched and traditional approaches have their strengths in certain contexts, the leadership field has recognized that they can also limit leaders' abilities to enable their organizations to be engaged, adaptable, and responsive. Consequently, some new approaches have emerged that are taking hold in academic work and professional practice. The authors highlight and explore some of these new approaches-the authentic, self, shared, and network approaches to leadership-with attention to their application in and utility for the AHSC context.

  14. Luxury Primary Care, Academic Medical Centers, and the Erosion of Science and Professional Ethics

    Science.gov (United States)

    Donohoe, Martin

    2004-01-01

    Medical schools and teaching hospitals have been hit particularly hard by the financial crisis affecting health care in the United States. To compete financially, many academic medical centers have recruited wealthy foreign patients and established luxury primary care clinics. At these clinics, patients are offered tests supported by little evidence of their clinical and/or cost effectiveness, which erodes the scientific underpinnings of medical practice. Given widespread disparities in health, wealth, and access to care, as well as growing cynicism and dissatisfaction with medicine among trainees, the promotion by these institutions of an overt, two-tiered system of care, which exacerbates inequities and injustice, erodes professional ethics. Academic medical centers should divert their intellectual and financial resources away from luxury primary care and toward more equitable and just programs designed to promote individual, community, and global health. The public and its legislators should, in turn, provide adequate funds to enable this. Ways for academic medicine to facilitate this largesse are discussed. PMID:14748866

  15. Perspective: Malpractice in an academic medical center: a frequently overlooked aspect of professionalism education.

    Science.gov (United States)

    Hochberg, Mark S; Seib, Carolyn D; Berman, Russell S; Kalet, Adina L; Zabar, Sondra R; Pachter, H Leon

    2011-03-01

    Understanding how medical malpractice occurs and is resolved is important to improving patient safety and preserving the viability of a physician's career in academic medicine. Every physician is likely to be sued by a patient, and how the physician responds can change his or her professional life. However, the principles of medical malpractice are rarely taught or addressed during residency training. In fact, many faculty at academic medical centers know little about malpractice.In this article, the authors propose that information about the inciting causes of malpractice claims and their resolution should be incorporated into residency professionalism curricula both to improve patient safety and to decrease physician anxiety about a crucial aspect of medicine that is not well understood. The authors provide information on national trends in malpractice litigation and residents' understanding of malpractice, then share the results of their in-depth review of surgical malpractice claims filed during 2001-2008 against their academic medical center. The authors incorporated those data into an evidence-driven curriculum for residents, which they propose as a model for helping residents better understand the events that lead to malpractice litigation, as well as its process and prevention.

  16. Variation in Costs of Spinal Implants in United States Academic Medical Centers.

    Science.gov (United States)

    Pahlavan, Sohrab; Berven, Sigurd; Bederman, Stacey Samuel

    2016-03-01

    Retrospective study of benchmarking database. To evaluate the variability in direct costs of spinal implants across various academic medical centers, determining variability between and within specific manufacturers, and to measure the relationship between purchasing volume and price. Spinal implants are a significant component of the cost of surgery. There is an absence of transparency of how much various medical centers in the United States pay for implants because of the use of nondisclosure agreements as part of price negotiations. Transparency of information on costs and awareness of costs by physicians will be useful in managing costs in a value-based health care economy. Purchasing records of 45 academic medical centers over a 12-month period were examined. Purchasing volume and unit pricing for pedicle screws (PS), anterior cervical plates (ACP), and transforaminal lumbar interbody fusion (TLIF) cages were collected for 6 manufacturers. Overall variation in implant costs across centers and for each manufacturer was determined as was the relationship between purchasing volume and unit price. We found variation in implant costs between medical centers, and between manufacturers for PS, ACP and TLIF similar to joint replacement implants. Regression analysis showed that for each 10-fold increase in purchasing volume, the unit price decreased by $126 for PS, $242 for ACP, and $789 for TLIF. There was variation in implant costs between medical centers and manufacturers of implants, with a small negative relationship between purchasing volume and cost. Transparency in cost negotiation, surgeon awareness of costs and alignment between surgeon and hospital goals may help decrease the cost of spinal implants, and the cost of care for patients undergoing instrumented fusions.

  17. Nursing schools and academic health centers: toward improved alignment and a synergistic partnership.

    Science.gov (United States)

    Emami, Azita; Jaffe, Darcy; Minton-Foltz, Paula; Parker, Grace; Manfredi, Susan; Braungardt, Theresa; Marley, Kelly W; Cooley, Laura; Siem, Staishy Bostick

    2017-01-01

    This paper presents the findings from a national survey which the University of Washington conducted among leaders of 32 US academic nursing institutions that are part of academic health centers (AHCs) and complements these findings with results from a separate report by the American Association of Colleges of Nursing. While expressing overall satisfaction with their AHC relationships, these leaders find that nursing is often given greater parity in matters of education and research than in mission setting, financial, and governance matters. AHCs are being asked to meet new health care challenges in new ways, starting with the education of health care professionals. AHCs need to be restructured to give nursing full parity if the nation's and world's needs for preventive and clinical care are to be best met.

  18. Critical Care Organizations in Academic Medical Centers in North America: A Descriptive Report.

    Science.gov (United States)

    Pastores, Stephen M; Halpern, Neil A; Oropello, John M; Kostelecky, Natalie; Kvetan, Vladimir

    2015-10-01

    With the exception of a few single-center descriptive reports, data on critical care organizations are relatively sparse. The objectives of our study were to determine the structure, governance, and experience to date of established critical care organizations in North American academic medical centers. A 46-item survey questionnaire was electronically distributed using Survey Monkey to the leadership of 27 identified critical care organizations in the United States and Canada between September 2014 and February 2015. A critical care organization had to be headed by a physician and have primary governance over the majority, if not all, of the ICUs in the medical center. We received 24 responses (89%). The majority of the critical care organizations (83%) were called departments, centers, systems, or operations committees. Approximately two thirds of respondents were from larger (> 500 beds) urban institutions, and nearly 80% were primary university medical centers. On average, there were six ICUs per academic medical center with a mean of four ICUs under critical care organization governance. In these ICUs, intensivists were present in-house 24/7 in 49%; advanced practice providers in 63%; hospitalists in 21%; and telemedicine coverage in 14%. Nearly 60% of respondents indicated that they had a separate hospital budget to support data management and reporting, oversight of their ICUs, and rapid response teams. The transition from the traditional model of ICUs within departmentally controlled services or divisions to a critical care organization was described as gradual in 50% and complete in only 25%. Nearly 90% indicated that their critical care organization governance structure was either moderately or highly effective; a similar number suggested that their critical care organizations were evolving with increasing domain and financial control of the ICUs at their respective institutions. Our survey of the very few critical care organizations in North American

  19. Establishing an Integrative Medicine Program Within an Academic Health Center: Essential Considerations.

    Science.gov (United States)

    Eisenberg, David M; Kaptchuk, Ted J; Post, Diana E; Hrbek, Andrea L; O'Connor, Bonnie B; Osypiuk, Kamila; Wayne, Peter M; Buring, Julie E; Levy, Donald B

    2016-09-01

    Integrative medicine (IM) refers to the combination of conventional and "complementary" medical services (e.g., chiropractic, acupuncture, massage, mindfulness training). More than half of all medical schools in the United States and Canada have programs in IM, and more than 30 academic health centers currently deliver multidisciplinary IM care. What remains unclear, however, is the ideal delivery model (or models) whereby individuals can responsibly access IM care safely, effectively, and reproducibly in a coordinated and cost-effective way.Current models of IM across existing clinical centers vary tremendously in their organizational settings, principal clinical focus, and services provided; practitioner team composition and training; incorporation of research activities and educational programs; and administrative organization (e.g., reporting structure, use of medical records, scope of clinical practice) and financial strategies (i.e., specific business plans and models for sustainability).In this article, the authors address these important strategic issues by sharing lessons learned from the design and implementation of an IM facility within an academic teaching hospital, the Brigham and Women's Hospital at Harvard Medical School; and review alternative options based on information about IM centers across the United States.The authors conclude that there is currently no consensus as to how integrative care models should be optimally organized, implemented, replicated, assessed, and funded. The time may be right for prospective research in "best practices" across emerging models of IM care nationally in an effort to standardize, refine, and replicate them in preparation for rigorous cost-effectiveness evaluations.

  20. Analysis of Academic Medical Center Graduate Medical Education Websites for Policies Regarding Restrictive Covenants in Non-ACGME Fellowships.

    Science.gov (United States)

    Juern, Jeremy S; Stahl, David M; Weigelt, John A

    2017-10-25

    The topic of restrictive covenants in fellowships that are not approved by the Accreditation Council for Graduate Medical Education (ACGME) has not been studied. To investigate the presence of institutional polices at academic medical centers regarding restrictive covenants in non-ACGME fellowships. The graduate medical education (GME) office website of 132 academic medical centers was evaluated and searched for the following as of June 1, 2017: presence of any ACGME residency or fellowship, presence of any non-ACGME fellowship, presence of GME policies and procedures, presence of a restrictive covenant policy, and if that policy applies to non-ACGME fellowships. A total of 96 academic medical centers had non-ACGME fellowships. Of these, 56 prohibit restrictive covenants in non-ACGME fellowships because of either their GME policy or state law. Seven academic medical centers have a GME policy that allows restrictive covenants in non-ACGME fellowships. Two academic medical centers clearly state that fellows in a certain subspecialty fellowship will be required to sign a restrictive covenant. GME policies at academic medical centers that allow restrictive covenants in non-ACGME fellowships are very uncommon. The practice of having fellows sign a restrictive covenant in a non-ACGME fellowship is in conflict with an American Medical Association ethics statement, ACGME institutional requirement IV.L, and the rules of the San Francisco Match. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  1. Academic partnerships to increase nursing education capacity: centralized faculty resource and clinical placement centers.

    Science.gov (United States)

    Burns, Paulette; Williams, Sally Harper; Ard, Nell; Enright, Carissa; Poster, Elizabeth; Ransom, Sharon A

    2011-01-01

    The North Texas Consortium of Professional Nursing Programs and Practice Partners is a regional academic partnership of nursing education and practice organizational leaders working together to share innovative ideas and best practices and to improve efficiencies that impact nursing education. The region's 15 nursing schools produced 25% of the Texas graduates, or 1,782 graduates, in 2008-2009. Yet, 3,522 graduates are needed in 2013-2014 to meet the projected north Texas demand. Barriers to increasing enrollment and graduation numbers were the lack of sufficient faculty to meet demand and insufficient numbers of clinical placement sites. To increase the capacity for graduating the numbers of nurses needed, the region developed a three-pronged plan to overcome each of these barriers: expansion of partnership members and development of a regional computerized clinical placement center and faculty resource center. The academic partnership expanded its members to include the 15 schools of nursing, more than 50 hospitals, and the Dallas Fort Worth Hospital Council (DFWHC) Foundation for the purposes of governance of the two proposed computerized centers and strategic planning for increased capacity. The faculty resource center is a centralized, one-stop shop for those interested in teaching and those needing faculty. The Centralized Clinical Placement Center is expected to streamline the nursing student clinical placements process and monitor the numbers of students per site at a given time so as to ensure that placements are at capacity and that schools of nursing benefit fairly in placing students in specialty areas to meet course objectives. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Laparoscopic sleeve gastrectomy leads the U.S. utilization of bariatric surgery at academic medical centers.

    Science.gov (United States)

    Varela, J Esteban; Nguyen, Ninh T

    2015-01-01

    Analysis of a recent single state bariatric surgery registry revealed that laparoscopic sleeve gastrectomy was the most common bariatric procedure starting in 2012. The objective of this study was to examine the trend in utilization of laparoscopic sleeve gastrectomy performed at academic medical centers in the United States. Using ICD-9 diagnosis and procedure codes, clinical data obtained from the University HealthSystem Consortium database for all bariatric procedures performed for the treatment of severe obesity between October 1, 2011, and June 30, 2014. Quarterly trends in utilization for the 4 most commonly performed bariatric operations were examined, and comparisons between procedures were performed. A total of 54,953 bariatric procedures were performed. Utilization of laparoscopic sleeve gastrectomy increased from 23.7% of all bariatric procedures during the fourth quarter of 2011 to 60.7% during the second quarter of 2014 while laparoscopic gastric bypass decreased from 62.2% to 37.0%, respectively. Utilization of laparoscopic sleeve gastrectomy surpassed that of laparoscopic gastric bypass in the second quarter of 2013 (50.6% versus 45.8%). During the same time period, utilization of open gastric bypass fell from 6.6% to 1.5%, and the use of laparoscopic adjustable gastric banding decreased from 7.5% to .8%. Within the context of U.S. academic medical centers, there has been a significant increase in the utilization of laparoscopic sleeve gastrectomy, which has surpassed laparoscopic gastric bypass utilization since 2013. Laparoscopic sleeve gastrectomy is now the most commonly performed bariatric procedure at the national level within academic centers. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  3. Implementation of epic beaker anatomic pathology at an academic medical center

    Directory of Open Access Journals (Sweden)

    John Larry Blau

    2017-01-01

    Full Text Available Background: Beaker is a relatively new laboratory information system (LIS offered by Epic Systems Corporation as part of its suite of health-care software and bundled with its electronic medical record, EpicCare. It is divided into two modules, Beaker anatomic pathology (Beaker AP and Beaker Clinical Pathology. In this report, we describe our experience implementing Beaker AP version 2014 at an academic medical center with a go-live date of October 2015. Methods: This report covers preimplementation preparations and challenges beginning in September 2014, issues discovered soon after go-live in October 2015, and some post go-live optimizations using data from meetings, debriefings, and the project closure document. Results: We share specific issues that we encountered during implementation, including difficulties with the proposed frozen section workflow, developing a shared specimen source dictionary, and implementation of the standard Beaker workflow in large institution with trainees. We share specific strategies that we used to overcome these issues for a successful Beaker AP implementation. Several areas of the laboratory-required adaptation of the default Beaker build parameters to meet the needs of the workflow in a busy academic medical center. In a few areas, our laboratory was unable to use the Beaker functionality to support our workflow, and we have continued to use paper or have altered our workflow. In spite of several difficulties that required creative solutions before go-live, the implementation has been successful based on satisfaction surveys completed by pathologists and others who use the software. However, optimization of Beaker workflows has continued to be an ongoing process after go-live to the present time. Conclusions: The Beaker AP LIS can be successfully implemented at an academic medical center but requires significant forethought, creative adaptation, and continued shared management of the ongoing product by

  4. Trends in academic health sciences libraries and their emergence as the "knowledge nexus" for their academic health centers.

    Science.gov (United States)

    Kronenfeld, Michael R

    2005-01-01

    The objective of this study was to identify trends in academic health sciences libraries (AHSLs) as they adapt to the shift from a print knowledgebase to an increasingly digital knowledgebase. This research was funded by the 2003 David A. Kronick Traveling Fellowship. The author spent a day and a half interviewing professional staff at each library. The questionnaire used was sent to the directors of each library in advance of the visit, and the directors picked the staff to be interviewed and set up the schedule. Seven significant trends were identified. These trends are part of the shift of AHSLs from being facility and print oriented with a primary focus on their role as repositories of a print-based knowledgebase to a new focus on their role as the center or "nexus" for the organization, access, and use of an increasingly digital-based knowledgebase. This paper calls for a national effort to develop a new model or structure for health sciences libraries to more effectively respond to the challenges of access and use of a digital knowledgebase, much the same way the National Library of Medicine did in the 1960s and 1970s in developing and implementing the National Network of Libraries of Medicine. The paper then concludes with some examples or ideas for research to assist in this process.

  5. Trends in academic health sciences libraries and their emergence as the “knowledge nexus” for their academic health centers*

    Science.gov (United States)

    Kronenfeld, Michael R.

    2005-01-01

    Objectives: The objective of this study was to identify trends in academic health sciences libraries (AHSLs) as they adapt to the shift from a print knowledgebase to an increasingly digital knowledgebase. This research was funded by the 2003 David A. Kronick Traveling Fellowship. Methods: The author spent a day and a half interviewing professional staff at each library. The questionnaire used was sent to the directors of each library in advance of the visit, and the directors picked the staff to be interviewed and set up the schedule. Results: Seven significant trends were identified. These trends are part of the shift of AHSLs from being facility and print oriented with a primary focus on their role as repositories of a print-based knowledgebase to a new focus on their role as the center or “nexus” for the organization, access, and use of an increasingly digital-based knowledgebase. Conclusion: This paper calls for a national effort to develop a new model or structure for health sciences libraries to more effectively respond to the challenges of access and use of a digital knowledgebase, much the same way the National Library of Medicine did in the 1960s and 1970s in developing and implementing the National Network of Libraries of Medicine. The paper then concludes with some examples or ideas for research to assist in this process. PMID:15685271

  6. Establishing a new clinical informationist role in an academic health sciences center.

    Science.gov (United States)

    Aldrich, Alison M; Schulte, Stephanie J

    2014-01-01

    The concept of clinical informationists is not new, but has recently been gaining more widespread acceptance across the United States. This article describes the lessons and challenges learned from starting a new clinical informationist service targeted to internal medicine residents in a large academic medical center. Lessons included the need for becoming immersed in evidence-based practice fundamentals; becoming comfortable with the pace, realities, and topics encountered during clinical rounds; and needing organizational commitment to both the evidence-based practice paradigm and clinical informationist role. Challenges included adapting to organizational culture, resident burnout, and perceptions of information overload.

  7. Roles of managers in academic health centers: strategies for the managed care environment.

    Science.gov (United States)

    Guo, Kristina L

    2002-03-01

    This article addresses survival strategies of academic health centers (AHCs) in responding to market pressures and government reforms. Using six case studies of AHCs, the study links strategic changes in structure and management to managerial role performance. Utilizing Mintzberg's classification of work roles, the roles of liaison, monitor, entrepreneur, and resource allocator were found to be used by top-level managers as they implement strategies to enhance the viability of their AHCs. Based on these new roles, the study recommends improving management practices through education and training as well as changing organizational culture to support management decision making and foster the continued growth of managers and their AHCs.

  8. Rubbia to advise on research

    CERN Multimedia

    1993-01-01

    Carlo Rubbia, the author of the Rubbia report on high performance computing and networking, has been called in by the European Commission to advise on the future of the Community's research policy. He is a Nobel Prize winner for physics (1984), and director-general of CERN in Geneva. Rubbia will be one of three internationally reowned European scientists called in by the Commission.

  9. Trends in the Use of Medical Imaging to Diagnose Appendicitis at an Academic Medical Center.

    Science.gov (United States)

    Repplinger, Michael D; Weber, Andrew C; Pickhardt, Perry J; Rajamanickam, Victoria P; Svenson, James E; Ehlenbach, William J; Westergaard, Ryan P; Reeder, Scott B; Jacobs, Elizabeth A

    2016-09-01

    To quantify the trends in imaging use for the diagnosis of appendicitis. A retrospective study covering a 22-year period was conducted at an academic medical center. Patients were identified by International Classification of Diseases-9 diagnosis code for appendicitis. Medical record data extraction of these patients included imaging test used (ultrasound, CT, or MRI), gender, age, and body mass index (BMI). The proportion of patients undergoing each scan was calculated by year. Regression analysis was performed to determine whether age, gender, or BMI affected imaging choice. The study included a total of 2,108 patients, including 967 (43.5%) females and 599 (27%) children (imaging used for the diagnosis of appendicitis decreased over time (P medical center, CT use increased more than 20-fold. However, no statistically significant trend was found for increased use of ultrasound or MRI. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  10. A Novel Measure of "Good" Mentoring: Testing Its Reliability and Validity in Four Academic Health Centers.

    Science.gov (United States)

    Pololi, Linda H; Evans, Arthur T; Civian, Janet T; Gibbs, Brian K; Gillum, Linda H; Brennan, Robert T

    2016-01-01

    Despite the well-recognized benefits of mentoring in academic medicine, there is a lack of clarity regarding what constitutes effective mentoring. We developed a tool to assess mentoring activities experienced by faculty and evaluated evidence for its validity. The National Initiative on Gender, Culture, and Leadership in Medicine-"C-Change"-previously developed the C-Change Faculty Survey to assess the culture of academic medicine. After intensive review, we added six items representing six components of mentoring to the survey-receiving help with career and personal goals, learning skills, sponsorship, and resources. We tested the items in four academic health centers during 2013 to 2014. We estimated reliability of the new items and tested the correlation of the new items with a mentoring composite variable representing faculty mentoring experiences as positive, neutral, or inadequate and with other C-Change dimensions of culture. Among the 1520 responding faculty (response rate 61-63%), there was a positive association between each of the six mentoring activities and satisfaction with both the amount and quality of mentoring received. There was no difference by sex. Cronbach α coefficients ranged from 0.89 to 0.95 across subgroups of faculty (by sex, race, and principal roles). The mentoring responses were associated most closely with dimensions of Institutional Support (r = 0.58, P Mentoring scale is a valid instrument to assess mentoring. Survey results could facilitate mentoring program development and evaluation.

  11. A New Community Health Center/Academic Medicine Partnership for Medicaid Cost Control, Powered by the Mega Teaching Health Center.

    Science.gov (United States)

    Rieselbach, Richard E; Epperly, Ted; Friedman, Aaron; Keahey, David; McConnell, Eleanor; Nichols, Karen; Nycz, Greg; Roberts, Jeanette; Schmader, Kenneth; Shin, Peter; Shtasel, Derri

    2018-03-01

    Community health centers (CHCs), a principal source of primary care for over 24 million patients, provide high-quality affordable care for medically underserved and lower-income populations in urban and rural communities. The authors propose that CHCs can assume an important role in the quest for health care reform by serving substantially more Medicaid patients. Major expansion of CHCs, powered by mega teaching health centers (THCs) in partnership with regional academic medical centers (AMCs) or teaching hospitals, could increase Medicaid beneficiaries' access to cost-effective care. The authors propose that this CHC expansion could be instrumental in limiting the added cost of Medicaid expansion via the Affordable Care Act (ACA) or subsequent legislation. Nevertheless, expansion cannot succeed without developing this CHC-AMC partnership both (1) to fuel the currently deficient primary care provider workforce pipeline, which now greatly limits expansion of CHCs; and (2) to provide more CHC-affiliated community outreach sites to enhance access to care. The authors describe the current status of Medicaid and CHCs, plus the evolution and vulnerability of current THCs. They also explain multiple features of a mega THC demonstration project designed to test this new paradigm for Medicaid cost control. The authors contend that the demonstration's potential for success in controlling costs could provide help to preserve the viability of current and future expanded state Medicaid programs, despite a potential ultimate decrease in federal funding over time. Thus, the authors believe that the new AMC-CHC partnership paradigm they propose could potentially facilitate bipartisan support for repairing the ACA.

  12. The role of the academic medical center library in training public librarians.

    Science.gov (United States)

    Wessel, Charles B; Wozar, Jody A; Epstein, Barbara A

    2003-07-01

    This project enhanced access to and awareness of health information resources on the part of public libraries in western Pennsylvania. The Health Sciences Library System (HSLS), University of Pittsburgh, conducted a needs assessment and offered a series of workshops to 298 public librarians. The National Library of Medicine-funded project "Access to Electronic Health Information" at the HSLS, University of Pittsburgh, provided Internet health information training to public libraries and librarians in sixteen counties in western Pennsylvania. Through this project, this academic medical center library identified the challenges for public librarians in providing health-related reference service, developed a training program to address those challenges, and evaluated the impact of this training on public librarians' ability to provide health information. The HSLS experience indicates academic medical center libraries can have a positive impact on their communities by providing health information instruction to public librarians. The success of this project--demonstrated by the number of participants, positive course evaluations, increased comfort level with health-related reference questions, and increased use of MEDLINEplus and other quality information resources--has been a catalyst for continuation of this programming, not only for public librarians but also for the public in general. A training needs assessment, course evaluation, and impact training survey were used in developing the curriculum and evaluating the impact of this training on public librarians' professional activities.

  13. Collaborating to improve the global competitiveness of US academic medical centers.

    Science.gov (United States)

    Allen, Molly; Garman, Andrew; Johnson, Tricia; Hohmann, Samuel; Meurer, Steve

    2012-01-01

    President Obama announced the National Export Initiative in his 2010 State of the Union address and set the ambitious goal of doubling US exports by the end of 2014 to support millions of domestic jobs. Understanding the competitive position of US health care in the global market for international patients, University Health System Consortium (UHC), an alliance of 116 academic medical centers and 272 of their affiliated hospitals, representing 90 percent of the nation's non-profit academic medical centers partnered with Rush University, a private University in Chicago, IL and the International Trade Administration of the US Department of Commerce International Trade Administration (ITA) to participate in the Market Development Cooperator Program. The goal of this private-public partnership is to increase the global competitiveness of the US health care industry, which represents over 16 percent of the GDP, amongst foreign health care providers. This article provides an overview of the US health care market and outlines the aims of the US Cooperative for International Patient Programs, the end result of the partnership between UHC, ITA and Rush University.

  14. United States academic medical centers: priorities and challenges amid market transformation.

    Science.gov (United States)

    Thompson, Irene M; Anason, Barbara

    2012-01-01

    United States academic medical centers (AMCs) have upheld their long-standing reputation for excellence by teaching and training the next generation of physicians, supporting medical research, providing world-class medical care, and offering breakthrough treatments for highly complex medical cases. In recent years, the pace and direction of change reshaping the American health care industry has created a set of new and profound challenges that AMC leaders must address in order to sustain their institutions. University HealthSystem Consortium (UHC) is an alliance of 116 leading nonprofit academic medical centers and 276 of their affiliated hospitals, all of which are focused on delivering world-class patient care. Formed in 1984, UHC fosters collaboration with and among its members through its renowned programs and services in the areas of comparative data and analytics, performance improvement, supply chain management, strategic research, and public policy. Each year, UHC surveys the executives of its member institutions to understand the issues they view as most critical to sustaining the viability and success of their organizations. The results of UHC's most recent 2011 member survey, coupled with a 2012 Strategic Health Perspectives Harris Interactive presentation, based in parton surveys of major health care industry stakeholders reveal the most important and relevant issues and opportunities that hospital leaders face today, as the United States health care delivery system undergoes a period of unprecedented transformation.

  15. Productivity assessment of physician assistants and nurse practitioners in oncology in an academic medical center.

    Science.gov (United States)

    Moote, Marc; Nelson, Ron; Veltkamp, Robin; Campbell, Darrell

    2012-05-01

    Demand for oncologists will increase dramatically over the next 15 years. Physician assistants (PAs) and Nurse practitioners (NPs) have been identified as one solution to meet the projected shortages in oncology. It has previously been reported that 56% of oncologists work with PAs and NPs, more than two thirds of whom believe it benefits their practice with some noted productivity advantages. The purpose of this study was to quantify the productivity of PAs and NPs working in oncology in an academic medical center. A 2-week self-reported time study was performed in a single large academic medical center. Services were categorized as billable, bundled, care facilitation, administrative, and other based on time spent performing services in each category. Current procedural terminology codes were used to determine the economic value of services provided. A total of 54 PAs and NPs were included in the final analysis. PAs and NPs reported similar clinical activities. Overall, there was high variability noted in terms of productivity, notably with PA/NP direct billable revenue. Opportunities were identified to improve utilization of oncology PAs and NPs, with suggestions for future research related to PA and NP productivity tracking. Productivity measurement for PAs and NPs can be challenging. To our knowledge, this is the first study that quantifies PA and NP productivity in oncology according to known economic indicators such as charges and work relative value units.

  16. Needs Assessment for Research Use of High-Throughput Sequencing at a Large Academic Medical Center.

    Science.gov (United States)

    Geskin, Albert; Legowski, Elizabeth; Chakka, Anish; Chandran, Uma R; Barmada, M Michael; LaFramboise, William A; Berg, Jeremy; Jacobson, Rebecca S

    2015-01-01

    Next Generation Sequencing (NGS) methods are driving profound changes in biomedical research, with a growing impact on patient care. Many academic medical centers are evaluating potential models to prepare for the rapid increase in NGS information needs. This study sought to investigate (1) how and where sequencing data is generated and analyzed, (2) research objectives and goals for NGS, (3) workforce capacity and unmet needs, (4) storage capacity and unmet needs, (5) available and anticipated funding resources, and (6) future challenges. As a precursor to informed decision making at our institution, we undertook a systematic needs assessment of investigators using survey methods. We recruited 331 investigators from over 60 departments and divisions at the University of Pittsburgh Schools of Health Sciences and had 140 respondents, or a 42% response rate. Results suggest that both sequencing and analysis bottlenecks currently exist. Significant educational needs were identified, including both investigator-focused needs, such as selection of NGS methods suitable for specific research objectives, and program-focused needs, such as support for training an analytic workforce. The absence of centralized infrastructure was identified as an important institutional gap. Key principles for organizations managing this change were formulated based on the survey responses. This needs assessment provides an in-depth case study which may be useful to other academic medical centers as they identify and plan for future needs.

  17. Diagnosis of attention-deficit/hyperactivity disorder by developmental pediatricians in academic centers: A DBPNet study.

    Science.gov (United States)

    Feldman, Heidi M; Blum, Nathan J; Gahman, Amy E; Shults, Justine

    2015-01-01

    To describe the developmental-behavioral pediatricians (DBPs), patients, and clinical practices used in the diagnostic assessments of attention-deficit/hyperactivity disorder (ADHD) within all 12 academic medical centers comprising Developmental-Behavioral Pediatrics Research Network (DBPNet). Between December 2011 and June 2012, all DBPs who evaluated children with ADHD or autism spectrum disorders were asked to complete a diagnostic encounter survey form for up to 10 consecutive new cases that resulted in the diagnosis of ADHD or autism spectrum disorder. Fifty-two clinicians returned one or more forms for children diagnosed with ADHD (n = 211). DBPs were generally experienced full-time academics. Children were 76.3% male, 62.3% white, 24.5% African American, and 20.7% Hispanic. Mean child age was 8.0 + 3.1 years. DBPs reviewed parent ratings of behavior in 84.4% and teacher ratings in 69.2% of cases. They reviewed or completed at least one developmental assessment in 79.2% of cases: intelligence (60.2%), academic (57.8%), fine motor or visual motor (39.3%), speech/language (34.6%), or adaptive skills (28.9%). They made the diagnosis of coexisting conditions in 82.7% of cases, including learning disabilities (31.8%), speech/language disorders (31.8%), anxiety (14.2%), externalizing disorders (10.9%), and sleep disorders (9.5%). Among 146 children not medicated before the visit, stimulant medications were initiated in 15 children (10.2%). Within DBPNet, DBPs were highly likely to complete comprehensive assessments of ADHD that went beyond the requirements of primary care practice guidelines. They typically identified coexisting developmental and learning conditions. They did not typically prescribe medication at the end of diagnostic encounters. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  18. A journey through meaningful use at a large academic medical center: lessons of leadership, administration, and technical implementation.

    Science.gov (United States)

    Unger, Melissa D; Aldrich, Alison M; Hefner, Jennifer L; Rizer, Milisa K

    2014-01-01

    Successfully reporting meaningful use of electronic health records to the Centers for Medicare and Medicaid Services can be a challenging process, particularly for healthcare organizations with large numbers of eligible professionals. This case report describes a successful meaningful use attestation process undertaken at a major academic medical center. It identifies best practices in the areas of leadership, administration, communication, ongoing support, and technological implementation.

  19. The Future of Dental Schools in Research Universities and Academic Health Centers.

    Science.gov (United States)

    McCauley, Laurie K

    2017-09-01

    As a profession, dentistry is at a point of discernible challenge as well as incredible opportunity in a landscape of evolving changes to health care, higher education, and evidence-based decision making. Respecting the past yet driving forward, a well-mapped future course is critical. Orchestrating this course in a collaborative manner is essential for the visibility, well-being, and potentially the existence of the dental profession. The research performed in dental institutions needs to be contemporary, aligned with biomedical science in general, and united with other disciplines. Dentistry is at risk of attrition in the quality of its research and discovery mission if participation with bioscience colleagues in the collaborative generation of new knowledge is underoptimized. A fundamental opportunity dentistry has is to contribute via its position in academic health centers. Rigorous research as to the impact of interprofessional education and collaborative care on population health outcomes provides significant potential for the dental profession to participate and/or lead such evidence-centered efforts. It is imperative that academic dental institutions are part of interdisciplinary and transdisciplinary organizations that move health care into its new day. Strategizing diversity by bringing together people who have different ways of seeing problems to share perspectives, heuristics, interpretations, technologies, and predictive models across disciplines will lead to impactful progress. Academic dental institutions are a natural part of an emphasis on translational research and acceleration of implementing new scientific discoveries. Dentistry needs to remain an essential and integrated component of higher education in the health professions; doing so necessitates deliberate, respectful, and committed change. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  20. Leadership in academic health centers in the US: a review of the role and some recommendations.

    Science.gov (United States)

    Weil, Thomas P

    2014-01-01

    The leadership of the US's most complex academic health centers (AHCs)/medical centers requires individuals who possess a high level of clinical, organizational, managerial, and interpersonal skills. This paper first outlines the major attributes desired in a dean/vice president of health affairs before then summarizing the educational opportunities now generally available to train for such leadership and management roles. For the most part, the masters in health administration (MHA), the traditional MBA, and the numerous alternatives primarily available at universities are considered far too general and too lacking in emotional intelligence tutoring to be particularly relevant for those who aspire to these most senior leadership positions. More appropriate educational options for these roles are discussed: (a) the in-house leadership and management programs now underway at some AHCs for those selected early on in their career for future executive-type roles as well as for those who are appointed later on to a chair, directorship or similar position; and (b) a more controversial approach of potentially establishing at one or a few universities, a mid-career, professional program (a maximum of 12 months and therefore, being completed in less time than an MBA) leading to a masters degree in academic health center administration (MHCA) for those who aspire to fill a senior AHC leadership position. The proposed curriculum as outlined herein might be along the lines of some carefully designed masters level on-line, self-teaching modules for the more technical subjects, yet vigorously emphasizing integrate-type courses focused on enhancing personal and professional team building and leadership skills. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  1. Intermediate uveitis: pattern of etiology, complications, treatment and outcome in a tertiary academic center.

    Science.gov (United States)

    Ness, Thomas; Boehringer, Daniel; Heinzelmann, Sonja

    2017-04-27

    Patients with intermediate uveitis (IU) represent a heterogenous group characterized by a wide spectrum of etiologies and regional differences. Aim of the study was to analyze the characteristics of patients with IU examined in an academic center in Germany. We conducted a retrospective analysis of the clinical records of all patients with intermediate uveitis referred to the Eye Center, University of Freiburg from 2007 to 2014. Diagnosis followed the Standardization in Uveitis Nomenclature (SUN) criteria. Data analysis included: etiology of IU, demographics, complications, treatment and visual acuity. We identified 159 patients with intermediate uveitis during that period. Mean age at diagnosis was 35 years. Most are female (64%), and the mean duration of IU was 6.1 years (range 1 month - 35 years). Etiology of IU was idiopathic in 59%. Multiple sclerosis (MS) (20%) and sarcoidosis (10%) were frequent systemic causes of IU. Other etiologies including infectious diseases (tuberculosis, borreliosis) or immune-mediated conditions (eg, after vaccination) were present in 11%. The pattern of complications included macular edema (CME) (36%), cataract (24%), secondary glaucoma (7%), and epiretinal membrane formation (19%). Periphlebitis and optic neuritis were more frequent in conjunction with MS. Treatment comprised local and systemic steroids, immunosuppressive agents, biologics, and surgery. Best corrected visual acuity was better than 20/25 in 60% of the eyes after more than 10 years of follow-up. In our German academic center, most IU cases were idiopathic or associated with MS or sarcoidosis. In contrast to other countries, infectious cases were rare. Patients' overall visual prognosis is favorable even when the duration of IU has been long and and despite numerous complications.

  2. Moral Distress in Nurses Providing Direct Patient Care at an Academic Medical Center.

    Science.gov (United States)

    Sirilla, Janet; Thompson, Kathrynn; Yamokoski, Todd; Risser, Mark D; Chipps, Esther

    2017-04-01

    Moral distress is the psychological response to knowing the appropriate action but not being able to act due to constraints. Previous authors reported moral distress among nurses, especially those that work in critical care units. The aims of this study were: (1) to examine the level of moral distress among nurses who work at an academic health system, (2) to compare the level of moral distress in nurses who work across specialty units at an academic health system, (3) to compare moral distress by the demographic characteristics of nurses and work experience variables, and (4) to identify demographic characteristics and type of clinical setting that may predict which nurses are at high risk for moral distress. A cross-sectional survey design was used with staff nurses who work on inpatient units and ambulatory units at an academic medical center. The moral distress scale-revised (MDS-R) was used to assess the intensity and frequency of moral distress. The overall mean MDS-R score in this project was low at 94.97 with mean scores in the low to moderate range (44.57 to 134.58). Nurses who work in critical care, perioperative services, and procedure areas had the highest mean MDS-R scores. There have been no previous reports of higher scores for nurses working in perioperative and procedure areas. There was weak positive correlation between MDS-R scores and years of experience (Rho = .17, p = .003) but no correlation between age (Rho = .02, p = .78) or education (Rho = .05, p = .802) and moral distress. Three variables were found useful in predicting moral distress: the type of unit and responses to two qualitative questions related to quitting their job. Identification of these variables allows organizations to focus their interventions. © 2017 Sigma Theta Tau International.

  3. Academic medical centers as innovation ecosystems to address population -omics challenges in precision medicine.

    Science.gov (United States)

    Silva, Patrick J; Schaibley, Valerie M; Ramos, Kenneth S

    2018-02-15

    While the promise of the Human Genome Project provided significant insights into the structure of the human genome, the complexities of disease at the individual level have made it difficult to utilize -omic information in clinical decision making. Some of the existing constraints have been minimized by technological advancements that have reduced the cost of sequencing to a rate far in excess of Moore's Law (a halving in cost per unit output every 18 months). The reduction in sequencing costs has made it economically feasible to create large data commons capturing the diversity of disease across populations. Until recently, these data have primarily been consumed in clinical research, but now increasingly being considered in clinical decision- making. Such advances are disrupting common diagnostic business models around which academic medical centers (AMCs) and molecular diagnostic companies have collaborated over the last decade. Proprietary biomarkers and patents on proprietary diagnostic content are no longer driving biomarker collaborations between industry and AMCs. Increasingly the scope of the data commons and biorepositories that AMCs can assemble through a nexus of academic and pharma collaborations is driving a virtuous cycle of precision medicine capabilities that make an AMC relevant and highly competitive. A rebalancing of proprietary strategies and open innovation strategies is warranted to enable institutional precision medicine asset portfolios. The scope of the AMC's clinical trial and research collaboration portfolios with industry are increasingly dependent on the currency of data, and less on patents. Intrapeneurial support of internal service offerings, clinical trials and clinical laboratory services for example, will be important new points of emphasis at the academic-industry interface. Streamlining these new models of industry collaboration for AMCs are a new area for technology transfer offices to offer partnerships and to add value

  4. Governing Academic Medical Center Systems: Evaluating and Choosing Among Alternative Governance Approaches.

    Science.gov (United States)

    Chari, Ramya; O'Hanlon, Claire; Chen, Peggy; Leuschner, Kristin; Nelson, Christopher

    2018-02-01

    The ability of academic medical centers (AMCs) to fulfill their triple mission of patient care, medical education, and research is increasingly being threatened by rising financial pressures and resource constraints. Many AMCs are, therefore, looking to expand into academic medical systems, increasing their scale through consolidation or affiliation with other health care systems. As clinical operations grow, though, the need for effective governance becomes even more critical to ensure that the business of patient care does not compromise the rest of the triple mission. Multi-AMC systems, a model in which multiple AMCs are governed by a single body, pose a particular challenge in balancing unity with the needs of component AMCs, and therefore offer lessons for designing AMC governance approaches. This article describes the development and application of a set of criteria to evaluate governance options for one multi-AMC system-the University of California (UC) and its five AMCs. Based on a literature review and key informant interviews, the authors identified criteria for evaluating governance approaches (structures and processes), assessed current governance approaches using the criteria, identified alternative governance options, and assessed each option using the identified criteria. The assessment aided UC in streamlining governance operations to enhance their ability to respond efficiently to change and to act collectively. Although designed for UC and a multi-AMC model, the criteria may provide a systematic way for any AMC to assess the strengths and weaknesses of its governance approaches.

  5. Fostering innovation in medicine and health care: what must academic health centers do?

    Science.gov (United States)

    Dzau, Victor J; Yoediono, Ziggy; Ellaissi, William F; Cho, Alex H

    2013-10-01

    There is a real need for innovation in health care delivery, as well as in medicine, to address related challenges of access, quality, and affordability through new and creative approaches. Health care environments must foster innovation, not just allowing it but actively encouraging it to happen anywhere and at every level in health care and medicine-from the laboratory, to the operating room, bedside, and clinics. This paper reviews the essential elements and environmental factors important for health-related innovation to flourish in academic health systems.The authors maintain that innovation must be actively cultivated by teaching it, creating "space" for and supporting it, and providing opportunities for its implementation. The authors seek to show the importance of these three fundamental principles and how they can be implemented, highlighting examples from across the country and their own institution.Health innovation cannot be relegated to a second-class status by the urgency of day-to-day operations, patient care, and the requirements of traditional research. Innovation needs to be elevated to a committed endeavor and become a part of an organization's culture, particularly in academic health centers.

  6. Responding to the Marketplace: Workforce Balance and Financial Risk at Academic Health Centers.

    Science.gov (United States)

    Retchin, Sheldon M

    2016-07-01

    Elsewhere in this issue, Welch and Bindman present research demonstrating that academic health centers (AHCs) continue to disproportionately comprise specialists and subspecialist faculty physicians compared with community-based physician groups. This workforce composition has served AHCs well through the years-specialists fuel the clinical engine of the major tertiary and quaternary missions of AHCs, and they also dominate much of the clinical and translational research enterprise. AHCs are not alone-less than one-third of U.S. physicians practice primary care. However, health reform has prompted many health systems to reconsider this configuration. Payers, employers, and policy makers are shifting away from fee-for-service toward value-based care. Large community-based physician groups and their parent health systems appear to be far ahead of AHCs with a more balanced physician workforce. Many are leveraging their emphasis on primary care to participate in population health initiatives, such as accountable care organizations, and some own their own health plans. These approaches largely assume some element of financial risk and require both a more balanced workforce and an infrastructure to accommodate the management of covered lives. It remains to be seen whether AHCs will reconsider their own physician specialty composition to emphasize primary care-and, if they do, whether the traditional academic model, or a more community-based approach, will prevail.

  7. Marketing strategy: an essential component of business development for academic health centers.

    Science.gov (United States)

    Souba, W W; Haluck, C A; Menezes, M A

    2001-02-01

    Historically, academic health centers (AHCs) have detached themselves from commercialism and entrepreneurism, viewing these activities as being inconsistent with many of their core academic values. Word-of-mouth promotion was their primary, if not sole, marketing strategy. Less emphasis was placed on preparing, pricing, distributing, and promoting these services to targeted audiences. Understanding customers' needs was not a top priority. The marketing strategies and tools currently being developed and utilized by AHCs were reviewed. In an effort to attract customers and win contracts, AHCs are aggressively marketing themselves by designing new services, promoting those services much more intensely, restructuring the entire distribution system that delivers those services, and crafting pricing strategies that build in flexibility. With growing frequency, these marketing tactics are part and parcel of a carefully crafted data-driven strategic plan designed to meet the business-development goals of the institution. In order to carry out their missions, AHCs have recognized that they can no longer rest on their "ivory tower" laurels. They must learn how to market themselves in a market economy.

  8. The impact of leadership training programs on physicians in academic medical centers: a systematic review.

    Science.gov (United States)

    Straus, Sharon E; Soobiah, Charlene; Levinson, Wendy

    2013-05-01

    To identify the impact of leadership training programs at academic medical centers (AMCs) on physicians' knowledge, skills, attitudes, behaviors, and outcomes. In 2011, the authors conducted a systematic review of the literature, identifying relevant studies by searching electronic databases (MEDLINE, EMBASE, CINAHL, Cochrane Central Register), scanning reference lists, and consulting experts. They deemed eligible any qualitative or quantitative study reporting on the implementation and evaluation of a leadership program for physicians in AMCs. Two independent reviewers conducted the review, screening studies, abstracting data, and assessing quality. The authors initially identified 2,310 citations. After the screening process, they had 11 articles describing 10 studies. Three were controlled before-and-after studies, four were before-and-after case series, and three were cross-sectional surveys. The authors did not conduct a meta-analysis because of the methodological heterogeneity across studies. Although all studies were at substantial risk of bias, the highest-quality ones showed that leadership training programs affected participants' advancement in academic rank (48% versus 21%, P=.005) and hospital leadership position (30% versus 9%, P=.008) and that participants were more successful in publishing papers (3.5 per year versus 2.1 per year, Pleadership programs have modest effects on outcomes important to AMCs. Given AMCs' substantial investment in these programs, rigorous evaluation of their impact is essential. High-quality studies, including qualitative research, will allow the community to identify which programs are most effective.

  9. Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services.

    Science.gov (United States)

    Larson, Satu; Chapman, Susan; Spetz, Joanne; Brindis, Claire D

    2017-09-01

    Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers (SBHCs) may be one strategy to decrease health disparities. Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if research was related to childhood trauma's effects, mental health care disparities, SBHC mental health services, or SBHC impact on academic achievement. Eight studies show a significant risk of mental health disorders and poor academic achievement when exposed to childhood trauma. Seven studies found significant disparities in pediatric mental health care in the US. Nine studies reviewed SBHC mental health service access, utilization, quality, funding, and impact on school achievement. Exposure to chronic childhood trauma negatively impacts school achievement when mediated by mental health disorders. Disparities are common in pediatric mental health care in the United States. SBHC mental health services have some showed evidence of their ability to reduce, though not eradicate, mental health care disparities. © 2017, American School Health Association.

  10. Political strategy, business strategy, and the academic medical center: linking theory and practice.

    Science.gov (United States)

    Souba, W W; Weitekamp, M R; Mahon, J F

    2001-09-01

    The purpose of this paper is to link external political strategy theory to a specific health care setting-that of the academic medical center (AMC). Political strategy encompasses those activities undertaken by AMCs to acquire, develop, and use power (clout, influence, and credibility) to gain an advantage in situations of conflict. It should be differentiated from internal politics, a topic that will not be dealt with in this review. Political strategy should also be distinguished from but not divorced from competitive strategy. As political and social action can change the competitive landscape and the rules of competition, AMCs must become adept in issues management and stakeholder management. The focus on political strategy is a reflection of the enormous changes in the external environment that have impacted AMCs in recent years. These changes have often emerged out of political and social action and they impact significantly on the organization's more traditional business strategies. We suggest that a tighter alignment between political and business strategies in the future will help ensure organizational survival and success. This article reviews the literature and theory in corporate political strategy and illustrates the application of political strategy with examples of issues and problems faced by AMCs. Models of political strategy are well crafted, and this article concludes with succinct observations on the use of political strategies to enhance the business-based strategies of AMCs. Although the focus is on AMCs, the use of political strategies is applicable to any health care institution. Copyright 2001 Academic Press.

  11. An ethical framework for identifying, preventing, and managing conflicts confronting leaders of academic health centers.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B

    2004-11-01

    Leaders of academic health centers (AHCs) hold positions that by their very nature have a high potential for ethical conflict. The authors offer an ethical framework for identifying, preventing, and managing conflicts in the leadership of AHCs. This framework is based on and implements both the ethical concept of AHCs as fiduciary organizations and also the legitimate interests of various stakeholders. The authors describe practical steps that can be tools for the preventive-ethics leadership of AHCs that enable leaders to avoid strategic ambiguity and strategic procrastination and replace these with transparency. The ethical framework is illustrated by applying it to an organizational case study. The major contribution of the ethical framework is that it transforms decision making from simply negotiating power struggles to explicitly identifying and making ethical decisions based on the legitimate interests and fiduciary responsibilities of all stakeholders.

  12. Reducing patients' falls rate in an Academic Medical Center (AMC) using Six Sigma "DMAIC" approach.

    Science.gov (United States)

    Kuwaiti, Ahmed Al; Subbarayalu, Arun Vijay

    2017-05-08

    Purpose The purpose of this paper is to evaluate the impact of adopting the Six Sigma define, measure, analyze, improve and control (DMAIC) approach in reducing patients fall rate in an Academic Medical Center, Saudi Arabia. Design/methodology/approach A prospective study design was adopted and this study was conducted at King Fahd Hospital of the University (KFHU) during the year 2014. Based on the historical data of the patients' falls reported at KFHU during the year 2013, the goal was fixed to reduce the falls rate from 7.18 toSix Sigma "DMAIC" approach improves the processes related to the prevention of falls. A greater reduction in patients falls rate (over 70 percent) was observed after the implementation of the improvement strategy.

  13. Nurses' perception of ethical climate at a large academic medical center.

    Science.gov (United States)

    Lemmenes, Donna; Valentine, Pamela; Gwizdalski, Patricia; Vincent, Catherine; Liao, Chuanhong

    2016-09-07

    Nurses are confronted daily with ethical issues while providing patient care. Hospital ethical climates can affect nurses' job satisfaction, organizational commitment, retention, and physician collaboration. At a metropolitan academic medical center, we examined nurses' perceptions of the ethical climate and relationships among ethical climate factors and nurse characteristics. We used a descriptive correlational design and nurses (N = 475) completed Olson's Hospital Ethical Climate Survey. Data were analyzed using STATA. Approvals by the Nursing Research Council and Institutional Review Board were obtained; participants' rights were protected. Nurses reported an ethical climate total mean score of 3.22 ± 0.65 that varied across factors; significant differences were found for ethical climate scores by nurses' age, race, and specialty area. These findings contribute to what is known about ethical climate and nurses' characteristics and provides the foundation to develop strategies to improve the ethical climate in work settings. © The Author(s) 2016.

  14. Quality Assessment of Acute Inpatient Pain Management in an Academic Health Center.

    Science.gov (United States)

    Lin, Richard J; Reid, M Carrington; Chused, Amy E; Evans, Arthur T

    2016-02-01

    The quality of acute inpatient pain management remains suboptimal and poorly understood. In this retrospective study, we analyze acute pain management practice in a large academic health center using several quality indicators. Not surprisingly, despite high rate of pain assessment, many patients still have frequent, prolonged, and unrelieved severe pain episodes. Upon examination of naloxone administration, we identify potential inappropriate opioid prescription practices such as the use of wrong opioids in hepatic and renal failure and simultaneous use of multiple short-acting opioids. Most importantly, we find that chronic opioid users appear to suffer the most in terms of undertreatment of pain as well as opioid overdose, highlighting the urgent need to target this underserved population of patients. © The Author(s) 2014.

  15. From Laennec to lobotomy: teaching medical history at academic medical centers.

    Science.gov (United States)

    Lerner, B H

    2000-05-01

    Although clinicians without a sense of history may not be condemned to repeat the past, the historical record offers many informative lessons. For one thing, history demonstrates the changing nature of scientific knowledge; current understandings of health and disease may prove as ephemeral as earlier discarded theories. In addition, history reminds us that social and cultural factors influence how physicians diagnose and treat various medical conditions. When attempting to teach the history of medicine at academic medical centers, instructors should be innovative as opposed to comprehensive. Students and residents are likely to find recent historical issues to be more relevant, particularly when such material can be integrated into the existing curriculum. Provocative topics include depictions of medicine in old Hollywood films, the contributions made by famous physicians at one's own institution, and historical debates over controversial events, such as the Tuskegee syphilis study and the use of lobotomy in mental institutions in the 1950s.

  16. Implementation of Epic Beaker Clinical Pathology at an academic medical center

    Directory of Open Access Journals (Sweden)

    Matthew D Krasowski

    2016-01-01

    Full Text Available Background: Epic Beaker Clinical Pathology (CP is a relatively new laboratory information system (LIS operating within the Epic suite of software applications. To date, there have not been any publications describing implementation of Beaker CP. In this report, we describe our experience in implementing Beaker CP version 2012 at a state academic medical center with a go-live of August 2014 and a subsequent upgrade to Beaker version 2014 in May 2015. The implementation of Beaker CP was concurrent with implementations of Epic modules for revenue cycle, patient scheduling, and patient registration. Methods: Our analysis covers approximately 3 years of time (2 years preimplementation of Beaker CP and roughly 1 year after using data summarized from pre- and post-implementation meetings, debriefings, and the closure document for the project. Results: We summarize positive aspects of, and key factors leading to, a successful implementation of Beaker CP. The early inclusion of subject matter experts in the design and validation of Beaker workflows was very helpful. Since Beaker CP does not directly interface with laboratory instrumentation, the clinical laboratories spent extensive preimplementation effort establishing middleware interfaces. Immediate challenges postimplementation included bar code scanning and nursing adaptation to Beaker CP specimen collection. The most substantial changes in laboratory workflow occurred with microbiology orders. This posed a considerable challenge with microbiology orders from the operating rooms and required intensive interventions in the weeks following go-live. In postimplementation surveys, pathology staff, informatics staff, and end-users expressed satisfaction with the new LIS. Conclusions: Beaker CP can serve as an effective LIS for an academic medical center. Careful planning and preparation aid the transition to this LIS.

  17. Blood Product Utilization Among Trauma and Nontrauma Massive Transfusion Protocols at an Urban Academic Medical Center.

    Science.gov (United States)

    Patel, Eshan U; Ness, Paul M; Marshall, Christi E; Gniadek, Thomas; Efron, David T; Miller, Peter M; Zeitouni, Joseph A; King, Karen E; Bloch, Evan M; Tobian, Aaron A R

    2017-09-01

    Hospital-wide massive transfusion protocols (MTPs) primarily designed for trauma patients may lead to excess blood products being prepared for nontrauma patients. This study characterized blood product utilization among distinct trauma and nontrauma MTPs at a large, urban academic medical center. A retrospective study of blood product utilization was conducted in patients who required an MTP activation between January 2011 and December 2015 at an urban academic medical center. Trauma MTP containers included 6 red blood cell (RBC) units, 5 plasma units, and 1 unit of apheresis platelets. Nontrauma MTP containers included 6 RBC and 3 plasma units. There were 334 trauma MTP activations, 233 nontrauma MTP activations, and 77 nontrauma MTP activations that subsequently switched to a trauma MTP ("switched activations"). All nontrauma MTP activations were among bleeding patients who did not have a traumatic injury (100% [233/233]). Few patients with a nontrauma activation required ad hoc transfusion of RBC units (1.3% [95% confidence interval {CI}, 0.3%-3.7%]) or plasma (3.4% [95% CI, 1.5%-6.7%]), and only 45.5% (95% CI, 39.0%-52.1%) required ad hoc transfusion of apheresis platelets. Compared to trauma and switched activations, nontrauma activations transfused a lower median number of RBC, plasma, and apheresis platelet units (P use of hospital-wide nontrauma MTPs are warranted since an MTP designed for nontrauma patient populations may yield a key strategy to optimize blood product utilization in comparison to a universal MTP for both trauma and nontrauma patients.

  18. Obesity perceptions and documentation among primary care clinicians at a rural academic health center.

    Science.gov (United States)

    Aleem, Sohaib; Lasky, Rosalind; Brooks, W Blair; Batsis, John A

    2015-01-01

    Obesity recognition in primary care is important to address the epidemic. We aimed to evaluate primary care clinician-reported documentation, management practices, beliefs and attitudes toward obesity compared to body mass index (BMI) calculation, obesity prevalence and actual documentation of obesity as an active problem in electronic health record in a rural academic center. Our target population for previously validated clinician survey was 56 primary care providers working at 3 sites. We used calendar year 2012 data for assessment of baseline system performance for metrics of documentation of BMI in primary care visits, and proportion of visits in patients with obesity with obesity as a problem. Standard statistical methods assessed the data. Survey response rate was 91%. Average age of respondents was 48.9 years and 62.7% were females. 72.5% clinicians reported having normal BMI. The majority of clinicians reported regularly documenting obesity as an active problem, and utilized motivational interviewing and basic good nutrition and healthy exercise. Clinicians identified lack of discipline and exercise time, access to unhealthy food and psychosocial issues as major barriers. Most denied disliking weight loss discussion or patients taking up too much time. In 21,945 clinic visits and 11,208 annual preventive care visits in calendar year 2012, BMI was calculated in 93% visits but obesity documentation as an active problem only 27% of patients meeting BMI criteria for obesity. Despite high clinician-reported documentation of obesity as an active problem, actual obesity documentation rates remained low in a rural academic medical center. Copyright © 2015 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  19. Comparison and alignment of an academic medical center's strategic goals with ASHP initiatives.

    Science.gov (United States)

    Engels, Melanie J; Chaffee, Bruce W; Clark, John S

    2015-12-01

    An academic medical center's strategic goals were compared and aligned with the 2015 ASHP Health-System Pharmacy Initiative and the Pharmacy Practice Model Initiative (PPMI). The department's pharmacy practice model steering committee identified potential solutions to narrow prioritized gaps using a modified nominal group technique and a multivoting dot technique. Five priority solutions were identified and assigned to work groups to develop business plans, which included admission medication history and reconciliation for high-risk patients and those with complex medication regimens, pharmacist provision of discharge counseling to high-risk patients and those with complex medication regimens, improved measurement and reporting of the impact of PPMI programs on patient outcomes, implementation of a departmentwide formalized peer review and evaluation process, and the greeting of every patient at some time during his or her visit by a pharmacy team member. Stakeholders evaluated the business plans based on feasibility, financial return on investment, and anticipated safety enhancements. The solution that received the highest priority ranking and was subsequently implemented was "improved measurement and reporting of the impact of PPMI programs on patient outcomes." A defined process was followed for identifying gaps among current practices at an academic medical center and the 2015 ASHP Health-System Pharmacy Initiative and the PPMI. A key priority to better document the impact of pharmacists on patient care was identified for our department by using a nominal group technique brainstorming process and a multivoting dot technique and creating standardized business plans for five potential priority projects. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  20. The Role of Advising in Leadership Development.

    Science.gov (United States)

    Chrystal-Green, Nancy E

    2018-06-01

    This chapter addresses the roles and responsibilities of advising; specifically, how advisors can cultivate both individual and group settings to be important teaching and learning environments and how to advise with leadership development in mind. © 2018 Wiley Periodicals, Inc.

  1. Estimating the degree of emergency department overcrowding in academic medical centers: results of the National ED Overcrowding Study (NEDOCS).

    Science.gov (United States)

    Weiss, Steven J; Derlet, Robert; Arndahl, Jeanine; Ernst, Amy A; Richards, John; Fernández-Frackelton, Madonna; Schwab, Robert; Stair, Thomas O; Vicellio, Peter; Levy, David; Brautigan, Mark; Johnson, Ashira; Nick, Todd G; Fernández-Frankelton, Madonna

    2004-01-01

    No single universal definition of emergency department (ED) overcrowding exists. The authors hypothesize that a previously developed site-sampling form for academic ED overcrowding is a valid model to quantify overcrowding in academic institutions and can be used to develop a validated short form that correlates with overcrowding. A 23-question site-sampling form was designed based on input from academic physicians at eight medical schools representative of academic EDs nationwide. A total of 336 site-samplings at eight academic medical centers were conducted at 42 computer-generated random times over a three-week period by independent observers at each site. These sampling times ranged from very slow to severely overcrowded. The outcome variable was the degree of overcrowding as assessed by the charge nurse and ED physicians. The full model consisted of objective data that were obtained by counting the number of patients, determining patients' waiting times, and obtaining information from registration, triage, and ancillary services. Specific objective data were indexed to site-specific demographics. The outcome and objective data were compared using a multiple linear regression to determine predictive validity of the full model. A five-question reduced model was calculated using a backward stepdown procedure. Predictive validity and relationships between the outcome and objective data were assessed using a mixed-effects linear regression model, treating center as random effect. Overcrowding occurred 12% to 73% of the time (mean, 35%), with two hospitals being overcrowded more than 50% of the time. Comparison of objective and outcome data resulted in an R(2) of 0.49 (p Overcrowding varied widely between academic centers during the study period. Results of a five-question reduced model are valid and accurate in predicting the degree of overcrowding in academic centers.

  2. Ethical Problems in Advising Theses and Dissertations.

    Science.gov (United States)

    Schiff, Frederick; Ryan, Michael

    1996-01-01

    Reports results of a survey investigating what practices journalism faculty advisers perceive as appropriate and ethical (when advising theses and dissertations) in several potentially troublesome areas: problems with appropriation of student work; problems of joint authorship; appropriateness of adviser input; reasons for writing a thesis or…

  3. Advising as Servant Leadership: Investigating Student Satisfaction

    Science.gov (United States)

    Paul, W. Kohle; Fitzpatrick, Colleen

    2015-01-01

    Student satisfaction with advising is positively linked to first-year student retention and sophomore persistence to their senior year. However, inconsistencies in the advising literature confound conclusions about the most effective advising approach to elicit student satisfaction. Positive links between the servant leadership approach and…

  4. 76 FR 27959 - Investment Adviser Performance Compensation

    Science.gov (United States)

    2011-05-13

    ... 3235-AK71 Investment Adviser Performance Compensation AGENCY: Securities and Exchange Commission... under the Investment Advisers Act of 1940 that permits investment advisers to charge performance based..., Office of Regulatory Policy, Division of Investment Management, Securities and Exchange Commission, 100 F...

  5. Improved Screening Mammogram Workflow by Maximizing PACS Streamlining Capabilities in an Academic Breast Center.

    Science.gov (United States)

    Pham, Ramya; Forsberg, Daniel; Plecha, Donna

    2017-04-01

    The aim of this study was to perform an operational improvement project targeted at the breast imaging reading workflow of mammography examinations at an academic medical center with its associated breast centers and satellite sites. Through careful analysis of the current workflow, two major issues were identified: stockpiling of paperwork and multiple worklists. Both issues were considered to cause significant delays to the start of interpreting screening mammograms. Four workflow changes were suggested (scanning of paperwork, worklist consolidation, use of chat functionality, and tracking of case distribution among trainees) and implemented in July 2015. Timestamp data was collected 2 months before (May-Jun) and after (Aug-Sep) the implemented changes. Generalized linear models were used to analyze the data. The results showed significant improvements for the interpretation of screening mammograms. The average time elapsed for time to open a case reduced from 70 to 28 min (60 % decrease, p workflow for diagnostic mammograms at large unaltered even with increased volume of mammography examinations (31 % increase of 4344 examinations for May-Jun to 5678 examinations for Aug-Sep). In conclusion, targeted efforts to improve the breast imaging reading workflow for screening mammograms in a teaching environment provided significant performance improvements without affecting the workflow of diagnostic mammograms.

  6. Dealing With Deans and Academic Medical Center Leadership: Advice From Leaders.

    Science.gov (United States)

    Sanfilippo, Fred; Powell, Deborah; Folberg, Robert; Tykocinski, Mark

    2018-01-01

    The 2017 Association of Pathology Chairs Annual Meeting included a session for department chairs and other department leaders on "how to deal with deans and academic medical center leadership." The session was focused on discussing ways to foster positive relationships with university, medical school, and health system leaders, and productively address issues and opportunities with them. Presentations and a panel discussion were provided by 4 former pathology chairs who subsequently have served as medical deans and in other leadership positions including university provost, medical center CEO, and health system board chair. There was a strong consensus among the participants on how best to deal with superiors about problems, conflicts, and requests for additional resources and authority. The importance of teamwork and accountability in developing a constructive and collaborative relationship with leaders and peers was discussed in detail. Effectiveness in communication, negotiation, and departmental advocacy were highlighted as important skills. As limited resources and increased regulations have become growing problems for universities and health systems, internal stress and competition have increased. In this rapidly changing environment, advice on how chairs can interact most productively with institutional leaders is becoming increasingly important.

  7. Employee health benefit redesign at the academic health center: a case study.

    Science.gov (United States)

    Marshall, Julie; Weaver, Deirdre C; Splaine, Kevin; Hefner, David S; Kirch, Darrell G; Paz, Harold L

    2013-03-01

    The rapidly escalating cost of health care, including the cost of providing health care benefits, is a significant concern for many employers. In this article, the authors examine a case study of an academic health center that undertook a complete redesign of its health benefit structure to control rising costs, encourage use of its own provider network, and support employee wellness. With the implementation in 2006 of a high-deductible health plan combined with health reimbursement arrangements and wellness incentives, the Penn State Hershey Medical Center (PSHMC) was able to realize significant cost savings and increase use of its own network while maintaining a high level of employee satisfaction. By contracting with a single third-party administrator for its self-insured plan, PSHMC reduced its administrative costs and simplified benefit choices for employees. In addition, indexing employee costs to salary ensured that this change was equitable for all employees, and the shift to a consumer-driven health plan led to greater employee awareness of health care costs. The new health benefit plan's strong focus on employee wellness and preventive health has led to significant increases in the use of preventive health services, including health risk assessments, cancer screenings, and flu shots. PSHMC's experience demonstrates the importance of clear and ongoing communication with employees throughout--before, during, and even after--the process of health benefit redesign.

  8. Increasing Therapist Productivity: Using Lean Principles in the Rehabilitation Department of an Academic Medical Center.

    Science.gov (United States)

    Johnson, Diana; Snedeker, Kristie; Swoboda, Michael; Zalieckas, Cheryl; Dorsey, Rachel; Nohe, Cassandra; Smith, Paige; Roche, Renuka

    The Department of Rehabilitation Services, within the University of Maryland Medical Center's 650-bed academic medical center, was experiencing difficulty in meeting productivity standards. Therapists in the outpatient division believed they were not spending enough time performing billable patient care activities. Therapists in the inpatient division had difficulty keeping pace with the volume of incoming referrals. Collectively, these issues caused dissatisfaction among referral sources and frustration among the staff within the rehabilitation department. The department undertook a phased approach to address these issues that included examining the evidence, using Lean process improvement principles, and employing transformational leadership strategies to drive improvements in productivity and efficiency. The lessons learned support the importance of having meaningful metrics appropriate for the patient population served, the use of Lean as an effective tool for improving productivity in rehabilitation departments, the impact of engaging staff at the grassroots level, and the importance of having commitment from leaders. The study findings have implications for not only rehabilitation and hospital leadership, but CEOs and managers of any business who need to eliminate waste or increase staff productivity.

  9. Academic Health Center Psychology Representation to the Council of Faculty and Academic Societies (CFAS) of the Association of American Medical Colleges (AAMC).

    Science.gov (United States)

    Cubic, Barbara A; Shaffer, Laura A

    2017-06-01

    This paper outlines the perspectives of the two currently appointed representatives of the Association of Psychologists in Academic Health Centers (APAHC) to the Council of Faculty and Academic Societies (CFAS) of the Association of American Medical Colleges (AAMC). The authors focus on why it is important for psychologists, especially those in academic health centers (AHCs), to be part of CFAS. The goal of the paper is to demonstrate how involvement in organizations like the AAMC helps AHC psychologists serve as ambassadors for psychology in AHCs and assists AHC psychologists in staying fluent regarding hot topics within academic medicine. The first author is a more senior member of APAHC, and so reflects the perspective of long-serving APAHC members; the second author reflects the perspectives of newer generations of APAHC members, those who have been active in APAHC for 10 years or less. The authors discuss their experiences being at national CFAS meetings. They describe meeting events including presentations such as those by national policy experts and scholars; and speed mentoring with medical residents from the AAMC Organization of Resident Representatives. Of special importance has been their opportunities for informal conversations with the AAMC's President and CEO, Board Chair, and Chief Public Policy Officer. They also have participated in networking functions that encourage interdisciplinary knowledge sharing and relationship building.

  10. Houston Community College (HCC)-Mobile Go Center Program

    Science.gov (United States)

    Ramirez, Daniel; Sterling, Cheryl; Grays, Shantay R.

    2010-01-01

    The Houston Community College Mobile Go Center brings college enrollment assistance to the doorstep of our community. It operates in a variety of settings, offering college-going material and person-to-person assistance at numerous city events. Services include assistance with academic advising, completing the FAFSA, college application process,…

  11. An Analysis of Information Technology Adoption by IRBs of Large Academic Medical Centers in the United States.

    Science.gov (United States)

    He, Shan; Botkin, Jeffrey R; Hurdle, John F

    2015-02-01

    The clinical research landscape has changed dramatically in recent years in terms of both volume and complexity. This poses new challenges for Institutional Review Boards' (IRBs) review efficiency and quality, especially at large academic medical centers. This article discusses the technical facets of IRB modernization. We analyzed the information technology used by IRBs in large academic institutions across the United States. We found that large academic medical centers have a high electronic IRB adoption rate; however, the capabilities of electronic IRB systems vary greatly. We discuss potential use-cases of a fully exploited electronic IRB system that promise to streamline the clinical research work flow. The key to that approach utilizes a structured and standardized information model for the IRB application. © The Author(s) 2014.

  12. Health Systems Innovation at Academic Health Centers: Leading in a New Era of Health Care Delivery.

    Science.gov (United States)

    Ellner, Andrew L; Stout, Somava; Sullivan, Erin E; Griffiths, Elizabeth P; Mountjoy, Ashlin; Phillips, Russell S

    2015-07-01

    Challenged by demands to reduce costs and improve service delivery, the U.S. health care system requires transformational change. Health systems innovation is defined broadly as novel ideas, products, services, and processes-including new ways to promote healthy behaviors and better integrate health services with public health and other social services-which achieve better health outcomes and/or patient experience at equal or lower cost. Academic health centers (AHCs) have an opportunity to focus their considerable influence and expertise on health systems innovation to create new approaches to service delivery and to nurture leaders of transformation. AHCs have traditionally used their promotions criteria to signal their values; creating a health systems innovator promotion track could be a critical step towards creating opportunities for innovators in academic medicine. In this Perspective, the authors review publicly available promotions materials at top-ranked medical schools and find that while criteria for advancement increasingly recognize systems innovation, there is a lack of specificity on metrics beyond the traditional yardstick of peer-reviewed publications. In addition to new promotions pathways and alternative evidence for the impact of scholarship, other approaches to fostering health systems innovation at AHCs include more robust funding for career development in health systems innovation, new curricula to enable trainees to develop skills in health systems innovation, and new ways for innovators to disseminate their work. AHCs that foster health systems innovation could meet a critical need to contribute both to the sustainability of our health care system and to AHCs' continued leadership role within it.

  13. Forging stronger partnerships between academic health centers and patient-driven organizations.

    Science.gov (United States)

    Gallin, Elaine K; Bond, Enriqueta; Califf, Robert M; Crowley, William F; Davis, Pamela; Galbraith, Richard; Reece, E Albert

    2013-09-01

    In this article, the authors review the unique role that patient-driven organizations, such as patient advocacy groups and voluntary health organizations (PAG/VHOs), play in translational and clinical research. The importance of fostering collaborations between these organizations and U.S. academic health centers (AHCs) is also discussed. Although both the PAG/VHO community and AHCs are heterogeneous, and although not all organizations are well governed or provide independent, well-researched views, there are many outstanding, well-managed, independent PAG/VHOs in the United States whose missions overlap with those of AHCs. The characteristics of effective PAG/VHOs that would serve as excellent partners for AHCs are discussed, and examples are provided regarding their many contributions, which have included advancing research on rare diseases, recruiting patients for clinical trials, and establishing patient registries and biospecimen banks. The authors present feedback obtained from informal discussions with PAG/VHO staff, as well as a survey of a small sample of organizations, that has identified bureaucratic processes, negotiating intellectual property rights, and institutional review board (IRB) delays as the most problematic areas of interactions with AHCs. Actions are suggested for building effective partnerships between the two sectors and the activities that AHCs should undertake to facilitate their interactions with PAG/VHOs including streamlining contract review and IRB processes and finding ways to better align the incentives motivating academic clinical and translational investigators with the goals of PAG/VHOs. This article is one product of the Clinical Research Forum's Partnering with Patient Advocacy Groups Initiative.

  14. Integrating research, clinical care, and education in academic health science centers.

    Science.gov (United States)

    King, Gillian; Thomson, Nicole; Rothstein, Mitchell; Kingsnorth, Shauna; Parker, Kathryn

    2016-10-10

    Purpose One of the major issues faced by academic health science centers (AHSCs) is the need for mechanisms to foster the integration of research, clinical, and educational activities to achieve the vision of evidence-informed decision making (EIDM) and optimal client care. The paper aims to discuss this issue. Design/methodology/approach This paper synthesizes literature on organizational learning and collaboration, evidence-informed organizational decision making, and learning-based organizations to derive insights concerning the nature of effective workplace learning in AHSCs. Findings An evidence-informed model of collaborative workplace learning is proposed to aid the alignment of research, clinical, and educational functions in AHSCs. The model articulates relationships among AHSC academic functions and sub-functions, cross-functional activities, and collaborative learning processes, emphasizing the importance of cross-functional activities in enhancing collaborative learning processes and optimizing EIDM and client care. Cross-functional activities involving clinicians, researchers, and educators are hypothesized to be a primary vehicle for integration, supported by a learning-oriented workplace culture. These activities are distinct from interprofessional teams, which are clinical in nature. Four collaborative learning processes are specified that are enhanced in cross-functional activities or teamwork: co-constructing meaning, co-learning, co-producing knowledge, and co-using knowledge. Practical implications The model provides an aspirational vision and insight into the importance of cross-functional activities in enhancing workplace learning. The paper discusses the conceptual and empirical basis to the model, its contributions and limitations, and implications for AHSCs. Originality/value The model's potential utility for health care is discussed, with implications for organizational culture and the promotion of cross-functional activities.

  15. Academic Seminars of the Center for Study of the Battle of Stalingrad

    Directory of Open Access Journals (Sweden)

    Maksim M. Zagorulko

    2017-10-01

    Full Text Available Center for study of the battle of Stalingrad was founded in October 2015 in order to comprehensively study the role of the battle of Stalingrad in world history, its influence on the course of the Great Patriotic war, displaying the results of the study in print and other publications. In 2016, seven seminars were organized and conducted at its base in the form of round tables on relevant and understudied topics on the great battle on the Volga, certain aspects of the historical-economic, socio-cultural life of the country and people during the battle of Stalingrad. In 2017 this work has been continued – for seven months five seminars have been held. In the framework of the round tables the attention is focused on the interaction of the front and rear, organization of mobilization economy, defense construction, problems of job search. Participants of the seminars inform about the introduction into scientific circulation of archival sources, summarize the results of research. The round tables bring together members of the Committee for Culture of the Volgograd region administration, state archives, the Museum-reserve Staraya Sarepta (‘Old Sarepta’, Museum and factory Krasny Oktyabr (‘Red October’, the local historians, teachers and students of universities, students of schools. The article presents a review of the scientific seminars in the form of “round tables” organized by the Centre for study of the battle of Stalingrad in 2016-2017, the authors introduce the reader to the topics of academic seminars, the content of the reports. The text of the article is prepared by permanent participant of the seminar I.A. Lysenko, academic editing – by Director of the seminar since its inception, veteran of the Great Patriotic war, doctor of economic sciences, Professor Maksim M. Zagorulko.

  16. Engaging a Wider Community: The Academic Library as a Center for Creativity, Discovery, and Collaboration

    Science.gov (United States)

    Shapiro, Steven D.

    2016-01-01

    Academic libraries have reported long-term declines in circulation, reference transactions, reserves, and in-house library materials usage. Increasingly, libraries are perceived as being less critical to the academic enterprise. Are these trends irreversible? Perhaps public libraries and some innovative academic libraries can provide us with some…

  17. The Council of Psychological Advisers.

    Science.gov (United States)

    Sunstein, Cass R

    2016-01-01

    Findings in behavioral science, including psychology, have influenced policies and reforms in many nations. Choice architecture can affect outcomes even if material incentives are not involved. In some contexts, default rules, simplification, and social norms have had even larger effects than significant economic incentives. Psychological research is helping to inform initiatives in savings, finance, highway safety, consumer protection, energy, climate change, obesity, education, poverty, development, crime, corruption, health, and the environment. No nation has yet created a council of psychological advisers, but the role of behavioral research in policy domains is likely to grow in the coming years, especially in light of the mounting interest in promoting ease and simplification ("navigability"); in increasing effectiveness, economic growth, and competitiveness; and in providing low-cost, choice-preserving approaches.

  18. Academic-health department collaborative relationships are reciprocal and strengthen public health practice: results from a study of academic research centers.

    Science.gov (United States)

    Neri, Elizabeth M; Ballman, Marie R; Lu, Hua; Greenlund, Kurt J; Grunbaum, Jo Anne

    2014-01-01

    Collaborations between academic institutions and state and local health departments have been shown to enhance the public health core functions of Assurance by improving the public health workforce's knowledge and skills. Few studies have analyzed how academic-health department collaborations enhance Assessment and Policy Development core functions. This qualitative study explores types of collaborations between health departments and Prevention Research Centers (PRCs) and how they align with the core functions. Prevention Research Centers are academic institutions funded by the Centers for Disease Control and Prevention to conduct public health research and translate research results for policies and practices. We reviewed each PRC's annual report from fiscal year 2011 and abstracted descriptions of PRC-health department collaborations. We identified 14 themes of PRC-health department collaborations and conducted a qualitative analysis to describe the dimensions and distribution of themes. Of the 37 PRCs, 36 reported 215 collaborations with 19 city, 97 county, 31 state, and 46 tribal health departments. Themes of research, survey, and surveillance aligned with the Assessment core function and evaluation, strategic planning, technical assistance, and program implementation supported the Policy Development and Assurance core functions. Overall, health departments provided on-the-ground expertise to inform PRC research, ensuring its applicability to public health practice. Reciprocally, PRCs improved data quality, increased the scientific rigor of health department processes and programs, and filled knowledge gaps within health departments. Both PRCs and health departments enhanced the relevance of public health programs and practices by grounding implementation and evaluation in community needs and views. Findings from this study demonstrate that PRC-health department collaborations often enhanced multiple core functions that could lead to implementation of evidence

  19. Intercultural Communication Competence: Advising International Students in a Texas Community College

    Science.gov (United States)

    Zhang, Yi

    2015-01-01

    Academic advising has long been considered a critical factor to student success. With a qualitative, phenomenological research design, this study was undertaken to better understand the lived experiences of academic advisors in communicating with international students in a community college context. Intercultural communication competence was used…

  20. Plastic Surgery Complications from Medical Tourism Treated in a U.S. Academic Medical Center.

    Science.gov (United States)

    Ross, Kimberly M; Moscoso, Andrea V; Bayer, Lauren R; Rosselli-Risal, Liliana; Orgill, Dennis P

    2018-04-01

    Medical tourism is a growing, multi-billion dollar industry fueled by improvements in the global transportation infrastructure. The authors studied patients living in the United States who travel to other countries for plastic surgical procedures and returned to have their complications treated in the authors' center. A retrospective patient evaluation was performed. Patients who had presented to an urban tertiary academic hospital plastic surgery service with complications or complaints associated with plastic surgery performed in a developing country were studied. The authors collected demographic information, types of surgery performed, destinations, insurance coverage, and complications. Seventy-eight patients were identified over 7 years. Most commonly, complications were seen following abdominoplasty (n = 35), breast augmentation (n = 25), and foreign body injections (n = 15). Eighteen patients underwent multiple procedures in one operative setting. The most common destination country was the Dominican Republic (n = 59). Complications included surgical-site infections (n = 14), pain (n = 14), and wound healing complications (n = 12). Eighty-six percent of patients (n = 67) relied on their medical insurance to pay for their follow-up care or manage their complications, with the most common type of health insurance coverage being Massachusetts Medicaid (n = 48). Cosmetic surgery performed in developing countries can carry substantial risks of complications that can be challenging to patients, primary care providers, insurers, and plastic surgical teams not associated with the original surgery. These complications pose significant burdens on our public health systems.

  1. Transitioning From Volume to Value: One Academic Medical Center's Approach to Improving Population Health.

    Science.gov (United States)

    Halvorson, Stephanie A C; Tanski, Mary E; Yackel, Thomas R

    2017-05-01

    The U.S. health care system is undergoing a major transformation. Clinical delivery systems are now being paid according to the value of the care they provide, in accordance with the Triple Aim, which incorporates improving the quality and cost of care and the patient experience. Increasingly, financial risk is being transferred from insurers to clinical delivery systems that become responsible for both episode-based clinical care and the longitudinal care of patients. Thus, these delivery systems need to develop strategies to manage the health of populations. Academic medical centers (AMCs) serve a unique role in many markets yet may be ill prepared for this transformation. In 2013, Oregon Health & Science University (OHSU) partnered with a large health insurer and six other hospitals across the state to form Propel Health, a collaborative partnership designed to deliver the tools, methods, and support necessary for population health management. OHSU also developed new internal structures and transformed its business model to embrace this value-based care model. Each Propel Health partner included the employees and dependents enrolled in its employee medical plan, for approximately 55,000 covered individuals initially. By 2017, Propel Health is expected to cover 110,000 individuals. Other outcomes to measure in the future include the quality and cost of care provided under this partnership. Anticipated challenges to overcome include insufficient primary care networks, conflicting incentives, local competition, and the magnitude of the transformation. Still, the time is right for AMCs to commit to improving the health of populations.

  2. The Changing Landscape of Molecular Diagnostic Testing: Implications for Academic Medical Centers

    Directory of Open Access Journals (Sweden)

    Heidi L. Rehm

    2016-01-01

    Full Text Available Over the last decade, the field of molecular diagnostics has undergone tremendous transformation, catalyzed by the clinical implementation of next generation sequencing (NGS. As technical capabilities are enhanced and current limitations are addressed, NGS is increasingly capable of detecting most variant types and will therefore continue to consolidate and simplify diagnostic testing. It is likely that genome sequencing will eventually serve as a universal first line test for disorders with a suspected genetic origin. Academic Medical Centers (AMCs, which have been at the forefront of this paradigm shift are now presented with challenges to keep up with increasing technical, bioinformatic and interpretive complexity of NGS-based tests in a highly competitive market. Additional complexity may arise from altered regulatory oversight, also triggered by the unprecedented scope of NGS-based testing, which requires new approaches. However, these challenges are balanced by unique opportunities, particularly at the interface between clinical and research operations, where AMCs can capitalize on access to cutting edge research environments and establish collaborations to facilitate rapid diagnostic innovation. This article reviews present and future challenges and opportunities for AMC associated molecular diagnostic laboratories from the perspective of the Partners HealthCare Laboratory for Molecular Medicine (LMM.

  3. The potential conflict between policy and ethics in caring for undocumented immigrants at academic health centers.

    Science.gov (United States)

    Cacari Stone, Lisa; Steimel, Leah; Vasquez-Guzman, Estela; Kaufman, Arthur

    2014-04-01

    Academic health centers (AHCs) are at the forefront of delivering care to the diverse medically underserved and uninsured populations in the United States, as well as training the majority of the health care workforce, who are professionally obligated to serve all patients regardless of race or immigration status. Despite AHCs' central leadership role in these endeavors, few consolidated efforts have emerged to resolve potential conflicts between national, state, and local policies that exclude certain classifications of immigrants from receiving federal public assistance and health professionals' social missions and ethical oath to serve humanity. For instance, whereas the 2010 Patient Protection and Affordable Care Act provides a pathway to insurance coverage for more than 30 million Americans, undocumented immigrants and legally documented immigrants residing in the United States for less than five years are ineligible for Medicaid and excluded from purchasing any type of coverage through state exchanges. To inform this debate, the authors describe their experience at the University of New Mexico Hospital (UNMH) and discuss how the UNMH has responded to this challenge and overcome barriers. They offer three recommendations for aligning AHCs' social missions and professional ethics with organizational policies: (1) that AHCs determine eligibility for financial assistance based on residency rather than citizenship, (2) that models of medical education and health professions training provide students with service-learning opportunities and applied community experience, and (3) that frontline staff and health care professionals receive standardized training on eligibility policies to minimize discrimination towards immigrant patients.

  4. Issues for academic health centers to consider before implementing a balanced-scorecard effort.

    Science.gov (United States)

    Zelman, W N; Blazer, D; Gower, J M; Bumgarner, P O; Cancilla, L M

    1999-12-01

    Because of changes in the health care environment, it is likely that strategic planning and management will become much more important to academic health centers (AHCs) than in the past. One approach to strategic planning and management that is gaining the considerable interest of health care organizations is the balanced scorecard. Based on a year's experience in examining this management tool, and on early implementation efforts, the authors critically evaluate the applicability of the balanced-scorecard approach at AHCs in relation to two fundamental questions: Does the decentralized nature of most AHCs mitigate the potential usefulness of the balanced-scorecard approach? Are the balanced scorecard's four perspectives (learning and growth, internal; customer; and financial) appropriate for AHCs, which are neither for-profit nor manufacturing organizations? The authors conclude that (1) the unique characteristics of AHCs may mitigate the full benefit of the balanced-scorecard approach, and (2) in cases where it is used, some key modifications must be made in the balanced-scorecard approach to account for those unique characteristics. For example, in a corporation, the key question from the financial perspective is "To succeed financially, how should we appear to our stockholders?" But in an AHC, this question must be revised to "What financial condition must we achieve to allow us to accomplish our mission?"

  5. Improving Initiation and Tracking of Research Projects at an Academic Health Center: A Case Study.

    Science.gov (United States)

    Schmidt, Susanne; Goros, Martin; Parsons, Helen M; Saygin, Can; Wan, Hung-Da; Shireman, Paula K; Gelfond, Jonathan A L

    2017-09-01

    Research service cores at academic health centers are important in driving translational advancements. Specifically, biostatistics and research design units provide services and training in data analytics, biostatistics, and study design. However, the increasing demand and complexity of assigning appropriate personnel to time-sensitive projects strains existing resources, potentially decreasing productivity and increasing costs. Improving processes for project initiation, assigning appropriate personnel, and tracking time-sensitive projects can eliminate bottlenecks and utilize resources more efficiently. In this case study, we describe our application of lean six sigma principles to our biostatistics unit to establish a systematic continual process improvement cycle for intake, allocation, and tracking of research design and data analysis projects. The define, measure, analyze, improve, and control methodology was used to guide the process improvement. Our goal was to assess and improve the efficiency and effectiveness of operations by objectively measuring outcomes, automating processes, and reducing bottlenecks. As a result, we developed a web-based dashboard application to capture, track, categorize, streamline, and automate project flow. Our workflow system resulted in improved transparency, efficiency, and workload allocation. Using the dashboard application, we reduced the average study intake time from 18 to 6 days, a 66.7% reduction over 12 months (January to December 2015).

  6. Development and Implementation of an Inpatient Otolaryngology Consultation Service at an Academic Medical Center.

    Science.gov (United States)

    Huddle, Matthew G; London, Nyall R; Stewart, C Matthew

    2018-02-01

    To design and implement a formal otolaryngology inpatient consultation service that improves satisfaction of consulting services, increases educational opportunities, improves the quality of patient care, and ensures sustainability after implementation. This was a retrospective cohort study in a large academic medical center encompassing all inpatient otolaryngology service consultations from July 2005 to June 2014. Staged interventions included adding fellow coverage (July 2007 onward), intermittent hospitalist coverage (July 2010 onward), and a physician assistant (October 2011 onward). Billing data were collected for incidences of new patient and subsequent consultation charges. The 2-year preimplementation period (July 2005-June 2007) was compared with the postimplementation periods, divided into 2-year blocks (July 2007-June 2013). Outcome measures of patient encounters and work relative value units were compared between pre- and postimplementation blocks. Total encounters increased from 321 preimplementation to 1211, 1347, and 1073 in postimplementation groups ( P service was designed with supervisory oversight by non-Accreditation Council for Graduate Medical Education fellows and then expanded to include intermittent hospitalist management, followed by the addition of a dedicated physician assistant. These additions have led to the formation of a sustainable consultation service that supports the mission of high-quality care and service to consulting teams.

  7. An Assessment of Organizational Health Literacy Practices at an Academic Health Center.

    Science.gov (United States)

    Prince, Latrina Y; Schmidtke, Carsten; Beck, Jules K; Hadden, Kristie B

    Organizational health literacy is the degree to which an organization considers and promotes the health literacy of patients. Addressing health literacy at an organizational level has the potential to have a greater impact on more health consumers in a health system than individual-level approaches. The purpose of this study was to assess health care practices at an academic health center using the 10 attributes of a health-literate health care organization. Using a survey research design, the Health Literate Healthcare Organization 10-Item Questionnaire was administered online using total population sampling. Employees (N = 10 300) rated the extent that their organization's health care practices consider and promote patients' health literacy. Differences in responses were assessed using factorial analysis of variance. The mean response was 4.7 on a 7-point Likert scale. Employee training and communication about costs received the lowest ratings. Univariate analyses revealed that there were no statistically significant differences (P = .05) by employees' health profession, years of service, or level of patient contact. There were statistically significant differences by highest education obtained with lowest ratings from employees with college degrees. Survey responses indicate a need for improvements in health care practices to better assist patients with inadequate health literacy.

  8. Academic health centers on the front lines: survival strategies in highly competitive markets.

    Science.gov (United States)

    Blumenthal, D; Weissman, J S; Griner, P F

    1999-09-01

    The authors describe approaches that five academic health centers (AHCs) have taken to reduce costs, enhance quality, or improve their market positions since the onset of price competition and managed care. The five AHCs, all on the West Coast, were selected for study because they (1) are located in markets that had been highly competitive for the longest time; (2) are committed to all the major missions of AHCs; and (3) own or substantially control their major clinical teaching facilities. The study findings reflect the status of the five AHCs during the fall of 1998. Although some findings may no longer be current (especially in light of ongoing implementation of the Balanced Budget Act of 1997), they still provide insights into the options and opportunities available to many AHCs in highly competitive markets. The authors report on the institutions' financial viability (positive), levels of government support (advantageous), and competition from other AHCs (modest). They outline the study AHCs' survival strategies in three broad areas: increasing revenues via exploiting market niches, reducing costs, and reorganizing to improve internal governance and decision making. They also report how marketplace competition and the strategies the AHCs used to confront it have affected the AHCs' missions. The authors summarize the outstanding lessons that all AHCs can learn from the experiences of the AHCs studied, although adding that AHCs in other parts of the country should use caution in looking to the West Coast AHCs for answers.

  9. Education of nurse practitioners in academic nurse-managed centers: student perspectives.

    Science.gov (United States)

    Tanner, Clare L; Pohl, Joanne; Ward, Sheila; Dontje, Kathy

    2003-01-01

    Clinical experiences for advanced practice nurses are increasingly a challenge. Finding settings that demonstrate primary care nursing practice in its finest form can be difficult. This article reports on nurse practitioner (NP) student feedback on clinical placements in the academic nurse-managed centers (ANMCs) associated with four Michigan schools or colleges of nursing. Student feedback was solicited over three years through site and preceptor evaluation tools and focus groups. Students were overwhelmingly satisfied with their experience in ANMCs. Being mentored by an NP preceptor in an ANMC was a valuable experience for students. They valued the role modeling of the NP and the quality of their preceptors' instruction. Students stated that the nursing model of care to which they were exposed was congruent with classroom learning. They reported learning to apply an understanding of their patients' economic, social, and cultural situations to treatment decisions and patient-education efforts and learning to understand the role of community-based care. One limitation of ANMCs from the students' perspective was a relatively low volume of patients, particularly in the initial years. However, the benefit of having time to spend with clients and to reflect on clinical practice was also articulated.

  10. Utilization and outcome of laparoscopic versus robotic general and bariatric surgical procedures at Academic Medical Centers.

    Science.gov (United States)

    Villamere, James; Gebhart, Alana; Vu, Stephen; Nguyen, Ninh T

    2015-07-01

    Robotic-assisted general and bariatric surgery is gaining popularity among surgeons. The aim of this study was to analyze the utilization and outcome of laparoscopic versus robotic-assisted laparoscopic techniques for common elective general and bariatric surgical procedures performed at Academic Medical Centers. We analyzed data from University HealthSystem Consortium clinical database from October 2010 to February 2014 for all patients who underwent laparoscopic versus robotic techniques for eight common elective general and bariatric surgical procedures: gastric bypass, sleeve gastrectomy, gastric band, antireflux surgery, Heller myotomy (HM), cholecystectomy (LC), colectomy, rectal resection (RR). Utilization and outcome measures including demographics, in-hospital mortality, major complications, 30-day readmission, length of stay (LOS), and costs were compared between techniques. 96,694 laparoscopic and robotic procedures were analyzed. Utilization of the robotic approach was the highest for RR (21.4%), followed by HM (9.1%). There was no significant difference in in-hospital mortality or major complications between laparoscopic versus robotic techniques for all procedures. Only two procedures had improved outcome associated with the robotic approach: robotic HM and robotic LC had a shorter LOS compared to the laparoscopic approach (2.8 ± 3.6 vs. 2.3 ± 2.1; respectively, p bariatric surgical procedures with the highest utilization for rectal resection. Compared to conventional laparoscopy, there were no observed clinical benefits associated with the robotic approach, but there was a consistently higher cost.

  11. Accuracy of patient's turnover time prediction using RFID technology in an academic ambulatory surgery center.

    Science.gov (United States)

    Marchand-Maillet, Florence; Debes, Claire; Garnier, Fanny; Dufeu, Nicolas; Sciard, Didier; Beaussier, Marc

    2015-02-01

    Patients flow in outpatient surgical unit is a major issue with regards to resource utilization, overall case load and patient satisfaction. An electronic Radio Frequency Identification Device (RFID) was used to document the overall time spent by the patients between their admission and discharge from the unit. The objective of this study was to evaluate how a RFID-based data collection system could provide an accurate prediction of the actual time for the patient to be discharged from the ambulatory surgical unit after surgery. This is an observational prospective evaluation carried out in an academic ambulatory surgery center (ASC). Data on length of stay at each step of the patient care, from admission to discharge, were recorded by a RFID device and analyzed according to the type of surgical procedure, the surgeon and the anesthetic technique. Based on these initial data (n = 1520), patients were scheduled in a sequential manner according to the expected duration of the previous case. The primary endpoint was the difference between actual and predicted time of discharge from the unit. A total of 414 consecutive patients were prospectively evaluated. One hundred seventy four patients (42%) were discharged at the predicted time ± 30 min. Only 24% were discharged behind predicted schedule. Using an automatic record of patient's length of stay would allow an accurate prediction of the discharge time according to the type of surgery, the surgeon and the anesthetic procedure.

  12. The ebb and flow model: a philosophy of organizational learning in the academic health center.

    Science.gov (United States)

    Dimario, Francis J

    2012-02-01

    Academic health centers (AHCs) have traditionally been a vibrant locale for cutting-edge medical research, androgogic education and innovative clinical care for the most vexing diseases. While these pursuits have coexisted and flourished, the realities of the health-care business environment have demanded reformatting and emulation of a corporate organizational model. This evolution has impacted the core identities of the AHC and challenged individual medical-educators, clinician-scientists and basic science investigators to persist and succeed in this milieu. The AHC has a unique capacity to muster the innate learning drive of these individuals into an organizational mission as it balances the pressures exerted from both the internal and external environments. The AHC as an organization can be viewed as an experimental condition with modifiable variables to which its professionals can react, adapt to, and transform. Organizational learning and change implementation is in essence an experiment in human behavior modification. While all individuals are subject to change, merely assembling them in a single locale determines neither a predictable homogeneous outcome nor the success of their endeavor. This article highlights some of these propositions and offers a philosophical approach to advance the AHC as an organization through the creativity and innovation of its professional ranks.

  13. Leadership Development Programs at Academic Health Centers: Results of a National Survey.

    Science.gov (United States)

    Lucas, Raymond; Goldman, Ellen F; Scott, Andrea R; Dandar, Valerie

    2018-02-01

    To identify the prevalence and characteristics of faculty leadership development programs (LDPs) offered by North American academic health centers (AHCs) and to uncover gaps in leadership training. Faculty development/affairs deans of the 161 Association of American Medical Colleges member schools were surveyed in 2015 on their approach to faculty leadership training. For AHCs delivering their own training, the survey included questions about LDP participants, objectives, curriculum, delivery, resources, and evaluation. The literature on leadership and leadership development was used to develop a taxonomy of leadership competencies, which formed the basis of the survey questions related to program content. Survey results were analyzed with descriptive statistics and chi-square analysis for categorical data. Of the 94 respondents (response rate 58%), 93 provided some form of leadership training and 61 provided a formal internal faculty LDP. Content was variable and rarely based on a specific leadership competency model. Although programs described innovative approaches to learning, lectures and case discussions were the predominant approaches. Evaluation beyond participant satisfaction was uncommon. Faculty LDPs were common, with some programs describing elements informed by the leadership literature. However, nationally programs can improve by basing content on a leadership competency model, incorporating multiple approaches to teaching, and implementing more rigorous program evaluation.

  14. Assessment of inpatient multimodal cardiac imaging appropriateness at large academic medical centers.

    Science.gov (United States)

    Remfry, Andrew; Abrams, Howard; Dudzinski, David M; Weiner, Rory B; Bhatia, R Sacha

    2015-11-14

    Responding to concerns regarding the growth of cardiac testing, the American College of Cardiology Foundation (ACCF) published Appropriate Use Criteria (AUC) for various cardiac imaging modalities. Single modality cardiac imaging appropriateness has been reported but there have been no studies assessing the appropriateness of multiple imaging modalities in an inpatient environment. A retrospective study of the appropriateness of cardiac tests ordered by the inpatient General Internal Medicine (GIM) and Cardiology services at three Canadian academic hospitals was conducted over two one-month periods. Cardiac tests characterized were transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), single-photon emission tomography myocardial perfusion imaging (SPECT), and diagnostic cardiac catheterization. Overall, 553 tests were assessed, of which 99.8% were classifiable by AUC. 91% of all studies were categorized as appropriate, 4% may be appropriate and 5% were rarely appropriate. There were high rates of appropriate use of all modalities by GIM and Cardiology throughout. Significantly more appropriate diagnostic catheterizations were ordered by Cardiology than GIM (93% vs. 82%, p = imaging modalities in this multi-centered study on Cardiology and GIM inpatients in the acute care setting. The rate of appropriate ordering was high across all imaging modalities. We recommend further work towards improving appropriate utilization of cardiac imaging resources focus on the out-patient setting.

  15. Three-Year Experience of an Academic Medical Center Ombuds Office.

    Science.gov (United States)

    Raymond, John R; Layde, Peter M

    2016-03-01

    An ombuds is an individual who informally helps people or groups (visitors) resolve disputes and/or interpersonal conflicts as an alternative to formal dispute resolution mechanisms within an organization. Ombuds are nearly ubiquitous in many governmental, business, and educational settings but only recently have gained visibility at medical schools. Medical schools in the United States are increasingly establishing ombuds offices as part of comprehensive conflict management systems to address concerns of faculty, staff, students, and others. As of 2015, more than 35 medical schools in the United States have active ombuds Web pages. Despite the growing number of medical schools with ombuds offices, the literature on medical school ombuds offices is scant. In this article, the authors review the first three years of experience of the ombuds office at the Medical College of Wisconsin, a freestanding medical and graduate school with a large physician practice. The article is written from the perspective of the inaugural ombuds and the president who initiated the office. The authors discuss the rationale for, costs of, potential advantages of, and initial reactions of faculty, staff, and administration to having an ombuds office in an academic medical center. Important questions relevant to medical schools that are considering an ombuds office are discussed. The authors conclude that an ombuds office can be a useful complement to traditional approaches for conflict management, regulatory compliance, and identification of systemic issues.

  16. The academic health center in complex humanitarian emergencies: lessons learned from the 2010 Haiti earthquake.

    Science.gov (United States)

    Babcock, Christine; Theodosis, Christian; Bills, Corey; Kim, Jimin; Kinet, Melodie; Turner, Madeleine; Millis, Michael; Olopade, Olufunmilayo; Olopade, Christopher

    2012-11-01

    On January 12, 2010, a 7.0-magnitude earthquake struck Haiti. The event disrupted infrastructure and was marked by extreme morbidity and mortality. The global response to the disaster was rapid and immense, comprising multiple actors-including academic health centers (AHCs)-that provided assistance in the field and from home. The authors retrospectively examine the multidisciplinary approach that the University of Chicago Medicine (UCM) applied to postearthquake Haiti, which included the application of institutional structure and strategy, systematic deployment of teams tailored to evolving needs, and the actual response and recovery. The university mobilized significant human and material resources for deployment within 48 hours and sustained the effort for over four months. In partnership with international and local nongovernmental organizations as well as other AHCs, the UCM operated one of the largest and more efficient acute field hospitals in the country. The UCM's efforts in postearthquake Haiti provide insight into the role AHCs can play, including their strengths and limitations, in complex disasters. AHCs can provide necessary intellectual and material resources as well as technical expertise, but the cost and speed required for responding to an emergency, and ongoing domestic responsibilities, may limit the response of a large university and hospital system. The authors describe the strong institutional backing, the detailed predeployment planning and logistical support UCM provided, the engagement of faculty and staff who had previous experience in complex humanitarian emergencies, and the help of volunteers fluent in the local language which, together, made UCM's mission in postearthquake Haiti successful.

  17. Citations in Life Science Patents to Publicly Funded Research at Academic Medical Centers.

    Science.gov (United States)

    Sampat, Bhaven N; Pincus, Harold Alan

    2015-12-01

    The contributions of Academic Medical Centers (AMCs) to biomedical innovation have been difficult to measure because of the challenges involved in tracing knowledge flows from their origin to their uses. The authors examined patent citation linkages between AMC research funded by the National Institutes of Health (NIH) and patents. In prospective analyses, they examine the extent to which articles resulting from NIH grants to AMCs awarded between 1990 and 1995 were cited in drug and medical patents. The authors then examine the extent to which these patents are associated with marketed drugs. In retrospective analyses, they examine the share of drugs approved between 2000 and 2009 that have citation links to NIH-funded AMC research. The prospective analyses show over a third of AMC grants resulted in publications that were cited in patents. Most the patents are drug and biotechnology patents, and are assigned to private firms. Patents citing NIH-funded AMC publications were associated with 106 new FDA approved drugs, half of which are new molecular entities and a quarter of which are priority NMEs. The retrospective analyses showed that about half of the new molecular entities approved over the 2000-2009 period had citations links to NIH-funded AMC research. There are strong links between articles from NIH-funded AMC research and private sector medical patenting, including drugs. More research is needed to better understand the types of links the citations represent and their implications for public policy. © 2015 Wiley Periodicals, Inc.

  18. Medical Directors of Breastfeeding Programs at Academic Medical Centers: Duties and Challenges.

    Science.gov (United States)

    Rosen-Carole, Casey B

    An emerging trend in Academic Medical Centers (AMCs) is to coordinate breastfeeding care, research, and trainee education through "medical director" positions. Little is known about their duties, supports, and challenges. To determine the duties and challenges of directors of breastfeeding medicine in AMCs. A survey was distributed four times over a 3-month period to three listservs with a total of 860 members. Physicians directing breastfeeding programs or services at AMCs were included. Participants were asked about details of their employment, time distribution of the position, their role in education, billing practices, and major hurdles. Thirty-two physicians responded to the survey: 25 from the United States, and seven international. Only 22% of respondents had formal job descriptions and only 31% reported being paid for their breastfeeding work. Most positions were created in the past 10 years (75%), were housed in Departments of Pediatrics (75%), and provided clinical services for breastfeeding in inpatient and outpatient settings. Ninety-one percent of respondents educated trainees and provided oversight of lactation consultants. Major hurdles included difficulties with billing for services, lack of protected time and personal reimbursement, lack of formal structure and job descriptions, and lack of buy-in at the institutional and sometimes governmental levels. Medical Directors of Breastfeeding Services may be increasingly prevalent in AMCs and are engaged in inpatient and outpatient clinical work, trainee education, and lactation consultant oversight. Both financial and structural hurdles were reported by those holding these positions.

  19. The status of interprofessional education and interprofessional prevention education in academic health centers: a national baseline study.

    Science.gov (United States)

    Greer, Annette G; Clay, Maria; Blue, Amy; Evans, Clyde H; Garr, David

    2014-05-01

    Given the emphasis on prevention in U.S. health care reform efforts, the importance of interprofessional education (IPE) that prepares health professions students to be part of effective health care teams is greater than ever. This study examined the prevalence and nature of IPE and interprofessional (IP) prevention education in U.S. academic health centers. The authors extracted a 10-item survey from the longer published IPE Assessment and Planning Instrument. In September 2010, they sent the survey to 346 health professions leaders in health sciences schools and colleges at 100 academic health centers. These institutions were identified via the online membership list of the Association of Academic Health Centers. The authors conducted descriptive statistical analysis and cross-tabulations. Surveys were completed by 127 contacts at 68 universities in 31 states and the District of Columbia. IPE was more prevalent than IP prevention education in all categories of measurement. Respondents affirmed existence of IPE in courses (85.0%) and in clinical rotations/internships (80.3%). The majority reported personnel with responsibility for IPE (68.5%) or prevention education (59.8%) at their institutional unit, and 59.8% reported an IPE office or center. This study provides evidence that IPE and IP prevention education exist in academic health centers, but additional attention should be paid to the development of IP prevention education. Sample syllabi, job descriptions, and policies may be available to support adoption of IPE and IP prevention education. Further effort is needed to increase the integration of IP and prevention education into practice.

  20. Performance evaluation of Al-Zahra academic medical center based on Iran balanced scorecard model.

    Science.gov (United States)

    Raeisi, Ahmad Reza; Yarmohammadian, Mohammad Hossein; Bakhsh, Roghayeh Mohammadi; Gangi, Hamid

    2012-01-01

    Growth and development in any country's national health system, without an efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the system's goals. The balanced scorecard (BSC) is a technique widely used to measure the performance of an organization. The basic core of the BSC is guided by the organization's vision and strategies, which are the bases for the formation of four perspectives of BSC. The goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences, based on Iran BSC model. This is a combination (quantitative-qualitative) research which was done at Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences in 2011. The research populations were hospital managers at different levels. Sampling method was purposive sampling in which the key informed personnel participated in determining the performance indicators of hospital as the BSC team members in focused discussion groups. After determining the conceptual elements in focused discussion groups, the performance objectives (targets) and indicators of hospital were determined and sorted in perspectives by the group discussion participants. Following that, the performance indicators were calculated by the experts according to the predetermined objectives; then, the score of each indicator and the mean score of each perspective were calculated. Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by the participants in the focus discussion group included five strategies, which were customer satisfaction, continuous quality improvement, development of human resources, supporting innovation, expansion of services and improving the productivity. Research participants also agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community perspective (customer), two objectives and

  1. Rejecting conventional wisdom: how academic medical centers can regain their leadership positions.

    Science.gov (United States)

    Krauss, K; Smith, J

    1997-07-01

    Academic medical centers (i.e., medical schools and their principal hospitals) are following very similar strategies in attempts to secure their futures. It is likely that these undifferentiated strategies will fail, since most of them have been copied from the lower-cost, geographically better-positioned hospitals and health systems. Despite a wealth of innovative, entrepreneurial talent and the potential to reshape the world that AMCs live in, most AMCs are in reactive modes. Future directions and strategies are almost always shaped, forced, and justified by external pressures. The major problem with the strategic plans of most AMCs is that they are based on conventional industry wisdom. Strategic plans tend not to be analytically driven. The insight and understanding of those factors that drive the demand for AMCs' services and determine the performances of AMCs are lacking. The authors note some questions that are critical to the formulation of strategies for AMCs. For example, how can the research mission be changed from a cost-based to a value-based endeavor? Most AMCs cannot answer these questions, and if they do address them in the planning process, they do so superficially. Several examples of the factors that need to be understood are also given, such as patients' purposes and needs in seeking specialty care. Alternative strategies are listed, such as maintaining and exploiting the economic irrationality of the market rather than acting as if it were economically rational or forcing it to become so. Last, the authors outline the scope of the changes that are required and urge AMCs to reject conventional wisdom, determine their own unique situations, and work from there.

  2. The utilization of fluorescent cholangiography during robotic cholecystectomy at an inner-city academic medical center.

    Science.gov (United States)

    Sharma, Sidharth; Huang, Raymond; Hui, Shirley; Smith, Michael C; Chung, Paul J; Schwartzman, Alexander; Sugiyama, Gainosuke

    2017-11-27

    In recent years, fluorescent cholangiography using Indocyanine green (ICG) dye has been used to aid identification of structures during robotic cholecystectomy. We sought to compare cholecystectomy with ICG dye versus laparoscopic cholecystectomy at an inner-city academic medical center. Between January 2013 and July 2016, we identified 287 patients of which 191 patients underwent laparoscopic cholecystectomy and 96 patients underwent robotic cholecystectomy with ICG dye. Preoperative risk variables of interest included age, sex, race, body mass index (BMI), and acute cholecystitis. Primary outcome of interest was conversion to open procedures while secondary outcome was length of stay. The two groups were similar in their BMI (31.98 vs. 31.10 kg/m 2 for the laparoscopic and robotic, respectively, p = 0.32). The laparoscopic group had a greater mean age compared to the robotic group (47.77 vs. 43.61 years, p = 0.04). There was no significant difference in sex and emergency surgery between the two groups. Fewer open conversions were found in the robotic than the laparoscopic group [2 (2.1%) vs. 17 (8.9%), p = 0.03]. In multiple logistic regression, robotic cholecystectomy with ICG also showed a lower risk of conversion compared to laparoscopic cholecystectomy, but the difference did not reach statistical significance (OR 0.42, 95% CI 0.11-1.65, p = 0.22). ICG fluorescent cholangiography during robotic cholecystectomy may contribute to proper identification of biliary structures and may reduce the rates of open conversion. The preliminary results of fewer open conversions are promising. Further studies with a large randomized prospective controlled study should be taken for further evaluation.

  3. Introducing sexual orientation and gender identity into the electronic health record: one academic health center's experience.

    Science.gov (United States)

    Callahan, Edward J; Sitkin, Nicole; Ton, Hendry; Eidson-Ton, W Suzanne; Weckstein, Julie; Latimore, Darin

    2015-02-01

    Many U.S. populations experience significant health disparities. Increasing health care providers' awareness of and education about sexual orientation (SO) and gender identity (GI) diversity could help reduce health disparities among lesbian, gay, bisexual, and transgender (LGBT) patients. The authors share the University of California, Davis, Health System's (UCDHS's) experience as it became the first U.S. academic health center to formally introduce patient SO/GI demographic data into its electronic health record (EHR) as a step toward reducing LGBT health disparities. Adding these data to the EHR initially met with resistance. The authors, members of the UCDHS Task Force for Inclusion of SO/GI in the EHR, viewed this resistance as an invitation to educate leaders, providers, and staff about LGBT health disparities and to expose providers to techniques for discussing SO/GI with patients. They describe the strategies they employed to effect institutional culture change, including involvement of senior leadership, key informant interviews, educational outreach via grand rounds and resident workshops, and creation of a patient safety net through inviting providers to self-identify as welcoming LGBT patients. The ongoing cultural change process has inspired spin-off projects contributing to an improved climate for LGBT individuals at UCDHS, including an employee organization supporting SO/GI diversity, support for and among LGBT medical learners through events and listservs, development and implementation of an LGBT health curriculum, and creation of peer navigator programs for LGBT patients with cancer. The authors reflect on lessons learned and on institutional pride in and commitment to providing quality care for LGBT patients.

  4. Preventability of early vs. late readmissions in an academic medical center.

    Directory of Open Access Journals (Sweden)

    Kelly L Graham

    Full Text Available It is unclear if the 30-day unplanned hospital readmission rate is a plausible accountability metric.Compare preventability of hospital readmissions, between an early period [0-7 days post-discharge] and a late period [8-30 days post-discharge]. Compare causes of readmission, and frequency of markers of clinical instability 24h prior to discharge between early and late readmissions.120 patient readmissions in an academic medical center between 1/1/2009-12/31/2010.Sum-score based on a standard algorithm that assesses preventability of each readmission based on blinded hospitalist review; average causation score for seven types of adverse events; rates of markers of clinical instability within 24h prior to discharge.Readmissions were significantly more preventable in the early compared to the late period [median preventability sum score 8.5 vs. 8.0, p = 0.03]. There were significantly more management errors as causative events for the readmission in the early compared to the late period [mean causation score [scale 1-6, 6 most causal] 2.0 vs. 1.5, p = 0.04], and these errors were significantly more preventable in the early compared to the late period [mean preventability score 1.9 vs 1.5, p = 0.03]. Patients readmitted in the early period were significantly more likely to have mental status changes documented 24h prior to hospital discharge than patients readmitted in the late period [12% vs. 0%, p = 0.01].Readmissions occurring in the early period were significantly more preventable. Early readmissions were associated with more management errors, and mental status changes 24h prior to discharge. Seven-day readmissions may be a better accountability measure.

  5. Reducing liberal red blood cell transfusions at an academic medical center.

    Science.gov (United States)

    Saag, Harry S; Lajam, Claudette M; Jones, Simon; Lakomkin, Nikita; Bosco, Joseph A; Wallack, Rebecca; Frangos, Spiros G; Sinha, Prashant; Adler, Nicole; Ursomanno, Patti; Horwitz, Leora I; Volpicelli, Frank M

    2017-04-01

    Educational and computerized interventions have been shown to reduce red blood cell (RBC) transfusion rates, yet controversy remains surrounding the optimal strategy needed to achieve sustained reductions in liberal transfusions. The purpose of this study was to assess the impact of clinician decision support (CDS) along with targeted education on liberal RBC utilization to four high-utilizing service lines compared with no education to control service lines across an academic medical center. Clinical data along with associated hemoglobin levels at the time of all transfusion orders between April 2014 and December 2015 were obtained via retrospective chart review. The primary outcome was the change in the rate of liberal RBC transfusion orders (defined as any RBC transfusion when the hemoglobin level is >7.0 g/dL). Secondary outcomes included the annual projected reduction in the number of transfusions and the associated decrease in cost due to these changes as well as length of stay (LOS) and death index. These measures were compared between the 12 months prior to the initiative and the 9-month postintervention period. Liberal RBC utilization decreased from 13.4 to 10.0 units per 100 patient discharges (p = 0.002) across the institution, resulting in a projected 12-month savings of $720,360. The mean LOS and the death index did not differ significantly in the postintervention period. Targeted education combined with the incorporation of CDS at the time of order entry resulted in significant reductions in the incidence of liberal RBC utilization without adversely impacting inpatient care, whereas control service lines exposed only to CDS had no change in transfusion habits. © 2016 AABB.

  6. Impact of Mobile Dose-Tracking Technology on Medication Distribution at an Academic Medical Center.

    Science.gov (United States)

    Kelm, Matthew; Campbell, Udobi

    2016-05-01

    Medication dose-tracking technologies have the potential to improve efficiency and reduce costs associated with re-dispensing doses reported as missing. Data describing this technology and its impact on the medication use process are limited. The purpose of this study is to assess the impact of dose-tracking technology on pharmacy workload and drug expense at an academic, acute care medical center. Dose-tracking technology was implemented in June 2014. Pre-implementation data were collected from February to April 2014. Post-implementation data were collected from July to September 2014. The primary endpoint was the percent of re-dispensed oral syringe and compounded sterile product (CSP) doses within the pre- and post-implementation periods per 1,000 discharges. Secondary endpoints included pharmaceutical expense generated from re-dispensing doses, labor costs, and staff satisfaction with the medication distribution process. We observed an average 6% decrease in re-dispensing of oral syringe and CSP doses from pre- to post-implementation (15,440 vs 14,547 doses; p = .047). However, when values were adjusted per 1,000 discharges, this trend did not reach statistical significance (p = .074). Pharmaceutical expense generated from re-dispensing doses was significantly reduced from pre- to post-implementation ($834,830 vs $746,466 [savings of $88,364]; p = .047). We estimated that $2,563 worth of technician labor was avoided in re-dispensing missing doses. We also saw significant improvement in staff perception of technology assisting in reducing missing doses (p = .0003), as well as improvement in effectiveness of resolving or minimizing missing doses (p = .01). The use of mobile dose-tracking technology demonstrated meaningful reductions in both the number of doses re-dispensed and cost of pharmaceuticals dispensed.

  7. The "for-benefit" academic medical center: a solution for survival.

    Science.gov (United States)

    Sabeti, Heerad; Kahn, Marc J; Sachs, Benjamin P

    2015-05-01

    Academic medical centers (AMCs) are the backbone of the U.S. health care system. They provide a disproportionate share of charity care and serve as a training ground for future physicians. Yet, AMCs face profound economic challenges, from changes in funding to changes in the health care market. To survive, many AMCs will need to form integrated health systems, a process expected to cost tens, if not hundreds, of millions of dollars. Nearly all AMCs are structured as not-for- profit entities, which places restrictions on their ability to forge partnerships, pursue joint ventures, and access private capital, often essential elements for forming such integrated systems. An alternative model known as the "for-benefit" corporation can allow AMCs to retain their important social mission and the other advantages of their not-for-profit status while allowing them flexibility and access to both investment and philanthropic capital. To pursue the for-benefit pathway, AMCs have two options-either they could work within the constraints of existing laws to restructure themselves as for-benefit entities, or they could create, under federal law, a new for-benefit AMC model, allowing for the orderly conversion of not-for-profit AMCs. Essential components of a for-benefit AMC include a social purpose, access to multiple forms of capital, the use of earnings to support its purpose, transparency, aligned compensation, and tax exemptions. Restructuring an AMC as a for-benefit entity enables it to both advance shareholder value and further the public good.

  8. Therapeutic Drug Monitoring of Pentobarbital: Experience at an Academic Medical Center.

    Science.gov (United States)

    Humble, Robert M; Ehlers, Alexandra; Pakalniskis, Brittany L; Morris, Cory; Drees, Denny; Kulhavy, Jeff; Krasowski, Matthew D

    2015-12-01

    Pentobarbital is used for management of intractable seizures and for reducing elevated intracranial pressure. Dosing of pentobarbital can be aided by therapeutic drug monitoring (TDM). There is no commercially available automated assay for measurement of pentobarbital serum/plasma concentrations; consequently, chromatography-based assays are often used. Pentobarbital TDM was studied over a 14-year period at an academic medical center. 154 patients (94 adult, 60 pediatric) were identified who had pentobarbital levels ordered at least once during a hospital encounter. Chart review included patient diagnosis, indication for pentobarbital therapy, recent or concomitant medication with other barbiturates, patient disposition, organ donation, pentobarbital dosing changes, and neurosurgical procedures. Pentobarbital serum/plasma concentrations were determined on an automated clinical chemistry platform with a laboratory-developed test adapted from a urine barbiturates immunoassay. Chart review showed therapeutic use of pentobarbital generally consistent with previously published literature. The most common errors observed involved confusion in barbiturate names (eg, mix-up of pentobarbital and phenobarbital in test ordering or in provider notes) that seemed to have minimal impact on TDM effectiveness, with pentobarbital serum/plasma concentrations generally within target ranges. The laboratory-developed pentobarbital immunoassay showed cross-reactivity with phenobarbital and butalbital that was eliminated by alkaline and heat pretreatment. The immunoassay was linear to 20 mcg/mL and correlated closely with gas chromatography-mass spectrometry measurements at a reference laboratory. Pentobarbital TDM can be performed by immunoassay on an automated clinical chemistry platform, providing an alternative to chromatography-based methods. Confusion in barbiturate names is common, especially pentobarbital and phenobarbital.

  9. Impact of add-on laboratory testing at an academic medical center: a five year retrospective study

    OpenAIRE

    Nelson, Louis S.; Davis, Scott R.; Humble, Robert M.; Kulhavy, Jeff; Aman, Dean R.; Krasowski, Matthew D.

    2015-01-01

    Background Clinical laboratories frequently receive orders to perform additional tests on existing specimens (?add-ons?). Previous studies have examined add-on ordering patterns over short periods of time. The objective of this study was to analyze add-on ordering patterns over an extended time period. We also analyzed the impact of a robotic specimen archival/retrieval system on add-on testing procedure and manual effort. Methods In this retrospective study at an academic medical center, ele...

  10. Same-Day Cancellation in Ambulatory Surgery: A Retrospective Review at a Large Academic Tertiary Referral Center.

    Science.gov (United States)

    Smith, Bradford B; Smith, Mark M; Hyder, Joseph A; Mauermann, William J; Warner, Mary E; Licatino, Lauren K; Barbara, David W

    Although ambulatory surgery offers patients convenience and reduced costs, same-day cancellation of ambulatory surgery negatively affects patient experiences and operational efficiency. We conducted a retrospective analysis to determine the frequency and reasons for same-day cancellations in an outpatient surgery center at a large academic tertiary referral center. Of 41 389 ambulatory surgical procedures performed, same-day cancellations occurred at a rate of 0.5% and were usually unforeseeable in nature. Focusing on foreseeable cancellations offers opportunities for enhanced patient satisfaction, improved quality of care, and systems-based practice improvements to mitigate cancellations related to areas such as scheduling or patient noncompliance.

  11. A Survey of Intravenous Remifentanil Use for Labor Analgesia at Academic Medical Centers in the United States.

    Science.gov (United States)

    Aaronson, Jaime; Abramovitz, Sharon; Smiley, Richard; Tangel, Virginia; Landau, Ruth

    2017-04-01

    Remifentanil is most commonly offered when neuraxial labor analgesia is contraindicated. There is no consensus regarding the optimal administration, dosing strategy, or requirements for maternal monitoring, which may pose a patient safety issue. This exploratory survey evaluated the current practices regarding remifentanil use for labor analgesia at academic centers in the United States. Of 126 obstetric anesthesia directors surveyed, 84 (67%) responded. In 2014 to 2015, an estimated 36% (95% confidence interval: 25.7-46.3) of centers used remifentanil, most of which did so less than 5 times. Some serious maternal and neonatal respiratory complications occurred, emphasizing that clinical protocols and adequate monitoring are key to ensure maternal and neonatal safety.

  12. Critical Advising: A Freirian-Inspired Approach

    Science.gov (United States)

    Puroway, Andrew W.

    2016-01-01

    Advising is not a politically neutral activity. It requires pedagogical grounding that promotes critical reflection and action consistent with praxis. Advisors can turn to literature citing Brazilian educator and critical pedagogue, Paulo Freire, for discussions on praxis, and they can use a Freirian-inspired advising approach to connect the…

  13. College Advising: Current Perceptions, Future Directions.

    Science.gov (United States)

    Chapman, David W.; Gill, Stephen J.

    1981-01-01

    Examines the college admissions activities that high school counselors believe are most effective in providing accurate information to students. Also examines the current role of the counselor in college advising and reports on what counselors predict will be the trends in college advising. (Author/RC)

  14. 33 CFR 327.6 - Legal adviser.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Legal adviser. 327.6 Section 327... PUBLIC HEARINGS § 327.6 Legal adviser. At each public hearing, the district counsel or his designee may serve as legal advisor to the presiding officer. In appropriate circumstances, the district engineer may...

  15. Teaching professional writing in an academic health sciences center: the Writing Center model at the Medical University of South Carolina.

    Science.gov (United States)

    Smith, Tom G; Ariail, Jennie; Richards-Slaughter, Shannon; Kerr, Lisa

    2011-01-01

    Writing is taught as professional competency in higher education generally, but the health science education literature emphasizes writing as a pedagogical means rather than a professional end. The Medical University of South Carolina established a Writing Center in 1994 to teach professional writing. This report describes the rationale for profession-specific, graduate-level writing instruction; summarizes the Writing Center model; and reports usage data. Students have reported improvement in particular texts and said they would be better able to complete writing tasks in the future. Interventions modeled after the Writing Center and staffed with professionally trained writing teachers may provide a means to pool resources to teach writing as professional competency. The Writing Center has provided the expertise to teach professional writing without demanding curricular revision.

  16. The Psychology Department Model Advisement Procedure: A Comprehensive, Systematic Approach to Career Development Advisement

    Science.gov (United States)

    Howell-Carter, Marya; Nieman-Gonder, Jennifer; Pellegrino, Jennifer; Catapano, Brittani; Hutzel, Kimberly

    2016-01-01

    The MAP (Model Advisement Procedure) is a comprehensive, systematic approach to developmental student advisement. The MAP was implemented to improve advisement consistency, improve student preparation for internships/senior projects, increase career exploration, reduce career uncertainty, and, ultimately, improve student satisfaction with the…

  17. Annual Report of the Operations Research Center and Department of Systems Engineering for Academic Year 2004

    National Research Council Canada - National Science Library

    Kwinn, Michael

    2004-01-01

    ...) for the Academic Year 03-04. The annual research report includes a statement of purpose for research which supports DSE and the ORCEN, a description of the two organizations, a list of the key personnel responsible for executing...

  18. Autoverification in a core clinical chemistry laboratory at an academic medical center

    Directory of Open Access Journals (Sweden)

    Matthew D Krasowski

    2014-01-01

    Full Text Available Background: Autoverification is a process of using computer-based rules to verify clinical laboratory test results without manual intervention. To date, there is little published data on the use of autoverification over the course of years in a clinical laboratory. We describe the evolution and application of autoverification in an academic medical center clinical chemistry core laboratory. Subjects and Methods: At the institution of the study, autoverification developed from rudimentary rules in the laboratory information system (LIS to extensive and sophisticated rules mostly in middleware software. Rules incorporated decisions based on instrument error flags, interference indices, analytical measurement ranges (AMRs, delta checks, dilution protocols, results suggestive of compromised or contaminated specimens, and ′absurd′ (physiologically improbable values. Results: The autoverification rate for tests performed in the core clinical chemistry laboratory has increased over the course of 13 years from 40% to the current overall rate of 99.5%. A high percentage of critical values now autoverify. The highest rates of autoverification occurred with the most frequently ordered tests such as the basic metabolic panel (sodium, potassium, chloride, carbon dioxide, creatinine, blood urea nitrogen, calcium, glucose; 99.6%, albumin (99.8%, and alanine aminotransferase (99.7%. The lowest rates of autoverification occurred with some therapeutic drug levels (gentamicin, lithium, and methotrexate and with serum free light chains (kappa/lambda, mostly due to need for offline dilution and manual filing of results. Rules also caught very rare occurrences such as plasma albumin exceeding total protein (usually indicative of an error such as short sample or bubble that evaded detection and marked discrepancy between total bilirubin and the spectrophotometric icteric index (usually due to interference of the bilirubin assay by immunoglobulin (Ig M monoclonal

  19. Spectrum of tablet computer use by medical students and residents at an academic medical center

    Directory of Open Access Journals (Sweden)

    Robert Robinson

    2015-07-01

    Full Text Available Introduction. The value of tablet computer use in medical education is an area of considerable interest, with preliminary investigations showing that the majority of medical trainees feel that tablet computers added value to the curriculum. This study investigated potential differences in tablet computer use between medical students and resident physicians.Materials & Methods. Data collection for this survey was accomplished with an anonymous online questionnaire shared with the medical students and residents at Southern Illinois University School of Medicine (SIU-SOM in July and August of 2012.Results. There were 76 medical student responses (26% response rate and 66 resident/fellow responses to this survey (21% response rate. Residents/fellows were more likely to use tablet computers several times daily than medical students (32% vs. 20%, p = 0.035. The most common reported uses were for accessing medical reference applications (46%, e-Books (45%, and board study (32%. Residents were more likely than students to use a tablet computer to access an electronic medical record (41% vs. 21%, p = 0.010, review radiology images (27% vs. 12%, p = 0.019, and enter patient care orders (26% vs. 3%, p < 0.001.Discussion. This study shows a high prevalence and frequency of tablet computer use among physicians in training at this academic medical center. Most residents and students use tablet computers to access medical references, e-Books, and to study for board exams. Residents were more likely to use tablet computers to complete clinical tasks.Conclusions. Tablet computer use among medical students and resident physicians was common in this survey. All learners used tablet computers for point of care references and board study. Resident physicians were more likely to use tablet computers to access the EMR, enter patient care orders, and review radiology studies. This difference is likely due to the differing educational and professional demands placed on

  20. Evaluation of recombinant activated protein C for severe sepsis at a tertiary academic medical center

    Directory of Open Access Journals (Sweden)

    Anger KE

    2013-06-01

    Full Text Available Kevin E Anger,1 Jeremy R DeGrado,1 Bonnie C Greenwood,1 Steven A Cohen,2 Paul M Szumita1 1Department of Pharmacy, Brigham and Women’s Hospital, Boston, MA, USA; 2Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, VA, USA Purpose: Early clinical trials of recombinant human activated protein C (rhAPC for severe sepsis excluded patients at high risk of bleeding. Recent literature suggests bleeding rates are higher in clinical practice and may be associated with worsened outcomes. Our objective was to evaluate baseline demographics; incidence, and risk factors for major bleeding; and mortality of patients receiving rhAPC for severe sepsis at our institution. Methods: A retrospective study was performed for all patients receiving rhAPC for treatment of severe sepsis at a tertiary academic medical center from January 2002 to June 2009. Demographic information, clinical variables, intensive care unit, and hospital outcomes were recorded. Results: Of the 156 patients that received rhAPC, 54 (34.6% did not meet institutional criteria for safe use at baseline due to bleeding precaution or contraindication. Twenty-three (14.7% patients experienced a major bleeding event. Multivariate analysis demonstrated baseline International Normalized Ratio ≥2.5 (odds ratio [OR] 3.68, 95% confidence interval [CI]: 1.28–10.56; P = 0.03 and platelet count ≤100 × 103/mm3 (OR 2.86, 95% CI: 1.07–7.67; P = 0.01 as significant predictors of a major bleed. Overall hospital mortality was 57.7%. Multivariate analysis demonstrated the presence of ≥3 organ dysfunctions (OR 2.46, 95% CI: 1.19–5.09; P < 0.05 and medical intensive care unit admission (OR 1.99, 95% CI: 1.00–3.98; P = 0.05 were independent variables associated with hospital mortality. Conclusion: Patients receiving rhAPC at our institution had higher APACHE II scores, mortality, and major bleeding events than published

  1. Elimination of waste: creation of a successful Lean colonoscopy program at an academic medical center.

    Science.gov (United States)

    Damle, Aneel; Andrew, Nathan; Kaur, Shubjeet; Orquiola, Alan; Alavi, Karim; Steele, Scott R; Maykel, Justin

    2016-07-01

    Lean processes involve streamlining methods and maximizing efficiency. Well established in the manufacturing industry, they are increasingly being applied to health care. The objective of this study was to determine feasibility and effectiveness of applying Lean principles to an academic medical center colonoscopy unit. Lean process improvement involved training endoscopy personnel, observing patients, mapping the value stream, analyzing patient flow, designing and implementing new processes, and finally re-observing the process. Our primary endpoint was total colonoscopy time (minutes from check-in to discharge) with secondary endpoints of individual segment times and unit colonoscopy capacity. A total of 217 patients were included (November 2013-May 2014), with 107 pre-Lean and 110 post-Lean intervention. Pre-Lean total colonoscopy time was 134 min. After implementation of the Lean process, mean colonoscopy time decreased by 10 % to 121 min (p = 0.01). The three steps of the process affected by the Lean intervention (time to achieve adequate sedation, time to recovery, and time to discharge) decreased from 3.7 to 2.4 min (p 4.0 to 3.4 min (p = 0.09), and 41.2 to 35.4 min (p = 0.05), respectively. Overall, unit capacity of colonoscopies increased from 39.6 per day to 43.6. Post-Lean patient satisfaction surveys demonstrated an average score of 4.5/5.0 (n = 73) regarding waiting time, 4.9/5.0 (n = 60) regarding how favorably this experienced compared to prior colonoscopy experiences, and 4.9/5.0 (n = 74) regarding professionalism of staff. One hundred percentage of respondents (n = 69) stated they would recommend our institution to a friend for colonoscopy. With no additional utilization of resources, a single Lean process improvement cycle increased productivity and capacity of our colonoscopy unit. We expect this to result in increased patient access and revenue while maintaining patient satisfaction. We believe these results are widely

  2. There is no "i" in teamwork in the patient-centered medical home: defining teamwork competencies for academic practice.

    Science.gov (United States)

    Leasure, Emily L; Jones, Ronald R; Meade, Lauren B; Sanger, Marla I; Thomas, Kris G; Tilden, Virginia P; Bowen, Judith L; Warm, Eric J

    2013-05-01

    Evidence suggests that teamwork is essential for safe, reliable practice. Creating health care teams able to function effectively in patient-centered medical homes (PCMHs), practices that organize care around the patient and demonstrate achievement of defined quality care standards, remains challenging. Preparing trainees for practice in interprofessional teams is particularly challenging in academic health centers where health professions curricula are largely siloed. Here, the authors review a well-delineated set of teamwork competencies that are important for high-functioning teams and suggest how these competencies might be useful for interprofessional team training and achievement of PCMH standards. The five competencies are (1) team leadership, the ability to coordinate team members' activities, ensure appropriate task distribution, evaluate effectiveness, and inspire high-level performance, (2) mutual performance monitoring, the ability to develop a shared understanding among team members regarding intentions, roles, and responsibilities so as to accurately monitor one another's performance for collective success, (3) backup behavior, the ability to anticipate the needs of other team members and shift responsibilities during times of variable workload, (4) adaptability, the capability of team members to adjust their strategy for completing tasks on the basis of feedback from the work environment, and (5) team orientation, the tendency to prioritize team goals over individual goals, encourage alternative perspectives, and show respect and regard for each team member. Relating each competency to a vignette from an academic primary care clinic, the authors describe potential strategies for improving teamwork learning and applying the teamwork competences to academic PCMH practices.

  3. Marital and job satisfaction among non-resident physicians at a Hispanic academic medical center, 2006-2007.

    Science.gov (United States)

    Colón-de Martí, Luz N; Acevedo, Luis F; Céspedes-Gómez, Wayca R

    2009-01-01

    Marital satisfaction has been previously associated with job satisfaction although few studies have addressed this issue among Hispanic physicians. Marital and job satisfaction were assessed in a sample of 92 legally married non-residents physicians working at a Hispanic Academic Medical Center during the 2006-2007 academic year. Marital satisfaction was assessed using the Dyadic Adjustment Scale (DAS) and job satisfaction was measured using a 18-item scale. Response rate was 34.8%. Most (70.7%) of the subjects were males. Forty- five percent (45.0%) belonged to the surgical specialties group. The mean scale value for marital satisfaction was found to be in the average range. Almost all (88.7%) the participants reported being "satisfied "to "very satisfied" with their job. Ninety percent (90.0%) of the surgical specialists and 86.9% of the non-surgical specialists reported being satisfied with their job. The percentage of participants that reported to be "very satisfied" with their job, was higher among the group of surgical specialists (23.3%) than among the non-surgical specialists (13.0%) There was no significant relationship between marital satisfaction and job satisfaction. Also, no statistically significant difference was observed in the level of marital satisfaction and job satisfaction when surgical and non-surgical physicians were compared. The findings on marital satisfaction obtained in this sample were similar to those observed in a previous study of resident physicians at the same academic medical center.

  4. African American Students in a California Community College: Perceptions of Cultural Congruity and Academic Self-Concept within a Black Culture Center

    Science.gov (United States)

    James, Tenisha Celita

    2017-01-01

    This study focused on the cultural congruity and academic self-concept of African American students in a community college setting who participated in a Black Culture Center. The purpose of this quantitative correlational study was to examine the relationship between cultural congruity and academic self-concept through the following two research…

  5. Organizational culture in an academic health center: an exploratory study using a competing values framework.

    Science.gov (United States)

    Ovseiko, Pavel V; Buchan, Alastair M

    2012-06-01

    Implementing cultural change and aligning organizational cultures could enhance innovation, quality, safety, and job satisfaction. The authors conducted this mixed-methods study to assess academic physician-scientists' perceptions of the current and preferred future organizational culture at a university medical school and its partner health system. In October 2010, the authors surveyed academic physicians and scientists jointly employed by the University of Oxford and its local, major partner health system. The survey included the U.S. Veterans Affairs Administration's 14-item Competing Values Framework instrument and two extra items prompting respondents to identify their substantive employer and to provide any additional open-ended comments. Of 436 academic physicians and scientists, 170 (39%) responded. Of these, 69 (41%) provided open-ended comments. Dominant hierarchical culture, moderate rational and team cultures, and underdeveloped entrepreneurial culture characterized the health system culture profile. The university profile was more balanced, with strong rational and entrepreneurial cultures, and moderate-to-strong hierarchical and team cultures. The preferred future culture (within five years) would emphasize team and entrepreneurial cultures and-to a lesser degree-rational culture, and would deemphasize hierarchical culture. Whereas the university and the health system currently have distinct organizational cultures, academic physicians and scientists would prefer the same type of culture across the two organizations so that both could more successfully pursue the shared mission of academic medicine. Further research should explore strengthening the validity and reliability of the organizational culture instrument for academic medicine and building an evidence base of effective culture change strategies and interventions.

  6. The Adviser: Professional Journalist and Professional Educator.

    Science.gov (United States)

    Kopenhaver, Lillian Lodge

    1981-01-01

    Offers information and guidelines delineating the roles and responsibilities of an adviser to student publications--to safeguard students' First Amendment rights and to ensure that students will have freedom of expression. (RL)

  7. Researchers defend European science adviser role

    Science.gov (United States)

    Williams, Andrew

    2014-09-01

    Physicists are among those to call for Europe to retain the post of chief scientific adviser following an open letter signed by nine non-governmental organizations - including Greenpeace - that had said the position should be scrapped.

  8. Student Participation in Academic Advising: Propensity, Behavior, Attribution and Satisfaction

    Science.gov (United States)

    Braun, Jakob; Zolfagharian, Mohammadali

    2016-01-01

    While there is general consensus that students are more or less participants in their educational experiences, the relationship between student participation and satisfaction has not been extensively examined in higher education literature. Looking to participation research in other literatures serves as a starting point for exploring this link.…

  9. A mid year comparison study of career satisfaction and emotional states between residents and faculty at one academic medical center

    Directory of Open Access Journals (Sweden)

    Wessel Kristen

    2006-07-01

    Full Text Available Abstract Background The Accreditation Council for Graduate Medical Education's (ACGME new requirements raise multiple challenges for academic medical centers. We sought to evaluate career satisfaction, emotional states, positive and negative experiences, work hours and sleep among residents and faculty simultaneously in one academic medical center after implementation of the ACGME duty hour requirements. Methods Residents and faculty (1330 in the academic health center were asked to participate in a confidential survey; 72% of the residents and 66% of the faculty completed the survey. Results Compared to residents, faculty had higher levels of satisfaction with career choice, competence, importance and usefulness; lower levels of anxiousness and depression. The most positive experiences for both groups corresponded to strong interpersonal relationships and educational value; most negative experiences to poor interpersonal relationships and issues perceived outside of the physician's control. Approximately 13% of the residents and 14% of the faculty were out of compliance with duty hour requirements. Nearly 5% of faculty reported working more than 100 hours per week. For faculty who worked 24 hour shifts, nearly 60% were out of compliance with the duty-hour requirements. Conclusion Reasons for increased satisfaction with career choice, positive emotional states and experiences for faculty compared to residents are unexplained. Earlier studies from this institution identified similar positive findings among advanced residents compared to more junior residents. Faculty are more frequently at risk for duty-hour violations. If patient safety is of prime importance, faculty, in particular, should be compliant with the duty hour requirements. Perhaps the ACGME should contain faculty work hours as part of its regulatory function.

  10. Impact of Writing Proficiency and Writing Center Participation on Academic Performance

    Science.gov (United States)

    Bielinska-Kwapisz, Agnieszka

    2015-01-01

    Purpose: Given that there exists in the literature relatively little research into the effectiveness of writing centers at universities, the purpose of this paper is to show the impact of university writing centers on first-year business seminar student writing. Design/methodology/approach: This quantitative study involved 315 first-year…

  11. The Role of Family Characteristics for Students' Academic Outcomes: A Person-Centered Approach.

    Science.gov (United States)

    Häfner, Isabelle; Flunger, Barbara; Dicke, Anna-Lena; Gaspard, Hanna; Brisson, Brigitte M; Nagengast, Benjamin; Trautwein, Ulrich

    2017-04-17

    Using data from 1,571 ninth-grade students (M age  = 14.62) from 82 academic track schools in Germany and their predominantly Caucasian middle-class parents, configurations of different family characteristics reported by parents were investigated. Latent profile analyses considering academic involvement, family interest, parents' self-concept, child's need for support, and parents' time and energy identified average, indifferent, motivated and engaged, motivated and disengaged, and involved families. Cross-sectional and longitudinal associations with students' motivational (self-concept, effort, and interest) and achievement outcomes (achievement test and grades) in math were analyzed. Students from families classified as motivated and disengaged showed higher initial levels motivation and achievement. Over 5 months, these students also showed an increase in self-concept and higher achievement than students from other family types. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

  12. Creating 21st-Century Laboratories and Classrooms for Improving Population Health: A Call to Action for Academic Medical Centers.

    Science.gov (United States)

    DeVoe, Jennifer E; Likumahuwa-Ackman, Sonja; Shannon, Jackilen; Steiner Hayward, Elizabeth

    2017-04-01

    Academic medical centers (AMCs) in the United States built world-class infrastructure to successfully combat disease in the 20th century, which is inadequate for the complexity of sustaining and improving population health. AMCs must now build first-rate 21st-century infrastructure to connect combating disease and promoting health. This infrastructure must acknowledge the bio-psycho-social-environmental factors impacting health and will need to reach far beyond the AMC walls to foster community "laboratories" that support the "science of health," complementary to those supporting the "science of medicine"; cultivate community "classrooms" to stimulate learning and discovery in the places where people live, work, and play; and strengthen bridges between academic centers and these community laboratories and classrooms to facilitate bidirectional teaching, learning, innovation, and discovery.Private and public entities made deep financial investments that contributed to the AMC disease-centered approach to clinical care, education, and research in the 20th century. Many of these same funders now recognize the need to transform U.S. health care into a system that is accountable for population health and the need for a medical workforce equipped with the skills to measure and improve health. Innovative ideas about communities as centers of learning, the importance of social factors as major determinants of health, and the need for multidisciplinary perspectives to solve complex problems are not new; many are 20th-century ideas still waiting to be fully implemented. The window of opportunity is now. The authors articulate how AMCs must take bigger and bolder steps to become leaders in population health.

  13. An informatics-based tool to assist researchers in initiating research at an academic medical center: Vanderbilt Customized Action Plan.

    Science.gov (United States)

    Pulley, Jill M; Harris, Paul A; Yarbrough, Tonya; Swafford, Jonathan; Edwards, Terri; Bernard, Gordon R

    2010-01-01

    The regulatory review and approval process is a significant part of the workflow associated with initiating clinical and translational research projects. Ambiguity concerning submission requirements and expected times associated with the review process can create additional work for research teams and ultimately delay important scientific projects. In an effort to provide assistance to investigators, we have developed an online interactive interface which elicits basic study characteristics for a single project and subsequently produces a list of required administrative applications needed for approval along with clear instructions concerning expectations from the research team. This system, the Vanderbilt Customized Action Plan (V-CAP), was launched in October 2006 and has been well received by researchers. In this article, the authors present (1) the V-CAP project design, (2) a reference workflow associated with Vanderbilt policies and regulations, (3) the V-CAP metrics of use by Vanderbilt research teams, and (4) a list of recommendations for other academic centers considering a similar systems-based approach for helping researchers efficiently navigate processes related to regulatory approval. The informatics-systems-based approach of the V-CAP is scalable to other academic medical centers and may serve as a useful model to help researchers navigate the complexity of the regulatory approvals process.

  14. Job satisfaction and motivation among physicians in academic medical centers: insights from a cross-national study.

    Science.gov (United States)

    Janus, Katharina; Amelung, Volker E; Baker, Laurence C; Gaitanides, Michael; Schwartz, Friedrich W; Rundall, Thomas G

    2008-12-01

    Our study assesses how work-related monetary and nonmonetary factors affect physicians' job satisfaction at three academic medical centers in Germany and the United States, two countries whose differing health care systems experience similar problems in maintaining their physician workforce. We used descriptive statistics and factor and correlation analyses to evaluate physicians' responses to a self-administered questionnaire. Our study revealed that German physician respondents were less satisfied overall than their U.S. counterparts. In both countries, participation in decision making that may affect physicians' work was an important correlate of satisfaction. In Germany other important factors were opportunities for continuing education, job security, extent of administrative work, collegial relationships, and access to specialized technology. In the U.S. sample, job security, financial incentives, interaction with colleagues, and cooperative working relationships with colleagues and management were important predictors of overall job satisfaction. The implications of these findings for the development of policies and management tactics to increase physician job satisfaction in German and U.S. academic medical centers are discussed.

  15. The Classroom as an Institutional Resource: An Example in Computer-Assisted Advising.

    Science.gov (United States)

    Lowry, Glenn R.; Grites, Thomas J.

    1982-01-01

    In a Stockton State advising program focusing on career planning and personal development as well as academic programs, a project undertaken by students in the Information and Systems Sciences program helped improve the student data delivery system and save time. Sample records, flow charts, and costs are provided. (MSE)

  16. In Their Own Words: Best Practices for Advising Millennial Students about Majors

    Science.gov (United States)

    Montag, Tamara; Campo, Jill; Weissman, Julie; Walmsley, Angela; Snell, Alex

    2012-01-01

    Utilizing generational theory, we explored the relationship between Millennial characteristics and students' major selection and academic advising experiences. We conducted focus groups of students with senior standing at a private, midwestern university, and we utilized a closed coding technique to analyze the qualitative data. Consistent with…

  17. Using an Electronic Perioperative Documentation Tool to Identify Returns to Operating Room (ROR) in a Tertiary Care Academic Medical Center.

    Science.gov (United States)

    Cima, Robert R; Dhanorker, Sarah R; Ostendorf, Christopher L; Ntekpe, Mfonabasi; Mudundi, Raghu V; Habermann, Elizabeth B; Deschamps, Claude

    2017-03-01

    The metric "Unplanned returns to operating room (ROR)" is being tracked in surgical quality dashboards; 70% of unplanned RORs may be related to surgical complications. With increasing regionalization of trauma and complex surgical care at tertiary care academic centers, it is unclear if a simple ROR metric is a valid assessment of surgical quality at such centers. A real-time electronic tool was used to identify all RORs-planned and unplanned-in a high-volume, high-complexity academic surgical practice at Mayo Clinic-Rochester within 45 days of the index operation. Analysis by ROR type and indication was performed. During the analysis period (June 2014-February 2015) 44,031 operations were performed, with 5,552 subsequent RORs (13%). Of all RORs, 51% (n = 2,818) were planned staged returns, 29% (n = 1,589) were unrelated, 15% (n = 830) were unplanned and 6% (n = 315) were planned because of previous complications. Overall, unplanned reoperations were uncommon (n = 830, 2% of all operations). The most common indications for unplanned RORs included "other" (32%, n = 266), bleeding related (24%, n = 198) and wound complications (20%, n = 166). In a high-volume, high-complexity academic surgical practice, RORs occurred after 13% of cases. Unplanned returns were infrequent and usually were associated with complications; most RORs were planned staged or unrelated returns. A simple ROR metric that does not consider planned/unrelated returns is likely not a valid surgical quality measure. Electronic tools designed specifically to identify in real-time RORs, associated indication, and clinical validation should provide more reliable data for public reporting and quality improvement efforts. Copyright © 2016 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  18. Peer Learning and Academic Standing in Japanese Writing Centers: Preliminary Findings

    OpenAIRE

    DELGREGO, Nicholas

    2018-01-01

     This preliminary research shows incidences of positive true peer learning duringtutoring sessions in writing centers at Japanese universities. In most writing centers atJapanese universities, tutors are required to be graduate students. There is apreconceived notion among some administrative staff and some faculty that undergraduatestudents are unable to properly assist each other because someone must always be in the“teacher role” and someone must always be in the “learner role”. This assum...

  19. Career advising in family medicine: a theoretical framework for structuring the medical student/faculty advisor interview

    Directory of Open Access Journals (Sweden)

    Melissa Bradner

    2013-08-01

    Full Text Available Background: There are unique challenges to recruiting students into the specialty of family medicine within academic medical centers. Methods: At Virginia Commonwealth University, we developed an advising framework to help students address institutional and personal obstacles to choosing family medicine as a career. Results: The role of a faculty advisor is not to direct the student to a career choice but rather to foster a mentor relationship and help the student come to his or her own realizations regarding career choice. The faculty advisor/medical student interview is conceptualized as five discussion topics: self-knowledge, perception, organizational voice, cognitive dissonance, and anticipatory counseling. Conclusion: This framework is intended to assist faculty in their efforts to encourage students to consider a career in family medicine.

  20. Reflections from a chair: Leadership of a clinical department at an academic medical center.

    Science.gov (United States)

    Willett, Christopher G

    2015-11-01

    The leadership position of an academic departmental chair can be a positive and rewarding opportunity. These rewards principally stem from the success of the faculty, residents, other trainees, nurses, and everyone supporting the department. With health care reform and the constraints of the federal budget, increasing attention and time has become directed toward administrative management. There are multiple and often competing constituencies and agendas requiring thoughtful strategies to achieve departmental goals. The objectives of a chair are advancing patient care, education, and research. True excellence of a department is achieved by the innovation of its faculty. © 2015 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  1. Supporting Residential Student Organization Advisers: A 21st Century Adviser Training and Development Program

    Science.gov (United States)

    Shapiro, Cory Adam

    2012-01-01

    The purpose for this doctoral action research study was to discover if and how an updated training and development curriculum benefited residential student organization advisers at Arizona State University (ASU). Eleven advisers of residential student organizations completed a pilot training and development program and agreed to participate in a…

  2. Optimized Bayesian dynamic advising theory and algorithms

    CERN Document Server

    Karny, Miroslav

    2006-01-01

    Written by one of the world's leading groups in the area of Bayesian identification, control, and decision making, this book provides the theoretical and algorithmic basis of optimized probabilistic advising. Starting from abstract ideas and formulations, and culminating in detailed algorithms, the book comprises a unified treatment of an important problem of the design of advisory systems supporting supervisors of complex processes. It introduces the theoretical and algorithmic basis of developed advising, relying on novel and powerful combination black-box modelling by dynamic mixture models

  3. Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.

    Science.gov (United States)

    Padula, William V; Makic, Mary Beth F; Mishra, Manish K; Campbell, Jonathan D; Nair, Kavita V; Wald, Heidi L; Valuck, Robert J

    2015-06-01

    Prevention of pressure ulcers, one of the hospital-acquired conditions (HACs) targeted by the 2008 nonpayment policy of the Centers for Medicare & Medicaid Services (CMS), is a critical issue. This study was conducted to determine the comparative effectiveness of quality improvement (QI) interventions associated with reduced hospital-acquired pressure ulcer (HAPU) rates. In an quasi-experimental design, interrupted time series analyses were conducted to determine the correlation between HAPU incidence rates and adoption of QI interventions. Among University HealthSystem Consortium hospitals, 55 academic medical centers were surveyed from September 2007 through February 2012 for adoption patterns of QI interventions for pressure ulcer prevention, and hospital-level data for 5,208 pressure ulcer cases were analyzed. Between- and within-hospital reduction significance was tested with t-tests post-CMS policy intervention. Fifty-three (96%) of the 55 hospitals used QI interventions for pressure ulcer prevention. The effect size analysis identified five effective interventions that each reduced pressure ulcer rates by greater than 1 case per 1,000 patient discharges per quarter: leadership initiatives, visual tools, pressure ulcer staging, skin care, and patient nutrition. The greatest reductions in rates occurred earlier in the adoption process (pinterventions had clinically meaningful associations with reduced stage III and IV HAPU incidence rates in 55 academic medical centers. These QI interventions can be used in support of an evidence-based prevention protocol for pressure ulcers. Hospitals can not only use these findings from this study as part of a QI bundle for preventing HAPUs.

  4. Mentoring programs for underrepresented minority faculty in academic medical centers: a systematic review of the literature.

    Science.gov (United States)

    Beech, Bettina M; Calles-Escandon, Jorge; Hairston, Kristen G; Langdon, Sarah E; Latham-Sadler, Brenda A; Bell, Ronny A

    2013-04-01

    Mentoring is critical for career advancement in academic medicine. However, underrepresented minority (URM) faculty often receive less mentoring than their nonminority peers. The authors conducted a comprehensive review of published mentoring programs designed for URM faculty to identify "promising practices." Databases (PubMed, PsycINFO, ERIC, PsychLit, Google Scholar, Dissertations Abstracts International, CINHAL, Sociological Abstracts) were searched for articles describing URM faculty mentoring programs. The RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance) formed the model for analyzing programs. The search identified 73 citations. Abstract reviews led to retrieval of 38 full-text articles for assessment; 18 articles describing 13 programs were selected for review. The reach of these programs ranged from 7 to 128 participants. Most evaluated programs on the basis of the number of grant applications and manuscripts produced or satisfaction with program content. Programs offered a variety of training experiences, and adoption was relatively high, with minor changes made for implementing the intended content. Barriers included time-restricted funding, inadequate evaluation due to few participants, significant time commitments required from mentors, and difficulty in addressing institutional challenges faced by URM faculty. Program sustainability was a concern because programs were supported through external funds, with minimal institutional support. Mentoring is an important part of academic medicine, particularly for URM faculty who often experience unique career challenges. Despite this need, relatively few publications exist to document mentoring programs for this population. Institutionally supported mentoring programs for URM faculty are needed, along with detailed plans for program sustainability.

  5. A systematic strategic planning process focused on improved community engagement by an academic health center: the University of Kansas Medical Center's story.

    Science.gov (United States)

    Cook, David C; Nelson, Eve-Lynn; Ast, Cori; Lillis, Teresa

    2013-05-01

    A growing number of academic health centers (AHCs) are considering approaches to expand collaboration with their communities in order to address complex and multisystem health concerns. In 2010, internal leaders at the University of Kansas Medical Center undertook a strategic planning process to enhance both community engagement activities and the scholarship resulting from these engagement activities. The authors describe the strategic planning process, recommendations, and actions associated with elevating community engagement within the AHC's mission and priorities. The strategic planning process included conducting an inventory of community engagement activities within the AHC; analyzing strengths, weaknesses, opportunities, and threats for community engagement work; and identifying goals and strategies to improve future community engagement activities and scholarship. The resulting road map for enhancing community engagement at their institution through 2015 consists of four main strategies: emphasize scholarship in community engagement, revise organizational structures to better facilitate community engagement, prioritize current engagement activities to ensure appropriate use of resources, and enhance communication of engagement initiatives to further develop stakeholder relationships.The authors also discuss implementation of the plan to date and highlight lessons learned that may inform other AHCs as they enhance and expand similar endeavors.

  6. Harvard Catalyst | The Clinical Translational Science Center IND/IDE Consult Service: Providing an IND/IDE Consult Service in a Decentralized Network of Academic Healthcare Centers

    Science.gov (United States)

    Winkler, Sabune J.; Bierer, Barbara E.; Wolf, Delia

    2014-01-01

    Abstract The Food and Drug Administration (FDA) regulations require sponsors of clinical investigations involving an investigational drug or device to submit an Investigational New Drug (IND) or Investigational Device Exemption (IDE) application. Strict adherence to applicable regulations is vital to the success of clinical research. Unlike most major pharmaceutical sponsors, investigator sponsors often do not fully appreciate their regulatory obligations nor have resources to ensure compliance. As a result they can place themselves and their institutions at risk. Nevertheless, investigator‐initiated clinical trials are vital to the further development of innovative drugs, biologics, and medical devices. The IND/IDE Subcommittee under the Regulatory Knowledge and Support Program at Harvard Catalyst, The Harvard Clinical and Translational Science Center worked in collaboration with Harvard and Harvard affiliated institutions to create and launch an IND/IDE Consult Service in a decentralized network of collaborating Academic Healthcare Centers (AHC). The IND/IDE Consult Service offers expertise, resources, and shared experiences to assist sponsor‐investigators and IRBs in meeting regulatory requirements for conducting and reviewing investigator‐initiated IND/IDE studies. The scope of the services provided by the Harvard Catalyst IND/IDE Consult Service are described, including the specifics of the service, lessons learned, and challenges faced, in a scalable model that builds inter‐institutional capacity. PMID:24455986

  7. Student-Centered Instruction and Academic Achievement: Linking Mechanisms of Educational Inequality to Schools’ Instructional Strategy

    DEFF Research Database (Denmark)

    Andersen, Ida Gran; Andersen, Simon Calmar

    2017-01-01

    inequality. Using combined survey and register data for more than 56,000 students in 825 schools, this article conducts the first empirical test of the argument that instructional strategies which emphasize student responsibility and activity, also referred to as student-centered instruction, increase...

  8. Beyond Career Collection Development: Academic Libraries Collaborating with Career Center for Student Success

    Science.gov (United States)

    Pun, Raymond; Kubo, Hiromi

    2017-01-01

    This paper explores a case study at Fresno State and how the library partners with the career center to support student success in career placement and advancement. The article will share opportunities and challenges in forming and maintaining such partnership and offer some best practices to deliver career research workshops collaboratively.

  9. Nurse manager perceptions of role satisfaction and retention at an academic medical center.

    Science.gov (United States)

    Zwink, Jennifer E; Dzialo, Maureen; Fink, Regina M; Oman, Kathleen S; Shiskowsky, Kaycee; Waite, Kathi; DeVine, Deborah; Sanders, Carolyn L; Le-Lazar, Jamie T T

    2013-03-01

    The aim of this study was to explore the perceptions of inpatient acute care nurse managers (NM) employed at an academic Magnet® hospital about factors that influence NM retention, including current work environment, satisfaction, work-life balance, sucssful NM traits, and personal development and educational needs. Nurse managers are challenged with increased workloads impacting their ability to implement all role components. A qualitative descriptive study design used focus group methodology to explore perceptions of the NM role. Nurse managers identified staff recognition, support, peer relationships, collaboration, and ability to make positive change as factors influencing their decision to remain in the role. Burnout factors included workload issues, work-life imbalance, and difficulty sustaining positive relationships. Traits supporting success were communication, resiliency, integrity, and a visionary outlook. Suggestions for NM development and education were identified. Findings can be used to improve NM satisfaction, work-life balance, recruitment, retention, and succession planning.

  10. 77 FR 28476 - Political Contributions by Certain Investment Advisers

    Science.gov (United States)

    2012-05-15

    ...] Political Contributions by Certain Investment Advisers AGENCY: Securities and Exchange Commission. ACTION... Investment Advisers Act of 1940 (``Advisers Act'') to correct an inadvertent error in the rule as published...-6787 or [email protected] , Office of Investment Adviser Regulation, Division of Investment Management, U...

  11. Time Spent by Breast Imaging Radiologists to Perform Value-Added Activities at an Academic Cancer Center.

    Science.gov (United States)

    Collado-Mesa, Fernando; Klevos, Geetika; Arheart, Kristopher; Banks, James; Yepes, Monica; Net, Jose

    2017-04-01

    Health care reform in the United States has generated a paradigm shift in the practice of radiology aimed at increasing the degree of patient-centered care. We conducted a study to quantify the amount of time breast imaging radiologists spend on value-added activities at an academic comprehensive cancer center located in Miami, Florida, and accredited by the American College of Radiology as a Breast Imaging Center of Excellence. A prospective, observational study was conducted during a period of 20 consecutive workdays. Three participating breast imaging radiologists maintained a real-time log of each activity performed. A generalized linear model was used to perform a 1-way analysis of variance. An alpha level of .05 was used to determine statistical significance. The average daily time dedicated to these activities was 92.1 minutes (range, 56.4-132.2). The amount of time significantly differed among breast imaging radiologists and correlated with their assigned daily role (P value-added activities to help improve patients' experience across the continuity of their care. We propose that similar studies be conducted at other institutions to better assess the magnitude of this finding across different breast imaging care settings.

  12. Collaboration between a college of pharmacy and a for-profit health system at an academic medical center.

    Science.gov (United States)

    Bird, Matthew L; Dunn, Rebecca L; Hagemann, Tracy M; Burton, Michael E; Britton, Mark L; St Cyr, Mark B

    2012-07-01

    The genesis and growth of a successful 14-year partnership between the University of Oklahoma (OU) college of pharmacy and the OU Medical Center (OUMC) department of pharmacy are described. Pursuant to a 1998 joint operating agreement, the medical center and pharmacy school have achieved a high degree of collaboration on a wide range of educational and clinical initiatives. The close relationship has conferred a number of benefits on both institutions, including (1) expanded experiential education opportunities for pharmacy students, (2) joint faculty and staff funding arrangements that have facilitated the development and accreditation of OU pharmacy residency programs, and (3) patient care initiatives that have increased awareness of pharmacists' important contributions in areas such as venous thromboembolism prophylaxis, antibiotic stewardship, and core measures compliance. In addition to the formal integration of the college of pharmacy into the OUMC organizational structure, ongoing teamwork by clinicians and administrators at the two institutions has strengthened the 14-year partnership while helping to identify creative solutions to evolving communications, technology, and reimbursement challenges. Potential growth opportunities include the expansion of pharmacy services into additional service areas and greater involvement by OU pharmacy school faculty in the training of medical, nursing, and allied health professionals. A large for-profit academic medical center and a college of pharmacy developed a successful collaboration that is mutually beneficial and provides increased clinical, educational, and scholarly opportunities, advancing the mission of both institutions.

  13. A Human Capital Approach to Career Advising

    Science.gov (United States)

    Shaffer, Leigh S.; Zalewski, Jacqueline M.

    2011-01-01

    We began this series by addressing the challenges of career advising in a volatile, uncertain, complex, and ambiguous environment. In this article, we define human capital and suggest that advisors encourage students to utilize the principle of maximizing human capital when making decisions. We describe the personal traits and attitudes needed to…

  14. The Advising Workplace: Generational Differences and Challenges

    Science.gov (United States)

    Gordon, Virginia; Steele, Peg

    2005-01-01

    The American workplace today is unlike any other in history because for the first time it is made up of four distinct generations. The advising workplaces on today's college campuses mirror this generational diversity. Four generations and their different perceptions of work attitudes and values, management expectations, communication patterns,…

  15. Child-centered versus teacher-directed teaching practices: Associations with the development of academic skills in the first grade at school

    OpenAIRE

    Lerkkanen, Marja-Kristiina; Kiuru, Noona; Pakarinen, Eija; Poikkeus, Anna-Maija; Rasku-Puttonen, Helena; Siekkinen, Martti; Nurmi, Jari-Erik

    2016-01-01

    This study examined the extent to which child-centered versus teacher-directed teaching practices predicted the development of children’s reading and math skills in the first year of elementary school. In addition, we investigated whether associations between teaching practices and children’s academic skills development in Grade 1 differed among children who had low, average, or high initial academic skills at the beginning of school. The reading and math skills of 1,132 Finnish c...

  16. Fully aligned academic health centers: a model for 21st-century job creation and sustainable economic growth.

    Science.gov (United States)

    Reece, E Albert; Chrencik, Robert A; Miller, Edward D

    2012-07-01

    Alignment is the degree to which component parts of academic health centers (AHCs) work cohesively. Full alignment allows AHCs to act quickly and cohesively toward common goals and to take advantage of opportunities that present themselves, particularly where collaboration is essential. Maryland's two major AHCs-University of Maryland Medicine (UMM) and Johns Hopkins Medicine (JHM)-have experienced periods of significant misalignment during each of their histories. Their most recent periods of misalignment caused significant negative economic and academic impacts. However, the process of realigning their clinical and research missions has not only given them a renewed economic vigor but has also paid significant dividends for the state of Maryland, helping it weather the current recession much better than other regions of the country. The two AHCs' continued economic success during the recession has led Maryland lawmakers to increasingly seek out their expertise in attempts to stimulate economic development. Indeed, UMM, JHM, and other fully aligned AHCs have shown that they can be powerful economic engines and offer a model of job growth and economic development in the 21st century.

  17. Department of Petroleum Engineering and Center for Petroleum and Geosystems Engineering annual report, 1990--1991 academic year

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-01

    The Department of Petroleum Engineering at The University of Texas at Austin is one of more than 20 such departments in the United States and more than 40 worldwide. The department has more than 20 faculty members and, as of the fall of 1990, 146 undergraduate and 156 graduate students. During the 1990--91 academic year, undergraduate enrollment is up slightly from the several downturns that began in 1986; graduate enrollment continues to increase, significantly in the number of Ph.D. candidates enrolled. The 1990--91 academic year was one of consolidation of gains. A remote teaching program in the Midland-Odessa area was initiated. During 1991, the Center for Petroleum and Geosystems Engineering (CPGE) continued its large, diversified research activities related to oil, gas and geopressured/geothermal energy production, energy and mineral resources analysis, and added new research projects in other areas such as groundwater remediation. Many of these research projects included interdisciplinary efforts involving faculty, research scientists and graduate students in chemistry, mathematics, geology, geophysics, engineering mechanics, chemical engineering, microbiology and other disciplines. Several projects were undertaken in cooperation with either the Bureau of Economic Geology or the Institute for Geophysics at The University of Texas at Austin. Collaborative research projects with scientists at Brookhaven National Laboratory, Los Alamos National Laboratory, Rice University, and Sandia National Laboratory were also initiated. About 43 companies from seven countries around the world continued to provide the largest portion of research funding to CPGE.

  18. Department of Petroleum Engineering and Center for Petroleum and Geosystems Engineering annual report, 1990--1991 academic year

    Energy Technology Data Exchange (ETDEWEB)

    1991-12-31

    The Department of Petroleum Engineering at The University of Texas at Austin is one of more than 20 such departments in the United States and more than 40 worldwide. The department has more than 20 faculty members and, as of the fall of 1990, 146 undergraduate and 156 graduate students. During the 1990--91 academic year, undergraduate enrollment is up slightly from the several downturns that began in 1986; graduate enrollment continues to increase, significantly in the number of Ph.D. candidates enrolled. The 1990--91 academic year was one of consolidation of gains. A remote teaching program in the Midland-Odessa area was initiated. During 1991, the Center for Petroleum and Geosystems Engineering (CPGE) continued its large, diversified research activities related to oil, gas and geopressured/geothermal energy production, energy and mineral resources analysis, and added new research projects in other areas such as groundwater remediation. Many of these research projects included interdisciplinary efforts involving faculty, research scientists and graduate students in chemistry, mathematics, geology, geophysics, engineering mechanics, chemical engineering, microbiology and other disciplines. Several projects were undertaken in cooperation with either the Bureau of Economic Geology or the Institute for Geophysics at The University of Texas at Austin. Collaborative research projects with scientists at Brookhaven National Laboratory, Los Alamos National Laboratory, Rice University, and Sandia National Laboratory were also initiated. About 43 companies from seven countries around the world continued to provide the largest portion of research funding to CPGE.

  19. Interprofessional academic health center leadership development: the case of the University of Alabama at Birmingham's Healthcare Leadership Academy.

    Science.gov (United States)

    Savage, Grant T; Duncan, W Jack; Knowles, Kathy L; Nelson, Kathleen; Rogers, David A; Kennedy, Karen N

    2014-05-01

    The study describes the genesis of the University of Alabama at Birmingham's Healthcare Leadership Academy (HLA), highlights the HLA's outcomes, discloses how the HLA has changed, and delineates future directions for academic health center (AHC) interprofessional leadership training. While interprofessional training is recognized as an important component of the professional education for health professionals, AHCs have not focused on interprofessional leadership training to prepare future AHC leaders. As professional bureaucracies, AHCs require leadership distributed across different professions; these leaders not only should be technical experts, but also skilled at interprofessional teamwork and collaborative governance. The HLA is examined using the case method, which is supplemented with a descriptive analysis of program evaluation data and outcomes. The HLA has created a networked community of AHC leaders; the HLA's interprofessional team projects foster innovative problem solving. Interprofessional leadership training expands individuals' networks and has multiple organizational benefits. © 2014.

  20. Introducing a primer for career development and promotion: succeeding as a psychologist in an academic health center.

    Science.gov (United States)

    Christophersen, Edward; Butt, Zeeshan

    2012-12-01

    Noting a lack of such a resource, the authors developed a primer summarizing key concepts for career development and promotion for psychologists working in an academic health center. The present article presents a brief summary of the primer; however, the full version is available as an APAHC membership benefit (or for a small fee for non-members) by visiting http://www.div12.org/section8/index.html and is a supplement to the December issue of Volume 19 of the Journal of Clinical Psychology in Medical Settings (Supplementary material 1). The primer complements other APAHC membership benefits, which may be helpful for early career or more seasoned psychologists planning for career transitions.

  1. The impact of ED nurse manager leadership style on staff nurse turnover and patient satisfaction in academic health center hospitals.

    Science.gov (United States)

    Raup, Glenn H

    2008-10-01

    Nurse managers with effective leadership skills are an essential component to the solution for ending the nursing shortage. Empirical studies of existing ED nurse manager leadership styles and their impact on key nurse management outcomes such as staff nurse turnover and patient satisfaction have not been performed. The specific aims of this study were to determine what types of leadership styles were used by ED nurse managers in academic health center hospitals and examine their influence on staff nurse turnover and patient satisfaction. ED nurse managers were asked to complete the Multifactor Leadership Questionnaire and a 10-item researcher defined nurse manager role and practice demographics survey. Completed surveys (15 managers and 30 staff nurses) representing 15 out of 98 possible U.S. academic health centers were obtained. Fisher's exact test with 95% confidence intervals were used to analyze the data. The sample percentage of managers who exhibited Transformational leadership styles and demographic findings of nurse manager age, total years experience and length of time in current position matched current reports in the literature. A trend of lower staff nurse turnover with Transformational leadership style compared to non-Trasformational leadership styles was identified. However, the type of leadership style did not appear to have an effect on patient satisfaction. The ED is an ever-changing, highly regulated, critical-care environment. Effective ED nurse manager leadership strategies are vital to maintaining the standards of professional emergency nursing practice to create an environment that can produce management outcomes of decreased staff nurse turnover, thereby enhancing staff nurse retention and potentially impacting patient satisfaction.

  2. Improving Communication Skills: A Course for Academic Medical Center Surgery Residents and Faculty.

    Science.gov (United States)

    Raper, Steven E; Gupta, Meera; Okusanya, Olugbenga; Morris, Jon B

    2015-01-01

    To improve physician/patient communication and familiarize surgeons with contemporary skills for and metrics assessing communication, courses were developed to provide academic general surgery residents and faculty with a toolkit of information, behaviors, and specific techniques. If academic faculty are expected to mentor residents in communication and residents are expected to learn good communication skills, then both should have the necessary education to accomplish such a goal. Didactic lectures introduced current concepts of physician-patient communication including information on better patient care, fewer malpractice suits, and the move toward transparency of communication metrics. Next, course participants viewed and critiqued "Surgi-Drama" videos, with actors simulating "before" and "after" physician-patient communication scenarios. Finally, participants were provided with a "toolkit" of techniques for improving physician-patient communication including "2-3-4"-a semiscripted short communication tool residents and other physicians can use in patient encounters-and a number of other acronymic approaches. Each participant was asked to complete an anonymous evaluation to assess course content satisfaction. Overall, 86% of residents participated (68/79), with a 52% response rate (35/68) for the evaluation tool. Overall, 88% of faculty participated (84/96), with an 84% response rate (71/84). Residents voiced satisfaction with all domains. For faculty, satisfaction was quantitatively confirmed (Likert score 4 or 5) in 4 of 7 domains, with the highest satisfaction in "communication of goals" and "understanding of the HCAHPS metric." The percentage of "top box" Doctor Communication Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores and national percentile ranking showed a sustained increase more than 1 and 2 years from the dates of the courses. The assessment of communication skills is increasing in importance in the practice of

  3. A study of factors influencing surgical cesarean delivery times in an academic tertiary center.

    Science.gov (United States)

    Gonzalez Fiol, A; Meng, M-L; Danhakl, V; Kim, M; Miller, R; Smiley, R

    2018-05-01

    Knowledge of hospital-specific average cesarean delivery operative times, and factors influencing length of surgery, can serve as a guide for anesthesiologists when choosing the optimal anesthetic technique. The aim of this study was to determine operative times and the factors influencing those times for cesarean delivery. We conducted a retrospective review of all 1348 cesarean deliveries performed at an academic hospital in 2011. The primary outcome was mean operative time for first, second, third and fourth or more cesarean deliveries. The secondary goal was to identify factors influencing operative time. Variables included age, body mass index, previous surgery, gestational age, urgency of cesarean delivery, anesthesia type, surgeon's seniority, layers closed, and performance of tubal ligation. Mean (standard deviation) operative times for first (n=857), second (n=353), third (n=108) and fourth or more (n=30) cesarean deliveries were 56 (19), 60 (19), 69 (28) and 82 (31) minutes, respectively (P cesarean delivery or the presence of other factors that could increase operative time may warrant catheter-based anesthetic techniques or the addition of adjunctive medications to prolong spinal anesthetic block. Institutional and individual surgeon factors may play an even more important role in determining surgical time. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Job satisfaction among young board-certified surgeons at academic centers in Europe and North America.

    Science.gov (United States)

    Raptis, Dimitri Aristotle; Schlegel, Andrea; Tschuor, Christoph; Clavien, Pierre-Alain

    2012-11-01

    To identify independent factors influencing job satisfaction of academic surgeons within their first 10 years after board certification. Job satisfaction is increasingly recognized as a crucial factor for high performance of individuals and teams in most organizations. Sophisticated tools are now available to assess job satisfaction in medicine. A survey among 439 faculty surgeons from 16 European countries, United States, and Canada was conducted in 2011. Satisfaction at work was analyzed using the validated Global Job Satisfaction (GJS) instrument (score range, -36 to +36), modified to an extended version (eGJS) (score range, -87 to +87) covering additional personal and environmental factors. Independent factors were identified with multiple logistic regression analysis. Response rate was high at 59% (439/744). Median age of responders was 39 years, with 17% women. North American surgeons scored higher on the eGJS when compared with Europeans (median: 21 vs. 33, respectively, P factors of high job satisfaction included protected time for research (odds ratio [OR]: 9), good team relationship (OR: 7), female sex (OR: 5), having a partner (OR: 4), feeling enthusiastic about work (OR: 4), being pleased with life accomplishments (OR: 4), having the standard of living one deserves (OR: 3), and clinical autonomy (OR: 3). In contrast, independent predictors of poor job satisfaction were feeling frustrated by work (ie, a burnout item) (OR: 37), worrying about personal life at work (OR: 3), and having to work too many weekends (OR: 3). Satisfaction in young faculty members mostly relates to research opportunities, clinical autonomy, burnout, and lifestyle. Understanding satisfaction factors may improve productivity and competence.

  5. Increase in Utilization of Afterhours Medical Imaging: A Study of Three Canadian Academic Centers.

    Science.gov (United States)

    Chaudhry, Shivani; Dhalla, Irfan; Lebovic, Gerald; Rogalla, Patrik; Dowdell, Timothy

    2015-11-01

    The objectives of our study were to assess trends in afterhours medical imaging utilization for emergency department (ED) and inpatient (IP) patient populations from 2006-2013, including analysis by modality and specialty and with adjustment for patient volume. For this retrospective study, we reviewed the number of CT, MRI, and ultrasound studies performed for the ED and IP patients during the afterhours time period (5pm - 8am on weekdays and 24 hours on weekends and statutory holidays) from 2006-2013 at three different Canadian academic hospitals. We used the Jonckheere-Terpstra (JT) test to determine statistical significance of imaging and patient volume trends. A regression model was used to examine whether there was an increasing trend over time in the volume of imaging tests per 1000 patients. For all three sites from 2006-2013 during the afterhours time period: There was a statistically significant increasing trend in total medical imaging volume, which also held true when the volumes were assessed by modality and by specialty. There was a statistically significant increasing trend in ED and IP patient volume. When medical imaging volumes were adjusted for patient volumes, there was a statistically significant increasing trend in imaging being performed per patient. Afterhours medical imaging volumes demonstrated a statistically significant increasing trend at all three sites from 2006-2013 when assessed by total volume, modality, and specialty. During the same time period and at all three sites, the ED and IP patient volumes also demonstrated a statistically significant increasing trend with more medical imaging, however, being performed per patient. Copyright © 2015 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  6. Interdisciplinary expert consultation via a teleradiology platform. Influence on therapeutic decision-making and patient referral rates to an academic tertiary care center

    International Nuclear Information System (INIS)

    Helck, Andreas; Matzko, M.; Trumm, C.G.; Grosse, C.; Reiser, M.; Ertl-Wagner, B.; Piltz, S.

    2009-01-01

    In addition to teleradiological reporting as a nighthawking or a regular service, teleradiological communication can be used for interdisciplinary expert consultation. We intended to evaluate an interdisciplinary consultation system based on a teleradiology platform with regard to its impact on therapeutic decision-making, directed patient referrals to an academic tertiary care center and the economic benefit for the hospital providing the service. Therefore, consultations from five secondary care centers and consecutive admissions to an academic tertiary care center were prospectively evaluated over a time period of six months. A total of 69 interdisciplinary expert consultations were performed. In 54% of the cases the patients were consecutively referred to the university hospital for further treatment. In all acutely life-threatening emergencies (n=9), fast and focused treatment by referral to the academic tertiary care center was achieved (average time to treat 130 min). The admissions to the academic tertiary care center led to improved utilization of its facilities with additional revenue of more than 1 000 000 Euro p.a. An interdisciplinary expert consultation via a teleradiology platform enables fast and efficient expert care with improved and accelerated patient management and improved utilization of the service providing hospital. (orig.)

  7. The changing indications and rates of cesarean section in one academic center over a 16-year period (1997-2012).

    Science.gov (United States)

    Lurie, Samuel; Shalev, Amir; Sadan, Oscar; Golan, Abraham

    2016-08-01

    To compare trends and rates of cesarean section delivery by indication in one academic center. A retrospective analysis of the indications of all cesarean sections performed in Edith Wolfson Medical Center, Holon, Israel, a tertiary healthcare university facility, during 1997-2012 was done. Each delivery was assigned to the primary indication noted for that pregnancy, regardless of other indications reported. Whenever more than one indication was present, the principle indication chosen by the attending obstetrician was chosen for the analysis. The cesarean section rate gradually rose from 15.29% in 1997 to 21.10% in 2012, with an overall cesarean section rate of 20.66%. The cesarean section rate between 1997 and 2000 was 17.52%, between 2001 and 2004 was 18.5%, between 2005 and 2009 was 22.86%, and between 2009 and 2012 was 22.07% (p cesarean section (26.0%), non-reassuring fetal heart rate pattern (18.1%), malpresentation (16.9%), labor dystocia (8.8%), and suspected macrosomia (7.2%). Previous cesarean section persistently increased and was the leading indication throughout the years. Any attempt to reverse this trend must be based on reduction of the primary cesarean section rate. Copyright © 2016. Published by Elsevier B.V.

  8. Professional writing in nursing education: creating an academic-community writing center.

    Science.gov (United States)

    Latham, Christine L; Ahern, Nancy

    2013-11-01

    Contemporary professional nursing requires competency in both oral and written communication. Outside of writing for publication, instructional methods to teach professional writing in baccalaureate nursing programs are not well documented in the literature. The need for professional writing, coupled with the need to diversify the workforce with students from varying ethnic and educational backgrounds, creates some additional challenges to meet programmatic requirements for scholarly, evidence-based writing outcomes. As two new prelicensure programs were initiated, a comprehensive assessment was conducted that included student focus groups and writing assessment tools to assess writing quality and student support needs. As a result of these data, faculty implemented curricular and instructional revisions and created a writing center that was staffed by older adult volunteers who had careers in writing. The processes, tools, and preliminary outcomes of these faculty-initiated changes to improve student support for writing are presented. Copyright 2013, SLACK Incorporated.

  9. Harm A. Weber academic center, post-occupancy building performance and comfort perceptions

    Directory of Open Access Journals (Sweden)

    Keelan P. Kaiser

    2012-10-01

    Full Text Available The Weber Center at Judson University, a mixed mode, naturally ventilated building in a continental climate, has been in operation for just over a year, with initial occupancy in August 2007. This paper compares the design objectives and building performance expectations against the first yearof actual energy consumption in a first of a series of post-occupancy evaluations. The paper contrasts the building performance with general user satisfaction and perceptions of comfort through a post occupancy evaluation of user surveys and interviews. The innovations involved in this building, particularly mechanical strategies atypical in contemporary practice within this climate and region, have introduced some interesting problems that have been documented in the post-occupancy evaluation process, while confirming many of the original intentions of the design.

  10. Referral and final diagnoses of patients assessed in an academic vertigo center

    Directory of Open Access Journals (Sweden)

    Rebekka eGeser

    2012-11-01

    Full Text Available OBJECTIVE: To identify under-diagnosed neuro-otological disorders and to evaluate whether under-diagnosing depends on the age of the patient.MATERIAL AND METHODS: Retrospective analysis of medical charts from 951 consecutive patients (685 under and 266 above the age of 65 years who entered diagnostic procedures at the Interdisciplinary Center for Vertigo and Balance Disorders, University Hospital Zurich, Switzerland. Final diagnoses were compared to referral diagnoses.RESULTS: Relative to referral diagnoses, the proportion of patients finally diagnosed with benign paroxysmal positional vertigo (BPPV almost doubled both in younger (< 65 year from 12.7% to 25.1% and older patients (from 20.7% to 37.6%. Striking relative increases were found for the diagnoses multisensory dizziness in older patients (from 20.7% to 37.6% and vestibular migraine in younger patients (1.8% to 20.2%. In both age groups, the proportion of patients with undetermined diagnoses was reduced by about 60% (younger: 69.8% to 9.8%; older: 69.2% to 12.4% by the diagnostic procedures in the vertigo center. These changes were all significant (p < 0.05 in McNemar tests with continuity correction (2x2 tables: focused diagnosis vs. other diagnoses, referral vs. final.CONCLUSION: Significant changes of diagnoses can be expected by a specialized neuro-otological work-up. In particular, BPPV, multisensory dizziness, and vestibular migraine are under-diagnosed by referring physicians. This finding calls for better education of primary care takers in the field of neuro-otology.

  11. Referral and final diagnoses of patients assessed in an academic vertigo center.

    Science.gov (United States)

    Geser, Rebekka; Straumann, Dominik

    2012-01-01

    To identify under-diagnosed neuro-otological disorders and to evaluate whether under-diagnosing depends on the age of the patient. Retrospective analysis of medical charts from 951 consecutive patients (685 under and 266 above the age of 65 years) who entered diagnostic procedures at the Interdisciplinary Center for Vertigo and Balance Disorders, University Hospital Zurich, Switzerland. Final diagnoses were compared to referral diagnoses. Relative to referral diagnoses, the proportion of patients finally diagnosed with benign paroxysmal positional vertigo (BPPV) almost doubled both in younger (<65 year from 12.7 to 25.1%) and older patients (from 20.7 to 37.6%). Striking relative increases were found for the diagnoses multisensory dizziness in older patients (from 20.7 to 37.6%) and vestibular migraine in younger patients (1.8 to 20.2%). In both age groups, the proportion of patients with undetermined diagnoses was reduced by about 60% (younger: 69.8 to 9.8%; older: 69.2 to 12.4%) by the diagnostic procedures in the vertigo center. These changes were all significant (p < 0.05) in McNemar tests with continuity correction (2 × 2 tables: focused diagnosis vs. other diagnoses, referral vs. final). Significant changes of diagnoses can be expected by a specialized neuro-otological work-up. In particular, BPPV, multisensory dizziness, and vestibular migraine are under-diagnosed by referring physicians. This finding calls for better education of primary care takers in the field of neuro-otology.

  12. NASA as a Convener: Government, Academic and Industry Collaborations Through the NASA Human Health and Performance Center

    Science.gov (United States)

    Davis, Jeffrey R.; Richard, Elizabeth E.

    2011-01-01

    On October 18, 2010, the NASA Human Health and Performance center (NHHPC) was opened to enable collaboration among government, academic and industry members. Membership rapidly grew to 60 members (http://nhhpc.nasa.gov ) and members began identifying collaborative projects as detailed below. In addition, a first workshop in open collaboration and innovation was conducted on January 19, 2011 by the NHHPC resulting in additional challenges and projects for further development. This first workshop was a result of the SLSD successes in running open innovation challenges over the past two years. In 2008, the NASA Johnson Space Center, Space Life Sciences Directorate (SLSD) began pilot projects in open innovation (crowd sourcing) to determine if these new internet-based platforms could indeed find solutions to difficult technical problems. From 2008 to 2010, the SLSD issued 34 challenges, 14 externally and 20 internally. The 14 external challenges were conducted through three different vendors: InnoCentive, Yet2.com and TopCoder. The 20 internal challenges were conducted using the InnoCentive platform, customized to NASA use, and promoted as NASA@Work. The results from the 34 challenges involved not only technical solutions that were reported previously at the 61st IAC, but also the formation of new collaborative relationships. For example, the TopCoder pilot was expanded by the NASA Space Operations Mission Directorate to the NASA Tournament Lab in collaboration with Harvard Business School and TopCoder. Building on these initial successes, the NHHPC workshop in January of 2011, and ongoing NHHPC member discussions, several important collaborations are in development: Space Act Agreement between NASA and GE for collaborative projects, NASA and academia for a Visual Impairment / Intracranial Hypertension summit (February 2011), NASA and the DoD through the Defense Venture Catalyst Initiative (DeVenCI) for a technical needs workshop (June 2011), NASA and the San Diego Zoo

  13. Presidential Science Advising from Roosevelt to Reagan

    Science.gov (United States)

    Herken, Gregg

    2004-05-01

    The relationship between American presidents and science has always been surprisingly idiosyncratic. Chief executives from Franklin Roosevelt to Ronald Reagan have adopted very different approaches to dealing with the scientific community. The early history of presidential science advising is the story of a few energetic individuals who sought to influence government policy when there was no established method for scientists to approach the White House. President Eisenhower created such a channel in 1957 with the President's Science Advisory Committee [PSAC]. Under Ike, advising the president became for the first time a systematic and formal enterprise for scientists. But the decades after Sputnik witnesses a steady waning of the importance of the president's scientists. This decline was accelerated by the Vietnam war and controversies over anti-ballistic missile defense and the supersonic transport, culminating in the abolition of PSAC by the Nixon administration in 1973. To some observers, science advising reached its nadir a decade later, with President Reagan's announcement of the Strategic Defense Initiative (SDI). The advent of "Star Wars" demonstrated the influence of a small, select group of politically-active scientists: a consultative process reminscient of the ad hoc situation pre-PSAC.

  14. The Harvard Joint Center for Radiation Therapy, 1968-1999: a unique concept and its relationship to the prevailing times in academic medicine

    International Nuclear Information System (INIS)

    Coleman, C. Norman; Govern, Frank S.; Svensson, Goran; Mitchell, Ronald; Chaffey, John T.

    2000-01-01

    Purpose: Institutional structure, function, and philosophy reflect the organizational needs, and tend to mirror societal values of the times. For many years, the field of radiation oncology had among its major academic centers, an organization that served as a model for collaboration among health care institutions in an effort to serve the common good of its patients, hospitals, professional colleagues, and community. For over three decades, the Joint Center for Radiation Therapy (JCRT) was a leader in developing new organizational approaches for academic and clinical radiation oncology through the philosophy of collaboration in patient care, education, and research. Methods and Results: In tracing the development and changes in organizational philosophy and structure of the JCRT, one can see the impact on academic oncology and cancer care through the emergence of both radiation and medical oncology as independent subspecialties, the importance of the National Cancer Act of 1971 accompanied by the growth of the NIH research and training programs and, more recently, the effect of the changing attitudes and approaches of hospitals, academicians, practitioners, and policy makers to health care delivery, structures, and cooperation. Conclusion: Lessons learned from the 31-year history of the JCRT may help provide organizational insight useful in guiding academic oncology and academic medical centers through periods of change

  15. Evaluation of the "Angelina Jolie Effect" on Screening Mammography Utilization in an Academic Center.

    Science.gov (United States)

    Huesch, Marco D; Schetter, Susann; Segel, Joel; Chetlen, Alison

    2017-08-01

    The aim of this study was to understand the impact on screening mammography at our institution, comparing weekly utilization in the 2 years before and the 2 years after Ms Angelina Jolie disclosed in the New York Times on May 13, 2013, that she had had a prophylactic double mastectomy. All 48,110 consecutive screening mammograms conducted at our institution between May 16, 2011, and May 16, 2015, were selected from our electronic medical record system. We used interrupted time series statistical models and graphical methods on utilization data to understand utilization changes before and after Ms Jolie's news. The graphed trend of weekly screening mammogram utilization failed to show changes around the time of interest. Analytical models and statistical tests also failed to show a step change increase or acceleration of utilization around May 2013. However, graphical and time series analyses showed a flattening of utilization in the middle of 2014. In our well-powered analysis in a large regional breast imaging center, we found no support for the hypothesis that this celebrity news drove increased screening. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  16. Management of a comprehensive radiation safety program in a major American University and affiliated academic medical center

    International Nuclear Information System (INIS)

    Yoshizumi, T.T.; Reiman, R.E.; Vylet, V.; Clapp, J.R.; Thomann, W.R.; Lyles, K.W.

    2000-01-01

    Duke University, which operates under eight radiation licenses issued by the State of North Carolina, consists of a leading medical center including extensive inpatient and outpatient facilities, a medical school, biomedical research labs, and an academic campus including two major accelerator facilities. The Nuclear Medicine and Radiation Oncology departments handle over 40,000 diagnostic and therapeutic procedures annually, including approximately 160 radioiodine therapeutic cases. In biomedical research labs, about 300 professors are authorized to use radioactive materials. Over 2,000 radiation workers are identified on campus. Over the past two years, we have transformed the existing radiation safety program into a more responsive and more accountable one. Simultaneously, the institutional 'culture' changed, and the Radiation Safety Division came to be viewed as a helpful ally by investigators. The purpose of this paper is to present our experiences that have made this transformation possible. Our initiatives included; (a) defining short-term and long-term goals; (b) establishing a definitive chain of authority; (c) obtaining an external review by a consultant Health Physicist; (d) improving existing radiation safety programs; (e) reorganizing the Radiation Safety Division, with creation of multidisciplinary professional staff positions; (f) implementing campus-wide radiation safety training, (g) increasing technician positions; (h) establishing monthly medical center radiation safety executive meeting. As a result progress made at the Divisional level includes; (a) culture change by recruiting professionals with academic credentials and recent college graduates; (b) implementing weekly staff meetings and monthly quality assurance meetings; (c) achieving academic prominence by publishing and presenting papers in national meetings; (d) senior staff achieving faculty appointments with academic departments; (e) senior staff participating in graduate student

  17. The role of tourist destination in international students’ choice of academic center: the case of erasmus programme in the Canary Islands

    Directory of Open Access Journals (Sweden)

    Francisco J. García\\u2011Rodríguez

    2015-01-01

    Full Text Available The study measures the importance of the university and the tourist destination factors in the international students´ choice of placement for their studies and their further satisfaction. Using a sample from the Erasmus Exchange Programme in the Canary Islands, one of the main European tourist destinations, the results show the potential that academic tourism could have for the host destination and in particular, the importance of the attraction factors linked to the destination rather than those associated with the academic center. Hence, to take advantage of this potential, it is essential to develop collaborative strategies among the managers of the destination and those responsible for the academic center analyzed.

  18. Mentoring Faculty: A US National Survey of Its Adequacy and Linkage to Culture in Academic Health Centers.

    Science.gov (United States)

    Pololi, Linda H; Evans, Arthur T; Civian, Janet T; Vasiliou, Vasilia; Coplit, Lisa D; Gillum, Linda H; Gibbs, Brian K; Brennan, Robert T

    2015-01-01

    The aims of this study were to (1) describe the quantity and quality of mentoring faculty in US academic health centers (AHCs), (2) measure associations between mentoring and 12 dimensions that reflect the culture of AHCs, and (3) assess whether mentoring predicts seriously contemplating leaving one's institution. During 2007-2009, our National Initiative on Gender, Culture and Leadership in Medicine (C - Change) conducted a cross-sectional study of faculty from 26 representative AHCs in the United States using the 74-item C - Change Faculty Survey to assess relationships of faculty characteristics and various aspects of the institutional culture (52% response rate). Among the 2178 eligible respondents (assistant, associate, and full professors), we classified their mentoring experience as either inadequate, neutral, or positive. In this national sample, 43% of the 2178 respondents had inadequate mentoring; only 30% had a positive assessment of mentoring. There was no statistical difference by sex, minority status, or rank. Inadequate mentoring was most strongly associated with less institutional support, lower self-efficacy in career advancement, and lower scores on the trust/relationship/inclusion scale. The percent of faculty who had seriously considered leaving their institution was highest among those who had inadequate mentoring (58%), compared to those who were neutral (28%) or had positive mentoring (14%) (all paired comparisons, p mentoring was frequently inadequate and this was associated with faculty contemplating leaving their institutions. Positive mentoring, although less prevalent, was associated with many other positive dimensions of AHCs. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

  19. Dissecting Costs of CT Study: Application of TDABC (Time-driven Activity-based Costing) in a Tertiary Academic Center.

    Science.gov (United States)

    Anzai, Yoshimi; Heilbrun, Marta E; Haas, Derek; Boi, Luca; Moshre, Kirk; Minoshima, Satoshi; Kaplan, Robert; Lee, Vivian S

    2017-02-01

    The lack of understanding of the real costs (not charge) of delivering healthcare services poses tremendous challenges in the containment of healthcare costs. In this study, we applied an established cost accounting method, the time-driven activity-based costing (TDABC), to assess the costs of performing an abdomen and pelvis computed tomography (AP CT) in an academic radiology department and identified opportunities for improved efficiency in the delivery of this service. The study was exempt from an institutional review board approval. TDABC utilizes process mapping tools from industrial engineering and activity-based costing. The process map outlines every step of discrete activity and duration of use of clinical resources, personnel, and equipment. By multiplying the cost per unit of capacity by the required task time for each step, and summing each component cost, the overall costs of AP CT is determined for patients in three settings, inpatient (IP), outpatient (OP), and emergency departments (ED). The component costs to deliver an AP CT study were as follows: radiologist interpretation: 40.1%; other personnel (scheduler, technologist, nurse, pharmacist, and transporter): 39.6%; materials: 13.9%; and space and equipment: 6.4%. The cost of performing CT was 13% higher for ED patients and 31% higher for inpatients (IP), as compared to that for OP. The difference in cost was mostly due to non-radiologist personnel costs. Approximately 80% of the direct costs of AP CT to the academic medical center are related to labor. Potential opportunities to reduce the costs include increasing the efficiency of utilization of CT, substituting lower cost resources when appropriate, and streamlining the ordering system to clarify medical necessity and clinical indications. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  20. The Phenomenon of Collaboration: A Phenomenologic Study of Collaboration between Family Medicine and Obstetrics and Gynecology Departments at an Academic Medical Center

    Science.gov (United States)

    Brown, David R.; Brewster, Cheryl D.; Karides, Marina; Lukas, Lou A.

    2011-01-01

    Collaboration is essential to manage complex real world problems. We used phenomenologic methods to elaborate a description of collaboration between two departments at an academic medical center who considered their relationship to represent a model of effective collaboration. Key collaborative structures included a shared vision and commitment by…

  1. Using quality improvement methods to improve door-to-balloon time at an academic medical center.

    Science.gov (United States)

    Huang, Robert L; Donelli, Anderson; Byrd, Jeannie; Mickiewicz, Marc A; Slovis, Corey; Roumie, Christianne; Elasy, Tom A; Dittus, Robert S; Speroff, Ted; Disalvo, Tom; Zhao, David

    2008-02-01

    1) Describe a quality improvement (QI) process to decrease door-to-balloon time (D2B); 2) Explain implementation of evidence-based strategies to improve D2B. The ACC/AHA 2006 guideline target for ST-elevation myocardial infarction (STEMI) is a D2B of 90 minutes (min). QI methods can be used to identify areas for improvement, measure current processes, and provide rapid-cycle feedback about which strategies are effective. We studied all STEMI patients presenting to Vanderbilt University Medical Center from July 2005 through November 2006. A process flow chart was created and all D2B process steps were analyzed. In February 2006, evidence-based strategies were implemented to address bottlenecks and decrease D2B. Statistical process control (SPC) was used to monitor D2B time in real-time. Targeted changes led to a 44 min decrease (p < 0.001) in overall median D2B time from 108 min (interquartile range [IQR] = 94-122 min) to 64 min (IQR = 56-94 min). Subinterval time periods for emergency department (ED)-to-electrocardiogram (ECG) time decreased by 7 min (p = 0.008), ECG-to-cardiac catheterization laboratory (CCL) time decreased by 18 min (p = 0.01), and CCL-to-balloon time decreased by 4 min (p = 0.19). After implementation, SPC charts revealed a 50% decrease in the central mean line and narrower control limits indicating more reliable performance. Using QI methods of flow-charting, identifying bottlenecks, targeting strategies to bottleneck areas, and real-time monitoring with SPC and rapid-cycle feedback, D2B processes can be systematically redesigned for improvement. QI methods can be used by individual institutions to customize and implement strategies for their particular context.

  2. Trends in Otolaryngology Consultation Patterns at an Academic Quaternary Care Center.

    Science.gov (United States)

    Choi, Kevin J; Kahmke, Russel R; Crowson, Matthew G; Puscas, Liana; Scher, Richard L; Cohen, Seth M

    2017-05-01

    The consultation patterns of an otolaryngology-head and neck surgery service have not previously been reported. The time, resources, and attention required to operate such a consultation service are unknown. To assess trends in otolaryngology-head and neck surgery consultations conducted in emergency departments (EDs) and inpatient services. A retrospective analysis was conducted of the medical records of patients at a quaternary care center receiving inpatient otolaryngology consultations from January 1 to December 31, 2014. Clinical evaluation and bedside and operative procedures performed by the otolaryngology-head and neck surgery service. Demographics, reason for consultation, diagnosis, bedside procedures, operative interventions, and admission variables. A total of 1491 consultations were completed for adult (1091 [73.2%]; 854 men and 637 women; mean [SD] age 50.3 [19.3] years) and pediatric (400 [26.8%]; 232 boys and 168 girls; mean [SD] age, 4.0 [5.2] years) patients. Of the 1491 consultations, 766 (51.4%) originated from inpatient teams vs 725 (48.6%) from the ED. A total of 995 of all consultations (66.7%) resulted in a bedside procedure, and 243 (16.3%) required operative intervention. Consultations regarding airway evaluation (362 [47.3%] vs 143 [19.7%]), management of epistaxis (78 [10.2%] vs 33 [4.6%]), and rhinologic evaluation (79 [10.3%] vs 18 [2.5%]) were more frequent from inpatient teams than from the ED. Consultations regarding management of head and neck infections (162 [22.3%] vs 32 [4.2%]), facial trauma (235 [32.4%] vs 16 [2.1%]), and postoperative complications (73 [10.1%] vs 2 [0.3%]) were more frequent in the ED. Of the 725 consultations performed in the ED, 212 patients (29.2%) required hospitalization. The consultation volume of an otolaryngology-head and neck surgery service requires significant time and resources. Consultations are most often for rhinologic or laryngologic issues and are reflective of the clinical setting in which

  3. Translanguaging in Self-Access Language Advising: Informing Language Policy

    Directory of Open Access Journals (Sweden)

    Naoki Fujimoto-Adamson

    2012-03-01

    Full Text Available This study investigates language advising in a self-access center (SAC with the purpose of informing language policy. This center is located in a new Japanese university and has shifted from an initially teacher-imposed ‘English-only’ language policy into one which encourages “translanguaging” (Blackledge & Creese, 2010, p. 105 between the students’ and center advisors’ (termed as mentors in this center L1 (Japanese and their L2 (English. Data from audio-recordings of interaction with advisors and students and between students themselves, interviews with mentors, and student questionnaires all reveal how translanguaging occurs in practice and how it helps to create a learning space in which the “local, pragmatic coping tactics” (Lin, 2005, p. 46 of code-switching offer a more viable approach for learning than under its initial monolingual policy. Mentor interviews and student questionnaires indicate generally positive attitudes towards translanguaging; however, some students still favor an ‘English-only’ policy. Conclusions reveal that a looser language policy in the center is emerging in which mentors now guide students towards their own individualized language policies. It is argued in this paper that this “code choice” (Levine, 2011 in language use is therefore aligned more closely to the principles of student-direction in self-access use.

  4. Level I academic trauma center integration as a model for sustaining combat surgical skills: The right surgeon in the right place for the right time.

    Science.gov (United States)

    Hight, Rachel A; Salcedo, Edgardo S; Martin, Sean P; Cocanour, Christine S; Utter, Garth; Galante, Joseph M

    2015-06-01

    As North Atlantic Treaty Organization (NATO) countries begin troop withdrawal from Afghanistan, military medicine needs programs for combat surgeons to retain the required knowledge and surgical skills. Each military branch runs programs at various Level I academic trauma centers to deliver predeployment training and provide a robust trauma experience for deploying surgeons. Outside of these successful programs, there is no system-wide mechanism for nondeploying military surgeons to care for a high volume of critically ill trauma patients on a regular basis in an educational environment that promotes continued professional development. We hypothesize that fully integrated military-civilian relationship regional Level I trauma centers provide a surgical experience more closely mirroring that seen in a Role III hospital than local Level II and Level III trauma center or medical treatment facilities. We characterized the Level I trauma center practice using the number of trauma resuscitations, operative trauma/acute care surgery procedures, number of work shifts, operative density (defined as the ratio of operative procedures/days worked), and frequency of educational conferences. The same parameters were collected from two NATO Role III hospitals in Afghanistan during the peak of Operation Enduring Freedom. Data for two civilian Level II trauma centers, two civilian Level III trauma centers, and a Continental United States Military Treatment Facility without trauma designation were collected. The number of trauma resuscitations, number of 24-hour shifts, operative density, and educational conferences are shown in the table for the Level I trauma center compared with the different institutions. Civilian center trauma resuscitations and operative density were highest at the Level I trauma center and were only slightly lower than what was seen in Afghanistan. Level II and III trauma centers had lower numbers for both. The Level I trauma center provided the most frequent

  5. Use of a data warehouse at an academic medical center for clinical pathology quality improvement, education, and research

    Directory of Open Access Journals (Sweden)

    Matthew D Krasowski

    2015-01-01

    Full Text Available Background: Pathology data contained within the electronic health record (EHR, and laboratory information system (LIS of hospitals represents a potentially powerful resource to improve clinical care. However, existing reporting tools within commercial EHR and LIS software may not be able to efficiently and rapidly mine data for quality improvement and research applications. Materials and Methods: We present experience using a data warehouse produced collaboratively between an academic medical center and a private company. The data warehouse contains data from the EHR, LIS, admission/discharge/transfer system, and billing records and can be accessed using a self-service data access tool known as Starmaker. The Starmaker software allows users to use complex Boolean logic, include and exclude rules, unit conversion and reference scaling, and value aggregation using a straightforward visual interface. More complex queries can be achieved by users with experience with Structured Query Language. Queries can use biomedical ontologies such as Logical Observation Identifiers Names and Codes and Systematized Nomenclature of Medicine. Result: We present examples of successful searches using Starmaker, falling mostly in the realm of microbiology and clinical chemistry/toxicology. The searches were ones that were either very difficult or basically infeasible using reporting tools within the EHR and LIS used in the medical center. One of the main strengths of Starmaker searches is rapid results, with typical searches covering 5 years taking only 1-2 min. A "Run Count" feature quickly outputs the number of cases meeting criteria, allowing for refinement of searches before downloading patient-identifiable data. The Starmaker tool is available to pathology residents and fellows, with some using this tool for quality improvement and scholarly projects. Conclusion: A data warehouse has significant potential for improving utilization of clinical pathology testing

  6. Use of a data warehouse at an academic medical center for clinical pathology quality improvement, education, and research.

    Science.gov (United States)

    Krasowski, Matthew D; Schriever, Andy; Mathur, Gagan; Blau, John L; Stauffer, Stephanie L; Ford, Bradley A

    2015-01-01

    Pathology data contained within the electronic health record (EHR), and laboratory information system (LIS) of hospitals represents a potentially powerful resource to improve clinical care. However, existing reporting tools within commercial EHR and LIS software may not be able to efficiently and rapidly mine data for quality improvement and research applications. We present experience using a data warehouse produced collaboratively between an academic medical center and a private company. The data warehouse contains data from the EHR, LIS, admission/discharge/transfer system, and billing records and can be accessed using a self-service data access tool known as Starmaker. The Starmaker software allows users to use complex Boolean logic, include and exclude rules, unit conversion and reference scaling, and value aggregation using a straightforward visual interface. More complex queries can be achieved by users with experience with Structured Query Language. Queries can use biomedical ontologies such as Logical Observation Identifiers Names and Codes and Systematized Nomenclature of Medicine. We present examples of successful searches using Starmaker, falling mostly in the realm of microbiology and clinical chemistry/toxicology. The searches were ones that were either very difficult or basically infeasible using reporting tools within the EHR and LIS used in the medical center. One of the main strengths of Starmaker searches is rapid results, with typical searches covering 5 years taking only 1-2 min. A "Run Count" feature quickly outputs the number of cases meeting criteria, allowing for refinement of searches before downloading patient-identifiable data. The Starmaker tool is available to pathology residents and fellows, with some using this tool for quality improvement and scholarly projects. A data warehouse has significant potential for improving utilization of clinical pathology testing. Software that can access data warehouse using a straightforward visual

  7. Successfully accelerating translational research at an academic medical center: the University of Michigan-Coulter translational research partnership program.

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    Pienta, Kenneth J

    2010-12-01

    Translational research encompasses the effective movement of new knowledge and discoveries into new approaches for prevention, diagnosis, and treatment of disease. There are many roadblocks to successful bench to bedside research, but few have received as much recent attention as the "valley of death". The valley of death refers to the lack of funding and support for research that moves basic science discoveries into diagnostics, devices, and treatments in humans, and is ascribed to be the result of companies unwilling to fund research development that may not result in a drug or device that will be utilized in the clinic and conversely, the fact that researchers have no access to the funding needed to carry out preclinical and early clinical development to demonstrate potential efficacy in humans. The valley of death also exists because bridging the translational gap is dependent on successfully managing an additional four risks: scientific, intellectual property, market, and regulatory. The University of Michigan (UM) has partnered with the Wallace H. Coulter Foundation (CF) to create a model providing an infrastructure to overcome these risks. This model is easily adoptable to other academic medical centers (AMCs). © 2010 Wiley Periodicals, Inc.

  8. Itemized Hospital Charges for Acute Cerebral Infarction Patients Influenced by Severity in an Academic Medical Center in Korea

    Science.gov (United States)

    Yoon, Sung Sang; Chang, Hyejung

    2012-01-01

    Background and Purpose Stroke imposes a major burden on patients, their families, and the national healthcare system. The purpose of this study was to determine the itemized hospital charges in acute ischemic stroke patients according to their severity by partitioning the charges in detail and then examining whether stroke severity was a significant contributor to these charges. Methods This study analyzed data of first-time acute ischemic stroke patients who had been admitted to an academic medical center between September 2003 and April 2009. The patients' demographic and clinical characteristics were analyzed descriptively, and then eight categorized hospital charges as well as the total charge were compared among patients grouped according to stroke severity, using analysis of variance. Multiple regression analyses were conducted to test the influence of stroke severity on itemized hospital charges as well as the total charge, while controlling for other related factors. Results More-severe strokes were associated with a higher total charge. Significantly higher charges were associated with patients with more-severe strokes regarding all charged items except imaging studies. The charges for imaging studies were similar across all severities of stroke. While controlling for other factors, a significant impact of stroke severity was found in both the total hospital charge and most itemized charges. Conclusions Itemized hospital charges for inpatients with acute ischemic stroke varied according to stroke severity. Stroke severity was a significant factor influencing the itemized charges of acute hospitalization of ischemic stroke patients. PMID:22523514

  9. Perceptions of the 2011 ACGME duty hour requirements among residents in all core programs at a large academic medical center.

    Science.gov (United States)

    Sandefur, Benjamin J; Shewmaker, Diana M; Lohse, Christine M; Rose, Steven H; Colletti, James E

    2017-11-10

    The Accreditation Council for Graduate Medical Education (ACGME) implemented revisions to resident duty hour requirements (DHRs) in 2011 to improve patient safety and resident well-being. Perceptions of DHRs have been reported to vary by training stage and specialty among internal medicine and general surgery residents. The authors explored perceptions of DHRs among all residents at a large academic medical center. The authors administered an anonymous cross-sectional survey about DHRs to residents enrolled in all ACGME-accredited core residency programs at their institution. Residents were categorized as medical and pediatric, surgery, or other. In total, 736 residents representing 24 core specialty residency programs were surveyed. The authors received responses from 495 residents (67%). A majority reported satisfaction (78%) with DHRs and believed DHRs positively affect their training (73%). Residents in surgical specialties and in advanced stages of training were significantly less likely to view DHRs favorably. Most respondents believed fatigue contributes to errors (89%) and DHRs reduce both fatigue (80%) and performance of clinical duties while fatigued (74%). A minority of respondents (37%) believed that DHRs decrease medical errors. This finding may reflect beliefs that handovers contribute more to errors than fatigue (41%). Negative perceived effects included diminished patient familiarity and continuity of care (62%) and diminished clinical educational experiences for residents (41%). A majority of residents reported satisfaction with the 2011 DHRs, although satisfaction was significantly less among residents in surgical specialties and those in advanced stages of training.

  10. Clinical Profile, Predictors of Mortality, and Treatment of Patients after Myocardial Infarction, in an Academic Medical Center Hospital

    Directory of Open Access Journals (Sweden)

    Zornoff Leonardo A. M.

    2002-01-01

    Full Text Available OBJECTIVE: To evaluate clinical profiles, predictors of 30-day mortality, and the adherence to international recommendations for the treatment of myocardial infarction in an academic medical center hospital. METHODS: We retrospectively studied 172 patients with acute myocardial infarction, admitted in the intensive care unit from January 1992 to December 1997. RESULTS: Most patients were male (68%, white (97%, and over 60 years old (59%. The main risk factor for coronary atherosclerotic disease was systemic blood hypertension (63%. Among all the variables studied, reperfusion therapy, smoking, hypertension, cardiogenic shock, and age were the predictors of 30-day mortality. Most commonly used medications were: acetylsalicylic acid (71%, nitrates (61%, diuretics (51%, angiotensin-converting enzyme inhibitors (46%, thrombolytic therapy (39%, and beta-blockers (35%. CONCLUSION: The absence of reperfusion therapy, smoking status, hypertension, cardiogenic shock, and advanced age are predictors of 30-day mortality in patients with acute myocardial infarction. In addition, some medications that are undoubtedly beneficial have been under-used after acute myocardial infarction.

  11. The response of academic medical centers to the 2010 Haiti earthquake: the Mount Sinai School of Medicine experience.

    Science.gov (United States)

    Ripp, Jonathan A; Bork, Jacqueline; Koncicki, Holly; Asgary, Ramin

    2012-01-01

    On January 12, 2010, Haiti was struck by a 7.0 earthquake which left the country in a state of devastation. In the aftermath, there was an enormous relief effort in which academic medical centers (AMC) played an important role. We offer a retrospective on the AMC response through the Mount Sinai School of Medicine (MSSM) experience. Over the course of the year that followed the Earthquake, MSSM conducted five service trips in conjunction with two well-established groups which have provided service to the Haitian people for over 15 years. MSSM volunteer personnel included nurses, resident and attending physicians, and specialty fellows who provided expertise in critical care, emergency medicine, wound care, infectious diseases and chronic disease management of adults and children. Challenges faced included stressful and potentially hazardous working conditions, provision of care with limited resources and cultural and language barriers. The success of the MSSM response was due largely to the strength of its human resources and the relationship forged with effective relief organizations. These service missions fulfilled the institution's commitment to social responsibility and provided a valuable training opportunity in advocacy. For other AMCs seeking to respond in future emergencies, we suggest early identification of a partner with field experience, recruitment of administrative and faculty support across the institution, significant pre-departure orientation and utilization of volunteers to fundraise and advocate. Through this process, AMCs can play an important role in disaster response.

  12. College Student Perceptions and Ideals of Advising: An Exploratory Analysis

    Science.gov (United States)

    Christian, Tiffany Y.; Sprinkle, Julie E.

    2013-01-01

    Student advising has been a staple of the college experience for decades. However, the importance of advising differs greatly through the lens of the observer. Students may feel that advising is a "waste of time" or that they already know what they need to take to meet degree requirements. Conversely, other students may want the added…

  13. Satisfaction with Information Centers, E-Journals and Specilized Databases and their Correlation with the Age and Academic Rank of Faculty Members

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    Mojdeh Salajegheh

    2010-04-01

    Full Text Available The present study intends to study the extent of utilization of information centers and e-journals as well as satisfaction rate and to correlate these with age and academic status of faculty members at medical schools in Iranian medical universities. A questionnaire was used for data collection. 700 faculty members were selected using regular random sampling. Results indicate that faculty members use e-journals more than printed journals. Satisfaction rate with databases as well as their utilization is high. Digital libraries are used heavily for document access. A combination of digital library and print library comes second, followed by using print libraries exclusively. The study further demonstrates that there is a link between variables such as age and using e-journals, age and using information centers, age and satisfaction with specialized databases. There was no correlation between academic status and e-journal usage, academic status and satisfaction with electronic databases and academic ranking with using information centers.

  14. [Current Research Activities on Person-Centered Medicine in Academic Institutes of General Practice in Germany and Austria].

    Science.gov (United States)

    Weber, Annemarie; Schelling, Jörg; Kohls, Niko; van Dyck, Marcus; Poggenburg, Stephanie; Vajda, Christian; Hirsch, Jameson; Sirois, Fuschia; Toussaint, Loren; Offenbächer, Martin

    2017-10-11

    Aim of study Person-centered medicine (PCM) with its focus on humanistic-biographical-oriented medicine and integrated, positive-salutogenic health is a central aspect in the patient-physician relationship in general practice. The objective of this analysis is to assess the prevalence and type of research project in academic institutions of general practice in Germany (Ger) and Austria (At) and the thematic priorities of the projects in the areas PCM, health promotion (HP), prevention (PRE) and conventional medicine (CM). Methods A search was conducted (September-December 2015) on the websites of 30 institutes and divisions of general medicine for their current research projects. The retrieved projects were assigned to five categories: PCM, HP, PRE, CM and others. Subsequently, we identified the targeted patient groups of the projects as well as the thematic focus in the categories PCM, HP, PRE and CM with focus on PCM and HP. Results 541 research projects were identified, 452 in Germany and 89 in Austria. Research projects were only included if they were explicitly indicated as research-oriented. Seventy projects addressed PCM aspects, 15 projects HP aspects, 32 projects PRE aspects and 396 projects CM aspects. The most frequently target groups in the categories PCM (24 of 70) and HP (7 of 15) were chronically ill patients. The most common thematic focus in PCM was communication (13 of 70) and in HP, physical activity (6 of 15). Conclusion The vast majority of research projects investigated conventional medical topics. The percentage of research activities in the field of PCM (13%) or PCM including HP (16%) in Ger and At is below the European average of 20%. From our point of view, PCM and HP need to be implemented to a greater extent in general practice. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Multidisciplinary Prerounding Meeting as a Continuous Quality Improvement Tool: Leveraging to Reduce Continuous Benzodiazepine Use at an Academic Medical Center.

    Science.gov (United States)

    Flannery, Alexander H; Thompson Bastin, Melissa L; Montgomery-Yates, Ashley; Hook, Corrine; Cassity, Evan; Eaton, Phillip M; Morris, Peter E

    2018-01-01

    Evidence-based medicine often has many barriers to overcome prior to implementation in practice, hence the importance of continuous quality improvement. We report on a brief (≤10 minutes) multidisciplinary meeting prior to rounds to establish a dashboard for continuous quality improvement and studied the success of this meeting on a particular area of focus: continuous infusion benzodiazepine minimization. This was a prospective observational study of patients admitted to the medical intensive care unit (MICU) of a large academic medical center over a 4-month period. A morning multidisciplinary prerounding meeting was implemented to report on metrics required to establish a dashboard for MICU care for the previous 24 hours. Fellows and nurse practitioners on respective teams reported on key quality metrics and other important data related to patient census. Continuous benzodiazepines were tracked daily as the number of patients per team who had orders for a continuous benzodiazepine infusion. The aim of this report is to describe the development of the morning multidisciplinary prerounding meeting and its impact on continuous benzodiazepine use, along with associated clinical outcomes. The median number of patients prescribed a continuous benzodiazepine daily decreased over this time period and demonstrated a sustained reduction at 1 year. Furthermore, sedation scores improved, corresponding to a reduction in median duration of mechanical ventilation. The effectiveness of this intervention was mapped post hoc to conceptual models used in implementation science. A brief multidisciplinary meeting to review select data points prior to morning rounds establishes mechanisms for continuous quality improvement and may serve as a mediating factor for successful implementation when initiating and monitoring practice change in the ICU.

  16. Impact of physician assistants on the outcomes of patients with acute myelogenous leukemia receiving chemotherapy in an academic medical center.

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    Glotzbecker, Brett E; Yolin-Raley, Deborah S; DeAngelo, Daniel J; Stone, Richard M; Soiffer, Robert J; Alyea, Edwin P

    2013-09-01

    Inpatient academic medical center care historically has been delivered by faculty physicians in conjunction with physicians in training (house officers [HOs]). Alternative staffing models have emerged secondary to American Counsel for Graduate Medical Education work-hour restrictions. The purpose of this study was to assess the quality of acute myelogenous leukemia (AML) care provided by a physician assistant (PA) service compared with a traditional model. Data were retrospectively collected on patients admitted with AML for reinduction chemotherapy from 2008 to 2012. Primary outcome measures were inpatient mortality and length of stay (LOS). Secondary measures included readmissions, intensive care unit (ICU) transfers, consults requested, and radiologic studies ordered. Ninety-five patients with AML were reviewed. Forty-seven patients (49.5%) were admitted to the HO service, and 48 patients (50.5%) were admitted to the PA service. Demographic data were similar between services. LOS was significantly different between the services, with a mean of 36.8 days with the HO model compared with 30.9 days with the PA service (P=.03). The 14-day readmission rate also differed significantly; it was 10.6% (five of 47 patients) and zero for the HO and PA models, respectively (P=.03). The mean number of consults with the HO model was 2.11 (range, zero to five) versus 1.47 (range, zero to four) with the PA service (P=.03). Mortality and ICU transfers were not significantly different. The data demonstrate equivalent mortality and ICU transfers, with a decrease in LOS, readmission rates, and consults for patients cared for in the PA service. This suggests that the PA service is associated with increased operational efficiency and decreased health service use without compromising health care outcomes.

  17. Knowledge of the Costs of Diagnostic Imaging: A Survey of Physician Trainees at a Large Academic Medical Center.

    Science.gov (United States)

    Vijayasarathi, Arvind; Duszak, Richard; Gelbard, Rondi B; Mullins, Mark E

    2016-11-01

    To study the awareness of postgraduate physician trainees across a variety of specialties regarding the costs of common imaging examinations. During early 2016, we conducted an online survey of all 1,238 physicians enrolled in internships, residencies, and fellowships at a large academic medical center. Respondents were asked to estimate Medicare national average total allowable fees for five commonly performed examinations: two-view chest radiograph, contrast-enhanced CT abdomen and pelvis, unenhanced MRI lumbar spine, complete abdominal ultrasound, and unenhanced CT brain. Responses within ±25% of published amounts were deemed correct. Respondents were also asked about specialty, postgraduate year of training, previous radiology education, and estimated number of imaging examinations ordered per week. A total of 381 of 1,238 trainees returned complete surveys (30.8%). Across all five examinations, only 5.7% (109/1,905) of responses were within the correct ±25% range. A total of 76.4% (291/381) of all respondents incorrectly estimated every examination's cost. Estimation accuracy was not associated with number of imaging examinations ordered per week or year of training. There was no significant difference in cost estimation accuracy between those who participated in medical school radiology electives and those who did not (P = .14). Only 17.5% of trainees considered their imaging cost knowledge adequate. Overall, 75.3% desire integration of cost data into clinical decision support and/or computerized physician order entry systems. Postgraduate physician trainees across all disciplines demonstrate limited awareness of the costs of commonly ordered imaging examinations. Targeted medical school education and integration of imaging cost information into clinical decision support / computerized physician order entry systems seems indicated. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  18. Advising patients on nutrition and healthy eating.

    Science.gov (United States)

    Patience, Sara

    2016-11-24

    This article looks at the current UK guidelines for a healthy diet for the general population and considers the current debates and changes within that advice and how they may affect health outcomes. It is impossible to read a newspaper, magazine or social media article without being exposed to dietary advice, nutritional research or the latest diet craze. It is essential that nurses are able to advise their patients on research-based UK guidelines for a healthy diet, and be able to respond to patient questions on diet-related matters, ensuring the information they give is not based on current media opinion or celebrity views. This paper summarises the evidence found within current guidelines to help nurses ensure their practice is evidence based. This will help meet the requirements of the Nursing and Midwofery Council's (2015) Code, including delivering fundamentals of care and being able to practise in line with best available evidence.

  19. Total sleep time obtained from actigraphy versus sleep logs in an academic sleep center and impact on further sleep testing

    Directory of Open Access Journals (Sweden)

    Auger RR

    2013-10-01

    Full Text Available R Robert Auger,1,2 Ranji Varghese,1 Michael H Silber,1,3 Nancy L Slocumb1 1Center for Sleep Medicine, 2Department of Psychiatry and Psychology, 3Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN, USA Background: While actigraphy has been deemed ideal for the longitudinal assessment of total sleep time (TST by select groups, endorsement has not been universal and reimbursement is lacking, preventing its widespread use in clinical practice. This study compares longitudinal TST data obtained by actigraphy and logs preceding a clinical evaluation, and secondarily ascertains whether longitudinal TST impacts clinicians' decisions to proceed with further sleep testing. Methods: This was a retrospective, consecutive chart review spanning about 4 months in an academic sleep center. Eighty-four patients wore actigraphs in anticipation of clinical evaluations. Concomitant completion of sleep logs is routinely requested in this setting. Longitudinal TST data available in complete form was reviewed in a blinded fashion among a subset of these patients. A review of text from clinical notes of an expanded cohort with complete actigraphy data (regardless of the degree of completion of logs enabled determination of the frequency and rationale for cancellation of prescheduled sleep testing. Results: Of 84 actigraphy recordings, 90% produced complete data, and 30% produced fully completed logs. Among the subset with both available in complete form, significant mean TST differences were observed on weekends (7.06 ± 2.18 hours versus 8.30 ± 1.93 hours, P = 0.009, but not on weekdays (7.38 ± 1.97 hours versus 7.72 ± 1.62 hours, P = 0.450 for actigraphy and logs, respectively. Further analyses revealed poor agreement between the two measures, with predominantly increased TST estimation with logs. Among those with complete actigraphy data (±logs, testing was cancelled in 11 (15%, eight of whom (73% presented with hypersomnia and three of whom

  20. Adventures in Advising: Strategies, Solutions, and Situations to Student Problems in the Criminology and Criminal Justice Field

    Science.gov (United States)

    Mier, Carrie

    2018-01-01

    Teaching and research are often the most focused upon aspects of working within academia in criminology and criminal justice (Sitren & Applegate, 2012; Jonson & Moon, 2014; Pratt, 2014), but an overlooked and underappreciated part of an undergraduate's overall higher education success is academic advising (Light, 2001). There has been…

  1. AAAC&U's Integrative Liberal Learning and the CAS Standards: Advising for a 21st Century Liberal Education

    Science.gov (United States)

    Robbins, Rich

    2014-01-01

    The Association of American Colleges and Universities presented and promoted integrative liberal learning as a collaborative goal that all institutions of higher education must strive to achieve. The similarities between the goals of integrative liberal learning and the Standards for Academic Advising by the Council for the Advancement of…

  2. Adherence of Academic Radiologists in a Non-English Speaking Imaging Center to the BI-RADS Standards of Reporting Breast MRI

    Directory of Open Access Journals (Sweden)

    Sepideh Sefidbakht

    2015-01-01

    Full Text Available Objectives: To assess the adherence of academic radiologists in a university center to BI-RADS lexicon (BLA and to evaluate the structural completeness of breast MRI reports. Materials and Methods: Breast MRI reports made during 2012 in a single academic center by six readers were scored for formal completeness (FS including recording the MRI protocol, making relevant clinical correlation, and describing background enhancement; BLA including mass rather than lesion, describing lesion outline, enhancement characteristics, and dynamic curve; and also expressing the final conclusion using BLA, resulting in a maximal total score of 8. FS and BLA were correlated with reader characteristics including breast imaging background, years of academic experience, and number of breast MRIs reported yearly. Tests used for statistical analysis were the Mann-Whitney U test and analysis of variance (ANOVA. Results: Overall BLA was 38.9%. This percentage was 60.1% and 3.7% in radiologists with and without breast imaging background, respectively (P = 0.000. Mean FS among all readers was 3.81 ± 1.75. This score was 2.54 ± 1.1 for readers without breast imaging background and 4.6 ± 1.6 for the readers regularly involved in breast imaging (P = 0.000. Conclusions: Higher degree of BLA and higher mean FS were associated with radiologists regularly involved in breast imaging. No association was found with years of academic experience or number of breast MRIs interpreted yearly.

  3. Treatment at high-volume facilities and academic centers is independently associated with improved survival in patients with locally advanced head and neck cancer.

    Science.gov (United States)

    David, John M; Ho, Allen S; Luu, Michael; Yoshida, Emi J; Kim, Sungjin; Mita, Alain C; Scher, Kevin S; Shiao, Stephen L; Tighiouart, Mourad; Zumsteg, Zachary S

    2017-10-15

    The treatment of head and neck cancers is complex and associated with significant morbidity, requiring multidisciplinary care and physician expertise. Thus, facility characteristics, such as clinical volume and academic status, may influence outcomes. The current study included 46,567 patients taken from the National Cancer Data Base who were diagnosed with locally advanced invasive squamous cell carcinomas of the oropharynx, larynx, and hypopharynx and were undergoing definitive radiotherapy. High-volume facilities (HVFs) were defined as the top 1% of centers by the number of patients treated from 2004 through 2012. Multivariable Cox regression and propensity score matching were performed to account for imbalances in covariates. The median follow-up was 55.1 months. Treatment at a HVF (hazard ratio, 0.798; 95% confidence interval, 0.753-0.845 [Ppatients treated at an HVF versus lower-volume facilities, respectively (Ppatients treated at academic versus nonacademic facilities (Pnumber of patients treated. The impact of facility volume and academic designation on survival was observed when using a variety of thresholds to define HVF, and across the vast majority of subgroups, including both oropharyngeal and nonoropharyngeal subsites. Patients with locally advanced head and neck squamous cell carcinoma who are undergoing curative radiotherapy at HVFs and academic centers appear to have improved survival. Cancer 2017;123:3933-42. © 2017 American Cancer Society. © 2017 American Cancer Society.

  4. Adherence of Academic Radiologists in a Non-English Speaking Imaging Center to the BI-RADS Standards of Reporting Breast MRI.

    Science.gov (United States)

    Sefidbakht, Sepideh; Jalli, Reza; Izadpanah, Ensieh

    2015-01-01

    To assess the adherence of academic radiologists in a university center to BI-RADS lexicon (BLA) and to evaluate the structural completeness of breast MRI reports. Breast MRI reports made during 2012 in a single academic center by six readers were scored for formal completeness (FS) including recording the MRI protocol, making relevant clinical correlation, and describing background enhancement; BLA including mass rather than lesion, describing lesion outline, enhancement characteristics, and dynamic curve; and also expressing the final conclusion using BLA, resulting in a maximal total score of 8. FS and BLA were correlated with reader characteristics including breast imaging background, years of academic experience, and number of breast MRIs reported yearly. Tests used for statistical analysis were the Mann-Whitney U test and analysis of variance (ANOVA). Overall BLA was 38.9%. This percentage was 60.1% and 3.7% in radiologists with and without breast imaging background, respectively (P = 0.000). Mean FS among all readers was 3.81 ± 1.75. This score was 2.54 ± 1.1 for readers without breast imaging background and 4.6 ± 1.6 for the readers regularly involved in breast imaging (P = 0.000). Higher degree of BLA and higher mean FS were associated with radiologists regularly involved in breast imaging. No association was found with years of academic experience or number of breast MRIs interpreted yearly.

  5. Cooperating to learn teaching to cooperate: adviser processes for program implement CA/AC

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    José Ramón LAGO

    2011-11-01

    Full Text Available The aim of this paper is present some results of advise strategy to introduce cooperative learning from the «Cooperating to Learn/ Learning to Cooperate» CL/LC Programme. The first part situates the research project and the research objective focused on how introduction of CL/LC program through a process of advice facilitates permanent improvements to the inclusion of students. In the second we analyzed the phases and tasks of an adviser process for the introduction of cooperative learning and three stages to build on cooperative learning in school: the introduction, generalization and consolidation. The third part is the central part. We describe five process of adviser to implement cooperative learning which we can observe different degrees and modalities of collaboration between teachers and counselors and between teachers. Is possible the first step of a network centers to work cooperatively.

  6. A regional assessment of medicaid access to outpatient orthopaedic care: the influence of population density and proximity to academic medical centers on patient access.

    Science.gov (United States)

    Patterson, Brendan M; Draeger, Reid W; Olsson, Erik C; Spang, Jeffrey T; Lin, Feng-Chang; Kamath, Ganesh V

    2014-09-17

    Access to care is limited for patients with Medicaid with many conditions, but data investigating this relationship in the orthopaedic literature are limited. The purpose of this study was to investigate the relationship between health insurance status and access to care for a diverse group of adult orthopaedic patients, specifically if access to orthopaedic care is influenced by population density or distance from academic teaching hospitals. Two hundred and three orthopaedic practices within the state of North Carolina were randomly selected and were contacted on two different occasions separated by three weeks. An appointment was requested for a fictitious adult orthopaedic patient with a potential surgical problem. Injury scenarios included patients with acute rotator cuff tears, zone-II flexor tendon lacerations, and acute lumbar disc herniations. Insurance status was reported as Medicaid at the time of the first request and private insurance at the time of the second request. County population density and the distance from each practice to the nearest academic hospital were recorded. Of the 203 practices, 119 (59%) offered the patient with Medicaid an appointment within two weeks, and 160 (79%) offered the patient with private insurance an appointment within this time period (p populous areas were more likely to offer an appointment to patients with Medicaid than practices in more populous areas. Practices that were farther from academic hospitals were more likely to offer an appointment to patients with Medicaid than practices closer to academic hospitals. This study illustrates the barriers to timely outpatient orthopaedic care that patients with Medicaid face. The findings from our study imply that patients with Medicaid in more populous areas and in areas closer to academic medical centers are less likely to obtain an outpatient orthopaedic appointment than patients with Medicaid in less populous areas and in areas more distant from academic medical

  7. Recruiting and Advising Challenges in Actuarial Science

    Science.gov (United States)

    Case, Bettye Anne; Guan, Yuanying Michelle; Paris, Stephen

    2014-01-01

    Some challenges to increasing actuarial science program size through recruiting broadly among potential students are identified. Possible solutions depend on the structures and culture of the school. Up to three student cohorts may result from partition of potential students by the levels of academic progress before program entry: students…

  8. Research Plan of the Operations Research Center and Department of Systems Engineering for the Academic Year 2005

    National Research Council Canada - National Science Library

    Kwinn, Michael

    2004-01-01

    ...) for the Academic Year 04-05. The research plan includes a statement of purpose for research which supports DSE and the ORCEN, a description of the two organizations, a list of the key personnel responsible for executing the plan...

  9. Annual Report of the Department of Systems Engineering and the Operations Research Center for the Academic Year 2005

    National Research Council Canada - National Science Library

    Kwinn, Michael J., Jr; McGinnis, Michael L

    2005-01-01

    ...) for the Academic Year 04-05. The annual research report includes a statement of purpose for research which supports DSE and the ORCEN, a description of the two organizations, a list of the key personnel responsible for executing...

  10. Annual Faculty Research Report of the Department of Systems Engineering and the Operations Research Center for the Academic Year 2007

    National Research Council Canada - National Science Library

    Goerger, Simon R; Trainor, Timothy E; Finnegan, Patrick

    2008-01-01

    ...) for the Academic Year 2007. The annual research report includes a statement of purpose for research which supports DSE and the ORCEN, a description of the two organizations, a list of the key personnel responsible for executing...

  11. Annual Faculty Research Report of the Department of Systems Engineering and the Operations Research Center for the Academic Year 2006

    National Research Council Canada - National Science Library

    Goerger, Simon R; Trainor, Timothy E; Finnegan, Patrick

    2006-01-01

    ...) for the Academic Year 2006. The annual research report includes a statement of purpose for research which supports DSE and the ORCEN, a description of the two organizations, a list of the key personnel responsible for executing...

  12. Predictors of Academic Performance and School Engagement--Integrating Persistence, Motivation and Study Skills Perspectives Using Person-Centered and Variable-Centered Approaches

    Science.gov (United States)

    Moreira, Paulo A. S.; Dias, Paulo; Vaz, Filipa Machado; Vaz, Joao Machado

    2013-01-01

    There is a growing need for the integration of various theoretical perspectives on academic performance, especially the theories on educational persistence, and motivational theories. Recent models of students' engagement with school incorporate different dimensions of students, family and school. However, some authors are arguing that academic…

  13. Prevalence of Elevated Serum Creatinine Concentration in Dogs Presenting to a Veterinary Academic Medical Center (2010-2014).

    Science.gov (United States)

    Babyak, J M; Weiner, D E; Noubary, F; Sharp, C R

    2017-11-01

    The epidemiology of kidney disease is not extensively described in dogs. To better understand the prevalence of elevated serum creatinine concentration in dogs. Client-owned dogs. A retrospective, observational cross-sectional study design was used. We made a dataset of 115,631 hospital visits of all dogs presenting from October 2010 to October 2014. We estimated the prevalence and risk of elevated serum creatinine, defined as >1.6 mg/dL, in evaluated dogs. Of 115,631 visits, 98,693 were outpatient visits and 16,938 were hospital admissions. Among outpatient visits, 9,983 (10.1%) had serum creatinine assessment (4,423 [44.3%] visits were first visits), whereas, among hospital admissions, 12,228 (60.0%) had at least 1 serum creatinine (7,731 [75.6%] admissions were first admissions). The prevalence of elevated serum creatinine concentration in all evaluated dogs was 11.5% (95% CI: 11.0%, 11.9%); 10.2% (95% CI: 9.6%, 10.8%) of inpatients and 12.9% (95% CI: 12.1%, 13.8%) of outpatients had elevated serum creatinine concentration. The relative risk (RR) of elevated serum creatinine concentration was significantly higher in geriatric dogs (outpatient RR 1.45 [95% CI: 1.23, 1.70], inpatient RR 1.43 [95% CI: 1.16, 1.76]) and lower in young dogs (outpatient RR 0.39 [95% CI: 0.26, 0.59], inpatient RR 0.44 [95% CI: 0.32, 0.62]) when compared to the measured population risk. When selected for laboratory evaluation, the proportion of dogs presenting to an academic medical center with evidence of kidney injury is high compared to previous reports and might reflect a population of sicker dogs. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  14. Graduate Students’ Satisfaction on the Thesis Advising Practices

    Directory of Open Access Journals (Sweden)

    Susan S. Janer

    2017-02-01

    Full Text Available This descriptive action research focused on the satisfaction of the students on the advising practices of their thesis advisers. The 28 respondents of the study were purposively and incidentally chosen. The findings, derived from the use of unstructured interview and survey questionnaire, revealed that most of the students are satisfied with their thesis advisers in terms of their knowledge of student’s research, professional characteristics and qualities, and personality factors as revealed by the overall weighted mean values of 2.68, 2.72, and 2.72 respectively. The students along thesis advising observed various practices of the faculty members. Students chose their advisers based on their availability, field of specialization, and coaching and mentoring abilities. Based on the findings, this study recommends that the faculty members be given more training to further enhance their abilities in thesis advising. The college may also tap other research-reputable faculty members to become research advisers. An orientation activity among the students may also be conducted to assist them in choosing the faculty member with an appropriate research reputation and also to brief them on the roles they will play as thesis advisers. The need to revisit the policies of the School of Graduate Studies (SGS is also highly recommended. Hence, this study proposes some amendments on the existing guidelines of the department along thesis advising.

  15. Improved Outcomes Following Hepatocellular Carcinoma (HCC) Diagnosis in Patients Screened for HCC in a Large Academic Liver Center versus Patients Identified in the Community.

    Science.gov (United States)

    Okoronkwo, Nneoma; Wang, Yucai; Pitchumoni, Capecomorin; Koneru, Baburao; Pyrsopoulos, Nikolaos

    2017-03-28

    Background and Aims: Hepatocellular carcinoma (HCC) is the sixth most commonly occurring cancer worldwide. Knowledge and adherence to HCC surveillance guidelines has been associated with earlier detection. We sought to evaluate characteristics and outcomes following HCC diagnosis in patients screened for HCC in a large academic liver center versus patients diagnosed and referred from the community. Methods : We reviewed the records of patients diagnosed with HCC in the liver center of an academic institution from January 1999 till December 2013. Patients were classified into two groups: patients followed in our hepatology clinic and patients with HCC recently referred to our center. Univariate analysis was performed using chi-squared test and multivariate analysis was performed using SPSS 22.0. Results: The records of 410 patients were reviewed, and included 77.3% of patients referred from the community and 22.7% of patients followed in our clinic. In the clinic group, 75.6% were identified with one nodule at initial diagnosis, compared to 65.6% in the referral group. Patients in the referral group were more likely to present with tumors ≥5 cm at diagnosis, with 28.7% compared to 5.4% in the clinic group ( p HCC diagnosis and are more likely to meet the Milan criteria and undergo transplant. Early referral to a specialized transplant center, if feasible, where a multidisciplinary approach is utilized might be essential in the management of chronic liver disease.

  16. Establishing a regional network of academic centers to support decision making for new vaccine introduction in Latin America and the Caribbean: the ProVac experience.

    Science.gov (United States)

    Toscano, C M; Jauregui, B; Janusz, C B; Sinha, A; Clark, A D; Sanderson, C; Resch, S; Ruiz Matus, C; Andrus, J K

    2013-07-02

    The Pan American Health Organization's ProVac Initiative, designed to strengthen national decision making regarding the introduction of new vaccines, was initiated in 2004. Central to realizing ProVac's vision of regional capacity building, the ProVac Network of Centers of Excellence (CoEs) was established in 2010 to provide research support to the ProVac Initiative, leveraging existing capacity at Latin American and Caribbean (LAC) universities. We describe the process of establishing the ProVac Network of CoEs and its initial outcomes and challenges. A survey was sent to academic, not-for-profit institutions in LAC that had recently published work in the areas of clinical decision sciences and health economic analysis. Centers invited to join the Network were selected by an international committee on the basis of the survey results. Selection criteria included academic productivity in immunization-related work, team size and expertise, successful collaboration with governmental agencies and international organizations, and experience in training and education. The Network currently includes five academic institutions across LAC. Through open dialog and negotiation, specific projects were assigned to centers according to their areas of expertise. Collaboration among centers was highly encouraged. Faculty from ProVac's technical partners were assigned as focal points for each project. The resulting work led to the development and piloting of tools, methodological guides, and training materials that support countries in assessing existing evidence and generating new evidence on vaccine introduction. The evidence generated is shared with country-level decision makers and the scientific community. As the ProVac Initiative expands to other regions of the world with support from immunization and public health partners, the establishment of other regional and global networks of CoEs will be critical. The experience of LAC in creating the current network could benefit the

  17. 21st century community learning centers--improving the academic performance of at-risk students: a Bronx tale.

    Science.gov (United States)

    Dodd, Arleen T; Bowen, Lizette M

    2011-01-01

    The authors of this article report on an intervention designed to improve the academic component of an extended after-school program. The agency involved in this intervention was a non-profit community action group (CAG) agency whose mission is to improve the socio-economic well-being of the residents of Upper Manhattan, the Bronx, and New York City. The agency has a staff of 200 that serve high school students. The intervention program was designed to (1) improve the working relationship between teachers, families, and students in the after-school program, (2) develop new and innovative ways to improve the academic curricula of the after-school program, and (3) provide continuous education to stakeholders to the after-school program. Improvements in student performance relating to attendance, academic work, discipline and social behaviors were reported. The intervention reported in this article has the potential of supporting learning and developmental outcomes over time.

  18. Assessing the Impact of School-Based Health Centers on Academic Achievement and College Preparation Efforts: Using Propensity Score Matching to Assess School-Level Data in California.

    Science.gov (United States)

    Bersamin, Melina; Garbers, Samantha; Gaarde, Jenna; Santelli, John

    2016-08-01

    This study examines the association between school-based health center (SBHC) presence and school-wide measures of academic achievement and college preparation efforts. Publicly available educational and demographic data from 810 California public high schools were linked to a list of schools with an SBHC. Propensity score matching, a method to reduce bias inherent in nonrandomized control studies, was used to select comparison schools. Regression analyses, controlling for proportion of English-language learners, were conducted for each outcome including proportion of students participating in three College Board exams, graduation rates, and meeting university graduation requirements. Findings suggest that SBHC presence is positively associated with college preparation outcomes but not with academic achievement outcomes (graduation rates or meeting state graduation requirements). Future research must examine underlying mechanisms supporting this association, such as school connectedness. Additional research should explore the role that SBHC staff could have in supporting college preparation efforts. © The Author(s) 2016.

  19. Understanding the Advising Learning Process Using Learning Taxonomies

    Science.gov (United States)

    Muehleck, Jeanette K.; Smith, Cathleen L.; Allen, Janine M.

    2014-01-01

    To better understand the learning that transpires in advising, we used Anderson et al.'s (2001) revision of Bloom's (1956) taxonomy and Krathwohl, Bloom, and Masia's (1964) affective taxonomy to analyze eight student-reported advising outcomes from Smith and Allen (2014). Using the cognitive processes and knowledge domains of Anderson et al.'s…

  20. Air Advising: A Critical Component of Joint Engagement

    Science.gov (United States)

    2013-01-01

    to air advising. It is important for surface components to artic - ulate their air advising requirements through their geographic combatant commands...improve their political , military, and economic stability and security. However, the Air Force can deliver even more positive foreign policy

  1. Distinguishing Mentoring, Coaching, and Advising for Leadership Development.

    Science.gov (United States)

    Hastings, Lindsay J; Kane, Cindy

    2018-06-01

    Mentoring, coaching, and advising are often confused as similar interactions with developmental intent, yet their scope, purpose, and utility in leadership development are distinct. The purpose of this chapter is to provide clarity as to what constitutes mentoring, coaching, and advising for leadership development and to compare and contrast each relationship type. © 2018 Wiley Periodicals, Inc.

  2. Editorial - Special issue on advising for language learner autonomy

    Directory of Open Access Journals (Sweden)

    Katherine Thornton

    2012-03-01

    Full Text Available A very warm welcome to the first issue of SiSAL journal of 2012, a special issue associated with the recent IATEFL Learner Autonomy SIG-sponsored conference, Advising for Language Learner Autonomy, held on November 12, 2011, at Kanda University of International Studies. This issue features papers from presenters at the conference who are all involved in advising for language learning (ALL. This conference was the first to be entirely dedicated to the field of language advising, and as such marks another significant landmark in the journey of ALL towards being fully recognized as a professional field in its own right (previous landmarks being the publication of the first book on advising in 2001 by Mozzon-McPherson and Vismans, a special issue of System in 2007, and the introduction of a professional qualification in learning advising at the University of Hull.

  3. Academic and non-academic career options for marine scientists. - Support measures for early career scientists offered at MARUM - Center for Marine Environmental Sciences, University of Bremen, Germany

    Science.gov (United States)

    Hebbeln, Dierk; Klose, Christina

    2015-04-01

    Early career scientists at MARUM cover a wide range of research topics and disciplines including geosciences, biology, chemistry, social sciences and law. Just as colourful as the disciplinary background of the people, are their ideas for their personal careers. With our services and programmes, we aim to address some important career planning needs of PhD students and early career Postdocs, both, for careers in science and for careers outside academia. For PhD students aiming to stay in science, MARUM provides funding opportunities for a research stay abroad for a duration of up to 6 months. A range of courses is offered to prepare for the first Postdoc position. These include trainings in applying for research funding, proposal writing and interview skills. Following MARUM lectures which are held once a month, early career scientists are offered the opportunity to talk to senior scientists from all over the world in an informal Meet&Greet. Mentoring and coaching programmes for women in science are offered in cooperation with the office for equal opportunities at the University of Bremen. These programmes offer an additional opportunity to train interpersonal skills and to develop personal career strategies including a focus on special challenges that especially women might (have to) face in the scientific community. Early career scientists aiming for a non-academic career find support on different levels. MARUM provides funding opportunities for placements in industry, administration, consulting or similar. We offer trainings in e.g. job hunting strategies or interview skills. For a deeper insight into jobs outside the academic world, we regularly invite professionals for informal fireside chats and career days. These events are organised in cooperation with other graduate programmes in the region to broaden the focus of both, the lecturers and the participants. A fundamental component of our career programmes is the active involvement of alumni of MARUM and our

  4. Building and evaluating an informatics tool to facilitate analysis of a biomedical literature search service in an academic medical center library.

    Science.gov (United States)

    Hinton, Elizabeth G; Oelschlegel, Sandra; Vaughn, Cynthia J; Lindsay, J Michael; Hurst, Sachiko M; Earl, Martha

    2013-01-01

    This study utilizes an informatics tool to analyze a robust literature search service in an academic medical center library. Structured interviews with librarians were conducted focusing on the benefits of such a tool, expectations for performance, and visual layout preferences. The resulting application utilizes Microsoft SQL Server and .Net Framework 3.5 technologies, allowing for the use of a web interface. Customer tables and MeSH terms are included. The National Library of Medicine MeSH database and entry terms for each heading are incorporated, resulting in functionality similar to searching the MeSH database through PubMed. Data reports will facilitate analysis of the search service.

  5. Improving the quality of health services organization structure by reengineering: circular design and clinical case impact in an academic medical center.

    Science.gov (United States)

    Lartin-Drake, J M; Curran, C; Gillis-Donovan, J; Kruger, N R; Ziegenfuss, J T; Ostrem, J; Zanotti, M

    1996-01-01

    Innovation to improve the quality of structure and process in health care organization is reported in this case example of change in an academic medical center. Interactive planning and the circular organization design concept were the driving principles and methods. This report presents the needs for and initial obstructions to change, planning and project design work, a description of the change process, and illustrative accomplishments to date--two cases, one of conscious sedation policy and one of nuisance pages. Evaluative criteria for judging the progress and lessons of the project regarding key design characteristics also are included.

  6. Effects of a Centered Virtual Teaching Environment on Learning Styles in the Academic Performance of College Students

    Directory of Open Access Journals (Sweden)

    H. Fontalvo

    2009-03-01

    Full Text Available Based on the concept of adaptive hypermedia, the webCT platform was used to design a learning virtual environment that would allow students’ interaction of different support materials with their usual styles of learning. GA Latin Square design was used to determine the role that environment and learning styles, along with intrinsic motivation, played on academic performance, navigation patterns, and number of visits to the support materials. The study showed an important difference in academic performance in favor of the Balanced group. Intrinsic motivation was the main explicative factor for the differences found beyond learning styles. The conclusion was that there are differences in the way of using the objects of learning, and that there are differentiated patterns to access the support material, depending on the students’ learning styles.

  7. Aligning Work Processes and the Adviser Portal Bank System

    DEFF Research Database (Denmark)

    Jørgensen, Jens Bæk; Lassen, Kristian Bisgaard

    2006-01-01

    The Adviser Portal (AP) is a new IT system for 15 Danish banks. The main goal of AP is to increase the efficiency and quality of bank advisers’ work. Re- quirements engineering for AP includes describing new work processes that must be supported by AP using a combination of: (1) prose and informal...... drawings; (2) The Adviser Portal (AP) is a new IT system for 15 Danish banks. The main goal of AP is to increase the efficiency and quality of bank advisers' work. Requirements engineering for AP includes describing new work processes that musty be supported by AP using a combination of: (1) prose......, important work process....

  8. A Study of The Influence of Advising on Underrepresented Minority Undergraduate Student Persistence in STEM

    Science.gov (United States)

    Weir, Michael J.

    In the United States, undergraduate underrepresented minority (URM) students tend to change out of declared majors in science, technology, engineering and math (STEM) disciplines at a rate of nearly sixty percent prior to earning a post secondary degree. This phenomenon contributes to a general concern that the United States is not producing enough STEM trained skilled workers to meet future employment needs of industry and government. Although there has been research developed to examine how to increase the numbers of URM students enrolling in STEM programs at higher education institutions, retention of these students remains critical. One area of increasing focus for researchers is to understand how multiple factors impact the college experience of URM students and how those factors may contribute to the student decision to persist in earning a STEM disciple degree. This research study is a phenomenological mixed method study that examines how students experience the phenomenon of advising and the influence of the advising experience of undergraduate URM students on their likelihood of persisting in STEM at a northeast US technology oriented post secondary institution. Persistence, from the perspective of the student, is driven by cognitive psychological attributes such as confidence, motivation and self-efficacy. Utilizing a Social Cognitive theoretical framework, this study examines how three distinct undergraduate URM student populations enrolled in; an Academic Services Program, Honors College, and the general undergraduate population at this institution experience advising and how their experiences may influence their propensity to persist in earning a STEM oriented degree.

  9. End-of-life care at an academic medical center: are attending physicians, house staff, nurses, and bereaved family members equally satisfied? Implications for palliative care.

    Science.gov (United States)

    Galanos, Anthony Nicholas; Morris, Deborah A; Pieper, Carl F; Poppe-Ries, Angela M; Steinhauser, Karen E

    2012-02-01

    End-of-life care is deemed to be poor in the United States - particularly in large teaching hospitals. Via a brief survey, we examined satisfaction with end-of-life care for those patients who died in our academic medical center from provider and family perspectives. To assess the correlation between overall satisfaction between providers (attending, housestaff, and nurses) as well as family members for decedents who died in our hospital, we conducted a satisfaction survey regarding care in the last three days of life. The nine item survey was administered within 1 week of the patient s death to care providers and approximately 8 to 12 weeks to next of kin. There were 166 deaths examined over the four month study period. Overall satisfaction with care was 3.02 out of 4.0, and differed by respondent group (p= 0.035). Correlation between respondents was very low (range 0.02 to 0.51). The least discordance was between residents and interns (0.5), who had the lowest level of satisfaction (2.72). Housestaff and attendings had the lowest overall correlation in mean satisfaction scores (0.05). Most providers knew their patients for 24 hours or less. Overall satisfaction was high, but there was discordance among different providers. Continuity of care was limited. Age and location of death alone did not significantly affect satisfaction with end-of-life care. Implications of this type of research for improving end of life care at academic centers are discussed.

  10. An informatics-based tool to assist researchers in initiating research at an academic medical center: Vanderbilt Customized Action Plan (V-CAP)

    Science.gov (United States)

    Pulley, Jill M.; Harris, Paul A.; Yarbrough, Tonya; Swafford, Jonathan; Edwards, Terri; Bernard, Gordon R.

    2013-01-01

    The regulatory review and approval process is a significant part of the workflow associated with initiating clinical and translational research projects. Ambiguity concerning submission requirements and expected times associated with the review process can create additional work for research teams and ultimately delay important scientific projects. In an effort to provide assistance to investigators, we have developed an online interactive interface which elicits basic study characteristics for a single project and subsequently produces a list of required administrative applications needed for approval along with clear instructions concerning expectations from the research team. This system, the Vanderbilt Customized Action Plan (V-CAP), was launched in October, 2006 and been used extensively. The informatics systems-based approach is scalable to other academic medical centers and the authors report details concerning: (1) V-CAP project design; (2) a reference workflow associated with Vanderbilt policies and regulations; (3) V-CAP metrics of use by Vanderbilt research teams; and (4) a list of recommendations for other academic centers considering a similar systems-based approach for helping researchers efficiently navigate processes related to regulatory approval. PMID:20042844

  11. Feasibility of Telerehabilitation Implementation as a Novel Experience in Rehabilitation Academic Centers and Affiliated Clinics in Tehran: Assessment of Rehabilitation Professionals’ Attitudes

    Directory of Open Access Journals (Sweden)

    Sara Movahedazarhouligh

    2015-01-01

    Full Text Available Introduction. This study aimed to assess rehabilitation professionals’ attitude toward implementation and application of telerehabilitation technology as a novel study in rehabilitation academic centers and affiliated clinics in Tehran. Methods. It was a descriptive cross-sectional study. To collect data, a researcher-designed questionnaire was developed. 141 rehabilitation experts participated in the study. Results. A majority of faculty members (78% and clinicians (89.7% either were in “definite agreement” or “somewhat agreed” with implementation and application of this technology, which demonstrates an overall positive attitude. Discussion. Based on the positive attitudes of the majority of participants toward implementation and application of this technology and their preferences in offering different telerehabilitation services, it seems that there is an appropriate and desirable acceptance and administrative culture to implement this technology among rehabilitation experts in Tehran. It is thus expected that implementation and application of this technology will be a promising experience in rehabilitation academic centers and affiliate clinics in Tehran.

  12. SU-E-P-01: An Informative Review On the Role of Diagnostic Medical Physicist in the Academic and Private Medical Centers

    International Nuclear Information System (INIS)

    Weir, V; Zhang, J

    2014-01-01

    Purpose: The role of physicist in the academic and private hospital environment continues to evolve and expand. This becomes more obvious with the newly revised requirements of the Joint Commission (JC) on imaging modalities and the continued updated requirements of ACR accreditation for medical physics (i.e., starting in June 2014, a physicists test will be needed before US accreditation). We provide an informative review on the role of diagnostic medical physicist and hope that our experience will expedite junior physicists in understanding their role in medical centers, and be ready to more opportunities. Methods: Based on our experience, diagnostic medical physicists in both academic and private medical centers perform several clinical functions. These include providing clinical service and physics support, ensuring that all ionizing radiation devices are tested and operated in compliance with the State and Federal laws, regulations and guidelines. We also discuss the training and education required to ensure that the radiation exposure to patients and staff is as low as reasonably achievable. We review the overlapping roles of medical and health physicist in some institutions. Results: A detailed scheme on the new requirements (effective 7/1/2014) of the JC is provided. In 2015, new standards for fluoroscopy, cone beam CT and the qualifications of staff will be phased in. A summary of new ACR requirements for different modalities is presented. Medical physicist have other duties such as sitting on CT and fluoroscopy committees for protocols design, training of non-radiologists to meet the new fluoroscopy rules, as well as helping with special therapies such as Yittrium 90 cases. Conclusion: Medical physicists in both academic and private hospitals are positioned to be more involved and prominent. Diagnostic physicists need to be more proactive to involve themselves in the day to day activities of the radiology department

  13. Intraoperative fluid and pharmacologic management and the anesthesiologist's supervisory role for nontraditional technologies during liver transplantation: a survey of US academic centers.

    Science.gov (United States)

    Schumann, R; Mandell, S; Michaels, M D; Klinck, J; Walia, A

    2013-01-01

    Volume resuscitation and use of vasoactive medications during liver transplantation has not been systematically assessed. Furthermore, the anesthesiologist's role for intraoperative oversight of technologies such as renal replacement therapy and procedures such as venovenous bypass is poorly defined, and it is unclear if the center's annual transplant frequency affects these practices. We conducted a database analysis of the Liver Transplant Anesthesia Consortium survey 202 that addresses these questions. Data from US academic liver transplant anesthesia programs meeting inclusion criteria were included. Results were categorized by their annual transplant volume. A representative sample of 66% of all eligible centers contributed to the results. Normal saline among crystalloids and albumin among colloids were the most frequently chosen maintenance and non-blood product volume expansion fluids, with little variation by center size. A large variety of vasoactive agents is routinely utilized across programs, with vasopressors as a cornerstone of hemodynamic support. Large programs seem to use less of these agents compared with lower volume centers. Anesthesiologists are increasingly involved in oversight and management of intraoperative renal replacement therapies, venovenous bypass and cell saver devices with rising transplant frequency. This new insight may be indicative of skill sets needed by members of liver transplantation anesthesia teams and should be considered in curriculum design for hepatobiliary transplant anesthesia fellowships. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Amarillo National Resource Center for Plutonium 1999 plan

    International Nuclear Information System (INIS)

    1999-01-01

    The purpose of the Amarillo National Resource Center for Plutonium is to serve the Texas Panhandle, the State of Texas and the US Department of Energy by: conducting scientific and technical research; advising decision makers; and providing information on nuclear weapons materials and related environment, safety, health, and nonproliferation issues while building academic excellence in science and technology. This paper describes the electronic resource library which provides the national archives of technical, policy, historical, and educational information on plutonium. Research projects related to the following topics are described: Environmental restoration and protection; Safety and health; Waste management; Education; Training; Instrumentation development; Materials science; Plutonium processing and handling; and Storage

  15. Amarillo National Resource Center for Plutonium 1999 plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-01-30

    The purpose of the Amarillo National Resource Center for Plutonium is to serve the Texas Panhandle, the State of Texas and the US Department of Energy by: conducting scientific and technical research; advising decision makers; and providing information on nuclear weapons materials and related environment, safety, health, and nonproliferation issues while building academic excellence in science and technology. This paper describes the electronic resource library which provides the national archives of technical, policy, historical, and educational information on plutonium. Research projects related to the following topics are described: Environmental restoration and protection; Safety and health; Waste management; Education; Training; Instrumentation development; Materials science; Plutonium processing and handling; and Storage.

  16. Comparison of tissue plasminogen activator administration management between Telestroke Network hospitals and academic stroke centers: the Telemedical Pilot Project for Integrative Stroke Care in Bavaria/Germany.

    Science.gov (United States)

    Audebert, Heinrich J; Kukla, Christian; Vatankhah, Bijan; Gotzler, Berthold; Schenkel, Johannes; Hofer, Stephan; Fürst, Andrea; Haberl, Roman L

    2006-07-01

    Systemic thrombolysis is the only therapy proven to be effective for ischemic stroke. Telemedicine may help to extend its use. However, concerns remain whether management and safety of tissue plasminogen activator (tPA) administration after telemedical consultation are equivalent in less experienced hospitals compared with tPA administration in academic stroke centers. During the second year of the ongoing Telemedical Pilot Project for Integrative Stroke Care, all systemic thrombolyses in stroke patients of the 12 regional clinics and the 2 stroke centers were recorded prospectively. Patients' demographics, stroke severity (National Institutes of Health Stroke Scale), frequency of administration, time management, protocol violations, and safety were included in the analysis. In 2004, 115 of 4727 stroke or transient ischemic attack patients (2.4%) in the community hospitals and 110 of 1889 patients in the stroke centers (5.8%) received systemic thrombolysis. Prehospital latencies were shorter in the regional hospitals despite longer distances. Door to needle times were shorter in the stroke centers. Although blood pressure was controlled more strictly in community hospitals, symptomatic intracerebral hemorrhage rate (7.8%) was higher (P=0.14) than in stroke centers (2.7%) but still within the range of the National Institute of Neurological Disorders and Stroke trial. In-hospital mortality rate was low in community hospitals (3.5%) and in stroke centers (4.5%). Although with a lower rate of systemic thrombolysis, there was no evidence of lower treatment quality in the remote hospitals. With increasing numbers of tPA administration and growing training effects, the telestroke concept promises better coverage of systemic thrombolysis in nonurban areas.

  17. Evaluating Imaging Follow-Up Strategies and Costs of Unruptured Intracranial Aneurysms Treated with Endovascular Techniques: A Survey of Academic Neurovascular Centers in the United States.

    Science.gov (United States)

    Gupta, Raghav; Griessenauer, Christoph J; Adeeb, Nimer; Chua, Michelle H; Moore, Justin M; Patel, Apar S; Thomas, Ajith J; Ogilvy, Christopher S

    2016-10-01

    Unruptured intracranial aneurysms (UIAs) are being detected and treated with endovascular techniques at an increasing rate, with little evidence on the optimal imaging follow-up protocol. We performed a survey of academic neurovascular centers in the United States to assess imaging follow-up strategies and costs after endovascular treatment of UIAs. An online survey on 5-year follow-up strategies of UIAs treated with endovascular techniques was distributed to neurovascular directors of 101 academic neurovascular centers using the American Association of Neurological Surgeons/Congress of Neurological Surgeons Joint Cerebrovascular Section database. An online healthcare marketplace, NewChoiceHealth, was used to calculate costs. Of 33 (32.7%) institutions that responded to the survey, 26 (25.7%) provided data suitable for analysis. Nine (34.6%), 10 (38.5%), 4 (15.4%), and 3 (11.5%) centers were located in the northeastern, southern, midwestern, and western regions of the United States. Total costs of 5-year follow-up imaging after primary coil embolization and stent-assisted coiling procedures were $3391-$32,882. Costs for aneurysms treated with flow diversion were $2788-$46,670. Eighteen (69.2%) institutions performed cerebral angiography at 6-month follow-up after coil embolization and stent-assisted coiling, and 19 (73.1%) institutions performed cerebral angiography 6 months after flow diversion. Of institutions, 20% affirmed that they maintained an identical imaging follow-up regimen after treatment of ruptured aneurysms. There is significant heterogeneity in imaging follow-up strategies and their associated costs. Stratification of patients by risk of recanalization and corresponding adjustment of follow-up imaging may be 1 strategy to limit unnecessary imaging and control costs. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. College Students' Use and Understanding of an Electronic Social Network for Academics, Academic Help Seeking, and Academic Advising

    Science.gov (United States)

    Amador, Paul Vincent

    2011-01-01

    The arrival of a new generation of students, known as the Net Generation (Junco, 2010), into colleges and universities has demanded changes to the traditional administrative and support services provided on campuses across the nation. In times of ever-changing technological advances, colleges and universities have begun to utilize new and…

  19. Trainee Knowledge of Imaging Appropriateness and Safety: Results of a Series of Surveys From a Large Academic Medical Center.

    Science.gov (United States)

    Hollingsworth, Thaddeus D; Duszak, Richard; Vijayasarathi, Arvind; Gelbard, Rondi B; Mullins, Mark E

    2017-10-31

    In order to provide high quality care to their patients and utilize imaging most judiciously, physician trainees should possess a working knowledge of appropriate use, radiation dose, and safety. Prior work has suggested knowledge gaps in similar areas. We aimed to evaluate the knowledge of imaging appropriateness, radiation dose, and MRI and contrast safety of physician trainees across a variety of specialties. Between May 2016 and January 2017, three online surveys were distributed to all interns, residents, and fellows in ACGME accredited training programs at a large academic institution over two academic years. Response rates to three surveys ranged from 17.2% (218 of 1266) for MRI and contrast material safety, 19.1% (242 of 1266) for imaging appropriateness, to19.9% (246 of 1238) for radiation dose. Overall 72% (509 of 706) of survey respondents reported regularly ordering diagnostic imaging examinations, but fewer than half (47.8%; 470 of 984) could correctly estimate radiation dose across four commonly performed imaging studies. Only one third (34%; 167 of 488) of trainees chose appropriate imaging in scenarios involving pregnant patients. Trainee post-graduate year was not significantly correlated with overall radiation safety scores, and no significant difference was found between radiation safety or appropriate imaging scores of those who participated in a medical school radiology elective vs. those who did not. A total of 84% (57 of 68) of radiology trainees and 43% (269 of 630) of non-radiology trainees considered their knowledge adequate but that correlated only weakly correlated to actual knowledge scores (pimaging safety exist among many trainees. In order to enhance the value of imaging at the population level, further work is needed to assess the most appropriate method and stage of training to address these knowledge gaps. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. 38 CFR 17.251 - The Subcommittee on Academic Affairs.

    Science.gov (United States)

    2010-07-01

    ... Academic Affairs. 17.251 Section 17.251 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants for Exchange of Information § 17.251 The Subcommittee on Academic Affairs. There is... Subcommittee on Academic Affairs, and the Subcommittee shall advise the Secretary, through the Under Secretary...

  1. Revenue Increase following 2017 Multiple Procedures Payment Reduction Modification: Differential Impact on Neuroradiology-Report from an Academic Medical Center.

    Science.gov (United States)

    Noveiry, B B; Varzaneh, F N; Yousem, D M

    2018-02-22

    The Centers for Medicare and Medicaid Services imposed a 25% professional component multiple procedure payment reduction for the professional component of advanced diagnostic imaging modalities in January 2012. In 2017, the Centers for Medicare and Medicaid Services rolled back the multiple procedure payment reduction to 5% for subsequent imaging. To evaluate the effect of this change, we analyzed 5 months of Centers for Medicare and Medicaid Services procedures at Johns Hopkins Medical Institution. We analyzed the procedure codes and reimbursement rate for studies performed between January 1 and May 31, 2017. Patients with Medicare insurance who had multiple diagnostic procedures in a day were selected. Per the Centers for Medicare and Medicaid Services guidelines, procedures with the highest price were considered fully reimbursed and subsequent studies were marked for differences between 25% (2013-2016) and 5% reduction (2017). We included 8787 patients with 22,236 procedures (mean, 2.53 studies/day). CT, MR imaging, and ultrasound scans composed 75.9%, 21.5%, and 2.6% of all studies, with 61.2%, 54.9%, and 85.4% of the procedures of each technique subject to multiple procedure payment reduction, respectively. The projected reimbursement for these studies was $1,666,437, which translated to a $179,782 (12.1%) increase in revenue comparing 25%-versus-5% multiple procedure payment reduction rates for 5 months: $128,542 for CT, $47,802 for MR imaging, and $3439 for ultrasound. The annual overall prorated increase in revenue would be $431,476. The impact was maximal for neuroradiology. With the recent favorable adjustment in multiple procedure payment reduction regulations, CT-heavy subspecialties like neuroradiology benefit the most with revenue increases. Different practice settings might experience revenue increases to a different extent, depending on the procedure and payer mix. © 2018 by American Journal of Neuroradiology.

  2. Data Day to Day: building a community of expertise to address data skills gaps in an academic medical center.

    Science.gov (United States)

    Surkis, Alisa; LaPolla, Fred Willie Zametkin; Contaxis, Nicole; Read, Kevin B

    2017-04-01

    The New York University Health Sciences Library data services team had developed educational material for research data management and data visualization and had been offering classes at the request of departments, research groups, and training programs, but many members of the medical center were unaware of these library data services. There were also indications of data skills gaps in these subject areas and other data-related topics. The data services team enlisted instructors from across the medical center with data expertise to teach in a series of classes hosted by the library. We hosted eight classes branded as a series called "Data Day to Day." Seven instructors from four units in the medical center, including the library, taught the classes. A multipronged outreach approach resulted in high turnout. Evaluations indicated that attendees were very satisfied with the instruction, would use the skills learned, and were interested in future classes. Data Day to Day met previously unaddressed data skills gaps. Collaborating with outside instructors allowed the library to serve as a hub for a broad range of data instruction and to raise awareness of library services. We plan to offer the series three times in the coming year with an expanding roster of classes.

  3. The power of collaboration: using internet-based tools to facilitate networking and benchmarking within a consortium of academic health centers.

    Science.gov (United States)

    Korner, Eli J; Oinonen, Michael J; Browne, Robert C

    2003-02-01

    The University HealthSystem Consortium (UHC) represents a strategic alliance of 169 academic health centers and associated institutions engaged in knowledge sharing and idea-generation. The use of the Internet as a tool in the delivery of UHC's products and services has increased dramatically over the past year and will continue to increase during the foreseeable future. This paper examines the current state of UHC-member institution driven tools and services that utilize the Web as a fundamental component in their delivery. The evolution of knowledge management at UHC, its management information and reporting tools, and expansion of e-commerce provide real world examples of Internet use in health care delivery and management. Health care workers are using these Web-based tools to help manage rising costs and optimize patient outcomes. Policy, technical, and organizational issues must be resolved to facilitate rapid adoption of Internet applications.

  4. Bridging the divide: building infrastructure to support community-academic partnerships and improve capacity to conduct patient-centered outcomes research.

    Science.gov (United States)

    Huang, Jennifer; Lipman, Paula Darby; Daniel Mullins, C

    2017-12-01

    For research to be useful, trustworthy, and ultimately lead to greater dissemination of findings to patients and communities, it is important to train and mentor academic researchers to meaningfully engage community members in patient-centered outcomes research (PCOR). Thus, it is necessary for research institutions to strengthen their underlying infrastructure to support PCOR. PATIENTS-PATient-centered Involvement in Evaluating effectiveNess of TreatmentS-at the University of Maryland, Baltimore, focuses on improving PCOR methods and addressing health disparities. It relies on evidence-based engagement methods to sustain and leverage innovative partnerships so patients, health care providers, and academic partners are motivated to participate in the conduct and dissemination of PCOR. Program components address training needs, bi-directional engagement, cultural competency, and dissemination and implementation. Activities (guided by community representatives, leadership from university schools, patient advocates, and PCOR experts) include providing resources, conducting PCOR projects, engaging community members, and disseminating PCOR findings. With its emphasis on the broad range of PCOR topics and methods, and through fostering sustainable relationships with community members and researchers, PATIENTS has successfully cultivated bi-directional partnerships and provided operational and scientific support for a new generation of skilled PCOR researchers. Early evidence of effectiveness includes progress in training and mentoring students and investigators, an increase in submission of PCOR proposals, and community-informed strategies for dissemination. Programs such as PATIENTS reinforce the value of bridging the traditional divide between academia and communities to support patient- and community-engaged dissemination and implementation research and foster sustainable PCOR infrastructure.

  5. An exploration of key issues and potential solutions that impact physician wellbeing and professional fulfillment at an academic center.

    Science.gov (United States)

    Schrijver, Iris; Brady, Keri J S; Trockel, Mickey

    2016-01-01

    Background. Physician wellness is a vital element of a well-functioning health care system. Not only is physician wellness empirically associated with quality and patient outcomes, but its ramifications span individual, interpersonal, organizational, and societal levels. The purpose of this study was to explore academic physicians' perceptions about their work-related wellness, including the following questions: (a) What are the workplace barriers and facilitators to their wellness? (b) What workplace solutions do theythinkwouldimprove their wellness? (c)What motivates their work? and (d) What existing wellness programs are they aware of? Methods. A multi-method design was applied to conduct a total of 19 focus group sessions in 17 clinical departments. All academic faculty ranks and career lines were represented in the 64 participating physicians, who began the sessions with five open-ended survey questions pertaining to physician wellness in their work environment. Participants entered their answers into a web-based survey program that enabled anonymous data collection. The initial survey component was followed by semi-structured focus group discussion. Data analysis of this qualitative study was informed by the general inductive approach as well as a review of extant literature through September 2015 on physician wellness, professional fulfillment, satisfaction, dissatisfaction, burnout and work-life. Results. Factors intrinsic to the work of physicians dominated the expressed reasons for work motivation. These factors all related to the theme of overall contribution, with categories of meaningful work, patient care, teaching, scientific discovery, self-motivation and matching of career interests. Extrinsic factors such as perceptions of suboptimal goal alignment, inadequate support, restricted autonomy, lack of appreciation, and suboptimal compensation and benefits dominated the risk of professional dissatisfaction. Discussion. Our findings indicate that the

  6. An exploration of key issues and potential solutions that impact physician wellbeing and professional fulfillment at an academic center

    Directory of Open Access Journals (Sweden)

    Iris Schrijver

    2016-03-01

    Full Text Available Background. Physician wellness is a vital element of a well-functioning health care system. Not only is physician wellness empirically associated with quality and patient outcomes, but its ramifications span individual, interpersonal, organizational, and societal levels. The purpose of this study was to explore academic physicians’ perceptions about their work-related wellness, including the following questions: (a What are the workplace barriers and facilitators to their wellness? (b What workplace solutions do theythinkwouldimprove their wellness? (cWhat motivates their work? and (d What existing wellness programs are they aware of? Methods. A multi-method design was applied to conduct a total of 19 focus group sessions in 17 clinical departments. All academic faculty ranks and career lines were represented in the 64 participating physicians, who began the sessions with five open-ended survey questions pertaining to physician wellness in their work environment. Participants entered their answers into a web-based survey program that enabled anonymous data collection. The initial survey component was followed by semi-structured focus group discussion. Data analysis of this qualitative study was informed by the general inductive approach as well as a review of extant literature through September 2015 on physician wellness, professional fulfillment, satisfaction, dissatisfaction, burnout and work-life. Results. Factors intrinsic to the work of physicians dominated the expressed reasons for work motivation. These factors all related to the theme of overall contribution, with categories of meaningful work, patient care, teaching, scientific discovery, self-motivation and matching of career interests. Extrinsic factors such as perceptions of suboptimal goal alignment, inadequate support, restricted autonomy, lack of appreciation, and suboptimal compensation and benefits dominated the risk of professional dissatisfaction. Discussion. Our findings

  7. Teenage Pregnancies: Risk Factors and Associated Neonatal Outcomes in an Eastern-European Academic Perinatal Care Center.

    Science.gov (United States)

    Suciu, Laura Mihaela; Pasc, Andrada Larisa; Cucerea, Manuela; Bell, Edward F

    2016-03-01

    This study aims to compare women with early (13-16 years), late teenage (17-19 years), and adult (25-29 years) pregnancies regarding pregnancy risk factors and reproductive outcomes. An observational study, utilizing medical charts and direct interview, conducted in an academic hospital during January 2011 and December 2012. Our sample comprised 395 teenage and 736 adult pregnancies. Pregnant teenagers were more likely than adults to be single (41.7 vs. 33.2%; odds ratio [OR]: 1.43, 95% confidence interval [CI]: 1.11-1.84), to live in a rural area (70.9 vs. 53.9%; OR: 2.07, 95% CI: 1.60-2.69), and to live with extended family (74.2 vs. 16.0%; OR: 15.04, 95% CI: 11.15-20.29). Adolescent mothers were more likely than adult mothers to give birth by vaginal delivery (78.5 vs. 69.6%; OR: 1.82, 95% CI: 1.17-2.84), and rate of operative delivery was lower amongst this group (8.6 vs. 9.8%; OR: 0.8, 95% CI: 0.5-1.3). The newborns of adolescent mothers were more likely to be low birth weight (14.9 vs. 9.1%; OR: 1.75, 95% CI: 1.20-2.54) and more likely to successfully breastfeed (91.9 vs. 82.2%; OR: 2.45; 95% CI: 1.63-3.69) but the length of hospital stay was similar with adult mothers' newborns. The distinct risk factors and behaviors associated with pregnancy, among teenagers may help address the health needs of this unique and vulnerable group and their offspring. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  8. Successful strategies for the reduction of operating room turnover times in a tertiary care academic medical center.

    Science.gov (United States)

    Kodali, Bhavani S; Kim, Dennie; Bleday, Ronald; Flanagan, Hugh; Urman, Richard D

    2014-04-01

    Turnover time (TOT) is one of the classic measures of operating room (OR) efficiency. There have been numerous efforts to reduce TOTs, sometimes through the employment of a process improvement framework. However, most examples of process improvement in the TOT focus primarily on operational changes to workflows and statistical significance. These examples of process improvement do not detail the complex organizational challenges associated with implementing, expanding, and sustaining change. TOT data for general and gastrointestinal surgery were collected retrospectively over a 26-mo period at a large multispecialty academic institution. We calculated mean and median TOTs. TOTs were excluded if the sequence of cases was changed or cases were canceled. Data were retrieved from the perioperative nursing data entry system. Using performance improvement strategies, we determined how various events and organizational factors created an environment that was receptive to change. This ultimately led to a sustained decrease in the OR TOT both in the general and gastrointestinal surgery ORs that were the focus of the study (44.8 min versus 48.6 min; P < 0.0001) and other subspecialties (49.3 min versus 53.0 min; P < 0.0001), demonstrating that the effect traveled outside the study area. There are obstacles, such as organizational culture and institutional inertia, that OR leaders, managers, and change agents commonly face. Awareness of the numerous variables that may support or impede a particular change effort can inform effective change implementation strategies that are "organizationally compatible." Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Analysis of Thrombophilia Test Ordering Practices at an Academic Center: A Proposal for Appropriate Testing to Reduce Harm and Cost.

    Directory of Open Access Journals (Sweden)

    Yu-Min Shen

    Full Text Available Ideally, thrombophilia testing should be tailored to the type of thrombotic event without the influence of anticoagulation therapy or acute phase effects which can give false positive results that may result in long term anticoagulation. However, thrombophilia testing is often performed routinely in unselected patients. We analyzed all consecutive thrombophilia testing orders during the months of October and November 2009 at an academic teaching institution. Information was extracted from electronic medical records for the following: indication, timing, comprehensiveness of tests, anticoagulation therapy at the time of testing, and confirmatory repeat testing, if any. Based on the findings of this analysis, we established local guidelines in May 2013 for appropriate thrombophilia testing, primarily to prevent testing during the acute thrombotic event or while the patient is on anticoagulation. We then evaluated ordering practices 22 months after guideline implementation. One hundred seventy-three patients were included in the study. Only 34% (58/173 had appropriate indications (unprovoked venous or arterial thrombosis or pregnancy losses. 51% (61/119 with an index clinical event were tested within one week of the event. Although 46% (79/173 were found to have abnormal results, only 46% of these had the abnormal tests repeated for confirmation with 54% potentially carrying a wrong diagnosis with long term anticoagulation. Twenty-two months after guideline implementation, there was an 84% reduction in ordered tests. Thus, this study revealed that a significant proportion of thrombophilia testing was inappropriately performed. We implemented local guidelines for thrombophilia testing for clinicians, resulting in a reduction in healthcare costs and improved patient care.

  10. Implementation of an enhanced safety-engineered sharp device oversight and bloodborne pathogen protection program at a large academic medical center.

    Science.gov (United States)

    Talbot, Thomas R; Wang, Deede; Swift, Melanie; St Jacques, Paul; Johnson, Susan; Brinsko, Vicki; Thayer, Valerie; Dail, Teresa; Feistritzer, Nancye; Polancich, Shea

    2014-11-01

    Exposure of healthcare personnel to bloodborne pathogens (BBPs) can be prevented in part by using safety-engineered sharp devices (SESDs) and other safe practices, such as double gloving. In some instances, however, safer devices and practices cannot be utilized because of procedural factors or the lack of a manufactured safety device for the specific clinical use. In these situations, a standardized system to examine requests for waiver from expected practices is necessary. Before-after program analysis. Large academic medical center. Vanderbilt University Medical Center developed a formalized system for an improved waiver process, including an online submission and tracking site, and standards surrounding implementation of core safe practices. The program's impact on sharp device injuries and utilization of double gloving and blunt sutures was examined. Following implementation of the enhanced program, there was an increase in the amount of undergloves and blunt sutures purchased for surgical procedures, suggesting larger utilization of these practices. The rate of sharp device injuries of all at-risk employees decreased from 2.32% to 2.12%, but this decline was not statistically significant (P = .14). The proportion of reported injuries that were deemed preventable significantly decreased from 72.7% (386/531) before implementation to 63.9% (334/523; P = .002) after implementation of the enhanced program. An enhanced BBP protection program was successful at providing guidance to increase safe practices and at improving the management of SESD waiver requests and was associated with a reduction in preventable sharp device injuries.

  11. A Prolonged Outbreak of KPC-3-Producing Enterobacter cloacae and Klebsiella pneumoniae Driven by Multiple Mechanisms of Resistance Transmission at a Large Academic Burn Center.

    Science.gov (United States)

    Kanamori, Hajime; Parobek, Christian M; Juliano, Jonathan J; van Duin, David; Cairns, Bruce A; Weber, David J; Rutala, William A

    2017-02-01

    Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacter cloacae has been recently recognized in the United States. Whole-genome sequencing (WGS) has become a useful tool for analysis of outbreaks and for determining transmission networks of multidrug-resistant organisms in health care settings, including carbapenem-resistant Enterobacteriaceae (CRE). We experienced a prolonged outbreak of CRE E. cloacae and K. pneumoniae over a 3-year period at a large academic burn center despite rigorous infection control measures. To understand the molecular mechanisms that sustained this outbreak, we investigated the CRE outbreak isolates by using WGS. Twenty-two clinical isolates of CRE, including E. cloacae (n = 15) and K. pneumoniae (n = 7), were sequenced and analyzed genetically. WGS revealed that this outbreak, which seemed epidemiologically unlinked, was in fact genetically linked over a prolonged period. Multiple mechanisms were found to account for the ongoing outbreak of KPC-3-producing E. cloacae and K. pneumoniae This outbreak was primarily maintained by a clonal expansion of E. cloacae sequence type 114 (ST114) with distribution of multiple resistance determinants. Plasmid and transposon analyses suggested that the majority of bla KPC-3 was transmitted via an identical Tn4401b element on part of a common plasmid. WGS analysis demonstrated complex transmission dynamics within the burn center at levels of the strain and/or plasmid in association with a transposon, highlighting the versatility of KPC-producing Enterobacteriaceae in their ability to utilize multiple modes to resistance gene propagation. Copyright © 2017 American Society for Microbiology.

  12. 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.

    Directory of Open Access Journals (Sweden)

    Christine Ritchie

    Full Text Available The Geriatric Resources for the Assessment and Care of Elders (GRACE program has been shown to decrease acute care utilization and increase patient self-rated health in low-income seniors at community-based health centers.To describe adaptation of the GRACE model to include adults of all ages (named Care Support and to evaluate the process and impact of Care Support implementation at an urban academic medical center.152 high-risk patients (≥5 ED visits or ≥2 hospitalizations in the past 12 months enrolled from four medical clinics from 4/29/2013 to 5/31/2014.Patients received a comprehensive in-home assessment by a nurse practitioner/social worker (NP/SW team, who then met with a larger interdisciplinary team to develop an individualized care plan. In consultation with the primary care team, standardized care protocols were activated to address relevant key issues as needed.A process evaluation based on the Consolidated Framework for Implementation Research identified key adaptations of the original model, which included streamlining of standardized protocols, augmenting mental health interventions and performing some assessments in the clinic. A summative evaluation found a significant decline in the median number of ED visits (5.5 to 0, p = 0.015 and hospitalizations (5.5 to 0, p<0.001 6 months before enrollment in Care Support compared to 6 months after enrollment. In addition, the percent of patients reporting better self-rated health increased from 31% at enrollment to 64% at 9 months (p = 0.002. Semi-structured interviews with Care Support team members identified patients with multiple, complex conditions; little community support; and mild anxiety as those who appeared to benefit the most from the program.It was feasible to implement GRACE/Care Support at an academic medical center by making adaptations based on local needs. Care Support patients experienced significant reductions in acute care utilization and significant improvements

  13. Variations in PET/CT methodology for oncologic imaging at U.S. academic medical centers: an imaging response assessment team survey.

    Science.gov (United States)

    Graham, Michael M; Badawi, Ramsey D; Wahl, Richard L

    2011-02-01

    In 2005, 8 Imaging Response Assessment Teams (IRATs) were funded by the National Cancer Institute (NCI) as supplemental grants to existing NCI Cancer Centers. After discussion among the IRATs regarding the need for increased standardization of clinical and research PET/CT methodology, it became apparent that data acquisition and processing approaches differ considerably among centers. To determine the variability in detail, a survey of IRAT sites and IRAT affiliates was performed. A 34-question instrument evaluating patient preparation, scanner type, performance approach, display, and analysis was developed. Fifteen institutions, including the 8 original IRATs and 7 institutions that had developed affiliate IRATs, were surveyed. The major areas of variation were (18)F-FDG dose (259-740 MBq [7-20 mCi]) uptake time (45-90 min), sedation (never to frequently), handling of diabetic patients, imaging time (2-7 min/bed position), performance of diagnostic CT scans as a part of PET/CT, type of acquisition (2-dimensional vs. 3-dimensional), CT technique, duration of fasting (4 or 6 h), and (varying widely) acquisition, processing, display, and PACS software--with 4 sites stating that poor-quality images appear on PACS. There is considerable variability in the way PET/CT scans are performed at academic institutions that are part of the IRAT network. This variability likely makes it difficult to quantitatively compare studies performed at different centers. These data suggest that additional standardization in methodology will be required so that PET/CT studies, especially those performed quantitatively, are more comparable across sites.

  14. Aim for Wow-ability when Selecting Student Center Furniture.

    Science.gov (United States)

    Payne, Jill M.

    2003-01-01

    Advises colleges to keep in mind several qualities when purchasing furniture for student centers: durability, cleanability, repairability, flexibility, storability, credibility, sustainability, comfort, affordability, and "wowability." (EV)

  15. Are Evidence-based Practices Associated With Effective Prevention of Hospital-acquired Pressure Ulcers in US Academic Medical Centers?

    Science.gov (United States)

    Padula, William V; Gibbons, Robert D; Valuck, Robert J; Makic, Mary B F; Mishra, Manish K; Pronovost, Peter J; Meltzer, David O

    2016-05-01

    In 2008, the Centers for Medicare and Medicaid Services (CMS) established nonpayment policies resulting from costliness of hospital-acquired pressure ulcers (HAPUs) to hospitals. This prompted hospitals to adopt quality improvement (QI) interventions that increase use of evidence-based practices (EBPs) for HAPU prevention. To evaluate the longitudinal impact of CMS policy and QI adoption on HAPU rates. We characterized longitudinal adoption of 25 QI interventions that support EBPs through hospital leadership, staff, information technology, and performance and improvement. Quarterly counts of HAPU incidence and inpatient characteristics were collected from 55 University HealthSystem Consortium hospitals between 2007 and 2012. Mixed-effects regression models tested the longitudinal association of CMS policy, HAPU coding, and QI on HAPU rates. The models assumed level-2 random intercepts and random effects for CMS policy and EBP implementation to account for between-hospital variability in HAPU incidence. Controlling for all 25 QI interventions, specific updates to EBPs for HAPU prevention had a significant, though modest reduction on HAPU rates (-1.86 cases/quarter; P=0.002) and the effect of CMS nonpayment policy on HAPU prevention was much greater (-11.32 cases/quarter; P<0.001). HAPU rates were significantly lower after changes in CMS reimbursement. Reductions are associated with hospital-wide implementation of EBPs for HAPU prevention. Given that administrative data were used, it remains unknown whether these improvements were due to changes in coding or improved quality of care.

  16. Applying JIT principles to resident education to reduce patient delays: a pilot study in an academic medical center pain clinic.

    Science.gov (United States)

    Williams, Kayode A; Chambers, Chester G; Dada, Maqbool; Christo, Paul J; Hough, Douglas; Aron, Ravi; Ulatowski, John A

    2015-02-01

    This study investigated the effect on patient waiting times, patient/doctor contact times, flow times, and session completion times of having medical trainees and attending physicians review cases before the clinic session. The major hypothesis was that review of cases prior to clinic hours would reduce waiting times, flow times, and use of overtime, without reducing patient/doctor contact time. Prospective quality improvement. Specialty pain clinic within Johns Hopkins Outpatient Center, Baltimore, MD, United States. Two attending physicians participated in the intervention. Processing times for 504 patient visits are involved over a total of 4 months. Trainees were assigned to cases the day before the patient visit. Trainees reviewed each case and discussed it with attending physicians before each clinic session. Primary measures were activity times before and after the intervention. These were compared and also used as inputs to a discrete event simulation to eliminate differences in the arrival process as a confounding factor. The average time that attending physicians spent teaching trainees while the patient waited was reduced, but patient/doctor contact time was not significantly affected. These changes reduced patient waiting times, flow times, and clinic session times. Moving some educational activities ahead of clinic time improves patient flows through the clinic and decreases congestion without reducing the times that trainees or patients interact with physicians. Wiley Periodicals, Inc.

  17. Implementation of the surgical safety checklist at a tertiary academic center: Impact on safety culture and patient outcomes.

    Science.gov (United States)

    Zingiryan, Areg; Paruch, Jennifer L; Osler, Turner M; Hyman, Neil H

    2017-08-01

    The impact and efficacy of the World Health Organization Surgery Safety Checklist (SSC) is uncertain. We sought to determine if the SSC decreases complications and examined the attitudes of the surgical team members following implementation of the SSC. A 28-question survey was developed to assess perspectives of surgical team members at the University of Vermont Medical Center (UVMC). The University Health System Consortium database was examined to compare the rates of nine complications before and after SSC implementation using Chi square analysis and Fisher's exact test. There was no significant decrease in any of the nine complications 2 years after SSC implementation. There was overall agreement that the SSC improved communication, safety, and prevented errors in the operating room. However, there was disagreement between nursing and surgeons over whether all three parts of the SSC were always completed. Implementation of the SSC did not result in a significant decrease in perioperative morbidity or mortality. However, it did improve the perception of safety culture by operating room staff. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Complications of Trauma Patients Admitted to the ICU in Level I Academic Trauma Centers in the United States

    Directory of Open Access Journals (Sweden)

    Stefania Mondello

    2014-01-01

    Full Text Available Background. The aims of this study were to evaluate the complications that occur after trauma and the characteristics of individuals who develop complications, to identify potential risk factors that increase their incidence, and finally to investigate the relationship between complications and mortality. Methods. We did a population-based retrospective study of trauma patients admitted to ICUs of a level I trauma center. Logistic regression analyses were performed to determine independent predictors for complications. Results. Of the 11,064 patients studied, 3,451 trauma patients developed complications (31.2%. Complications occurred significantly more in younger male patients. Length of stay was correlated with the number of complications (R=0.435,P<0.0001. The overall death rate did not differ between patients with or without complications. The adjusted odds ratio (OR of developing complication for patients over age 75 versus young adults was 0.7 (P<0.0001. Among males, traumatic central nervous system (CNS injury was an important predictor for complications (adjusted OR 1.24. Conclusions. Complications after trauma were found to be associated with age, gender, and traumatic CNS injury. Although these are not modifiable factors, they may identify subjects at high risk for the development of complications, allowing for preemptive strategies for prevention.

  19. Access of primary and secondary literature by health personnel in an academic health center: implications for open access*

    Science.gov (United States)

    Steinberg, Ryan M.; Moorhead, Laura; O'Brien, Bridget; Willinsky, John

    2013-01-01

    Purpose: The research sought to ascertain the types and quantity of research evidence accessed by health personnel through PubMed and UpToDate in a university medical center over the course of a year in order to better estimate the impact that increasing levels of open access to biomedical research can be expected to have on clinical practice in the years ahead. Methods: Web log data were gathered from the 5,042 health personnel working in the Stanford University Hospitals (SUH) during 2011. Data were analyzed for access to the primary literature (abstracts and full-text) through PubMed and UpToDate and to the secondary literature, represented by UpToDate (research summaries), to establish the frequency and nature of literature consulted. Results: In 2011, SUH health personnel accessed 81,851 primary literature articles and visited UpToDate 110,336 times. Almost a third of the articles (24,529) accessed were reviews. Twenty percent (16,187) of the articles viewed were published in 2011. Conclusion: When it is available, health personnel in a clinical care setting frequently access the primary literature. While further studies are needed, this preliminary finding speaks to the value of the National Institutes of Health public access policy and the need for medical librarians and educators to prepare health personnel for increasing public access to medical research. PMID:23930091

  20. Access of primary and secondary literature by health personnel in an academic health center: implications for open access.

    Science.gov (United States)

    Maggio, Lauren A; Steinberg, Ryan M; Moorhead, Laura; O'Brien, Bridget; Willinsky, John

    2013-07-01

    The research sought to ascertain the types and quantity of research evidence accessed by health personnel through PubMed and UpToDate in a university medical center over the course of a year in order to better estimate the impact that increasing levels of open access to biomedical research can be expected to have on clinical practice in the years ahead. Web log data were gathered from the 5,042 health personnel working in the Stanford University Hospitals (SUH) during 2011. Data were analyzed for access to the primary literature (abstracts and full-text) through PubMed and UpToDate and to the secondary literature, represented by UpToDate (research summaries), to establish the frequency and nature of literature consulted. In 2011, SUH health personnel accessed 81,851 primary literature articles and visited UpToDate 110,336 times. Almost a third of the articles (24,529) accessed were reviews. Twenty percent (16,187) of the articles viewed were published in 2011. When it is available, health personnel in a clinical care setting frequently access the primary literature. While further studies are needed, this preliminary finding speaks to the value of the National Institutes of Health public access policy and the need for medical librarians and educators to prepare health personnel for increasing public access to medical research.

  1. 75 FR 77051 - Rules Implementing Amendments to the Investment Advisers Act of 1940

    Science.gov (United States)

    2010-12-10

    ...) pension consultants; (iii) investment advisers affiliated with an adviser registered with the Commission... Exchange Commission 31 Parts 275 and 279 Rules Implementing Amendments to the Investment Advisers Act of... Implementing Amendments to the Investment Advisers Act of 1940 AGENCY: Securities and Exchange Commission...

  2. 78 FR 42122 - Bridge Builder Trust and Olive Street Investment Advisers, LLC; Notice of Application

    Science.gov (United States)

    2013-07-15

    ... Builder Trust and Olive Street Investment Advisers, LLC; Notice of Application July 9, 2013. AGENCY...: Bridge Builder Trust (the ``Trust'') and Olive Street Investment Advisers (the ``Adviser'') (collectively... Financial Way, Suite 100, Glendora, CA 91741; The Adviser: James A. Tricarico, Olive Street Investment...

  3. Advising in austerity reflections on challenging times for advice agencies

    CERN Document Server

    Kirwan, Samuel

    2016-01-01

    Advising in austerity provides a lively and thought-provoking account of the conditions, consequences and challenges of advice work in the UK. It examines how advisors negotiate the private troubles of those who come to Citizens Advice Bureaux (CAB) and construct ways forward.

  4. 78 FR 14848 - Duties of Brokers, Dealers, and Investment Advisers

    Science.gov (United States)

    2013-03-07

    ...'') (opposing the Study's findings and, among other things, stating that ``stronger analytical and empirical... recognize that retail customers are unlikely to have significant empirical and quantitative information. We... interest\\21\\ and disclosure practices of investment advisers and broker-dealers, as well as the economics...

  5. Strategies for Advising Disabled Students for Postsecondary Education. [Update.

    Science.gov (United States)

    Hartman, Rhona C.; Baker, Bonnie

    This fact sheet suggests several strategies for counseling students with disabilities who are considering postsecondary education opportunities. It was designed to assist those who advise or counsel students with disabilities in high school, community and junior colleges, career training schools, vocational technical schools, 4-year colleges,…

  6. Leadership Development in Digital Spaces Through Mentoring, Coaching, and Advising.

    Science.gov (United States)

    Guthrie, Kathy L; Meriwether, Jason L

    2018-06-01

    The increasing population of students engaging in online and digital spaces poses unique leadership development challenges in mentoring, coaching, and advising. This chapter discusses the importance of using digital spaces for leadership development and students' sense of belonging. © 2018 Wiley Periodicals, Inc.

  7. Assessing Student Leadership Development From Mentoring, Coaching, and Advising.

    Science.gov (United States)

    Bureau, Daniel A; Lawhead, Justin

    2018-06-01

    Leadership educators must demonstrate the contributions their programs make to the learning and development of students. This chapter provides an overview of assessment principles for educators to apply in their practices of mentoring, coaching, and advising. © 2018 Wiley Periodicals, Inc.

  8. Customer loyalty guidelines for independent financial advisers in South Africa

    Directory of Open Access Journals (Sweden)

    Estelle van Tonder

    2016-04-01

    Research purpose: The purpose of this study was to develop guidelines for creating customer loyalty towards independent financial advisers in South Africa. Motivation: To succeed, financial advisers need to build good relationships with clients and ensure they remain loyal to them in the long term. Research design, approach and method: A convenience non-probability sampling technique was applied, and altogether 262 self-administered questionnaires were completed and used in the analysis. Descriptive and standard multiple regression analysis and the one-way analysis of variance (ANOVA technique were used to test four hypotheses formulated for the study. Main findings: Relationship commitment must be established in a trustworthy environment, regardless of the type of province where the business is operated. Practical/managerial implications: In urban provinces (such as Gauteng both trusting relationships and commitment could lead to customer loyalty; in semi-urban provinces (such as North-West only the commitment variable might do so. Independent financial advisers in both provinces should explore additional factors that could foster customer loyalty. Contributions: The research findings of this study challenge the seminal work of Morgan and Hunt (1994 by establishing that in South Africa, the extent to which trust and commitment predicts customer loyalty is specific to both industrial and geographical location. This study further provides customer loyalty guidelines for independent financial advisers in South Africa.

  9. 75 FR 41017 - Political Contributions by Certain Investment Advisers

    Science.gov (United States)

    2010-07-14

    ... by which public contracts are awarded. Similarly, investment advisers that seek to influence... enterprise corruption and State securities fraud for selling access to management of public funds in return... the award of advisory contracts by public pension plans, by making political contributions to, or...

  10. The Implementation and Results of the Academic Administration System in the Center for Education Quality Development Network under the Jurisdiction of the Office of the Basic Education Commission of Thailand

    Science.gov (United States)

    Ruanglae, Phumiphat; Sirisuthi, Chaiyuth; Weangsamoot, Visoot

    2017-01-01

    This purpose of this study was twofold. The researcher aimed to investigate the implementation results of the academic administration system in the Center for Education Quality Development Network under the jurisdiction of the Office of the Basic Education Commission of Thailand and to design the Actions Research which can be effectively utilized…

  11. Evaluating the value of a web-based natural medicine clinical decision tool at an academic medical center

    Directory of Open Access Journals (Sweden)

    Karpa Kelly

    2011-10-01

    Full Text Available Abstract Background Consumer use of herbal and natural products (H/NP is increasing, yet physicians are often unprepared to provide guidance due to lack of educational training. This knowledge deficit may place consumers at risk of clinical complications. We wished to evaluate the impact that a natural medicine clinical decision tool has on faculty attitudes, practice experiences, and needs with respect to H/NP. Methods All physicians and clinical staff (nurse practitioners, physicians assistants (n = 532 in departments of Pediatrics, Family and Community Medicine, and Internal Medicine at our medical center were invited to complete 2 electronic surveys. The first survey was completed immediately before access to a H/NP clinical-decision tool was obtained; the second survey was completed the following year. Results Responses were obtained from 89 of 532 practitioners (16.7% on the first survey and 87 of 535 (16.3% clinicians on the second survey. Attitudes towards H/NP varied with gender, age, time in practice, and training. At baseline, before having an evidence-based resource available, nearly half the respondents indicated that they rarely or never ask about H/NP when taking a patient medication history. The majority of these respondents (81% indicated that they would like to learn more about H/NP, but 72% admitted difficulty finding evidence-based information. After implementing the H/NP tool, 63% of database-user respondents indicated that they now ask patients about H/NP when taking a drug history. Compared to results from the baseline survey, respondents who used the database indicated that the tool significantly increased their ability to find reliable H/NP information (P Conclusions Our results demonstrate healthcare provider knowledge and confidence with H/NP can be improved without costly and time-consuming formal H/NP curricula. Yet, it will be challenging to make providers aware of such resources.

  12. The relationship between participation in student-centered discussions and the academic achievement of fifth-grade science students

    Science.gov (United States)

    Mathues, Patricia Kelly

    Although the social constructivist theory proposed by Vygotsky states the value of discourse as a contribution to the ability of the learner to create meaning, student-led discussions have often been relegated to the language arts classroom. The standards created by the National Council of Teachers of English and the International Reading Association have long recognized that learners create meaning in a social context. The National Science Education Standards have also challenged science teachers to facilitate discourse. However, the science standards document provides no specific structure through which such discourse should be taught. This study investigated the effectiveness of a discussion strategy provided by Shoop and Wright for teaching and conducting student-centered discussions (SCD). Fifth graders in one school were randomly selected and randomly assigned to one of two science classes; 22 students in one class learned and applied the SCD strategies while a second class with 19 students learned the same science concepts from a teacher using traditional methods as described by Cazden. This study used a pretest-posttest design to test the hypothesis that participation in SCD's would effect a difference in fifth-graders' abilities to comprehend science concepts. Results of independent-samples t-tests showed that while there was no significant difference between the mean ability scores of the two groups of subjects as measured by a standardized mental abilities test, the mean pretest score of the traditional group was significantly higher than the SCD group's mean pretest score. ANCOVA procedures demonstrated that the SCD group's mean posttest score was significantly higher than the mean posttest score of the traditional group. Data analysis supported the rejection of the null hypothesis. The investigator concluded that the SCD methodology contributed to students' understanding of the science concepts. Results of this study challenge content area teachers to

  13. 75 FR 77190 - Exemptions for Advisers to Venture Capital Funds, Private Fund Advisers With Less Than $150...

    Science.gov (United States)

    2010-12-10

    ... capital investment. Often these companies are formed from ideas and entrepreneurs that come out of... Companies 2. Management Involvement 3. Limitation on Leverage 4. No Redemption Rights 5. Represents Itself... and (iii) does not act as an investment adviser to a registered investment company or a company that...

  14. Emetogenicity-risk procedures in same day surgery center of an academic university hospital in United States: a retrospective cost-audit of postoperative nausea vomiting management.

    Science.gov (United States)

    Gupta, Deepak; Haber, Halim

    2014-06-01

    Despite the variable results of published studies, it is imperative for ambulatory surgery centers to self-audit local cost-implications for post-operative nausea and vomiting (PONV) management. Our retrospective cost-audit assessed if there were comparative peri-anesthesia care cost-trends among patients who had undergone Low-Emetogenicity-Risk Procedures (LERP), Moderate-Emetogenicity-Risk Procedures (MERP) and Severe-Emetogenicity-Risk Procedures (SERP). This study was a review of Same Day Surgery Center practices in an academic university hospital setting during a three-year period (2010-2012). The patient lists were accessed from CIS and CITRIX App Bar for time audit and OR (operating room) schedule reports. Subsequently, OR pharmacy department ran a search for peri-operative anti-emetics and opioids that were billed for the patients at Same Day Surgery Center for the review period. The primary outcomes were the comparative costs/charges of these medications and comparative durations/ charges for these patients' stay in the post-anesthesia care unit (PACU). Secondary outcomes analyzed in the study included peri-anesthesia durations. A total of 8,657 patient records were analyzed. Almost all analyzed variables revealed statistically significant inter-variable positive correlations. The patients' age was significantly (P < 0.001) different among LERP/MERP/SERP patients (LERP: 48.8 +/- 14.7 years; MERP: 61.8 +/- 14.6 years; SERP: 51.3 +/- 14.5 years). In regards to primary and secondary outcomes, the statistical significant differences among LERP/MERP/SERP patients (after correcting for both patients' age as well as patients' sex) were only achieved for preoperative times (P = 0.002; Power = 0.9), operating room recovery times (P = 0.003; Power = 0.9), PACU stay times (P < 0.001; Power = 1.0), and PACU charges (P < 0.001; Power = 1.0). PACU stay times and PACU charges were significantly higher in patients who had undergone SERP as compared to patients who had

  15. Increased Adoption of Quality Improvement Interventions to Implement Evidence-Based Practices for Pressure Ulcer Prevention in U.S. Academic Medical Centers.

    Science.gov (United States)

    Padula, William V; Mishra, Manish K; Makic, Mary Beth F; Wald, Heidi L; Campbell, Jonathan D; Nair, Kavita V; Valuck, Robert J

    2015-12-01

    In 2008, the U.S. Centers for Medicare and Medicaid Services enacted a nonpayment policy for stage III and IV hospital-acquired pressure ulcers (HAPUs), which incentivized hospitals to improve prevention efforts. In response, hospitals looked for ways to support implementation of evidence-based practices for HAPU prevention, such as adoption of quality improvement (QI) interventions. The objective of this study was to quantify adoption patterns of QI interventions for supporting evidence-based practices for HAPU prevention. This study surveyed wound care specialists working at hospitals within the University HealthSystem Consortium. A questionnaire was used to retrospectively describe QI adoption patterns according to 25 HAPU-specific QI interventions into four domains: leadership, staff, information technology (IT), and performance and improvement. Respondents indicated QI interventions implemented between 2007 and 2012 to the nearest quarter and year. Descriptive statistics defined patterns of QI adoption. A t-test and statistical process control chart established statistically significant increase in adoption following nonpayment policy enactment in October 2008. Increase are described in terms of scope (number of QI domains employed) and scale (number of QI interventions within domains). Fifty-three of the 55 hospitals surveyed reported implementing QI interventions for HAPU prevention. Leadership interventions were most frequent, increasing in scope from 40% to 63% between 2008 and 2012; "annual programs to promote pressure ulcer prevention" showed the greatest increase in scale. Staff interventions increased in scope from 32% to 53%; "frequent consult driven huddles" showed the greatest increase in scale. IT interventions increased in scope from 31% to 55%. Performance and improvement interventions increased in scope from 18% to 40%, with "new skin care products . . ." increasing the most. Academic medical centers increased adoption of QI interventions

  16. Preventing and responding to complaints of sexual harassment in an academic health center: a 10-year review from the Medical University of South Carolina.

    Science.gov (United States)

    Best, Connie L; Smith, Daniel W; Raymond, John R; Greenberg, Raymond S; Crouch, Rosalie K

    2010-04-01

    There is a high incidence of sexual harassment and gender discrimination in academic health center (AHC) settings according to multiple surveys of medical students. Therefore, it is incumbent on AHCs to develop programs both to educate faculty, residents, and students and to handle complaints of possible episodes of sexual harassment or gender discrimination. Despite the apparent high prevalence of gender discrimination and sexual harassment, and the importance of handling complaints of gender discrimination and sexual harassment in a prompt, consistent, and rational manner, there are few descriptions of programs that address those concerns in AHCs.Herein, the authors describe their experiences in dealing with complaints of sexual harassment and gender discrimination for a 10-year period of time (late 1997 to early 2007) at the Medical University of South Carolina, through an Office of Gender Equity. They describe their complaint process, components of their prevention training, and the outcomes of 115 complaints. Key elements of their policies are highlighted. The authors offer an approach that could serve as a model for other AHCs.

  17. Integrating Quality Improvement and Continuing Professional Development at an Academic Medical Center: A Partnership Between Practice Plan, Hospital, and Medical School.

    Science.gov (United States)

    Gold, Barbara; England, Dawn; Riley, William; Jacobs-Halsey, Ginny; Webb, Corinne; Daniels, Bobbi

    2016-01-01

    While quality improvement (QI) initiatives can be a highly effective means for improving health care delivery in academic medical centers (AMCs), many health care professionals are not formally trained in basic QI methodology, engaging clinicians in QI activities can be challenging, and there is often a lack of integration and coordination among QI functions (eg, Departments of Quality and Safety, Continuing Professional Development). In our AMC, we undertook a collaborative approach to achieve better vertical and horizontal integration of our QI education efforts. This article provides a case example describing our organizational context, what was done, and with what effect and makes our example and lessons learned available to others. We developed a new educational QI program that was jointly planned and implemented by a group comprising major QI stakeholders. This project was intended to create horizontal organizational linkages between continuing professional development, clinicians, the hospital, and QI department and produce QI activities that aligned with the strategic objectives of senior management. The group developed and implemented a curriculum based on Lean methodology and concepts from the Institute for Health Care Improvement Model for Improvement. Two cohorts (27 teams) completed the training and planned and implemented QI projects. All projects were aligned with organizational quality, safety, and patient experience goals. The majority of projects met their aim statements. This case description provides an example of successful horizontal integration of an AMCs' QI functions to disseminate knowledge and implement meaningful QI aligned with strategic objectives (vertical integration).

  18. Application of the balanced scorecard to an academic medical center in Taiwan: the effect of warning systems on improvement of hospital performance.

    Science.gov (United States)

    Chen, Hsueh-Fen; Hou, Ying-Hui; Chang, Ray-E

    2012-10-01

    The balanced scorecard (BSC) is considered to be a useful tool for management in a variety of business environments. The purpose of this article is to utilize the experimental data produced by the incorporation and implementation of the BSC in hospitals and to investigate the effects of the BSC red light tracking warning system on performance improvement. This research was designed to be a retrospective follow-up study. The linear mixed model was applied for correcting the correlated errors. The data used in this study were secondary data collected by repeated measurements taken between 2004 and 2010 by 67 first-line medical departments of a public academic medical center in Taipei, Taiwan. The linear mixed model of analysis was applied for multilevel analysis. Improvements were observed with various time lags, from the subsequent month to three months after red light warning. During follow-up, the red light warning system more effectively improved controllable costs, infection rates, and the medical records completion rate. This further suggests that follow-up management promotes an enhancing and supportive effect to the red light warning. The red light follow-up management of BSC is an effective and efficient tool where improvement depends on ongoing and consistent attention in a continuing effort to better administer medical care and control costs. Copyright © 2012. Published by Elsevier B.V.

  19. Using an evidence-based approach for system selection at a large academic medical center: lessons learned in selecting an ambulatory EMR at Mount Sinai Hospital.

    Science.gov (United States)

    Kannry, Joseph; Mukani, Sonia; Myers, Kristin

    2006-01-01

    The experience of Mount Sinai Hospital is representative of the challenges and problems facing large academic medical centers in selecting an ambulatory EMR. The facility successfully revived a stalled process in a challenging financial climate, using a framework of science and rigorous investigation. The process incorporated several innovations: 1) There was a thorough review of medical informatics literature to develop a mission statement, determine practical objectives and guide the demonstration process; 2) The process involved rigorous investigation of vendor statements, industry statements and other institution's views of vendors; 3) The initiative focused on user-centric selection, and the survey instrument was scientifically and specifically designed to assess user feedback; 4) There was scientific analysis of validated findings and survey results at all steering meetings; 5) The process included an assessment of vendors' ability to support research by identifying funded and published research; 6) Selection involved meticulous total cost of ownership analysis to assess and compare real costs of implementing a vendor solution; and finally, 7) There were iterative meetings with stakeholders, executives and users to understand needs, address concerns and communicate the vision.

  20. Outline in 1997 Japan compound material academic meeting technological prize winning technology; Kenchiku, doboku kozobutsu no hoshu{center_dot}hokyo yo forukatousito no kaihatsu

    Energy Technology Data Exchange (ETDEWEB)

    Iba, Yoshitomo.; Uemura, Masahiko.; Murakami, Shinkichi.; Saito, Makoto.; Kobayashi, Akira. [Nittetsu Composite Corp., Tokyo (Japan)

    1999-03-15

    That function declines in the sutra time target, and it is finally destroyed, or a construction structure thing bears putting off that life by managing efficient maintenance it is possible. The factor of the function decline of the structure thing, the degree of the decline, and so on are grasped quantitatively, and efficient repair reinforcement time and a method of construction are chosen, and you must carry it out for that. It is paying attention to the development of the method of construction to reinforce the maintenance repair of the construction structure thing by using the tip compound factor from such a viewpoint. In the beginning, a material cost was very expensive, and the recognition not to use it was very general in such a construction field. In such recognition, in Tonen Corp. incorporated company, it has paid attention to the use possibility in the construction field of the tip compound factor since early, research and development have been done continuously from 1980, that It succeeds in, and it is the method of construction that a repair reinforces a concrete structure thing by the tip material that the method of construction which got the technological prize of the Japan compound material academic meeting in 1997 moved carbon fiber to the center. (NEDO)

  1. Outline in 1997 Japan compound material academic meeting technological prize winning technology. Kenchiku, doboku kozobutsu no hoshu[center dot]hokyo yo forukatousito no kaihatsu

    Energy Technology Data Exchange (ETDEWEB)

    Iba, Yoshitomo.; Uemura, Masahiko.; Murakami, Shinkichi.; Saito, Makoto.; Kobayashi, Akira. (Nittetsu Composite Corp., Tokyo (Japan))

    1999-03-15

    That function declines in the sutra time target, and it is finally destroyed, or a construction structure thing bears putting off that life by managing efficient maintenance it is possible. The factor of the function decline of the structure thing, the degree of the decline, and so on are grasped quantitatively, and efficient repair reinforcement time and a method of construction are chosen, and you must carry it out for that. It is paying attention to the development of the method of construction to reinforce the maintenance repair of the construction structure thing by using the tip compound factor from such a viewpoint. In the beginning, a material cost was very expensive, and the recognition not to use it was very general in such a construction field. In such recognition, in Tonen Corp. incorporated company, it has paid attention to the use possibility in the construction field of the tip compound factor since early, research and development have been done continuously from 1980, that It succeeds in, and it is the method of construction that a repair reinforces a concrete structure thing by the tip material that the method of construction which got the technological prize of the Japan compound material academic meeting in 1997 moved carbon fiber to the center. (NEDO)

  2. A nonresident cardiovascular inpatient service improves residents' experiences in an academic medical center: a new model to meet the challenges of the new millennium.

    Science.gov (United States)

    Nishimura, Rick A; Linderbaum, Jane A; Naessens, James M; Spurrier, Barbara; Koch, Mark B; Gaines, Kim A

    2004-05-01

    Hospital practices in academic medical centers have fewer medical residents available to provide hospital care, necessitating alternative models for patient care. This article reports a new model for care of inpatients with cardiovascular diseases. In 1998, a new nonresident cardiovascular patient care (Cardiology IV) service was implemented that used a team approach of staff attending cardiologists, cardiovascular fellows, midlevel practitioners (nurse practitioners and physician's assistants), and nurses to evaluate and treat patients. Standard dismissal information was collected for all patients dismissed in 1998 to compare diagnosis-related group, length of stay, in-hospital mortality, and 30-day readmission rates for Cardiology IV. These characteristics were compared with those for the remaining resident teaching services. Patients' satisfaction surveys from 1997 and 1998 were compared. Attending physicians' and internal medicine residents' satisfaction before and after the implementation of the new service was also compared. Staff and resident physicians were more satisfied with their hospital rotations after this intervention was introduced. Optimal patient care was maintained, and efficiency enhanced. Patients on Cardiology IV had a shorter length of stay compared with patients on the resident teaching service. This new hospital model has provided an alternative to patient care without the need for residents and protects education on the conventional teaching services. This model maintains optimal patient care and has resulted in enhanced satisfaction of attending staff and residents.

  3. Implementing a national program to reduce catheter-associated urinary tract infection: a quality improvement collaboration of state hospital associations, academic medical centers, professional societies, and governmental agencies.

    Science.gov (United States)

    Fakih, Mohamad G; George, Christine; Edson, Barbara S; Goeschel, Christine A; Saint, Sanjay

    2013-10-01

    Catheter-associated urinary tract infection (CAUTI) represents a significant proportion of healthcare-associated infections (HAIs). The US Department of Health and Human Services issued a plan to reduce HAIs with a target 25% reduction of CAUTI by 2013. Michigan's successful collaborative to reduce unnecessary use of urinary catheters and CAUTI was based on a partnership between diverse hospitals, the state hospital association (SHA), and academic medical centers. Taking the lessons learned from Michigan, we are now spreading this work throughout the 50 states. This national spread leverages the expertise of different groups and organizations for the unified goal of reducing catheter-related harm. The key components of the project are (1) centralized coordination of the effort and dissemination of information to SHAs and hospitals, (2) data collection based on established definitions and approaches, (3) focused guidance on the technical practices that will prevent CAUTI, (4) emphasis on understanding the socioadaptive aspects (both the general, unit-wide issues and CAUTI-specific challenges), and (5) partnering with specialty organizations and governmental agencies who have expertise in the relevant subject area. The work may serve in the future as a model for other large improvement efforts to address other hospital-acquired conditions, such as venous thromboembolism and falls.

  4. Implementation and quality assessment of a pharmacy services call center for outpatient pharmacies and specialty pharmacy services in an academic health system.

    Science.gov (United States)

    Rim, Matthew H; Thomas, Karen C; Chandramouli, Jane; Barrus, Stephanie A; Nickman, Nancy A

    2018-04-02

    The implementation and quality assessment of a pharmacy services call center (PSCC) for outpatient pharmacies and specialty pharmacy services within an academic health system are described. Prolonged wait times in outpatient pharmacies or hold times on the phone affect the ability of pharmacies to capture and retain prescriptions. To support outpatient pharmacy operations and improve quality, a PSCC was developed to centralize handling of all outpatient and specialty pharmacy calls. The purpose of the PSCC was to improve the quality of pharmacy telephone services by (1) decreasing the call abandonment rate, (2) improving the speed of answer, (3) increasing first-call resolution, (4) centralizing all specialty pharmacy and prior authorization calls, (5) increasing labor efficiency and pharmacy capacities, (6) implementing a quality evaluation program, and (7) improving workplace satisfaction and retention of outpatient pharmacy staff. The PSCC centralized pharmacy calls from 9 pharmacy locations, 2 outpatient clinics, and a specialty pharmacy. Since implementation, the PSCC has achieved and maintained program goals, including improved abandonment rate, speed of answer, and first-call resolution. A centralized 24-7 support line for specialty pharmacy patients was also successfully established. A quality calibration program was implemented to ensure service quality and excellent patient experience. Additional ongoing evaluations measure the impact of the PSCC on improving workplace satisfaction and retention of outpatient pharmacy staff. The design and implementation of the PSCC have significantly improved the health system's patient experiences, efficiency, and quality. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  5. Race/Ethnicity, Primary Language, and Income Are Not Demographic Drivers of Mortality in Breast Cancer Patients at a Diverse Safety Net Academic Medical Center

    Directory of Open Access Journals (Sweden)

    Divya A. Parikh

    2015-01-01

    Full Text Available Objective. To examine the impact of patient demographics on mortality in breast cancer patients receiving care at a safety net academic medical center. Patients and Methods. 1128 patients were diagnosed with breast cancer at our institution between August 2004 and October 2011. Patient demographics were determined as follows: race/ethnicity, primary language, insurance type, age at diagnosis, marital status, income (determined by zip code, and AJCC tumor stage. Multivariate logistic regression analysis was performed to identify factors related to mortality at the end of follow-up in March 2012. Results. There was no significant difference in mortality by race/ethnicity, primary language, insurance type, or income in the multivariate adjusted model. An increased mortality was observed in patients who were single (OR = 2.36, CI = 1.28–4.37, p=0.006, age > 70 years (OR = 3.88, CI = 1.13–11.48, p=0.014, and AJCC stage IV (OR = 171.81, CI = 59.99–492.06, p<0.0001. Conclusions. In this retrospective study, breast cancer patients who were single, presented at a later stage, or were older had increased incidence of mortality. Unlike other large-scale studies, non-White race, non-English primary language, low income, or Medicaid insurance did not result in worse outcomes.

  6. How to Reduce Head CT Orders in Children with Hydrocephalus Using the Lean Six Sigma Methodology: Experience at a Major Quaternary Care Academic Children's Center.

    Science.gov (United States)

    Tekes, A; Jackson, E M; Ogborn, J; Liang, S; Bledsoe, M; Durand, D J; Jallo, G; Huisman, T A G M

    2016-06-01

    Lean Six Sigma methodology is increasingly used to drive improvement in patient safety, quality of care, and cost-effectiveness throughout the US health care delivery system. To demonstrate our value as specialists, radiologists can combine lean methodologies along with imaging expertise to optimize imaging elements-of-care pathways. In this article, we describe a Lean Six Sigma project with the goal of reducing the relative use of pediatric head CTs in our population of patients with hydrocephalus by 50% within 6 months. We applied a Lean Six Sigma methodology using a multidisciplinary team at a quaternary care academic children's center. The existing baseline imaging practice for hydrocephalus was outlined in a Kaizen session, and potential interventions were discussed. An improved radiation-free workflow with ultrafast MR imaging was created. Baseline data were collected for 3 months by using the departmental radiology information system. Data collection continued postintervention and during the control phase (each for 3 months). The percentage of neuroimaging per technique (head CT, head ultrasound, ultrafast brain MR imaging, and routine brain MR imaging) was recorded during each phase. The improved workflow resulted in a 75% relative reduction in the percentage of hydrocephalus imaging performed by CT between the pre- and postintervention/control phases (Z-test, P = .0001). Our lean interventions in the pediatric hydrocephalus care pathway resulted in a significant reduction in head CT orders and increased use of ultrafast brain MR imaging. © 2016 by American Journal of Neuroradiology.

  7. An academic hospitalist model to improve healthcare worker communication and learner education: Results from a quasi-experimental study at a veterans affairs medical center

    Science.gov (United States)

    Saint, Sanjay; Fowler, Karen E; Krein, Sarah L; Flanders, Scott A; Bodnar, Timothy W; Young, Eric; Moseley, Richard H

    2013-01-01

    BACKGROUND Although hospitalists may improve efficiency and quality of inpatient care, their effect on healthcare-worker communication and education has been less well-studied. OBJECTIVE To test various approaches to improving healthcare-worker communication and learner education within the context of a newly designed academic hospital medicine program. DESIGN Before-and-after design with concurrent control group. SETTING A Midwestern Veterans Affairs medical center. INTERVENTION Multimodal systems redesign of 1 of 4 medical teams (Gold team) that included clinical modifications (change in rounding structure, with inclusion of nurses, a Clinical Care Coordinator, and a pharmacist) and educational interventions (providing explicit expectations of learners and providing a reading list for both learners and attending physicians). MEASUREMENTS Number of admissions, length of stay, readmissions, house officer and medical student ratings of attendings' teaching, medical student internal medicine National Board of Medical Examiners Subject Examination (“shelf” exam) scores, and clinical staff surveys. RESULTS Length of stay was reduced by about 0.3 days on all teams after the initiative began (P = 0.004), with no significant differences between Gold and non-Gold teams. The majority of physicians (83%) and nurses (68%) felt that including nurses during rounds improved healthcare-worker communication; significantly more nurses were satisfied with communication with the Gold team than with the other teams (71% vs 53%; P = 0.02). Gold attendings generally received higher teaching scores compared with non-Gold attendings, and third-year medical students on the Gold team scored significantly higher on the shelf exam compared with non–Gold team students (84 vs 82; P = 0.006). CONCLUSIONS Academic hospitalists working within a systems redesign intervention were able to improve healthcare-worker communication and enhance learner education without increasing

  8. Advising Practices: A Survey of Self-Access Learner Motivations and Preferences

    Directory of Open Access Journals (Sweden)

    Leander S. Hughes, Nathan P. Krug, and Stacey L. Vye

    2012-06-01

    Full Text Available Based on queries from students who frequently visit the English Resource Center (ERC at Saitama University, this research team set out to examine what motivational factors encourage ERC attendees to participate for an extended period of time in the Center on a regular basis. Initial indications are that social collaborative learning amongst peers at the Center is the most significant long-term motivational factor for students to become involved with learning English in the ERC. More specifically, this study explores factors that encourage these learners to become regular and perhaps more autonomous center participants in terms of advising practices such as (a what factors led students to their initial discovery of ERC, (b what inspired that very first visit, (c what encouraged learners to continue to attend the Center on a regular basis, (d what attendees value about the ERC, and finally (e what might be done to ensure that greater support is provided for students who come to the ERC for the first time.

  9. Lean principles to optimize instrument utilization for spine surgery in an academic medical center: an opportunity to standardize, cut costs, and build a culture of improvement.

    Science.gov (United States)

    Lunardini, David; Arington, Richard; Canacari, Elena G; Gamboa, Kelly; Wagner, Katiri; McGuire, Kevin J

    2014-09-15

    Case study OBJECTIVE.: To optimize the utilization of operating room instruments for orthopedic and neurosurgical spine cases in an urban level 1 academic medical center through application of Lean principles. Process improvement systems such as Lean have been adapted to health care and offer an opportunity for frank assessment of surgical routines to increase efficiency and enhance value. The goal has been to safely reduce the financial burden to the health care system without compromising care and if possible reallocate these resources or gains in efficiency to further improve the value to the patient. The investigators identified instruments as a source of waste in the operating room and proposed a Lean process assessment. The instruments and the instrument processing workflow were described. An audit documented the utilization of each instrument by orthopedic surgeons and neurosurgeons through observation of spine cases. The data were then presented to the stakeholders, including surgeons, the perioperative director, and representatives from nursing, central processing, and the surgical technicians. Of the 38 cases audited, only 89 (58%) of the instruments were used at least once. On the basis of the data and stakeholder consensus, 63 (41%) of the instruments were removed, resulting in a weight reduction of 17.5 lb and consolidation of 2 instrument sets into 1. Projected cost savings were approximately $41,000 annually. Although new instruments were purchased to standardize sets, the return on investment was estimated to be 2 years. Inefficient surgical routines may comprise significant resource waste in an institution. Process assessment is an important tool in decreasing health care costs, with objectivity provided by Lean or similar principles, and essential impetus to change provided by stakeholders. 4.

  10. Impact of tissue-based genomic profiling on clinical decision making in the management of patients with metastatic breast cancer at academic centers.

    Science.gov (United States)

    Santa-Maria, Cesar A; Kruse, Megan; Raska, Paola; Weiss, Mia; Swoboda, April; Mutonga, Martin B; Abraham, Jame; Jain, Sarika; Nanda, Rita; Montero, Alberto J

    2017-11-01

    Genomic profiling can identify targetable mutations; however, the impact of tissue-based genomic profiling on clinical decision making for patients with metastatic breast cancer has not been well characterized. Patients with stage IV breast cancer who had undergone genomic profiling between 7/2013 and 3/2015 were identified at three academic cancer centers. Genomic analysis was determined to have impacted clinical decision if (A) a patient was enrolled onto a genotype-matched clinical trial or (B) prescribed off-label an FDA-approved therapy targeting an identified mutation. The frequency of mutated genes was determined. A total of 117 patients with stage IV breast cancer were identified. Median age was 46 (25-75). Fifty-three patients (45%) had ER-positive/HER2-negative disease, 50 (43%) had ER-negative/HER2-negative disease, and 14 (12%) had ER-any/HER2-positive disease. Median number of previous therapies received prior to genomic profiling was 2 (range 0-15), and median follow-up after testing was obtained after 5.8 months (range 0-24.4 months). Commercial reports indicated that 85 (73%) patients had at least one mutation targetable by an FDA-approved medication, and 112 (96%) patients had at least one clinical trial available; however, clinical management was only affected in 11 patients (9%). The most frequent mutations observed were those in TP53, FGF, PI3KCA, MYC, ZNF, FGFR, CCND, ARID1A, GATA3, and MAP; frequencies of these mutations varied by clinical subtype. Tumor genomic profiling affected clinical management in a minority of patients with metastatic breast cancer, thus these data do not support the routine use of genomic profiling outside of a clinical trial.

  11. Impact of around-the-clock in-house cardiology fellow coverage on door-to-balloon time in an academic medical center

    Science.gov (United States)

    Kohan, Luke C; Nagarajan, Vijaiganesh; Millard, Michael A; Loguidice, Michael J; Fauber, Nancy M; Keeley, Ellen C

    2017-01-01

    Objectives To assess if a change in our cardiology fellowship program impacted our ST elevation myocardial infarction (STEMI) program. Background Fellows covering the cardiac care unit were spending excessive hours in the hospital while on call, resulting in increased duty hours violations. A night float fellow system was started on July 1, 2012, allowing the cardiac care unit fellow to sign out to a night float fellow at 5:30 pm. The night float fellow remained in-house until the morning. Methods We performed a retrospective study assessing symptom onset to arrival, arterial access to first device, and door-to-balloon (D2B) times, in consecutive STEMI patients presenting to our emergency department before and after initiation of the night float fellow system. Results From 2009 to 2013, 208 STEMI patients presented to our emergency department and underwent primary percutaneous coronary intervention. There was no difference in symptom onset to arrival (150±102 minutes vs 154±122 minutes, p=0.758), arterial access to first device (12±8 minutes vs 11±7 minutes, p=0.230), or D2B times (50±32 minutes vs 52±34 minutes, p=0.681) during regular working hours. However, there was a significant decrease in D2B times seen during off-hours (72±33 minutes vs 49±15 minutes, p=0.007). There was no difference in in-hospital mortality (11% vs 8%, p=0.484) or need for intra-aortic balloon pump placement (7% vs 8%, p=0.793). Conclusion In academic medical centers, in-house cardiology fellow coverage during off-hours may expedite care of STEMI patients. PMID:28458558

  12. Association of cancer-related mortality, age and gonadectomy in golden retriever dogs at a veterinary academic center (1989-2016.

    Directory of Open Access Journals (Sweden)

    Michael S Kent

    Full Text Available Golden retriever dogs have been reported to have an increased prevalence of cancer compared to other breeds. There is also controversy over the effect spay or neuter status might have on longevity and the risk for developing cancer. The electronic medical records system at an academic center was searched for all dogs who had a necropsy exam from 1989-2016. 9,677 canine necropsy examinations were completed of which 655 were golden retrievers. Age was known for 652 with a median age of death 9.15 years. 424 of the 652 (65.0% were determined to have died because of cancer. The median age for dying of a cause other than cancer was 6.93 years while those dying of cancer had a median age of 9.83 years (p<0.0001. There was no significant difference in the proportion of intact males and castrated males dying of cancer (p = 0.43 but a greater proportion of spayed females died of cancer compared to intact females (p = 0.001. Intact female dogs had shorter life spans than spayed female dogs (p<0.0001, but there were no differences between intact and castrated males. Intriguingly, being spayed or neutered did not affect the risk of a cancer related death but increasing age did. The most common histologic diagnosis found in golden retrievers dying of cancer was hemangiosarcoma (22.64% followed by lymphoid neoplasia (18.40%. Overall golden retriever dogs have a substantial risk of cancer related mortality in a referral population and age appears to have a larger effect on cancer related mortality than reproductive status.

  13. The Academic Medical Center Linear Disability Score for evaluation of physical reserve on admission to the ICU: can we query the relatives?

    Science.gov (United States)

    Hofhuis, José G M; Dijkgraaf, Marcel G W; Hovingh, Aly; Braam, Richard L; van de Braak, Lisa; Spronk, Peter E; Rommes, Johannes H

    2011-01-01

    Evaluating the pre-morbid functional status in critically ill patients is important and frequently done using the physical component score (PCS) of the Short Form 36, although this approach has its limitations. The Academic Medical Center Linear Disability Score (ALDS) is a recently developed generic item bank used to measure the disability status of patients with a broad range of diseases. We aimed to study whether proxy scoring with the ALDS could be used to assess the patients' functional status on admission for cardiac care unit (CCU) or ICU patients and how the ALDS relates to the PCS using the Short Form 12 (SF-12). Patients and proxies completed the ALDS and SF-12 score in the first 72 hours following ICU scheduled surgery (n = 14), ICU emergency admission (n = 56) and CCU emergency admission (n = 70). In all patients (n = 140) a significant intra-class correlation was found for the ALDS (0.857), the PCS (0.798) and the mental component score (0.679) between patients and their proxy. In both scheduled and emergency admissions, a significant correlation was found between patients and their proxy for the ALDS, although the lowest correlation was found for the ICU scheduled admissions (0.755) compared with the ICU emergency admissions (0.889). In CCU patients, the highest significant correlation between patients and proxies was found for the ALDS (0.855), for the PCS (0.807) and for the mental component score (0.740). Relatives in close contact with critically ill patients can adequately reflect the patient's level of disability on ICU and CCU admission when using the ALDS item bank, which performed at least as well as the PCS. The ALDS could therefore be a useful alternative for the PCS of the SF-12.

  14. Comparison of clinicopathologic variables in coexistence cancers of the endometrium and ovary: A review of 55 cases in an academic center in Iran

    Directory of Open Access Journals (Sweden)

    Hossein Sadidi

    2015-01-01

    Full Text Available Background: The coexistence primary cancers of the endometrium and ovary are relatively uncommon. The purpose of this study was to characterize patients diagnosed primary synchronous endometrial and ovarian cancer (SEOC, endometrial cancer (EC with ovarian metastasis, and ovarian cancer (OC with endometrial metastasis and compare clinicopathologic variables and prognosis. Materials and Methods: All the patients with diagnosis of both endometrium and OC, who hospitalized between 2002 and 2012 in an academic center affiliated to Tehran University of Medical Sciences, were evaluated with respect to different clinicopathologic variables, follow-up times, and outcomes. Results: Fifty-five patients had been diagnosed with both endometrium and OC. 17, 26, and 12 patients were diagnosed as SEOC, EC, and OC, respectively. The frequency of abnormal uterine bleeding was significantly lower in OC (16.7% compared to others (58.8% in SEOC and 53.8% in EC. However, the abdominal/pelvic pain was significantly higher in OC (50% compared to others (35.3% in SEOC and 34.6% in EC (P < 0.05. Complex atypical hyperplasia (87.5%, endometriosis (88.8%, and endometrioid carcinoma (54.5% was observed most in SEOC group. The duration of follow-up time was between 3 and 171 months with a mean of 16 months. There was no death in SEOC who followed. Survivals of patients between three group were statistically significant (P = 0.032. Conclusion: Our results showed that overall survival (OS and progression-free survival (PFS of SEOC patients is better than those with EC and OC (P = 0.032.

  15. A Case Study and Analysis of a Successful and Collaborative Student-Centered Textbook Reserve Program in a Mid-Size Academic Library

    Science.gov (United States)

    Schlak, Timothy M.; Johnston, Bruce

    2018-01-01

    This article presents an innovative textbook reserve program at a mid-sized academic library. Research conducted subsequent to the program's launch showed a positive correlation between students' use of the program and their perceived academic success. In addition, the program has proved effective at helping students with college affordability.…

  16. An Organisational Architecture to Support Personalised Learning: Parents' Perspectives on the Academic Advisers

    Science.gov (United States)

    Dorrington, Jamie

    2018-01-01

    This article reports some of the findings from research conducted by the author, who was also the principal of Saint Stephen's College, a coeducational independent school in South-east Queensland. The school was in the early stages of transitioning to a new organisational architecture (the way the physical, digital and human resources are aligned)…

  17. JEA's Code of Ethics for Advisers; and Sites for Additional Ethics Information.

    Science.gov (United States)

    Bowen, John

    1997-01-01

    Lists general principles that media advisers should follow, the 12 points agreed upon as the Journalism Education Association's (JEA) Code of Ethics for Advisers, and a list of Web sites that deal with journalism ethics. (PA)

  18. [Vaping (electronic cigarette): how to advise smokers in 2017 ?

    Science.gov (United States)

    Jacot Sadowski, Isabelle; Humair, Jean-Paul; Cornuz, Jacques

    2017-06-07

    Questions about electronic cigarettes, also called electronic nicotine delivery systems (ENDS), are very common when advising patients to stop smoking in medical practice. It is widely recognized that the risks of vaping are significantly lower than those of smoking, although there are uncertainties about its long-term health effects. Some studies suggest that vaping helps to stop smoking. Effective smoking cessation medications should be recommended in first line but vaping should not be discouraged when patients choose to use this device, as the main aim is smoking cessation. This paper proposes recommendations about vaping in common situations in medical practice with smokers.

  19. Cognitive and Non-Cognitive Influences on Pre-Health College Students' Advising Utilization

    Science.gov (United States)

    O'Mealia, Melinda M.

    2017-01-01

    The purpose of this research effort was to examine the Rutgers University pre-health students' advising utilization and the association of advising to medical school admission, for 2012-2016. A variety of variables allied with the Social Cognitive Career Theory and advising practice shaped the examination framework. Specifically, the researcher…

  20. Neurofibromatosis and the role of the specialist adviser.

    Science.gov (United States)

    Redman, Carolyn

    2017-09-11

    Neurofibromatosis (NF) is a genetic condition that mainly involves the nervous system. There are two types: NF1 affects about one in 2,500 of the population worldwide and NF2 affects one in 35,000. Both types result in complex health problems for patients and can pose significant challenges for all those involved in their management. Established in 1981, The Neuro Foundation is a patient-focused charity that funds a network of specialist advisers who work in partnership with the NHS to offer support and advice for families affected by NF and the professionals who care for them. With a significant level of autonomy, the specialist adviser role is flexible in matching the needs of those affected while working cooperatively alongside the national specialist services for NF1 and NF2. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  1. Analysis of vitamin D status at two academic medical centers and a national reference laboratory: result patterns vary by age, gender, season, and patient location.

    Science.gov (United States)

    Genzen, Jonathan R; Gosselin, Jennifer T; Wilson, Thomas C; Racila, Emilian; Krasowski, Matthew D

    2013-11-05

    Testing for 25-hydroxyvitamin D [25(OH)D] has increased dramatically in recent years. The present report compares overall utilization and results for 25(OH)D orders at two academic medical centers - one in New York and one in Iowa - in order to characterize the vitamin D status of our inpatient and outpatient populations. Results are also compared to those from a national reference laboratory to determine whether patterns at these two institutions reflect those observed nationally. Retrospective data queries of 25(OH)D orders and results were conducted using the laboratory information systems at Weill Cornell Medical College / New York Presbyterian Hospital (WCMC), University of Iowa Hospitals and Clinics (UIHC), and ARUP Laboratories (ARUP). Chart review was conducted for cases with very high or low serum 25(OH)D levels in the WCMC and UIHC datasets. The majority of tests were ordered on females and outpatients. Average serum 25(OH)D levels were higher in female versus male patients across most ages in the WCMC, UIHC, and ARUP datasets. As expected, average serum 25(OH)D levels were higher in outpatients than inpatients. Serum 25(OH)D levels showed seasonal periodicity, with average levels higher in summer than winter and correlating to regional UV index. Area plots demonstrated a peak of increased 25(OH)D insufficiency / deficiency in adolescent females, although overall worse 25(OH)D status was found in male versus female patients in the WCMC, UIHC, and ARUP datasets. Surprisingly, improved 25(OH)D status was observed in patients starting near age 50. Finally, chart review of WCMC and UIHC datasets revealed over-supplementation (especially of ≥ 50,000 IU weekly doses) in the rare cases of very high 25(OH)D levels. General nutritional deficiency and/or severe illness was found in most cases of severe 25(OH)D deficiency. 25(OH)D status of patients seen by healthcare providers varies according to age, gender, season, and patient location. Improved 25(OH

  2. Analysis of vitamin D status at two academic medical centers and a national reference laboratory: result patterns vary by age, gender, season, and patient location

    Science.gov (United States)

    2013-01-01

    Background Testing for 25-hydroxyvitamin D [25(OH)D] has increased dramatically in recent years. The present report compares overall utilization and results for 25(OH)D orders at two academic medical centers - one in New York and one in Iowa – in order to characterize the vitamin D status of our inpatient and outpatient populations. Results are also compared to those from a national reference laboratory to determine whether patterns at these two institutions reflect those observed nationally. Methods Retrospective data queries of 25(OH)D orders and results were conducted using the laboratory information systems at Weill Cornell Medical College / New York Presbyterian Hospital (WCMC), University of Iowa Hospitals and Clinics (UIHC), and ARUP Laboratories (ARUP). Chart review was conducted for cases with very high or low serum 25(OH)D levels in the WCMC and UIHC datasets. Results The majority of tests were ordered on females and outpatients. Average serum 25(OH)D levels were higher in female versus male patients across most ages in the WCMC, UIHC, and ARUP datasets. As expected, average serum 25(OH)D levels were higher in outpatients than inpatients. Serum 25(OH)D levels showed seasonal periodicity, with average levels higher in summer than winter and correlating to regional UV index. Area plots demonstrated a peak of increased 25(OH)D insufficiency / deficiency in adolescent females, although overall worse 25(OH)D status was found in male versus female patients in the WCMC, UIHC, and ARUP datasets. Surprisingly, improved 25(OH)D status was observed in patients starting near age 50. Finally, chart review of WCMC and UIHC datasets revealed over-supplementation (especially of ≥ 50,000 IU weekly doses) in the rare cases of very high 25(OH)D levels. General nutritional deficiency and/or severe illness was found in most cases of severe 25(OH)D deficiency. Conclusions 25(OH)D status of patients seen by healthcare providers varies according to age, gender, season

  3. Procedural Portfolio Planning in Plastic Surgery, Part 2: Collaboration Between Surgeons and Hospital Administrators to Develop a Funds Flow Model for Procedures Performed at an Academic Medical Center.

    Science.gov (United States)

    Hultman, Charles Scott

    2016-06-01

    Although plastic surgeons make important contributions to the clinical, educational, and research missions of academic medical centers (AMCs), determining the financial value of a plastic surgery service can be difficult, due to complex cost accounting systems. We analyzed the financial impact of plastic surgery on an AMC, by examining the contribution margins and operating income of surgical procedures. We collaborated with hospital administrators to implement 3 types of strategic changes: (1) growth of areas with high contribution margin, (2) curtailment of high-risk procedures with negative contribution margin, (3) improved efficiency of mission-critical services with high resource consumption. Outcome measures included: facility charges, hospital collections, contribution margin, operating margin, and operating room times. We also studied the top 50 Current Procedural Terminology codes (total case number × charge/case), ranking procedures for profitability, as determined by operating margin. During the 2-year study period, we had no turnover in faculty; did not pursue any formal marketing; did not change our surgical fees, billing system, or payer mix; and maintained our commitment to indigent care. After rebalancing our case mix, through procedural portfolio planning, average hospital operating income/procedure increased from $-79 to $+816. Volume and diversity of cases increased, with no change in payer mix. Although charges/case decreased, both contribution margin and operating margin increased, due to improved throughput and decreased operating room times. The 5 most profitable procedures for the hospital were hernia repair, mandibular osteotomy, hand skin graft, free fibula flap, and head and neck flap, whereas the 5 least profitable were latissimus breast reconstruction, craniosynostosis repair, free-flap breast reconstruction, trunk skin graft, and cutaneous free flap. Total operating income for the hospital, from plastic surgery procedures, increased

  4. A prototype expert system for advising operational procedures

    International Nuclear Information System (INIS)

    Ohi, T.; Saiki, A.; Terashita, N.; Sasaki, K.

    1990-01-01

    Development of an operator support system has come to be an important subject for Nuclear Power Plants. An expert system for advising operational procedures for nuclear power plants was developed to provide operators with adequate operation plans. The system consists of two parts. One is the operation interpretation module that uses the knowledge base of operational procudures represented in the form of an extended Petri net model. The other is the operation consultation module that uses a hierarchical qualitative model of a nuclear power plant. The structure of each knowledge base and the method of inference to generate adequate operations plan were investigated. The availability of our concept has been confirmed by the protorype system for CVCS (Chemical and Volume Control System) of PWR. This concept can be applied to the operator support system to supply operation guidance under anomalous plant conditions

  5. Proceedings of the first ADVISES Young Researchers Workshop

    DEFF Research Database (Denmark)

    2005-01-01

    , it is hoped that this will contribute to a new and more unified research agenda for the development of safety-critical, interactive systems. One of thetraining instruments is the Young Researchers Workshop, which is arranged and coordinated by the young researchers themselves. It is an event where the young......The research training network Analysis Design and Validation of Interactive Safety-critical and Error-tolerant Systems (ADVISES) focus on coaching and supervising Post Docs and Ph.D. students. The main objective is to provide a multi-disciplinary researchtraining that can combat the impact of human...... error during the design, operation and management of safety-critical, interactive systems. Additionally, the exchange of knowledge, practices, tools and experience between adjacent (but still too distinct)disciplines can lead to the efficient integration of complementary research methods. Ultimately...

  6. Academic Blogging: Academic Practice and Academic Identity

    Science.gov (United States)

    Kirkup, Gill

    2010-01-01

    This paper describes a small-scale study which investigates the role of blogging in professional academic practice in higher education. It draws on interviews with a sample of academics (scholars, researchers and teachers) who have blogs and on the author's own reflections on blogging to investigate the function of blogging in academic practice…

  7. Swedish energy advisers' perceptions regarding and suggestions for fulfilling homeowner expectations

    International Nuclear Information System (INIS)

    Mahapatra, Krushna; Nair, Gireesh; Gustavsson, Leif

    2011-01-01

    Municipality energy advice services were re-introduced in Sweden in 1998 as a way of advising end-users, mainly owners of detached houses, on energy issues. In this paper, we investigate Swedish energy advisers' perceptions of homeowners' awareness of the energy advice service and their perceived ability to fulfil homeowners' expectations. Our study is based on a mail-in questionnaire survey conducted in 2009 and distributed to municipality energy advisers in all municipalities in Sweden. About 66% of the energy advisers responded. The results show that 43% of the energy advisers thought that fewer than 50% of the homeowners were aware of the service and that mass media advertisements and presentations at different organisations could improve homeowner awareness. Energy adviser attitudes, job satisfaction, and the perception that the advisers possessed up-to-date and good knowledge and sufficient financial resources to execute their duties had a significant influence on their perceived ability to fulfil homeowner expectations. Increased training in technical aspects of energy measures and increased financial support were the two measures most widely suggested as a means to improve energy advisers' performance. - Highlights: → Survey of Swedish energy advisers about their perceptions of energy advice service. → 43% of the respondents thought that fewer than 50% of the homeowners were aware of the service. → About half of the respondents reported that they were able to fulfil homeowners' expectations. → More training and financial support were two widely suggested means to improve advisers' performance.

  8. Analysis of Document Delivery Data of the National Academic Network and Information Center ULAKBİM Belge Sağlama Verilerinin Analizi

    Directory of Open Access Journals (Sweden)

    Yurdagül Ünal

    2004-06-01

    Full Text Available This study aims to determine the document delivery requests submitted to the Document Delivery Services Unit of the National Academic Network and Information Center (ULAKBİM. It concentrates on the journals and their age whence document delivery requests were filled. We tracked the data with regards to document delivery requests that were submitted to the Unit for two months. We found that the Documet Delivery Services Unit satisfied two-thirds (6.036 of a total of 9.213 document delivery requests submitted to the Unit during the two months' period of our study. Requests were satisfied from a total of 1.671 journal titles. Almost half (42% of those journal titles were used only once for document delivery purposes. A small number (135 of "core" journals satisfied one-thirds (35% of requests and the distribution of journals conforms to Bradford's Law of Scattering. Half (median of all requests were satisfied from journal issues that were published within the last seven years. This indicates that more recent articles are requested much more heavily, which is parallel with the phenomenon of literature obsolescence. From submission to the mailing of the document, it took a total of 15 days to fill a document delivery request. Data regarding document delivery requests should be gathered for collection development purposes. It would then be possible to identify core journals and their back issues that should be acquired and maintained. Bu araştırmada amaç, ULAKBİM Cahit Arf Bilgi Merkezi Belge Sağlama Hizmetleri Birimi'ne gelen isteklerin hangi dergilerde ve hangi yıllarda yayımlanan makalelere yapıldığını belirlemektir. Çalışmada, belge sağlama istekleri ile ilgili veriler, iki ay süreyle Birim e yapılan isteklerin izlenmesi suretiyle elde edilmiştir. Araştırmamızın sonunda Birim'e yapılan 9.213 isteğin üçte ikisinin (6.036 karşılandığı görülmüştür. İstekler 1.671 ayrı dergiden sağlanmış ve bu dergilerin

  9. Academic Hospitality

    Science.gov (United States)

    Phipps, Alison; Barnett, Ronald

    2007-01-01

    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  10. Monuments to Academic Carelessness

    Science.gov (United States)

    2014-01-01

    In 1942, Katherine Frost Bruner published an article titled “Of psychological writing: Being some valedictory remarks on style.” It was published in Journal of Abnormal and Social Psychology, the journal for which she served as editorial assistant between 1937 and 1941. Her collection of advice to writing scholars has been widely quoted, including by several editions of The Publication Manual of the American Psychological Association. The most frequently quoted message in Bruner’s article deals with the importance of making sure that references in academic texts are complete and accurate. Exploring the citation history of this particular message reveals an ironic point: the great majority of those who have quoted Bruner’s words on reference accuracy have not done so accurately. The case may serve as a reminder of the importance of the basic academic principle of striving to use primary sources. The most startling finding in this study is how frequently this principle is violated, even by authors who advise and educate academic writers. PMID:28479644

  11. The impact of development of customer online banking skills on customer adviser skills

    OpenAIRE

    Dubois, M.; Bobillier Chaumon, M.-E.; Retour, Didier

    2011-01-01

    International audience; The object of this article is the development of customer banking skills as a result of using online banking and its impact on the competence of customer advisers in face-to-face customer contacts. We focus on the use of software applications by customer advisers (CA) during customer contacts. The main results show that online banking enables customers to develop a range of banking skills. In order to deliver the service required by the context, advisers select the req...

  12. From classroom tutor to hypertext adviser: an evaluation

    Directory of Open Access Journals (Sweden)

    Michael Kemp

    2002-12-01

    Full Text Available This paper describes a three-year experiment to investigate the possibility of making economies by replacing practical laboratory sessions with courseware while attempting to ensure that the quality of the student learning experience did not suffer. Pathology labs are a central component of the first-year medical undergraduate curriculum at Southampton. Activities in these labs had been carefully designed and they were supervised by lab demonstrators who were subject domain experts. The labs were successful in the eyes of both staff and students but were expensive to conduct, in terms of equipment and staffing. Year by year evaluation of the introduction of courseware revealed that there was no measurable difference in student performance as a result of introducing the courseware, but that students were unhappy about the loss of interaction with the demonstrators. The final outcome of this experiment was a courseware replacement for six labs which included a software online hypertext adviser. The contribution of this work is that it adds to the body of empirical evidence in support of the importance of maintaining dialogue with students when introducing courseware, and it presents an example of how this interaction might be achieved in software.

  13. A review and evaluation of the Langley Research Center's Scientific and Technical Information Program. Results of phase 4: Knowledge and attitudes survey, academic and industrial personnel

    Science.gov (United States)

    Pinelli, T. E.; Glassman, M.; Glassman, N. A.

    1981-01-01

    Feedback from engineers and scientists in the academic and industrial community provided an assessment of the usage and perceived quality of NASA Langley generated STI and the familiarity and usage of selected NASA publications and services and identified ways to increase the accessibility of Langley STI. The questionnaire utilized both open and closed ended questions and was pretested for finalization. The questions were organized around the seven objectives for Phase IV. From a contact list of nearly 1,200 active industrial and academic researchers, approximately 600 addresses were verified. The 497 persons who agreed to participate were mailed questionnaires. The 381 completed questionnaires received by the cutoff date were analyzed. Based on the survey findings, recommendations were made for increasing the familiarity with and use of NASA and Langley STI and selected NASA publications and services. In addition, recommendations were made for increasing the accessibility of Langley STI.

  14. Academic dishonsty

    African Journals Online (AJOL)

    User

    avoidance and mastery orientation, Cumulative Grade Point Average (CGPA), awareness of academic rules and regulations, assessment practices, faculty, and university attended predicted the different types of academic dishonesty with varying levels of significance. INTRODUCTION. Today's undergraduate students are ...

  15. Academics respond

    DEFF Research Database (Denmark)

    Hazel, Spencer

    2015-01-01

    Contribution to the article "Academics respond: Brexit would weaken UK university research and funding", Guardian Witness, The Guardian, UK......Contribution to the article "Academics respond: Brexit would weaken UK university research and funding", Guardian Witness, The Guardian, UK...

  16. Advising Undergraduates in a Department of Soil Science and/or Agronomy.

    Science.gov (United States)

    Lee, Gerhard B.

    1987-01-01

    Offers suggestions to advisers of undergraduate students in agriculture. Recommends that advisers be competent, concerned, compassionate, and provide an open-door attitude toward their advisees. Suggests that students be guided toward good study habits and participation in intern programs. (TW)

  17. International Student-Athlete Adjustment Issues: Advising Recommendations for Effective Transitions

    Science.gov (United States)

    Newell, Emily M.

    2015-01-01

    Through an extensive literature review, student--athlete college transition issues as well as concerns of international student-athletes are identified. Research on general student advising, developmental advising, and mentoring literature points to successful tactics for assisting domestic students, international students, and student-athletes…

  18. Doctoral Advising: A Grounded Theory Exploration of Female Mainland Chinese International Students

    Science.gov (United States)

    Kuttig, Miao Yan

    2012-01-01

    The quality of the doctoral advising relationship is paramount in the success of doctoral education. This study explores female Mainland Chinese student's advising experience in their respective doctoral programs, including the factors that influence their experience, the challenges they encounter, and concerns they have in their programs.…

  19. 17 CFR 270.15a-4 - Temporary exemption for certain investment advisers.

    Science.gov (United States)

    2010-04-01

    ... an interest-bearing escrow account with the fund's custodian or a bank; (B) If a majority of the fund...-day period, the amount in the escrow account (including interest earned) will be paid to the... contract with the investment adviser, the investment adviser will be paid, out of the escrow account, the...

  20. Supporting Independent Learning Environments: An Analysis of Structures and Roles of Language Learning Advisers

    Science.gov (United States)

    Mozzon-McPherson, Marina

    2007-01-01

    This article examines the contribution of language learning advisers to the creation of synergy in specific learning spaces and considers advisers' roles in relation to the development of successful learner self-management (LSM). Starting with an historical overview of the evolution of the self-access centre at the University of Hull, the article…

  1. 17 CFR 275.206(4)-1 - Advertisements by investment advisers.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Advertisements by investment... COMMISSION (CONTINUED) RULES AND REGULATIONS, INVESTMENT ADVISERS ACT OF 1940 § 275.206(4)-1 Advertisements by investment advisers. (a) It shall constitute a fraudulent, deceptive, or manipulative act...

  2. 76 FR 71127 - Reporting by Investment Advisers to Private Funds and Certain Commodity Pool Operators and...

    Science.gov (United States)

    2011-11-16

    ... of the Dodd-Frank Wall Street Reform and Consumer Protection Act. The new SEC rule requires investment advisers registered with the SEC that advise one or more private funds and have at least $150... July 21, 2010, President Obama signed into law the Dodd-Frank Wall Street Reform and Consumer...

  3. 20 CFR 410.687 - Rules governing the representation and advising of claimants and parties.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Rules governing the representation and advising of claimants and parties. 410.687 Section 410.687 Employees' Benefits SOCIAL SECURITY... Representation of Parties § 410.687 Rules governing the representation and advising of claimants and parties. No...

  4. academic libraries

    African Journals Online (AJOL)

    Information Impact: Journal of Information and Knowledge Management

    Enhancing research visibility of academics: the role of academic libraries. Information Impact: Journal of Information and. Knowledge Management. 2017, Vol. .... Social media platforms allow users to connect, create, promote, share and follow interest groups. With these capabilities, academic libraries can make use of ...

  5. Healthy Eating and Academic Achievement

    Centers for Disease Control (CDC) Podcasts

    2014-12-09

    This podcast highlights the evidence that supports the link between healthy eating and improved academic achievement. It also identifies a few actions to support a healthy school nutrition environment to improve academic achievement.  Created: 12/9/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 12/9/2014.

  6. Physical Activity and Academic Achievement

    Centers for Disease Control (CDC) Podcasts

    2014-12-09

    This podcast highlights the evidence that supports the link between physical activity and improved academic achievement. It also identifies a few actions to support a comprehensive school physical activity program to improve academic achievement.  Created: 12/9/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 12/9/2014.

  7. Former hotel and conference center to become Graduate Life Center

    OpenAIRE

    Harris, Sally L.

    2005-01-01

    Over the next five weeks, Virginia Tech will take the initial steps to transform the former Donaldson Brown Hotel and Conference Center into an innovative, fully integrated Graduate Life Center encompassing academic, social, residential, and administrative functions.

  8. Quantification of the impact of multifaceted initiatives intended to improve operational efficiency and the safety culture: a case study from an academic medical center radiation oncology department.

    Science.gov (United States)

    Chera, Bhishamjit S; Mazur, Lukasz; Jackson, Marianne; Taylor, Kinely; Mosaly, Prithima; Chang, Sha; Deschesne, Kathy; LaChapelle, Dana; Hoyle, Lesley; Saponaro, Patricia; Rockwell, John; Adams, Robert; Marks, Lawrence B

    2014-01-01

    We have systematically been incorporating several operational efficiency and safety initiatives into our academic radiation oncology clinic. We herein quantify the impact of these initiatives on prospectively collected, clinically meaningful, metrics. The data from 5 quality improvement initiatives, each focused on a specific safety/process concern in our clinic, are presented. Data was collected prospectively: operational metrics recorded before and after implementation of the initiative were compared using statistical analysis. Results from the Agency for Health Care Research and Quality (AHRQ) patient safety culture surveys administered during and after many of these initiatives were similarly compared. (1) Workload levels for nurses assisting with brachytherapy were high (National Aeronautics and Space Administration Task Load Index (NASA-TLX) scores >55-60, suggesting, "overwork"). Changes in work flow and procedure room layout reduced workload to more acceptable levels (NASA-TLX 50% to safety culture," we conducted a pre- and postanalysis using the AHRQ survey. Improvements in all measured dimensions were noted. Quality improvement initiatives can be successfully implemented in an academic radiation oncology department to yield measurable improvements in operations resulting in improvement in patient safety culture. Copyright © 2014 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  9. Community‐Based Participatory Research Skills and Training Needs in a Sample of Academic Researchers from a Clinical and Translational Science Center in the Northeast

    Science.gov (United States)

    DiGirolamo, Ann; Geller, Alan C.; Tendulkar, Shalini A.; Patil, Pratima; Hacker, Karen

    2012-01-01

    Abstract Purpose: To determine the community‐based participatory research (CBPR) training interests and needs of researchers interested in CBPR to inform efforts to build infrastructure for conducting community‐engaged research. Method: A 20‐item survey was completed by 127 academic health researchers at Harvard Medical School, Harvard School of Public Health, and Harvard affiliated hospitals. Results: Slightly more than half of the participants reported current or prior experience with CBPR (58 %). Across all levels of academic involvement, approximately half of the participants with CBPR experience reported lacking skills in research methods and dissemination, with even fewer reporting skills in training of community partners. Regardless of prior CBPR experience, about half of the respondents reported having training needs in funding, partnership development, evaluation, and dissemination of CBPR projects. Among those with CBPR experience, more than one‐third of the participants wanted a mentor in CBPR; however only 19 % were willing to act as a mentor. Conclusions: Despite having experience with CBPR, many respondents did not have the comprehensive package of CBPR skills, reporting a need for training in a variety of CBPR skill sets. Further, the apparent mismatch between the need for mentors and availability in this sample suggests an important area for development. Clin Trans Sci 2012; Volume #: 1–5 PMID:22686211

  10. Community-based participatory research skills and training needs in a sample of academic researchers from a clinical and translational science center in the Northeast.

    Science.gov (United States)

    DiGirolamo, Ann; Geller, Alan C; Tendulkar, Shalini A; Patil, Pratima; Hacker, Karen

    2012-06-01

    To determine the community-based participatory research (CBPR) training interests and needs of researchers interested in CBPR to inform efforts to build infrastructure for conducting community-engaged research. A 20-item survey was completed by 127 academic health researchers at Harvard Medical School, Harvard School of Public Health, and Harvard affiliated hospitals. Slightly more than half of the participants reported current or prior experience with CBPR (58 %). Across all levels of academic involvement, approximately half of the participants with CBPR experience reported lacking skills in research methods and dissemination, with even fewer reporting skills in training of community partners. Regardless of prior CBPR experience, about half of the respondents reported having training needs in funding, partnership development, evaluation, and dissemination of CBPR projects. Among those with CBPR experience, more than one-third of the participants wanted a mentor in CBPR; however only 19 % were willing to act as a mentor. Despite having experience with CBPR, many respondents did not have the comprehensive package of CBPR skills, reporting a need for training in a variety of CBPR skill sets. Further, the apparent mismatch between the need for mentors and availability in this sample suggests an important area for development. © 2012 Wiley Periodicals, Inc.

  11. Swedish energy advisers' perceptions regarding and suggestions for fulfilling homeowner expectations

    Energy Technology Data Exchange (ETDEWEB)

    Mahapatra, Krushna, E-mail: krushna.mahapatra@miun.se [Ecotechnology, Mid Sweden University, SE-83125 Ostersund (Sweden); Nair, Gireesh, E-mail: gireesh.nair@miun.se [Ecotechnology, Mid Sweden University, SE-83125 Ostersund (Sweden); Gustavsson, Leif, E-mail: leif.gustavsson@miun.se [Ecotechnology, Mid Sweden University, SE-83125 Ostersund (Sweden); Linnaeus University, SE-35195 Vaexjoe (Sweden)

    2011-07-15

    Municipality energy advice services were re-introduced in Sweden in 1998 as a way of advising end-users, mainly owners of detached houses, on energy issues. In this paper, we investigate Swedish energy advisers' perceptions of homeowners' awareness of the energy advice service and their perceived ability to fulfil homeowners' expectations. Our study is based on a mail-in questionnaire survey conducted in 2009 and distributed to municipality energy advisers in all municipalities in Sweden. About 66% of the energy advisers responded. The results show that 43% of the energy advisers thought that fewer than 50% of the homeowners were aware of the service and that mass media advertisements and presentations at different organisations could improve homeowner awareness. Energy adviser attitudes, job satisfaction, and the perception that the advisers possessed up-to-date and good knowledge and sufficient financial resources to execute their duties had a significant influence on their perceived ability to fulfil homeowner expectations. Increased training in technical aspects of energy measures and increased financial support were the two measures most widely suggested as a means to improve energy advisers' performance. - Highlights: > Survey of Swedish energy advisers about their perceptions of energy advice service. > 43% of the respondents thought that fewer than 50% of the homeowners were aware of the service. > About half of the respondents reported that they were able to fulfil homeowners' expectations. > More training and financial support were two widely suggested means to improve advisers' performance.

  12. Publish or perish: remaining academically relevant and visible in the ...

    African Journals Online (AJOL)

    Academic institutions are advised to avail their publications in the listed databases and embrace electronic publishing through hosting of university journals in university websites, self archiving or starting institutional repositories and also listing under directory of institutional repositories. Embracing open access in ...

  13. Influence of Public Relations and Reference Services on Academic ...

    African Journals Online (AJOL)

    in academic institutions includes among others: reference services, public relation services, lending services, user ... public. Public relations counsel the practitioner in the field, advises his library boss on his attitudes and conduct needed to achieve social objectives. .... found helpful, then national or international resources ...

  14. Canadian National Guidelines and Recommendations for Integrating Career Advising Into Medical School Curricula.

    Science.gov (United States)

    Howse, Kelly; Harris, June; Dalgarno, Nancy

    2017-11-01

    Career planning, decision making about specialty choice, and preparation for residency matching are significant sources of stress for medical students. Attempts have been made to structure and formalize career advising by including it in accreditation standards. There is an expressed need for national guidelines on career advising for medical students. The Future of Medical Education in Canada Postgraduate (FMEC PG) Implementation Project was created to ensure Canadian medical trainees receive the best education possible. From this, a diverse sub-working group (SWG), representing different Canadian regions, was formed to review career advising processes across the country. The SWG developed, through a modified formal consensus methodology, a strategy for medical student career advising that is adaptable to all schools in alignment with existing accreditation standards. The SWG outlined five guiding principles and five essential elements for Canadian universities offering an MD degree with recommendations on how to integrate the elements into each school's career advising system. The five essential elements are a structured approach to career advising, information about available career options, elective guidance, preparation for residency applications, and social accountability. This Perspective endorses the view of the FMEC PG Implementation Project that national guidelines are important to ensure Canadian medical schools are consistently meeting accreditation standards by providing reliable and quality career advising to all medical students. The SWG's position, based on national and provincial feedback, is that these guidelines will stimulate discourse and action regarding the requirements and processes to carry out these recommendations nationwide and share across borders.

  15. Afghan Tortoise, Korean Hare: Advising in Hard and Soft Cultures

    Science.gov (United States)

    2010-01-01

    5 Ibid., 69. It would not have been valid to 6 Landman, 69. 7 Ibid., 36. 8 Art of Design, Student Text, Version 2.0 (Fort...Etiquette (Portland, Oregon: Graphic Arts Center Publishing Company, 1991), 11-17. 38 emphasize these values, the indigenous forces failed to meet the...Korea and excelled in architecture, sculpture and painting.177 Confucian thought entered into Korea became the dominant religious doctrine after the

  16. Data science as an academic discipline

    Directory of Open Access Journals (Sweden)

    F Jack Smith

    2006-11-01

    Full Text Available I recall being a proud young academic about 1970; I had just received a research grant to build and study a scientific database, and I had joined CODATA. I was looking forward to the future in this new exciting discipline when the head of my department, an internationally known professor, advised me that data was “a low level activity” not suitable for an academic. I recall my dismay. What can we do to ensure that this does not happen again and that data science is universally recognized as a worthwhile academic activity? Incidentally, I did not take that advice, or I would not be writing this essay, but moved into computer science. I will use my experience to draw comparisons between the problems computer science had to become academically recognized and those faced by data science.

  17. The 2016 Academic Emergency Medicine Consensus Conference, Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda May 10, 2016, New Orleans, LA.

    Science.gov (United States)

    Grudzen, Corita R; Anderson, Jana R; Carpenter, Christopher R; Hess, Erik P

    2016-12-01

    Shared decision making in emergency medicine has the potential to improve the quality, safety, and outcomes of emergency department (ED) patients. Given that the ED is the gateway to care for patients with a variety of illnesses and injuries and the safety net for patients otherwise unable to access care, shared decision making in the ED is relevant to numerous disciplines and the interests of the United States (U.S.) public. On May 10, 2016 the 16th annual Academic Emergency Medicine (AEM) consensus conference, "Shared Decision Making: Development of a Policy-Relevant Patient-Centered Research Agenda" was held in New Orleans, Louisiana. During this one-day conference clinicians, researchers, policy-makers, patient and caregiver representatives, funding agency representatives, trainees, and content experts across many areas of medicine interacted to define high priority areas for research in 1 of 6 domains: 1) diagnostic testing; 2) policy, 3) dissemination/implementation and education, 4) development and testing of shared decision making approaches and tools in practice, 5) palliative care and geriatrics, and 6) vulnerable populations and limited health literacy. This manuscript describes the current state of shared decision making in the ED context, provides an overview of the conference planning process, the aims of the conference, the focus of each respective breakout session, the roles of patient and caregiver representatives and an overview of the conference agenda. The results of this conference published in this issue of AEM provide an essential summary of the future research priorities for shared decision making to increase quality of care and patient-centered outcomes. © 2016 by the Society for Academic Emergency Medicine.

  18. Estimating Ten-Year Trends in Septic Shock Incidence and Mortality in United States Academic Medical Centers Using Clinical Data.

    Science.gov (United States)

    Kadri, Sameer S; Rhee, Chanu; Strich, Jeffrey R; Morales, Megan K; Hohmann, Samuel; Menchaca, Jonathan; Suffredini, Anthony F; Danner, Robert L; Klompas, Michael

    2017-02-01

    Reports that septic shock incidence is rising and mortality rates declining may be confounded by improving recognition of sepsis and changing coding practices. We compared trends in septic shock incidence and mortality in academic hospitals using clinical vs claims data. We identified all patients with concurrent blood cultures, antibiotics, and vasopressors for ≥ two consecutive days, and all patients with International Classification of Diseases, 9th edition (ICD-9) codes for septic shock, at 27 academic hospitals from 2005 to 2014. We compared annual incidence and mortality trends. We reviewed 967 records from three hospitals to estimate the accuracy of each method. Of 6.5 million adult hospitalizations, 99,312 (1.5%) were flagged by clinical criteria, 82,350 (1.3%) by ICD-9 codes, and 44,651 (0.7%) by both. Sensitivity for clinical criteria was higher than claims (74.8% vs 48.3%; P Septic shock incidence, based on clinical criteria, rose from 12.8 to 18.6 cases per 1,000 hospitalizations (average, 4.9% increase/y; 95% CI, 4.0%-5.9%), while mortality declined from 54.9% to 50.7% (average, 0.6% decline/y; 95% CI, 0.4%-0.8%). In contrast, septic shock incidence, based on ICD-9 codes, increased from 6.7 to 19.3 per 1,000 hospitalizations (19.8% increase/y; 95% CI, 16.6%-20.9%), while mortality decreased from 48.3% to 39.3% (1.2% decline/y; 95% CI, 0.9%-1.6%). A clinical surveillance definition based on concurrent vasopressors, blood cultures, and antibiotics accurately identifies septic shock hospitalizations and suggests that the incidence of patients receiving treatment for septic shock has risen and mortality rates have fallen, but less dramatically than estimated on the basis of ICD-9 codes. Copyright © 2016 American College of Chest Physicians. All rights reserved.

  19. Assessment of clinical workload for general and specialty genetic counsellors at an academic medical center: a tool for evaluating genetic counselling practices.

    Science.gov (United States)

    Heald, Brandie; Rybicki, Lisa; Clements, Diane; Marquard, Jessica; Mester, Jessica; Noss, Ryan; Nardini, Monica; Polk, Jill; Psensky, Brittany; Rigelsky, Christina; Schreiber, Allison; Shealy, Amy; Smith, Marissa; Eng, Charis

    2016-01-01

    With genomics influencing clinical decisions, genetics professionals are exponentially called upon as part of multidisciplinary care. Increasing demand for genetic counselling, a limited workforce, necessitates practices improve efficiency. We hypothesised that distinct differences in clinical workload exist between various disciplines of genetic counselling, complicating practice standardisation and patient volume expectations. We thus sought to objectively define and assess workload among various specialties of genetic counselling. Twelve genetic counsellors (GCs), representing 9.3 clinical FTE, in general or specialty (cancer, cardiovascular or prenatal) services at an academic health system developed a data collection tool for assessing time and complexity. Over a 6-week period, the data were recorded for 583 patient visits (136 general and 447 specialty) and analysed comparing general versus specialty GCs. Variables were compared with hierarchical linear models for ordinal or continuous data and hierarchical logistic models for binary data. General GCs completed more pre- and post-visit activities ( P =0.011) and spent more time ( P =0.009) per case. General GCs reported greater case discussion with other providers ( P practice carry a higher pre- and post-visit workload compared with GCs in specialty practices. General GCs may require lower patient volumes than specialty GCs to allow time for additional pre- and post-visit activities. Non-clinical activities should be transferred to support staff.

  20. Factors threatening the survival of independent financial advisers in their organisational life cycle: an exploratory study

    Directory of Open Access Journals (Sweden)

    Estelle van Tonder

    2011-06-01

    Full Text Available This study investigates various threats to the survival of independent financial advisers in their organisational life cycle.  Telephone interviews were conducted to gain more insight into the demographic data of the respondents and to attempt to group them into life cycle stages.  Personal interviews were conducted to investigate the respondents' problems.  The contribution of this study is twofold:  First, general life cycle stages applicable to the businesses of independent financial advisers were determined.  Secondly, the study identified the important problems as well as those that ought to be consideration in the advisers' businesses.  The findings could be of assistance to independent financial advisers in analysing both their current business position and their planning for future requirements as the business develops from one stage to the next.

  1. Advising Indigenous Forces: American Advisors in Korea, Vietnam, and El Salvador

    Science.gov (United States)

    2006-01-01

    Team MATA Military Assistance Training and Advisory (course) MD Maryland MI military intelligence MILGROUP Military Group (El Salvador ) MILZONE...Advising Indigenous Forces: American Advisors in Korea, Vietnam, and El Salvador Robert D. Ramsey III Global War on Terrorism Occasional Paper 18...Advising Indigenous Forces: American Advisors in Korea, vietnam, and El Salvador 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6

  2. Expatriate academics

    DEFF Research Database (Denmark)

    Selmer, Jan; Lauring, Jakob

    2011-01-01

    Purpose – The literature on business expatriates has been increasing rapidly, but research on expatriate academics has remained scant, despite the apparent increasing globalisation of the academic world. Therefore, more research is needed on the latter group of expatriates. This paper aims to fil...

  3. Recruitment, advising, and retention programs - Challenges and solutions to the international problem of poor nursing student retention: A narrative literature review.

    Science.gov (United States)

    Mooring, Quanza E

    2016-05-01

    The aim of this literature review was to identify emerging themes in current research to identify challenges to nursing student retention internationally, as well as strategies to improve persistence. A narrative literature review was conducted. Using CINAHL and HealthSource databases, journal articles were reviewed and evaluated for emerging themes related to the causes of high nursing student attrition rates and strategies to overcome this issue. A five-step approach was used to complete the narrative review, beginning with problem identification, followed by the literature search, data analysis, theme emergence and synthesis of the information. The literature review supports the idea that poor retention is related not only to student ability, but also to a lack of necessary intervention by faculty beginning with the admission process and continuing throughout the curriculum. Alterations should be made in the recruitment and student selection process. Aggressive academic advising strategies should be implemented, and retention programs should be interwoven in to the nursing curriculum. Student retention is a multifaceted issue that requires a multi-modal approach. Changes in recruitment, implementation of academic advising, and curriculum integration have the potential to help correct the problem. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Chronic low back pain patients' use of, level of knowledge of and perceived benefits of complementary medicine: a cross-sectional study at an academic pain center.

    Science.gov (United States)

    Dubois, Julie; Scala, Emmanuelle; Faouzi, Mohamed; Decosterd, Isabelle; Burnand, Bernard; Rodondi, Pierre-Yves

    2017-04-04

    Chronic pain patients often use complementary medicine (CM) to alleviate their pain; however, little is known about the use of CM by chronic low back pain (cLBP) patients. We investigated the frequency of use of CM by cLBP patients, the perceived effects of these therapies, patients' knowledge regarding CM, and patient-physician communication regarding CM. A cross-sectional survey was conducted from November 2014 to February 2015. A questionnaire was distributed by physicians to 238 consecutive patients consulting for cLBP at the Pain Center of Lausanne University Hospital, Switzerland. Poisson regression model was used to analyze patients' level of knowledge regarding various CMs, and the logistic regression model was used to assess CM use for cLBP. The questionnaire was returned by 168 cLBP patients (response rate: 70.6%). Lifetime prevalence of CM use for cLBP was 77.3%. The most commonly used therapies were osteopathy (48.8%), massage (45.2%) and acupuncture (31.6%), rated for their usefulness on a 0-10 scale as a mean ± SD of 5.4 ± 2.7, 5.9 ± 2.5 and 3.8 ± 3.2, respectively. The CM treatment best known by patients was osteopathy, followed by massage and acupuncture. If their doctors proposed CM as a treatment for cLBP, 78% of participants reported being very or somewhat likely to try CM. Respondents with CM health insurance were more likely to use CM (OR = 2.26; 95%CI: 1.07-4.78; p = 0.031) for cLBP. Respondents having experienced cLBP for more than five years were more likely to use CM to treat their cLBP than respondents having experienced cLBP for one year or less (OR = 2.84; 95%CI: 1.02-7.88; p = 0.044). More than three-quarters of cLBP patients in our sample did use CM to treat their cLBP. The results showed that the most commonly used therapies were not necessarily the highest rated in terms of perceived usefulness. These results highlight the importance of developing integrative pain centers in which patients may obtain advice

  5. Catheter-associated urinary tract infection (CAUTI) after term cesarean delivery: incidence and risk factors at a multi-center academic institution.

    Science.gov (United States)

    Moulton, Laura; Lachiewicz, Mark; Liu, Xiaobo; Goje, Oluwatosin

    2018-02-01

    The purpose of this study is to identify the rate of catheter-associated urinary tract infection (CAUTI) after Cesarean delivery (CD) and to determine if any factors increase risk of infection. A retrospective cohort study was performed at a multi-center institution for patients who underwent CD in 2013. All patients had urinary catheters inserted before surgery. Diagnosis followed IDSA guidelines with culture growing greater than 10 3 CFU of bacteria per mL with symptoms or symptomatic urinary tract infections treated at provider discretion. Statistical analysis was assessed with Chi-square and Student's t-test followed by logistic regression. Of 2419 patients, 36 patients developed CAUTI (1.5%). In the 24 (66.7%) cases diagnosed by IDSA guidelines, Escherichia coli was the most common causative organism (54.1%); followed by Enterococcus faecalis (16.7%), Streptococccus agalactiae (8.3%), and Group A Streptococcus (8.3%). Longer operative time (OR 1.013; 95% 1.002-1.023; p = .02) and pregnancies complicated by STI (OR 4.15; 95% CI 1.11-15.0; p < .05) were associated with higher rates of CAUTI. The overall rate of CAUTI after CD was low at 1.5%. Escherichia coli was the most common causative pathogen. Identification of the patients at high risk for CAUTI allows for risk reduction measures.

  6. An update on radiation absorbed dose to patients from diagnostic nuclear medicine procedures in Tehran: A study on four academic centers

    Science.gov (United States)

    Motazedian, Motahareh; Tabeie, F; Vatankhah, P; Shafiei, B; Amoui, M; Atefi, M; Ansari, M; Asli, I Neshandar

    2016-01-01

    Purpose: Use of radiopharmaceuticals for diagnostic nuclear medicine procedures is one of the main sources of radiation exposure. We performed this study with respect to the rapid growth in nuclear medicine in Iran and lack of updated statistics. Materials and Methods: The data were obtained for all active Nuclear Medicine Centers affiliated to Shahid Beheshti University of Medical Sciences during 2009 and 2010. Results: The most frequently performed procedures were bone (30.16%), cardiac (28.96%), renal (17.97%), and thyroid (7.93%) scans. There was a significant decrease in the number of thyroid scintigraphies with 131I and 99mTc-sulfur colloid liver/spleen scans and tremendous increase in the frequencies of cardiac and bone scintigraphies compared to one decade ago. Conclusion: Compared to previous studies, there were striking changes in trends of diagnostic nuclear medicine procedures in Tehran. This field is still evolving in the country, and this trend will further change with the introduction of positron emission tomography scanners in future. PMID:27095860

  7. Academic Allies

    DEFF Research Database (Denmark)

    Byberg, Rebekka Birkebo

    the national associations of European law: Fédération Internationale pour le Droit Européen, the European law journal Common Market Law Review, and the ITL project, carried out at the European University Institute.It carefully documents an alliance between academics and community actors with the aim...... of providing academic support to the constitutional claim, and it argues that the academic discipline of European law was built and developed through a circular attribution of legal ideas, legitimacy, and self-image between the European Court of Justice, the Commission, and academia –most particularly so...

  8. Top ten challenges when interfacing a laboratory information system to an electronic health record: Experience at a large academic medical center.

    Science.gov (United States)

    Petrides, Athena K; Tanasijevic, Milenko J; Goonan, Ellen M; Landman, Adam B; Kantartjis, Michalis; Bates, David W; Melanson, Stacy E F

    2017-10-01

    Recent U.S. government regulations incentivize implementation of an electronic health record (EHR) with computerized order entry and structured results display. Many institutions have also chosen to interface their EHR to their laboratory information system (LIS). Reported long-term benefits include increased efficiency and improved quality and safety. In order to successfully implement an interfaced EHR-LIS, institutions must plan years in advance and anticipate the impact of an integrated system. It can be challenging to fully understand the technical, workflow and resource aspects and adequately prepare for a potentially protracted system implementation and the subsequent stabilization. We describe the top ten challenges that we encountered in our clinical laboratories following the implementation of an interfaced EHR-LIS and offer suggestions on how to overcome these challenges. This study was performed at a 777-bed, tertiary care center which recently implemented an interfaced EHR-LIS. Challenges were recorded during EHR-LIS implementation and stabilization and the authors describe the top ten. Our top ten challenges were selection and harmonization of test codes, detailed training for providers on test ordering, communication with EHR provider champions during the build process, fluid orders and collections, supporting specialized workflows, sufficient reports and metrics, increased volume of inpatient venipunctures, adequate resources during stabilization, unanticipated changes to laboratory workflow and ordering specimens for anatomic pathology. A few suggestions to overcome these challenges include regular meetings with clinical champions, advanced considerations of reports and metrics that will be needed, adequate training of laboratory staff on new workflows in the EHR and defining all tests including anatomic pathology in the LIS. EHR-LIS implementations have many challenges requiring institutions to adapt and develop new infrastructures. This article

  9. WE-G-BRA-01: Patient Safety and Treatment Quality Improvement Through Incident Learning: Experience of a Non-Academic Proton Therapy Center

    International Nuclear Information System (INIS)

    Zheng, Y; Johnson, R; Zhao, L; Ramirez, E; Rana, S; Singh, H; Chacko, M

    2015-01-01

    proton centers are encouraged

  10. The Wicked Problem of Embedding Academic Literacies: Exploring Rhizomatic Ways of Working through an Adaptive Leadership Approach

    Science.gov (United States)

    Benzie, Helen Joy; Pryce, Alison; Smith, Keith

    2017-01-01

    Embedding academic literacies in higher education courses has been a major focus of the work of learning advisers. A number of studies present the results of embedding in specific courses without discussing the processes of negotiation or the different people involved. This paper is about embedding academic literacies in the Business faculty as…

  11. Academic Marketing

    Directory of Open Access Journals (Sweden)

    Ecaterina Daniela ZECA

    2017-06-01

    Full Text Available Academic Marketing is an investment in a future dominated by The Forth Industrial Revolution and Globalization and not an expense. This aspect will basically alter our way to teach and to learn. In its dimensions, arguably changes will be like anything we has seen before. We try to assess how will be all unfold but, anyway, academic field response at this challenge should be integrated and comprehensive, involving all stakeholders both public and private sectors, because these changes herald upheaval of whole organizations. The educational service is a special one, delivered today but with effects in the future, the future of the individual, the future of generation, the future of nations. The educational service policy adapted to the requirements of time, brings to the front the opportunity of academic marketing. To analyze demand in a professional way, to measure trends and correlated university programs with the forecast demand for jobs, it is the subject. In the case of academic education, we are talking also about cost, distribution and promotion policies, but being a special service we also discuss about ethic boundaries. This work is an open chapter focusing studies on academic megamarketing, the work keeping up with the pace of change, students enrolment mobility, overtakes job market, and an imposed win-win-win formula, applied for students, local community and academic field.

  12. Midwestern US Farmers Perceive Crop Advisers as Conduits of Information on Agricultural Conservation Practices.

    Science.gov (United States)

    Eanes, Francis R; Singh, Ajay S; Bulla, Brian R; Ranjan, Pranay; Prokopy, Linda S; Fales, Mary; Wickerham, Benjamin; Doran, Patrick J

    2017-11-01

    Nonpoint source pollution from agricultural land uses continues to pose one of the most significant threats to water quality in the US, with measurable impacts across local, regional, and national scales. The impact and the influence of targeted conservation efforts are directly related to the degree to which farmers are familiar with and trust the entities providing the information and/or outreach. Recent research suggests that farmers consistently rank independent and retail-affiliated crop advisers as among the most trusted and influential sources for agronomic information, but little is understood about whether farmers are willing to receive advice from crop advisers on the use of practices that conserve soil and water, and, if so, whether crop advisers will be perceived as influential. We present survey data from farmers (n = 1461) in Michigan's Saginaw Bay (Lake Huron) watershed to explore these questions. Results suggest that farmers view crop advisers as trustworthy sources of information about conservation, and influential on management practices that have large conservation implications. We discuss these results, along with perceived barriers and opportunities to crop advisers partnering with traditional conservation agencies to enhance the impact of voluntary conservation programs.

  13. Midwestern US Farmers Perceive Crop Advisers as Conduits of Information on Agricultural Conservation Practices

    Science.gov (United States)

    Eanes, Francis R.; Singh, Ajay S.; Bulla, Brian R.; Ranjan, Pranay; Prokopy, Linda S.; Fales, Mary; Wickerham, Benjamin; Doran, Patrick J.

    2017-11-01

    Nonpoint source pollution from agricultural land uses continues to pose one of the most significant threats to water quality in the US, with measurable impacts across local, regional, and national scales. The impact and the influence of targeted conservation efforts are directly related to the degree to which farmers are familiar with and trust the entities providing the information and/or outreach. Recent research suggests that farmers consistently rank independent and retail-affiliated crop advisers as among the most trusted and influential sources for agronomic information, but little is understood about whether farmers are willing to receive advice from crop advisers on the use of practices that conserve soil and water, and, if so, whether crop advisers will be perceived as influential. We present survey data from farmers ( n = 1461) in Michigan's Saginaw Bay (Lake Huron) watershed to explore these questions. Results suggest that farmers view crop advisers as trustworthy sources of information about conservation, and influential on management practices that have large conservation implications. We discuss these results, along with perceived barriers and opportunities to crop advisers partnering with traditional conservation agencies to enhance the impact of voluntary conservation programs.

  14. Case study: a midclerkship crisis-lessons learned from advising a medical student with career indecision.

    Science.gov (United States)

    Levine, Rachel B; Cayea, Danelle; Shochet, Robert B; Wright, Scott M

    2010-04-01

    Advising medical students is a challenging task. Faculty who serve as advisors for students require specific skills and knowledge to do their jobs effectively. Career choice is one of the many complex issues about which medical students often seek assistance from a faculty advisor. The authors present a case of a third-year medical student with career indecision, with a focus on the various factors that may be influencing her thinking about career choice. Key advising principles are provided as a framework for the discussion of the case and include reflection, self-disclosure, active listening, support and advocacy, confidentiality, and problem solving. These principles were developed as part of the Advising Case Conference series of the Johns Hopkins University School of Medicine Colleges Advisory Program. Emergent themes from the case included a student's evolving professional identity, a student's distress and burnout, lifestyle considerations, and advisor bias and self-awareness. The authors propose reflective questions to enhance meaningful discussions between the advisor and student and assist in problem solving. Many of these questions, together with the key advising principles, are generalizable to a variety of advising scenarios between advisors and learners at all levels of training.

  15. National Center for Disaster Medicine and Public Health

    Data.gov (United States)

    Federal Laboratory Consortium — The National Center for Disaster Medicine and Public Health (NCDMPH) is an academic center tasked with leading federal, and coordinating national, efforts to develop...

  16. Comprehension of climatic and occupational heat stress amongst agricultural advisers and workers in Slovenia

    DEFF Research Database (Denmark)

    Pogačar, Tjaša; Črepinšek, Zalika; Kajfež Bogataj, Lučka

    2017-01-01

    Climate changes and the associated higher frequency of heat waves in Middle-European countries will aggravate occupational heat stress experienced by Slovenian workers. Appropriate behavioral adaptations are important coping strategies and it is pertinent to establish if knowledge among advisers...... and workers is sufficient and identify the symptoms experienced by workers. Therefore a survey including 230 farmers and 86 agricultural advisers was completed. Thermal comfort ranged from hot to extremely hot for 85 ± 5 % of farmers working outside and heat stress had a negative impact on well-being (74 ± 6...... with nausea or vomiting (19 ± 8 vs 9 ± 5 %). 81 ± 4 % of the responders reported that more time is required to complete tasks when the weather is hot. Nevertheless, 61 ± 6 % of farmers have never been informed of the impacts of heat stress and 29 ± 10 % of the agricultural advisers does not include...

  17. Names of power and the acquisition of academic literacy | Katz ...

    African Journals Online (AJOL)

    , wherein lived experience and academic discourse can interact to strengthen each other. Keywords: narrative pedagogy, learner-centered, names, academic literacy, democratic, writing as discovery. Journal for Language Teaching Vol.

  18. If you feed them, they will come: a prospective study of the effects of complimentary food on attendance and physician attitudes at medical grand rounds at an academic medical center.

    Science.gov (United States)

    Segovis, Colin M; Mueller, Paul S; Rethlefsen, Melissa L; LaRusso, Nicholas F; Litin, Scott C; Tefferi, Ayalew; Habermann, Thomas M

    2007-07-12

    Evidence suggests that attendance at medical grand rounds at academic medical centers is waning. The present study examined whether attendance at medical grand rounds increased after providing complimentary food to attendees and also assessed attendee attitudes about complimentary food. In this prospective, before-and-after study, attendance at medical grand rounds was monitored from September 25, 2002, to June 2, 2004, using head counts. With unrestricted industry (eg, pharmaceutical) financial support, complimentary food was provided to medical grand rounds attendees beginning June 4, 2003. Attendance was compared during the pre-complimentary food and complimentary food periods. Attitudes about the complimentary food were assessed with use of a survey administered to attendees at the conclusion of the study period. The mean (+/- SD) overall attendance by head counts increased 38.4% from 184.1 +/- 90.4 during the pre-complimentary food period to 254.8 +/- 60.5 during the complimentary food period (P attend grand rounds because of complimentary food, 53.6% indicated that their attendance increased as a result of complimentary food, and 53.1% indicated that their attendance would decrease if complimentary food was no longer provided. Notably, 80.3% indicated that food was not a distraction, and 81.7% disagreed that industry representatives had influence over medical grand rounds because of their financial support for the food. Providing free food may be an effective strategy for increasing attendance at medical grand rounds.

  19. If you feed them, they will come: A prospective study of the effects of complimentary food on attendance and physician attitudes at medical grand rounds at an academic medical center

    Directory of Open Access Journals (Sweden)

    Litin Scott C

    2007-07-01

    Full Text Available Abstract Background Evidence suggests that attendance at medical grand rounds at academic medical centers is waning. The present study examined whether attendance at medical grand rounds increased after providing complimentary food to attendees and also assessed attendee attitudes about complimentary food. Methods In this prospective, before-and-after study, attendance at medical grand rounds was monitored from September 25, 2002, to June 2, 2004, using head counts. With unrestricted industry (eg, pharmaceutical financial support, complimentary food was provided to medical grand rounds attendees beginning June 4, 2003. Attendance was compared during the pre-complimentary food and complimentary food periods. Attitudes about the complimentary food were assessed with use of a survey administered to attendees at the conclusion of the study period. Results The mean (± SD overall attendance by head counts increased 38.4% from 184.1 ± 90.4 during the pre-complimentary food period to 254.8 ± 60.5 during the complimentary food period (P Conclusion Providing free food may be an effective strategy for increasing attendance at medical grand rounds.

  20. Cooperating to learn teaching to cooperate: adviser processes for program implement CA/AC

    OpenAIRE

    José Ramón LAGO; Pere PUJOLÀS; Mila NARANJO

    2011-01-01

    The aim of this paper is present some results of advise strategy to introduce cooperative learning from the «Cooperating to Learn/ Learning to Cooperate» CL/LC Programme. The first part situates the research project and the research objective focused on how introduction of CL/LC program through a process of advice facilitates permanent improvements to the inclusion of students. In the second we analyzed the phases and tasks of an adviser process for the introduction of cooperative learning an...

  1. Food for thought? Potential conflicts of interest in academic experts advising government and charities on dietary policies

    OpenAIRE

    Newton, Alex; Lloyd-Williams, Ffion; Bromley, Helen; Capewell, Simon

    2016-01-01

    Background A conflict of interest (CoI) can occur between public duty and private interest, in which a public official?s private-capacity interest could improperly influence the performance of their official duties and responsibilities. The most tangible and commonly considered CoI are financial. However, CoI can also arise due to other types of influence including interpersonal relationships, career progression, or ideology. CoI thus exist in academia, business, government and non-government...

  2. Investigation of the teaching cognition and capabilities of clinical advisers for masters degree level nursing specialty graduate students

    Directory of Open Access Journals (Sweden)

    Xiao-Lei Zhao

    2014-03-01

    Conclusion: Clinical advisers for nursing specialty graduate students in our survey were generally inexperienced with regarding to training and culturing nursing graduate students. These advisers were prepared for core teaching competency, but were not qualified to conduct scientific research. Based on these results, it would be beneficial to provide the clinical advisers more training on teaching cognition for graduate students and improve their competency to perform scientific research.

  3. Acquiring E-Books for Academic Libraries

    OpenAIRE

    Woodward, Hazel

    2007-01-01

    This paper outlines the recent work of the UK’s Joint Information Systems Committee ( JISC) in the area of e-books. The JISC Collections Team is responsible for negotiating deals with publishers and aggregators of e-content for all UK higher education libraries - some 180 in total. In other words it acts as a national consortium for the UK academic community, although it should be noted that all deals are negotiated on an ‘opt-in’ basis. The JISC Collections Team is advised by a series of for...

  4. Academic Cloning.

    Science.gov (United States)

    Sikula, John P.; Sikula, Andrew F.

    1980-01-01

    The authors define "cloning" as an integral feature of all educational systems, citing teaching practices which reward students for closely reproducing the teacher's thoughts and/or behaviors and administrative systems which tend to promote like-minded subordinates. They insist, however, that "academic cloning" is not a totally…

  5. Academic Freedom.

    Science.gov (United States)

    Tobin, Brian G.

    The strength of academic freedom has always depended upon historical circumstances. In the United States, higher education began with institutions founded and controlled by religious sects. The notion of who gets educated and to what ends expanded as American democracy expanded. By the 1980's, legitimate calls for equality became a general…

  6. 78 FR 39784 - Invesco Advisers, Inc., et al.; Notice of Application

    Science.gov (United States)

    2013-07-02

    ... as a regular consultant or as a business or legal adviser and who shares a community of interest with... (including, without limitation, the managers of the Funds) such management responsibility. The Manager of the... reasonably believe that such individual will be a sophisticated investor capable of understanding and...

  7. An educational campaign to increase chiropractic intern advising roles on patient smoking cessation

    Directory of Open Access Journals (Sweden)

    Strasser Sheryl M

    2006-10-01

    Full Text Available Abstract Background Tobacco use, particularly smoking, is the most preventable cause of death in the United States. More than 400,000 premature deaths are associated with its use and the health care costs are in the billions. All health care provider groups should be concerned with patients who continue to smoke and use tobacco. The US Preventive Services Taskforce and Health People 2010 guidelines encourage providers to counsel smokers on cessation. Current studies, though limited regarding chiropractic advising practices indicate a low engagement rate when it comes to providing cessation information. Objective To test a campaign regarding initial impact aimed at increasing chiropractic interns advising on cessation and delivery of information to smokers on cessation. Discussion Chiropractic interns do engage patients on smoking status and can be encouraged to provide more cessation messages and information to patients. The initial impact assessment of this campaign increased the provision of information to patients by about 25%. The prevalence of smoking among chiropractic patients, particularly at teaching clinics may be lower than the national averages. Conclusion Chiropractic interns can and should be encouraged to advise smokers about cessation. A systematic method of intake information on smoking status is needed and a standardized education protocol for chiropractic colleges is needed. Chiropractic colleges should assess the adequacy of their advising roles and implement changes to increase cessation messages to their patients as soon as possible.

  8. Comprehension of climatic and occupational heat stress amongst agricultural advisers and workers in Slovenia

    DEFF Research Database (Denmark)

    Pogačar, Tjaša; Črepinšek, Zalika; Kajfež Bogataj, Lučka

    2017-01-01

    and workers is sufficient and identify the symptoms experienced by workers. Therefore a survey including 230 farmers and 86 agricultural advisers was completed. Thermal comfort ranged from hot to extremely hot for 85 ± 5 % of farmers working outside and heat stress had a negative impact on well-being (74 ± 6...

  9. Exxon and Higher Education: Reflections on One Student-to-Student Advising Program.

    Science.gov (United States)

    Petschauer, Peter

    1983-01-01

    Describes the implementation of Exxon's Student-to-Student advising program at Wautauga College. Advanced students are hired to teach beginning students basic college survival skills including time management, taking lecture notes, reading textbooks, taking exams, writing reports, making oral presentation, and improving interpersonal relations.…

  10. 22 CFR 64.8 - Obligation of employee to advise agency.

    Science.gov (United States)

    2010-04-01

    ... Section 64.8 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES PARTICIPATION BY FEDERAL EMPLOYEES IN CULTURAL EXCHANGE PROGRAMS OF FOREIGN COUNTRIES § 64.8 Obligation of employee to advise agency. Any Federal employee receiving any offer of a grant or other assistance under a cultural exchange...

  11. 34 CFR 303.651 - Advising and assisting the lead agency in its administrative duties.

    Science.gov (United States)

    2010-07-01

    ... administrative duties. 303.651 Section 303.651 Education Regulations of the Offices of the Department of... Functions of the Council § 303.651 Advising and assisting the lead agency in its administrative duties. Each... responsibility to the appropriate agency; and (c) Promotion of the interagency agreements under § 303.523...

  12. 75 FR 1455 - Custody of Funds or Securities of Clients by Investment Advisers

    Science.gov (United States)

    2010-01-11

    ... Investments (July 28, 2009); Consortium Letter; G&D Letter; IAA Letter; NRS Letter; comment letter of Bruce... by the surprise examination, such as tests of valuations of pool investments, income, operating... transactions to test during the period that the adviser will not be able to anticipate. We have therefore...

  13. An educational campaign to increase chiropractic intern advising roles on patient smoking cessation.

    Science.gov (United States)

    Evans, Marion W; Hawk, Cheryl; Strasser, Sheryl M

    2006-10-12

    Tobacco use, particularly smoking, is the most preventable cause of death in the United States. More than 400,000 premature deaths are associated with its use and the health care costs are in the billions. All health care provider groups should be concerned with patients who continue to smoke and use tobacco. The US Preventive Services Taskforce and Health People 2010 guidelines encourage providers to counsel smokers on cessation. Current studies, though limited regarding chiropractic advising practices indicate a low engagement rate when it comes to providing cessation information. To test a campaign regarding initial impact aimed at increasing chiropractic interns advising on cessation and delivery of information to smokers on cessation. Chiropractic interns do engage patients on smoking status and can be encouraged to provide more cessation messages and information to patients. The initial impact assessment of this campaign increased the provision of information to patients by about 25%. The prevalence of smoking among chiropractic patients, particularly at teaching clinics may be lower than the national averages. Chiropractic interns can and should be encouraged to advise smokers about cessation. A systematic method of intake information on smoking status is needed and a standardized education protocol for chiropractic colleges is needed. Chiropractic colleges should assess the adequacy of their advising roles and implement changes to increase cessation messages to their patients as soon as possible.

  14. How Do We Advise the Pest Control Industry in the Post-Organochlorine Era?

    Science.gov (United States)

    J.R.J. French

    1991-01-01

    Given the banning of organochlorines for use as termiticides in North America, and with the possibility of such bans occurring in future in Australia and elsewhere, how do we as entomologists advise the pest control industry in termite control? A brief historical review of pesticide bans and the relevance of these bans to the present situation are discussed....

  15. A study of physicians' interest in advising (recommending vasectomy in Egypt

    Directory of Open Access Journals (Sweden)

    Ahmed M. Hassanin

    2017-12-01

    Conclusion: However more than half of physicians had a positive perception of vasectomy, only 24.9% advised Egyptian men to undergo the procedure. Sociocultural factors and religious issues hindered physicians to recommend vasectomy in Egypt. Vasectomy was recommended when it was absolutely needed.

  16. 77 FR 35082 - Arrow Investment Advisers, LLC and Arrow Investments Trust; Notice of Application

    Science.gov (United States)

    2012-06-12

    ... SECURITIES AND EXCHANGE COMMISSION [Investment Company Act Release No. 30100; 812-13937] Arrow Investment Advisers, LLC and Arrow Investments Trust; Notice of Application June 6, 2012. AGENCY: Securities... 6(c) of the Investment Company Act of 1940 (``Act'') for an exemption from sections 2(a)(32), 5(a)(1...

  17. 12 CFR 703.5 - Discretionary control over investments and investment advisers.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Discretionary control over investments and investment advisers. 703.5 Section 703.5 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS INVESTMENT AND DEPOSIT ACTIVITIES § 703.5 Discretionary control over investments and...

  18. "Saturday Night Live" Goes to High School: Conducting and Advising a Political Science Fair Project

    Science.gov (United States)

    Allen, Meg; Brewer, Paul R.

    2010-01-01

    This article uses a case study to illustrate how science fair projects--which traditionally focus on "hard science" topics--can contribute to political science education. One of the authors, a high school student, conducted an experimental study of politics for her science fair project. The other author, a faculty member, was asked to advise the…

  19. 76 FR 42949 - Rules Implementing Amendments to the Investment Advisers Act of 1940

    Science.gov (United States)

    2011-07-19

    ... amendments, including amendments to the Commission's pay to play rule, that address a number of other changes... Commission's ``pay to play'' rule,\\10\\ to address a number of other changes to the Advisers Act made by the... Play'' Rule 2. Technical and Conforming Amendments a. Rules 203(b)(3)-1 and 203(b)(3)-2 b. Rule 204-2 c...

  20. Factors Mediating the Interactions between Adviser and Advisee during the Master's Thesis Project: A Quantitative Approach

    Science.gov (United States)

    Rodrigues Jr., Jose Florencio; Lehmann, Angela Valeria Levay; Fleith, Denise De Souza

    2005-01-01

    Building on previous studies centred on the interaction between adviser and advisee in masters thesis projects, in which a qualitative approach was used, the present study uses factor analysis to identify the factors that determine either a successful or unsuccessful outcome for the masters thesis project. There were five factors relating to the…