WorldWideScience

Sample records for academic medical centers

  1. 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.

  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 medical centers write their own rules.

    Science.gov (United States)

    Freischlag, Julie Ann

    2011-09-01

    The interaction between pharmaceutical and device companies and hospitals and physicians has undergone significant transformation in the past few years due to the public's perception that bias may result when such relationships are not disclosed and monitored. Policies need to be written by medical centers and hospitals to preserve and retain the trust of the public. The policy written by Johns Hopkins Medical Institutions is outlined and its implications discussed in this article. The importance of such policies in guiding young faculty and staff as they begin their careers cannot be overemphasized. Copyright © 2011. Published by Mosby, Inc.

  4. 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.

  5. Palliative care benchmarks from academic medical centers.

    Science.gov (United States)

    Twaddle, Martha L; Maxwell, Terri L; Cassel, J Brian; Liao, Solomon; Coyne, Patrick J; Usher, Barbara M; Amin, Alpesh; Cuny, Joanne

    2007-02-01

    Palliative care is growing in the United States but little is known about the quality of care delivered. To benchmark the quality of palliative care in academic hospitals. Multicenter, cross-sectional, retrospective chart review conducted between October 1, 2002 and September 30, 2003. Thirty-five University HealthSystem Consortium (UHC) academic hospitals across the United States. A total of 1596 patient records. (1) adults, (2) high-mortality diagnoses: selected cancers, heart failure, human immunodeficiency virus (HIV), and respiratory conditions requiring ventilator support, (3) length of stay (LOS) more than 4 days, and (4) two prior admissions in the preceding 12 months. Compliance with 11 key performance measures (KPM) derived from practice standards, literature evidence, and input from a multidisciplinary expert committee. Analyses examined relationships between provision of the KPM and specific outcomes. Wide variability exists among academic hospitals in the provision of the KPM (0%-100%). The greater the compliance with KPM, the greater the improvement in quality outcomes, cost and LOS. Assessment of pain (96.1%) and dyspnea (90.2%) was high, but reduction of these symptoms was lower (73.3% and 77.2%). Documentation of prognosis (33.4%), psychosocial assessment (26.2%), communication with family/patient (46%), and timely planning for discharge disposition (53.4%) were low for this severely ill population (16.8% hospital mortality). Only 12.9% received a palliative care consultation. The study reveals significant opportunities for improvement in the effective delivery of palliative care. Care that met KPM was associated with improved quality, reduced costs and LOS. Institutions that benchmarked above 90% did so by integrating KPM into daily care processes and utilizing systematized triggers, forms and default pathways. The presence of a formalized palliative care program within a hospital system had a positive effect on the achievement of KPM, whether or

  6. Medical Informatics in Academic Health Science Centers.

    Science.gov (United States)

    Frisse, Mark E.

    1992-01-01

    An analysis of the state of medical informatics, the application of computer and information technology to biomedicine, looks at trends and concerns, including integration of traditionally distinct enterprises (clinical information systems, financial information, scholarly support activities, infrastructures); informatics career choice and…

  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. 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.

  9. Case study: a data warehouse for an academic medical center.

    Science.gov (United States)

    Einbinder, J S; Scully, K W; Pates, R D; Schubart, J R; Reynolds, R E

    2001-01-01

    The clinical data repository (CDR) is a frequently updated relational data warehouse that provides users with direct access to detailed, flexible, and rapid retrospective views of clinical, administrative, and financial patient data for the University of Virginia Health System. This article presents a case study of the CDR, detailing its five-year history and focusing on the unique role of data warehousing in an academic medical center. Specifically, the CDR must support multiple missions, including research and education, in addition to administration and management. Users include not only analysts and administrators but clinicians, researchers, and students.

  10. Missed diagnosis of psychotic depression at 4 academic medical centers.

    Science.gov (United States)

    Rothschild, Anthony J; Winer, Jesse; Flint, Alastair J; Mulsant, Benoit H; Whyte, Ellen M; Heo, Moonseong; Fratoni, Susan; Gabriele, Michelle; Kasapinovic, Sonja; Meyers, Barnett S

    2008-08-01

    Major depressive disorder with psychotic features (psychotic depression), though occurring relatively frequently in the general population, is a commonly missed psychiatric diagnosis. To ascertain accuracy of diagnosis of psychotic depression among inpatients at 4 academic medical centers and explore whether presenting symptoms, treatment setting, and physician's level of training affect the accuracy of diagnosis. The medical records of 65 patients who met DSM-IV criteria for psychotic depression following systematic assessment were analyzed to ascertain the concordance between chart diagnoses and research diagnoses arrived at using the Structured Clinical Interview for DSM-IV. The patients were participants in the National Institute of Mental Health Study of Pharmacotherapy of Psychotic Depression, conducted from December 28, 2002, through June 18, 2004, at 4 academic medical centers. For each patient's hospital visit, separate standardized data forms were completed on the basis of each physician's assessment of the patient prior to screening for the study. Hospital records from the emergency room and from admission to psychiatric units were reviewed. Among these 65 patients, 130 chart diagnoses had been made. Psychotic depression had not been diagnosed prior to research assessments for 27% of the 130 diagnoses in our sample. The 3 most common diagnoses assigned to patients meeting research criteria for psychotic depression were major depressive disorder without psychotic features, depression not otherwise specified, and mood disorder not otherwise specified. Failure to identify psychotic depression was more likely when symptoms of depressed mood, hallucinations, or delusions were not noted in the medical record (all p depression is frequently missed in emergency room and inpatient settings. The findings of this study are sobering given the serious morbidity and mortality of psychotic depression and the implications for treatment if an inaccurate diagnosis is made

  11. Early experiences with big data at an academic medical center

    National Research Council Canada - National Science Library

    Halamka, John D

    2014-01-01

    .... Various departments of the medical center and the physician practice groups affiliated with it have implemented electronic health records, filmless imaging, and networked medical devices to such an...

  12. 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.

  13. Deficits in allergy knowledge among physicians at academic medical centers.

    Science.gov (United States)

    Stukus, David R; Green, Todd; Montandon, Shari V; Wada, Kara J

    2015-07-01

    Allergic conditions have high prevalence in the general population. Misconceptions regarding the diagnosis and management of allergic disease among physicians can lead to suboptimal clinical care. To determine the extent of allergy-related knowledge deficits among physicians. Pediatric and internal medicine resident and attending physicians from 2 separate academic medical centers were asked to answer an anonymous electronic survey. Survey questions addressed 7 different allergy content areas. Four hundred eight physicians completed surveys (23.9% response rate). Respondents had few correct answers (mean ± SD 1.91 ± 1.43). Pediatric respondents had a larger number of correct answers compared with medicine-trained physicians (P immunology elective correlated with a larger number of correct responses (P pediatric and internal medicine physicians and across all levels of training and specialty. Given the prevalence of allergic conditions, the potential implications of a negative impact on clinical care are staggering. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  14. Strategic groups and performance differences among academic medical centers.

    Science.gov (United States)

    Schreyögg, Jonas; von Reitzenstein, Constantin

    2008-01-01

    The performance of academic medical centers (AMCs) differs from that of other hospitals because AMCs must combine the delivery of patient care with teaching and research. : This study investigates the effects of strategic group membership as opposed to other structural determinants on the performance of AMCs. We used data from 24 German AMCs and applied data envelopment analysis with superefficiency to measure the performance of AMCs by considering AMC-specific inputs and outputs for patient care, teaching, and research. We used cluster analysis to identify strategic groups and applied regression analysis to explore their impact on performance. Our results reveal two strategic groups based on a specialization either in teaching or in research. The strategic group that specialized in research showed significantly better performance; structural variables did not play a major role. The results provide an important justification for managers to develop suitable strategic concepts for AMCs. If low organizational efficiency is detected, managers need to consider analyzing whether their AMC belongs to an appropriate strategic group. An emphasis on research may increase overall efficiency.

  15. 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.

  16. U.S. academic medical centers under the managed health care environment.

    Science.gov (United States)

    Guo, K

    1999-06-01

    This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U.S. health care system through their missions of conducting cutting-edge biomedical research, pursuing clinical and technological innovations, providing state-of-the-art medical care and producing highly qualified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical science. To survive the threats of managed care in the health care environment, academic medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 108 CEOs in all the academic medical centers in the U.S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.

  17. 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.

  18. 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.

  19. First things first: foundational requirements for a medical home in an academic medical center.

    Science.gov (United States)

    Forman, Jane; Harrod, Molly; Robinson, Claire; Annis-Emeott, Ann; Ott, Jessica; Saffar, Darcy; Krein, Sarah L; Greenstone, Clinton L

    2014-07-01

    In 2010, the Veterans Health Administration (VHA) began implementation of its medical home, Patient Aligned Care Teams (PACT), in 900 primary care clinics nationwide, with 120 located in academically affiliated medical centers. The literature on Patient-Centered Medical Home (PCMH) implementation has focused mainly on small, nonacademic practices. To understand the experiences of primary care leadership, physicians and staff during early PACT implementation in a VHA academically affiliated primary care clinic and provide insights to guide future PCMH implementation. We conducted a qualitative case study during early PACT implementation. Primary care clinical leadership, primary care providers, residents, and staff. Between February 2011 and March 2012, we conducted 22 semi-structured interviews, purposively sampling participants by clinic role, and convenience sampling within role. We also conducted observations of 30 nurse case manager staff meetings, and collected data on growth in the number of patients, staff, and physicians. We used a template organizing approach to data analysis, using select constructs from the Consolidated Framework for Implementation Research (CFIR). Establishing foundational requirements was an essential first step in implementing the PACT model, with teamlets able to do practice redesign work. Short-staffing undermined development of teamlet working relationships. Lack of co-location of teamlet members in clinic and difficulty communicating with residents when they were off-site hampered communication. Opportunities to educate and reinforce PACT principles were constrained by the limited clinic hours of part-time primary care providers and residents, and delays in teamlet formation. Large academic medical centers face special challenges in implementing the medical home model. In an era of increasing emphasis on patient-centered care, our findings will inform efforts to both improve patient care and train clinicians to move from physician

  20. Tracking patient satisfaction at an academic medical center.

    Science.gov (United States)

    Lancaster, W; Lancaster, J

    1992-01-01

    Rising consumer expectations for convenient, quality health care is forcing many hospitals to focus increasing attention to measuring consumer perception and satisfaction with the care provided. At the University of Virginia Health Sciences Center, getting in close touch with the consumer has assumed a strategic position. As one part of the evolving Marketing Information System, a patient satisfaction tracking system is being designed to illicit patient feedback and hospital responses to service issues, assess patient satisfaction with various services, serve as a benchmark for evaluating changes in satisfaction over time, and provide necessary information for medical center planning, marketing and evaluation.

  1. 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.

  2. A suicide prevention advisory group at an academic medical center.

    Science.gov (United States)

    Hough, David; Lewis, Philip

    2010-05-01

    During a 15-month period, there were seven suicides among patients who were in active treatment or who had been seen recently by providers in the Department of Psychiatry of Tripler Army Medical Center, Honolulu, Hawaii. As a result, a Suicide Prevention Advisory Group (SPAG) was formed to identify possible causes and make recommendations aimed at improving the identification and treatment of suicidal patients. The group made 11 specific recommendations. No known suicides occurred during the 22 months after the implementation of the Suicide Prevention Advisory Group's recommendations.

  3. 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 (use increased over time for the entire cohort (2.9% to 82.4%, P use increased more in females and adults than in males and children, but differences in trends were not statistically significant (male versus female, P = .8; adult versus child, P = .1). The percentage of patients who had no imaging used for the diagnosis of appendicitis decreased over time (P use of ultrasound or MRI over the study period. With increasing BMI, CT was more frequently used. Of those diagnosed with appendicitis at an academic 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.

  4. Interns' experiences of disruptive behavior in an academic medical center.

    Science.gov (United States)

    Mullan, Charles P; Shapiro, Jo; McMahon, Graham T

    2013-03-01

    The first year of graduate medical education is an important period in the professional development of physicians. Disruptive behavior interferes with safe and effective clinical practice. To determine the frequency and nature of disruptive behavior perceived by interns and attending physicians in a teaching hospital environment. All 516 interns at Partners HealthCare (Boston, MA) during the 2010 and 2011 academic years were eligible to complete an anonymous questionnaire. A convenience nonrandom sample of 40 attending physicians also participated. A total of 394 of 516 eligible interns (76.4%) participated. Attendings and interns each reported that their team members generally behaved professionally (87.5% versus 80.4%, respectively). A significantly greater proportion of attendings than interns felt respected at work (90.0% versus 71.5% respectively; P  =  .01). Disruptive behavior was experienced by 93% of interns; 54% reported that they experienced it once a month or more. Interns reported disruptive behavior significantly more frequently than attending physicians, including increased reports of condescending behavior (odds ratio [OR], 5.46 for interns compared with attendings; P disruption, and were significantly more likely than faculty to identify nurses as the source of disruptive behavior (OR, 10.40; P disruption. Although interns generally feel respected at work, they frequently experience disruptive behavior. Interns described more disruptive behaviors than a convenience sample of attending physicians at our institution.

  5. Development and implementation of a comprehensive strategic plan for medical education at an academic medical center.

    Science.gov (United States)

    Schwartzstein, Richard M; Huang, Grace C; Coughlin, Christine M

    2008-06-01

    Despite their vital contributions to the training of future physicians, many academic teaching hospitals have grown operationally and financially distinct from affiliated medical schools because of divergent missions, contributing to the erosion of clinical training. Some institutions have responded by building hybrid organizations; others by creating large health care networks with variable relationships with the affiliated medical school. In this case, the authors wished to establish the future educational mission of their medical center as a core element of the institution by creating data-driven recommendations for reorganization, programs, and financing. They conducted a self-study of all constituents, the results of which confirmed the importance of education at their institution but also revealed the insufficiency of incentives for teaching. They underwent an external review by a committee of prominent educators, and they involved administrators at the hospital and the medical school. Together, these inputs composed an informed assessment of medical education at their teaching hospital, from which they developed and actualized an institution-wide strategic plan for education. Over the course of three years, they centralized the administrative structure for education, implemented programs that cross departments and reinforce the UME-GME continuum, and created transparency in the financing of medical education. The plan was purposefully aligned with the clinical and research strategic plans by supporting patient safety in programs and the professional development of faculty. The application of a rigorous strategic planning process to medical education at an academic teaching hospital can focus the mission, invigorate faculty, and lead to innovative programs.

  6. 97 Medical Apparatuses tested at the Academic Medical Center (AMC) Amsterdam for interference by WLAN/WiFi signals

    NARCIS (Netherlands)

    Hensbroek, R.

    2009-01-01

    This research describes the influence of WLAN 1 signals on medical apparatuses in the Academic Medical Center (AMC) Amsterdam. The results in this report were obtained by testing medical equipment with WLAN signals. A comparable research was reported earlier. See TNO report KvL/P&Z 2007.117 dated

  7. Managing information in the academic medical center: building an integrated information environment.

    Science.gov (United States)

    Fuller, S; Braude, R M; Florance, V; Frisse, M E

    1995-10-01

    The strategic importance of integrated information systems and resources for academic medical centers should not be underestimated. Ten years ago, the National Library of Medicine in collaboration with the Association of Academic Medical Centers initiated the Integrated Advanced Information Management System (IAIMS) program to assist academic medical centers in defining a process for addressing deficiencies in their information environments. The authors give a brief history of the IAIMS program, and they describe both the characteristics of an integrated information environment and the technical and organizational structures necessary to create such an environment. Strategies some institutions have used to implement integrated information systems are also outlined. Finally, the authors discuss the role of librarians in integrated information system design.

  8. 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

  9. Smartphones in medicine: emerging practices in an academic medical center.

    Science.gov (United States)

    Johnson, Angela C; El Hajj, Stephanie C; Perret, J Nelson; Caffery, Terrell S; Jones, Glenn N; Musso, Mandi W

    2015-01-01

    Advances in mobile phone technology now provide a myriad of resources to physicians' fingertips. However, the medical profession continues to struggle with potential for misuse of these devices. There is a need for better understanding of physicians' uses of smartphones in order to establish guidelines for appropriate and professional behavior. The purpose of the current study was to survey physicians' and medical students' practices concerning smartphone use in the healthcare setting. Physicians and medical students were asked to complete anonymous surveys regarding uses of smartphones within the past month in various healthcare settings. Overall, the participants reported distinctly different patterns in the uses they made of their phones in different settings (P<.001), with most individuals engaging in most behaviors while on break but few using their smartphones while with patients or during procedures. It appears that physicians and medical students make decisions about using their smartphones according to some combination of three considerations: degree of relevance to patient care, the appropriateness of the behavior in front of patients, and the issue of how disruptive that behavior may be.

  10. Emergency department discharge prescription errors in an academic medical center.

    Science.gov (United States)

    Murray, Kelly A; Belanger, April; Devine, Lauren T; Lane, Aaron; Condren, Michelle E

    2017-04-01

    This study described discharge prescription medication errors written for emergency department patients. This study used content analysis in a cross-sectional design to systematically categorize prescription errors found in a report of 1000 discharge prescriptions submitted in the electronic medical record in February 2015. Two pharmacy team members reviewed the discharge prescription list for errors. Open-ended data were coded by an additional rater for agreement on coding categories. Coding was based upon majority rule. Descriptive statistics were used to address the study objective. Categories evaluated were patient age, provider type, drug class, and type and time of error. The discharge prescription error rate out of 1000 prescriptions was 13.4%, with "incomplete or inadequate prescription" being the most commonly detected error (58.2%). The adult and pediatric error rates were 11.7% and 22.7%, respectively. The antibiotics reviewed had the highest number of errors. The highest within-class error rates were with antianginal medications, antiparasitic medications, antacids, appetite stimulants, and probiotics. Emergency medicine residents wrote the highest percentage of prescriptions (46.7%) and had an error rate of 9.2%. Residents of other specialties wrote 340 prescriptions and had an error rate of 20.9%. Errors occurred most often between 10:00 am and 6:00 pm.

  11. Training Tomorrow's Doctors: The Medical Education Mission of Academic Health Centers. A Report of the Commonwealth Fund Task Force on Academic Health Centers.

    Science.gov (United States)

    Commonwealth Fund, New York, NY.

    This report, fifth of a series on Academic Health Centers (AHCs), addresses the fundamental rationale of such centers: the education of the health care workforce. None of the missions of the 125 AHCs in the United States, medical schools and their closely affiliated hospitals and physician groups, is more important than the education of…

  12. Positioning academic medical centers and teaching hospitals to thrive in the next decade.

    Science.gov (United States)

    Morris, D E

    1985-06-01

    Market share for academic medical centers and teaching hospitals will decline over the next five years necessitating new strategies to ensure growth and profitability. These types of institutions are, however, in a strong position to compete and gain market share locally by building a defensible competitive advantage. This article offers three avenues for increasing market share: networking, brand name product differentiation, and business diversification.

  13. Research Strategies for Academic Medical Centers: A Framework for Advancements toward Translational Excellence

    Science.gov (United States)

    Haley, Rand; Champagne, Thomas J., Jr.

    2017-01-01

    This review article presents a simplified framework for thinking about research strategy priorities for academic medical centers (AMCs). The framework can serve as a precursor to future advancements in translational medicine and as a set of planning guideposts toward ultimate translational excellence. While market pressures, reform uncertainties,…

  14. The History of SHSAAMc: Student Health Services at Academic Medical Centers

    Science.gov (United States)

    Veeser, Peggy Ingram; Hembree, Wylie; Bonner, Julia

    2008-01-01

    This article presents an historical review of the organization known as Student Health Services at Academic Medical Centers (SHSAAMc). The authors discuss characteristics of health service directors as well as the history of meetings, discussion, and leadership. The focus of the group is the healthcare needs of health professions students at…

  15. Developing a Sustainable Research Culture in an Independent Academic Medical Center

    Science.gov (United States)

    Joyce, Jeffrey N.

    2013-01-01

    Independent academic medical centers (IAMC) are challenged to develop and support a research enterprise and maintain primary goals of healthcare delivery and financial solvency. Strategies for promoting translational research have been shown to be effective at institutions in the top level of federal funding, but not for smaller IAMCs. The…

  16. 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.

  17. 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.

  18. [The advantages of a large tertiary academic medical center in managing disease and promoting health: a glimpse into Sheba Medical Center].

    Science.gov (United States)

    Segal, Gad; Zimlichman, Eyal

    2015-02-01

    Academic medical centers have traditionally been at the forefront of medical training for the next generation of clinicians, providing the highest quality of care and conducting translational and clinical research. The Sheba Medical Center is the largest academic medical center in Israel and, as such, has been shaping the medical scene in Israel since the birth of the State. The cornerstones of the Sheba Medical Center have always brought together the best clinicians, fostering a multidisciplinary approach environment, encouraging research and innovation from lab to bedside and compassionate, patient-centered care. Clinicians at Sheba enjoy the wide variety of clinical conditions that are present at the hospital, the existence of multiple professions and specialties from neonates to geriatric rehabilitation and the advanced technologies available to patients. In this special issue we describe some of the important work that takes place at Sheba, while emphasizing the above-mentioned advantages.

  19. 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.

  20. 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.

  1. 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.

  2. Primary care compensation at an academic medical center: a model for the mixed-payer environment.

    Science.gov (United States)

    Sussman, A J; Fairchild, D G; Coblyn, J; Brennan, T A

    2001-07-01

    The authors' academic medical center, Brigham and Women's Hospital, Boston, Massachusetts, developed a primary care physician (PCP) salary incentive program for employed academic physicians. This program, first implemented in 1999, was needed to meet the financial imperatives placed on the institution by managed care and the Balanced Budget Act of 1997; its goal was to create a set of incentives for PCPs that is consistent with the mission of the academic center and helps motivate and reward PCP's work. The program sought to simultaneously increase productivity while optimizing resource utilization in a mixed-payer environment. The salary incentive program uses work relative-value units (wRVUs) as the measure of productivity. In addition to productivity-derived base pay, bonus incentives are added for efficient medical management, quality of care, teaching, and seniority. The authors report that there was significant concern from several members of the physician staff before the plan was implemented; they felt that the institution's PCPs were already operating at maximum clinical capacity. However, after the first year of operation of this plan, there was an overall 20% increase in PCP productivity. Increases were observed in all PCP subgroups when stratified by professional experience, clinical time commitment, and practice location. The authors conclude that the program has succeeded in giving incentives for academic PCPs to achieve under the growing demands for revenue self-sufficiency, managed care performance, quality of care, and academic commitment.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. Characteristics of postgraduate year 1 pharmacy residency programs at academic medical centers.

    Science.gov (United States)

    Phillips, Holly; Jasiak, Karalea D; Lindberg, Lance S; Ryzner, Kristi L

    2011-08-01

    The training components and other characteristics of postgraduate year 1 (PGY1) pharmacy residency programs at a sample of academic medical centers were evaluated. A questionnaire was sent via e-mail to the directors of 98 PGY1 residency programs at academic medical centers in the University HealthSystem Consortium (UHC) to elicit benchmarking data on issues such as recruitment, learning experiences, resident staffing requirements, resident research projects and professional presentations, opportunities for resident participation in teaching activities, and requirements for faculty service as preceptors; 72 program directors responded to the survey. The residency programs represented in the survey reported an average of approximately 14 applicants for each available position in 2010 and an average of about five candidate interviews per available position. The survey results indicated wide variation in the learning experiences offered by PGY1 programs (the most commonly reported rotations were in administration, critical care, internal medicine, ambulatory care, and drug information), with a high degree of individualization of elective rotations. Almost all programs had a mandatory staffing component, typically requiring 4-10 hours of service weekly. Results of this survey indicate that there is a large amount of variation in the components of PGY1 pharmacy residency programs among UHC academic medical centers. The majority of respondents reported no change in the number of residency positions offered within the past two years, but they reported an increase in the number of applications from 2009 to 2010.

  8. Comparison of patient outcomes in academic medical centers with and without value analysis programs

    Directory of Open Access Journals (Sweden)

    Murray AS

    2012-09-01

    Full Text Available Adrienne S Murray, Michael Griswold, Imran Sunesara, Ed SmithUniversity of Mississippi Health Care, University of Mississippi Medical Center, Jackson, MS, USABackground: Value analysis is the science of balancing the mandate to deliver high-quality clinical outcomes with the necessity to drive down costs in order to thrive in the challenging economics of health care. This study compared average length of stay, direct cost, morbidity, and mortality across the cardiology, cardiovascular, neuroscience, and orthopedic service lines, in academic medical centers with and without value analysis programs (VAPs. The basic question was, “Do academic medical centers with VAPs have lower average length of stay, better morbidity and mortality rates, and lower overall supply costs?”Methods and results: The clinical data base/resource manager (CDB/RM of the University HealthSystem Consortium was utilized as secondary data for this study. Reports from the CDB/RM were generated from 2006 to 2011. Continuous variable differences across VAP status were examined using Wilcoxon two-sample tests. Primary analyses used multilevel linear mixed model methods to estimate the effects of VAPs on primary outcomes (average length of stay, cost, morbidity, mortality. Association components of the linear mixed models incorporated random effects at the hospital level and robust, Huber-White, standard errors were calculated. There was no significant difference for average length of stay, direct cost, morbidity, and mortality between academic medical centers with and without VAPs. However, outcomes were not noted to be substantially worse.Conclusion: Numerous case studies reveal that aggressively active VAPs do decrease hospital cost. Also, this study did not find a negative impact on patient care. Further studies are needed to explore the benefits of value analysis and its effect on patient outcomes.Keywords: value analysis, average length of stay, morbidity, mortality

  9. 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.

  10. 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

  11. Key Elements of Clinical Physician Leadership at an Academic Medical Center

    Science.gov (United States)

    Dine, C. Jessica; Kahn, Jeremy M; Abella, Benjamin S; Asch, David A; Shea, Judy A

    2011-01-01

    Background A considerable body of literature in the management sciences has defined leadership and how leadership skills can be attained. There is considerably less literature about leadership within medical settings. Physicians-in-training are frequently placed in leadership positions ranging from running a clinical team or overseeing a resuscitation effort. However, physicians-in-training rarely receive such training. The objective of this study was to discover characteristics associated with effective physician leadership at an academic medical center for future development of such training. Methods We conducted focus groups with medical professionals (attending physicians, residents, and nurses) at an academic medical center. The focus group discussion script was designed to elicit participants' perceptions of qualities necessary for physician leadership. The lead question asked participants to imagine a scenario in which they either acted as or observed a physician leader. Two independent reviewers reviewed transcripts to identify key domains of physician leadership. Results Although the context was not specified, the focus group participants discussed leadership in the context of a clinical team. They identified 4 important themes: management of the team, establishing a vision, communication, and personal attributes. Conclusions Physician leadership exists in clinical settings. This study highlights the elements essential to that leadership. Understanding the physician attributes and behaviors that result in effective leadership and teamwork can lay the groundwork for more formal leadership education for physicians-in-training. PMID:22379520

  12. Key elements of clinical physician leadership at an academic medical center.

    Science.gov (United States)

    Dine, C Jessica; Kahn, Jeremy M; Abella, Benjamin S; Asch, David A; Shea, Judy A

    2011-03-01

    A considerable body of literature in the management sciences has defined leadership and how leadership skills can be attained. There is considerably less literature about leadership within medical settings. Physicians-in-training are frequently placed in leadership positions ranging from running a clinical team or overseeing a resuscitation effort. However, physicians-in-training rarely receive such training. The objective of this study was to discover characteristics associated with effective physician leadership at an academic medical center for future development of such training. We conducted focus groups with medical professionals (attending physicians, residents, and nurses) at an academic medical center. The focus group discussion script was designed to elicit participants' perceptions of qualities necessary for physician leadership. The lead question asked participants to imagine a scenario in which they either acted as or observed a physician leader. Two independent reviewers reviewed transcripts to identify key domains of physician leadership. Although the context was not specified, the focus group participants discussed leadership in the context of a clinical team. They identified 4 important themes: management of the team, establishing a vision, communication, and personal attributes. Physician leadership exists in clinical settings. This study highlights the elements essential to that leadership. Understanding the physician attributes and behaviors that result in effective leadership and teamwork can lay the groundwork for more formal leadership education for physicians-in-training.

  13. An academic medical center model for community colorectal cancer screening: the Centers for Disease Control and Prevention demonstration program experience.

    Science.gov (United States)

    Lane, Dorothy S; Cavanagh, Mary F; Messina, Catherine R; Anderson, Joseph C

    2010-08-01

    During 2005-2009, the Centers for Disease Control and Prevention funded five colorectal cancer (CRC) screening demonstration projects around the United States; only one was based in an academic medical center (AMC) rather than a health department. The Suffolk County Preventive Endoscopy Project (Project SCOPE) was a collaborative effort between Stony Brook University Medical Center (SBUMC) and the Suffolk County Department of Health Services. Project SCOPE's objective was to increase CRC screening among Suffolk County residents at least 50 years old who had inadequate or no insurance coverage for CRC screening. The demonstration application drew on the screening, diagnostic, and treatment resources of the AMC and the indigent populations using its outpatient clinics. Patients at 10 county health centers were a primary target for (previously inaccessible) colonoscopy screening. The project's organizational center was SBUMC's preventive medicine department, which was linked to SBUMC's large gastroenterology practice. The specific staffing, financial, and training issues faced by this project provide insights for others who are similarly interested in community engagement. During 40 months of screening, 800 indigent, culturally diverse patients were recruited, and they underwent colonoscopy. Challenges encountered included unreachable referred patients (425 patients; 28% of referrals) and medical ineligibility (e.g., symptomatic comorbid conditions). Pending legislation providing federal funding for a national program offers other AMCs the opportunity to adopt a model such as that proven feasible during Project SCOPE. The lessons learned may have broader application for fostering collaborative AMC partnerships and for enhancing recruitment and retention of participants through outreach.

  14. Good Neighbors: Shared Challenges and Solutions Toward Increasing Value at Academic Medical Centers and Universities.

    Science.gov (United States)

    Clancy, Gerard P

    2015-12-01

    Academic medical centers (AMCs) and universities are experiencing increasing pressure to enhance the value they offer at the same time that they are facing challenges related to outcomes, controlling costs, new competition, and government mandates. Yet, rarely do the leaders of these academic neighbors work cooperatively to enhance value. In this Perspective the author, a former university regional campus president with duties in an AMC as an academic physician, shares his insights into the shared challenges these academic neighbors face in improving the value of their services in complex environments. He describes the successes some AMCs have had in generating revenues from new clinical programs that reduce the overall cost of care for larger populations. He also describes how several universities have taken a comprehensive approach to reduce overhead and administrative costs. The author identifies six themes related to successful value improvement efforts and provides examples of successful strategies used by AMCs and their university neighbors to improve the overall value of their programs. He concludes by encouraging leaders of AMCs and universities to share information about their successes in value improvements with each other, to seek additional joint value enhancement efforts, and to market their value improvements to the public.

  15. 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.

  16. Population health and the academic medical center: the time is right.

    Science.gov (United States)

    Gourevitch, Marc N

    2014-04-01

    Optimizing the health of populations, whether defined as persons receiving care from a health care delivery system or more broadly as persons in a region, is emerging as a core focus in the era of health care reform. To achieve this goal requires an approach in which preventive care is valued and "nonmedical" determinants of patients' health are engaged. For large, multimission systems such as academic medical centers, navigating the evolution to a population-oriented paradigm across the domains of patient care, education, and research poses real challenges but also offers tremendous opportunities, as important objectives across each mission begin to align with external trends and incentives. In clinical care, opportunities exist to improve capacity for assuming risk, optimize community benefit, and make innovative use of advances in health information technology. Education must equip the next generation of leaders to understand and address population-level goals in addition to patient-level needs. And the prospects for research to define strategies for measuring and optimizing the health of populations have never been stronger. A remarkable convergence of trends has created compelling opportunities for academic medical centers to advance their core goals by endorsing and committing to advancing the health of populations.

  17. 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.

  18. Commentary: The battle of Louisville: money, power, politics, and publicity at an academic medical center.

    Science.gov (United States)

    Halperin, Edward C

    2011-10-01

    In 2009, the entire clinical faculty of the Department of Neurosurgery of the University of Louisville School of Medicine elected to become employees of a nearby community hospital. This took place in the context of the financial burden of caring for the indigent, declining reimbursement, clinical demands for neurosurgical coverage of a level 1 trauma center, rising salaries for neurosurgeons, and competitive pressure on hospitals. The author, who was dean of the school of medicine at the time, would not accept the abrupt withdrawal of these clinicians from the faculty practice plan, single-point contracting, and academic governance of clinical work assignments. Politicians, the press, and accreditation bodies quickly weighed in as the university, the school, and the public good were placed in jeopardy. The motivations for this event-the community hospital defending its market share and physician recruitment and retention pipeline, the dean defending principles of academic governance and the faculty practice plan-and the responses of the participants offer an instructive case study for academic medical management. The author concludes that one might view the protagonists of this episode not as defenders of principles but, rather, as pawns in a larger drama playing out related to a perfect storm of economic and social pressures in American medicine.

  19. Preparing an Academic Medical Center to Manage Patients Infected With Ebola: Experiences of a University Hospital.

    Science.gov (United States)

    Schultz, Carl H; Koenig, Kristi L; Alassaf, Wajdan

    2015-10-01

    As Ebola has spread beyond West Africa, the challenges confronting health care systems with no experience in managing such patients are enormous. Not only is Ebola a significant threat to a population's health, it can infect the medical personnel trying to treat it. As such, it represents a major challenge to those in public health, emergency medical services (EMS), and acute care hospitals. Our academic medical center volunteered to become an Ebola Treatment Center as part of the US effort to manage the threat. We developed detailed policies and procedures for Ebola patient management at our university hospital. Both the EMS system and county public health made significant contributions during the development process. This article shares information about this process and the outcomes to inform other institutions facing similar challenges of preparing for an emerging threat with limited resources. The discussion includes information about management of (1) patients who arrive by ambulance with prior notification, (2) spontaneous walk-in patients, and (3) patients with confirmed Ebola who are interfacility transfers. Hospital management includes information about Ebola screening procedures, personal protective equipment selection and personnel training, erection of a tent outside the main facility, establishing an Ebola treatment unit inside the facility, and infectious waste and equipment management. Finally, several health policy considerations are presented.

  20. 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.

  1. The impact of the lack of health insurance: how should academic medical centers and medical schools respond?

    Science.gov (United States)

    Coleman, David L

    2006-08-01

    The lack of health insurance has significant deleterious effects on the health of individual patients and creates substantial financial pressure on health care institutions. Despite the historical role of academic medical centers (AMCs) and medical schools in caring for the uninsured, financial shortfalls have increased pressure on these institutions to restrict care of this population. Limiting care of the uninsured, however, conflicts with the ethical foundations of academic medicine and risks further harm to the health of this population. Instead of restricting care, the effects of uninsurance should be mitigated through the joint efforts of medical schools and AMCs by measuring clinical work using work Relative Value Units rather than collections; recognizing faculty who provide care for the uninsured in the promotions process; adjusting billing rates for clinical services according to patients' ability to pay; delivering one standard of care irrespective of insurance status; continuing to evaluate the impact of uninsurance and intervention strategies; providing leadership in measuring and improving the quality of care; ensuring that trainees and the public are familiar with the effects of a lack of health insurance; and assisting safety net providers by providing educational materials pertinent to their respective patient populations and more fully integrating these providers into the academic community. Although all physicians in the private and public sectors should share in the care of the uninsured, academic medicine must remain faithful to its historical role of providing care to the uninsured and should improve the health of the uninsured through a proactive strategy involving advocacy, clinical care, education, and research.

  2. Confronting conflict: addressing institutional conflicts of interest in academic medical centers.

    Science.gov (United States)

    Liang, Bryan A; Mackey, Tim

    2010-01-01

    Individual conflicts of interest are rife in healthcare, and substantial attention has been given to address them. Yet a more substantive concern-institutional conflicts of interest ("ICOIs") in academic medical centers ("AMCs") engaged in research and clinical care-have yet to garner sufficient attention, despite their higher stakes for patient safety and welfare. ICOIs are standard in AMCs, are virtually unregulated, and have led to patient deaths. Upon review of ICOIs, we find a clear absence of substantive efforts to confront these conflicts. We also assess the Jesse Gelsinger case, which resulted in the death of a study participant exemplifying a deep-seated culture of institutional indifference and complicity in unmanaged conflicts. Federal policy, particularly the Bayh-Dole Act, also creates and promotes ICOIs. Efforts to address ICOIs are narrow or abstract, and do not provide for a systemic infrastructure with effective enforcement mechanisms. Hence, in this paper, we provide a comprehensive proposal to address ICOIs utilizing a "Centralized System" model that would proactively review, manage, approve, and conduct assessments of conflicts, and would have independent power to evaluate and enforce any violations via sanctions. It would also manage any industry funds and pharmaceutical samples and be a condition of participation in public healthcare reimbursement and federal grant funding. The ICOI policy itself would provide for disclosure requirements, separate management of commercial enterprise units from academic units, voluntary remediation of conflicts, and education on ICOIs. Finally, we propose a new model of medical education-academic detailing-in place of current marketing-focused "education." Using such a system, AMCs can wean themselves from industry reliance and promote a culture of accountability and independence from industry influence. By doing so, clinical research and treatment can return to a focus on patient care, not profits.

  3. Integrating complementary and alternative medicine into academic medical centers: Experience and perceptions of nine leading centers in North America

    Directory of Open Access Journals (Sweden)

    Waters Kellie

    2005-12-01

    Full Text Available Background Patients across North America are using complementary and alternative medicine (CAM with increasing frequency as part of their management of many different health conditions. The objective of this study was to develop a guide for academic health sciences centers that may wish to consider starting an integrative medicine program. Methods We queried North American leaders in the field of integrative medicine to identify initial sites. Key stakeholders at each of the initial sites visited were then asked to identify additional potential study sites (snowball sampling, until no new sites were identified. We conducted structured interviews to identify critical factors associated with success and failure in each of four domains: research, education, clinical care, and administration. During the interviews, field notes were recorded independently by at least two investigators. Team meetings were held after each visit to reach consensus on the information recorded and to ensure that it was as complete as possible. Content analysis techniques were used to identify key themes that emerged from the field notes. Results We identified ten leading North American integrative medical centers, and visited nine during 2002–2003. The centers visited suggested that the initiation of an integrative medicine program requires a significant initial outlay of funding and a motivated "champion". The centers had important information to share regarding credentialing, medico-legal issues and billing for clinical programs; identifying researchers and research projects for a successful research program; and strategies for implementing flexible educational initiatives and establishing a functional administrative structure. Conclusion Important lessons can be learned from academic integrative programs already in existence. Such initiatives are timely and feasible in a variety of different ways and in a variety of settings.

  4. 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.

  5. Bariatric Surgery and Liver Cancer in a Consortium of Academic Medical Centers.

    Science.gov (United States)

    Yang, Baiyu; Yang, Hannah P; Ward, Kristy K; Sahasrabuddhe, Vikrant V; McGlynn, Katherine A

    2016-03-01

    Obesity is implicated as an important factor in the rising incidence of liver cancer in the USA. Bariatric surgery is increasingly used for treating morbid obesity and comorbidities. Using administrative data from UHC, a consortium of academic medical centers in the USA, we compared the prevalence of liver cancer among admissions with and without a history of bariatric surgery within a 3-year period. Admissions with a history of bariatric surgery had a 61 % lower prevalence of liver cancer compared to those without a history of bariatric surgery (prevalence ratio 0.39, 95 % confidence interval 0.35-0.44), and these inverse associations persisted within strata of sex, race, and ethnicity. This hospital administrative record-based analysis suggests that bariatric surgery could play a role in liver cancer prevention.

  6. 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.

  7. Neighborhood poverty rate and mortality in patients receiving critical care in the academic medical center setting.

    Science.gov (United States)

    Zager, Sam; Mendu, Mallika L; Chang, Domingo; Bazick, Heidi S; Braun, Andrea B; Gibbons, Fiona K; Christopher, Kenneth B

    2011-06-01

    Poverty is associated with increased risk of chronic illness but its contribution to critical care outcome is not well defined. We performed a multicenter observational study of 38,917 patients, aged ≥ 18 years, who received critical care between 1997 and 2007. The patients were treated in two academic medical centers in Boston, Massachusetts. Data sources included 1990 US census and hospital administrative data. The exposure of interest was neighborhood poverty rate, categorized as 40%. Neighborhood poverty rate is the percentage of residents below the federal poverty line. Census tracts were used as the geographic units of analysis. Logistic regression examined death by days 30, 90, and 365 post-critical care initiation and in-hospital mortality. Adjusted ORs were estimated by multivariable logistic regression models. Sensitivity analysis was performed for 1-year postdischarge mortality among patients discharged to home. Following multivariable adjustment, neighborhood poverty rate was not associated with all-cause 30-day mortality: 5% to 10% OR, 1.05 (95% CI, 0.98-1.14; P = .2); 10% to 20% OR, 0.96 (95% CI, 0.87-1.06; P = .5); 20% to 40% OR, 1.08 (95% CI, 0.96-1.22; P = .2); > 40% OR, 1.20 (95% CI, 0.90-1.60; P = .2); referent in each is poverty rate was not associated with 1-year-postdischarge mortality. Our study suggests that there is no relationship between the neighborhood poverty rate and mortality up to 1 year following critical care at academic medical centers.

  8. 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.

  9. 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.

  10. The cost of medical dictation transcription at an academic family practice center.

    Science.gov (United States)

    Lawler, F H; Scheid, D C; Viviani, N J

    1998-01-01

    Very little is known about the volume or cost of medical transcription in primary care. A study of the number of lines and cost of transcription at an academic family practice center was performed to establish the average number of lines and costs of transcription by level of service and type of provider (faculty physician, physician assistant, resident physician, and others). Parallel 4-month sets of computerized billing records and computerized transcription summary logs (listing the patient name and identification, the dictator, the number of lines of dictation, and the date for each dictation) were merged and analyzed to compare the cost and volume of dictation by types of service and types of provider. During the study period there were 11,085 patient encounters, 9013 with transcription. The average cost of transcription per encounter using transcription was $3.96 and the median was $3.64. The cost per encounter ranged from $0.39 (3 lines of dictation) to $24.83 (191 lines of dictation). Faculty physicians and physician assistants had the lowest cost, resident physicians were intermediate in cost, and others (such as medical students) had the highest costs for medical transcription. Transcription costs rose with increasing level of service but became a smaller proportion of the collected fee, averaging only 5% for a level 5 encounter. The cost of transcription as a part of overhead was higher than anticipated. Specific education regarding dictation form and content and ways to decrease these costs is appropriate.

  11. 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.

  12. 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.

  13. 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.

  14. Improved Operating Room Efficiency via Constraint Management: Experience of a Tertiary-Care Academic Medical Center.

    Science.gov (United States)

    Kimbrough, Charles W; McMasters, Kelly M; Canary, Jeff; Jackson, Lisa; Farah, Ian; Boswell, Mark V; Kim, Daniel; Scoggins, Charles R

    2015-07-01

    Suboptimal operating room (OR) efficiency is a universal complaint among surgeons. Nonetheless, maximizing efficiency is critical to institutional success. Here, we report improvement achieved from low-cost, low-technology measures instituted within a tertiary-care academic medical center/Level I trauma center. Improvements in preadmission testing and OR scheduling, including appointing a senior nurse anesthetist to help direct OR use, were instituted in March 2012. A retrospective review of prospectively maintained OR case data was performed to evaluate time periods before and after program implementation, as well as to assess trends over time. Operating room performance metrics were compared using Mann-Whitney and chi-squared tests. Changes over time were analyzed using linear regression. Data including all surgical cases were available for a 36-month period; 10 months (6,581 cases) before program implementation and 26 months afterward (17,574 cases). Dramatic improvement was seen in first-case on-time starts, which increased from 39.3% to 83.8% (p efficiency and case volume. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Implementation of computerized prescriber order entry in four academic medical centers.

    Science.gov (United States)

    Cooley, Thomas W; May, Dianne; Alwan, Michael; Sue, Caron

    2012-12-15

    Lessons learned through the transition to computerized prescriber order entry (CPOE) at four academic medical centers are reviewed. CPOE is an important strategy in efforts to improve medication and patient safety and achieve compliance with federal health care information technology objectives. Pharmacy-led CPOE implementation teams at Brigham and Women's Hospital, Georgia Health Sciences Health System, UC Health University Hospital, and University of Utah Hospitals and Clinics were challenged to overcome different types of resource, staffing, and hardware-software constraints. Their collective experience points to a number of factors that are essential to successful CPOE implementation, including (1) involvement by all ancillary personnel in system planning, development, implementation, and refinement, (2) selection of CPOE equipment that offers a high level of interoperability with existing information systems and automated dispensing machines, (3) development of electronic order sets and clinical decision support (CDS) tools that are designed for ease of use and tailored to the hospital's clinical workflows, and (4) dedication of adequate resources and time for staff training, technical support, and system troubleshooting and maintenance. In particular, facilities transitioning to CPOE must secure initial and ongoing physician input and feedback to ensure patient safety and reduce CDS-related problems and other barriers to broad system acceptance. Before implementing CPOE, addressing institutional considerations pertaining to system selection, preimplementation preparation, staff training, necessary equipment, program rollout, and postimplementation maintenance can increase the likelihood of a smooth transition to CPOE and optimal system performance.

  16. Evaluation of intravenous medication errors with smart infusion pumps in an academic medical center

    National Research Council Canada - National Science Library

    Ohashi, Kumiko; Dykes, Patricia; McIntosh, Kathleen; Buckley, Elizabeth; Wien, Matt; Bates, David W

    2013-01-01

    While some published research indicates a fairly high frequency of Intravenous (IV) medication errors associated with the use of smart infusion pumps, the generalizability of these results are uncertain...

  17. A comprehensive model to build improvement capability in a pediatric academic medical center.

    Science.gov (United States)

    Kaminski, Gerry M; Schoettker, Pamela J; Alessandrini, Evaline A; Luzader, Carolyn; Kotagal, Uma

    2014-01-01

    Cincinnati Children's Hospital Medical Center developed a comprehensive model to build quality improvement (QI) capability to support its goal to transform its delivery system through a series of training courses. Two online modules orient staff to basic concepts and terminology and prepare them to participate more effectively in QI teams. The basic program (Rapid Cycle Improvement Collaborative, RCIC) is focused on developing the capability to use basic QI tools and complete a narrow-scoped project in approximately 120 days. The Intermediate Improvement Science Series (I(2)S(2)) program is a leadership course focusing on improvement skills and developing a broader and deeper understanding of QI in the context of the organization and external environment. The Advanced Improvement Methods (AIM) course and Quality Scholars Program stimulate the use of more sophisticated methods and prepare Cincinnati Children's Hospital Medical Center (CCHMC) and external faculty to undertake QI research. The Advanced Improvement Leadership Systems (AILS) sessions enable interprofessional care delivery system leadership teams to effectively lead a system of care, manage a portfolio of projects, and to deliver on CCHMC's strategic plan. Implementing these programs has shown us that 1) a multilevel curricular approach to building improvement capability is pragmatic and effective, 2) an interprofessional learning environment is critical to shifting mental models, 3) repetition of project experience with coaching and feedback solidifies critical skills, knowledge and behaviors, and 4) focusing first on developing capable interprofessional improvement leaders, versus engaging in broad general QI training across the whole organization, is effective. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  18. The Academic Medical Center Linear Disability Score item bank: psychometric properties of a new generic disability measure in rheumatoid arthritis

    NARCIS (Netherlands)

    Weisscher, Nadine; Wijbrandts, Carla A.; de Haan, Rob; Glas, Cees A. W.; Vermeulen, Marinus; Tak, Paul Peter

    2007-01-01

    OBJECTIVE: To determine the psychometric properties of the Academic Medical Center (AMC) Linear Disability Scale (ALDS) item bank in a population of patients with rheumatoid arthritis (RA). METHODS: 129 patients with RA completed the ALDS and Health Assessment Questionnaire Disability Index (HAQ-DI)

  19. Association Between Academic Medical Center Pharmaceutical Detailing Policies and Physician Prescribing.

    Science.gov (United States)

    Larkin, Ian; Ang, Desmond; Steinhart, Jonathan; Chao, Matthew; Patterson, Mark; Sah, Sunita; Wu, Tina; Schoenbaum, Michael; Hutchins, David; Brennan, Troyen; Loewenstein, George

    2017-05-02

    In an effort to regulate physician conflicts of interest, some US academic medical centers (AMCs) enacted policies restricting pharmaceutical representative sales visits to physicians (known as detailing) between 2006 and 2012. Little is known about the effect of these policies on physician prescribing. To analyze the association between detailing policies enacted at AMCs and physician prescribing of actively detailed and not detailed drugs. The study used a difference-in-differences multivariable regression analysis to compare changes in prescribing by physicians before and after implementation of detailing policies at AMCs in 5 states (California, Illinois, Massachusetts, Pennsylvania, and New York) that made up the intervention group with changes in prescribing by a matched control group of similar physicians not subject to a detailing policy. Academic medical center implementation of policies regulating pharmaceutical salesperson visits to attending physicians. The monthly within-drug class market share of prescriptions written by an individual physician for detailed and nondetailed drugs in 8 drug classes (lipid-lowering drugs, gastroesophageal reflux disease drugs, diabetes drugs, antihypertensive drugs, hypnotic drugs approved for the treatment of insomnia [sleep aids], attention-deficit/hyperactivity disorder drugs, antidepressant drugs, and antipsychotic drugs) comparing the 10- to 36-month period before implementation of the detailing policies with the 12- to 36-month period after implementation, depending on data availability. The analysis included 16 121 483 prescriptions written between January 2006 and June 2012 by 2126 attending physicians at the 19 intervention group AMCs and by 24 593 matched control group physicians. The sample mean market share at the physician-drug-month level for detailed and nondetailed drugs prior to enactment of policies was 19.3% and 14.2%, respectively. Exposure to an AMC detailing policy was associated with a

  20. A division of medical communications in an academic medical center's department of medicine.

    Science.gov (United States)

    Drazen, Jeffrey M; Shields, Helen M; Loscalzo, Joseph

    2014-12-01

    Excellent physician communication skills (physician-to-patient and patient-to-physician) have been found to have a positive impact on patient satisfaction and may positively affect patient health behaviors and health outcomes. Such skills are also essential for accurate, succinct, and clear peer-to-peer (physician-to-physician), physician-to-lay-public, and physician-to-media communications. These skills are not innate, however; they must be learned and practiced repeatedly. The Division of Medical Communications (DMC) was created within the Department of Medicine at Brigham and Women's Hospital as an intellectual home for physicians who desire to learn and teach the wide variety of skills needed for effective communication.In this Perspective, the authors provide an overview of the key types of medical communications and share the DMC model as an innovative approach to providing expert guidance to physicians and physicians-in-training as they develop, practice, and refine their communication skills. Current DMC projects and programs include a Volunteer Patient Teaching Corps, which provides feedback to medical students, residents, and faculty on communication skills; a controlled trial of a modified team-based learning method for attending rounds; expert coaching in preparation for presentations of all types (e.g., grand rounds; oral presentations or poster presentations on basic science, clinical, or medical education research); sessions on speaking to the media and running a meeting well; and courses on writing for publication. Objective assessment of the impact of each of these interventions is planned.

  1. Effective strategies in improving operating room case delays and cancellations at an academic medical center.

    Science.gov (United States)

    Kaye, Alan David; McDowell, Joseph L; Diaz, James H; Buras, Jay A; Young, Amy E; Urman, Richard D

    2015-01-01

    Traditionally, the operating room (OR) in an academic medical center has faced numerous challenges to effective clinical productivity, including additional missions of teaching and research. Level 1 trauma poses more challenges related to the need for additional specialized personnel in anesthesia, surgery, and nursing. The present investigation explores lessons learned in efficiency, teamwork, and data evaluation at a level 1 academic teaching facility. The months of July 2012, July 2013, and July 2014 were selected for this study. Multiple strategies were implemented through the Operating Room Committee during this time in an effort to reduce the number of OR delays and cancellations. Case cancellations decreased significantly over the three-year period, while delays remained relatively stable. In July 2012, 15.0% of cases were cancelled and 10.2% were delayed. Cancellations decreased to 6.3% in 2013 and to 5.9% in 2014. The total number of cases completed per month increased each year throughout the study, from 577 in 2012 to 649 in 2013 to 842 in 2014. These results are remarkable in comparison to the greater-than 20% cancellation rate recorded in 2005 when the current OR leadership team first assessed OR efficiency. An increase in the number of cases completed per month likely can be attributed to a reduction in the number of case cancellations. Increased efficiency allows for more operations to be performed, leading to increased profitability and an increased ability of hospitals to continue caring for patients. We advocate the implementation of a comprehensive multidisciplinary strategy for sustained improvement in OR efficiency and utilization.

  2. Creating a longitudinal integrated clerkship with mutual benefits for an academic medical center and a community health system.

    Science.gov (United States)

    Poncelet, Ann Noelle; Mazotti, Lindsay A; Blumberg, Bruce; Wamsley, Maria A; Grennan, Tim; Shore, William B

    2014-01-01

    The longitudinal integrated clerkship is a model of clinical education driven by tenets of social cognitive theory, situated learning, and workplace learning theories, and built on a foundation of continuity between students, patients, clinicians, and a system of care. Principles and goals of this type of clerkship are aligned with primary care principles, including patient-centered care and systems-based practice. Academic medical centers can partner with community health systems around a longitudinal integrated clerkship to provide mutual benefits for both organizations, creating a sustainable model of clinical training that addresses medical education and community health needs. A successful one-year longitudinal integrated clerkship was created in partnership between an academic medical center and an integrated community health system. Compared with traditional clerkship students, students in this clerkship had better scores on Clinical Performance Examinations, internal medicine examinations, and high perceptions of direct observation of clinical skills.Advantages for the academic medical center include mitigating the resources required to run a longitudinal integrated clerkship while providing primary care training and addressing core competencies such as systems-based practice, practice-based learning, and interprofessional care. Advantages for the community health system include faculty development, academic appointments, professional satisfaction, and recruitment.Success factors include continued support and investment from both organizations' leadership, high-quality faculty development, incentives for community-based physician educators, and emphasis on the mutually beneficial relationship for both organizations. Development of a longitudinal integrated clerkship in a community health system can serve as a model for developing and expanding these clerkship options for academic medical centers.

  3. 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.

  4. Practical Issues in Delivery of Clinician-to-Patient Telemental Health in an Academic Medical Center.

    Science.gov (United States)

    Abrams, Jessica; Sossong, Sarah; Schwamm, Lee H; Barsanti, Lauren; Carter, Michael; Kling, Naomi; Kotarski, Meghan; Leddy, Jaclyn; Meller, Benjamin; Simoni, Marcy; Sullivan, Michael; Wozniak, Janet

    In the age of online communication, psychiatric care can now be provided via videoconferencing technologies. While virtual visits as a part of telepsychiatry and telemental health provide a highly efficient and beneficial modality of care, the implementation of virtual visits requires attention to quality and safety issues. As practitioners continue to utilize this technology, issues of clinician licensing, treatment outcomes of virtual visits versus in-person visits, and cost offset require ongoing study. This review provides an overview of the topics of technology, legal and regulatory issues, clinical issues, and cost savings as they relate to practicing psychiatry and psychology via virtual visits in an academic medical center. We review the telepsychiatry/telemental health effectiveness literature from 2013 to the present. Our literature searches used the following terms: telemental health effective, telepsychiatry effective, telepsychiatry efficacy, and telemental health efficacy. These searches produced 58 articles, reduced to 16 when including only articles that address effectiveness of clinician-to-patient services. The technological, legal, and regulatory issues vary from state to state and over time. The emerging research addressing diverse populations and disorders provides strong evidence for the effectiveness of telepsychiatry. Cost savings are difficult to precisely determine and depend on the scope of the cost and benefit measured. Establishing a telepsychiatry program requires a comprehensive approach with up-to-date legal and technological considerations.

  5. 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.

  6. The impact of interhospital transfers on surgical quality metrics for academic medical centers.

    Science.gov (United States)

    Crippen, Cristina J; Hughes, Steven J; Chen, Sugong; Behrns, Kevin E

    2014-07-01

    The emergence of pay-for-performance systems pose a risk to an academic medical center's (AMC) mission to provide care for interhospital surgical transfer patients. This study examines quality metrics and resource consumption for a sample of these patients from the University Health System Consortium (UHC) and our Department of Surgery (DOS). Standard benchmarks, including mortality rate, length of stay (LOS), and cost, were used to evaluate the impact of interhospital surgical transfers versus direct admission (DA) patients from January 2010 to December 2012. For 1,423,893 patients, the case mix index for transfer patients was 38 per cent (UHC) and 21 per cent (DOS) greater than DA patients. Mortality rates were 5.70 per cent (UHC) and 6.93 per cent (DOS) in transferred patients compared with 1.79 per cent (UHC) and 2.93 per cent (DOS) for DA patients. Mean LOS for DA patients was 4 days shorter. Mean total costs for transferred patients were greater $13,613 (UHC) and $13,356 (DOS). Transfer patients have poorer outcomes and consume more resources than DA patients. Early recognition and transfer of complex surgical patients may improve patient rescue and decrease resource consumption. Surgeons at AMCs and in the community should develop collaborative programs that permit collective assessment and decision-making for complicated surgical patients.

  7. Nurse practitioners' role perception, stress, satisfaction, and intent to stay at a Midwestern academic medical center.

    Science.gov (United States)

    Brom, Heather M; Melnyk, Bernadette M; Szalacha, Laura A; Graham, Margaret

    2016-05-01

    There is a growing demand for nurse practitioners (NPs) within academic medical centers (AMCs) because of physician shortages and increased need for access to care. In order to retain these NPs, it is important to assess their role perception and satisfaction. The purpose of this study was to evaluate these concepts and their relationships to stress and intent to stay. A 90-item descriptive survey, including a new role perception scale and the Misener Nurse Practitioner Job Satisfaction Scale, was administered to all NPs at a Midwestern AMC. The response rate was 62.4% (n = 181). Overall, the NPs had moderate role perception (M = 4.30, SD = 1.23) and were somewhat satisfied (M = 4.23, SD = 0.74). Over a third (39.4%) reported they were unsure about staying or did not intend to stay in their position. Intent to stay and stress were moderately correlated with overall satisfaction and weakly correlated with role perception. There were significant differences in the intrapractice and professional aspects of job satisfaction based on their supervisor. With increased NP needs, it is crucial for AMCs and NP supervisors to assess role perception, satisfaction, and stress among NPs in order to ensure a stable, satisfied, and productive workforce. ©2015 American Association of Nurse Practitioners.

  8. 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 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.

  9. 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

  10. Long-term Patterns of Patient Portal Use for Pediatric Patients at an Academic Medical Center.

    Science.gov (United States)

    Steitz, Bryan; Cronin, Robert M; Davis, Sharon E; Yan, Ellen; Jackson, Gretchen P

    2017-08-02

    Patient portal adoption has increased over the last two decades. Most research about patient portals has focused on adult populations in the primary care and medical specialty settings. We describe initial and long-term portal use by pediatric patients and their caregivers in a broadly deployed patient portal at an academic medical center. We analyzed portal usage for pediatric patients and their caregivers from 2008 to 2014. We recorded usage events with time stamps; user role defined as self, surrogate (i.e., parent or guardian), or delegate; and functions accessed. Usage events were grouped into sessions to calculate descriptive statistics by patient age, user role, and active use over time. From 2008 to 2014, the number of portal accounts increased from 633 to 17,128. 15.9% of pediatric patients had their own account; 93.6%, a surrogate account; and 2.2% a delegate account. During the study period, 15,711 unique users initiated 493,753 sessions and accessed 1,491,237 functions. Most commonly used functions were secure messaging (accessed in 309,204 sessions; 62.6%); test results (174,239; 35.3%) and appointments (104,830; 21.2%). Function usage was greatest for patients ages 0-2 years (136,245 functions accessed; 23.1%) and 15-17 years (109,241;18.5%). Surrogate users conducted 83.2% of logins for adolescent patients. Portal accounts were actively used for portal usage increased with age. Most accounts for pediatric patients were only used actively for a few years, with peak usage for patients in early childhood and late adolescence.

  11. The impact of electronic medical record implementation on the outpatient volumes of a midsize academic center.

    Science.gov (United States)

    Reddy, Karishma G; Yu, Jack C

    2014-09-01

    Despite the proposed clinical advantages of electronic medical records (EMRs), many questions remain regarding how EMRs may limit the number of patients a provider can see on a day-to-day basis. In this study, we measured the impact of EMR implementation on outpatient volumes in the setting of a midsize academic medical center (AMC) in the southeast. The AMC outpatient visit volumes of two 12-month periods, one before and one after the EMR implementation, were collected. The mean monthly outpatient visits before and after EMR implementation were compared using the 2-tailed Student t test without assumption for equal variance. We also normalized the total annual visits to the number of full-time equivalent physicians. Power calculation was performed to measure type II error whenever P value was greater than 0.05. There was an 8.37% increase in total outpatient visits after EMR implementation, with the monthly number of patients seen increasing from a mean (SD) of 25,763.75 (1673.96) to 27,919.92 (2229.07) (P = 0.018). However, this increase disappears when normalized to full-time equivalent. After conducting multiple subunit analyses of a multiphysician primary care clinic (Family Medicine), specialty clinic (Plastic Surgery), and single-physician specialty clinic (Pediatric Plastic Surgery), we also did not find a statistically significant difference in outpatient clinic volumes after EMR implementation. Despite the burdensome time requirements many physicians subjectively attribute to EMRs, this study shows that the EMR has not really caused a statistically significant decrease in outpatient volumes in the setting of a midsize AMC.

  12. 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.

  13. A new survey to evaluate conflict of interest policies at academic medical centers

    Science.gov (United States)

    Hams, Marcia; Zentner, Lynn; Schmidt, Cory; Dweik, Raed A.; Karafa, Matthew; Rose, Susannah L.

    2017-01-01

    Background A majority of academic medical centers (AMCs) have now adopted conflict of interest policies (COI) to address relationships with pharmaceutical and device industries that can increase the risk of bias in patient care, education and research. However, AMCs may have little information on the impact of their policies. This paper provides a new method, which is a free, publicly-available survey, to fill this information gap and improve COI programs at AMCs. Methods & findings The survey, piloted in three AMCs and designed in collaboration with national conflicts of interest policy experts, covers a range of universal compliance-related concerns, which allows institutions to tailor questions to align with their own policies and culture. The survey was low-burden, and provided important data for these AMCs to evaluate their policies. A descriptive analysis of the pooled pilot site data (n = 1578) was performed, which found that a majority of respondents did not have financial ties with industry and a majority was satisfied with specific COI policies at their institutions. The analysis also showed that the survey is sensitive to differences that AMCs will find meaningful. For instance, individuals with industry ties were significantly more likely than individuals without ties to think that COI policies unnecessarily hindered interactions with industry (p = .004), were ineffective at reducing harm to patients (p .001). Conclusion The survey is now free and publicly available for use by any institution. AMCs can use the results to update and refine policies, and to provide ongoing education regarding existing policies. PMID:28296898

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

    Science.gov (United States)

    Krasowski, Matthew D; Davis, Scott R; Drees, Denny; Morris, Cory; Kulhavy, Jeff; Crone, Cheri; Bebber, Tami; Clark, Iwa; Nelson, David L; Teul, Sharon; Voss, Dena; Aman, Dean; Fahnle, Julie; Blau, John L

    2014-01-01

    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. 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. 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 gammopathy). Our results suggest that a high rate of

  15. 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.

  16. Benchmarking risk-adjusted adult antibacterial drug use in 70 US academic medical center hospitals.

    Science.gov (United States)

    Polk, Ron E; Hohmann, Samuel F; Medvedev, Sofia; Ibrahim, Omar

    2011-12-01

    Antimicrobial stewardship programs are advised to measure and risk-adjust antimicrobial use to facilitate interhospital comparisons, a process called benchmarking. The purpose of this investigation was to evaluate a new benchmarking strategy for antibacterials. Hospital-wide adult antibacterial drug use in 2009 was measured as days of therapy (DOT) and length of therapy (LOT) from billing records in 70 US academic medical centers (AMCs). Patients were assigned to 1 of 35 clinical service lines (CSL) based on their Medicare Severity Diagnosis Related Group. Expected (E) use was determined by indirect standardization and compared with observed (O) use. Of 1,791 ,180 discharged adults, 63.7% received antibacterial drugs; the range by CSL was 14.3% (psychiatry) to 99.7% (lung transplant). Mean ± SD hospital-wide use was 839 ± 106 DOTs (range, 594-1109) and 536 ± 53.0 LOT (range, 427-684) per 1000 patient-days. The ventilator support CSL had the most DOT per discharge, 39.4 ± 9.4 days; the LOT was 21.5 ± 4.5 days. The hospital-wide O/E ratio range was 0.7-1.45; in 5 AMCs the ratio exceeded the 90% confidence interval (CI) and was below the 90% CI in 6. Variability in use was explained by the proportion of treated patients within each CSL and mean LOT and DOT per discharge. Adult antibacterial drug use was benchmarked to expected use adjusted for patient mix, and outlier hospitals were identified. Differences between expected and observed use reflect usage patterns that were benchmarked and are targets for evaluation and intervention.

  17. A Multicomponent Fall Prevention Strategy Reduces Falls at an Academic Medical Center.

    Science.gov (United States)

    France, Dan; Slayton, Jenny; Moore, Sonya; Domenico, Henry; Matthews, Julia; Steaban, Robin L; Choma, Neesha

    2017-09-01

    While the reduction in fall rates has not kept pace with the reduction of other hospital-acquired conditions, patient safety research and quality improvement (QI) initiatives at the system and hospital levels have achieved positive results and provide insights into potentially effective risk reduction strategies. An academic medical center developed a QI-based multicomponent strategy for fall prevention and pilot tested it for six months in three high-risk units-the Neuroscience Acute Care Unit, the Myelosuppression/Stem Cell Transplant Unit, and the Acute Care for the Elderly Unit-before implementing and evaluating the strategy hospitalwide. The multicomponent fall strategy was evaluated using a pre-post study design. The main outcome measures were falls and falls with harm measured in events per 1,000 patient-days. Fall rates were monitored and compared for three classes of falls: (1) accidental, (2) anticipated physiologic, and (3) unanticipated physiologic. Statistical process control charts showed that the pilot units had achieved significant reductions in falls with harm during the last five months of data collection. Wald test and segmented regression analyses revealed significant improvements in pooled postintervention fall rates, stratified by fall type. The hospitalwide implementation of the program resulted in a 47% overall reduction in falls in the postintervention period. A fall prevention strategy that targeted the spectrum of risk factors produced measurable improvement in fall rates and rates of patient harm. Hospitals must continue developing, rigorously testing, and sharing their results and experiences in implementing and sustaining multicomponent fall prevention strategies. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  18. Variations in survival after cardiac arrest among academic medical center-affiliated hospitals.

    Directory of Open Access Journals (Sweden)

    Michael Christopher Kurz

    Full Text Available Variation exists in cardiac arrest (CA survival among institutions. We sought to determine institutional-level characteristics of academic medical centers (AMCs associated with CA survival.We examined discharge data from AMCs participating with Vizient clinical database-resource manager. We identified cases using ICD-9 diagnosis code 427.5 (CA or procedure code 99.60 (CPR. We estimated hospital-specific risk-standardized survival rates (RSSRs using mixed effects logistic regression, adjusting for individual mortality risk. Institutional and community characteristics of AMCs with higher than average survival were compared with those with lower survival.We analyzed data on 3,686,296 discharges in 2012, of which 33,700 (0.91% included a CA diagnosis. Overall survival was 42.3% (95% CI 41.8-42.9 with median institutional RSSR of 42.6% (IQR 35.7-51.0; Min-Max 19.4-101.6. We identified 28 AMCs with above average survival (median RSSR 61.8% and 20 AMCs with below average survival (median RSSR 26.8%. Compared to AMCs with below average survival, those with high CA survival had higher CA volume (median 262 vs.119 discharges, p = 0.002, total beds (722 vs. 452, p = 0.02, and annual surgical volume (24,939 vs. 13,109, p<0.001, more likely to offer cardiac catheterization (100% vs. 72%, p = 0.007 or cardiac surgery (93% vs. 61%, p = 0.02 and cared for catchment areas with higher household income ($61,922 vs. $49,104, p = 0.004 and lower poverty rates (14.6% vs. 17.3%, p = 0.03.Using discharge data from Vizient, we showed AMCs with higher CA and surgical case volume, cardiac catheterization and cardiac surgery facilities, and catchment areas with higher socioeconomic status had higher risk-standardized CA survival.

  19. 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

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

    OpenAIRE

    Nelson, Louis S.; Scott R Davis; 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...

  1. [ACADEMIC SURGICAL SERVICES IN A TERTIARY MEDICAL CENTER IN THE NEGEV-DESERT, PERIPHERY OF ISRAEL: IS IT A HYBRID?].

    Science.gov (United States)

    Mizrahi, Solly

    2016-02-01

    Soroka Medical Center, a major affiliated hospital of the Faculty of Health Sciences in Ben Gurion University of the Negev, serving 1,000,000 citizens in the south part of Israel and is designated as a "peripheral hospital". Herein, we address the factors that influence our high level academic surgical training program with its broad base surgical experience, which focused on the "spirit of Beer Sheba". Should we call our program a hybrid?

  2. The benefits and challenges of research centers and institutes in academic medicine: findings from six universities and their medical schools.

    Science.gov (United States)

    Mallon, William T

    2006-06-01

    To understand the benefits and challenges of using centers and institutes in the academic research enterprise, and to explore institutional strategies that capitalize on the strengths and ameliorate the weaknesses of the center/institute structure. Using a qualitative research design, the author and associates interviewed over 150 faculty members and administrators at six medical schools and their parent universities in 2004. Interview data were transcribed, coded, and analyzed using a grounded theory approach. This methodology generated rich descriptions and explanations of the six institutions, which can produce extrapolations to, but not necessarily findings that are generalizable to, other institutions and settings. Centers and institutes offer a number of benefits to academic institutions. Centers can aid in faculty recruitment and retention, facilitate collaboration in research, secure research resources, offer a sense of community and promote continued learning, afford organizational flexibility, and focus on societal problems and raise funds. Despite their many benefits, centers can also create tensions and present management challenges to institutional leaders. Centers can compete with departments over resources, complicate faculty recruitment, contribute to a fragmented mission, resist effective evaluation, pose governance problems, and impede junior faculty development. Institutional leaders might capitalize on the strengths of centers through three strategies: (1) reward leaders who embrace a collaborative point of view and develop a culture that frowns upon empire building; (2) distinguish among the many entities that share the "center" or "institute" labels; and (3) acknowledge that departments must maintain their place in the organizational milieu.

  3. Impact of managed care on the economics of laboratory operation in an academic medical center.

    Science.gov (United States)

    Benge, H; Bodor, G S; Younger, W A; Parl, F F

    1997-07-01

    Throughout the 1980s, the number of laboratory tests performed in the United States grew at an annual rate of over 10%, and laboratory costs accounted for approximately 10% of overall health care expenditures. Recently, the influence of capitation, emphasis on cost-effectiveness, and changing roles among specialists and primary care physicians have begun to affect the growth of laboratory testing. We examined the impact of managed care on the economics of the clinical chemistry laboratory at Vanderbilt University Medical Center, Nashville, Tenn, to define the relative position of the clinical laboratory in the managed care environment of an academic medical center. The following data were prospectively collected between fiscal years 1984/1985 and 1995/1996: number of inpatients and outpatients, average length of stay, number of laboratory tests, total laboratory revenue, direct costs (consisting of salary and consumable costs), and number of full-time-equivalent (FTE) personnel. Using these data, we derived the following parameters: revenue and direct cost per patient, and revenue and productivity per FTE. Between 1984/1985 and 1995/1996 the number of inpatients and outpatients increased 33% and 155%, respectively. Laboratory utilization, expressed as tests per patient, increased from 17 to 22 for inpatients between 1984/1985 and 1991/1992, and then sharply declined to 14.5 tests by 1995/1996, a 34% decrease compared with the 1991/1992 level. Laboratory utilization for outpatients increased from 0.23 in 1984/1985 to 0.45 tests in 1991/1992, decreased to 0.38 in 1993/1994, but then rose again to 0.43 in 1995/1996. Total revenue more than doubled between 1984/1985 and 1991/1992, mostly owing to increased inpatient revenue. Since 1992/1993, inpatient revenue has steadily declined, leading to a decrease in total revenue, which was partially offset by a continuous increase in outpatient revenue. In 1995/1996, outpatient revenue accounted for 32.1% of total revenue

  4. 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 < 0.01), 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

  5. 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

  6. Global collaborative healthcare: assessing the resource requirements at a leading Academic Medical Center.

    Science.gov (United States)

    Rosson, Nicole J; Hassoun, Heitham T

    2017-09-20

    Academic Medical Centers ("AMCs") have served as a hub of the United States ("US") health system and represented the state-of-the art in American health care for well over a century. Currently, the global healthcare market is both massive and expanding and is being altered by the unprecedented impact of technological advances and globalization. This provides AMCs a platform to enter into trans-national collaborative partnerships with healthcare organizations around the world, thus providing a means to deliver on its promise globally while also expanding and diversifying its resources. A number of leading US AMCs have engaged in global collaborative healthcare, employing different models based on services offered, global distribution, and inclination to assume risk. Engaging in these collaborations requires significant effort from across the health system, and an understanding of the resources required is paramount for effective delivery and to avoid overextension and diversion from the primary mission of these organizations. The goal of this paper is to discuss the role of US AMCs in this current global healthcare landscape and to also investigate our institutional faculty and staff resource requirements to support the operating model. We extracted and retrospectively analyzed data from the JHI Global Services database for a 3-year period (Jan, 2013-Dec, 2015) to determine total utilization (hours and full time equivalent (FTE)), utilization by profession, and clinical and non-clinical areas of expertise. JHI utilized on average 21,940 h annually, or 10.55 FTEs of faculty and staff subject matter experts. The majority of the hours are for work performed by physician faculty members from 23 departments within the School of Medicine, representing 77% percent or on average 16,894 h annually. Clinical and allied health departments had an average annual utilization of 17,642 h or 7.8 FTEs, while non-clinical departments, schools and institutes averaged 4298 h or 1

  7. Advancing LGBT Health at an Academic Medical Center: A Case Study.

    Science.gov (United States)

    Yehia, Baligh R; Calder, Daniel; Flesch, Judd D; Hirsh, Rebecca L; Higginbotham, Eve; Tkacs, Nancy; Crawford, Beverley; Fishman, Neil

    2015-12-01

    Academic health centers are strategically positioned to impact the health of lesbian, gay, bisexual and transgender (LGBT) populations by advancing science, educating future generations of providers, and delivering integrated care that addresses the unique health needs of the LGBT community. This report describes the early experiences of the Penn Medicine Program for LGBT Health, highlighting the favorable environment that led to its creation, the mission and structure of the Program, strategic planning process used to set priorities and establish collaborations, and the reception and early successes of the Program.

  8. 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.

  9. Changing resident test ordering behavior: a multilevel intervention to decrease laboratory utilization at an academic medical center.

    Science.gov (United States)

    Vidyarthi, Arpana R; Hamill, Timothy; Green, Adrienne L; Rosenbluth, Glenn; Baron, Robert B

    2015-01-01

    Hospital laboratory test volume is increasing, and overutilization contributes to errors and costs. Efforts to reduce laboratory utilization have targeted aspects of ordering behavior, but few have utilized a multilevel collaborative approach. The study team partnered with residents to reduce unnecessary laboratory tests and associated costs through multilevel interventions across the academic medical center. The study team selected laboratory tests for intervention based on cost, volume, and ordering frequency (complete blood count [CBC] and CBC with differential, common electrolytes, blood enzymes, and liver function tests). Interventions were designed collaboratively with residents and targeted components of ordering behavior, including system changes, teaching, social marketing, academic detailing, financial incentives, and audit/feedback. Laboratory ordering was reduced by 8% cumulatively over 3 years, saving $2 019 000. By involving residents at every stage of the intervention and targeting multiple levels simultaneously, laboratory utilization was reduced and cost savings were sustained over 3 years. © 2014 by the American College of Medical Quality.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. Radiological protection for pregnant women at a large academic medical Cancer Center.

    Science.gov (United States)

    Chu, Bae; Miodownik, Daniel; Williamson, Matthew J; Gao, Yiming; St Germain, Jean; Dauer, Lawrence T

    2017-11-01

    Most radiation protection programs, regulations and guidance apply specific restrictions to the occupational exposure of pregnant workers. The aim of this study was to compile data from the declared pregnant woman (DPW) radiation protection program over more than 5years at a large, high-volume, comprehensive oncology academic/medical institution and to evaluate for effectiveness against existing regulations and guidance. A retrospective review was performed of the data collected as part of the DPW radiation protection program from January 2010 through May 2016, including the number of declared pregnancies, worker category, personal and fetal dosimetry monitoring measurements, workplace modifications, as well as the monthly and total recorded badge results during the entire pregnancy. 245 pregnancies were declared. The mean monthly fetal radiation dosimetry result was 0.009mSv with a median of 0.005mSv and a maximum of 0.39mSv. The mean total dose over the entire pregnancy was estimated to be 0.08mSv with a median of 0.05mSv and a maximum of 0.89mSv. Only 8 (3.2%) of the 245 declared pregnancies required that workplace modifications be implemented for the worker. The implementation of a declared pregnancy and fetal assessment program, careful planning, an understanding of the risks, and minimization of radiation dose by employing appropriate radiation safety measures as needed, can allow medical staff to perform procedures and normal activities without incurring significant risks to the conceptus, or significant interruptions of job activities for most medical workers. Copyright © 2017. Published by Elsevier Ltd.

  15. Treatment as usual (TAU) for depression: a comparison of psychotherapy, pharmacotherapy, and combined treatment at a large academic medical center.

    Science.gov (United States)

    Blais, Mark A; Malone, Johanna C; Stein, Michelle B; Slavin-Mulford, Jenelle; O'Keefe, Sheila M; Renna, Megan; Sinclair, Samuel J

    2013-03-01

    Depression is among the most prevalent and burdensome psychiatric disorders in the United States (Kessler et al., Achieves of General Psychiatry 62:617-627, 2005). There is substantial empirical support regarding efficacy of pharmacotherapy, psychotherapy, and combined treatment (both pharmacotherapy and psychotherapy) for treating depression. However, far less is known about the effectiveness of these treatments for real-world patients treated within routine clinical care settings (Cahill et al., The British Journal of Clinical Psychology 49:421-453, 2010). This study seeks to explore the effectiveness of treatment as usual (TAU) for depression in a large cohort of psychiatric outpatients receiving psychotherapy, pharmacotherapy, or combined treatment within an academic medical center. Initial and follow-up self-report assessments were analyzed for 1,322 patients receiving treatment for depression. Using these data, we determined treatment effect sizes, rates of reliable improvement (and deterioration), and rates of clinically significant improvement for psychotherapy, pharmacotherapy, and combined care. On average, all treatments produced significant improvement with effect sizes surpassing our no-treatment benchmark. No significant between-group (treatment) differences in self-report outcomes were found. The rates of reliable change were similar for all treatment groups consistent with past research. The present findings support the effectiveness of psychotherapy, pharmacotherapy, and combined treatment as routinely provided within a large academic medical center for the treatment of real-world patients suffering with depression.

  16. Functional alignment, not structural integration, of medical schools and teaching hospitals is associated with high performance in academic health centers.

    Science.gov (United States)

    Keroack, Mark A; McConkie, Nathan R; Johnson, Erika K; Epting, Gladys J; Thompson, Irene M; Sanfilippo, Fred

    2011-08-01

    Debates continue regarding optimal structures for governance and administration between medical schools and their teaching hospitals. Structural integration (SI) for 85 academic health centers was characterized as high (single leader or fiduciary) or low (multiple leaders or fiduciaries). Functional alignment (FA) was estimated from questionnaire responses by teaching hospitals' chief executive officers, and an index was calculated quantifying organizational collaboration across several functional areas. SI and FA were examined for their association with global performance measures in teaching, research, clinical care, finance, and efficiency. AHCs with high SI had significantly higher FA, though overlap between high-SI and low-SI institutions was considerable. SI was not significantly associated with any performance measure. In contrast, FA was significantly associated with higher performance in teaching, research, and finance but not clinical care and efficiency. FA between medical schools and their primary teaching hospitals more strongly predicts academic health centers' performance than does SI. As demands for greater collaboration increase under health reform, emphasis should be placed on increasing FA rather than SI. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Development of a substance abuse consultation and referral service in an academic medical center: challenges, achievements and dissemination.

    Science.gov (United States)

    Murphy, Mary K; Chabon, Brenda; Delgado, Arelis; Newville, Howard; Nicolson, Stephen E

    2009-03-01

    Approximately 25% of US hospital beds are occupied by individuals with active substance use disorders (SUD). Acute medical hospitalization provides an opportunity to address SUDs and provide patient-centered intervention and referral for treatment. Nationally, some hospitals have developed substance abuse consultation departments to improve the care of hospitalized substance users. In this paper we describe the Addiction Psychiatry Service (APS) in a large urban hospital which provides bed-side SUD consultation, screening, intervention and referral to treatment. APS utilizes the multiple disciplines of psychology, social work and medicine to integrate substance abuse services throughout the hospital and educate future generations of medical and psychology trainees. We conclude with how the APS service is informing the development of similar programs in other academic departments within our hospital and best practice recommendations to further disseminate this service model.

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

    Science.gov (United States)

    Johnston, Kenton J; Hockenberry, Jason M; Rask, Kimberly J; Cunningham, Lynn; Brigham, Kenneth L; Martin, Greg S

    2015-08-01

    To evaluate the impact of a pilot workplace health partner intervention delivered by a predictive health institute to university and academic medical center employees on per-member, per-month health care expenditures. We analyzed the health care claims of participants versus nonparticipants, with a 12-month baseline and 24-month intervention period. Total per-member, per-month expenditures were analyzed using two-part regression models that controlled for sex, age, health benefit plan type, medical member months, and active employment months. Our regression results found no statistical differences in total expenditures at baseline and intervention. Further sensitivity analyses controlling for high cost outliers, comorbidities, and propensity to be in the intervention group confirmed these findings. We find no difference in health care expenditures attributable to the health partner intervention. The intervention does not seem to have raised expenditures in the short term.

  19. Conversion of Provider EMR Training from Instructor-Led Training to eLearning at an Academic Medical Center.

    Science.gov (United States)

    Sharp, Karen; Williams, Michele; Aldrich, Alison; Bogacz, Adrienne; Denier, Sighle; McAlearney, Ann S

    2017-07-26

    This case study overviews the conversion of provider training of the electronic medical record (EMR) from an instructor-led training (ILT) program to eLearning at an Academic Medical Center (AMC). This conversion provided us with both a useful training tool and the opportunity to maximize efficiency within both our training and optimization team and organization. eLearning Development Principles were created and served as a guide to assist us with designing an eLearning curriculum using a five step process. The result was a new training approach that allowed learners to complete training at their own pace, and even test out of sections based on demonstrated competency. The information we have leads us to believe that a substantial return on our investment can be obtained from the conversion with positive impacts that have served as the foundation for the future of end user EMR training at our AMC.

  20. 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.

  1. 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

  2. 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.

  3. May you live in interesting times. Academic medical centers, academic societies, and the coming dominance of government and business in American medicine.

    Science.gov (United States)

    Howard, R J

    1994-11-01

    The coming changes in the organization and financing of medicine will lead to dominance of government and business in the American health care system. These changes will have a profound effect on academic medical centers (AMCs). To compete for managed care contracts and maintain their patient bases, AMCs will have to compete with private providers on cost, something they are ill-equipped to do because of their high cost structures. The AMCs are likely to have lower patient care revenues and alter the makeup of their faculties to reduce the number of specialists and increase the number of primary care physicians. Undergraduate and graduate medical education and research are also likely to suffer adverse consequences as a result of these changes. With the number of specialist residency positions decreased, it will be difficult for faculty to replace residents with physicians' assistants or nurse clinicians. Faculty may have to devote more time to patient care, and research and education may suffer. The decreased revenues of AMCs will affect the Surgical Infection Society and other academic societies. Society members may limit the number of societies to which they belong as their incomes or those of their departments are threatened.

  4. Mandatory Child Life Consultation and Its Impact on Pediatric MRI Workflow in an Academic Medical Center.

    Science.gov (United States)

    Durand, Daniel J; Young, Mollie; Nagy, Paul; Tekes, Aylin; Huisman, Thierry A G M

    2015-06-01

    Pediatric patients undergoing MRI often require general anesthesia, which may improve image quality but is associated with significant medical risk and economic cost. It has previously been shown that certified child life specialists using high-tech interventions (eg, MRI-compatible video goggles) significantly reduce the number of pediatric MRI patients who require sedation. Most imaging centers lack such technology, however, and it remains unclear whether simpler and less costly child life interventions may be equally effective in avoiding general anesthesia. The aim of this study was to assess the impact of requiring mandatory child life evaluation for all patients aged 5 to 18 years undergoing MRI before referral for general anesthesia. Inserting this simple step into the scheduling workflow significantly reduced the use of general anesthesia in this population: general anesthesia was required in 564 of 2,433 MRI cases during the 1-year baseline period compared with 484 of 2,526 cases during the 1-year intervention period (P child life evaluation avoided the use of general anesthesia in approximately 102 patients during the intervention period. Further subgroup analysis revealed that avoidance of general anesthesia was highly significant in the 5- to 10-year-old age group, whereas those aged 11 to 18 years experienced only a trend toward modestly decreased use of general anesthesia. These results suggest that mandatory evaluation for standard child life interventions is a worthwhile step that can save many children from unnecessary exposure to the risks, cost, and inconvenience of general anesthesia. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  5. 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.

  6. 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.

  7. Physicians' perceptions of institutional and leadership factors influencing their job satisfaction at one academic medical center.

    Science.gov (United States)

    Demmy, Todd L; Kivlahan, Coleen; Stone, Tamara T; Teague, Lynn; Sapienza, Pam

    2002-12-01

    Academic physicians' perceptions about their institution's function and leadership should provide insights toward improving faculty recruitment and retention. The authors surveyed 105 non-management and non-emeritus physicians who had been hired by (57%) or left (43%) the University of Missouri-Columbia School of Medicine (MUHC) in 1991-1998. The questionnaire measured both the importance and the availability of 14 institutional and leadership factors and the physicians' perceptions of satisfaction with their careers. Open-ended questions assessed additional concerns. In all, 56% of the overall satisfaction scores were unfavorable and, when grouped by faculty department, correlated inversely with departure rates (p =.04). Scores were surprisingly similar between those who left and those who remained at the institution. "Protected time for research or personal use" was the highest faculty priority regardless of level of overall satisfaction. "Equitable distribution of salary/resources" (p =.007) and "trust-communication with chair/division head" (p =.003) predicted good satisfaction independently. Openended responses for remaining at the university related to the pleasant local community (49%), intellectual issues (46%), and humanitarian issues (5%). Responses for considering opportunities elsewhere were administrative frustration (59%), income enhancement (18%), career advancement (9%), academic frustration (9%), and other (5%). Recommendations for enhancing recruitment and retention were fix administrative concerns (45%); improve research (20%), income (9%), physician support (9%), clinical programs (8%), and autonomy (5%); and other (4%). Surveying physicians who were recently hired or who have left an institution provides useful information to promote organizational changes that could improve physician retention.

  8. Integrating Education into Primary Care Quality and Cost Improvement at an Academic Medical Center

    Science.gov (United States)

    Harrison, R. Van; Standiford, Connie J.; Green, Lee A.; Bernstein, Steven J.

    2006-01-01

    Introduction: In 1996 the University of Michigan Health System created the Guidelines Utilization, Implementation, Development, and Evaluation Studies (GUIDES) unit to improve the quality and cost-effectiveness of primary care for common medical problems. GUIDES's primary functions are to oversee the development of evidence-based, practical…

  9. Pharmacy Response to the Boston Marathon Bombings at a Tertiary Academic Medical Center.

    Science.gov (United States)

    Sylvester, Katelyn W; Rocchio, Megan A; Belisle, Caryn; Matta, Lina; Goralnick, Eric

    2014-08-01

    Effective crisis response requires multidisciplinary communication and rapid action. Our goals are to highlight the experience of a pharmacy department's response to the 2013 Boston Marathon bombing, to discuss the role of the pharmacist in a crisis response, and to identify potential learning opportunities for a future mass casualty event. Our initial response targeted 3 general areas: staffing, supplies, and communication. Pharmacist and technician staffing was increased throughout the hospital, with a 6-fold increase of pharmacists to the emergency department (ED). To ensure adequate supplies were available, inventory on the ED automatic dispensing cabinets (ADC) was assessed for vaccines, antibiotics, and vasoactive medications. ED pharmacists prepared emergent intravenous medications in the ED while the sterile products room bolstered our supply of intravenous medications for patients in the ED and operating room. Overall, there was a 33% increase in the number of ADC transactions, with pharmacists representing 28% of all ADC transactions. To optimize communication, we formulated a comprehensive plan for the timely dissemination of information to the entire pharmacy staff. A mass casualty event is a rare occasion, and it is vital for the pharmacy department to respond rapidly with little notification. The role of a pharmacist is unique and can most effectively triage drug information and medication distribution, especially during times of high demand and high stress. © The Author(s) 2014.

  10. Centralized care management support for "high utilizers" in primary care practices at an academic medical center.

    Science.gov (United States)

    Williams, Brent C; Paik, Jamie L; Haley, Laura L; Grammatico, Gina M

    2014-01-01

    Although evidence of effectiveness is limited, care management based outside primary care practices or hospitals is receiving increased attention. The University of Michigan (UM) Complex Care Management Program (CCMP) provides care management for uninsured and underinsured, high-utilizing patients in multiple primary care practices. To inform development of optimal care management models, we describe the CCMP model and characteristics and health care utilization patterns of its patients. Of a consecutive series of 49 patients enrolled at CCMP in 2011, the mean (SD) age was 48 (+/- 14); 23 (47%) were women; and 29 (59%) were White. Twenty-eight (57%) had two or more chronic medical conditions, 39 (80%) had one or more psychiatric condition, 28 (57%) had a substance abuse disorder, and 11 (22%) were homeless. Through phone, e-mail, and face-to-face contact with patients and primary care providers (PCPs), care managers coordinated health and social services and facilitated access to medical and mental health care. Patients had a mean (SD) number of hospitalizations and emergency room (ER) visits in 6 months prior to enrollment of2.2 (2.5) and 4.2 (4.3), respectively, with a nonstatistically significant decrease in hospitalizations, hospital days, and emergency room visits in 6 months following enrollment in CCMP. Centralized care management support for primary care practices engages high-utilizing patients with complex medical and behavioral conditions in care management that would be difficult to provide through individual practices and may decrease health care utilization by these patients.

  11. Validation of the V66.7 Code for Palliative Care Consultation in a Single Academic Medical Center.

    Science.gov (United States)

    Hua, May; Li, Guohua; Clancy, Caitlin; Morrison, R Sean; Wunsch, Hannah

    2017-04-01

    Use of administrative data to study the effectiveness of specialized palliative care is limited by the lack of a reliable method to identify patients receiving palliative care consultation. The International Classification of Diseases, Ninth Revision (ICD-9) code V66.7 has been used, but its validity for this purpose is unknown. To examine the validity of the ICD-9 code V66.7 for identifying whether hospitalized patients received palliative care consultation. Retrospective cohort study. All patients of age ≥18 years admitted to a single academic medical center between August 2013 and August 2015. Sensitivity and specificity of the V66.7 code for palliative care consultation for all patients and several a priori identified subgroups. The reference standard was the presence of a palliative care consultation note in the electronic medical record. Of 100,910 admissions, 1999 received a palliative care consultation (2.0%) and 1846 (1.8%) had usage of the V66.7 code. Sensitivity and specificity for the V66.7 code were 49.9% and 99.1%, respectively. Sensitivity was considerably higher for certain subgroups, such as patients with dementia (76.3%) and metastatic cancer (66.3%); addition of age restrictions further improved sensitivity while maintaining high specificity. Specificity was substantially lower for patients who died during hospitalization (sensitivity 53.9%, specificity 75.1%). In a single center, the ICD-9 code V66.7 had poor sensitivity and high specificity for identifying hospitalized patients who received a palliative care consultation. Appropriate use of this code for this purpose should take these characteristics into consideration.

  12. 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

  13. 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

    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. Software

  14. 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

  15. 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…

  16. Implementation of continuous infusion of blood coagulation factors at an academic medical center.

    Science.gov (United States)

    Poppe, Lindsey B; Eckel, Stephen F; Savage, Scott W

    2012-03-15

    A multidisciplinary initiative to promote more cost-effective use of blood factor derivatives and increase pharmacist involvement in associated order verification, dispensing, and monitoring activities is described. After an evaluation of a hospital's procedures for the use of blood factor derivatives identified inconsistencies and opportunities for cost savings, a revised medication-use process promoting continuous infusion of selected products (factors VIII, IX, and VIII/von Willebrand factor) was developed by pharmacy staff with input from physicians and nurse educators. The implementation of the enhanced medication-use procedures included (1) the publication of a compendium of key information on commonly used blood factors, including specific guidance on dosing and administration, (2) the use of Web-based educational modules targeting pharmacists and nurses, (3) greater involvement by pharmacists in blood factor order justification and verification, (4) routine pharmacist assessment of pertinent laboratory values and other determinants of optimal dosing, and (5) refined procedures for changing i.v. tubing. Surveys of pharmacists conducted before and after the practice changes indicated a significant increase in their knowledge of blood factor products and evidence-based best practices for the management of hemophilia. Through a multidisciplinary initiative involving pharmacists, physicians, and nurses, new procedures to promote continuous infusion of selected blood factor products were implemented. Results of a postimplementation survey indicated that educational tools were effective in increasing pharmacists' knowledge of blood factor derivatives and hemophilia management.

  17. Benchmarking patient- and family-centered care: highlights from a study of practices in 26 academic medical centers.

    Science.gov (United States)

    Vermoch, Kathleen L; Bunting, Robert F

    2010-01-01

    Patient- and family-centered care (PFCC) is premised on the belief that patients, families, and healthcare providers who are empowered and engaged throughout the healthcare system are integral components, with each vital to the delivery of quality and safe care. Adopting a PFCC culture can result in improved quality, safety, communication, and patient satisfaction. University HealthSystem Consortium hospitals that have adopted these concepts have demonstrated significant improvements. By using an initial survey, developing benchmark parameters, and conducting ongoing analysis and feedback, these hospitals have developed ways to reap many benefits.

  18. Residents' and Fellows' Knowledge and Attitudes About Eating Disorders at an Academic Medical Center.

    Science.gov (United States)

    Anderson, Kristen; Accurso, Erin C; Kinasz, Kathryn R; Le Grange, Daniel

    2017-06-01

    This study examined physician residents' and fellows' knowledge of eating disorders and their attitudes toward patients with eating disorders. Eighty physicians across disciplines completed a survey. The response rate for this survey across disciplines was 64.5 %. Participants demonstrated limited knowledge of eating disorders and reported minimal comfort levels treating patients with eating disorders. Psychiatry discipline (p = 0.002), eating disorder experience (p = 0.010), and having ≥4 eating disorder-continuing medical education credits (p = 0.037) predicted better knowledge of anorexia nervosa but not bulimia nervosa. Psychiatry residents (p = 0.041), and those who had treated at least one eating disorder patient (p = 0.006), reported significantly greater comfort treating patients with eating disorders. These results suggest that residents and fellows from this sample may benefit from training to increase awareness and confidence necessary to treat patients with eating disorders. Sufficient knowledge and comfort are critical since physicians are often the first health care provider to have contact with patients who have undiagnosed eating disorders.

  19. What If a Resident or Medical Student Is Raped? Hospitals' and Academic Medical Centers' Title IX Obligations.

    Science.gov (United States)

    Manning, Melinda

    2018-01-01

    Title IX of the Education Amendments of 1972 protects medical students and residents from all forms of sexual discrimination, including sexual harassment and assault. Hospitals that train residents as well as medical students must follow Title IX mandates, including investigating and addressing all reports of sexual discrimination, harassment, or violence. While these processes can help eliminate potential barriers to women in medical training, the pressure to participate in an internal investigation can discourage some medical students and residents from seeking help. Hospitals should work closely with university Title IX officials to design and implement effective policies and procedures to both prevent and address all types of sexual discrimination as well as to support trainees who have been victimized. © 2018 American Medical Association. All Rights Reserved.

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

    Science.gov (United States)

    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.

  1. 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.

  2. 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. PMID:22232447

  3. Adherence to guideline-directed venous thromboembolism prophylaxis among medical and surgical inpatients at 33 academic medical centers in the United States.

    Science.gov (United States)

    Schleyer, Anneliese M; Schreuder, Astrid B; Jarman, Kenneth M; Logerfo, James P; Goss, J Richard

    2011-01-01

    This study's purpose was to describe compliance with established venous thromboembolism (VTE) prophylaxis guidelines in medical and surgical inpatients at US academic medical centers (AMCs). Data were collected for a 2007 University HealthSystem Consortium Deep Vein Thrombosis/Pulmonary Embolism (DVT/PE) Benchmarking Project that explored VTE in AMCs. Prophylaxis was considered appropriate based on 2004 American College of Chest Physicians guidelines. A total of 33 AMCs from 30 states participated. In all, 48% of patients received guideline-directed prophylaxis-59% were medical and 41% were surgical patients. VTE history was more common among medical patients with guideline-directed prophylaxis. Surgical patients admitted from the emergency department and with higher illness severity were more likely to receive appropriate prophylaxis. Despite guidelines, VTE prophylaxis remains underutilized in these US AMCs, particularly among surgical patients. Because AMCs provide the majority of physician training and should reflect and set care standards, this appears to be an opportunity for practice and quality improvement and for education.

  4. 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.

  5. Factors Associated with Clinical Research Recruitment in a Pediatric Academic Medical Center--A Web-Based Survey.

    Directory of Open Access Journals (Sweden)

    Erica Rose Denhoff

    Full Text Available One of the most difficult aspects of conducting clinical research is the ability to successfully recruit participants. Pediatric clinical research presents unique recruitment challenges that relate to the need for parental consent on behalf of a minor, child assent, and school attendance. Yet, this has been less well studied. We conducted a survey of investigators performing human subjects research in a single large academic pediatric hospital to better understand characteristics of studies with successful recruitment.We conducted a web-based survey from September 2011 to December 2011 of all principal investigators with an Institutional Review Board approved human subjects protocol at Boston Children's Hospital, a pediatric Academic Medical Center. The survey captured various characteristics of the protocols including study design, staffing, resources, and investigator experience and training as well as respondents' perceived barriers and facilitators to recruitment. We used chi square tests and Mantel-Haenszel test for linear trend to examine the relationship between selected predictor variables and the binary outcome of successful vs. unsuccessful recruitment and multivariable logistic regression analyses to examine the simultaneous influence of potential predictors on each outcome.Among the 349 eligible investigators, 52% responded to the survey, and 181 with valid data were included in the analyses. Two-thirds of the 87 protocols closed to enrollment reached 80% or more of their target enrollment, whereas, only one-third of the 94 protocols actively recruiting were meeting 80% of their target. Recruitment method appeared to be the only significant and independent factor associated with achieving 80% or more of target enrollment in closed to enrollment protocols. Closed to enrollment protocols that used recruitment in person were 4.55 times (95% CI 1.30 to 15.93; p = 0.02 more likely to achieve 80% or more of their target enrollment when

  6. Factors Associated with Clinical Research Recruitment in a Pediatric Academic Medical Center--A Web-Based Survey.

    Science.gov (United States)

    Denhoff, Erica Rose; Milliren, Carly E; de Ferranti, Sarah D; Steltz, Sarah K; Osganian, Stavroula K

    2015-01-01

    One of the most difficult aspects of conducting clinical research is the ability to successfully recruit participants. Pediatric clinical research presents unique recruitment challenges that relate to the need for parental consent on behalf of a minor, child assent, and school attendance. Yet, this has been less well studied. We conducted a survey of investigators performing human subjects research in a single large academic pediatric hospital to better understand characteristics of studies with successful recruitment. We conducted a web-based survey from September 2011 to December 2011 of all principal investigators with an Institutional Review Board approved human subjects protocol at Boston Children's Hospital, a pediatric Academic Medical Center. The survey captured various characteristics of the protocols including study design, staffing, resources, and investigator experience and training as well as respondents' perceived barriers and facilitators to recruitment. We used chi square tests and Mantel-Haenszel test for linear trend to examine the relationship between selected predictor variables and the binary outcome of successful vs. unsuccessful recruitment and multivariable logistic regression analyses to examine the simultaneous influence of potential predictors on each outcome. Among the 349 eligible investigators, 52% responded to the survey, and 181 with valid data were included in the analyses. Two-thirds of the 87 protocols closed to enrollment reached 80% or more of their target enrollment, whereas, only one-third of the 94 protocols actively recruiting were meeting 80% of their target. Recruitment method appeared to be the only significant and independent factor associated with achieving 80% or more of target enrollment in closed to enrollment protocols. Closed to enrollment protocols that used recruitment in person were 4.55 times (95% CI 1.30 to 15.93; p = 0.02) more likely to achieve 80% or more of their target enrollment when compared to those

  7. Malnutrition Diagnosis during Adult Inpatient Hospitalizations: Analysis of a Multi-Institutional Collaborative Database of Academic Medical Centers.

    Science.gov (United States)

    Tobert, Conrad M; Mott, Sarah L; Nepple, Kenneth G

    2018-01-01

    Malnutrition is a significant problem for hospitalized patients. However, the true prevalence of reported malnutrition diagnosis in real-world clinical practice is largely unknown. Using a large collaborative multi-institutional database, the rate of malnutrition diagnosis was assessed and used to assess institutional variables associated with higher rates of malnutrition diagnosis. The aim of this study was to define the prevalence of malnutrition diagnosis reported among inpatient hospitalizations. The University Health System Consortium (Vizient) database was retrospectively reviewed for reported rates of malnutrition diagnosis. All adult inpatient hospitalization at 105 member institutions during fiscal years 2014 and 2015 were evaluated. Malnutrition diagnosis based on the presence of an International Classification of Diseases-Ninth Revision diagnosis code. Hospital volume and publicly available hospital rankings and patient satisfaction scores were obtained. Multiple regression analysis was performed to assess the association between these variables and reported rates of malnutrition. A total of 5,896,792 hospitalizations were identified from 105 institutions during the 2-year period. It was found that 292,754 patients (5.0%) had a malnutrition diagnosis during their hospital stay. By institution, median rate of malnutrition diagnosis during hospitalization was 4.0%, whereas the rate of severe malnutrition diagnosis was 0.9%. There was a statistically significant increase in malnutrition diagnosis from 4.0% to 4.9% between 2014 and 2015 (P<0.01). Institutional factors associated with increased diagnosis of malnutrition were higher hospital volume, hospital ranking, and patient satisfaction scores (P<0.01). Missing a malnutrition diagnosis appears to be a universal issue because the rate of malnutrition diagnosis was consistently low across academic medical centers. Institutional variables were associated with the prevalence of malnutrition diagnosis, which

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

    Science.gov (United States)

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

    2015-01-01

    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. In this retrospective study at an academic medical center, electronic health records from were searched to obtain all add-on orders that were placed in the time period of May 2, 2009 to December 31, 2014. During the time period of retrospective study, 880,359 add-on tests were ordered on 96,244 different patients. Add-on testing comprised 3.3 % of total test volumes. There were 443,411 unique ordering instances, leading to an average of 1.99 add-on tests per instance. Some patients had multiple episodes of add-on test orders at different points in time, leading to an average of 9.15 add-on tests per patient. The majority of add-on orders were for chemistry tests (78.8 % of total add-ons) with the next most frequent being hematology and coagulation tests (11.2 % of total add-ons). Inpatient orders accounted for 66.8 % of total add-on orders, while the emergency department and outpatient clinics had 14.8 % and 18.4 % of total add-on orders, respectively. The majority of add-ons were placed within 8 hours (87.3 %) and nearly all by 24 hours (96.8 %). Nearly 100 % of add-on orders within the emergency department were placed within 8 hours. The introduction of a robotic specimen archival/retrieval unit saved an average of 2.75 minutes of laboratory staff manual time per unique add-on order. This translates to 24.1 hours/day less manual effort in dealing with add-on orders. Our study reflects the previous literature in showing that add-on orders significantly impact the workload of the clinical laboratory. The majority of add-on orders are clinical chemistry

  9. 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

    2017-09-11

    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.

  10. Academic Dishonesty in Medical Schools

    African Journals Online (AJOL)

    Being aware of academic dishonesty in the Medical School made it. 86.3% likely that a student would participate. Having ... Key words: Academic Dishonesty, Medical Training,. Medical Students. Ann Afr Surg. 2017;14(1): 19-21. .... on Plagiarism and Cheating, in Perspectives on Plagiarism and Intellectual Property in the.

  11. 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).

  12. Center forTelehealth and Cybermedicine Research, University of New Mexico Health Sciences Center: a model of a telehealth program within an academic medical center.

    Science.gov (United States)

    Alverson, Dale C; Dion, Denise; Migliorati, Margaret; Rodriguez, Adrian; Byun, Hannah W; Effertz, Glen; Duffy, Veronica; Monge, Benjamin

    2013-05-01

    An overview of the Center for Telehealth and Cybermedicine Research at the University of New Mexico Health Sciences Center was presented along with several other national and international programs as part of the of a symposium-workshop on telehealth, "Sustaining and Realizing the Promise of Telemedicine," held at the University of Michigan Health System in Ann Arbor, MI, May 18-19, 2012 and hosted by the University of Michigan Telemedicine Resource Center and its Director, Rashid Bashshur. This article describes our Center, its business plan, and a view to the future.

  13. 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.

  14. What's in a Name? The Necessary Transformation of the Academic Medical Center in the Era of Population Health and Accountable Care.

    Science.gov (United States)

    DiSesa, Verdi J; Kaiser, Larry R

    2015-07-01

    Academic medical centers (AMCs) and the physicians and other professionals who lead them need to recognize they are in a business that is making a transition from a system of "sickness" care to one of "health" care, accountable for the health of defined populations and for the value (quality divided by cost) of the services provided. This change has profound implications for how AMCs conceive themselves, how they function, and how they are paid for the work that they do. A failure to recognize how the disruption of the mission of AMCs is changing may impair them as irrevocably as other changes caused the demise of Kodak, once the world's leader in the manufacture and sale of photographic film and cameras. Leaders of academic medicine need to understand, respond to, and ultimately lead the transformation of our system of health. In this Commentary, the authors review the pressures driving these changes and potential responses to them-a process already under way. They summarize the issues in the question "Should the words 'health' and 'system' take the place of 'medical' and 'center' in our institutions' names and, more important, in how we conceive of what we do?" The authors propose the name "academic health system" to better identify primary objectives to measure success by the health of patients.

  15. Model of Current Practice Regarding Prescriptions of Controlled Substances and the Perceived Benefits of E-Prescribing in an Academic Medical Center.

    Science.gov (United States)

    Kupperman, Eli; Vigil, Daniel; Yazdani, Arash; Baldwin, Kevin

    2016-12-01

    To review current practices regarding prescribing controlled substances at an academic medical center and describe possible advantages of electronic prescribing of controlled substances (EPCS). A 10-question multiple choice survey was sent electronically to all house staff at an academic medical center. Aggregated data was analyzed for trends. 193 surveys (18.8 %) were completed. Of all respondents, 46.6 % were not able to write their own prescriptions. 70.0 % have used another provider's prescription pad to write prescriptions. 53.4 % have had prescriptions rejected or not filled by a pharmacy for being written incorrectly. 59.6 % kept a patient as an inpatient for a longer period of time due to the inability to obtain a prescription, costing an estimated $3.28 million per year. 58.0 % needed to have a patient return to the hospital to pick up prescriptions for an estimated 1583 return trips to the hospital yearly. 35.1 % had a patient return to the emergency department due to uncontrolled pain, estimated at $139,000 in yearly emergency department patient charges. The authors' survey highlights some of the financial, legal, efficiency, and satisfaction disadvantages due to the inability to use EPCS. Implementing EPCS and making it ubiquitous may limit some inefficiencies in academic hospital systems.

  16. Rapid prescreen of cervical liquid-based cytology preparations: results of a study in an academic medical center.

    Science.gov (United States)

    Frable, William J; Pedigo, Mary Ann; Powers, Celeste N; Yarrell, Cheryl; Ortiz, Becky; Clark, Mary E; Ebron, Tameka

    2012-08-01

    A rapid prescreening or rapid rescreening method for quality assurance in cervical cytology has been used in Europe and in Canada but has not been accepted in the United States. The rapid prescreen method was tested in a cytology laboratory that serves an academic medical center with a high-risk population for cervical cancer. For a period of 3 months, a tray of 20 sequentially numbered Surepath™ liquid-based preparations, randomly selected from the cervical cytology daily workload, were each prescreened in a random fashion for 1 minute. Experienced cytotechnologists performed the rapid prescreen. Results were recorded as negative, further review needed, or epithelial cell abnormality, category specified. The 20 cervical cytology preparations were then replaced in their same position in the daily workload for routine screening performed by another cytotechnologist. Final interpretation was by a cytopathologist as requested or required by Clinical Laboratory Improvement Amendments of 1988. The rapid prescreen data was tabulated and compared with data for a similar time period using the laboratory's normal quality assurance program. Seven hundred and twelve cases underwent rapid prescreen. Six hundred and forty-two were interpreted as negative. Twenty-six cases were interpreted as low-grade squamous intraepithelial lesion (LGSIL) or higher. Forty-four cases were classified as needing further review. For the 642 negative cases by rapid prescreening, routine screening reported 537 as negative and 105 as either abnormal or needed cytopathologist review. The error rate for the rapid prescreen is 50 of 712 (7.0%); for LGSIL and above 19 of 712 (2.6%). Of the 105 abnormal cases or those submitted for cytopathologist review, 31 were interpreted as atypical squamous cells of undermined significance (ASCUS), 41 cases as reactive/repair, 17 as LGSIL, 4 as unsatisfactory, 1 as atypical squamous cells, cannot rule out high-grade squamous intraepithelial lesion (ASC-H), 8 as

  17. 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.

  18. The C.L.E.A.R. Score: a new comprehensive assessment method for academic physicians in military medical centers.

    Science.gov (United States)

    Buller, Jerome L; Tetteh, Hassan A

    2012-07-01

    Evaluation of medical officer performance is a critical leadership role. This study offers a comprehensive evaluation system for military physicians. The Comprehensive Assessment equation (COMPASS equation), a modified Cobb-Douglas equation, was developed to evaluate academic physicians. The COMPASS equation assesses military physicians within five comprehensive dimensions: (1) Clinical (2) Leadership, (3) Educational (4) Administrative, and (5) Research productivity excellence to yield a composite "C.L.E.A.R. Score." The COMPASS equation's fidelity was tested with a cohort of military physicians within the department of Obstetrics and Gynecology in the Capital District Region and a C.L.E.A.R. score was calculated for individual physicians. Mean C.L.E.A.R score was 53.6 +/- 28.8 (range 10.1-98.5). The responsiveness of the model was tested using two hypothetical physician models: "low-performing-faculty" and "super-faculty," and calculated C.L.E.A.R. scores were 6.3 and 153.4, respectively. The C.L.E.A.R. score appears to recognize and assess the performance excellence of military physicians. Weighting measured characteristics of the COMPASS equation can be used to promote organizational priorities. Thus, leaders of military medicine can communicate institutional priorities and inculcate them through use of the COMPASS equation to reward and recognize the activities of military medical officers that are commensurate with institutional goals.

  19. [Effects of Mental Disorders on the Academic Outcomes of University Students--A Retrospective Study Using Medical Records from a Health Services Center].

    Science.gov (United States)

    Ishii, Terumi; Tachikawa, Hirokazu; Hori, Takafumi; Ishikawa, Masanori; Hatanaka, Kimitaka; Aiba, Miyuki; Asada, Takashi

    2015-01-01

    Falling behind in class is a serious problem for university students as it can lead to social problems and increase the risk of suicide. Although it is common for students suffering from mental disorders to fall behind academically, there have been few studies investigating the difficulties these students face in order to graduate from university. Therefore, we investigated factors associated with dropping out of school with the purpose of creating a strategy to improve the academic outcomes of students who regularly seek psychiatric consultation. We investigated undergraduate students who received consultation at Tsukuba University's Health Services Center Psychiatry Department and whose academic outcomes between the 2004 and 2013 academic years were known. Academic outcomes were obtained from Tsukuba University's grade management system by permission of the authority. The students were divided into either a graduate or dropout group depending on their academic outcomes. The medical records for both groups were retrospectively investigated, and factors that were predicted to affect academic outcomes were assessed using statistical methods. The dropout group was younger in grade and had a greater severity of illness at initial consultation. Moreover, this group had a greater number of consultation visits, showed less cooperation with the instructor in charge, had a significantly longer duration of social with drawal and temporary leave of absence from school, and had a significantly greater number of students with grade retention. When a time factor was incorporated in the analysis, the presence of grade retention/temporary leave of absence from school and social withdrawal was significantly correlated with dropping out of school. It was revealed that not only the mental disorder itself, but also psychosocial severity and the maladjusted state that occur secondary to such mental disorder influence academic outcomes. These results indicated that in order to improve

  20. Academic Health Centers and Health Care Reform.

    Science.gov (United States)

    Miles, Stephen H.; And Others

    1993-01-01

    A discussion of the role of academic health centers in health care reform efforts looks at the following issues: balancing academic objectivity and social advocacy; managing sometimes divergent interests of centers, faculty, and society; and the challenge to develop infrastructure support for reform. Academic health centers' participation in…

  1. The second market failure phenomenon in safety-net health systems: the case of a municipal academic medical center from 1980 to 2000.

    Science.gov (United States)

    Tataw, David

    2011-01-01

    The specific aim of this analysis is to demonstrate how the trade-off between efficiency and equity policy approaches affects the ability of at-risk children to access quality health care services at the King/Drew Medical Center of Los Angeles County from 1980 to 2000. The concept of a second market phenomenon is used as a framework to illustrate how efficiency-seeking behaviors of federal, state, and local government actors affected government intervention efforts initiated to remedy health care access hardships created by market failure in low-income communities. A second market failure occurs when government failure results from the reintroduction of market protocols in an environment where the market had originally failed to facilitate the distribution of basic goods and services. The review suggest that financial austerity at the Los Angeles County Department of Health Services in the context of federal, state, and local government policies that emphasized allocative efficiencies, compromised equity values by undermining access to quality pediatric services at the King/Drew Medical Center which was a municipal academic medical center.

  2. 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.

    Science.gov (United States)

    Ritchie, Christine; Andersen, Robin; Eng, Jessica; Garrigues, Sarah K; Intinarelli, Gina; Kao, Helen; Kawahara, Suzanne; Patel, Kanan; Sapiro, Lisa; Thibault, Anne; Tunick, Erika; Barnes, Deborah E

    2016-01-01

    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, phealth 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 in self-rated health.

  3. 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

    2013-12-01

    Although hospitalists may improve efficiency and quality of inpatient care, their effect on healthcare-worker communication and education has been less well-studied. To test various approaches to improving healthcare-worker communication and learner education within the context of a newly designed academic hospital medicine program. Before-and-after design with concurrent control group. A Midwestern Veterans Affairs medical center. 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). 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. 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). Academic hospitalists working within a systems redesign intervention were able to improve healthcare-worker communication and enhance learner education without increasing patient length of stay or readmission rates. © 2013 Society of The Authors. Journal of Hospital Medicine

  4. 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.

  5. Development and implementation of an integrated mobile situational awareness iPhone application VigiVU™ at an academic medical center.

    Science.gov (United States)

    Lane, Jason S; Sandberg, Warren S; Rothman, Brian

    2012-09-01

    We describe the decision drivers, development and implementation of an integrated mobile situational awareness application for the perioperative environment. This digital operating room tool for anesthesiologists facilitates direct supervision of in-room staff without requiring being tied to a stationary computer workstation. The iOS platform was used to create the VigiVU™ mobile application at Vanderbilt University Medical Center. The first working version was completed in 3 weeks with a scalable application for department-wide distribution requiring less than 1,000 development hours. The VigiVU™ application provides situational awareness via access to real time operating room video, patient vital signs, anesthetic interventions, OR management visualization tools, patient data protection, bidirectional voice and text communication, and integrated electronic medical record access. The application allows anesthesiologists to know the status of their patients in up to four locations simultaneously. The application provides the ability to visually follow the flow of patients through the operative suite and prioritize which patients need attention. The application provides a consistent user environment on several compatible iOS devices. A group of 40 beta testers has consistently used and maintained their copy of the application, suggesting user acceptance. We have demonstrated that it is possible to develop and implement an integrated mobile situational awareness application at a large academic medical center. Future research may determine whether perioperative deployment and utilization of VigiVU™ at our institution enhances patient safety and/or operating room efficiency.

  6. Factors Associated with Clinical Research Recruitment in a Pediatric Academic Medical Center--A Web-Based Survey

    National Research Council Canada - National Science Library

    Denhoff, Erica Rose; Milliren, Carly E; de Ferranti, Sarah D; Steltz, Sarah K; Osganian, Stavroula K

    2015-01-01

    .... Yet, this has been less well studied. We conducted a survey of investigators performing human subjects research in a single large academic pediatric hospital to better understand characteristics of studies with successful recruitment...

  7. Factors Associated with Clinical Research Recruitment in a Pediatric Academic Medical Center--A Web-Based Survey: e0140768

    National Research Council Canada - National Science Library

    Erica Rose Denhoff; Carly E Milliren; Sarah D de Ferranti; Sarah K Steltz; Stavroula K Osganian

    2015-01-01

    .... Yet, this has been less well studied. We conducted a survey of investigators performing human subjects research in a single large academic pediatric hospital to better understand characteristics of studies with successful recruitment...

  8. A case study on the safety impact of implementing smart patient-controlled analgesic pumps at a tertiary care academic medical center.

    Science.gov (United States)

    Tran, Mai; Ciarkowski, Scott; Wagner, Deborah; Stevenson, James G

    2012-03-01

    As with the use of any therapy involving opioids, patient-controlled analgesia (PCA)-related errors can lead to overdose and even death. "Smart" (computerized) pumps have medication safety enhancements, particularly those related to operator errors during administration, to improve overall safety and efficacy. After the occurrence of PCA-related errors that occurred at a tertiary care academic medical center, an analysis of PCA errors was conducted. The introduction of smart pumps was identified as a possible solution, and the medical center adopted the technology in 2006. A study was conducted to investigate the impact of implementation. The study had three primary objectives: (1) to evaluate history logs stored in the smart PCA pumps to characterize the nature of hard and soft stop alerts and identify potential errors that may have been averted, (2) to examine the impact of smart PCA pumps on voluntarily reported PCA therapy-related errors, and (3) to assess nursing perceptions regarding the improvement in safety due to the introduction of smart PCA pumps. The smart pumps potentially prevented 159 errors for the January-June 2007 period; upper hard limits had the most number of alerts, representing avoidance of errors with the greatest potential to be detrimental to the patient. In addition, pump-programming errors due to wrong concentration were eliminated after implementation. Finally, nursing staff perceived smart pumps to be valuable in improving patient safety. Smart PCA pumps had an important positive impact on PCA-related patient safety at the medical center. Other facilities should adopt PCA devices with additional safety features such as bar-code verification of the drug and concentration, as well as dosage limits, to prevent pump-programming errors.

  9. 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.

  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. Factors Associated with Clinical Research Recruitment in a Pediatric Academic Medical Center?A Web-Based Survey

    OpenAIRE

    Erica Rose Denhoff; Milliren, Carly E.; de Ferranti, Sarah D.; Sarah K Steltz; Osganian, Stavroula K.

    2015-01-01

    Background One of the most difficult aspects of conducting clinical research is the ability to successfully recruit participants. Pediatric clinical research presents unique recruitment challenges that relate to the need for parental consent on behalf of a minor, child assent, and school attendance. Yet, this has been less well studied. We conducted a survey of investigators performing human subjects research in a single large academic pediatric hospital to better understand characteristics o...

  12. Mentoring the next generation of physician-scientists in Japan: a cross-sectional survey of mentees in six academic medical centers.

    Science.gov (United States)

    Sakushima, Ken; Mishina, Hiroki; Fukuhara, Shunichi; Sada, Kenei; Koizumi, Junji; Sugioka, Takashi; Kobayashi, Naoto; Nishimura, Masaharu; Mori, Junichiro; Makino, Hirofumi; Feldman, Mitchell D

    2015-03-19

    Physician-scientists play key roles in biomedical research across the globe, yet prior studies have found that it is increasingly difficult to recruit and retain physician-scientists in research careers. Access to quality research mentorship may help to ameliorate this problem in the U.S., but there is virtually no information on mentoring in academic medicine in Japan. We conducted a survey to determine the availability and quality of mentoring relationships for trainee physician-scientists in Japan. We surveyed 1700 physician-scientists in post-graduate research training programs in 6 academic medical centers in Japan about mentorship characteristics, mentee perceptions of the mentoring relationship, and attitudes about career development. A total of 683 potential physician-scientist mentees completed the survey. Most reported that they had a departmental mentor (91%) with whom they met at least once a month; 48% reported that they were very satisfied with the mentoring available to them. Mentoring pairs were usually initiated by the mentor (85% of the time); respondents identified translational research skills (55%) and grant writing (50%) as unmet needs. Mentoring concerning long-term career planning was significantly associated with the intention to pursue research careers, however this was also identified by some mentees as an unmet need (35% desired assistance; 15% reported receiving it). More emphasis and formal training in career mentorship may help to support Japanese physician-scientist mentees to develop a sense of self-efficacy to pursue and stay in research careers.

  13. Commentary: A call to leadership: the role of the academic medical center in driving sustainable health system improvement through performance measurement.

    Science.gov (United States)

    Nedza, Susan M

    2009-12-01

    As the government attempts to address the high cost of health care in the United States, the issues being confronted include variations in the quality of care administered and the inconsistent application of scientifically proven treatments. To improve quality, methods of measurement and reporting with rewards or, eventually, penalties based on performance, must be developed. To date, well-intentioned national policy initiatives, such as value-based purchasing, have focused primarily on the measurement of discrete events and on attempts to construct incentives. While important, the current approach alone cannot improve quality, ensure equitability, decrease variability, and optimize value. Additional thought-leadership is required, both theoretical and applied. Academic medical centers' (AMCs') scholarly and practical participation is needed. Although quality cannot be sustainably improved without measurement, the existing measures alone do not ensure quality. There is not enough evidence to support strong measure development and, further, not enough insight regarding whether the existing measures have their intended effect of enhancing health care delivery that results in quality outcomes for patients. Perhaps the only way that the United States health care system will achieve a standard of quality care is through the strong embrace, effective engagement, intellectual insights, educational contributions, and practical applications in AMCs. Quality will never be achieved through public policies or national initiatives alone but instead through the commitment of the academic community to forward the science of performance measurement and to ensure that measurement leads to better health outcomes for our nation.

  14. A Metric-Based System for Evaluating the Productivity of Preclinical Faculty at an Academic Medical Center in the Era of Clinical and Translational Science.

    Science.gov (United States)

    Wiegers, Susan E; Houser, Steven R; Pearson, Helen E; Untalan, Ann; Cheung, Joseph Y; Fisher, Susan G; Kaiser, Larry R; Feldman, Arthur M

    2015-08-01

    Academic medical centers are faced with increasing budgetary constraints due to a flat National Institutes of Health budget, lower reimbursements for clinical services, higher costs of technology including informatics and a changing competitive landscape. As such, institutional stakeholders are increasingly asking whether resources are allocated appropriately and whether there are objective methods for measuring faculty contributions and engagement. The complexities of translational research can be particularly challenging when trying to assess faculty contributions because of team science. For over a decade, we have used an objective scoring system called the Matrix to assess faculty productivity and engagement in four areas: research, education, scholarship, and administration or services. The Matrix was developed to be dynamic, quantitative, and able to insure that a fully engaged educator would have a Matrix score that was comparable to a fully engaged investigator. In this report, we present the Matrix in its current form in order to provide a well-tested objective system of performance evaluation for nonclinical faculty to help academic leaders in decision making. © 2015 Wiley Periodicals, Inc.

  15. Effectiveness and Safety of Magnesium Replacement in Critically Ill Patients Admitted to the Medical Intensive Care Unit in an Academic Medical Center: A Retrospective, Cohort Study.

    Science.gov (United States)

    Hammond, Drayton A; Stojakovic, Jelena; Kathe, Niranjan; Tran, Julie; Clem, Oktawia A; Erbach, Kristina; King, Jarrod

    2017-01-01

    "Rules of thumb" for the replacement of electrolytes, including magnesium, in critical care settings are used, despite minimal empirical validation of their ability to achieve a target serum concentration. This study's purpose was to evaluate the effectiveness and safety surrounding magnesium replacement in medically, critically ill patients with mild-to-moderate hypomagnesemia. This was a single-center, retrospective, observational evaluation of episodes of intravenous magnesium replacement ordered for patients with mild-to-moderate hypomagnesemia (1.0-1.9 mEq/L) admitted to a medical intensive care unit from May 2014 to April 2016. The primary effectiveness outcome, achievement of target serum magnesium concentration (≥2 mEq/L) compared to expected achievement using a "rule of thumb" estimation that 1 g intravenous magnesium sulfate raises the magnesium concentration 0.15 mEq/L, was tested using 1-sample z test. Logistic regression analysis was conducted to assess the effect of infusion rate on target achievement. Of 152 days on which magnesium replacements were provided for 72 patients, a follow-up serum magnesium concentration was checked within 24 hours in 89 (58.6%) episodes. Of these 89 episodes, serum magnesium concentration reached target in only 49 (59.8%) episodes compared to an expected 89 (100%; P rule of thumb" estimation predicted.

  16. Association Between Exercise Frequency and Health Care Costs Among Employees at a Large University and Academic Medical Center.

    Science.gov (United States)

    Caretto, David C; Ostbye, Truls; Stroo, Marissa; Darcey, Dennis J; Dement, John

    2016-12-01

    The aim of this study was to evaluate the relationship between exercise frequency and health care costs associated with medical and pharmacy claims among a 10-year employee cohort. The relationship between self-reported exercise (days/week) and health care costs was analyzed with negative binomial regression, using an integrated database involving 32,044 person-years and linking employee demographics, health risk appraisal information, and health insurance claims. An association demonstrating exercise frequency lowering health care costs was present in most medical and prescription drug categories and was strongest among employees reporting 2 to 3 and 4 to 5 days/week of exercise. Increased exercise was associated with statistically significant reductions in endocrine disease costs and gastrointestinal prescription drug costs. This cohort demonstrates lower health care costs in employee populations when exercise frequency is increased. Employers may lower modifiable risk factors for chronic disease and reduce health care costs by promoting exercise among their employee population.

  17. 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 versus 53.0 min; P 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.

  18. Halting the revolving door of faculty turnover: recruiting and retaining clinician educators in an academic medical simulation center.

    Science.gov (United States)

    Kim, Sara; Ross, Brian; Wright, Andrew; Wu, Michael; Benedetti, Thomas; Leland, Farrah; Pellegrini, Carlos

    2011-06-01

    Simulation-based education is indispensable in preparing healthcare providers for patient care. Simulation centers and programs that serve as a critical platform for promoting patient safety and high-quality training depend on multiple requirements for success: diversified and sustainable financing, technical personnel with a long-term commitment to simulation education, simulation and information technology infrastructure designed to match priority training needs, and resources for curricular development, instruction, faculty development, and research. An additional requirement not widely discussed in the literature is the recruitment and retention of faculty who serve as simulation educators, which is the focus of this report.

  19. Evaluation of Electronic Health Record Implementation in Ophthalmology at an Academic Medical Center (An American Ophthalmological Society Thesis)

    Science.gov (United States)

    Chiang, Michael F.; Read-Brown, Sarah; Tu, Daniel C.; Choi, Dongseok; Sanders, David S.; Hwang, Thomas S.; Bailey, Steven; Karr, Daniel J.; Cottle, Elizabeth; Morrison, John C.; Wilson, David J.; Yackel, Thomas R.

    2013-01-01

    Purpose: To evaluate three measures related to electronic health record (EHR) implementation: clinical volume, time requirements, and nature of clinical documentation. Comparison is made to baseline paper documentation. Methods: An academic ophthalmology department implemented an EHR in 2006. A study population was defined of faculty providers who worked the 5 months before and after implementation. Clinical volumes, as well as time length for each patient encounter, were collected from the EHR reporting system. To directly compare time requirements, two faculty providers who utilized both paper and EHR systems completed time-motion logs to record the number of patients, clinic time, and nonclinic time to complete documentation. Faculty providers and databases were queried to identify patient records containing both paper and EHR notes, from which three cases were identified to illustrate representative documentation differences. Results: Twenty-three faculty providers completed 120,490 clinical encounters during a 3-year study period. Compared to baseline clinical volume from 3 months pre-implementation, the post-implementation volume was 88% in quarter 1, 93% in year 1, 97% in year 2, and 97% in year 3. Among all encounters, 75% were completed within 1.7 days after beginning documentation. The mean total time per patient was 6.8 minutes longer with EHR than paper (P<.01). EHR documentation involved greater reliance on textual interpretation of clinical findings, whereas paper notes used more graphical representations, and EHR notes were longer and included automatically generated text. Conclusion: This EHR implementation was associated with increased documentation time, little or no increase in clinical volume, and changes in the nature of ophthalmic documentation. PMID:24167326

  20. Educating youth about health and science using a partnership between an academic medical center and community-based science museum.

    Science.gov (United States)

    Bunce, Arwen E; Griest, Susan; Howarth, Linda C; Beemsterboer, Phyllis; Cameron, William; Carney, Patricia A

    2009-08-01

    Declining student interest and scholastic abilities in the sciences are concerns for the health professions. Additionally, the National Institutes of Health is committed to promoting more research on health behaviors among US youth, where one of the most striking contemporary issues is obesity. This paper reports findings on the impact of a partnership between Oregon Health and Science University (OHSU) and the Oregon Museum of Science and Industry linked to a 17-week exhibition of BodyWorlds3 and designed to inform rural underserved youth about science and health research. Self-administered survey measures included health knowledge, attitudes, intended health behaviors, and interest in the health professions. Four hundred four surveys (88% of participants) were included in analyses. Ninety percent or more found both the BodyWorlds (n = 404) and OHSU (n = 239) exhibits interesting. Dental care habits showed the highest level of intended behavior change (Dental = 45%, Exercise = 34%, Eating = 30%). Overall, females and middle school students were more likely than male and high school students, respectively, to state an intention to change exercise, eating and dental care habits. Females and high school students were more likely to have considered a career in health or science prior to their exhibit visit and, following the exhibit, were more likely to report that this intention had been reinforced. About 6% of those who had not previously considered a career in health or science (n = 225) reported being more likely to do so after viewing the exhibits. In conclusion, high quality experiential learning best created by community-academic partnerships appears to have the ability to stimulate interest and influence intentions to change health behaviors among middle and high school students.

  1. Evaluation of electronic health record implementation in ophthalmology at an academic medical center (an American Ophthalmological Society thesis).

    Science.gov (United States)

    Chiang, Michael F; Read-Brown, Sarah; Tu, Daniel C; Choi, Dongseok; Sanders, David S; Hwang, Thomas S; Bailey, Steven; Karr, Daniel J; Cottle, Elizabeth; Morrison, John C; Wilson, David J; Yackel, Thomas R

    2013-09-01

    To evaluate three measures related to electronic health record (EHR) implementation: clinical volume, time requirements, and nature of clinical documentation. Comparison is made to baseline paper documentation. An academic ophthalmology department implemented an EHR in 2006. A study population was defined of faculty providers who worked the 5 months before and after implementation. Clinical volumes, as well as time length for each patient encounter, were collected from the EHR reporting system. To directly compare time requirements, two faculty providers who utilized both paper and EHR systems completed time-motion logs to record the number of patients, clinic time, and nonclinic time to complete documentation. Faculty providers and databases were queried to identify patient records containing both paper and EHR notes, from which three cases were identified to illustrate representative documentation differences. Twenty-three faculty providers completed 120,490 clinical encounters during a 3-year study period. Compared to baseline clinical volume from 3 months pre-implementation, the post-implementation volume was 88% in quarter 1, 93% in year 1, 97% in year 2, and 97% in year 3. Among all encounters, 75% were completed within 1.7 days after beginning documentation. The mean total time per patient was 6.8 minutes longer with EHR than paper (P<.01). EHR documentation involved greater reliance on textual interpretation of clinical findings, whereas paper notes used more graphical representations, and EHR notes were longer and included automatically generated text. This EHR implementation was associated with increased documentation time, little or no increase in clinical volume, and changes in the nature of ophthalmic documentation.

  2. Motivation and academic achievement in medical students

    OpenAIRE

    Yousefy, Alireza; Ghassemi, Gholamreza; Firouznia, Samaneh

    2012-01-01

    Background: Despite their ascribed intellectual ability and achieved academic pursuits, medical students? academic achievement is influenced by motivation. This study is an endeavor to examine the role of motivation in the academic achievement of medical students. Materials and Methods: In this cross-sectional correlational study, out of the total 422 medical students, from 4th to final year during the academic year 2007?2008, at School of Medicine, Isfahan University of Medical Sciences, 344...

  3. Comprehensive Look at Blood Transfusion Utilization in Total Joint Arthroplasty at a Single Academic Medical Center under a Single Surgeon

    Directory of Open Access Journals (Sweden)

    Sean Robinson

    2013-01-01

    Full Text Available The utilization of autologous and allogeneic transfusions in total joint arthroplasties was to characterize patients who may benefit from giving preoperative blood donations. We conducted a retrospective chart review of 525 patients to document preoperative hematocrit, estimated blood loss, length of stay, transfusions, and medical comorbidities. Results of our review showed that total hip arthroplasty revision (THA-R had the highest prevalence of transfusions (60% followed by total hip arthroplasty (THA, 53%, total knee arthroplasty-revision (TKA-R, 33%, and total knee arthroplasty (TKA, 23%. There was significant waste of autologous donations: 92% of TKA patients, 64% of THA, and 33% of THA-R patients wasted on average 1.527, 1.321, and 1.5 autologous units, respectively. Pre-operative hematocrit was the strongest predictor of future transfusion need across all procedures, and primary THA had additional predictors in age and gender.

  4. Evaluation of lesion flow coefficient for the detection of coronary artery disease in patient groups from two academic medical centers.

    Science.gov (United States)

    Peelukhana, Srikara V; Banerjee, Rupak K; van de Hoef, Tim P; Kolli, Kranthi K; Effat, Mohamed; Helmy, Tarek; Leesar, Massoud; Kerr, Hanan; Piek, Jan J; Succop, Paul; Back, Lloyd; Arif, Imran

    2017-09-11

    In this study, lesion flow coefficient (LFC: ratio of % area stenosis [%AS] to the square root of the ratio of the pressure drop across the stenosis to the dynamic pressure in the throat region), that combines both the anatomical (%AS) and functional measurements (pressure and flow), was assessed for application in a clinical setting. Pressure, flow, and anatomical values were obtained from patients in 251 vessels from two different centers. Fractional flow reserve (FFR), Coronary flow reserve (CFR), hyperemic stenosis resistance index (HSR) and hyperemic microvascular index (HMR) were calculated. Anatomical data was corrected for the presence of guidewire and the LFC values were calculated. LFC was correlated with FFR, CFR, HSR, HMR, individually and in combination with %AS. The p<0.05 was used for statistical significance. LFC correlated significantly when the FFR (pressure-based), CFR (flow-based), and anatomical measure %AS were combined (r=0.64; p<0.05). Similarly, LFC correlated significantly when HSR, HMR, and %AS were combined (r=0.72; p<0.05). LFC was able to significantly (p<0.05) distinguish between the two concordant and the two discordant groups of FFR and CFR, corresponding to the clinically used cut-off values (FFR=0.80 and CFR=2.0). The LFC could also significantly (p<0.05) distinguish between the normal and abnormal microvasculature conditions in the presence of non-significant epicardial stenosis, while the comparison was borderline significant (p=0.09) in the presence of significant stenosis. LFC, a parameter that combines both the anatomical and functional end-points, has the potential for application in a clinical setting for CAD evaluation. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. 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.

  6. Trends in aminoglycoside use and gentamicin-resistant gram-negative clinical isolates in US academic medical centers: implications for antimicrobial stewardship.

    Science.gov (United States)

    Ababneh, Mera; Harpe, Spencer; Oinonen, Michael; Polk, Ron E

    2012-06-01

    To measure trends in aminoglycoside antibiotic use and gentamicin-resistant clinical isolates across a network of hospitals and compare network-level relationships with those of individual hospitals. Longitudinal observational investigation. US academic medical centers. Adult inpatients. Adult aminoglycoside use was measured from 2002 or 2003 through 2009 in 29 hospitals. Hospital-wide antibiograms assessed gentamicin resistance by proportions and incidence rates for Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, and Escherichia coli. Mixed-effects analysis of variance was used to assess the significance of changes in aminoglycoside use and changes in resistance rates and proportions. Generalized estimating equations were used to assess the relationship between aminoglycoside use and resistance. Mean aminoglycoside use declined by 41%, reflecting reduced gentamicin (P gentamicin-resistant P. aeruginosa decreased by 48% (P gentamicin-resistant E. coli increased by 166% and 124%, respectively (P resistance in E. coli. Resistance among K. pneumoniae and A. baumannii did not change. Relationships between aminoglycoside use and resistance at the network level were highly variable at the individual hospital level. Mean aminoglycoside use declined in this network of US hospitals and was associated with significant and opposite changes in rates of resistance for some organisms and no change for others. At the individual hospital level, antibiograms appear to be an unreliable reflection of antibiotic use, at least for aminoglycosides.

  7. 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.

  8. 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…

  9. Penn Center for Community Health Workers: Step-by-Step Approach to Sustain an Evidence-Based Community Health Worker Intervention at an Academic Medical Center.

    Science.gov (United States)

    Morgan, Anna U; Grande, David T; Carter, Tamala; Long, Judith A; Kangovi, Shreya

    2016-11-01

    Community-engaged researchers who work with low-income communities can be reliant on grant funding. We use the illustrative case of the Penn Center for Community Health Workers (PCCHW) to describe a step-by-step framework for achieving financial sustainability for community-engaged research interventions. PCCHW began as a small grant-funded research project but followed an 8-step framework to engage both low-income patients and funders, determine outcomes, and calculate return on investment. PCCHW is now fully funded by Penn Medicine and delivers the Individualized Management for Patient-Centered Targets (IMPaCT) community health worker intervention to 2000 patients annually.

  10. Academic Cancer Center Phase I Program Development

    OpenAIRE

    Frankel, Arthur E; Flaherty, Keith T; Weiner, George J.; Chen, Robert; Azad, Nilofer S.; Pishvaian, Michael J.; Thompson, John A.; Taylor, Matthew H.; Mahadevan, Daruka; Lockhart, A. Craig; Vaishampayan, Ulka N.; Berlin, Jordan D.; Smith, David C.; Sarantopoulos, John; Riese, Matthew

    2017-01-01

    Abstract Multiple factors critical to the effectiveness of academic phase I cancer programs were assessed among 16 academic centers in the U.S. Successful cancer centers were defined as having broad phase I and I/II clinical trial portfolios, multiple investigator?initiated studies, and correlative science. The most significant elements were institutional philanthropic support, experienced clinical research managers, robust institutional basic research, institutional administrative efforts to...

  11. Academic health centers and health care reform.

    Science.gov (United States)

    Miles, S H; Lurie, N; Fisher, E S; Haugen, D

    1993-09-01

    There is increasing support for the proposition that academic health centers have a duty to accept broad responsibility for the health of their communities. The Health of the Public program has proposed that centers become directly involved in the social-political process as advocates for reform of the health care system. Such engagement raises important issues about the roles and responsibilities of centers and their faculties. To address these issues, the authors draw upon the available literature and their experiences in recent health care reform efforts in Minnesota and Vermont in which academic health center faculty participated. The authors discuss (1) the problematic balance between academic objectivity and social advocacy that faculty must attempt when they engage in the health care reform process; (2) the management of the sometimes divergent interests of academic health centers, some of their faculty, and society (including giving faculty permission to engage in reform efforts and developing a tacit understanding that distinguishes faculty positions on reform issues from the center's position on such issues); and (3) the challenge for centers to develop infrastructure support for health reform activities. The authors maintain that academic health centers' participation in the process of health care reform helps them fulfill the trust of the public that they are obligated to and ultimately depend on.

  12. Creating and Maintaining a Successful Service Line in an Academic Medical Center at the Dawn of Value-Based Care: Lessons Learned From the Heart and Vascular Service Line at UMass Memorial Health Care.

    Science.gov (United States)

    Phillips, Robert A; Cyr, Jay; Keaney, John F; Messina, Louis M; Meyer, Theo E; Tam, Stanley K C; Korenda, Kathleen; Darrigo, Melinda; Kumar, Pooja; Challapalli, Sailu

    2015-10-01

    The service line (SL) model has been proven to help shift health care toward value-based services, which is characterized by coordinated, multidisciplinary, high-quality, and cost-effective care. However, academic medical centers struggle with how to effectively set up SL structures that overcome the organizational and cultural challenges associated with simultaneously delivering the highest-value care for the patient and advancing the academic mission. In this article, the authors examine the evolution of UMass Memorial Health Care's heart and vascular service line (HVSL) from 2006 to 2011 and describe the impact on its success of multiple strategic decisions. These include key academic physician leadership recruitments and engagement via a matrixed governance and management model; development of multidisciplinary teams; empowerment of SL leadership through direct accountability and authority over programs and budgets; joint educational and training programs; incentives for academic achievement; and co-localization of faculty, personnel, and facilities. The authors also explore the barriers to success, including the need to overcome historical departmental-based silos, cultural and training differences among disciplines, confusion engendered by a matrixed reporting structure, and faculty's unfamiliarity with the financial and organizational skills required to operate a successful SL. Also described here is the impact that successful implementation of the SL has on creating high-quality services, increased profitability, and contribution to the financial stability and academic achievement of the academic medical center.

  13. Academic Health Centers: Can They Survive?

    Science.gov (United States)

    Vanselow, Neal A.

    1986-01-01

    Explores the transformation occurring in health care and examines the implications of these changes for academic health centers. Identifies problem areas and suggests solutions for the education, research, and care programs. States that support and understanding for, as well as changes within, the centers are needed. (ML)

  14. Interschool Relationships in Academic Health Centers.

    Science.gov (United States)

    Morris, Alvin L.

    1981-01-01

    Within academic health centers there exists a well-established "pecking order" influencing daily life and reflecting fundamental relationships between medicine, dentistry, nursing, pharmacy, and allied health. Relationships between individual professionals and between schools within a center are examined for clues to possible change. (MSE)

  15. Does adherence to National Comprehensive Cancer Network guidelines improve pain-related outcomes? An evaluation of inpatient cancer pain management at an academic medical center.

    Science.gov (United States)

    Mearis, Michael; Shega, Joseph W; Knoebel, Randall W

    2014-09-01

    Evidence-based guidelines are in place for the management of cancer-related pain, yet adherence remains problematic throughout health systems because of efficacy and safety concerns. To evaluate adherence to the National Comprehensive Cancer Network (NCCN) guidelines on pain management among cancer inpatients and assess whether adherence is associated with pain control. A retrospective chart review of patients admitted to the hematology/oncology service at an academic medical center between April 1, 2011 and September 30, 2011 was conducted, and patients were allocated into groups based on adherence to NCCN guidelines. Pain control and safety outcomes were compared between adherence groups for the first 24 hours of hospital admission. Multivariate analyses were performed to identify predictors of regimens nonadherent to guidelines and predictors of inadequate achievement of analgesia. Among a random sample of 193 inpatients, 109 met the inclusion criteria of which 70 were guideline adherent and 39 nonadherent. A total of 63% of the patients initiated on NCCN adherent guidelines obtained analgesia at 24 hours compared with 41% in the nonadherent group (P=0.028). Average pain scores across the 24-hour period were lower in the adherent compared with the nonadherent group (3.5 vs. 4.4, respectively, P<0.001). Naloxone use, respiratory depression, and hypoxia did not significantly vary between adherence groups. Chronic home opioid exposure was significantly associated with nonadherent therapy (vs. adherent; odds ratio=3.04, confidence interval=1.28-7.18, P=0.01) and achievement of analgesia at 24 hours (vs. not; odds ratio=0.30, confidence interval=0.12-0.73, P<0.01). Adherence to NCCN guidelines remains insufficient, with nonadherence being associated with inadequate analgesia. Opioid-tolerant patients remain at higher risk for guideline nonadherence and inadequate analgesia. Quality improvement initiatives should target opioid-tolerant patients. Copyright © 2014

  16. Comparison of adherence rates for antiretroviral, blood pressure, or mental health medications for HIV-positive patients at an academic medical center outpatient pharmacy.

    Science.gov (United States)

    Langness, Jacob; Cook, Paul F; Gill, Jasjit; Boggs, Rachael; Netsanet, Nathan

    2014-08-01

    Despite advances in safety, tolerability, and decreased pill burden for human immunodeficiency virus (HIV) antiretroviral therapy (ART), nonadherence continues to be a major cause of HIV-related morbidity and mortality. Adherence to these medications presents particular challenges because persons living with HIV (PLWH) must use medication more consistently (≥ 95%) than persons with other chronic diseases, such as hypertension or diabetes mellitus (≥ 80%). To (a) quantify PLWH adherence rates to scheduled ART, blood pressure medications, or mental health medications, (b) examine how pill burden and dosing schedule affected adherence, and (c) analyze a non-HIV comparator group for comparison with PLWH patients on adherence rates. Patients ≥ 18 years of age, on any prescribed HIV ART, scheduled prescription blood pressure medication, or scheduled prescription mental health medication filled between March 1, 2012, and March 31, 2013, were included in the analysis of data from the University of Colorado Hospital outpatient pharmacy system. The proportion of days covered (PDC) was calculated to measure adherence. Statistical analyses were performed to compare adherence rates between groups. The study included 865 PLWH, who filled 1,943 antiviral prescriptions with an average PDC of 84.5%. However, only 40% of patients had high enough adherence to achieve therapeutic benefits based on a criterion of at least 95% of scheduled doses taken. When separated by regimen, 282 patients filled single-tablet once-daily regimens; 295 patients filled multitablet once-daily regimens; and 288 patients filled multitablet twice-daily regimens. The calculated PDC of PLWH on a single-tablet once-daily regimen was 89.7% versus 81.0% for PLWH on a multitablet once-daily regimen (P  less than  0.001). The average PDC for PLWH (n = 269) who filled 460 scheduled blood pressure prescriptions was 82.7%. The average PDC for PLWH (n = 295) filling 467 scheduled mental health

  17. Academic Cancer Center Phase I Program Development.

    Science.gov (United States)

    Frankel, Arthur E; Flaherty, Keith T; Weiner, George J; Chen, Robert; Azad, Nilofer S; Pishvaian, Michael J; Thompson, John A; Taylor, Matthew H; Mahadevan, Daruka; Lockhart, A Craig; Vaishampayan, Ulka N; Berlin, Jordan D; Smith, David C; Sarantopoulos, John; Riese, Matthew; Saleh, Mansoor N; Ahn, Chul; Frenkel, Eugene P

    2017-04-01

    Multiple factors critical to the effectiveness of academic phase I cancer programs were assessed among 16 academic centers in the U.S. Successful cancer centers were defined as having broad phase I and I/II clinical trial portfolios, multiple investigator-initiated studies, and correlative science. The most significant elements were institutional philanthropic support, experienced clinical research managers, robust institutional basic research, institutional administrative efforts to reduce bureaucratic regulatory delays, phase I navigators to inform patients and physicians of new studies, and a large cancer center patient base. New programs may benefit from a separate stand-alone operation, but mature phase I programs work well when many of the activities are transferred to disease-oriented teams. The metrics may be useful as a rubric for new and established academic phase I programs. The Oncologist 2017;22:369-374. © The Authors. The Oncologist published by Wiley Periodicals, Inc. on behalf of AlphaMed Press 2017.

  18. 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

  19. Perspectives from the Academic Health Center.

    Science.gov (United States)

    Bulger, Roger J.

    1996-01-01

    An administrator of an academic health center discusses effects of increased competition for funds including the necessity of segregating the three funding streams (service, education, and research) and the short-term increased costs of implementing educational technology solutions. He urges a broader health science vision and greater…

  20. Pharmacotherapy Treatment Patterns, Outcomes, and Health Resource Utilization Among Patients with Heart Failure with Reduced Ejection Fraction at a U.S. Academic Medical Center.

    Science.gov (United States)

    Bress, Adam P; King, Jordan B; Brixner, Diana; Kielhorn, Adrian; Patel, Harshali K; Maya, Juan; Lee, Vinson C; Biskupiak, Joseph; Munger, Mark

    2016-02-01

    To assess clinical characteristics, pharmacotherapy treatment patterns, resource utilization and associated charges, and morbidity and mortality outcomes among a real-world cohort of patients with heart failure with reduced ejection fraction (HFrEF) in an academic medical center setting. Retrospective analysis. Electronic health record database that includes clinical, laboratory, and administrative data for all facilities of the University of Utah Health Care System. A total of 989 adults with prevalent (preexisting) HFrEF, identified by using the International Classification of Diseases, Ninth Revision, Clinical Modification code 428.x (heart failure) between January 1, 2007, and June 30, 2013, and who had a left ventricular ejection fraction of 40% or lower. The cohort had a mean age of 64 ± 15 years and was predominantly white (71%) and male (74%). Patients received β-blockers, angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), and aldosterone receptor antagonists (ARAs) at rates of 79%, 69%, and 29%, respectively. Patients achieved target doses of β-blockers, ACEIs, and ARBs at rates of only 24%, 31%, and 13%, respectively. Overall, 58% of patients were prescribed dual therapy with a β-blocker and an ACEI or ARB, and 19% were prescribed triple therapy (β-blocker, an ACEI or ARB, and an ARA). Univariate and multivariate logistic regression models were used to assess the association between baseline characteristics with the presence of triple therapy. Two variables were statistically significant in both models: increasing age was associated with a lower odds of triple therapy (univariate: odds ratio [OR] 0.760, 95% confidence interval [CI] 0.673-0.857; multivariate: OR 0.768, 95% CI 0.625-0.942), whereas receipt of an implantable cardiac device was associated with a 2-fold increase in the odds of triple therapy (univariate: OR 2.1, 95% CI 1.4-3.1; multivariate: OR 2.1, 95% CI 1.3-3.5). During a mean ± SD follow

  1. An Analysis of Medication Errors at the Military Medical Center: Implications for a Systems Approach for Error Reduction

    National Research Council Canada - National Science Library

    Scheirman, Katherine

    2001-01-01

    An analysis was accomplished of all inpatient medication errors at a military academic medical center during the year 2000, based on the causes of medication errors as described by current research in the field...

  2. Preparing academic medical department physicians to successfully lead.

    Science.gov (United States)

    Revere, Lee; Robinson, Arlin; Schroth, Lynn; Mikhail, Osama

    2015-01-01

    The purpose of this paper is to present a case study which details the successful development, design and deployment of a leadership course for academic medical department chairs. The course provides a needed local and contextual alternative to the lengthy and often theoretical MBA/MHA. Faculty developers used a multi-tiered methodology for developing the physician leadership course. The methodology consisted of literature findings, needs assessment, stakeholder input and structured interviews with administrative leaders. The research, stakeholder input and interviews revealed an increasing number of physician leaders with a general lack of fundamental administrative leadership skills. These shortfalls are largely because of underexposure to core management competencies during medical school and limited contextual knowledge outside their organization. There is an urgent need for leadership development opportunities aimed at current and future academic medical department chairs. This research is limited by the assumptions that the curriculum meets the ever-changing needs of health-care leaders, the course's focus on academic medical department chairs within the Texas Medical Center and the lack of long range follow-up data to substantiate the effectiveness of the curriculum content and course structure. The Academic Medical Department Leadership course offers valuable management skills training which complements standard medical training. Much of the course structure and content is adaptable to physician administrative and leadership positions in all settings. Although the Academic Medical Department Leadership course is a response to a local concern, the study offers a generalizable approach to addressing the demand for skilled physician leaders.

  3. Academic postgraduate medical education -- an Oxford view.

    Science.gov (United States)

    Fleming, Kenneth; Pugh, Christopher; Best, Denise

    2014-02-01

    Postgraduate medical education in the UK has gone through a maelstrom of change in the last 20 years; many components have disadvantaged clinical academic training in particular. In this article we summarise some of the changes and describe the advantages of the creation of a dedicated clinical academic graduate school as a response to these changes.

  4. On Preparing Academic Health Centers for the Very Different 1980s.

    Science.gov (United States)

    Rogers, David E.

    1980-01-01

    Medical academic centers must adjust to a period of little or no real economic growth and make changes for continuing progress. Areas affected by the economic slowdown include policies regarding faculty private practice, the relationship between teaching hospitals and academic health centers, the production of primary care physicians, and the…

  5. Motivation and academic achievement in medical students.

    Science.gov (United States)

    Yousefy, Alireza; Ghassemi, Gholamreza; Firouznia, Samaneh

    2012-01-01

    Despite their ascribed intellectual ability and achieved academic pursuits, medical students' academic achievement is influenced by motivation. This study is an endeavor to examine the role of motivation in the academic achievement of medical students. In this cross-sectional correlational study, out of the total 422 medical students, from 4th to final year during the academic year 2007-2008, at School of Medicine, Isfahan University of Medical Sciences, 344 participated in completion of the Inventory of School Motivation (ISM), comprising 43 items and measuring eight aspects of motivation. The gold standard for academic achievement was their average academic marks at pre-clinical and clinical levels. Data were computer analyzed by running a couple of descriptive and analytical tests including Pearson Correlation and Student's t-student. Higher motivation scores in areas of competition, effort, social concern, and task were accompanied by higher average marks at pre-clinical as well as clinical levels. However, the latter ones showed greater motivation for social power as compared to the former group. Task and competition motivation for boys was higher than for girls. In view of our observations, students' academic achievement requires coordination and interaction between different aspects of motivation.

  6. Gender Differences in Receipt of National Institutes of Health R01 Grants Among Junior Faculty at an Academic Medical Center: The Role of Connectivity, Rank, and Research Productivity.

    Science.gov (United States)

    Warner, Erica T; Carapinha, René; Weber, Griffin M; Hill, Emorcia V; Reede, Joan Y

    2017-10-01

    To determine whether there were gender differences in likelihood of receiving a first National Institutes of Health (NIH) R01 award among 5445 instructors and assistant professors at Harvard Medical School (HMS). Data on R01 award principal investigators were obtained from NIH ExPORTER and linked with faculty data. Using Cox proportional hazard regression, we examined the association of gender with receipt of first R01 award between 2008 and 2015 accounting for demographics, research productivity metrics, and professional characteristics. Compared to males, females had fewer publications, lower h-index, smaller coauthor networks and were less likely to be assistant professors (p academic rank, previous K award, terminal degree, and HMS training were all significant predictors of receiving an R01 award. A relatively small proportion of HMS junior faculty obtained their first NIH R01 award during the study period. There was no significant gender difference in likelihood of award. However, we are unable to distinguish faculty that never applied from those who applied and were not successful.

  7. A pilot study to document the return on investment for implementing an ambulatory electronic health record at an academic medical center.

    Science.gov (United States)

    Grieger, Dara L; Cohen, Stephen H; Krusch, David A

    2007-07-01

    Adoption rates for electronic health records (EHRs) have been slow, despite growing enthusiasm. Cost is a frequently cited obstacle to implementing an EHR. The body of literature citing a positive return on investment is largely anecdotal and infrequently published in peer-reviewed journals. Five ambulatory offices, with a total of 28 providers, within the University of Rochester Medical Center, participated in a pilot project using an EHR to document the return on investment. A staged implementation of the Touchworks EHR (Allscripts) was undertaken from November 2003 to March 2004. Measurements of key financial indicators were made in the third calendar quarters of 2003 and 2005. These indicators included chart pulls, new chart creation, filing time, support staff salary, and transcription costs. In addition, patient cycle time, evaluation and management codes billed, and days in accounts receivable were evaluated to assess impact on office efficiency and billing. The savings realized were compared with the costs of the first 2 years of EHR use to determine return on investment. Total annual savings were $393,662 ($14,055 per provider). Total capital cost was $484,577. First-year operating expenses were $24,539. Total expenses for the first year were $509,539 ($18,182 per provider). Ongoing annual cost for subsequent years is $114,016 ($4,072 per provider). So, initial costs were recaptured within 16 months, with ongoing annual savings of $9,983 per provider. An EHR can rapidly demonstrate a positive return on investment when implemented in ambulatory offices associated with a university medical center, with a neutral impact on efficiency and billing.

  8. Academic Advising in Iranian Medical Schools

    Directory of Open Access Journals (Sweden)

    Aeen Mohammadi

    2009-02-01

    Full Text Available Background and purpose:To measure the status of academic advising in medical schools, the present study was designed at the Secretariat for Education and Student Affairs of the Ministry of Health and Medical Education.Methods: A benchmarking tool, to assess the quality of different aspects of that field was devised. Every school was asked to introduce a representative who would complete a questionnaire, which was designed to collect schools’ information.Results: All the divisions were visited by one of the project’s members to revise and approve the data. Then data retrieval was performed, verified and analyzed at the project’s office.Conclusion: There are 45 public and private medical schools nationwide, which were stratified based on their individual scores for academic advising.Keywords: ACADEMIC ADVISING, BENCHMARKING

  9. 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.

  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. The Mount Sinai Medical Center, New York.

    Science.gov (United States)

    Butler, R N; Adelman, R

    1988-03-01

    Aging is the third great antecedent to all disease, along with genetic factors and the environment. Yet, the role of aging in the genesis of the conditions of old age constitutes relatively new territory that has not been adequately explored in terms of education, the health care system, and research. A commitment to these areas was made in 1982 when the Mount Sinai Medical Center established the nation's first and only medical school department of geriatrics--the Gerald and May Ellen Ritter Department of Geriatrics and Adult Development. Recognizing that aging of the population constituted a major global public health challenge, leaders of the medical center turned to Robert N. Butler, MD, who was then director of the National Institute on Aging, for guidance in setting up an institute of gerontology and geriatrics. Because only a full-fledged academic department would have a claim on resources, curriculum, and clerkship time, Dr Butler recommended that such a department be developed at Mount Sinai. The Ritter Department of Geriatrics and Adult Development emphasized the wide scope of this new discipline through educational programs, clinical services, health policy studies, and research projects.

  12. What Ethical Issues Really Arise in Practice at an Academic Medical Center? A Quantitative and Qualitative Analysis of Clinical Ethics Consultations from 2008 to 2013.

    Science.gov (United States)

    Wasson, Katherine; Anderson, Emily; Hagstrom, Erika; McCarthy, Michael; Parsi, Kayhan; Kuczewski, Mark

    2016-09-01

    As the field of clinical ethics consultation sets standards and moves forward with the Quality Attestation process, questions should be raised about what ethical issues really do arise in practice. There is limited data on the type and number of ethics consultations conducted across different settings. At Loyola University Medical Center, we conducted a retrospective review of our ethics consultations from 2008 through 2013. One hundred fifty-six cases met the eligibility criteria. We analyzed demographic data on these patients and conducted a content analysis of the ethics consultation write-ups coding both the frequency of ethical issues and most significant, or key, ethical issue per case. Patients for whom ethics consultation was requested were typically male (55.8 %), white (57.1 %), between 50 and 69 years old (38.5 %), of non-Hispanic origin (85.9 %), and of Roman Catholic faith (43.6 %). Nearly half (47.4 %) were in the intensive care unit and 44.2 % died in the hospital. The most frequent broad ethical categories were decision-making (93.6 %), goals of care/treatment (80.8 %), and end-of-life (73.1 %). More specifically, capacity (57.1 %), patient's wishes/autonomy (54.5 %), and surrogate decision maker (51.3 %) were the most frequent particular ethical issues. The most common key ethical issues were withdrawing/withholding treatment (12.8 %), patient wishes/autonomy (12.2 %), and capacity (11.5 %). Our findings provide additional data to inform the training of clinical ethics consultants regarding the ethical issues that arise in practice. A wider research agenda should be formed to collect and compare data across institutions to improve education and training in our field.

  13. Viewing Prevention of Catheter-Associated Urinary Tract Infection as a System: Using Systems Engineering and Human Factors Engineering in a Quality Improvement Project in an Academic Medical Center.

    Science.gov (United States)

    Rhee, Chanhaeng; Phelps, M Eleanor; Meyer, Bruce; Reed, W Gary

    2016-01-01

    Urinary tract infections (UTIs) are the most commonly reported health care-associated infection (HAI) in the United States. Among UTIs acquired in the hospital, approximately 75% are associated with urinary catheters, with an estimated 15%-25% of all hospitalized patients receiving urinary catheters during their hospitalization. Despite ambitious national goals to reduce these infections, catheter-associated urinary tract infection (CAUTI) has not decreased in the United States. Systems engineering (SE) and human factors engi- neering (HFE) methods were used to reduce urinary catheter utilization and CAUTIs in a three-year (June 1, 2012-May 31, 2015) quality improvement project in a 610-bed academic medical center. These methods were used to define the factors leading to CAUTI and promote standardization of urinary catheter utilization, insertion, and maintenance. The total systemwide CAUTI count decreased from 135 cases at baseline to 74 cases at the end of the project's Year 1, to 59 cases at the end of Year 2, and 25 cases at the end of Year 3-alone, an 81.5% reduction from baseline. The control chart showed a steady decline in the CAUTI count within a few months after the project's start. By the end of Year 3, on the basis of an average attributable-per-patient cost of CAUTI ($1,007 per case), the estimated annual avoidable CAUTI costs decreased from approximately $135,945 to $25,175 per year. Urinary catheter utilization decreased by 27.3% during the same three-year period, and the systemwide CAUTI standardized infection ratio (SIR) decreased from 3.2 to 0.51 (84.1% from baseline). SE and HFE methods and principles can effectively decrease urinary catheter utilization and CAUTI incidence in an academic medical center hospital environment.

  14. Stress and academic performance among medical students.

    Science.gov (United States)

    Sohail, Nudrat

    2013-01-01

    To determine the relationship of stress and academic performance in first year medical students and to identify sources of stress, levels of stress and relevant coping strategies. Mixed method sequential. Allama Iqbal Medical College, Lahore, from March to December 2010. Survey questionnaire and in-depth interviews were carried out in the first year students with their consent. Two hundred and fifty students were surveyed, out of whom 120 students responded. Twelve students with their consent were interviewed. Non-probability purposive sampling was employed for both types of data collection. SPSS version 20 was used. The qualitative data generated through structured in-depth interviews, were analyzed by content analysis. Low level of stress was found in 7.5% (score ‹150), moderate level of stress was present in 71.67% (score between 150 and 300), and high level of stress was observed in 20.83% (score ›300) of the students. There is moderate negative (-0.583) and significant (p academic performance and sources of stress. Similarly there is moderate negative (-0.478) and significant (p academic performance and levels of stress. There was strong positive (0.799) and significant (p stress level and number of stress sources. The study showed a diversity of stress sources and a high level of stress in the medical students. The results also show that higher level of stress is associated with poor academic performance.

  15. Academic Dispensations and the Role of the Counseling Center

    Science.gov (United States)

    Meilman, Philip W.

    2011-01-01

    Many institutions of higher education have provisions for allowing academic latitude when serious mental health problems get in the way of learning. This article reviews a hierarchy of academic remedies that may be utilized and the role of the college counseling center with respect to their use. The discussion centers around counseling center…

  16. Health Care Reform and the Academic Health Center.

    Science.gov (United States)

    Kimmey, James R.

    1994-01-01

    A discussion of the implications of health care reform for academic health centers (a complex of institutions which educate health professionals) looks at problems in the current system, the role of academic health centers in the current system, financial pressures, revenue sources other than patient care, impact on health research, and human…

  17. [The relationship between academic self-efficacy and academic burnout in medical students].

    Science.gov (United States)

    Lee, Su Hyun; Jeon, Woo Taek

    2015-03-01

    The purpose of this study was to examine the correlation between academic burnout and academic self-efficacy in medical students. The study group comprised 446 students in years 1 to 4 of medical school. They were asked to rate their academic burnout and academic self-efficacy on a scale. The data were analyzed by multivariate analysis of variance and regression analysis. Academic self-efficacy was correlated negatively with academic burnout explaining 37% of academic burnout. Academic self-efficacy (especially self-confidence) had the greatest effect on academic burnout. The implications of these results are discussed in terms of an evaluation and support system for students.

  18. Academic medicine amenities unit: developing a model to integrate academic medical care with luxury hotel services.

    Science.gov (United States)

    Kennedy, David W; Kagan, Sarah H; Abramson, Kelly Brennen; Boberick, Cheryl; Kaiser, Larry R

    2009-02-01

    The interface between established values of academic medicine and the trend toward inpatient amenities units requires close examination. Opinions of such units can be polarized, reflecting traditional reservations about the ethical dilemma of offering exclusive services only to an elite patient group. An amenities unit was developed at the University of Pennsylvania Health System in 2007, using an approach that integrated academic medicine values with the benefits of philanthropy and service excellence to make amenities unit services available to all patients. Given inherent internal political concerns, a broadly based steering committee of academic and hospital leadership was developed. An academically appropriate model was conceived, anchored by four principles: (1) integration of academic values, (2) interdisciplinary senior leadership, (3) service excellence, and (4) recalibrated occupancy expectations based on multiple revenue streams. Foremost is ensuring the same health care is afforded all patients throughout the hospital, thereby overcoming ethical challenges and optimizing teaching experiences. Service excellence frames the service ethic for all staff, and this, in addition to luxury hotel-style amenities, differentiates the style and feel of the unit from others in the hospital. Recalibrated occupancy creates program viability given revenue streams redefined to encompass gifts and patient revenue, including both reimbursement and self-pay. The medical-surgical amenities patient-care unit has enjoyed a successful first year and a growing stream of returning patients and admitting physicians. Implications for other academic medical centers include opportunities to extrapolate service excellence throughout the hospital and to cultivate philanthropy to benefit services throughout the medical center.

  19. Academic dishonesty in Indian medical colleges.

    Science.gov (United States)

    Gitanjali, B

    2004-01-01

    Integrity is a necessary attribute expected in practitioners of medicine. Unfortunately there is evidence on hand that academic dishonesty is widely prevalent in many Indian medical colleges and that a proportion of students seem to think that there is nothing wrong in participating in such acts. This practice needs to be discouraged as those indulging in unethical acts during student days are likely to indulge in similar practices while dealing with their patients. It is, therefore, necessary that teachers in medical colleges show 'zero tolerance' to such acts. There is a need for faculty and administrators to be above board in their actions and be role models for ethical behaviour. Hence, acts of academic misconduct committed by faculty and administrators should also be dealt with quickly, fairly and firmly. A milieu of transparency, fairness and student awareness will go a long way in minimizing this pervasive malady.

  20. Academic dishonesty in Indian medical colleges

    Directory of Open Access Journals (Sweden)

    Gitanjali B

    2004-10-01

    Full Text Available Integrity is a necessary attribute expected in practitioners of medicine. Unfortunately there is evidence on hand that academic dishonesty is widely prevalent in many Indian medical colleges and that a proportion of students seem to think that there is nothing wrong in participating in such acts. This practice needs to be discouraged as those indulging in unethical acts during student days are likely to indulge in similar practices while dealing with their patients. It is, therefore, necessary that teachers in medical colleges show 'zero tolerance' to such acts. There is a need for faculty and administrators to be above board in their actions and be role models for ethical behaviour. Hence, acts of academic misconduct committed by faculty and administrators should also be dealt with quickly, fairly and firmly. A milieu of transparency, fairness and student awareness will go a long way in minimizing this pervasive malady.

  1. 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 patient treatment to a mean patients and staff of the treatment machine status (ie, delayed, on time). (3) The rates of replans by dosimetrists was reduced from 11% to 6% (P patient wait times by ≈ 45% (14 min; P patients experiencing delays on the simulator (>50% to patient 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.

  2. Columbia-Presbyterian Medical Center Integrated Academic Information Management System (IAIMS) Outpatient Clinical Information System Implemented in a Faculty General Medicine Practice

    OpenAIRE

    Shea, Steven; Clark, Anthony S.; Clayton, Paul D.

    1990-01-01

    We describe a clinical information system for hospital-based ambulatory care implemented in the context of the institution's IAIMS Phase III effort. Key features of this application are physician data entry to maintain summary clinical profiles that include medication lists, problem lists, and preventive care, and integration with other components of the Clinical Information System at the levels of the database, the user interface, and data sharing. A goal of this application is to provide co...

  3. Columbia-Presbyterian Medical Center Integrated Academic Information Management System (IAIMS) Outpatient Clinical Information System Implemented in a Faculty General Medicine Practice

    Science.gov (United States)

    Shea, Steven; Clark, Anthony S.; Clayton, Paul D.

    1990-01-01

    We describe a clinical information system for hospital-based ambulatory care implemented in the context of the institution's IAIMS Phase III effort. Key features of this application are physician data entry to maintain summary clinical profiles that include medication lists, problem lists, and preventive care, and integration with other components of the Clinical Information System at the levels of the database, the user interface, and data sharing. A goal of this application is to provide coded data as a substrate for computer-based decision support.

  4. World Health Organization (WHO) surgical safety checklist implementation and its impact on perioperative morbidity and mortality in an academic medical center in Chile.

    Science.gov (United States)

    Lacassie, Hector J; Ferdinand, Constanza; Guzmán, Sergio; Camus, Lorena; Echevarria, Ghislaine C

    2016-06-01

    Health care organizations are unsafe. Numerous centers have incorporated the WHO Surgical Safety Checklist in their processes with good results; however, only limited information is available about its effectiveness in Latin America. We aimed to evaluate the impact of the checklist implementation on the in-hospital morbidity and mortality rate in a tertiary health care center. After Institutional review board approval, and using data from our hospital administrative records, we conducted a retrospective analysis of all surgical encounters (n = 70,639) over the period from January 2005 to December 2012. Propensity scoring (PS) methods (matching and inverse weighting) were used to compare the pre and postintervention period, after controlling for selection bias. After PS matching (n = 29,250 matched pairs), the in-hospital mortality rate was 0.82% [95% confidence interval (CI), 0.73-0.92] before and 0.65% (95% CI, 0.57-0.74) after checklist implementation [odds ratio (OR) 0.73; 95% CI, 0.61-0.89]. The median length of stay was 3 days [interquartile range (IQR), 1-5] and 2 days (IQR, 1-4) for the pre and postchecklist period, respectively (P health care safer, especially in developing countries.

  5. Implementation Costs of an Enhanced Recovery After Surgery Program in the United States: A Financial Model and Sensitivity Analysis Based on Experiences at a Quaternary Academic Medical Center.

    Science.gov (United States)

    Stone, Alexander B; Grant, Michael C; Pio Roda, Claro; Hobson, Deborah; Pawlik, Timothy; Wu, Christopher L; Wick, Elizabeth C

    2016-03-01

    Despite positive results from several international Enhanced Recovery After Surgery (ERAS) protocols, the United States has been slow to adopt ERAS protocols, in part due to concern regarding the expenses of such a program. We sought to evaluate the potential annual net cost savings of implementing a US-based ERAS program. Using data from existing publications and experience with an ERAS program, a model of net financial costs was developed for surgical groups of escalating numbers of annual cases. Our example scenario provided a financial analysis of the implementation of an ERAS program at a United States academic institution based on data from the ERAS Program for Colorectal Surgery at The Johns Hopkins Hospital. Based on available data from the United States, ERAS programs lead to reductions in lengths of hospital stay that range from 0.7 to 2.7 days and substantial direct cost savings. Using example data from a quaternary hospital, the considerable cost of $552,783 associated with implementation of an ERAS program was offset by even greater savings in the first year of nearly $948,500, yielding a net savings of $395,717. Sensitivity analysis across several caseload and direct cost scenarios yielded similar savings in 20 of the 27 projections. Enhanced Recovery After Surgery protocols have repeatedly led to reduction in length of hospital stay and improved surgical outcomes. A financial model, based on published data and experience, projects that investment in an ERAS program can also lead to net financial savings for US hospitals. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  6. 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.

  7. The Challenges Facing Dental Schools and Academic Health Centers.

    Science.gov (United States)

    Anderson, Allen W.

    1995-01-01

    If dental schools are to be competitive in the current economic environment, they will need to collaborate with and become active participants in their academic health centers. The dental school can strengthen the center's competitive edge in the managed care market, strengthening the dental school's position in the center and generating new…

  8. Financial Performance of Academic Health Center Hospitals, 1994-2000.

    Science.gov (United States)

    Dobson, Allen; Koenig, Lane; Sen, Namrata; Ho, Silver; Gilani, Jawaria

    This study examined how competitive market dynamics between 1994 and 2000 have affected the financial stability of Academic Health Center (AHC) hospitals and their ability to support their academic and social missions. It looked at the financial challenges facing AHC hospitals through a survey involving 1,138 teaching hospitals. Findings…

  9. 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

  10. Psychology in academic health centers: a true healthcare home.

    Science.gov (United States)

    Rozensky, Ronald H

    2012-12-01

    This article is based on the invited presentation by the author at the American Psychological Association's Annual Convention, August 4-7, 2011, upon his receipt of the Joseph D. Matarazzo Award for Distinguished Contributions to Psychology in Academic Health Centers presented by the Association of Psychologists in Academic Health Centers. This article relates the history, roles, and responsibilities of psychologists in academic health centers to the ultimate survival and success of professional psychology. It describes implications of the Patient Protection and Affordable Care Act (ACA) on the institutional practice of psychology including how psychology's place in academic health centers positions the field well for the future of healthcare reform. The article provides several recommendations to help professional psychology prepare for that future of integrated, interprofessional healthcare.

  11. Academic and Family Conditions Associated with Intrinsic Academic Motivation in Japanese Medical Students: A Pilot Study

    Science.gov (United States)

    Tanaka, Masaaki; Watanabea, Yasuyoshi

    2012-01-01

    Objective: Intrinsic academic motivation is one of the most important psychological concepts in education, and it is related to academic outcomes in medical students. This study examined the relationships between academic and family conditions and intrinsic academic motivation. Design: Cross-sectional design. Setting: The study group consisted of…

  12. University Pre-medical Academic Performance as a Predictor of ...

    African Journals Online (AJOL)

    The present study was carried out to evaluate student achievement in medical school professional examinations in the light of previous pre-medical school academic performance. This was done as part of the process of evaluating factors which might contribute to academic success and high quality of medical education.

  13. The effects of attribution tendencies, academic stress, and coping efficacy on academic adjustment of medical students.

    Science.gov (United States)

    Yune, So-Joung; Park, Kwi Hwa; Chung, Wook-Jin; Lee, Sang-Yeoup

    2011-09-01

    This study investigated the relationship among types of attribution tendencies, academic stress, coping efficacy, and academic adjustment in medical students and identified the means by which the academic adjustment of medical students can improve. Four hundred forty-two subjects from 2 medical schools in Korea were analyzed; 202 were male, 206 were female, and 34 did not identify their gender. We surveyed their academic adjustment, attribution tendencies, academic stress, and coping efficacy. The data were analyzed by descriptive statistics, t-test, and stepwise multiple regression analysis. The male group scored higher on academic adjustment, internal attribution tendency, and coping efficacy but lower on academic stress than the female group. Coping efficacy and internal attribution tendency affected the academic adjustment positively while academic stress influenced it negatively. The study indicates that students with higher scores on coping efficacy and internal attribution tendency and who have lower scores on academic stress tend to adjust better academically in medical school. Therefore, these findings may be helpful for medical schools in designing effective academic adjustment programs to improve coping efficacy and internal attribution tendency and reduce academic stress. Further, these findings have important implications for planning learning consultation programs, especially in Year 1.

  14. Training Future Leaders of Academic Medicine: Internal Programs at Three Academic Health Centers.

    Science.gov (United States)

    Morahan, Page S.; Kasperbauer, Dwight; McDade, Sharon A.; Aschenbrener, Carol A.; Triolo, Pamela K.; Monteleone, Patricia L.; Counte, Michael; Meyer, Michael J.

    1998-01-01

    Reviews need for internal leadership training programs at academic health centers and describes three programs. Elements common to the programs include small classes, participants from many areas of academic medicine and health care, building on prior experience and training, training conducted away from the institution, short sessions, faculty…

  15. The Effect on Academic Health Centers of Tertiary Care in Community Hospitals.

    Science.gov (United States)

    Gee, David A.; Rosenfeld, Lisa A.

    1984-01-01

    The growing cost of medical education and the provision of care to the indigent can be endangered by the dilution of revenue sources traditionally available to the academic health centers but which are being taken over by suburban hospitals. (Author/MLW)

  16. Mergers involving academic health centers: a formidable challenge.

    Science.gov (United States)

    Pellegrini, V D

    2001-10-01

    Escalating economic pressures on the clinical enterprise threaten the missions of education and research in many of the most prestigious academic health centers. Following the model of industry, mergers of the healthcare delivery systems of teaching hospitals and clinics held promise for economies of scale and an improved operating margin. Failure to follow business principles in constructing the merged entity, differences in organizational governance and culture, and inability of physician leadership to prioritize, downsize, and consolidate clinical programs to optimize operational efficiencies all compromise the success of such mergers in academic medicine. Academic institutions and their respective governing boards need to exercise greater discipline in financial analysis and a willingness to make difficult decisions that show favor to one parent institution over another if mergers are to be effective in this setting. To date, an example of a vibrant and successful merger of academic health centers remains to be found.

  17. Career preference and medical students' biographical characteristics and academic achievement

    NARCIS (Netherlands)

    Soethout, M.B.M.; Heijmans, M.W.; ten Cate, O.T.J.

    2008-01-01

    Background: We know that medical students' biographical characteristics and academic achievement influence career preference. Less is known about the differential association of these characteristics with preference for distinct specialties at different stages of medical training. Aim: To

  18. Academic anxiety, locus of control, and achievement in medical school.

    Science.gov (United States)

    Grover, P L; Smith, D U

    1981-09-01

    Programs designed to assist medical students in academic difficulty typically fail to consider the importance of such factors as academic anxiety and the individual's mechanisms for coping with stress. The authors have addressed this issue by examining relationships among prior achievement, academic anxiety, locus of control, and performance in the first year of medical school. Academic anxiety not only was found to be significantly related to first year performance, but also, when combined with a measure of prior achievement, resulted in a significant increase in prediction. Additional evidence is presented which suggests that the relationship between academic anxiety and achievement may be curvilinear. Locus of control was found to correlate significantly with academic anxiety and tended to shift in a direction of greater externality during the first year of medical school. Findings are discussed within the framework of existing psychological research, and implications are presented for medical admissions, curricula, and counseling.

  19. Personality traits associated with intrinsic academic motivation in medical students.

    Science.gov (United States)

    Tanaka, Masaaki; Mizuno, Kei; Fukuda, Sanae; Tajima, Seiki; Watanabe, Yasuyoshi

    2009-04-01

    Motivation is one of the most important psychological concepts in education and is related to academic outcomes in medical students. In this study, the relationships between personality traits and intrinsic academic motivation were examined in medical students. The study group consisted of 119 Year 2 medical students at Osaka City University Graduate School of Medicine. They completed questionnaires dealing with intrinsic academic motivation (the Intrinsic Motivation Scale toward Learning) and personality (the Temperament and Character Inventory [TCI]). On simple regression analyses, the TCI dimensions of persistence, self-directedness, co-operativeness and self-transcendence were positively associated with intrinsic academic motivation. On multiple regression analysis adjusted for age and gender, the TCI dimensions of persistence, self-directedness and self-transcendence were positively associated with intrinsic academic motivation. The temperament dimension of persistence and the character dimensions of self-directedness and self-transcendence are associated with intrinsic academic motivation in medical students.

  20. Lameness surgeon joins equine medical center faculty

    OpenAIRE

    Musick, Marjorie

    2008-01-01

    Dr. M. Norris Adams has joined Virginia Tech's Marion duPont Scott Equine Medical Center as a clinical assistant professor in equine lameness and surgery. In this role, Adams will focus on elective orthopedic procedures and will assist with the expansion of the center's outpatient services program.

  1. Effectiveness of transcranial magnetic stimulation in clinical practice post-FDA approval in the United States: results observed with the first 100 consecutive cases of depression at an academic medical center.

    Science.gov (United States)

    Connolly, K Ryan; Helmer, Amanda; Cristancho, Mario A; Cristancho, Pilar; O'Reardon, John P

    2012-04-01

    Transcranial magnetic stimulation (TMS) is a US Food and Drug Administration-approved treatment for major depressive disorder (MDD) in patients who have not responded to 1 adequate antidepressant trial in the current episode. In a retrospective cohort study, we examined the effectiveness and safety of TMS in the first 100 consecutive patients treated for depression (full DSM-IV criteria for major depressive episode in either major depressive disorder or bipolar disorder) at an academic medical center between July 21, 2008, and March 25, 2011. TMS was flexibly dosed in a course of up to 30 sessions, adjunctive to current medications, for 85 patients treated for acute depression. The primary outcomes were response and remission rates at treatment end point as measured by the Clinical Global Impressions-Improvement scale (CGI-I) at 6 weeks. Secondary outcomes included change in the Hamilton Depression Rating Scale (HDRS); Quick Inventory of Depressive Symptomatology, self-report (QIDS-SR); Beck Depression Inventory (BDI); Beck Anxiety Inventory (BAI); and the Sheehan Disability Scale (SDS). Enduring benefit was assessed over 6 months in patients receiving maintenance TMS treatment. Data from 12 patients who received TMS as maintenance or continuation treatment after prior electroconvulsive therapy (ECT) or TMS given in a clinical trial setting were also reviewed. The clinical cohort was treatment resistant, with a mean of 3.4 failed adequate trials in the current episode. Thirty-one individuals had received prior lifetime ECT, and 60% had a history of psychiatric hospitalization. The CGI-I response rate was 50.6% and the remission rate was 24.7% at 6 weeks. The mean change was -7.8 points in HDRS score, -5.4 in QIDS-SR, -11.4 in BDI, -5.8 in BAI, and -6.9 in SDS. The HDRS response and remission rates were 41.2% and 35.3%, respectively. Forty-two patients (49%) entered 6 months of maintenance TMS treatment. Sixty-two percent (26/42 patients) maintained their responder

  2. Psychologists in academic health centers: traditions and innovations in education, science, and practice.

    Science.gov (United States)

    Robiner, William N; Seime, Richard J

    2008-03-01

    Psychologists, interns, and postdoctoral fellows convened in Minneapolis May 3-5, 2007 for the 3rd National Conference of the Association of Psychologists in Academic Health Centers (APAHC): "Psychologists in Academic Health Centers: Traditions and Innovations in Education, Science, and Practice." This paper reviews the development and organization of the conference, which built upon the two previous conferences of the Association of Medical School Psychologists. The articles in this special issue are based on a selected number of the 32 conference presentations, covering a range of timely topics that reflect the conference theme. Participants' positive perceptions and satisfaction with the conference reveal the value of such conferences focused on the activities, interests, opportunities, and challenges of psychologists who work in academic health centers (AHCs) and teaching hospitals. Moreover, the content and success of the conference underscores the importance of APAHC as an organization serving the needs and promoting the interests of psychologists affiliated with AHCs.

  3. Identifying challenges for academic leadership in medical universities in Iran.

    Science.gov (United States)

    Bikmoradi, Ali; Brommels, Mats; Shoghli, Alireza; Khorasani-Zavareh, Davoud; Masiello, Italo

    2010-05-01

    CONTEXT The crucial role of academic leadership in the success of higher education institutions is well documented. Medical education in Iran has been integrated into the health care system through a complex organisational change. This has called into question the current academic leadership, making Iranian medical universities and schools a good case for exploring the challenges of academic leadership. OBJECTIVES This study explores the leadership challenges perceived by academic managers in medical schools and universities in Iran. METHODS A qualitative study using 18 face-to-face, in-depth interviews with academic managers in medical universities and at the Ministry of Health and Medical Education in Iran was performed. All interviews were recorded digitally, transcribed verbatim and analysed by qualitative content analysis. RESULTS The main challenges to academic leadership could be categorised under three themes, each of which included three sub-themes: organisational issues (inefficacy of academic governance; an overly extensive set of missions and responsibilities; concerns about the selection of managers); managerial issues (management styles; mismatch between authority and responsibilities; leadership capabilities), and organisational culture (tendency towards governmental management; a boss-centred culture; low motivation). CONCLUSIONS This study emphasises the need for academic leadership development in Iranian medical schools and universities. The ability of Iranian universities to grow and thrive will depend ultimately upon the application of leadership skills. Thus, it is necessary to better designate authorities, roles of academic staff and leaders at governance.

  4. Implementing Huddles Improves Care Coordination in an Academic Health Center.

    Science.gov (United States)

    Townsend, Carolyn S; McNulty, Mary; Grillo-Peck, Adria

    To determine whether routinely scheduled, organized interdisciplinary huddles result in decreased length of stay and readmissions. The study was conducted in an academic health center (AHC) that also fills a community hospital need for a diverse inner-city population. Results are applicable in other care settings. Daily interdisciplinary huddles were piloted on 5 medical/surgical units. The 2015 readmission and length of stay data were compared with the 2013 baseline. There was a mean readmission reduction of 0.56%. A paired t test comparing the 2013 and 2015 readmission rates of the 5 units was significant (p < .05). There was a 0.42-day increase in the mean LOS between the 2013 baseline and the 2015 follow-up. A paired t test comparing 2013 and 2015 readmission rates of the 5 units was not significant at the .05 level. Daily interdisciplinary sessions can result in reduced readmissions. Long-lasting positive outcomes related to enhanced communication are possible. Requirements for success include consistency in the standard huddle content reviewed. Data should be followed closely throughout an extended period of time to identify trends and support sustainment. Creative means to obtain input from services that cover multiple units and not be able to attend huddles may be necessary. Staff turnover will impact success. Variation in physician engagement can be addressed by frequent communication on the "why" behind the significance of the huddles, as well as sharing of change data highlighting success stories.

  5. Medical center farmers markets: a strategic partner in the patient-centered medical home.

    Science.gov (United States)

    George, Daniel R; Rovniak, Liza S; Kraschnewski, Jennifer L; Morrison, Kathy J; Dillon, Judith F; Bates, Beth Y

    2013-08-01

    The number of medical center-based farmers markets has increased in the past decade, but little is known about how such organizations contribute to the preventive health goals of the patient-centered medical home. In 2010, we started a seasonal farmers market at Penn State Hershey Medical Center to help support the institution's commitment to the medical home. We obtained descriptive data on the farmers market from hospital and market records and tracking information on the market's Facebook and Twitter sites. We computed summary measures to characterize how the market has begun to meet the 6 standards of the 2011 National Committee for Quality Assurance's report on the medical home. During the 2010 and 2011 seasons, 146 medical center volunteers from 40 departments formed 23 interprofessional teams that spent an average of 551 volunteer hours per season at the market, providing health screenings (n = 695) and speaking to customers (n = 636) about preventive health. Fifty-five nonmedical community health partners provided 208 hours of service at the market alongside medical center staff. Market programming contributed to 5 regional preventive health partnerships and created opportunities for interprofessional mentoring, student leadership, data management, development of social media skills, and grant-writing experience. The market contributed to all 6 medical home standards outlined by the National Committee for Quality Assurance. Medical center markets can support medical home standards. With systematic tracking of the health effects and integration with electronic medical health records, markets hold potential to contribute to comprehensive patient-centered care.

  6. Incidence of academic failure and its underlying factors in Lorestan university of medical sciences

    Directory of Open Access Journals (Sweden)

    Farzad Ebrahimzadeh

    2016-02-01

    Full Text Available Background: Academic failure, conceived of as lack of success in one’s education, is of paramount importance for students of medical sciences and it might lead to more acute problems. The present study set out to investigate the prevalence and underlying reasons of academic failure in Lorestan University of medical sciences.  Materials and Methods: In this cohort study, academic records of all students of Lorestan University of Medical Sciences during the academic years of 2006-2011 were collected from education and student affair center and also, demographic and educational records were entered into a checklist. Inappropriate grade point average, being a provisional student, prolonged graduation, expulsion and dropout were taken into account as academic failure. To model the related effective factors, logistic regression was adopted and significance level was set at 0.05. Results: The cumulative incidence of academic failure was about 25.1%. Factors such as department, being self-funded or government-funded student, academic grade students are pursuing, the elapsed time between academic grades, gender and location of residence were related to academic failure (P<0.05. It is worth mentioning that no relationship was observed between the academic failure and being accepted based on quota system. Conclusion: The most important at risk groups were students of department of medicine and health, associate or medical doctoral students, self-funded students, students with a considerable time elapsed between their academic grades, male students and students living in dormitory. It is suggested that these students refer to consulting centers of university or educational supervisors and receive particular attention.

  7. Policy-Making and Governance in Academic Health Centers.

    Science.gov (United States)

    Hastings, Douglas A.; Crispell, Kenneth R.

    1980-01-01

    With a view of academic health centers (AHC) as unique organizations meriting investigation, key changes that have shaped AHCs, various modes of AHC organization and governance, and factors that make AHC policymaking so complex are discussed. Also examined are models and methods for analyzing AHC decision making. (Author/JMD)

  8. How One Academic Health Center Is Successfully Facing the Future.

    Science.gov (United States)

    Abdelhak, Sherif S.

    1996-01-01

    The approach taken by one academic health center, Allegheny Health, Education and Research Foundation (Pennsylvania), to changes in the economics of health care is described. The foundation is cultivating a more responsive organization, reengineering operations, and securing its revenue base in a variety of ways. Statistics are provided to…

  9. 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…

  10. Medical center staff attitudes about spanking.

    Science.gov (United States)

    Gershoff, Elizabeth T; Font, Sarah A; Taylor, Catherine A; Foster, Rebecca H; Garza, Ann Budzak; Olson-Dorff, Denyse; Terreros, Amy; Nielsen-Parker, Monica; Spector, Lisa

    2016-11-01

    Several medical professional organizations, including the American Academy of Pediatrics, recommend that parents avoid hitting children for disciplinary purposes (e.g., spanking) and that medical professionals advise parents to use alternative methods. The extent to which medical professionals continue to endorse spanking is unknown. This study is the first to examine attitudes about spanking among staff throughout medical settings, including non-direct care staff. A total of 2580 staff at a large general medical center and 733 staff at a children's hospital completed an online survey; respondents were roughly divided between staff who provide direct care to patients (e.g., physicians, nurses) and staff who do not (e.g., receptionists, lab technicians). Less than half (44% and 46%) of staff at each medical center agreed that spanking is harmful to children, although almost all (85% and 88%) acknowledged that spanking can lead to injury. Men, staff who report being religious, and staff who held non-direct care positions at the medical center reported stronger endorsement of spanking and perceived their co-workers to be more strongly in favor of spanking. Non-direct care staff were more supportive of spanking compared with direct care staff on every item assessed. All staff underestimated the extent to which their co-workers held negative views of spanking. If medical centers and other medical settings are to lead the charge in informing the community about the harms of spanking, comprehensive staff education about spanking is indicated. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Use of alcoholic beverages in VA medical centers

    Directory of Open Access Journals (Sweden)

    Qadri S Faiz

    2006-10-01

    Full Text Available Abstract Background Benzodiazepines are the first-line choice for the treatment of alcohol withdrawal syndrome. However, several hospitals continue to provide alcoholic beverages through their formulary for the treatment of alcohol withdrawal. While there are data on the prevalence of this practice in academic medical centers, there are no data on the availability of alcoholic beverages at the formularies of the hospitals operated by the department of Veteran's Affairs. Methods In this study, we surveyed the Pharmacy managers at 112 Veterans' Affairs Medical Centers (VAMCs to ascertain the availability of alcohol on the VAMC formularies, and presence or lack of a policy on the use of alcoholic beverages in their VA Medical Center. Results Of the pharmacy directors contacted, 81 responded. 8 did not allow their use, while 20 allowed their use. There was a lack of a consistent policy across the VA medical centers on availability and use of alcoholic beverages for the treatment of alcohol withdrawal syndrome. Conclusion There is lack of uniform policy on the availability of alcoholic beverages across the VAMCs, which may create potential problems with difference in the standards of care.

  12. The Academic Medical System: Reinvention to Survive the Revolution in Health Care.

    Science.gov (United States)

    Konstam, Marvin A; Hill, Joseph A; Kovacs, Richard J; Harrington, Robert A; Arrighi, James A; Khera, Amit

    2017-03-14

    Academic medical centers (AMCs) are presently facing enormous challenges arising from a prospective decline in government funding for research and education, shifting payment models emphasizing efficiency and value, and increasing competition. Left unabated, these challenges will drive many AMCs to de-emphasize or forsake their core missions in an effort to survive. Stemming from a symposium held at the 2015 Scientific Sessions of the American College of Cardiology titled, "The Academic Medical Center of the Future," we propose a series of changes, including internal restructuring, system-wide partnership, and novel approaches to support research and education, that are designed to better position AMCs to compete and face their growing challenges in a manner that preserves their essential missions. In aggregate, these changes will facilitate establishing the academic medical system of the future. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. 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.

  14. Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era

    Directory of Open Access Journals (Sweden)

    Wang HF

    2015-03-01

    Full Text Available Hua-fen Wang,1 Jing-fen Jin,1 Xiu-qin Feng,1 Xin Huang,1 Ling-ling Zhu,2 Xiao-ying Zhao,3 Quan Zhou4 1Division of Nursing, 2Geriatric VIP Ward, Division of Nursing, 3Office of Quality Administration, 4Department of Pharmacy, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China Background: Medication errors may occur during prescribing, transcribing, prescription auditing, preparing, dispensing, administration, and monitoring. Medication administration errors (MAEs are those that actually reach patients and remain a threat to patient safety. The Joint Commission International (JCI advocates medication error prevention, but experience in reducing MAEs during the period of before and after JCI accreditation has not been reported. Methods: An intervention study, aimed at reducing MAEs in hospitalized patients, was performed in the Second Affiliated Hospital of Zhejiang University, Hangzhou, People’s Republic of China, during the journey to JCI accreditation and in the post-JCI accreditation era (first half-year of 2011 to first half-year of 2014. Comprehensive interventions included organizational, information technology, educational, and process optimization-based measures. Data mining was performed on MAEs derived from a compulsory electronic reporting system. Results: The number of MAEs continuously decreased from 143 (first half-year of 2012 to 64 (first half-year of 2014, with a decrease in occurrence rate by 60.9% (0.338% versus 0.132%, P<0.05. The number of MAEs related to high-alert medications decreased from 32 (the second half-year of 2011 to 16 (the first half-year of 2014, with a decrease in occurrence rate by 57.9% (0.0787% versus 0.0331%, P<0.05. Omission was the top type of MAE during the first half-year of 2011 to the first half-year of 2014, with a decrease by 50% (40 cases versus 20 cases. Intravenous administration error was the

  15. Determinants of academic stress and stress-related self- medication ...

    African Journals Online (AJOL)

    of self-medication was 31.58 and 29.20 % among pharmacy and medical students, respectively. ... self-medication. Conclusion: Academic stress in undergraduate students in health disciplines is perceived to be high by the students. Examinations, course load and lack of ..... opinion and any grammatical or language errors.

  16. [Burnout effect on academic progress of Oncology medical residents].

    Science.gov (United States)

    González-Ávila, Gabriel; Bello-Villalobos, Herlinda

    2014-01-01

    In the formative period of the courses taken in medical specializations, new and greater responsibilities are accepted by physicians in personal and academic spheres. The interaction of several factors that encompass the practice of these physicians could surpass their capacity to cope, causing on these professionals a high level of stress and professional exhaustion, which will affect their academic development. The objective of this research was to establish if the occupational stress of these medical residents affects their academic progress. We administered the Spanish version of the Maslach Burnout Inventory (MBI) to 52 residents of three specializations in Oncology (Medical Oncology, Surgical Oncology, and Radio-Oncology). These residents accepted voluntarily at the same time of their third cognitive exam. The prevalence of burnout syndrome was 13.5 %, with a high frequency among medical residents of first degree. Medical Oncology residents showed a higher emotional exhaustion and lower personal fulfillment. Considering the three specializations, the academic progress was higher in the third year, with a significant difference to Surgical Oncology and Medical Oncology (p = 0.026 and 0.015, respectively). No significant difference was found between burnout syndrome, academic progress and sociodemographic characteristics. The presence of burnout syndrome does not affect the academic progress of Oncology medical residents.

  17. Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era.

    Science.gov (United States)

    Wang, Hua-Fen; Jin, Jing-Fen; Feng, Xiu-Qin; Huang, Xin; Zhu, Ling-Ling; Zhao, Xiao-Ying; Zhou, Quan

    2015-01-01

    Medication errors may occur during prescribing, transcribing, prescription auditing, preparing, dispensing, administration, and monitoring. Medication administration errors (MAEs) are those that actually reach patients and remain a threat to patient safety. The Joint Commission International (JCI) advocates medication error prevention, but experience in reducing MAEs during the period of before and after JCI accreditation has not been reported. An intervention study, aimed at reducing MAEs in hospitalized patients, was performed in the Second Affiliated Hospital of Zhejiang University, Hangzhou, People's Republic of China, during the journey to JCI accreditation and in the post-JCI accreditation era (first half-year of 2011 to first half-year of 2014). Comprehensive interventions included organizational, information technology, educational, and process optimization-based measures. Data mining was performed on MAEs derived from a compulsory electronic reporting system. The number of MAEs continuously decreased from 143 (first half-year of 2012) to 64 (first half-year of 2014), with a decrease in occurrence rate by 60.9% (0.338% versus 0.132%, Pmedications decreased from 32 (the second half-year of 2011) to 16 (the first half-year of 2014), with a decrease in occurrence rate by 57.9% (0.0787% versus 0.0331%, Pmedication errors. The number of MAEs in surgical wards was twice that in medicinal wards. Compared with non-intensive care units, the intensive care units exhibited higher occurrence rates of MAEs (1.81% versus 0.24%, Pmedication administration. JCI accreditation may help health systems enhance the awareness and ability to prevent MAEs and achieve successful quality improvements.

  18. Incremental validity of noncognitive tests for medical school academic achievement.

    Science.gov (United States)

    Markert, R J

    1983-05-01

    This paper reports an investigation of the incremental validity of noncognitive tests. Incremental validity is the predictive ability of a measure when entered into a regression equation after the routine predictors have first been included. Three noncognitive tests--Rotter Locus of Control, Adjective Check List, and Student Orientations Survey--were administered to a first-year medical school class. When entered after the usual academic predictors of success in medical school--Undergraduate Grade Point Average and Medical College Admission Test--the three noncognitive tests added little to the prediction of first-year medical school Grade Point Average. It is concluded that while noncognitive measures are useful in characterizing a medical school class and in discovering nonacademic correlates of academic success in medical school, limited incremental validity related to first-year academic performance was demonstrated.

  19. "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.

  20. Generation X: implications for faculty recruitment and development in academic health centers.

    Science.gov (United States)

    Bickel, Janet; Brown, Ann J

    2005-03-01

    Differences and tensions between the Baby Boom generation (born 1945-1962) and Generation X (born 1963-1981) have profound implications for the future of academic medicine. By and large, department heads and senior faculty are Boomers; today's residents and junior faculty are Generation X'ers. Looking at these issues in terms of the generations involved offers insights into a number of faculty development challenges, including inadequate and inexpert mentoring, work-life conflicts, and low faculty morale. These insights suggest strategies for strengthening academic medicine's recruitment and retention of Generation X into faculty and leadership roles. These strategies include (1) improving career and academic advising by specific attention to mentoring "across differences"--for instance, broaching the subject of formative differences in background during the initial interaction; adopting a style that incorporates information-sharing with engagement in problem solving; offering frequent, frank feedback; and refraining from comparing today to the glories of yesterday; to support such improvements, medical schools should recognize and evaluate mentoring as a core academic responsibility; (2) retaining both valued women and men in academic careers by having departments add temporal flexibility and create and legitimize less-than-full-time appointments; and (3) providing trainees and junior faculty with ready access to educational sessions designed to turn their "intellectual capital" into "academic career capital."Given the trends discussed in this article, such supports and adaptations are indicated to assure that academic health centers maintain traditions of excellence.

  1. Sleep disorder among medical students: relationship to their academic performance.

    Science.gov (United States)

    Abdulghani, Hamza M; Alrowais, Norah A; Bin-Saad, Norah S; Al-Subaie, Nourah M; Haji, Alhan M A; Alhaqwi, Ali I

    2012-01-01

    Medical students are exposed to a significant level of pressure due to academic demands. Their sleep pattern is characterized by insufficient sleep duration, delayed sleep onset, and occurrence of napping episodes during the day. To examine the prevalence of sleep disorder among medical students and investigate any relationship between sleep disorder and academic performance. This is a cross-sectional self-administered questionnaire-based study. The participants were medical students of the first, second, and third academic years. The Epworth Sleepiness Scale (ESS) was also included to identify sleep disorder and grade point average was recorded for academic performance. There were 491 responses with a response rate of 55%. The ESS score demonstrated that 36.6% of participants were considered to have abnormal sleep habits, with a statistically significant increase in female students (p = 0.000). Sleeping between 6-10 h per day was associated with normal ESS scores (p = 0.019) as well as the academic grades ≥ 3.75. Abnormal ESS scores were associated with lower academic achievement (p = 0.002). A high prevalence of sleep disorder was found in this group of students, specifically female students. Analysis of the relationship between sleep disorder and academic performance indicates a significant relationship between abnormal ESS scores, total sleeping hours, and academic performance.

  2. Effect of Teaching Academic Skills on Academic Achievement in Medical Emergency Students

    Directory of Open Access Journals (Sweden)

    Otaghi M

    2015-12-01

    Full Text Available Aims: An important aspect of the student’s learning in academic performance is self-regulating. Students without required academic achievement skills need educational approaches to obtain the required insight in self-regulate learning. The aim of this study was to determine the effects of teaching academic skills on academic achievement in the advanced diploma medical emergency students of Ilam University of Medical Sciences. Materials & Methods: The intervening pretest-posttest study without any control group was a section of a greater action-research study to conduct and implement an educational process. The intervention included two 3-hour educational workshops for ten academic skills at one month interval for 23 advanced diploma medical emergency students of Ilam University of Medical Sciences during their second educational semester in 2014. The study tool was a 10-phrase self-made questionnaire, its validity and reliability was confirmed. Data was analyzed in SPSS 21 software using Paired-T test. Findings: There was an increase in the mean total score of academic skills after the intervention (p=0.009. From ten skills, the differences between the mean scores before and after the intervention were significant only in academic planning skills (p=0.025, the utilization of the memory strengthening methods (p=0.045, and correct study techniques (p=0.031. Academic intervention affected the students’ academic achievement (GPA (p=0.001. Conclusion: Conducting academic skills educational workshops affects the utilization of the skills by the students and their academic achievements. 

  3. [How medical students perform academically by admission types?].

    Science.gov (United States)

    Kim, Se-Hoon; Lee, Keumho; Hur, Yera; Kim, Ji-Ha

    2013-09-01

    Despite the importance of selecting students whom are capable for medical education and to become a good doctor, not enough studies have been done in the category. This study focused on analysing the medical students' academic performance (grade point average, GPA) differences, flunk and dropout rates by admission types. From 2004 to 2010, we gathered 369 Konyang University College of Medicine's students admission data and analyzed the differences between admission method and academic achievement, differences in failure and dropout rates. Analysis of variance (ANOVA), ordinary least square, and logistic regression were used. The rolling students showed higher academic achievement from year 1 to 3 than regular students (p admission type variable as control variable in multiple regression model similar results were shown. But unlike the results of ANOVA, GPA differences by admission types were shown not only in lower academic years but also in year 6 (p admission types, regular admission type students showed higher drop out rate than the rolling ones which demonstrates admission types gives significant effect on flunk or dropout rates in medical students (p admissions type students tend to show lower flunk rate and dropout rates and perform better academically. This implies selecting students primarily by Korean College Scholastic Ability Test does not guarantee their academic success in medical education. Thus we suggest a more in-depth comprehensive method of selecting students that are appropriate to individual medical school's educational goal.

  4. Establishing policies for the relationship between industry and clinicians: lessons learned from two academic health centers.

    Science.gov (United States)

    Coleman, David L

    2008-09-01

    The relationship between faculty in academic health centers (AHCs) and commercial entities is critically important to improving the public health, yet it may be prone to conflicts of interest that adversely affect medical education, research, and clinical care. The Association of American Medical Colleges has recently recommended that medical schools and AHCs develop policies that better manage and occasionally prohibit interactions between academic medicine and industry. Because the development of more stringent policies is complex and potentially contentious, the author reports the lessons learned from developing new policies for the interactions between faculty and industry related to medical education and clinical care at Yale School of Medicine and Boston University School of Medicine/Boston Medical Center. The content of the policies was strongly influenced by the tenets of medical professionalism. Faculty support for new policies was strong, an iterative and inclusive process of formulation was critical, compromises in content were necessary, and the views of faculty concerning industry relationships were complex. After implementation of the new policies, the departmental food-related expenses increased, the loss of gifts was not appreciably missed, the faculty assumed more responsibility for educating trainees on the evaluation of new products, a central repository for receiving and evaluating grants from industry was useful, enforcement of the policies has been a lingering challenge, and the new policies generated positive publicity. Several recommendations are proposed. Creating these policies affirmed the importance of an inclusive process, open communication, support of institutional leadership, and focus on professional values.

  5. Satisfaction from Academic Activities among Medical Students in Malaysia

    Science.gov (United States)

    Al-Naggar, Redhwan A.; Bobryshev, Yuri V.

    2013-01-01

    There is a lack of data about the levels of satisfaction among medical students in regards to their academic activities in Malaysia. Therefore, the objective of this study was to fill the gap in the existing knowledge. A cross sectional study was carried out at the International medical school, the Management and Science University of Malaysia,…

  6. SLEEP PATTERN AND ACADEMIC PERFORMANCE OF MEDICAL STUDENTS OF A GOVERNMENT MEDICAL COLLEGE IN KERALA

    OpenAIRE

    Deepa Rajendran; Karthika.M; Prathibha M. T; Vinod P. B

    2017-01-01

    BACKGROUND Relationship between sleep pattern and academic performance of students is well accepted. The studies relating the sleep pattern of medical students and academic performance is limited. This study was conducted to identify sleep pattern of medical students and find out any relationship between sleep pattern and academic performance. MATERIALS AND METHODS A questionnaire-based study was carried out to assess sociodemographic parameters, sleep/wake timing, sle...

  7. Academic Leagues and medical formation: contributions and challenges

    Directory of Open Access Journals (Sweden)

    Albina Rodrigues Torres

    2008-01-01

    Full Text Available There has been a considerable increase in the number of academic leagues active within undergraduate medical courses in Brazil over the last few years. However, this phenomenon has not been accompanied by adequate reflection on its determinants, on the role of the leagues within the institutions or even on their pedagogical function. From these observations, the authors analyze the scant literature on this topic, describe the experience of the academic leagues of Botucatu Medical School, Unesp, and reflect on the role of these leagues in medical training, in an attempt to partially fill this gap and contribute towards this important discussion.

  8. Creating a Nursing Student Center for Academic and Professional Success.

    Science.gov (United States)

    Tantillo, Mary; Marconi, Maria A; Rideout, Kathy; Anson, Elizabeth A; Reifenstein, Karen A

    2017-04-01

    The purpose of this article is to describe the development of an innovative broad-based initiative supportive of academic and professional success, the Center for Academic and Professional Success (CAPS) at the University of Rochester School of Nursing. While CAPS was founded to support all nursing students, it was also carefully developed to meet the special needs of students in the accelerated program for non-nurses (APNN) due to their diversity and the intensity and rapidity of the APNN program. Faculty discussion, literature review, and student needs assessment findings informed program development. Outcome data obtained during the past 4 years are presented. Data revealed a correspondence between identified student needs and use of program services, as well as high satisfaction ratings. Findings supported the provision of both traditional academic support, as well as other critical supports to address the academic and social stressors associated with the transitions experienced by nontraditional, working, and graduate nursing students. [J Nurs Educ. 2017;56(4):235-239.]. Copyright 2017, SLACK Incorporated.

  9. 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.

  10. The value of a writing center at a medical university.

    Science.gov (United States)

    Ariail, Jennie; Thomas, Suzanne; Smith, Tom; Kerr, Lisa; Richards-Slaughter, Shannon; Shaw, Darlene

    2013-01-01

    Students often enter graduate healthcare/biomedical schools with insufficient undergraduate instruction in effective writing, yet the ability to write well affects their career opportunities in health care and in scientific research. The present study was conducted to determine the value and effectiveness of instruction by faculty with expertise in teaching writing at a writing center at an academic health science center. Two separate sources of data were collected and analyzed. First, an anonymous campus-wide survey assessed students' satisfaction and utilization of the university's Writing Center. Second, a nonexperimental objective study was conducted comparing a subsample of students who used versus those who did not receive instruction at the Writing Center on quality of writing, as determined by an evaluator who was blind to students' utilization status. From the campus-wide survey, more than 90% of respondents who used the center (which was 26% of the student body) agreed that it was a valuable and effective resource. From the objective study of writing quality, students who used the Writing Center were twice as likely as students who did not to receive an A grade on the written assignment, and the blinded evaluator accurately estimated which students used the Writing Center based on the clarity of writing. The instruction at the Writing Center at our university is highly valued by students, and its value is further supported by objective evidence of efficacy. Such a center offers the opportunity to provide instruction that medical and other healthcare students increasingly need without requiring additions to existing curricula. By developing competency in writing, students prepare for scholarly pursuits, and through the process of writing, they engage critical thinking skills that can make them more attuned to narrative and more reflective and empathetic in the clinical setting.

  11. 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.

  12. 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.

  13. [Academic achievement, engagement and burnout among first year medical students].

    Science.gov (United States)

    Gómez H, Paula; Pérez V, Cristhian; Parra P, Paula; Ortiz M, Liliana; Matus B, Olga; McColl C, Peter; Torres A, Graciela; Meyer K, Andrea

    2015-07-01

    Stress may affect the sense of wellbeing and academic achievement of university students. To assess the relationship of academic engagement and burnout with academic achievement among first year medical students. The Utrecht Work Engagement Scale-Student and Maslach Burnout Inventory Student Survey (MBI-SS) were applied to 277 first year medical students of four universities. Their results were correlated with the grades obtained in the different courses. Moderately high engagement and low burnout levels were detected. There was a high level of satisfaction with studies and a moderate exhaustion level. Academic achievement was associated with the degree of engagement with studies but not with burnout. Conglomerate analysis detected a group of students with high levels of wellbeing, characterized by high levels of academic engagement and low burnout. Other group had moderate levels of engagement and lack of personal fulfilment. Other group, identified as extenuated, had high levels of personal exhaustion and depersonalization. Finally the disassociated group had a low academic engagement, low emotional exhaustion, high levels of depersonalization and lack of personal fulfillment. Academic achievement is associated with the level of engagement with studies but not with burnout.

  14. The relationship between critical thinking skills with creativity and academic achievement in students Qom University of Medical Sciences

    OpenAIRE

    Davood Mohammadi; Zahra Moslemi; Mahin Ghomi

    2016-01-01

    Introduction: Critical thinking improves students’ problem solving ability and is one of the main outputs of academic centers. It has an important role in medical sciences as the students studying these branches of science are getting ready to attend clinical work. Critical thinking helps to convey skills from class to clinic. This study aimed at investigating the relationship between critical thinking skills with creativity and academic achievement in students Qom University of Medical...

  15. Academic disintegrity among medical students: a randomised response technique study.

    Science.gov (United States)

    Mortaz Hejri, Sameh; Zendehdel, Kazem; Asghari, Fariba; Fotouhi, Akbar; Rashidian, Arash

    2013-02-01

    Medical students, as tomorrow's doctors, are responsible for their patients' health; cheating may affect their academic knowledge and clinical skills. The main purpose of this study was to investigate the frequency of and attitudes towards academic disintegrity among medical students at Tehran University of Medical Sciences (TUMS). Anonymous questionnaires including questions about various types of academic disintegrity were distributed among medical students during the clerkship and internship phases of the curriculum. Randomised response technique (RRT) was used to maintain the responders' privacy. Because the study design guaranteed the confidentiality of respondents, the TUMS Institutional Review Board declared that formal ethical approval was not required. A total of 124 students were enrolled in this study, of whom 63 were in the clerkship phase and 61 were in the internship phase. Of these respondents, 29% (n = 36) were male. The most frequently reported type of academic disintegrity was found to be 'impersonating an absent student in a class' (93%) and the least frequent to be 'legitimising absences by using bribes' (5%). Only a small number of interns considered 'buying hospital shifts', 'selling hospital shifts', 'impersonating an absent student' and 'helping others to cheat in examinations' as representing academic disintegrity. Approximately one third of participants stated that the RRT increased their confidence in anonymity and 90% of students found the use of RRT not difficult. Academic integrity is widely disrespected in different ways among medical students. Effective policies and interventions are required to control these misbehaviours in future doctors in order to optimise medical practice. Almost all respondents found it not difficult to use the RRT; the technique proved to be an effective and easily applied method of eliciting truthful responses to sensitive questions and represents an alternative to conventional anonymising techniques.

  16. Health extension in new Mexico: an academic health center and the social determinants of disease.

    Science.gov (United States)

    Kaufman, Arthur; Powell, Wayne; Alfero, Charles; Pacheco, Mario; Silverblatt, Helene; Anastasoff, Juliana; Ronquillo, Francisco; Lucero, Ken; Corriveau, Erin; Vanleit, Betsy; Alverson, Dale; Scott, Amy

    2010-01-01

    The Agricultural Cooperative Extension Service model offers academic health centers methodologies for community engagement that can address the social determinants of disease. The University of New Mexico Health Sciences Center developed Health Extension Rural Offices (HEROs) as a vehicle for its model of health extension. Health extension agents are located in rural communities across the state and are supported by regional coordinators and the Office of the Vice President for Community Health at the Health Sciences Center. The role of agents is to work with different sectors of the community in identifying high-priority health needs and linking those needs with university resources in education, clinical service and research. Community needs, interventions, and outcomes are monitored by county health report cards. The Health Sciences Center is a large and varied resource, the breadth and accessibility of which are mostly unknown to communities. Community health needs vary, and agents are able to tap into an array of existing health center resources to address those needs. Agents serve a broader purpose beyond immediate, strictly medical needs by addressing underlying social determinants of disease, such as school retention, food insecurity, and local economic development. Developing local capacity to address local needs has become an overriding concern. Community-based health extension agents can effectively bridge those needs with academic health center resources and extend those resources to address the underlying social determinants of disease.

  17. Research and academic education in medical sexology.

    Science.gov (United States)

    Pinchera, A; Jannini, E A; Lenzi, A

    2003-01-01

    Advances in sexual pharmacology have stimulated the development of new analytical instruments in the management of sexual dysfunction, with increasing research in the area of basic mechanisms of human sexual response. However, the public is greatly interested and eager for new discoveries and pharmacological treatments to enhance sexual performance and relationships, and cure common sexual dysfunctions and symptoms. The need for sexology--in this case, a new "medical" sexology--to utilize scientific tools and be taught in medical schools is therefore evident.

  18. 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.

  19. A Successful US Academic Collaborative Supporting Medical Education in a Postconflict Setting

    Directory of Open Access Journals (Sweden)

    Patricia McQuilkin MD

    2014-12-01

    Full Text Available This article describes a model employed by the Academic Collaborative to Support Medical Education in Liberia to augment medical education in a postconflict setting where the health and educational structures and funding are very limited. We effectively utilized a cohort of visiting US pediatric faculty and trainees for short-term but recurrent clinical work and teaching. This model allows US academic medical centers, especially those with smaller residency programs, to provide global health experiences for faculty and trainees while contributing to the strengthening of medical education in the host country. Those involved can work toward a goal of sustainable training with a strengthened host country specialty education system. Partnerships such as ours evolve over time and succeed by meeting the needs of the host country, even during unanticipated challenges, such as the Ebola virus outbreak in West Africa.

  20. An academic health center sees both challenges and enabling forces as it creates an accountable care organization.

    Science.gov (United States)

    Tallia, Alfred F; Howard, Jenna

    2012-11-01

    Health care reform presents academic health centers with an opportunity to test new systems of care, such as accountable care organizations (ACOs), that are intended to improve patients' health and well-being, mitigate the anticipated shortage in primary care providers, and bend the cost curve. In its ongoing efforts to develop an ACO, the Robert Wood Johnson Medical School, an academic health center, has found helpful a rapidly evolving competitive environment and insurers willing to experiment with new models of care. But the center has also encountered six types of barriers: conceptual, financial, cultural, regulatory, organizational, and historical. How this academic health center has faced these barriers offers valuable lessons to other health systems engaged in creating ACOs.

  1. Educational Multimedia Materials in Academic Medical Training

    Directory of Open Access Journals (Sweden)

    Kołodziejczak Barbara

    2014-12-01

    Full Text Available This article presents an overview of generally available applications for creating multimedia and interactive educational materials, such as presentations, instructional videos, self-tests and interactive repetitions. With the use of the presented tools, pilot materials were developed to support the teaching of biostatistics at a medical university. The authors conducted surveys among students of faculties of medicine in order to evaluate the materials used in terms of quality and usefulness. The article presents the analysis of the results obtained.

  2. Academic entrepreneurship in a medical university: A system dynamics approach

    Directory of Open Access Journals (Sweden)

    Tofighi Sharam

    2017-01-01

    Full Text Available Academic entrepreneurship is a dynamic field which is growing after the second academic revolution that added entrepreneurial mission as the Third Mission of universities. In this sense, dynamics of this phenomenon is a suitable field of study and provides fruitful insights for both theory and practice. Thus, in this research, system dynamics approach is used to scrutinize academic entrepreneurship. The main question of this research is 'how academic entrepreneurship might evolve in a medical university of a developing country?' Therefore, Cross Impact Analysis method is used to examine the system behavior. In this study, the main attributes are adapted from a recent study by Salamzadeh et al. (2013a. Then, some policy variables are proposed and their effects on the model were shown. Findings show that although entrepreneurial ecosystem is growing in the country, still there are problems to be taken into account in order to improve the entrepreneurship in university.

  3. Opportunity for Collaboration Between Radiation Injury Treatment Network Centers and Medical Toxicology Specialists.

    Science.gov (United States)

    Davlantes, Elizabeth; Shartar, Samuel; Venero, Jennifer; Steck, Alaina; Langston, Amelia; Kazzi, Ziad N

    2017-08-01

    The Radiation Injury Treatment Network (RITN) comprises >50 centers across the United States that are poised to care for victims of a radiation emergency. The network is organized around bone marrow transplant centers because these facilities excel in both radiation medicine and the care of patients with severe bone marrow depression. A radiation emergency may cause not only irradiation from an external source but also internal contamination with radioactive material. Because medical toxicologists are trained in radiation injury management and have expertise in the management of internal contamination, RITN centers may benefit from partnerships with medical toxicology resources, which may be located at academic medical centers, hospital inpatient clinical services, outpatient clinics, or poison control centers. We determined the locations of existing RITN centers and assessed their proximity to various medical toxicology resources, including medical toxicology fellowship programs, inpatient toxicology services, outpatient toxicology clinics, and poison control centers. Data were derived from publicly available Internet sources in March 2015. The majority of RITN centers do not have a medical toxicology fellowship, an inpatient toxicology service, or an outpatient toxicology clinic within the same institution. Fifty-seven percent of RITN centers have at least one of these resources located in the same city, however, and 73% of centers have at least one of these resources or a poison control center within the same city. Ninety-five percent of RITN centers have at least one medical toxicology resource within the state. Most RITN centers are located in the same city as at least one medical toxicology resource. Establishing relationships between RITN centers and medical toxicologists needs to be explored further.

  4. Gendered Pedagogic Identities and Academic Professionalism in Greek Medical Schools

    Science.gov (United States)

    Tsouroufli, Maria

    2018-01-01

    Feminist scholarship has considered how pedagogical identities and emotions are implicated in the gender politics of belonging and othering in higher education. This paper examines how gendered and embodied pedagogy is mobilised in Greek medical schools to construct notions of the ideal academic and assert women's position women in Academic…

  5. Academic Dishonesty in Medical Schools | Musau | Annals of African ...

    African Journals Online (AJOL)

    Background: Dishonesty can be found in all aspects of human interaction and is known to be rampant in educational institutions. Little is known about it in medical training and the characteristics of those involved. This study explores the factors that drive academic dishonesty among aspiring doctors. Objective: To establish ...

  6. Connectedness, sense of community, and academic satisfaction in a novel community campus medical education model.

    Science.gov (United States)

    Vora, Rupal S; Kinney, Marjorie N

    2014-01-01

    Developing a sense of community and establishing connectivity are important in enhancing learners' success and preventing their sense of isolation. The A.T. Still University School of Osteopathic Medicine in Arizona (SOMA) has implemented a novel approach to medical education in which, beginning in the second year, students are geographically dispersed to 11 community campuses associated with community health centers around the United States, at both inner-city and rural locations. This study assessed students' sense of community, academic satisfaction, and level of connectedness in their first through fourth years of medical school at SOMA. The Rovai Classroom Community Scale and open-ended questions were administered via an online survey instrument to 412 students enrolled at SOMA for the 2011-2012 academic year. Participation was voluntary, and all results were anonymous. Data were analyzed using one-way ANOVA to compare results between classes. Comparisons revealed an increasing degree of isolation and a decreasing sense of community and academic satisfaction progressing from the first through fourth years of medical school. Students suggested possible solutions that may be applied to medical schools and other graduate schools to improve the level of connectedness for students who are learning at a distance. Connectivity, sense of community, and academic satisfaction may decrease for students in undergraduate medical education participating in a combination of distance learning and intermittent in-person activities. Interventions have the potential to improve these parameters. Long-term follow-up of students' satisfaction is suggested.

  7. Evaluation of Academic Performance, Academic Motivation, Hope for the Future and Life Satisfaction of Pharmacy Students of a Medical School

    National Research Council Canada - National Science Library

    Armaghan Eslami; Rezvan Hallaj; Niusha Didehvar; Leila Kouti; Kaveh Eslami

    2017-01-01

    Background: This study sought to investigate the evaluation of academic achievement, academic motivation and hope for the future and life satisfaction of Pharmacy Students of the Medical Sciences University...

  8. 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).

  9. 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.

  10. Formal peer-teaching in medical school improves academic performance: the MUSC supplemental instructor program.

    Science.gov (United States)

    Wong, Jeffrey G; Waldrep, Thomas D; Smith, Thomas G

    2007-01-01

    Formal systems of peer teaching are common in many advanced-degree graduate school programs but are less prevalent in medical schools. In 1997, The Medical University of South Carolina's Center for Academic Excellence created a Supplemental Instructor (SI) program in which interested upper-level medical students are hired to teach a small group of junior peers, primarily in basic science topics. The purpose of this study was to examine if participation as an SI leader resulted inmeasurable academic improvement for those students. This study examined if participation as a teacher in the SI program (SI leader) resulted in measurable academic improvement for those students. Admission characteristics (grade point average [GPA], Medical College Aptitude Test score, age, year of enrollment, and gender) of all SI leaders were compiled from the academic years 1996-2001. A second cohort of students, who shared the first group's admission characteristics but who chose not to teach as SIs, was identified as a comparison control group. Outcome measures included United States Medical Licensing Examination (USMLE) Step 1 and 2 scores and final medical school GPA. Paired student two-tailed t -test statistics compared group means on all outcome variables. There were 199 SI leaders with non-SI students matched controls studied. There were no significant differences upon admission between the two groups; however, the SI leader group had significantly higher USMLE Step 1 and Step 2 scores and final medical school GPA compared to the non-SI group. The activity of formal peer-teaching was beneficial to the SI leaders' own academic success as measured by GPA and USMLE test scores.

  11. Perceived Medical School stress of undergraduate medical students predicts academic performance: an observational study.

    Science.gov (United States)

    Kötter, Thomas; Wagner, Josefin; Brüheim, Linda; Voltmer, Edgar

    2017-12-16

    Medical students are exposed to high amounts of stress. Stress and poor academic performance can become part of a vicious circle. In order to counteract this circularity, it seems important to better understand the relationship between stress and performance during medical education. The most widespread stress questionnaire designed for use in Medical School is the "Perceived Medical School Stress Instrument" (PMSS). It addresses a wide range of stressors, including workload, competition, social isolation and financial worries. Our aim was to examine the relation between the perceived Medical School stress of undergraduate medical students and academic performance. We measured Medical School stress using the PMSS at two different time points (at the end of freshman year and at the end of sophomore year) and matched stress scores together with age and gender to the first medical examination (M1) grade of the students (n = 456). PMSS scores from 2 and 14 months before M1 proved to be significant predictors for medical students' M1 grade. Age and gender also predict academic performance, making older female students with high stress scores a potential risk group for entering the vicious circle of stress and poor academic performance. PMSS sum scores 2 and 14 months before the M1 exam seem to have an independent predictive validity for medical students' M1 grade. More research is needed to identify potential confounders.

  12. [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.

  13. Resource allocation in academic health centers: creating common metrics.

    Science.gov (United States)

    Joiner, Keith A; Castellanos, Nathan; Wartman, Steven A

    2011-09-01

    Optimizing resource allocation is essential for effective academic health center (AHC) management, yet guidelines and principles for doing so in the research and educational arenas remain limited. To address this issue, the authors analyzed responses to the 2007-2008 Association of Academic Health Centers census using ratio analysis. The concept was to normalize data from an individual institution to that same institution, by creating a ratio of two separate values from the institution (e.g., total faculty FTEs/total FTEs). The ratios were then compared across institutions. Generally, this strategy minimizes the effect of institution size on the responses, size being the predominant limitation of using absolute values for developing meaningful metrics. In so doing, ratio analysis provides a range of responses that can be displayed in graphical form to determine the range and distribution of values. The data can then be readily scrutinized to determine where any given institution falls within the distribution. Staffing ratios and operating ratios from up to 54 institutions are reported. For ratios including faculty numbers in the numerator or denominator, the range of values is wide and minimally discriminatory, reflecting heterogeneity across institutions in faculty definitions. Values for financial ratios, in particular total payroll expense/total operating expense, are more tightly clustered, reflecting in part the use of units with a uniform definition (i.e., dollars), and emphasizing the utility of such ratios in decision guidelines. The authors describe how to apply these insights to develop metrics for resource allocation in the research and educational arenas.

  14. NASA Johnson Space Center Medical Licensing Opportunities

    Science.gov (United States)

    Hernandez-Moya, Sonia

    2009-01-01

    This presentation reviews patented medical items that are available for licensing in the areas of Laboratory Technologies, Medical Devices, Medical Equipment and other technologies that are of interest to the medical community.

  15. Neurohormonal changes in medical students during academic stress.

    Science.gov (United States)

    Al-Ayadhi, Laila Y

    2005-01-01

    Academic stress is a good model of psychological stress in humans and is thus useful for studying psychoneurohormonal changes. The aim of the current study was to examine the effect of academic examination stress on activation of the hypothalamus-autonomic nervous system (HANS) and the hypothalamic-pituitary-adrenocortical (HPA) axis, through the measurements of changes in neuro-hormones during final exams as compared to the pre-exam baseline. Forty-eight first- and second-year female medical students participated. Plasma leptin, neuropeptide Y (NPY), nitrite, nitrate, andrenomedullin, cortisol and adrenocorticotropic hormone (ACTH) were measured at baseline and during final examinations. Plasma levels of cortisol, ACTH, NPY, adrenomedullin, nitrite and nitrate increased during times of academic stress as compared to baseline levels. However, only plasma leptin level was decreased during the academic stress as compared to baseline, probably through a negative feedback mechanism resulting from sympathetic stimulation. The results indicate that both the HANS and HPA are involved in this type of stress and both are activated at the same time. Academic stress induced significant neurohormonal changes. Leptin, NPY, nitrite, nitrate, adrenomedullin, cortisol and ACTH can be considered part of a complex mosaic model of the neuroendocrine system during academic stress.

  16. Medical students’ academic emotions: the role of perceived learning environment

    Directory of Open Access Journals (Sweden)

    NAEIMEH KOHOULAT

    2017-04-01

    Full Text Available Introduction: Research shows that there is a relationship between students’ perceptions of classroom and learning environment and their cognitive, affective, emotional and behavioral outcomes, so, in this study the relationship between medical students’ perception of learning environment and academic emotions was examined. Methods: The research method used was descriptive-correlative. The statistical population consisted of medical students of Shiraz University of Medical Sciences. Stratified sampling method was used to select 342 participants. They completed self-report questionnaires of Dundee Ready Educational Environment Measure (DREEM and Achievement Emotions Questionnaire (AEQ. All descriptive statistics, Pearson’s correlations and simultaneous multiple regression were performed using SPSS 14 software. Results: Simultaneous multiple regression of the students’ perceived learning environment on their academic achievement emotions showed that the perceived learning environment predicts the students’ academic emotions. Conclusion: The results of this study revealed that caring for and supportive learning environment can increase the students’ positive emotions and decrease their academic negative emotions (i.e. anxiety, shame, and hopelessness. Implications of the results are discussed.

  17. Chicago medical response to the 2010 earthquake in Haiti: translating academic collaboration into direct humanitarian response.

    Science.gov (United States)

    Babcock, Christine; Baer, Carolyn; Bayram, Jamil D; Chamberlain, Stacey; Chan, Jennifer L; Galvin, Shannon; Kim, Jimin; Kinet, Melodie; Kysia, Rashid F; Lin, Janet; Malik, Mamta; Murphy, Robert L; Olopade, C Sola; Theodosis, Christian

    2010-06-01

    On January 12, 2010, a major earthquake in Haiti resulted in approximately 212 000 deaths, 300 000 injuries, and more than 1.2 million internally displaced people, making it the most devastating disaster in Haiti's recorded history. Six academic medical centers from the city of Chicago established an interinstitutional collaborative initiative, the Chicago Medical Response, in partnership with nongovernmental organizations (NGOs) in Haiti that provided a sustainable response, sending medical teams to Haiti on a weekly basis for several months. More than 475 medical volunteers were identified, of whom 158 were deployed to Haiti by April 1, 2010. This article presents the shared experiences, observations, and lessons learned by all of the participating institutions. Specifically, it describes the factors that provided the framework for the collaborative initiative, the communication networks that contributed to the ongoing response, the operational aspects of deploying successive medical teams, and the benefits to the institutions as well as to the NGOs and Haitian medical system, along with the challenges facing those institutions individually and collectively. Academic medical institutions can provide a major reservoir of highly qualified volunteer medical personnel that complement the needs of NGOs in disasters for a sustainable medical response. Support of such collaborative initiatives is required to ensure generalizability and sustainability.

  18. Longitudinal analysis of the effect of academic failure tolerance on academic achievement fluctuation in medical school students

    OpenAIRE

    Su Jin Chae; Miran Kim; Ki Hong Chang

    2016-01-01

    Purpose: Academic failure tolerance (AFT) is one of the important psychological concepts in education, but its applications in medical education are rare. Thus, the purpose of this study was to investigate the effect of academic failure tolerance on academic achievement fluctuation among medical school students using a longitudinal research design. Methods: The subjects were 43 medical students who responded to the AFT test. This study analyzed the longitudinal data of achievement scores up t...

  19. Development of a medical academic degree system in China

    Directory of Open Access Journals (Sweden)

    Lijuan Wu

    2014-01-01

    Full Text Available Context: The Chinese government launched a comprehensive healthcare reform to tackle challenges to health equities. Medical education will become the key for successful healthcare reform. Purpose: We describe the current status of the Chinese medical degree system and its evolution over the last 80 years. Content: Progress has been uneven, historically punctuated most dramatically by the Cultural Revolution. There is a great regional disparity. Doctors with limited tertiary education may be licensed to practice, whereas medical graduates with advanced doctorates may have limited clinical skills. There are undefined relationships between competing tertiary training streams, the academic professional degree, and the clinical residency training programme (RTP. The perceived quality of training in both streams varies widely across China. As the degrees of master or doctor of academic medicine is seen as instrumental in career advancement, including employability in urban hospitals, attainment of this degree is sought after, yet is often unrelated to a role in health care, or is seen as superior to clinical experience. Meanwhile, the practical experience gained in some prestigious academic institutions is deprecated by the RTP and must be repeated before accreditation for clinical practice. This complexity is confusing both for students seeking the most appropriate training, and also for clinics, hospitals and universities seeking to recruit the most appropriate applicants. Conclusion: The future education reforms might include: 1 a domestic system of ‘credits’ that gives weight to quality clinical experience vs. academic publications in career advancement, enhanced harmonisation between the competing streams of the professional degree and the RTP, and promotion of mobility of staff between areas of excellence and areas of need; 2 International – a mutual professional and academic recognition between China and other countries by reference to

  20. Development of a medical academic degree system in China.

    Science.gov (United States)

    Wu, Lijuan; Wang, Youxin; Peng, Xiaoxia; Song, Manshu; Guo, Xiuhua; Nelson, Hugh; Wang, Wei

    2014-01-01

    The Chinese government launched a comprehensive healthcare reform to tackle challenges to health equities. Medical education will become the key for successful healthcare reform. We describe the current status of the Chinese medical degree system and its evolution over the last 80 years. Progress has been uneven, historically punctuated most dramatically by the Cultural Revolution. There is a great regional disparity. Doctors with limited tertiary education may be licensed to practice, whereas medical graduates with advanced doctorates may have limited clinical skills. There are undefined relationships between competing tertiary training streams, the academic professional degree, and the clinical residency training programme (RTP). The perceived quality of training in both streams varies widely across China. As the degrees of master or doctor of academic medicine is seen as instrumental in career advancement, including employability in urban hospitals, attainment of this degree is sought after, yet is often unrelated to a role in health care, or is seen as superior to clinical experience. Meanwhile, the practical experience gained in some prestigious academic institutions is deprecated by the RTP and must be repeated before accreditation for clinical practice. This complexity is confusing both for students seeking the most appropriate training, and also for clinics, hospitals and universities seeking to recruit the most appropriate applicants. The future education reforms might include: 1) a domestic system of 'credits' that gives weight to quality clinical experience vs. academic publications in career advancement, enhanced harmonisation between the competing streams of the professional degree and the RTP, and promotion of mobility of staff between areas of excellence and areas of need; 2) International - a mutual professional and academic recognition between China and other countries by reference to the Bologna Accord, setting up a system of easily comparable and

  1. Development of a medical academic degree system in China

    Science.gov (United States)

    Wu, Lijuan; Wang, Youxin; Peng, Xiaoxia; Song, Manshu; Guo, Xiuhua; Nelson, Hugh; Wang, Wei

    2014-01-01

    Context The Chinese government launched a comprehensive healthcare reform to tackle challenges to health equities. Medical education will become the key for successful healthcare reform. Purpose We describe the current status of the Chinese medical degree system and its evolution over the last 80 years. Content Progress has been uneven, historically punctuated most dramatically by the Cultural Revolution. There is a great regional disparity. Doctors with limited tertiary education may be licensed to practice, whereas medical graduates with advanced doctorates may have limited clinical skills. There are undefined relationships between competing tertiary training streams, the academic professional degree, and the clinical residency training programme (RTP). The perceived quality of training in both streams varies widely across China. As the degrees of master or doctor of academic medicine is seen as instrumental in career advancement, including employability in urban hospitals, attainment of this degree is sought after, yet is often unrelated to a role in health care, or is seen as superior to clinical experience. Meanwhile, the practical experience gained in some prestigious academic institutions is deprecated by the RTP and must be repeated before accreditation for clinical practice. This complexity is confusing both for students seeking the most appropriate training, and also for clinics, hospitals and universities seeking to recruit the most appropriate applicants. Conclusion The future education reforms might include: 1) a domestic system of ‘credits’ that gives weight to quality clinical experience vs. academic publications in career advancement, enhanced harmonisation between the competing streams of the professional degree and the RTP, and promotion of mobility of staff between areas of excellence and areas of need; 2) International – a mutual professional and academic recognition between China and other countries by reference to the Bologna Accord

  2. Longitudinal analysis of the effect of academic failure tolerance on academic achievement fluctuation in medical school students.

    Science.gov (United States)

    Chae, Su Jin; Kim, Miran; Chang, Ki Hong

    2016-03-01

    Academic failure tolerance (AFT) is one of the important psychological concepts in education, but its applications in medical education are rare. Thus, the purpose of this study was to investigate the effect of academic failure tolerance on academic achievement fluctuation among medical school students using a longitudinal research design. The subjects were 43 medical students who responded to the AFT test. This study analyzed the longitudinal data of achievement scores up to the 2nd academic year (2012-2013) among students who were divided into academic achievement improvement and decline groups. Comparing the improvement and decline groups' mean academic achievement fluctuation scores demonstrated that behavior and preferred task difficulty showed high scores whereas feeling scores were lower in the improvement group (pacademic failure, the students favored the more difficult subjects and were more assiduous in their studies. This will form an important basis for enhancing academic achievement among medical students.

  3. 75 FR 39622 - Proposed Information Collection (Health Resource Center Medical Center Payment Form) Activity...

    Science.gov (United States)

    2010-07-09

    ... comment. The PRA submission describes the nature of the information collection and its expected cost and... AFFAIRS Proposed Information Collection (Health Resource Center Medical Center Payment Form) Activity...: Health Resource Center Medical Center Payment Form, VA Form 10-0505. OMB Control Number: 2900-New (10...

  4. How one teaching hospital system and one medical school are jointly affirming their academic mission.

    Science.gov (United States)

    Rosenblatt, M; Rabkin, M T; Tosteson, D C

    1997-06-01

    The economic forces that are reshaping the practice of medicine and the funding of medical research will have great impact on clinical education and research in teaching hospitals and their associated medical schools. Changes in the setting of and approach to medical education will need to be made in order to continue to train physicians at the same high level as in the past and to maintain the productivity of our national biomedical research enterprise and its contributions to health. Academic leaders, such as department chiefs who have clinical service responsibilities, are finding it more and more difficult to manage simultaneously the demands of the clinical business, education, and research. In an effort to organize a teaching hospital and a medical school in a manner that would position them to maintain more effectively their common academic mission front and center with the clinical business, Harvard Medical School and the Beth Israel Hospital created a joint venture in 1996. The new nonprofit Institute for Education and Research has education and research as its top (and only) mission. It is designed to provide additional and specific academic leadership and to enable the joint venture to undertake strategic planning for the academic mission. In addition to the challenges it faces from changes in the external environment, the Institute for Education and Research will need to establish a new pattern of interactions internally within the parent institutions. Collaborations with department chairs and faculty are an essential ingredient for its success. It is hoped that this structure will prove to be a useful template for organizing other medical school-hospital collaborations on behalf of the academic mission.

  5. Correlation among academic stress, academic burnout, and academic performance in nursing and paramedic students of Qom University of Medical Sciences, Iran

    OpenAIRE

    hamid Asayesh; Fatemeh Sharififard; Mojtaba Mosavi; Zahra Taheri Kharameh; Zahra Aliakbarzade Arani; Alireza Shouri Bidgoli

    2016-01-01

    Background and Objectives: Learning is a stressful experience of human life; reduced adaption to stressors causes academic burnout which is a reason for academic failure among students. This study investigated the correlation among academic stress, academic burnout, and academic performance in nursing and paramedic students of Qom University of Medical Sciences. Methods: In this descriptive, cross-sectional study, 264 nursing and paramedic students were randomly selected. Demographic ch...

  6. Relationship between Learning Strategies and Academic Achievement in Medical College and Graduate Medical School Students.

    Science.gov (United States)

    Shin, Hong-Im; Jeon, Woo Tack; Yang, Eunbae B

    2010-09-01

    Cognitive researchers assume that learning strategies are related to three types of learning processes: 'surface learning,' 'strategy learning,' and 'deep learning.' A 'deep learning' approach is widely accepted to be associated with long-term success in medical school, contributing to the development of doctors who take desirable approaches to self-directed learning and studying in medical practice. Therefore, this study measured how medical students learn and determined whether the use of learning strategies differs between high and low academic performers. In addition, we compared medical college students with graduate medical school students with regard to the use of learning strategies. To explore the learning strategies of students and their relation to academic achievement, we performed LIST (Learning Strategies in Higher Education Inventory) in a sample of 111 Year 1 medical students. Medical students with high academic performance scored higher in most learning strategies than low performers. Additionally, learning strategies were used more frequently by graduate medical school students than medical students, specifically with regard to organization, elaboration, critical thinking, and time management. We conclude that learning strategy instruments provide information that enables medical students to optimize their study. To foster deep learning and intrinsic motivation in students, it might also be necessary to adopt more changes in teaching and assessment in medical schools.

  7. Curriculum Mapping with Academic Analytics in Medical and Healthcare Education.

    Science.gov (United States)

    Komenda, Martin; Víta, Martin; Vaitsis, Christos; Schwarz, Daniel; Pokorná, Andrea; Zary, Nabil; Dušek, Ladislav

    2015-01-01

    No universal solution, based on an approved pedagogical approach, exists to parametrically describe, effectively manage, and clearly visualize a higher education institution's curriculum, including tools for unveiling relationships inside curricular datasets. We aim to solve the issue of medical curriculum mapping to improve understanding of the complex structure and content of medical education programs. Our effort is based on the long-term development and implementation of an original web-based platform, which supports an outcomes-based approach to medical and healthcare education and is suitable for repeated updates and adoption to curriculum innovations. We adopted data exploration and visualization approaches in the context of medical curriculum innovations in higher education institutions domain. We have developed a robust platform, covering detailed formal metadata specifications down to the level of learning units, interconnections, and learning outcomes, in accordance with Bloom's taxonomy and direct links to a particular biomedical nomenclature. Furthermore, we used selected modeling techniques and data mining methods to generate academic analytics reports from medical curriculum mapping datasets. We present a solution that allows users to effectively optimize a curriculum structure that is described with appropriate metadata, such as course attributes, learning units and outcomes, a standardized vocabulary nomenclature, and a tree structure of essential terms. We present a case study implementation that includes effective support for curriculum reengineering efforts of academics through a comprehensive overview of the General Medicine study program. Moreover, we introduce deep content analysis of a dataset that was captured with the use of the curriculum mapping platform; this may assist in detecting any potentially problematic areas, and hence it may help to construct a comprehensive overview for the subsequent global in-depth medical curriculum

  8. Academic Health Center-Rural Community Collaborations: 'Healthy Linkages' to Improve the Health of Rural Populations.

    Science.gov (United States)

    Beech, Bettina M; Bruce, Marino A; Gamble, Abigail; Brunson, Claude; Jones, Michael L

    2016-04-01

    The purpose of this paper is to describe an extant theoretical model framing Mississippi Healthy Linkages, a successful academic-community partnership undergirding an emergency department (ED) diversion program. The partnership between the University of Mississippi Medical Center, Mississippi State Department of Health, and Federally Qualified Health Centers is grounded in the Structuration Model of Collaboration and utilizes collective action to support an organized system of care linking academic and community care settings to address health disparities, particularly for rural and vulnerable populations. Partners identified three interconnected segments of an integrated patient referral system to improve patient-level care, including galvanization of primary care services for ED patients, connection of primary care patients to specialty care, and linking ED patients with aftercare services. This academic-community partnership has significant benefits for linking health care and public health systems to address remote and vulnerable population health issues and serves as a model to be replicated in other areas of the United States, particularly in the Southeast and in rural areas.

  9. SLEEP PATTERN AND ACADEMIC PERFORMANCE OF MEDICAL STUDENTS OF A GOVERNMENT MEDICAL COLLEGE IN KERALA

    Directory of Open Access Journals (Sweden)

    Deepa Rajendran

    2017-03-01

    Full Text Available BACKGROUND Relationship between sleep pattern and academic performance of students is well accepted. The studies relating the sleep pattern of medical students and academic performance is limited. This study was conducted to identify sleep pattern of medical students and find out any relationship between sleep pattern and academic performance. MATERIALS AND METHODS A questionnaire-based study was carried out to assess sociodemographic parameters, sleep/wake timing, sleep duration, daytime sleepiness and academic performance. Academic performance was measured on the basis of the aggregate marks scored for the previous year university exam. RESULTS The study population included 349 students with a mean age of 21.4±1.1years. The student’s average weekday bedtime, rise time and total sleep time was 12:02a.m., 07:03a.m. and 7.23hrs., respectively. The corresponding values for weekends were 12:25a.m., 08:17a.m. and 08:18hrs. Mean sleep duration of night prior to exam was 5.16±1.50.Students with earlier bed/rise time and longer hours of sleep night prior to exam had better academic performance. CONCLUSION Academic performance of medical students showed significant negative correlation with sleep/wake timings and positive correlation with duration of sleepnight before examination.

  10. Assessment of mental workload and academic motivation in medical students.

    Science.gov (United States)

    Atalay, Kumru Didem; Can, Gulin Feryal; Erdem, Saban Remzi; Muderrisoglu, Ibrahim Haldun

    2016-05-01

    To investigate the level of correlation and direction of linearity between academic motivation and subjective workload. The study was conducted at Baskent University School of Medicine, Ankara, Turkey, from December 2013 to February 2014, and comprised Phase 5 Phase 6 medical students. Subjective workload level was determined by using National Aeronautics and Space Administration Task Load Index scale that was adapted to Turkish. Academic motivation values were obtained with the help of Academic Motivation Scale university form. SPSS 17 was used for statistical analysis. Of the total 105 subjects, 65(62%) students were in Phase 5 and 40(38%) were in Phase 6. Of the Phase 5 students, 18(27.7%) were boys and 47(72.3%) were girls, while of the Phase 6 students, 16(40%) were boys and 24(60%) were girls. There were significant differences in Phase 5 and Phase 6 students for mental effort (p=0.00) and physical effort (p=0.00). The highest correlation in Phase 5 was between mental effort and intrinsic motivation (r=0.343). For Phase 6, highest correlation was between effort and amotivation (r= -0.375). Subjective workload affected academic motivation in medical students.

  11. Team effectiveness in academic medical libraries: a multiple case study.

    Science.gov (United States)

    Martin, Elaine Russo

    2006-07-01

    The objective of this study is to apply J. Richard Hackman's framework on team effectiveness to academic medical library settings. The study uses a qualitative, multiple case study design, employing interviews and focus groups to examine team effectiveness in three academic medical libraries. Another site was selected as a pilot to validate the research design, field procedures, and methods to be used with the cases. In all, three interviews and twelve focus groups, with approximately seventy-five participants, were conducted at the case study libraries. Hackman identified five conditions leading to team effectiveness and three outcomes dimensions that defined effectiveness. The participants in this study identified additional characteristics of effectiveness that focused on enhanced communication, leadership personality and behavior, and relationship building. The study also revealed an additional outcome dimension related to the evolution of teams. Introducing teams into an organization is not a trivial matter. Hackman's model of effectiveness has implications for designing successful library teams.

  12. [Medical controlling as medical economical service center. Successful concept for orthopedics and trauma surgery centers?].

    Science.gov (United States)

    Auhuber, T C; Hoffmann, R

    2015-01-01

    The management of patients from administrative admission through the orthopedic-surgical treatment to completion of the billing is complex. Additional challenges originate from the necessity to treat patients in both outpatient and inpatient departments and in more than one medical sector. A superior coordination is essential for a successful cooperation of the various procedures of controlling. The model of a medical controlling department as a service center with effective competence in the management of service and cost, functions as a successful solution to the problem. Central elements of a successful medical economical case management are a well-defined assignment of tasks and definitions of intersections, the integration of health professionals and administrative employees, the utilization of software for process control and the implementation of inlier controlling.

  13. A way to approach the strategic decisions facing academic health centers.

    Science.gov (United States)

    Capper, S A; Fargason, C A

    1996-04-01

    Rapid changes taking place in the various markets served by academic health centers (AHCs) are forcing these institutions to make difficult strategic decisions that may change AHCs' historic priorities. The authors present an approach that can help AHCs visualize possible new configurations of their traditional services of research, education, and clinical care. This approach is based on successful strategic management methods from the private sector and involves a three-dimensional "topography of services" encompassing all possible configurations of AHCs' services. From among the many possible configurations, the authors discuss three in detail. The historic one, which they call the traditional model, is characteristic of AHCs that give high priority to biomedical and clinical research, have broad medical education activities, and deliver comprehensive, high-quality clinical care. In the future, this configuration will be rare, and two others are likely to predominate. First is the "revised" traditional model, which would offer "boutique" clinical services, biomedical research, and medical education for MD-PhD students, residents, and fellows seeking tertiary care or academic careers. The patient care required for undergraduate medical education and clinical research would be provided by partnerships with community-based providers. Second is the academic services model, which would focus on competitive primary and secondary clinical services, health services and operations research, and primary care medical education. The authors discuss the implications of these models for AHCs' organizational structures and faculty incentives. They conclude that the clarity with which AHCs' strategic decisions are made and communicated to faculties and the incentive systems that are selected to motivate faculty and to provide the selected services may ultimately determine which institutions survive.

  14. Impact of a Cleft and Craniofacial Center on an Academic Health System.

    Science.gov (United States)

    Pourtaheri, Navid; Kearney, Aaron; Wan, Derrick C; Lakin, Gregory

    2017-10-01

    The contributions of all physician specialties and ancillary services involved in cleft and craniofacial center care must be evaluated to fairly assess the financial impact of a cleft and craniofacial center. The authors hypothesized that the cleft and craniofacial center generates profitable downstream productivity for the academic health system. This was a retrospective cohort study of all patients who presented to a cleft and craniofacial center in the first quarter of 2011. Analysis included all health system encounters for each patient over a 2-year period using the electronic medical record and health system financial database. Sixty-two patients were seen (mean age, 11.4 years; 38 boys and 24 girls; 18 new and 44 established patients). Over 2 years, there were 618 health system encounters (599 outpatient and 19 inpatient encounters), 68 hospital days, and 110 procedures. The most common physician specialty was plastic surgery [312 encounters (50.5 percent)] and the most common ancillary service was speech therapy [256 encounters (41.4 percent)]. The overall reimbursement rate was 39.9 percent, with a majority payor-mix of government payors (62.1 percent). The total profit margin percentage from all encounters was 13.7 percent, which was greater for managed care compared with government payor (38.9 percent versus -10.8 percent; p = 0.022), inpatient compared to outpatient (24.5 percent versus -2.8 percent; p center generated profitable downstream productivity for the academic health system with referrals to 39 different physician and nonphysician specialties. Health system providers and the business team should align to analyze the center, enhance patient outcomes, and improve specialty care access for patients.

  15. Do study strategies predict academic performance in medical school?

    Science.gov (United States)

    West, Courtney; Sadoski, Mark

    2011-07-01

     Study strategies, such as time and study management techniques, seem to be consistently related to achievement even when aptitude is controlled for, but the picture is not entirely clear. As there is limited research in this area, we explored the relative strengths of academic aptitude, as measured by the Medical College Admission Test (MCAT), undergraduate grade point average (UGPA) and study strategies, as measured by the Learning and Study Strategies Inventory (LASSI), in predicting academic performance in 106 students in the first semester of an integrated curriculum.  Our purpose was to determine whether relationships could be identified between academic aptitude, study strategies and academic performance which would enable us to provide students with feedback in certain skill areas in order to maximise achievement. Data analysis consisted of four multiple regression analyses. The criterion variables were: semester overall final average, semester written examination average, semester practical examination average, and percentage correct on a customised National Board of Medical Examiners (NBME) examination. The predictor variables in each regression were: MCAT score; UGPA; and subscores on the 10 LASSI subscales for Anxiety, Attitude, Motivation, Concentration, Information Processing, Self-Testing, Selecting Main Idea, Study Aids, Time Management and Test-Taking Strategies. The results of three regressions indicated that two study skills, time management and self-testing, were generally stronger predictors of first-semester academic performance than aptitude. Improving the prioritisation and organisation of study time and teaching students to predict, compose and answer their own questions when studying may help to advance student performance regardless of student aptitude, especially on course-specific examinations. © Blackwell Publishing Ltd 2011.

  16. Correlation among academic stress, academic burnout, and academic performance in nursing and paramedic students of Qom University of Medical Sciences, Iran

    Directory of Open Access Journals (Sweden)

    hamid Asayesh

    2016-09-01

    Full Text Available Background and Objectives: Learning is a stressful experience of human life; reduced adaption to stressors causes academic burnout which is a reason for academic failure among students. This study investigated the correlation among academic stress, academic burnout, and academic performance in nursing and paramedic students of Qom University of Medical Sciences. Methods: In this descriptive, cross-sectional study, 264 nursing and paramedic students were randomly selected. Demographic characteristics checklist, academic burnout questionnaire, and academic stress scale were used to gather data, and grade point average was considered to be the indicator of academic performance. Linear regression analysis was used to analyze the data. The level of significance was considered to be p<0.05. Results: The mean score for students' academic burnout was 28.52±15.84. Univariate regression analysis showed that the students' employment, years of education, academic performance, and all academic stress subscales had a significant correlation with academic burnout. According to multivariate regression analysis, having a field of study-related occupation was a protective factor and academic stress a risk factor for academic burnout. Conclusion: The findings of this study showed that a large proportion of students experienced academic burnout, and students with higher levels of stress experienced more severe academic burnout and had poorer performance. Therefore, training ways to cope with stress can cause reduction in academic burnout and improvement of performance.

  17. The Organization and Governance of Academic Health Centers: Report of a Study.

    Science.gov (United States)

    Hastings, Douglas A.; And Others

    1981-01-01

    Selected data from an Association of Academic Health Centers study of academic health center organization and governance is discussed. Administrative roles and responsibilities, areas of concern (such as resource and space allocation), and anticipated conditions (e.g., accreditation, promotion and tenure) are reported. (MLW)

  18. The Dental School's Role in Academic Health Centers: Report of a Study.

    Science.gov (United States)

    Morris, Alvin L.; And Others

    1980-01-01

    Data from a study of the organization and governance of academic health centers is highlighted. Top administrators in academic health centers were surveyed to assemble information on the structural components and hierarchial relationships, the processes by which decisions are made, the way conflicts are resolved, and the future of institutions.…

  19. Result of a national audit of bariatric surgery performed at academic centers: a 2004 University HealthSystem Consortium Benchmarking Project.

    Science.gov (United States)

    Nguyen, Ninh T; Silver, Michael; Robinson, Malcolm; Needleman, Bradley; Hartley, Guilford; Cooney, Robert; Catalano, Robert; Dostal, Jackie; Sama, Danny; Blankenship, Jeanne; Burg, Kathryn; Stemmer, Edward; Wilson, Samuel E

    2006-05-01

    Bariatric surgery performed at US academic centers is safe and associated with low mortality. Multi-institutional consecutive cohort study. Academic medical centers. We audited the medical records from 40 consecutive bariatric surgery cases performed between October 1, 2003, and March 31, 2004, at each of the 29 institutions participating in the University HealthSystem Consortium Bariatric Surgery Benchmarking Project. All medical records that met inclusion criteria (patient age, >17 and Benchmarking Project, the risk for death within 30 days after bariatric surgery at academic centers is less than 1%. In addition, the practice of bariatric surgery at these centers has shifted from open surgery to predominately laparoscopic surgery. These quality-controlled outcome data can be used as a benchmark for the practice of bariatric surgery at most US hospitals.

  20. Faculty and staff teams: a tool for unifying the academic health center and improving mission performance.

    Science.gov (United States)

    Grigsby, R Kevin; Kirch, Darrell G

    2006-08-01

    The organizational structure of the academic health center (AHC) may present significant barriers to deep and lasting organizational change. The insular nature and structure often seen in academic departments and other units at AHCs result in competition for scarce resources, rather than in working together to add value to one another or to the organization as a whole. Successful unification around organizational performance goals is needed more than ever by AHCs as they struggle to meet their challenges. Over a five-year period (2000-2005) at the Penn State College of Medicine and Milton S. Hershey Medical Center, organizational inner cohesiveness was created through the use of teams that unified the clinical, academic, and research enterprises. Barriers that typically separate academic departments, such as a lack of understanding of the impact of organizational funds flow on each of the missions, were broken down. Traditional barriers between employees and management (e.g., poor communication, lack of clarity on organizational goals, and claims that neither side understood the other) were reduced. Problems that seemed to be intractable in the past such as an inequitable distribution of resources, responsibilities, and rewards, were solved through the implementation of a teams approach across departments and missions. The authors describe the creation and operation of these AHC-wide teams. The rationale for using teams is elucidated, the difference between teams and committees is defined, and data on five years of team performance are presented. The authors argue that the breadth of scope and comprehensiveness of the teams approach represents an effective model for implementing AHC-wide transformational change.

  1. Medical Center Staff Attitudes about Spanking

    OpenAIRE

    Gershoff, Elizabeth T.; Font, Sarah A.; Taylor, Catherine A.; Foster, Rebecca H.; Garza, Ann Budzak; Olson-Dorff, Denyse; Terreros, Amy; Nielsen-Parker, Monica; Spector, Lisa

    2016-01-01

    Several medical professional organizations, including the American Academy of Pediatrics, recommend that parents avoid hitting children for disciplinary purposes (e.g., spanking) and that medical professionals advise parents to use alternative methods. The extent to which medical professionals continue to endorse spanking is unknown. This study is the first to examine attitudes about spanking among staff throughout medical settings, including non-direct care staff. A total of 2,580 staff at a...

  2. Education in medical billing benefits both neurology trainees and academic departments.

    Science.gov (United States)

    Waugh, Jeff L

    2014-11-11

    The objective of residency training is to produce physicians who can function independently within their chosen subspecialty and practice environment. Skills in the business of medicine, such as clinical billing, are widely applicable in academic and private practices but are not commonly addressed during formal medical education. Residency and fellowship training include limited exposure to medical billing, but our academic department's performance of these skills was inadequate: in 56% of trainee-generated outpatient notes, documentation was insufficient to sustain the chosen billing level. We developed a curriculum to improve the accuracy of documentation and coding and introduced practice changes to address our largest sources of error. In parallel, we developed tools that increased the speed and efficiency of documentation. Over 15 months, we progressively eliminated note devaluation, increased the mean level billed by trainees to nearly match that of attending physicians, and increased outpatient revenue by $34,313/trainee/year. Our experience suggests that inclusion of billing education topics into the formal medical curriculum benefits both academic medical centers and trainees. © 2014 American Academy of Neurology.

  3. Debiasing the hidden curriculum: academic equality among medical specialties.

    Science.gov (United States)

    Woloschuk, Wayne; Wright, Bruce; McLaughlin, Kevin

    2011-01-01

    To compare the academic performance of students who entered family medicine residency programs with that of students who entered other disciplines and discern whether or not family physicians are as academically talented as their colleagues in other specialties. Retrospective quantitative study. University of Calgary in Alberta. Three graduating classes of students (2004 to 2006) from the University of Calgary medical school. Student performance on various undergraduate certifying examinations in years 1, 2, and 3, along with third-year in-training evaluation reports and total score on the Medical Council of Canada Qualifying Examination Part I. Complete data were available for 99% of graduates (N = 295). In the analysis, residency program (family medicine [n = 96] versus non-family medicine [n = 199]) served as the independent variable. Using a 1-way multivariate ANOVA (analysis of variance), no significant difference among any of the mean performance scores was observed (F(5289) = 1.73, P > .05). Students who entered family medicine were also well represented within the top 10 rankings of the various performance measures. The academic performance of students who pursued careers in family medicine did not differ from that of students who chose other specialties. Unfounded negativity toward family medicine has important societal implications, especially at a time when the gap between the number of family physicians and patients seeking primary care services appears to be widening.

  4. Medical Students Circadian Sleep Rhythms and Academic Performance

    Directory of Open Access Journals (Sweden)

    Isabel Pérez-Olmos

    2006-10-01

    Full Text Available Objective: to evaluate, with a preliminarystudy, the distribution of circadian rhythms, sleepschedule patterns and their relationship withacademic performance on medical students.Methodology: in this descriptive study, a 10 itemoriginal questionnaire about sleep rhythms andacademic performance was applied to medicalstudents from different semesters. Week (classtime and weekend schedules, preferences,daytime somnolence and academic performancewere asked. Three chronotypes (morningness,intermediate and eveningness were definedamong waking-sleeping preference, difficulty tosleep early, exam preparation preference hour and real sleep schedule. The sleep hour deficit perweek night was also calculated. Results: Of the318 medical students that answered the questionnaire,62.6% corresponded to intermediatechronotypes, 8.8% to evening-type and 28.7%to morning-type. Significant difference wasfound among the two chronotype tails (p=0.000,Chi-square 31.13. No correlation was foundbetween academic performance and age, sex,chronotype, week sleep deficit and sleep hours inweek and weekends. A 71.1% of the students slept6 or fewer hours during class time and 78% hada sleep deficit (more frequent in the eveningchronotype. Conclusions: No relation was foundbetween sleep chronotype and academic performance.Students tend to morningness. Fewstudies have been made on equatorial zones orwithout seasons.

  5. Cost analysis of awake versus asleep deep brain stimulation: a single academic health center experience.

    Science.gov (United States)

    Jacob, R Lorie; Geddes, Jonah; McCartney, Shirley; Burchiel, Kim J

    2016-05-01

    less than the expected cost (ratio 0.97). CONCLUSIONS In this single academic medical center cost analysis, DBS performed asleep was associated with a lower cost variation relative to the awake procedure. Furthermore, costs compared favorably to UHC-affiliated hospitals. While asleep DBS is not yet standard practice, this center exclusively performs asleep DBS at a lower cost than comparable institutions.

  6. Teaching in Medical Education | Center for Cancer Research

    Science.gov (United States)

    Many postdoctoral fellows are considering an academic career at a medical school. In addition to conducting research, new faculty members must learn effective teaching methodologies. This course will focus on good teaching practices, including basic strategies for developing and organizing a course. The purpose of the "Teaching in Medical Education (TIME)" course is to increase the scientist's ability to teach in medical education. The course will provide basic knowledge in teaching methods, course planning, writing a syllabus and developing examinations.

  7. The relationship among self-efficacy, perfectionism and academic burnout in medical school students.

    Science.gov (United States)

    Yu, Ji Hye; Chae, Su Jin; Chang, Ki Hong

    2016-03-01

    The purpose of this study was to examine the relationship among academic self-efficacy, socially-prescribed perfectionism, and academic burnout in medical school students and to determine whether academic self-efficacy had a mediating role in the relationship between perfectionism and academic burnout. A total of 244 first-year and second-year premed medical students and first- to fourth-year medical students were enrolled in this study. As study tools, socially-prescribed perfectionism, academic self-efficacy, and academic burnout scales were utilized. For data analysis, correlation analysis, multiple regression analysis, and hierarchical multiple regression analyses were conducted. Academic burnout had correlation with socially-prescribed perfectionism. It had negative correlation with academic self-efficacy. Socially-prescribed perfectionism and academic self-efficacy had 54% explanatory power for academic burnout. When socially-prescribed perfectionism and academic self-efficacy were simultaneously used as input, academic self-efficacy partially mediated the relationship between socially-prescribed perfectionism and academic burnout. Socially-prescribed perfectionism had a negative effect on academic self-efficacy, ultimately triggering academic burnout. This suggests that it is important to have educational and counseling interventions to improve academic self-efficacy by relieving academic burnout of medical school students.

  8. The relationship among self-efficacy, perfectionism and academic burnout in medical school students

    Directory of Open Access Journals (Sweden)

    Ji Hye Yu

    2016-03-01

    Full Text Available Purpose: The purpose of this study was to examine the relationship among academic self-efficacy, socially-prescribed perfectionism, and academic burnout in medical school students and to determine whether academic self-efficacy had a mediating role in the relationship between perfectionism and academic burnout. Methods: A total of 244 first-year and second-year premed medical students and first- to fourth-year medical students were enrolled in this study. As study tools, socially-prescribed perfectionism, academic self-efficacy, and academic burnout scales were utilized. For data analysis, correlation analysis, multiple regression analysis, and hierarchical multiple regression analyses were conducted. Results: Academic burnout had correlation with socially-prescribed perfectionism. It had negative correlation with academic self-efficacy. Socially-prescribed perfectionism and academic self-efficacy had 54% explanatory power for academic burnout. When socially-prescribed perfectionism and academic self-efficacy were simultaneously used as input, academic self-efficacy partially mediated the relationship between socially-prescribed perfectionism and academic burnout. Conclusion: Socially-prescribed perfectionism had a negative effect on academic self-efficacy, ultimately triggering academic burnout. This suggests that it is important to have educational and counseling interventions to improve academic self-efficacy by relieving academic burnout of medical school students.

  9. Academic Pancreas Centers of Excellence: Guidance from a multidisciplinary chronic pancreatitis working group at PancreasFest

    Science.gov (United States)

    Sheth, Sunil G.; Conwell, Darwin L.; Whitcomb, David C.; Alsante, Matthew; Anderson, Michelle A.; Barkin, Jamie; Brand, Randall; Cote, Gregory A.; Freedman, Steven D.; Gelrud, Andres; Gorelick, Fred; Lee, Linda S.; Morgan, Katherine; Pandol, Stephen; Singh, Vikesh K.; Yadav, Dhiraj; Mel Wilcox, C.; Hart, Phil A.

    2017-01-01

    Chronic pancreatitis (CP) is a progressive inflammatory disease, which leads to loss of pancreatic function and other disease-related morbidities. A group of academic physicians and scientists developed comprehensive guidance statements regarding the management of CP that include its epidemiology, diagnosis, medical treatment, surgical treatment, and screening. The statements were developed through literature review, deliberation, and consensus opinion. These statements were ultimately used to develop a conceptual framework for the multidisciplinary management of chronic pancreatitis referred to as an academic pancreas center of excellence (APCOE). PMID:28268158

  10. Use of laptop computers in an academic medical library.

    Science.gov (United States)

    Atlas, Michel C; Garza, Felix; Hinshaw, Ren

    2007-01-01

    Who borrows laptop computers in an academic health sciences library? Why do they choose to check out laptops? In a survey, laptop computer users responded that the laptops were used most frequently to do class-related work. Laptops were most often checked out because they could be taken to a quiet area of the library or to where the user had more room to work. The majority of such borrowers were satisfied or very satisfied with the laptops and the service from the library. The majority of those completing the survey were medical school students and graduate students. The circulation of laptop computers at this academic health sciences library is a very successful and popular program.

  11. Does academic assessment system type affect levels of academic stress in medical students? A cross-sectional study from Pakistan

    OpenAIRE

    Ali, Madiha; Asim, Hamna; Edhi, Ahmed Iqbal; Hashmi, Muhammad Daniyal; Khan, Muhammad Shahjahan; Naz, Farah; Qaiser, Kanza Noor; Qureshi, Sidra Masud; Zahid, Mohammad Faizan; Jehan, Imtiaz

    2015-01-01

    Introduction: Stress among medical students induced by academic pressures is on the rise among the student population in Pakistan and other parts of the world. Our study examined the relationship between two different systems employed to assess academic performance and the levels of stress among students at two different medical schools in Karachi, Pakistan.Methods: A sample consisting of 387 medical students enrolled in pre-clinical years was taken from two universities, one employing the se...

  12. Academic misconduct among students in medical colleges of Karachi, Pakistan.

    Science.gov (United States)

    Hafeez, Kamran; Laiq-Uz-Zaman Khan, Muhammad; Jawaid, Masood; Haroon, Saroona

    2013-05-01

    To determine the trends of academic misconduct in undergraduate students of different private and government section medical institutes. This cross sectional study was conducted at three medical colleges of Karachi, Pakistan. The students were evaluated by giving a self reported questionnaire containing various questions assessing their educational dishonesty and cheating behaviors. A total of 274 students from different years completed the questionnaire. Mean age was 21.48 ± 1.89 years. Most of the students were in 4(th) year (n=86; 31.3%). There were 182 (66.5%) females and 92 (33.5%) males. Majority of the students (n=155; 55.1%) accepted that they have cheated at least once. There was no significant difference regarding acceptance of cheating among different years of study (p=0.23) however females were found to accept cheating more as compared to males (p=0.036). First year students were found more to ask teachers for answers during OSCE (p=0.01). A large number of students accepted that they mark proxy for their friends (85.7%) and also ask their friends to mark proxy for them (85.03%). Nearly half (44.02%) of the students rotating in wards also admitted to write fake histories. A large number of medical students admitted cheating and involvement in other academic misconduct. We need to improve our educational system, formally add professional session and strict disciplinary action should be taken against those who are found guilty.

  13. 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

    2017-09-14

    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.Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a "work of the United States Government" for which copyright protection under Title 17 of the United States Code is not available. As such

  14. Getting off the bandwagon: an academic health center takes a different strategic path.

    Science.gov (United States)

    Malvey, D; Hyde, J C; Topping, S; Woodrell, F D

    2000-01-01

    Focusing on one state university academic health center (AHC) located in a rural setting in the southeastern United States, this case study investigates the strategic response to the increasingly turbulent and competitive environment in the healthcare industry. The qualitative research reported here involved a review of pertinent documents and archival data and interviews with key informants including AHC executives and staff, community leaders, and others. Additional information was obtained from published sources, including a literature review that covers a five-year period ending in 1997 and searches conducted using the key words "academic medical or health center." The AHC in this case study demonstrates how it is possible to respond proactively to changes in the environment without sacrificing the multiple missions of the institution. This AHC implemented strategies that ensure access for both inner city and rural underserved populations while providing venues for primary care training and educational programs. In addition, the AHC positioned itself to compete more effectively by implementing a continuous quality improvement program that is aimed at maximizing quality while controlling costs. Administrators in not only AHCs but also other healthcare organizations, such as community hospitals and competing systems, should consider the findings from this case study useful in evaluating existing strategies and possible alternatives. In particular, the use of an affiliation strategy for growth in a resource-poor environment may encourage organizations located in rural areas to consider innovative expansion strategies to develop integrated systems of care.

  15. Clinical and academic uses of smartphones among medical residents

    Directory of Open Access Journals (Sweden)

    Muhammad Haseeb

    2015-01-01

    Full Text Available Background and Objective: A smartphone is a cellular phone with an integrated computer that enables it to perform a wide array of tasks in addition to its primary purpose. Technological growth has been paralleled by a similar rise in the capabilities of modern day smartphones. And they have found their way into medical education as well as practice. iOS and Android based phones constitute the bulk of the smartphones. Together with their associated applications (apps, these devices have become an indispensable tool for the medical resident and practicing physician. The aim of this study is to make an objective assessment of the status of smartphones as a learning aid and practice tool among medical residents. Materials and Methods: The study was conducted on post-graduate trainees in the largest teaching hospital in Jammu province. The residents were approached in the hospital and requested to fill a pre-formulated questionnaire. 90 residents from different specialities were approached over a period of seven days. Results: 80% of the interviewees said they possessed a smartphone. The percentage was lower in first year trainees and highest in third year trainees. Android and iOS based phones were the devices most commonly used. 90% of those with smartphones said they used it for clinical or academic purposes in the hospital. Conclusion: A fairly large percentage of medical residents own smartphones. Most of them use these for clinical and academic purposes. Online resources and pre-installed apps are the two common resources accessed. There is a need for improving the credibility of online resources, and development of more medical apps for smartphones.

  16. Selecting medical students for academic and attitudinal outcomes in a Catholic medical school.

    Science.gov (United States)

    Quinlivan, Julie A; Lam, Lawrence T; Wan, Siu hong; Petersen, Rodney W

    2010-09-20

    To evaluate whether the four criteria used by the University of Notre Dame Australia (UNDA) to select medical students are successful in selecting for graduates with the desired outcomes of academic excellence and Catholic "mission fit". Prospective cohort study of medical students selected for 2008 and 2009 entry to UNDA in Sydney, New South Wales. The statistical association between the two academic selection criteria of the Graduate Australian Medical School Admissions Test (GAMSAT) and grade point average (GPA) compared with the outcome of medical school examination performance, and the two mission selection criteria of a portfolio score and interview score compared with the outcome of a positive attitude towards serving underserved communities as measured using the Medical Student Attitudes Toward the Underserved (MSATU) test. A total of 223 students were enrolled. GAMSAT section 3, GPA and the interview scores were significantly positively associated with academic performance (P attitude towards serving underserved communities, as measured by the MSATU score. None of the four selection tools used were significantly associated with medical students who had a positive attitude towards serving underserved communities.

  17. [E-learning in ENT: Usage in University Medical Centers in Germany].

    Science.gov (United States)

    Freiherr von Saß, Peter; Klenzner, Thomas; Scheckenbach, Kathrin; Chaker, Adam

    2017-03-01

    E-learning is an essential part of innovative medical teaching concepts. The challenging anatomy and physiology in ENT is considered particularly suitable for self-assessed and adaptive e-learning. Usage and data on daily experience with e-learning in German ENT-university hospitals are currently unavailable and the degree of implementation of blended learning including feed-back from medical students are currently not known. We investigated the current need and usage of e-learning in academic ENT medical centers in Germany. We surveyed students and chairs for Otorhinolaryngology electronically and paperbased during the summer semester 2015. Our investigation revealed an overall heterogenous picture on quality and quantity of offered e-learning applications. While the overall amount of e-learning in academic ENT in Germany is rather low, at least half of the ENT-hospitals in medical faculties reported that e-learning had improved their own teaching activities. More collaboration among medical faculties and academic ENT-centers may help to explore new potentials, overcome technical difficulties and help to realize more ambitious projects. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Medication wrong route administration: a poisons center-based study

    OpenAIRE

    Bloch-Teitelbaum, Alexandra; Lüde, Saskia; Rauber-Lüthy, Christine; Kupferschmidt, Hugo; Russmann, Stefan; Kullak-Ublick, Gerd A.; Ceschi, Alessandro

    2013-01-01

    OBJECTIVES: To describe clinical effects, circumstances of occurrence, management and outcomes of cases of inadvertent administration of medications by an incorrect parenteral route. METHODS: Retrospective single-center consecutive review of parenteral route errors of medications, reported to our center between January 2006 and June 2010. We collected demographic data and information on medications, route and time of administration, severity of symptoms/signs, treatment, and outcome. RE...

  19. Non-academic attributes of hidden curriculum in medical schools.

    Science.gov (United States)

    Khan, Aamer Zaman

    2013-01-01

    To identify the non-academic attributes developed during 5 years of training in medical school. Sequential mixed method. The study was conducted on final year medical students of four medical colleges in the city of Lahore, from March to September 2010. Probability random sampling was employed to identify public sector medical colleges for inclusion in the study through Lottery method. In the first phase, survey was done with the help of questionnaires, distributed amongst 280 students, selected on the basis of convenience sampling. It was triangulated with data collected by in-depth structured interviews on 46 students selected using purposive sampling after formal informed consent. For quantitative data percentages of the categorical variables were calculated through SPSS version 10. For qualitative data, themes and patterns were identified using Content Analysis technique. Majority of the medical students (80%) learn the attributes of integrity, self-reliance, tolerance and independence during their schooling. Sixty five percent students thought that the values of humanity, forbearance, righteous attitude in face of adversities and sympathetic behaviour towards peers and patients helped them in being better medical students. Thirty five percent said they faced the negative influences of gender bias and gender discrimination which has led to their impaired professional growth. Eighty percent of the students believe that the teaching methodology employed is teacher centric which does not let them become problem solvers, team players, reflective learners and hampers development of effective communication skills. Medical schooling in our part of the world helps in developing untaught attributes such as integrity, selfreliance, tolerance, independence, sympathetic attitude and good communication skills which are the same as are developed in the medical students of advanced countries, which can be fostered further by formally addressing them in the curriculum.

  20. Work-family balance and academic advancement in medical schools.

    Science.gov (United States)

    Fox, Geri; Schwartz, Alan; Hart, Katherine M

    2006-01-01

    This study examines various options that a faculty member might exercise to achieve work-family balance in academic medicine and their consequences for academic advancement. Three data sets were analyzed: an anonymous web-administered survey of part-time tenure track-eligible University of Illinois College of Medicine (UI-COM) faculty members conducted in 2003; exogenous data regarding the entire UI-COM faculty; and tenure rollback ("stop-the-clock") usage by all tenure track-eligible UI-COM faculty from 1994 to 2003. The data reveal a gender split in career-family balance priorities that affect academic advancement among part-time faculty. Women select part-time status for child care; men choose part-time to moonlight. Similarly, among all faculty members seeking tenure rollbacks, women request rollback for child care; men request rollback for other reasons. Among all faculty members, full-time men were more likely to be on the tenure track than any other group. Needs identified by the part-time faculty survey include improved mentoring in track selection, heightened awareness of options, such as tenure rollback, and provision of equitable benefits and opportunities. Policy changes, such as a prorated tenure track, are needed to support a family-friendly culture with flexibility throughout the career lifespan for both men and women medical faculty.

  1. Gender difference in academic planning activity among medical students.

    Directory of Open Access Journals (Sweden)

    Huy Van Nguyen

    Full Text Available BACKGROUND: In Vietnam, as doctor of medicine is socially considered a special career, both men and women who are enrolled in medical universities often study topics of medicine seriously. However, as culturally expected, women often perform better than men. Because of this, teaching leadership and management skill (LMS to develop academic planning activity (APA for female medical students would also be expected to be more effective than male counterparts. This research aimed to compare by gender the effect of teaching LMS on increasing APA, using propensity score matching (PSM. METHODS: In a cross-sectional survey utilizing a self-reported structured questionnaire on a systematic random sample of 421 male and female medical students in Hanoi Medical University, this study adopted first regression techniques to construct a fit model, then PSM to create a matched control group in order to allow for evaluating the effect of LMS education. RESULTS: There were several interesting gender differences. First, while for females LMS education had both direct and indirect effects on APA, it had only direct effect on males' APA. Second, after PSM to adjust for the possible confounders to balance statistically two groups - with and without LMS education, there is statistically a significant difference in APA between male and female students, making a net difference of 11% (p<.01, equivalent to 173 students. The difference in APA between exposed and matched control group in males and females was 9% and 20%, respectively. These estimates of 9.0 and 20.0 percentage point increase can be translated into the practice of APA by 142 males and 315 females, respectively, in the population. These numbers of APA among male and female students can be explained by LMS education. CONCLUSIONS: Gender appears to be a factor explaining in part academic planning activity.

  2. Implementing Personalized Medicine in the Academic Health Center

    OpenAIRE

    Weiss, Scott T.

    2016-01-01

    Recently we at Partners Health Care had a series of articles in the Journal of Personalized Medicine describing how we are going about implementing Personalized Medicine in an academic health care system [1–10].[...

  3. Implementing Personalized Medicine in the Academic Health Center.

    Science.gov (United States)

    Weiss, Scott T

    2016-09-21

    Recently we at Partners Health Care had a series of articles in the Journal of Personalized Medicine describing how we are going about implementing Personalized Medicine in an academic health care system [1-10].[...].

  4. Visual screening of oral cavity cancer in a male population: Experience from a medical center

    OpenAIRE

    Chang, I-How; Jiang, Rong-San; Wong, Yong-Kie; Wu, Shang-Heng; Chen, Fun-Jou; Liu, Shih-An

    2011-01-01

    Background: We aimed to evaluate the effectiveness of an oral cavity cancer visual screening program conducted in a tertiary academic medical center. We also wanted to determine which group of participants was at greater risk of contracting oral cavity cancer. Methods: Participants were first asked to relate their personal habits during the past 6 months. Visual screening of the oral cavity was then performed under adequate lighting and with proper instruments. Results: From March 2005 ...

  5. Faculty and student perceptions of academic counselling services at an academic health science center.

    Science.gov (United States)

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

    2013-06-01

    There are limited data on support services that facilitate students' academic success at academic health science centres. The authors explored faculty and students' perceptions of available academic counselling services (ACS) at an academic health science centre in the Southeastern United States. Participants were surveyed in May and June of 2011 regarding the ACS available at the institution. Fifty-nine percent of faculty respondents (N = 471) agreed that academic counselling was a necessary part of the institution, but only 26 % reported knowledge of how to refer students for academic counselling. Only 18 % stated they had previously referred a student for services. Fifty-four percent of student respondents (N = 360) agreed that academic counselling was a necessary part of the institution and 60 % stated that they would seek these services if needed. However, only 35 % of students reported that they were aware of how to access the services. These findings suggest a discrepancy between the belief that academic support services have value and their knowledge about how to utilize the services. It is recommended that academic health science centres consider the promotion of available academic support services amongst both faculty and students when designing and implementing programmes to reduce this potential obstacle to service utilization.

  6. Undergraduate medical academic performance is improved by scientific training.

    Science.gov (United States)

    Zhang, Lili; Zhang, Wei; Wu, Chong; Liu, Zhongming; Cai, Yunfei; Cao, Xingguo; He, Yushan; Liu, Guoxiang; Miao, Hongming

    2017-09-01

    The effect of scientific training on course learning in undergraduates is still controversial. In this study, we investigated the academic performance of undergraduate students with and without scientific training. The results show that scientific training improves students' test scores in general medical courses, such as biochemistry and molecular biology, cell biology, physiology, and even English. We classified scientific training into four levels. We found that literature reading could significantly improve students' test scores in general courses. Students who received scientific training carried out experiments more effectively and published articles performed better than their untrained counterparts in biochemistry and molecular biology examinations. The questionnaire survey demonstrated that the trained students were more confident of their course learning, and displayed more interest, motivation and capability in course learning. In summary, undergraduate academic performance is improved by scientific training. Our findings shed light on the novel strategies in the management of undergraduate education in the medical school. © 2017 by The International Union of Biochemistry and Molecular Biology, 45(5):379-384, 2017. © 2017 The International Union of Biochemistry and Molecular Biology.

  7. Team effectiveness in academic medical libraries: a multiple case study*

    Science.gov (United States)

    Russo Martin, Elaine

    2006-01-01

    Objectives: The objective of this study is to apply J. Richard Hackman's framework on team effectiveness to academic medical library settings. Methods: The study uses a qualitative, multiple case study design, employing interviews and focus groups to examine team effectiveness in three academic medical libraries. Another site was selected as a pilot to validate the research design, field procedures, and methods to be used with the cases. In all, three interviews and twelve focus groups, with approximately seventy-five participants, were conducted at the case study libraries. Findings: Hackman identified five conditions leading to team effectiveness and three outcomes dimensions that defined effectiveness. The participants in this study identified additional characteristics of effectiveness that focused on enhanced communication, leadership personality and behavior, and relationship building. The study also revealed an additional outcome dimension related to the evolution of teams. Conclusions: Introducing teams into an organization is not a trivial matter. Hackman's model of effectiveness has implications for designing successful library teams. PMID:16888659

  8. Institutional Research at (and for) Academic Health Centers: Who's Doing What? AIR 1992 Annual Forum Paper.

    Science.gov (United States)

    Freeman, Irving; Dailey, Don E.

    A study was done of the characteristics of institutional research in 51 academic health centers. Overall, slightly less than half of the centers had an identifiable institutional research unit. In general, the more autonomous the center from its parent campus, the more likely it was that it would have a separate institutional research unit. The…

  9. Tradition Meets Innovation: Transforming Academic Medical Culture at the University of Pennsylvania’s Perelman School of Medicine

    Science.gov (United States)

    Pati, Susmita; Reum, Josef; Conant, Emily; Tuton, Lucy Wolf; Scott, Patricia; Abbuhl, Stephanie; Grisso, Jeane Ann

    2013-01-01

    Traditional performance expectations and career advancement paths for academic physicians persist despite dramatic transformations in the academic workflow, workload, and workforce over the past twenty years. While the academic physician’s triple role as clinician, researcher, and educator has been lauded as the ideal by academic medical centers, current standards of excellence for promotion and tenure are based on outdated models. These models fail to reward collaboration and center around rigid career advancement plans that do little to accommodate the changing needs of individuals and organizations. Here, the authors describe an innovative, comprehensive, multi-pronged initiative at the Perelman School of Medicine at the University of Pennsylvania to initiate change in the culture of academic medicine and improve academic productivity, job satisfaction, and overall quality of life for junior faculty. As a key part of this intervention, task forces from each of the 13 participating departments/divisions met 5 times between September 2010 and January 2011 to produce recommendations for institutional change. The authors discuss how this initiative, using principles adopted from business transformation, generated themes and techniques that can potentially guide workforce environment innovation in academic health centers across the United States. Recommendations include embracing a promotion/tenure/evaluation system that supports and rewards tailored individual academic career plans; ensuring leadership, decision-making roles and recognition for junior faculty; deepening administrative and team supports for junior faculty; and solidifying and rewarding mentorship for junior faculty. By doing so, academic health centers can ensure the retention and commitment of faculty throughout all stages of their careers. PMID:23425986

  10. Operations improvement and reengineering at Ohio State University Medical Center.

    Science.gov (United States)

    Marsh, G; Guanciale, T; Simon, M

    1995-08-01

    Rising costs and increasing competition have forced hospitals to respond to the needs of their customers. At Ohio State University Medical Center, operations improvement and reengineering are being used to redesign processes and to position the medical center competitively in today's changing environment. An operations improvement team identified business processes with the greatest opportunity for positive impact based on the goals of the medical center. Next, these areas were prioritized and teams appointed to begin the reengineering process. Reengineering methods focused on specific outcomes, including improved patient satisfaction, reduced cost, and improved clinical and service quality. Throughout the process, the goals and successes of reengineering were communicated to the organization and community.

  11. Does academic assessment system type affect levels of academic stress in medical students? A cross-sectional study from Pakistan

    National Research Council Canada - National Science Library

    Ali, Madiha; Asim, Hamna; Edhi, Ahmed Iqbal; Hashmi, Muhammad Daniyal; Khan, Muhammad Shahjahan; Naz, Farah; Qaiser, Kanza Noor; Qureshi, Sidra Masud; Zahid, Mohammad Faizan; Jehan, Imtiaz

    2015-01-01

    .... Our study examined the relationship between two different systems employed to assess academic performance and the levels of stress among students at two different medical schools in Karachi, Pakistan...

  12. Academic misconduct among students in medical colleges of Karachi, Pakistan

    Science.gov (United States)

    Hafeez, Kamran; Laiq-uz-Zaman Khan, Muhammad; Jawaid, Masood; Haroon, Saroona

    2013-01-01

    Objective: To determine the trends of academic misconduct in undergraduate students of different private and government section medical institutes. Methodology: This cross sectional study was conducted at three medical colleges of Karachi, Pakistan. The students were evaluated by giving a self reported questionnaire containing various questions assessing their educational dishonesty and cheating behaviors. Results: A total of 274 students from different years completed the questionnaire. Mean age was 21.48 ± 1.89 years. Most of the students were in 4th year (n=86; 31.3%). There were 182 (66.5%) females and 92 (33.5%) males. Majority of the students (n=155; 55.1%) accepted that they have cheated at least once. There was no significant difference regarding acceptance of cheating among different years of study (p=0.23) however females were found to accept cheating more as compared to males (p=0.036). First year students were found more to ask teachers for answers during OSCE (p=0.01). A large number of students accepted that they mark proxy for their friends (85.7%) and also ask their friends to mark proxy for them (85.03%). Nearly half (44.02%) of the students rotating in wards also admitted to write fake histories. Conclusion: A large number of medical students admitted cheating and involvement in other academic misconduct. We need to improve our educational system, formally add professional session and strict disciplinary action should be taken against those who are found guilty. PMID:24353611

  13. 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…

  14. 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

  15. 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.

  16. Equine Medical Center Appoints Veterinary Advisory Board Members

    OpenAIRE

    Nadjar, Ann

    2003-01-01

    A Veterinary Advisory Board, comprised of Virginia- and Maryland-based equine practitioners, has been established to help the Marion duPont Scott Equine Medical Center continue its quest to provide excellence in equine healthcare for the region.

  17. Defining the medical imaging requirements for a rural health center

    CERN Document Server

    2017-01-01

    This book establishes the criteria for the type of medical imaging services that should be made available to rural health centers, providing professional rural hospital managers with information that makes their work more effective and efficient. It also offers valuable insights into government, non-governmental and religious organizations involved in the planning, establishment and operation of medical facilities in rural areas. Rural health centers are established to prevent patients from being forced to travel to distant urban medical facilities. To manage patients properly, rural health centers should be part of regional and more complete systems of medical health care installations in the country on the basis of a referral and counter-referral program, and thus, they should have the infrastructure needed to transport patients to urban hospitals when they need more complex health care. The coordination of all the activities is only possible if rural health centers are led by strong and dedicated managers....

  18. Organization development at work in a medical center.

    Science.gov (United States)

    Russell, A Y; Zimmerman, S; Bruce, R

    1978-01-01

    Organization development can work: Valley Medical Center in San Jose, California, has successfully restructured multiple lines of authority in the process of installing modern management and fiscal control processes.

  19. University of Nebraska Medical Center | Division of Cancer Prevention

    Science.gov (United States)

    Principal investigator: Michael (Tony) A. Hollingsworth, PhD Institution: Research Unit - University of Nebraska Medical Center Title of the PCDC Project This page is under construction. Please check back at a later date. |

  20. [SOROKA UNIVERSITY MEDICAL CENTER: THE ROAD TO LEADERSHIP IN QUALITY OF MEDICAL CARE, SERVICE AND RESEARCH].

    Science.gov (United States)

    Davidson, Ehud; Sheiner, Eyal

    2016-02-01

    Soroka University Medical Center is a tertiary hospital, and the sole medical center in the Negev, the southern part of Israel. Soroka has invested in quality, service and research. The region has developed joint programs in order to advance the quality of medical care whilst optimizing the utilization of available resources. In this editorial we describe the path to leadership in quality of medical care, service and research.

  1. Professionalism score and academic performance in osteopathic medical students.

    Science.gov (United States)

    Snider, Karen T; Johnson, Jane C

    2014-11-01

    During the first 2 years of osteopathic medical school, osteopathic manipulative medicine (OMM) courses use an objective professionalism score to measure student timeliness and appropriate dress for learning activities. To assess for correlations between this score and the numeric course grades of all first- and second-year basic science and clinical courses at a single osteopathic medical school. The professionalism scores obtained for each of the 7 quarters of the OMM course (2007-2012) were compared with the students' numeric final course grades and combined grade point average (GPA) of all courses in the corresponding quarter. Spearman correlation coefficients were used to determine the strength of the relationship between the professionalism score and the final course grades and the combined GPA. The mean (SD) professionalism score was 98.6% (3.3%), and scores ranged from 23.1% to 100%. Excluding the OMM course, the professionalism score was positively correlated with 29% of first-year course grades and 65% of second-year course grades. The professionalism score was predictive of academic performance in 16 of 23 clinical courses with the highest correlation for Principles of Medicine and Dermatology (ρ=0.28 and ρ=0.25, respectively). The OMM professionalism score was positively associated with GPA for quarters 1, 6, and 7 (P=.006, Posteopathic medical school courses, particularly clinical courses in the second-year curriculum. © 2014 The American Osteopathic Association.

  2. A Structural Model of Stress, Motivation, and Academic Performance in Medical Students

    National Research Council Canada - National Science Library

    Park, Jangho; Chung, Seockhoon; An, Hoyoung; Park, Seungjin; Lee, Chul; Kim, Seong Yoon; Lee, Jae-Dam; Kim, Ki-Soo

    2012-01-01

    .... Psychological parameters were assessed with the Medical Stress Scale, Minnesota Multiphasic Personality Inventory, Hamilton Depression Scale, Beck Depression Inventory, and Academic Motivation Scale...

  3. Cultures in conflict: a challenge to faculty of academic health centers.

    Science.gov (United States)

    Magill, M K; Catinella, A P; Haas, L; Hughes, C C

    1998-08-01

    Academic health centers (AHCs) are experiencing turmoil in all three of their traditional missions of teaching, research, and patient care. The authors examine origins of universities and medical education to place in historical context the stresses affecting AHCs at the end of the 20th century. They describe the cultures of the university to suggest strategies for successful adaptation to these stresses. Clashes of values and norms of the cultures within universities and AHCs can hinder effective adaptation to external change. Administrators, researchers, teachers, and clinicians can have strongly conflicting perspectives. For example, business skill is of increasing importance to the survival of the clinical enterprise, but not typically valued by faculty members. University faculty have often considered accountability as antithetical to academic freedom, and, until recently, accountability was not strongly demanded of AHCs. The authors conclude that AHC faculty must transcend the outdated view that the roles of the scholar, scientist, and healer are in opposition to those of the leader and manager. If AHCs are to survive and prosper through their current cultural transition, their faculty must understand all these roles as part of their intellectual and organizational responsibility.

  4. The Emerging Role of the Chief Research Informatics Officer in Academic Health Centers.

    Science.gov (United States)

    Sanchez-Pinto, L Nelson; Mosa, Abu S M; Fultz-Hollis, Kate; Tachinardi, Umberto; Barnett, William K; Embi, Peter J

    2017-08-16

    The role of the Chief Research Informatics Officer (CRIO) is emerging in academic health centers to address the challenges clinical researchers face in the increasingly digitalized, data-intensive healthcare system. Most current CRIOs are the first officers in their institutions to hold that role. To date there is very little published information about this role and the individuals who serve it. To increase our understanding of the CRIO role, the leaders who serve it, and the factors associated with their success in their organizations. The Clinical Research Informatics Working Group of the American Medical Informatics Association (AMIA) conducted a national survey of CRIOs in the United States and convened an expert panel of CRIOs to discuss their experience during the 2016 AMIA Annual Symposium. CRIOs come from diverse academic backgrounds. Most have advance training and extensive experience in biomedical informatics but the majority have been CRIOs for less than three years. CRIOs identify funding, data governance, and advancing data analytics as their major challenges. CRIOs play an important role in helping shape the future of clinical research, innovation, and data analytics in healthcare in their organizations. They share many of the same challenges and see the same opportunities for the future of the field. Better understanding the background and experience of current CRIOs can help define and develop the role in other organizations and enhance their influence in the field of research informatics.

  5. School-Based Health Centers and Academic Success

    Science.gov (United States)

    National Assembly on School-Based Health Care, 2012

    2012-01-01

    Poor academic outcomes and high dropout rates are major concerns of educators, policy makers, and parents alike--and poor health severely limits a child's motivation and ability to learn. Recent research confirms that "health disparities affect educational achievement". Improving students' health is integral to education reform.…

  6. A Medical Center Network for Optimized Lung Cancer Biospecimen Banking

    Science.gov (United States)

    2015-10-01

    1 Award Number: W81XWH-10-1-0818 TITLE: “A Medical Center Network for Optimized Lung Cancer Biospecimen Banking ” PRINCIPAL INVESTIGATOR: Christopher...To) 20Sep2014 - 19Sep2015 4. TITLE AND SUBTITLE “A Medical Center Network for Optimized Lung Cancer Biospecimen Banking ” 5a. CONTRACT NUMBER 5b...Although new subject enrollments and specimen collection have ceased, the LCBRN is committed to the outcome of this project, which is a bank of

  7. A SIMULATION MODEL FOR EMERGENCY MEDICAL SERVICES CALL CENTERS

    NARCIS (Netherlands)

    M. van Buuren (Martin); G.J. Kommer (Geert Jan); R.D. van der Mei (Rob); S. Bhulai (Sandjai); L. Yilmaz; W.K.V. Chan; I. Moon; T.M.K. Roeder; C. Macal; M.D. Rosetti

    2015-01-01

    htmlabstractIn pre-hospital health care the call center plays an important role in the coordination of emergency medical services (EMS). An EMS call center handles inbound requests for EMS and dispatches an ambulance if necessary. The time needed for triage and dispatch is part of the total response

  8. A simulation model for emergency medical services call centers

    NARCIS (Netherlands)

    van Buuren, M.; Kommer, G.J.; van der Mei, R.D.; Bhulai, S.

    2015-01-01

    In pre-hospital health care the call center plays an important role in the coordination of emergency medical services (EMS). An EMS call center handles inbound requests for EMS and dispatches an ambulance if necessary. The time needed for triage and dispatch is part of the total response time to the

  9. A simulation model for emergency medical services call centers

    NARCIS (Netherlands)

    M. van Buuren (Martin); G.J. Kommer (Geert Jan); R.D. van der Mei (Rob); S. Bhulai (Sandjai)

    2015-01-01

    htmlabstractIn pre-hospital health care the call center plays an important role in the coordination of emergency medical services (EMS). An EMS call center handles inbound requests for EMS and dispatches an ambulance if necessary. The time needed for triage and dispatch is part of the total response

  10. Commentary: Change we must: putting patients first with the institute model of academic health center organization.

    Science.gov (United States)

    Young, James B; Cosgrove, Delos M

    2012-05-01

    In the traditional department-based organizational structure of an academic health center, patients can be neglected as a result of fragmented systems of care. Specialty-driven, provider-oriented, economically influenced organizations dominated by research and education missions might, paradoxically, promote too little concern for the patient. All three components (education, research, and patient care) of academic health centers' tripartite mission are sacred, but times have changed. Academic health centers must rethink their traditional approach to achieving their mission. The authors describe the evolution at the Cleveland Clinic of a unique, institute-based reorganization that is focused on integrated disease- and organ-system-based patient care, research, and education. The authors argue that this model better focuses on the patient as well as on the institution's academic charge. It is a concept that should be more widely adopted with deference to individual institutional culture and history.

  11. 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.

  12. Realigning the Values of Academic Health Centers: The Role of Innovative Faculty Management.

    Science.gov (United States)

    Arana, George W.; McCurdy, Layton

    1995-01-01

    The current approach to research, teaching, clinical service, and administration at academic health centers is reviewed, and the traditional values underpinning this approach are challenged. A new form of faculty management that matches the individual faculty member's priorities and skills with the health center mission and which focuses on the…

  13. The Academic Computing, Tutoring, and Testing (ACTT) Center Survey--Spring 1996.

    Science.gov (United States)

    Hamilton, John

    As part of an effort to evaluate the Academic Computing, Tutoring, and Testing Center, Gainesville College, in Georgia, surveyed 672 students in morning classes, 424 students in evening classes, and all faculty and staff to determine their use of and satisfaction with the Center. Faculty and staff responses were received from 79 individuals,…

  14. [Relationships among emotional intelligence, ego-resilience, coping efficacy, and academic stress in medical students].

    Science.gov (United States)

    Yoo, Hyo Hyun; Park, Kwi Hwa

    2015-09-01

    The purpose of this study was to identify the causal relationship between emotional intelligence, ego-resilience, coping efficacy, and academic stress. Participants were 424 medical students from four medical schools in Korea. We examined their emotional intelligence, ego-resilience, coping efficacy, and academic stress using a t-test, an analysis of variance, correlational analysis, and path analysis. First- and second-year students scored higher on academic stress than did those from third- and fourth-year students. Further, coping efficacy mediated the relationships between emotional intelligence, ego-resilience, and academic stress. Academic stress was directly influenced by coping efficacy, and indirectly by emotional intelligence and ego-resilience. This showed that coping efficacy play an important role in academic stress. Our findings may help medical schools design educational programs to improve coping efficacy in students, and to reduce their academic stress.

  15. 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…

  16. 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...... educational inequality. We analyze whether the impact of student-centered instructional strategies on academic achievement differs for students with different socioeconomic backgrounds. Results suggest that a student-centered instructional strategy has a negative impact on academic achievement in general...

  17. The relationship between Persecution and perfectionism with Academic achievement and Burnout in medical students

    OpenAIRE

    Zahra Dasht Bozorgi

    2016-01-01

    Aims: The aim of this study was to investigate the relationship between Persecution, Maladjustment perfectionism and Adjustment perfectionism with Academic achievement and Academic Burnout among medical students. Methods: This cross-sectional and correlational study which was performed by medical students from the Medical University of Gondi Shapoor in Ahvaz in 2015. The sample group included 200 medical students who were selected by random-stratified sampling. Procrastination Assessment ...

  18. 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.

  19. A Successful Model for a Comprehensive Patient Flow Management Center at an Academic Health System.

    Science.gov (United States)

    Lovett, Paris B; Illg, Megan L; Sweeney, Brian E

    2016-05-01

    This article reports on an innovative approach to managing patient flow at a multicampus academic health system, integrating multiple services into a single, centralized Patient Flow Management Center that manages supply and demand for inpatient services across the system. Control of bed management was centralized across 3 campuses and key services were integrated, including bed management, case management, environmental services, patient transport, ambulance and helicopter dispatch, and transfer center. A single technology platform was introduced, as was providing round-the-clock patient placement by critical care nurses, and adding medical directors. Daily bed meetings with nurse managers and charge nurses drive action plans. This article reports immediate improvements in the first year of operations in emergency department walkouts, emergency department boarding, ambulance diversion, growth in transfer volume, reduction in lost transfers, reduction in time to bed assignment, and bed turnover time. The authors believe theirs is the first institution to integrate services and centralize bed management so comprehensively. © The Author(s) 2014.

  20. Evaluation of Academic Performance, Academic Motivation, Hope for the Future and Life Satisfaction of Pharmacy Students of a Medical School

    Directory of Open Access Journals (Sweden)

    Armaghan Eslami

    2017-09-01

    Full Text Available Background: This study sought to investigate the evaluation of academic achievement, academic motivation and hope for the future and life satisfaction of Pharmacy Students of the Medical Sciences University of Ahvaz and their relationship with the school years passed.Methods: The samples in this study were all pharmacy students studying in the College of Pharmacy, the Medical University of Ahvaz in the year 93-94. Moreover, standard questionnaires were used by this study for collecting data. In order to collect data with regard to hope, life satisfaction, motivation and academic satisfaction, the questionnaire of Snyder hope Scale (1991, Satisfaction with Life Scale questionnaire (SWLS, lepper motivation scale (2005 and Bahrani and Jokar questionnaire (1378 were used respectively.Moreover, data on Academic performance were acquired using the score of the students and the number of students dropping out in each entry and the data were analysed by using SPSS 20.Results: The results did not indicate any significant different in an investigation of five class of students and from four variables of hope, Academic motivation, academic achievement, life satisfaction. But contrast test for combined group showed that academic motivation and academic performance in freshmen students are significantly higher than the other four inputs.Third-year students possess less Academic motivation than other students.Senior students' Academic performance was also significantly lower than of students from other school years.Conclusion: freshmen students face challenges of the new environment, and this affects their academic performance. Besides in the third year of pharmacy school curriculum, pharmacy students pass the basic exam and the main pharmaceutical courses start for them, this might be the reason that their intrinsic motivation increase.  

  1. 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.

  2. 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.

  3. Possible Link between Medical Students' Motivation for Academic Work and Time Engaged in Physical Exercise

    Science.gov (United States)

    Aung, Myo Nyein; Somboonwong, Juraiporn; Jaroonvanichkul, Vorapol; Wannakrairot, Pongsak

    2016-01-01

    Physical exercise results in an active well-being. It is likely that students' engagement in physical exercise keeps them motivated to perform academic endeavors. This study aimed to assess the relation of time engaged in physical exercise with medical students' motivation for academic work. Prospectively, 296 second-year medical students…

  4. Correlations between Academic Achievement and Anxiety and Depression in Medical Students Experiencing Integrated Curriculum Reform

    OpenAIRE

    Yeh, Yi-Chun; Yen, Cheng-Fang; Lai, Chung-Sheng; Huang, Chun-Hsiung; Liu, Keh-Min; Huang, In-Ting

    2007-01-01

    This study aimed to examine the correlations between academic achievement and levels of anxiety and depression in medical students who were experiencing curriculum reform. The differences in academic achievement and the directions of correlations between academic achievement and anxiety and depression among the medical students with different levels of anxiety and depression were also examined. Grade 1 students from graduate-entry program and grade 3 students from undergraduate-entry program ...

  5. Good sleep quality is associated with better academic performance among Sudanese medical students

    OpenAIRE

    Mirghani, Hyder Osman; Mohammed, Osama Salih; Almurtadha, Yahia Mohamed; Ahmed, Moneir Siddig

    2015-01-01

    Background There is increasing awareness about the association of sleep quality and academic achievement among university students. However, the relationship between sleep quality and academic performance has not been examined in Sudan; this study assessed the relationship between sleep quality and academic performance among Sudanese medical students. Methods A case?control study was conducted among 165 male and female medical students at two Sudanese universities. Excellent (A) and pass (C) ...

  6. Benefits of student-centered tandem teaching in medical English

    Directory of Open Access Journals (Sweden)

    Antić Zorica

    2015-01-01

    Full Text Available This paper addresses some of the key notions about English for special purposes with special regard to English for medical purposes. The content was determined by observations and based on authors’ professional experience. The starting point of a medical English course is a thorough analysis of students’ needs, which is then used in course design and definition of appropriate learning goals. The student is at the center of learning and it is necessary to establish a positive cooperation between students and teachers. As medical English course is highly context-based, the inclusion of medical teachers can offer many opportunities for a successful learning process.

  7. Residency application screening tools: A survey of academic medical centers.

    Science.gov (United States)

    Hillebrand, Kristen; Leinum, Corey J; Desai, Sonya; Pettit, Natasha N; Fuller, Patrick D

    2015-06-01

    The current use and content of screening tools utilized by ASHP-accredited pharmacy residency programs were assessed. A survey consisting of 19 questions assessing residency programs and the screening of pharmacy residency program applicants was e-mailed to residency directors of 362 pharmacy residency programs at 105 University HealthSystem Consortium (UHC)-member institutions. Questions gathered general program demographic information, data related to applicant growth from residency years 2010-11 to 2011-12, and information about the residency screening processes currently used. Responses were received from 73 residency program sites (69.5%) of the 105 UHC-member institutions to whom the e-mail was sent. Many sites used screening tools to calculate applicants' scores and then determined which candidates to invite for an onsite interview based on applicants' scores and group discussion. Seventy-eight percent (n = 57) of the 73 responding institutions reported the use of a screening tool or rubric to select applicants to invite for onsite interviews. The most common method of evaluation was individual applicant review before meeting as a group to discuss candidate selection. The most important factor for determining which residency candidate to interview was the overall impression based on the candidate's curriculum vitae (CV) and letters of recommendation. Most residency programs in UHC-member hospitals used a screening tool to determine which applicants to invite for an onsite interview. The most important factor for determining which residency candidate to interview was the overall impression based on the candidate's CV and letters of recommendation. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  8. Student mistreatment in medical school and planning a career in academic medicine.

    Science.gov (United States)

    Haviland, Mark G; Yamagata, Hisashi; Werner, Leonard S; Zhang, Kehua; Dial, Thomas H; Sonne, Janet L

    2011-01-01

    Student mistreatment in medical school is a persistent problem with both known and unexplored consequences [corrected]. The purpose of this study was to determine whether a perception of having been mistreated in medical school had an association with planning a full-time career in academic medicine. Using Association of American Medical Colleges' 2000-2004 Medical School Graduation Questionnaire data, we evaluated the relationship between students' mistreatment experience and their career choice, academic versus nonacademic setting. Meta-analysis and regression were used to evaluate this relationship. At medical schools where relatively high percentages of graduating seniors were planning academic careers, students reporting mistreatment experiences were less likely at graduation to be planning careers in academic medicine. A perception of having been mistreated in medical school is related to students' career choices, a finding that may be useful to medical school administrators/faculty and students as mistreatment is addressed in program planning, counseling, and faculty recruitment.

  9. A Model for Integrating Ambulatory Surgery Centers Into an Academic Health System Using a Novel Ambulatory Surgery Coordinating Council.

    Science.gov (United States)

    Ishii, Lisa; Pronovost, Peter J; Demski, Renee; Wylie, Gill; Zenilman, Michael

    2016-06-01

    An increasing volume of ambulatory surgeries has led to an increase in the number of ambulatory surgery centers (ASCs). Some academic health systems have aligned with ASCs to create a more integrated care delivery system. Yet, these centers are diverse in many areas, including specialty types, ownership models, management, physician employment, and regulatory oversight. Academic health systems then face challenges in integrating these ASCs into their organizations. Johns Hopkins Medicine created the Ambulatory Surgery Coordinating Council in 2014 to manage, standardize, and promote peer learning among its eight ASCs. The Armstrong Institute for Patient Safety and Quality provided support and a model for this organization through its quality management infrastructure. The physician-led council defined a mission and created goals to identify best practices, uniformly provide the highest-quality patient-centered care, and continuously improve patient outcomes and experience across ASCs. Council members built trust and agreed on a standardized patient safety and quality dashboard to report measures that include regulatory, care process, patient experience, and outcomes data. The council addressed unintentional outcomes and process variation across the system and agreed to standard approaches to optimize quality. Council members also developed a process for identifying future goals, standardizing care practices and electronic medical record documentation, and creating quality and safety policies. The early success of the council supports the continuation of the Armstrong Institute model for physician-led quality management. Other academic health systems can learn from this model as they integrate ASCs into their complex organizations.

  10. Preclinical medical students' understandings of academic and medical professionalism: visual analysis of mind maps.

    Science.gov (United States)

    Janczukowicz, Janusz; Rees, Charlotte E

    2017-08-18

    Several studies have begun to explore medical students' understandings of professionalism generally and medical professionalism specifically. Despite espoused relationships between academic (AP) and medical professionalism (MP), previous research has not yet investigated students' conceptualisations of AP and MP and the relationships between the two. The current study, based on innovative visual analysis of mind maps, therefore aims to contribute to the developing literature on how professionalism is understood. We performed a multilayered analysis of 98 mind maps from 262 first-year medical students, including analysing textual and graphical elements of AP, MP and the relationships between AP and MP. The most common textual attributes of AP were learning, lifestyle and personality, while attributes of MP were knowledge, ethics and patient-doctor relations. Images of books, academic caps and teachers were used most often to represent AP, while images of the stethoscope, doctor and red cross were used to symbolise MP. While AP-MP relations were sometimes indicated through co-occurring text, visual connections and higher-order visual metaphors, many students struggled to articulate the relationships between AP and MP. While the mind maps' textual attributes shared similarities with those found in previous research, suggesting the universality of some professionalism attributes, our study provides new insights into students' conceptualisations of AP, MP and AP-MP relationships. We encourage medical educators to help students develop their understandings of AP, MP and AP-MP relationships, plus consider the feasibility and value of mind maps as a source of visual data for medical education research. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Preclinical medical students’ understandings of academic and medical professionalism: visual analysis of mind maps

    Science.gov (United States)

    Rees, Charlotte E

    2017-01-01

    Introduction Several studies have begun to explore medical students’ understandings of professionalism generally and medical professionalism specifically. Despite espoused relationships between academic (AP) and medical professionalism (MP), previous research has not yet investigated students’ conceptualisations of AP and MP and the relationships between the two. Objectives The current study, based on innovative visual analysis of mind maps, therefore aims to contribute to the developing literature on how professionalism is understood. Methods We performed a multilayered analysis of 98 mind maps from 262 first-year medical students, including analysing textual and graphical elements of AP, MP and the relationships between AP and MP. Results The most common textual attributes of AP were learning, lifestyle and personality, while attributes of MP were knowledge, ethics and patient-doctor relations. Images of books, academic caps and teachers were used most often to represent AP, while images of the stethoscope, doctor and red cross were used to symbolise MP. While AP-MP relations were sometimes indicated through co-occurring text, visual connections and higher-order visual metaphors, many students struggled to articulate the relationships between AP and MP. Conclusions While the mind maps’ textual attributes shared similarities with those found in previous research, suggesting the universality of some professionalism attributes, our study provides new insights into students’ conceptualisations of AP, MP and AP-MP relationships. We encourage medical educators to help students develop their understandings of AP, MP and AP-MP relationships, plus consider the feasibility and value of mind maps as a source of visual data for medical education research. PMID:28821520

  12. Self-reported extracurricular activity, academic success, and quality of life in UK medical students.

    Science.gov (United States)

    Lumley, Sophie; Ward, Peter; Roberts, Lesley; Mann, Jake P

    2015-09-19

    To explore the relationship between academic performance, extracurricular activity, and quality of life at medical school in the UK to aid our understanding of students' work-life balance. A cross-sectional study, using an electronic questionnaire distributed to UK final year medical students across 20 medical schools (4478 students). Participants reported the hours of self-regulated learning and extracurricular activities undertaken each year at medical school; along with their academic decile (1 = highest, 10 = lowest). Self-reported quality of life (QoL) was assessed using an established screening tool (7 = highest, 1 = lowest). Seven hundred responses were obtained, across 20 participating medical schools, response rate 16% (700/4478). Factors associated with higher academic achievement were: graduate entry course students (2 deciles higher, p academic study during term and revision periods (rho=-0.1, p academic achievement and QoL. Graduate-entry students attain higher decile scores despite similar self-reported duration of study.

  13. 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.

  14. Introduction to the special section from recent Association of Psychologists in Academic Health Centers (APAHC) programs.

    Science.gov (United States)

    Klepac, Robert K; Dixon, Kim E

    2010-12-01

    The Association of Psychologists in Academic Health Centers (APAHC) offers programming at the annual American Psychological Association (APA) conventions as well as periodic APAHC conferences. Participants from academic health centers across the country convened in St. Louis, Missouri, October 15-17, 2009, for the 4th National Conference of the Association of Psychologists in Academic Health Centers (APAHC). The title of the conference was ''Psychologists in Academic Health Centers: Facing Tomorrow's Challenges to AHC Programs and Careers.'' Efforts were made to include topics relevant to academic health center (AHC) practice including the unique challenges of working in AHCs and issues pertinent to the different stages of AHC careers. To facilitate networking, opportunities for discussion among conferees and presenters with shared interests and concerns were provided throughout the conference. This paper introduces the special section of JCPMS dedicated to the conference and provides a brief overview of its development and organization. Articles selected for inclusion represent a sampling of the four conference themes: (1) challenges to AHC programs, (2) staying current in critical clinical areas, (3) professional issues and challenges, and (4) challenges to developing careers. Post-conference evaluation data are presented as evidence of the need for further conferences with similar foci. The programming offered by APAHC at the APA convention in San Diego in 2010 built on the themes offered at the 2009 APAHC conference.

  15. Medical egg freezing: the importance of a patient-centered approach to fertility preservation.

    Science.gov (United States)

    Inhorn, Marcia C; Birenbaum-Carmeli, Daphna; Westphal, Lynn M; Doyle, Joseph; Gleicher, Norbert; Meirow, Dror; Raanani, Hila; Dirnfeld, Martha; Patrizio, Pasquale

    2017-11-09

    This binational qualitative study of medical egg freezing (MEF) examined women's motivations and experiences, including their perceived needs for patient-centered care in the midst of fertility- and life-threatening diagnoses. Forty-five women who had undertaken MEF were interviewed in the USA (33 women) and in Israel (12 women) between June 2014 and August 2016. Interviews lasted approximately 1 h and were conducted by two senior medical anthropologists, one in each country. Women were recruited from four American IVF clinics (two academic, two private) and two Israeli clinics (both academic) where MEF is being offered to cancer patients and women with other fertility-threatening medical conditions. Women who undertake MEF view their fertility and future motherhood as important components of their identities and recovery and, thus, are grateful for the opportunity to pursue fertility preservation. However, women who undergo MEF have special needs, given that they tend to be a "vulnerable" population of young (age < 30), unmarried, resource-constrained women, who are facing not only fertility loss but also the "double jeopardy" of cancer. Through in-depth, qualitative interviews, these women's MEF stories reveal 10 dimensions of care important to fertility preservation, including five "system factors" (information, coordination and integration, accessibility, physical comfort, cost) and five "human factors" (adolescent issues, male partner involvement, family involvement, egg disposition decisions, emotional support). Together, these dimensions of care constitute an important framework that can be best described as "patient-centered MEF." Women pursuing MEF have special medical needs and concerns, which require particular forms of patient-centered care. This study outlines 10 dimensions of patient-centered fertility preservation that are appropriate for MEF patients. This approach may help IVF clinics to be better prepared for delivering top-quality care to

  16. Impact of teaching intensity and academic status on medical resource utilization by teaching hospitals in Japan.

    Science.gov (United States)

    Sato, Daisuke; Fushimi, Kiyohide

    2012-11-01

    Teaching hospitals require excess medical resources to maintain high-quality care and medical education. To evaluate the appropriateness of such surplus costs, we examined the impact of teaching intensity defined as activities for postgraduate training, and academic status as functions of medical research and undergraduate teaching on medical resource utilization. Administrative data for 47,397 discharges from 40 academic and 12 non-academic teaching hospitals in Japan were collected. Hospitals were classified into three groups according to intern/resident-to-bed (IRB) ratio. Resource utilization of medical services was estimated using fee-for-service charge schedules and normalized with case mix grouping. 15-24% more resource utilization for laboratory examinations, radiological imaging, and medications were observed in hospitals with higher IRB ratios. With multivariate adjustment for case mix and academic status, higher IRB ratios were associated with 10-15% more use of radiological imaging, injections, and medications; up to 5% shorter hospital stays; and not with total resource utilization. Conversely, academic status was associated with 21-33% more laboratory examinations, radiological imaging, and medications; 13% longer hospital stays; and 10% more total resource utilization. While differences in medical resource utilization by teaching intensity may not be associated with indirect educational costs, those by academic status may be. Therefore, academic hospitals may need efficiency improvement and financial compensation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. A prospective analysis of stress and academic performance in the first two years of medical school.

    Science.gov (United States)

    Stewart, S M; Lam, T H; Betson, C L; Wong, C M; Wong, A M

    1999-04-01

    This study provides prospective, longitudinal data on the relationship between stress-related measures and academic performance during the first two years of medical school. First year medical students (n = 121) were surveyed prior to beginning classes (wave 1), and again 8 months later (wave 2). Personality variables predisposing to distress (optimism and trait anxiety), stress response (depression and state anxiety), and stress management strategies were assessed at wave 1 and wave 2. Pre-medical academic scores, and grades at the end of five assessment periods over the course of the first 2 years of medical school were also obtained. As expected, pre-medical-school academic performance strongly predicted performance in medical school. Academic performance before and during medical school was negatively related to reported stress levels. On bivariate correlations, there were numerous significant relationships between stress reported at waves 1 and 2, and medical school academic performance assessed after these measures. In addition there were modest negative correlations between self-reported coping strategies of 'humour' and 'wishful thinking', and consequent academic performance. However, the predictive value of stress and its management on prospective academic performance was much decreased once pre-medical-school performance was statistically controlled.

  18. Medical withdrawals from college for mental health reasons and their relation to academic performance.

    Science.gov (United States)

    Meilman, P W; Manley, C; Gaylor, M S; Turco, J H

    1992-03-01

    A collaborative study among the university health service, the dean's office, and the registrar's office examined the academic performance of 77 students who took medical withdrawals for mental health reasons from Dartmouth College during a 3-year period. In 71.4% of the cases, students withdrew from a term in progress; the remainder arranged to withdraw after they had completed a term but before starting a new term. Depression was a major factor in approximately half of the withdrawals. Grade point average improved significantly after return from the withdrawal, with a large jump in individual term averages occurring between the terms immediately preceding and immediately following return. We found no significant difference between the number of students who experienced disciplinary trouble before withdrawal and those who were disciplined afterward. Students who were depressed at the time of withdrawal did not fare as well academically upon return as those students who had not been depressed. The data suggest that procedures for handling mental health withdrawals and readmission are important ways in which the campus counseling center can support the university's academic mission.

  19. Awareness of academic use of smartphones and medical apps among medical students in a private medical college?

    Science.gov (United States)

    Shah, Jehanzaib; Haq, Usman; Bashir, Ali; Shah, Syed Aslam

    2016-02-01

    To assess the awareness of medical apps and academic use of smartphones among medical students. The questionnaire-based descriptive cross-sectional study was conducted in January 2015 and comprised medical students of the Rawal Institute of Health Sciences, Islamabad, Pakistan. The self-designed questionnaire was reviewed by a panel of expert for content reliability and validity. Questionnaires were distributed in the classrooms and were filled by the students anonymously. SPSS 16 was used for statistical analysis. Among the 569 medical students in the study, 545 (95.8%) had smartphones and 24(4.2%) were using simple cell phones. Overall, 226(41.46%) of the smart phone users were using some medical apps. Besides, 137(24.08%) were aware of the medical apps but were not using them. Also, 391(71.7%) students were not using any type of medical text eBooks through their phone, and only 154(28.3%) had relevant text eBooks in their phones. Medical college students were using smartphones mostly as a means of telecommunication rather than a gadget for improving medical knowledge.

  20. 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.

  1. Consumerism: forcing medical practices toward patient-centered care.

    Science.gov (United States)

    Ozmon, Jeff

    2007-01-01

    Consumerism has been apart of many industries over the years; now consumerism may change the way many medical practices deliver healthcare. With the advent of consumer-driven healthcare, employers are shifting the decision-making power to their employees. Benefits strategies like health savings accounts and high-deductible insurance plans now allow the patients to control how and where they spend their money on medical care. Practices that seek to attract the more affluent and informed consumers are beginning to institute patient-centered systems designs that invite patients to actively participate in their healthcare. This article will outline the changes in the healthcare delivery system facing medical practices, the importance of patient-centered care, and six strategies to implement to change toward more patient-centered care.

  2. Informed choice of entering medical school and academic success in Iranian medical students.

    Science.gov (United States)

    Farrokhi-Khajeh-Pasha, Yasin; Nedjat, Saharnaz; Mohammadi, Aeen; Malakan Rad, Elaheh; Majdzadeh, Reza

    2014-11-01

    One of the challenges medical education policy-makers confront is matriculants' informed choice of entering medicine. However, students' reasons for choosing medicine do not seem rational. We compared students who made an informed choice about entering medicine with those who did not, in terms of academic success. The study was carried out with a self-administered questionnaire on 220 final-year medical students randomly selected from six Iranian medical schools. Depending on their informed choice of entering medicine or not at the time of application, they were divided into two groups. We compared these two groups' academic achievement as well as their satisfaction with medicine. The students who had not made an informed choice had a higher tendency not to choose medicine if they were to start over (p value ≤0.001). The pre-admission scores of students who had made an informed choice of medicine were worse than the other group (p = 0.03). However, their final year scores as well as their satisfaction with medicine were higher than the other group. Idealistic views of medicine should be replaced by rational and logical ones to help students select the careers best suited to their abilities and talents.

  3. 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.

  4. Medical school faculty discontent: prevalence and predictors of intent to leave academic careers

    Directory of Open Access Journals (Sweden)

    Lowenstein Steven R

    2007-10-01

    Full Text Available Abstract Background Medical school faculty are less enthusiastic about their academic careers than ever before. In this study, we measured the prevalence and determinants of intent to leave academic medicine. Methods A 75-question survey was administered to faculty at a School of Medicine. Questions addressed quality of life, faculty responsibilities, support for teaching, clinical work and scholarship, mentoring and participation in governance. Results Of 1,408 eligible faculty members, 532 (38% participated. Among respondents, 224 (40%; CI95: 0.35, 0.44 reported that their careers were not progressing satisfactorily; 236 (42%; CI95: 0.38, 0.46 were "seriously considering leaving academic medicine in the next five years." Members of clinical departments (OR = 1.71; CI95: 1.01, 2.91 were more likely to consider leaving; members of inter-disciplinary centers were less likely (OR = 0.68; CI95: 0.47, 0.98. The predictors of "serious intent to leave" included: Difficulties balancing work and family (OR = 3.52; CI95: 2.34, 5.30; inability to comment on performance of institutional leaders (OR = 3.08; CI95: 2.07, 4.72; absence of faculty development programs (OR = 3.03; CI95: 2.00, 4.60; lack of recognition of clinical work (OR = 2.73; CI95: 1.60, 4.68 and teaching (OR = 2.47; CI95: 1.59, 3.83 in promotion evaluations; absence of "academic community" (OR = 2.67; CI95: 1.86, 3.83; and failure of chairs to evaluate academic progress regularly (OR = 2.60; CI95: 1.80, 3.74. Conclusion Faculty are a medical school's key resource, but 42 percent are seriously considering leaving. Medical schools should refocus faculty retention efforts on professional development programs, regular performance feedback, balancing career and family, tangible recognition of teaching and clinical service and meaningful faculty participation in institutional governance.

  5. STOR: From Pilot Project to Medical Center Implementation

    Science.gov (United States)

    Henke, J.; Whiting-O'Keefe, Q.E.; Whiting, A.; Schaffner, R.; Schnake, R.; Goldstein, R.; Abrego, J.

    1988-01-01

    Summary Time Oriented Record (STOR) is a clinical information system operating at the University of California San Francisco Medical Center (UCSF). It provides two major services: on-line display of clinical information in the hospitals and clinics and an ambulatory medical record that partially replaces the traditional paper medical record for outpatient patient visits. In 1985 STOR was approved for clinic-wide implementation in the UCSF ambulatory care clinics. The implementation will be completed in September 1989. STOR captures clinical data directly from clinicians via hand written notations and ancillary data from other UCSF computers via a local area network. Development on STOR is continuing in order to meet the changing and diversified environment of inpatient and outpatient practices found in a university medical center.

  6. Understanding the relationship between school-based health center use, school connection, and academic performance.

    Science.gov (United States)

    Strolin-Goltzman, Jessica; Sisselman, Amanda; Melekis, Kelly; Auerbach, Charles

    2014-05-01

    School-based health centers (SBHCs) benefit the overall health of underserved communities. In fact, there is an abundance of evidence suggesting the positive effects that SBHCs have on physical and mental health. However, research related to understanding the relationship of SBHCs to academic outcomes such as performance and school connectedness is sparse. The purpose of the current study was to (a) compare differences between elementary, middle, and high school student SBHC users and nonusers on school connectedness and (b) test the pathways between SBHC usage and academic performance. A structural equation model was tested and found significant pathways between SBHCs, school connectedness, and academic performance.

  7. Academic Medical Library Services Contribute to Scholarship in Medical Faculty and Residents

    Directory of Open Access Journals (Sweden)

    Peace Ossom Williamson

    2017-09-01

    Full Text Available A Review of: Quesenberry, A. C., Oelschlegel, S., Earl, M., Leonard, K., & Vaughn, C. J. (2016. The impact of library resources and services on the scholarly activity of medical faculty and residents. Medical Reference Services Quarterly, 35(3, 259-265. http://dx.doi.org/10.1080/02763869.2016.1189778 Abstract Objective – To assess the impact of academic medical library services and resources on information-seeking behaviours during the academic efforts of medical faculty and residents. Design – Value study derived from a 23-item survey. Setting – Public medical residency program and training hospital in Tennessee, USA. Subjects – 433 faculty and residents currently employed by or completing residency in an academic medical centre. Methods – Respondents completed a 23-question survey about their use of library resources and services in preparation for publishing, presenting, and teaching. The library services in the survey included literature searches completed by librarians and document delivery for preparation of publications, presentations, and lecture material. The survey also included questions about how resources were being accessed in preparation for scholarship. The survey sought information on whether respondents published articles or chapters or presented papers or posters in the previous three years. If respondents answered in the affirmative to one of the aforementioned methods of scholarship, they were provided with further questions about how they access library resources and whether they sought mediated literature search and document delivery services in preparation for their recent presentations and publications. The survey also included questions concerning what types of scholarly activity prompt faculty and residents to use online library resources. Main Results – The study was provided to 433 subjects, including 220 faculty and 213 residents, contacted through an email distribution list. The response rate to the

  8. 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.

  9. Stress among Medical Students and Its Association with Substance Use and Academic Performance

    OpenAIRE

    Leta Melaku; Andualem Mossie; Alemayehu Negash

    2015-01-01

    Background. Chronic stress among medical students affects academic performance of students and leads to depression, substance use, and suicide. There is, however, a shortage of such research evidence in Ethiopia. Objective. We aimed to estimate the prevalence and severity of stress and its association with substance use and academic performance among medical students. Methods. A cross-sectional survey was conducted on a sample of 329 medical students at Jimma University. Data were collected u...

  10. [Family medicine as a medical specialty and an academic discipline in the medical students' assessment].

    Science.gov (United States)

    Krztoń-Królewiecka, Anna; Jarczewska, Dorota Łucja; Windak, Adam

    2015-01-01

    Family medicine has been recognized as the key element of a good health care system. Despite the significance of the family physician's role the number of medical students choosing to train in family medicine has been declining in recent years. The aim of this study was to describe opinions about family medicine and family medicine teaching among medical students. A cross sectional study with an anonymous questionnaire was carried out. The study population was all sixth-year students in Faculty Medicine of Jagiellonian University Medical College, who completed family medicine course in winter semester of academic year 2012/2013. 111 students filled in the questionnaire. The response rate was 84.1%. Less than one third of respondents (30.6%) considered family medicine as a future career choice. Almost all students recognized responsibility of the family doctor for the health of community. 52% of respondents agreed that the family doctor is competent to provide most of the health care an individual may require. Experience from family medicine course was according to the students the most important factor influencing their opinions. Medical students appreciate the social role of family doctors. Family medicine teachers should not only pass on knowledge, but they also should encourage medical students to family medicine as a future career choice.

  11. Medical Student Perceptions of Global Surgery at an Academic Institution: Identifying Gaps in Global Health Education.

    Science.gov (United States)

    Mehta, Ambar; Xu, Tim; Murray, Matthew; Casey, Kathleen M

    2017-08-01

    Robust global health demands access to safe, affordable, timely surgical care for all. The long-term success of global surgery requires medical students to understand and engage with this emerging field. The authors characterized medical students' perceptions of surgical care relative to other fields within global health. An optional, anonymous survey was given to all Johns Hopkins medical students from February to March 2016 to assess perceptions of surgical care and its role in global health. Of 480 students, 365 (76%) completed the survey, with 150 (41%) reporting global health interests. One-third (34%) of responding students felt that surgical care is one of two fields with the greatest potential global health impact in the future, second to infectious disease (49%). A minority (28%) correctly identified that trauma results in more deaths worldwide than obstetric complications or HIV/AIDS, tuberculosis, and malaria combined. Relative to other examined fields, students perceived surgical care as the least preventive and cost-effective, and few students (3%) considered adequate surgical care the best indicator of a robust health care system. Students believed that practicing in a surgical field was least amenable to pursuing a global health career, citing several barriers. Medical students have several perceptions of global surgery that contradict current evidence and literature, which may have implications for their career choices. Opportunities to improve students' global health knowledge and awareness of global surgery career paths include updating curricula, fostering meaningful international academic opportunities, and creating centers of global surgery and global health consortia.

  12. Tradition meets innovation: transforming academic medical culture at the University of Pennsylvania's Perelman School of Medicine.

    Science.gov (United States)

    Pati, Susmita; Reum, Josef; Conant, Emily; Tuton, Lucy Wolf; Scott, Patricia; Abbuhl, Stephanie; Grisso, Jeane Ann

    2013-04-01

    Traditional performance expectations and career advancement paths for academic physicians persist despite dramatic transformations in the academic workflow, workload, and workforce over the past 20 years. Although the academic physician's triple role as clinician, researcher, and educator has been lauded as the ideal by academic health centers, current standards of excellence for promotion and tenure are based on outdated models. These models fail to reward collaboration and center around rigid career advancement plans that do little to accommodate the changing needs of individuals and organizations. The authors describe an innovative, comprehensive, multipronged initiative at the Perelman School of Medicine at the University of Pennsylvania to initiate change in the culture of academic medicine and improve academic productivity, job satisfaction, and overall quality of life for junior faculty. As a key part of this intervention, task forces from each of the 13 participating departments/divisions met five times between September 2010 and January 2011 to produce recommendations for institutional change. The authors discuss how this initiative, using principles adopted from business transformation, generated themes and techniques that can potentially guide workforce environment innovation in academic health centers across the United States. Recommendations include embracing a promotion/tenure/evaluation system that supports and rewards tailored individual academic career plans; ensuring leadership, decision-making roles, and recognition for junior faculty; deepening administrative and team supports for junior faculty; and solidifying and rewarding mentorship for junior faculty. By doing so, academic health centers can ensure the retention and commitment of faculty throughout all stages of their careers.

  13. Impact of personality temperaments and characters on academic performance and specialty selection among a group of Egyptian medical graduates.

    Science.gov (United States)

    El Sheikh, Mona M; Shaker, Nermin M; Hussein, Hanan; Ramy, Hisham A

    2014-08-01

    The relationship between personality temperaments, academic achievement and specialty interest is important because of its implications in career counseling. To assess the effect of personality on academic performance and career selection and to study the impact of some sociodemographic factors on academic achievement and career choice of medical graduates. A total of 436 medical graduates of Ain Shams medical school were approached, out of which 331 participated. They were given a sociodemographic questionnaire, and the Temperament and Character Inventory-Revised (TCI-R; 240) for personality construct; they had to answer questions about academic achievement, ranking, scores and choice of medical specialty. Novelty seeking (NS1, NS2 and NS3) and self-transcendence (ST1 and ST2) were correlated with graduation ranking, (r = .2, p = .00; r = .15, p = .009; r = .16, p = .005; r = .12, p = .003; r = .14, p = .02; r = .17, p = .004; r = .13, p = .03, respectively), that is, lower NS and ST had better academic outcome. Only high school score was associated with better achievement (p = .00). In specialty selection, females were significantly overrepresented in pediatrics and clinical pathology, whereas males were significantly predominating surgical specialties except for obstetrics and gynecology (p = .00). Students choosing patient-centered specialties had higher reward dependence (RD), persistence (PS) and cooperativeness (C); those choosing clinical pathology had highest harm avoidance (HA), whereas those choosing radiology had lowest HA and those choosing surgery had significantly higher self-directedness (SD3). Personality impacts academic achievement and specialty choice with other factors as gender and previous scholastic performance. © The Author(s) 2013.

  14. Academic nursing centers: the road from the past, the bridge to the future.

    Science.gov (United States)

    Barger, Sara E

    2004-02-01

    This article explores the development of academic nursing centers within an environment of evolving health policy and changing priorities and resources within nursing education during the past 3 decades. Etheredge's framework for this discussion identifies three health policy eras: the Age of Traditional Health Insurance (1965-1982); the Age of Regulated Prices for Government Programs (1983-1992); and the Age of Markets, Purchasing, and Managed Care (1993-2000). In this article, I suggest the current era is the Age of Uncertainty and Opportunity. Within each era, health policy changes are summarized, and changes in nursing education that influenced the evolution of academic nursing centers are identified. The uncertainty and opportunity of the current era is explored within the context of the Institute of Medicine (IOM) reports issued in 2000 and 2001. The new vision for clinical education in the health professions described in the 2001 report provides new opportunities for academic nursing centers. To take advantage of these opportunities, these centers must focus on quality issues as they continue to maintain a precarious balance between meeting the service needs of their clients and the academic needs of the nursing programs that own them. Centers that maintain this balance will be a bridge to the future for quality health professions education.

  15. The relationship between Persecution and perfectionism with Academic achievement and Burnout in medical students

    Directory of Open Access Journals (Sweden)

    Zahra Dasht Bozorgi

    2016-04-01

    Full Text Available Aims: The aim of this study was to investigate the relationship between Persecution, Maladjustment perfectionism and Adjustment perfectionism with Academic achievement and Academic Burnout among medical students. Methods: This cross-sectional and correlational study which was performed by medical students from the Medical University of Gondi Shapoor in Ahvaz in 2015. The sample group included 200 medical students who were selected by random-stratified sampling. Procrastination Assessment Scale, Perfectionism Inventory, Academic Burnout Inventory were used for collecting data. Data analysis was conducted by SPSS 20 software using Pearson correlation coefficient and Canonical Correlation Analysis. Results: The findings indicated that there is a significant relationship between the Predicting Variables (Persecution, Maladjustment perfectionism and Adjustment perfectionism and the Criteria Variables (Academic achievement and Academic Burnout. The amount of Canonical Correlation (0.91, (P<0.05 is an indication of a significant relationship between the two sets of variables. Conclusion: It can be concluded from this study that academic achievement not Academic Burnout was predicted by Persecution, Maladjustment perfectionism and adjustment perfectionism. Maladjustment perfectionism showed the greatest relationship with academic achievement. So Persecution, Maladjustment perfectionism and adjustment perfectionism can interfere with academic achievement.

  16. Characteristics of palliative care consultation at an academic level one trauma center.

    Science.gov (United States)

    Rivet, Emily B; Ferrada, Paula; Albrecht, Tara; Cassel, J Brian; Broering, Beth; Noreika, Danielle; Del Fabbro, Egidio

    2017-10-01

    The current status of palliative care consultation for trauma patients has not been well characterized. We hypothesized that palliative care consultation currently is requested for patients too late to have any clinical significance. A retrospective chart review was performed for traumatically injured patients' ≥18 years of age who received palliative care consultation at an academic medical center during a one-year period. The palliative care team evaluated 82 patients with a median age of 60 years. Pain and end of life were the most common reasons for consultation; interventions performed included delirium management and discussions about nutritional support. For decedents, median interval from palliative care consultation to death was 1 day. Twenty seven patients died (11 in the palliative care unit, 16 in an ICU). Nine patients were discharged to hospice. Most consultations were performed for pain and end of life management in the last 24 h of life, demonstrating the opportunity to engage the palliative care service earlier in the course of hospitalization. Copyright © 2017. Published by Elsevier Inc.

  17. Behind bars: the compelling case for academic health centers partnering with correctional facilities.

    Science.gov (United States)

    Trestman, Robert L; Ferguson, Warren; Dickert, Jeff

    2015-01-01

    Academic health centers (AHCs), particularly those that are publicly funded institutions, have as their mission the treatment of disadvantaged populations, the training of the next generation of clinicians, and the development and dissemination of new knowledge to reduce the burden of disease and improve the health of individuals and populations. Incarcerated populations have the most prevalent and acute disease burden and health disparities in the United States, even in comparison with inner-city populations. Yet, only a small proportion of AHCs have reached out to incarcerated populations to fulfill their mission. Those AHCs that have partnered with correctional facilities have overcome concerns about the value and popularity of "training behind bars"; the cost, liability, and pragmatics of caring for a medically complicated population; and the viability of correctional health research and extramural research funding. They have done so to great benefit to patients, students, and faculty. Partnering with correctional facilities to provide health care offers opportunities for AHCs to fulfill their core missions of clinical service, education, and research, while also enhancing their financial stability, to the benefit of all. In this Commentary, the authors discuss, based on their experiences, these concerns, how existing partnerships have overcome them, and the benefits of such relationships to both AHCs and correctional facilities.

  18. 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.

  19. The Harvard Medical School Academic Innovations Collaborative: transforming primary care practice and education.

    Science.gov (United States)

    Bitton, Asaf; Ellner, Andrew; Pabo, Erika; Stout, Somava; Sugarman, Jonathan R; Sevin, Cory; Goodell, Kristen; Bassett, Jill S; Phillips, Russell S

    2014-09-01

    Academic medical centers (AMCs) need new approaches to delivering higher-quality care at lower costs, and engaging trainees in the work of high-functioning primary care practices. In 2012, the Harvard Medical School Center for Primary Care, in partnership with with local AMCs, established an Academic Innovations Collaborative (AIC) with the goal of transforming primary care education and practice. This novel two-year learning collaborative consisted of hospital- and community-based primary care teaching practices, committed to building highly functional teams, managing populations, and engaging patients. The AIC built on models developed by Qualis Health and the Institute for Healthcare Improvement, optimized for the local AMC context. Foundational elements included leadership engagement and development, application of rapid-cycle process improvement, and the creation of teams to care for defined patient populations. Nineteen practices across six AMCs participated, with nearly 260,000 patients and 450 resident learners. The collaborative offered three 1.5-day learning sessions each year featuring shared learning, practice coaches, and improvement measures, along with monthly data reporting, webinars, and site visits. Validated self-reports by transformation teams showed that practices made substantial improvement across all areas of change. Important factors for success included leadership development, practice-level resources, and engaging patients and trainees. The AIC model shows promise as a path for AMCs to catalyze health system transformation through primary care improvement. In addition to further evaluating the impact of practice transformation, expansion will require support from AMCs and payers, and the application of similar approaches on a broader scale.

  20. [Academic performance in first year medical students: an explanatory multivariate model].

    Science.gov (United States)

    Urrutia Aguilar, María Esther; Ortiz León, Silvia; Fouilloux Morales, Claudia; Ponce Rosas, Efrén Raúl; Guevara Guzmán, Rosalinda

    2014-12-01

    Current education is focused in intellectual, affective, and ethical aspects, thus acknowledging their significance in students´ metacognition. Nowadays, it is known that an adequate and motivating environment together with a positive attitude towards studies is fundamental to induce learning. Medical students are under multiple stressful, academic, personal, and vocational situations. To identify psychosocial, vocational, and academic variables of 2010-2011 first year medical students at UNAM that may help predict their academic performance. Academic surveys of psychological and vocational factors were applied; an academic follow-up was carried out to obtain a multivariate model. The data were analyzed considering descriptive, comparative, correlative, and predictive statistics. The main variables that affect students´ academic performance are related to previous knowledge and to psychological variables. The results show the significance of implementing institutional programs to support students throughout their college adaptation.

  1. Academic Guidance for Undergraduate Students in a South African Medical School: Can we guide them all?

    Directory of Open Access Journals (Sweden)

    Mpho P Jama

    2017-02-01

    Full Text Available Higher education institutions, including medical schools, still grapple with the challenge of poor academic performance of students. Some studies report the positive results of providing academic guidance for common challenges such as poor and/or ineffective time management, study methods, test- and exam-taking techniques and management, and the high academic workload of undergraduate medical students. However, limited detailed insights and understanding of medical students who experience more complex challenges are available.  This study was conducted at a medical school in South Africa to determine undergraduate medical students’ perceptions of factors affecting their academic performance. A total of 89 semi-structured interviews were held with undergraduate medical students who were identified as having academic problems between 2012 and 2015. According to the results, more blacks, males and first- and second year students experienced poor academic performance. Prominent findings included the harsh realities and implications of lack of accommodation for black students; how poor academic performance can lead to an array of other social and psychological problems, such as withdrawal of bursaries and negative achievement emotions that some students experience. Compared to the usual objective measures of individual ability, the rich qualitative data of cases presented in this study reveal critical, real insights and understanding of students’ challenges from their own perspective.

  2. Differences in medical students' academic interest and performance across career choice motivations.

    Science.gov (United States)

    Kim, Kyong-Jee; Hwang, Jee Y; Kwon, Bum S

    2016-02-15

    To investigate medical students' career choice motivation and its relationship with their academic interest and performance. We conducted a cross-sectional study in a sample (n=207) of medical students at a private medical school in Korea, stratified by year of medical course. Data about participant demographics, career choice motivation and academic interest were collected using a self-report questionnaire. The item on career choice motivation enquired about the respondents' main reason for applying for medical school among 8 possible response options, which comprised two components of career choice motivation: intrinsic and extrinsic. The participants' levels of academic interest were measured in a Likert-type question. Participants' academic interest and Grade Point Averages (GPAs) were compared across the groups of different career motivations along with analyses of their admission scores for baseline comparisons. A total of 195 students completed the questionnaire (94%response rate). Seventy-four percent, (n=145; the intrinsic group) of the participants chose reasons related to intrinsic motivation, 22% (n=42; the extrinsic group) chose reasons pertaining to extrinsic motivation, and 4% (n = 8) chose other reasons for applying to medical school. The intrinsic group outperformed the extrinsic group in their GPAs, although their prior academic achievements did not differ significantly. The intrinsic group showed significantly higher levels of academic interest and also performed better in the admission interviews. Our study illustrates differences in medical students' academic interest and performance across career choice motivations. Further research is warranted to establish the predictive power of medical students' career choice motivation and academic interest on their academic performance.

  3. Health Care Transformation: The Role of Academic Health Centers and Their Psychologists.

    Science.gov (United States)

    Kirch, Darrell G; Ast, Cori E

    2017-06-01

    The health care system of the United States has been in a period of dramatic transformation since the passage of the Affordable Care Act in 2010, and the rate of change is accelerating. Historically, health care delivery was focused on the efforts of independent individual providers related to single patients, but the future will require interprofessional teamwork to achieve successful transformation. Academic health centers must identify nimble leaders who can harness the expertise of every team member to succeed in yielding the triple aim-better care for individuals, better health for populations, and lower overall cost. To create this change, there are several critical success factors for academic health center leaders, including creating a culture of collaboration, becoming "multipliers," embracing innovation, adhering to core professional ethics, and working to promote resilience. Given their extensive training and predisposition to these skills, psychologists are well-positioned to serve as leaders in today's academic health systems.

  4. 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.

  5. Trends in antibacterial use in hospitalized pediatric patients in United States academic health centers.

    Science.gov (United States)

    Pakyz, Amy L; Gurgle, Holly E; Ibrahim, Omar M; Oinonen, Michael J; Polk, Ronald E

    2009-06-01

    Trends in pediatric antibacterial use were examined in 20 academic health centers during the period 2002-2007. There was a significant increase in the use of linezolid (P macrolides (P = .001) and a significant decrease in the use of aminoglycosides (P < .001) and of first-generation cephalosporins (P < .001).

  6. 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…

  7. Leadership Practices of Clinical Trials Office Leaders in Academic Health Centers

    Science.gov (United States)

    Naser, Diana D.

    2012-01-01

    In the ever-changing clinical research environment, academic health centers seek leaders who are visionary and innovative. Clinical trials offices across the country are led by individuals who are charged with promoting growth and change in order to maximize performance, develop unique research initiatives, and help institutions achieve a…

  8. The Emerging Relationship between Academic Health Centers and Continuing Care Retirement Communities.

    Science.gov (United States)

    Hershey, H. Garland; And Others

    1990-01-01

    This study documents the rapid increase in the number of relationships between academic health centers and continuing-care retirement communities (CCRC) in the latter half of the 1980s. An example of such an arrangement is presented as well as the issues involved and levels of involvement with CCRC. (GLR)

  9. Tax Exemption Issues Facing Academic Health Centers in the Managed Care Environment.

    Science.gov (United States)

    Jones, Darryll K.

    1997-01-01

    Traditional characteristics of academic health centers are outlined, and conflicts with managed care are identified. Operating strategies designed to resolve the conflicts are discussed in light of tax statutes and regulations, Internal Revenue Service interpretations, and case law. Detailed references are included to provide a complete resource…

  10. Cultures in Conflict: A Challenge to Faculty of Academic Health Centers.

    Science.gov (United States)

    Magill, Michael K.; Catinella, A. Peter; Haas, Leonard; Hughes, Charles C.

    1998-01-01

    In the new health care environment, academic health center (AHC) faculty must transcend the outdated view that the roles of scholar, scientist, and healer are in opposition to those of leader and manager. If AHCs are to survive and prosper through their current cultural transition, faculty must understand all these roles as part of their…

  11. Correlates of Satisfaction, Intrapersonal Learning, and Academic Outcomes at Counseling Centers in a University System

    Science.gov (United States)

    Winterrowd, Erin; Priniski, Stacy J.; Achter, John; Abhold, Joseph J.

    2016-01-01

    Examining the role of college mental health services in promoting student personal and academic success is essential to demonstrating their utility to university communities and administrations. Student learning outcomes following counseling and satisfaction with mental health services were assessed across 16 counseling centers in one university…

  12. Achievement Motivation and Academic Motivation among Students of Kermanshah University of Medical Sciences in 2013

    OpenAIRE

    Firoozeh Khamoushi; Arash Parsa Moghaddam; Mahtab Sadeghi; Ali Akbar Parvizifard; Akram Ahmadzadeh

    2016-01-01

    Introduction: Students are often similar in terms of learning ability and talent. However, there are remarkable differences in their academic performance during their schooling, which can be due to the differences in their academic motivation and achievement motivation. The current study was carried out to compare achievement motivation and academic achievement among the students of Kermanshah University of Medical Sciences (KUMS) in 2013. Methods: In this descriptive Analytical cross-sec...

  13. Academic medical product development: an emerging alliance of technology transfer organizations and the CTSA.

    Science.gov (United States)

    Rose, Lynn M; Everts, Maaike; Heller, Caren; Burke, Christine; Hafer, Nathaniel; Steele, Scott

    2014-12-01

    To bring the benefits of science more quickly to patient care, the NIH National Center Advancing Translational Sciences (NCATS) supports programs that enhance the development, testing, and implementation of new medical products and procedures. The NCATS clinical and translational science award (CTSA) program is central to that mission; creating an academic home for clinical and translational science and supporting those involved in the discovery and development of new health-related inventions. The technology transfer Offices (TTO) of CTSA-funded universities can be important partners in the development process; facilitating the transfer of medical research to the commercial sector for further development and ultimately, distribution to patients. The Aggregating Intellectual Property (IP) Working Group (AWG) of the CTSA public private partnerships key function committee (PPP-KFC) developed a survey to explore how CTSA-funded institutions currently interface with their respective TTOs to support medical product development. The results suggest a range of relationships across institutions; approximately half have formal collaborative programs, but only a few have well-connected programs. Models of collaborations are described and provided as examples of successful CTSA/TTO partnerships that have increased the value of health-related inventions as measured by follow-on funding and industry involvement; either as a consulting partner or licensee. © 2014 Wiley Periodicals, Inc.

  14. Motivational profiles of medical students: association with study effort, academic performance and exhaustion.

    Science.gov (United States)

    Kusurkar, Rashmi A; Croiset, Gerda; Galindo-Garré, Francisca; Ten Cate, Olle

    2013-06-19

    Students enter the medical study with internally generated motives like genuine interest (intrinsic motivation) and/or externally generated motives like parental pressure or desire for status or prestige (controlled motivation). According to Self-determination theory (SDT), students could differ in their study effort, academic performance and adjustment to the study depending on the endorsement of intrinsic motivation versus controlled motivation. The objectives of this study were to generate motivational profiles of medical students using combinations of high or low intrinsic and controlled motivation and test whether different motivational profiles are associated with different study outcomes. Participating students (N = 844) from University Medical Center Utrecht, the Netherlands, were classified to different subgroups through K-means cluster analysis using intrinsic and controlled motivation scores. Cluster membership was used as an independent variable to assess differences in study strategies, self-study hours, academic performance and exhaustion from study. Four clusters were obtained: High Intrinsic High Controlled (HIHC), Low Intrinsic High Controlled (LIHC), High Intrinsic Low Controlled (HILC), and Low Intrinsic Low Controlled (LILC). HIHC profile, including the students who are interest + status motivated, constituted 25.2% of the population (N = 213). HILC profile, including interest-motivated students, constituted 26.1% of the population (N = 220). LIHC profile, including status-motivated students, constituted 31.8% of the population (N = 268). LILC profile, including students who have a low-motivation and are neither interest nor status motivated, constituted 16.9% of the population (N = 143). Interest-motivated students (HILC) had significantly more deep study strategy (p motivated (LIHC) and low-motivation (LILC) students. The interest-motivated profile of medical students (HILC) is associated with good study hours, deep

  15. Motivational profiles of medical students: Association with study effort, academic performance and exhaustion

    Science.gov (United States)

    2013-01-01

    Background Students enter the medical study with internally generated motives like genuine interest (intrinsic motivation) and/or externally generated motives like parental pressure or desire for status or prestige (controlled motivation). According to Self-determination theory (SDT), students could differ in their study effort, academic performance and adjustment to the study depending on the endorsement of intrinsic motivation versus controlled motivation. The objectives of this study were to generate motivational profiles of medical students using combinations of high or low intrinsic and controlled motivation and test whether different motivational profiles are associated with different study outcomes. Methods Participating students (N = 844) from University Medical Center Utrecht, the Netherlands, were classified to different subgroups through K-means cluster analysis using intrinsic and controlled motivation scores. Cluster membership was used as an independent variable to assess differences in study strategies, self-study hours, academic performance and exhaustion from study. Results Four clusters were obtained: High Intrinsic High Controlled (HIHC), Low Intrinsic High Controlled (LIHC), High Intrinsic Low Controlled (HILC), and Low Intrinsic Low Controlled (LILC). HIHC profile, including the students who are interest + status motivated, constituted 25.2% of the population (N = 213). HILC profile, including interest-motivated students, constituted 26.1% of the population (N = 220). LIHC profile, including status-motivated students, constituted 31.8% of the population (N = 268). LILC profile, including students who have a low-motivation and are neither interest nor status motivated, constituted 16.9% of the population (N = 143). Interest-motivated students (HILC) had significantly more deep study strategy (p motivated (LIHC) and low-motivation (LILC) students. Conclusions The interest-motivated profile of medical students (HILC) is

  16. The effects of personality traits on academic burnout in Korean medical students

    Directory of Open Access Journals (Sweden)

    Soo Jin Lee

    2017-06-01

    Conclusion: This study showed that personality might account for the burnout level in medical education. The importance of character dimension for modulating the effects of temperament traits on academic burnout was discussed for future research.

  17. Role of students' context in predicting academic performance at a medical school: a retrospective cohort study

    National Research Council Canada - National Science Library

    Thiele, Tamara; Pope, Daniel; Singleton, A; Stanistreet, D

    2016-01-01

    ...), and academic achievement at a Russell Group University. Retrospective cohort analysis. Applicants accepted at the University of Liverpool medical school between 2004 and 2006, finalising their studies between 2010 and 2011. 571 students...

  18. Relationship of academic success of medical students with motivation and pre-admission grades

    National Research Council Canada - National Science Library

    Luqman, Muhammad

    2013-01-01

    .... These students filled out 'Strength of Motivation for Medical School' (SMMS) questionnaire. The data of pre-admission grades of these students along with academic success in college according to examination results in different years were collected...

  19. Academic mentorship: an effective professional development strategy for medical reference librarians.

    Science.gov (United States)

    Wang, H

    2001-01-01

    Academic mentorship is a professional development strategy that enables fledgling professionals to take advantage of the skills and expertise of the senior members for professional growth. Although widely practiced in many other professions, academic mentorship has not been widely reported in medical librarianship. Drawing upon personal experience, the author reports the success story of an academic mentorship program implemented in an academic medical library and argues for academic mentorship to be widely adopted in academic medical libraries. This paper first reviews the literature on the concept of mentoring in an academic setting, and then describes the background, rationale, methods, and results of the mentorship programs the author has experienced. Lastly, based upon an analysis of several surveys and studies on coping skills for quality job performance of health sciences reference librarians, the paper discusses mentorship as one effective means to ease a new medical reference librarian's transition from his/her pre-service experience to the professional world of medical librarianship. It calls on other health sciences librarians to consider developing their own mentorship programs to promote their professional development and personal growth.

  20. Self-regulated learning and academic performance in medical education

    NARCIS (Netherlands)

    Lucieer, Susanna M.; Jonker, Laura; Visscher, Chris; Rikers, Remy M. J. P.; Themmen, Axel P. N.

    Content: Medical schools aim to graduate medical doctors who are able to self-regulate their learning. It is therefore important to investigate whether medical students' self-regulated learning skills change during medical school. In addition, since these skills are expected to be helpful to learn

  1. An Architecture for Continuous Data Quality Monitoring in Medical Centers.

    Science.gov (United States)

    Endler, Gregor; Schwab, Peter K; Wahl, Andreas M; Tenschert, Johannes; Lenz, Richard

    2015-01-01

    In the medical domain, data quality is very important. Since requirements and data change frequently, continuous and sustainable monitoring and improvement of data quality is necessary. Working together with managers of medical centers, we developed an architecture for a data quality monitoring system. The architecture enables domain experts to adapt the system during runtime to match their specifications using a built-in rule system. It also allows arbitrarily complex analyses to be integrated into the monitoring cycle. We evaluate our architecture by matching its components to the well-known data quality methodology TDQM.

  2. Predictors of academic performance of medical undergraduate students of microbiology class in Kolkata

    OpenAIRE

    Subhra Shankha Ro; Jayashree Chadalawada

    2014-01-01

    Context: Identification of the effect of valid factors on students' academic performance is of great importance to student counseling and policy making. Aims: This study was carried out to find the predictors of academic performance of 2 nd year undergraduate medical students of a renowned Medical College of Kolkata. Materials and Methods: This cross sectional study was carried out in a tertiary care teaching hospital of Kolkata. The information on factors like attendance percentage, sex, pla...

  3. Investigating the Relationship Between Internet Addiction and Academic Archievement of Medical Students (2013)

    OpenAIRE

    Rita Motidost Komleh; Agha Fatemeh Hosseini; Ladan Fata; Fakhrossadat Mirhosseini; Shoaleh Bigdeli

    2016-01-01

    Intensive use of the internet can be associated with negative psychological consequences and behavioral changes. These consequences affect different aspects of life including physical, mental and spiritual health and academic performance of the students as users. In this regard, this study is an attempt to determine the rate of internet addiction and its relationship to academic achievement among medical students of basic sciences studying at Tehran University of Medical Sciences. In this...

  4. The effects of personality traits on academic burnout in Korean medical students

    OpenAIRE

    Lee, Soo Jin; Choi, Young Jun; Chae, Han

    2017-01-01

    Background: Previous studies suggest that personality traits play an important role in academic burnout. The aim of this study was to investigate how Cloninger’s temperament and character traits explain academic burnout in a highly competitive environment of medical school. Methods: A total of 184 Korean medical students participated in the survey. The Cloninger’s Temperament and Character Inventory was measured around the beginning of the semester and Maslach Burnout Inventory-Student Sur...

  5. [NEURO-ONCOLOGY A NEW FIELD IN DAVIDOFF CANCER CENTER AT RABIN MEDICAL CENTER].

    Science.gov (United States)

    Yust-Katz, Shlomit; Limon, Dror; Abu-Shkara, Ramez; Siegal, Tali

    2017-08-01

    Neuro-oncology is a subspecialty attracting physicians from medical disciplines such as neurology, neurosurgery, pediatrics, oncology, and radiotherapy. It deals with diagnosis and management of primary brain tumors, as well as metastatic and non-metastatic neurological manifestations that frequently affect cancer patients including brain metastases, paraneoplastic syndromes and neurological complications of cancer treatment. A neuro-oncology unit was established in Davidoff Cancer Center at Rabin Medical Center. It provides a multidisciplinary team approach for management of brain tumors and services, such as expert outpatient clinics and inpatient consultations for the departments of oncology, hematology, bone marrow transplantation and other departments in the Rabin Medical Center. In addition, expert consultation is frequently provided to other hospitals that treat cancer patients with neurological manifestations. The medical disciplines that closely collaborate for the daily management of neuro-oncology patients include radiotherapy, hematology, oncology, neuro-surgery, neuro-radiology and neuro-pathology. The neuro-oncology center is also involved in clinical and laboratory research conducted in collaboration with researchers in Israel and abroad. The new service contributes substantially to the improved care of cancer patients and to the advance of research topics in the field of neuro-oncology.

  6. Relationship of academic success of medical students with motivation and pre-admission grades.

    Science.gov (United States)

    Luqman, Muhammad

    2013-01-01

    To determine predictive validity of pre-admission scores of medical students, evaluate correlation between level of motivation and later on academic success in a medical college. Analytical study. Foundation University Medical College, Islamabad, from June to August 2011. A non-probability convenience sampling of students of 1st to final year MBBS classes was done after obtaining informed consent. These students filled out 'Strength of Motivation for Medical School' (SMMS) questionnaire. The data of pre-admission grades of these students along with academic success in college according to examination results in different years were collected. The correlation between the pre-admission grades and score of SMMS questionnaire with their academic success in medical college was found by applying Pearson co-efficient of correlation in order to determine the predictive validity. Only 46% students revealed strong motivation. A significant, moderate correlation was found between preadmission scores and academic success in 1st year modular examination (0.52) which became weaker in various professional examinations in higher classes. However, no significant correlation was observed between motivation and academic success of medical students in college. Selecting medical students by pre-admission scores or motivation level alone may not be desirable. A combination of measures of cognitive ability criteria (FSc/pre-admission test scores) and non-cognitive skills (personality traits) is recommended to be employed with the use of right tools for selection of students in medical schools.

  7. The mediating effect of calling on the relationship between medical school students’ academic burnout and empathy

    Directory of Open Access Journals (Sweden)

    Su Jin Chae

    2017-09-01

    Full Text Available Purpose This study is aimed at identifying the relationships between medical school students’ academic burnout, empathy, and calling, and determining whether their calling has a mediating effect on the relationship between academic burnout and empathy. Methods A mixed method study was conducted. One hundred twenty-seven medical students completed a survey. Scales measuring academic burnout, medical students’ empathy, and calling were utilized. For statistical analysis, correlation analysis, descriptive statistics analysis, and hierarchical multiple regression analyses were conducted. For qualitative approach, eight medical students participated in a focus group interview. Results The study found that empathy has a statistically significant, negative correlation with academic burnout, while having a significant, positive correlation with calling. Sense of calling proved to be an effective mediator of the relationship between academic burnout and empathy. Conclusion This result demonstrates that calling is a key variable that mediates the relationship between medical students’ academic burnout and empathy. As such, this study provides baseline data for an education that could improve medical students’ empathy skills.

  8. Students at Kermanshah University of Medical Sciences: Academic Year 2015-2016

    Directory of Open Access Journals (Sweden)

    Khadijeh Jamshidi

    2017-12-01

    Full Text Available Background: Academic satisfaction is considered one of the most important factors affecting academic achievement among students. The purpose of the present study was to determine the relationship between academic satisfaction and academic achievement among students at Kermanshah University of Medical Sciences in Iran. Methods: The present cross-sectional study was conducted with 346 student participants using stratified random sampling. The research instrument included the Student Academic Satisfaction Questionnaire, the Academic Performance Rating Scale, and student grade point average (GPA. Descriptive and inferential statistics were used to analyze the data. A 0.05 significance level was used for statistical tests. Results: The mean score of academic satisfaction among students was 50.7 ± 9.8 and the academic satisfaction level was moderate in 46.2% of the students. Comparing the academic satisfaction level in different fields of study, students in health (58.5%, nursing (67.5%, and paramedics (51.1% reported a moderate satisfaction level and students in midwifery (84.2%, pharmacology (53.5%, medicine (69.3%, and dentistry (55.5% recorded a high satisfaction level (P < 0.05. There was also a significant and positive correlation between academic satisfaction and academic achievement (P = 0.001, r = 0.02. Conclusion: Academic satisfaction among the 46.2% students that reported a moderate level was far from the ideal level. The relationship between academic satisfaction and academic achievement also indicated that creating motivation among students and increasing their levels of satisfaction could provide the grounds for academic achievement among them as much as possible.

  9. Energy use baselining study for the National Naval Medical Center

    Energy Technology Data Exchange (ETDEWEB)

    Parker, G.B.; Halverson, M.A.

    1992-04-01

    This report provides an energy consumption profile for fourteen buildings at the National Naval Medical Center (NNMC) in Bethesda, Maryland. Recommendations are also made for viable energy efficiency projects funded with assistance from the servicing utility (Potomic Electric Power Company) in the form of rebates and incentives available in their Demand Side Management (DSM) program and through Shared Energy Savings (SES) projects. This report also provides estimates of costs and potential energy savings of the recommended projects.

  10. Nurturing 21st century physician knowledge, skills and attitudes with medical home innovations: the Wright Center for Graduate Medical Education teaching health center curriculum experience.

    Science.gov (United States)

    Thomas-Hemak, Linda; Palamaner Subash Shantha, Ghanshyam; Gollamudi, Lakshmi Rani; Sheth, Jignesh; Ebersole, Brian; Gardner, Katlyn J; Nardella, Julie; Ruddy, Meaghan P; Meade, Lauren

    2015-01-01

    Purpose. The effect of patient centered medical home (PCMH) curriculum interventions on residents' self-reported and demonstrated knowledge, skills and attitudes in PCMH competency arenas (KSA) is lacking in the literature. This study aimed to assess the impact of PCMH curricular innovations on the KSA of Internal Medicine residents. Methods. Twenty four (24) Internal Medicine residents-12 Traditional (TR) track residents and 12 Teaching Health Center (THC) track residents-began training in Academic Year (AY) 2011 at the Wright Center for Graduate Medical Education (WCGME). They were followed through AY2013, covering three years of training. PCMH curricular innovations were focally applied July 2011 until May 2012 to THC residents. These curricular innovations were spread program-wide in May 2012. Semi-annual, validated PCMH Clinician Assessments assessing KSA were started in AY2011 and were completed by all residents. Results. Mean KSA scores of TR residents were similar to those of THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than TR residents for most KSA. After program-wide implementation of PCMH innovations, mean scores of TR residents for all KSA improved and most became equalized to those of THC residents. Globally improved KSA scores of THC and TR residents were maintained through May 2014, with the majority of improvements above baseline and reaching statistical significance. Conclusions. PCMH curricular innovations inspired by Health Resources and Services Administration (HRSA's) Teaching Health Center funded residency program expansion quickly and consistently improved the KSA of Internal Medicine residents.

  11. Nurturing 21st century physician knowledge, skills and attitudes with medical home innovations: the Wright Center for Graduate Medical Education teaching health center curriculum experience

    Directory of Open Access Journals (Sweden)

    Linda Thomas-Hemak

    2015-02-01

    Full Text Available Purpose. The effect of patient centered medical home (PCMH curriculum interventions on residents’ self-reported and demonstrated knowledge, skills and attitudes in PCMH competency arenas (KSA is lacking in the literature. This study aimed to assess the impact of PCMH curricular innovations on the KSA of Internal Medicine residents.Methods. Twenty four (24 Internal Medicine residents—12 Traditional (TR track residents and 12 Teaching Health Center (THC track residents—began training in Academic Year (AY 2011 at the Wright Center for Graduate Medical Education (WCGME. They were followed through AY2013, covering three years of training. PCMH curricular innovations were focally applied July 2011 until May 2012 to THC residents. These curricular innovations were spread program-wide in May 2012. Semi-annual, validated PCMH Clinician Assessments assessing KSA were started in AY2011 and were completed by all residents.Results. Mean KSA scores of TR residents were similar to those of THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than TR residents for most KSA. After program-wide implementation of PCMH innovations, mean scores of TR residents for all KSA improved and most became equalized to those of THC residents. Globally improved KSA scores of THC and TR residents were maintained through May 2014, with the majority of improvements above baseline and reaching statistical significance.Conclusions. PCMH curricular innovations inspired by Health Resources and Services Administration (HRSA’s Teaching Health Center funded residency program expansion quickly and consistently improved the KSA of Internal Medicine residents.

  12. Relationship between academic performance and affective changes during the first year at medical school.

    Science.gov (United States)

    Del-Ben, Cristina Marta; Machado, Vanessa Foresto; Madisson, Mariani Mendes; Resende, Tamara Lovatto; Valério, Fernando Passador; Troncon, Luiz Ernesto De Almeida

    2013-05-01

    Entering medical school may be associated with changes in the students' life, which can affect academic motivation and impair academic performance. This work aimed at measuring longitudinally academic motivation, anxiety, depression and social adjustment in first-year medical students and determining the relationships between these variables and academic performance, as measured mainly by grades on regular exams. Eighty-five first-year medical students (age: 17-25 years) were included after giving informed consent. Beck's Anxiety (BAI) and Beck's Depression (BDI) Inventories, the self-reported Social Adjustment Scale (SAS-SR) and the Academic Motivation Scale (AMS) were applied two months after admission and at the end of the academic year. BAI scores increased throughout the year (7.3 ± 6.6 versus 28.8 ± 6.7; p 0.10). SAS-SR subscales scores remained stable, except for a decreasing pattern for leisure/social life (1.8 ± 0.4 versus 2.1 ± 0.4; p students showed increased anxiety, decreased academic motivation and a maladjusted leisure/social life, which however does not seem to affect academic achievement.

  13. Self-reported extracurricular activity, academic success, and quality of life in UK medical students

    OpenAIRE

    Lumley, Sophie; Ward, Peter; Roberts, Lesley; Mann, Jake P.

    2015-01-01

    Objectives To explore the relationship between academic performance, extracurricular activity, and quality of life at medical school in the UK to aid our understanding of students’ work-life balance. Methods A cross-sectional study, using an electronic questionnaire distributed to UK final year medical students across 20 medical schools (4478 students). Participants reported the hours of self-regulated learning and extracurricular activities undertaken each year at medical school; along with ...

  14. Perceived psychological stress among undergraduate medical students: Role of academic factors

    OpenAIRE

    Ranadip Chowdhury; Abhijit Mukherjee; Kaushik Mitra; Somnath Naskar; Prasanta Ray Karmakar; Saibendu Kumar Lahiri

    2017-01-01

    Recently, there is a growing concern about stress during undergraduate medical training. The objectives of our study were to assess perceived stress among undergraduate medical students and to find out academic factors as determinants. A cross-sectional, questionnaire-based survey was carried out among undergraduate medical students of R. G. Kar Medical College, India, during July 2011–June 2012. Perceived stress was assessed using the Perceived Stress Scale-14. A 10-item questionnaire was us...

  15. Medication wrong route administration: a poisons center-based study.

    Science.gov (United States)

    Bloch-Teitelbaum, Alexandra; Lüde, Saskia; Rauber-Lüthy, Christine; Kupferschmidt, Hugo; Russmann, Stefan; Kullak-Ublick, Gerd A; Ceschi, Alessandro

    2013-03-01

    To describe clinical effects, circumstances of occurrence, management and outcomes of cases of inadvertent administration of medications by an incorrect parenteral route. Retrospective single-center consecutive review of parenteral route errors of medications, reported to our center between January 2006 and June 2010. We collected demographic data and information on medications, route and time of administration, severity of symptoms/signs, treatment, and outcome. Seventy-eight cases (68 adults, 10 children) were available for analysis. The following wrong administration routes were recorded: paravenous (51%), intravenous (33%), subcutaneous (8%), and others (8%). Medications most frequently involved were iodinated x-ray contrast media (11%) and iron infusions (9%). Twenty-eight percent of the patients were asymptomatic and 54% showed mild symptoms; moderate and severe symptoms were observed in 9% and 7.7%, respectively, and were mostly due to intravenous administration errors. There was no fatal outcome. In most symptomatic cases local nonspecific treatment was performed. Enquiries concerning administration of medicines by an incorrect parenteral route were rare, and mainly involved iodinated x-ray contrast media and iron infusions. Most events occurred in adults and showed a benign clinical course. Although the majority of exposures concerned the paravenous route, the occasional severe cases were observed mainly after inadvertent intravenous administration.

  16. Differing perceptions among ethnic minority and Caucasian medical students which may affect their relative academic performance.

    Science.gov (United States)

    Chandauka, Rumbidzai E; Russell, Jean M; Sandars, John; Vivekananda-Schmidt, Pirashanthie

    2015-01-01

    Ethnic minority (EM) medical students in the United Kingdom underperform academically compared to their Caucasian counterparts, but the reasons are unclear and further understanding is required. To explore self-reported factors that might influence academic underperformance of EM medical students. An online semi-structured questionnaire was used to identify associations between several dimensions that had been identified in previous research and obtain free-text comments. Three-hundred and fifty-one medical students (73.3% Caucasian and 26.5% EM) from the Universities of Sheffield, Keele and London responded. EM medical students were less satisfied with their academic performance and less likely to feel they belonged to the medical school community due to their cultural background, including socio-economic factors. Differences exist between EM and Caucasian medical students in their learning experiences in medical school. There is a need to increase awareness, for both medical students and teaching staff, of the impact of cultural diversity on academic performance at medical school.

  17. Predictors of self-reported academic performance among undergraduate medical students of Hawassa University, Ethiopia

    Science.gov (United States)

    Gedefaw, Abel; Tilahun, Birkneh; Asefa, Anteneh

    2015-01-01

    Background This study was conducted to identify predictors of self-reported academic performance in undergraduate medical students at Hawassa University. Methods An analytical cross-sectional study involving 592 undergraduate medical students was conducted in November 2012. The academic performance of the study subjects was measured by self-reported cumulative grade point average (GPA) using a self-administered questionnaire. Data were entered and analyzed using Statistical Package for the Social Sciences version 16 software. Pearson’s bivariate correlations, multiple linear regression, and multiple logistic regression were used to identify predictors of academic performance. Results The self-reported academic performance of students had been decreasing as the academic years progressed, with the highest and lowest performance being in the premedicine (mean GPA 3.47) and clinical I (mean GPA 2.71) years, respectively. One hundred and fifty-eight (26.7%) of the participants had ever been delayed, 37 (6.2%) had ever re-sat for examination, and two (0.3%) had ever been warned due to academic failure. The overall variation in self-reported academic performance of the students was 32.8%. Participant age alone explained 21.9% of the variation. On the other hand, university entrance examination results, substance use at university, and medicine as first choice by students were identified as predictors of variation in self-reported academic performance, accounting for 6.9%, 2.7%, and academic performance was explained by the studied variables. Hence, efficacious mechanisms should be designed to combat the intervenable determinants of self-reported academic performance, like substance use and a low medical school entrance examination result. Further studies should also be undertaken to gain a better understanding of other unstudied determinants, like personality, learning style, cognitive ability, and the system used for academic evaluation. PMID:25914564

  18. Academic procrastination and related factors in students of Guilan University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    MM Chehrzad

    2017-03-01

    Full Text Available Introduction: One of the challenges that students faced during their education is academic procrastination. It means “delay in performing a task”. Since academic procrastination could effect on various aspects of students' personal and social life, by identifying related factors it may be limited. This study aimed to determined academic procrastination and related factors in Students of Guilan University of Medical Sciences in 2015. Methods:  In this cross-sectional study, 459 students of all major programs of Guilan University of Medical Sciences were selected by stratified random sampling method. Data collection scales included three parts of demographic information, academic information and Procrastination Assessment Scale for Students (PASS by Solomon and Rothblum. Data was analyzed with T- Test, ANOVA, multiple regressions by SPSS V. 20.  Result: Most of students were female (72.7%, single (86% and undergraduate (66.6%. Mean score of academic procrastination was 63.3±9.1 and most students (69.5% had moderate procrastination. Academic procrastination had significant difference with gender (p=0.002 and academic level (p=0.03. Also in multiple regression models, gender, program of study  and academic level were main predictors of procrastination.  Females, dental students and postgraduate students had higher level of academic procrastination. Conclusion: There is a moderate academic procrastination in students of Guilan University of Medical Sciences and its relationship with gender, program of study and academic level was observed.  Investigation on causes and appropriate strategies to reduce this behavior is recommended.

  19. Predictors of self-reported academic performance among undergraduate medical students of Hawassa University, Ethiopia.

    Science.gov (United States)

    Gedefaw, Abel; Tilahun, Birkneh; Asefa, Anteneh

    2015-01-01

    This study was conducted to identify predictors of self-reported academic performance in undergraduate medical students at Hawassa University. An analytical cross-sectional study involving 592 undergraduate medical students was conducted in November 2012. The academic performance of the study subjects was measured by self-reported cumulative grade point average (GPA) using a self-administered questionnaire. Data were entered and analyzed using Statistical Package for the Social Sciences version 16 software. Pearson's bivariate correlations, multiple linear regression, and multiple logistic regression were used to identify predictors of academic performance. The self-reported academic performance of students had been decreasing as the academic years progressed, with the highest and lowest performance being in the premedicine (mean GPA 3.47) and clinical I (mean GPA 2.71) years, respectively. One hundred and fifty-eight (26.7%) of the participants had ever been delayed, 37 (6.2%) had ever re-sat for examination, and two (0.3%) had ever been warned due to academic failure. The overall variation in self-reported academic performance of the students was 32.8%. Participant age alone explained 21.9% of the variation. On the other hand, university entrance examination results, substance use at university, and medicine as first choice by students were identified as predictors of variation in self-reported academic performance, accounting for 6.9%, 2.7%, and academic performance was explained by the studied variables. Hence, efficacious mechanisms should be designed to combat the intervenable determinants of self-reported academic performance, like substance use and a low medical school entrance examination result. Further studies should also be undertaken to gain a better understanding of other unstudied determinants, like personality, learning style, cognitive ability, and the system used for academic evaluation.

  20. Racial and ethnic minority medical students' perceptions of and interest in careers in academic medicine.

    Science.gov (United States)

    Sánchez, J P; Peters, Lutheria; Lee-Rey, Elizabeth; Strelnick, Hal; Garrison, Gwen; Zhang, Kehua; Spencer, Dennis; Ortega, Gezzer; Yehia, Baligh; Berlin, Anne; Castillo-Page, Laura

    2013-09-01

    To describe diverse medical students' perceptions of and interest in careers in academic medicine. In 2010, the authors invited students attending three national medical student conferences to respond to a survey and participate in six focus groups. The authors identified trends in data through bivariate analyses of the quantitative dataset and using a grounded theory approach in their analysis of focus group transcripts. The 601 survey respondents represented 103 U.S. medical schools. The majority (72%) were in their first or second year; 34% were black and 17% were Hispanic. Many respondents (64%) expressed interest in careers in academic medicine; teaching and research were viewed as positive influences on that interest. However, black and Hispanic respondents felt they would have a harder time succeeding in academia. The 73 focus group participants (25% black, 29% Hispanic) described individual- and institutional-level challenges to academic medicine careers and offered recommendations. They desired deliberate and coordinated exposure to academic career paths, research training, clarification of the promotion process, mentorship, protected time for faculty to provide teaching and research training, and an enhanced infrastructure to support diversity and inclusion. Medical students expressed an early interest in academic medicine but lacked clarity about the career path. Black and Hispanic students' perceptions of having greater difficulty succeeding in academia may be an obstacle to engaging them in the prospective pool of academicians. Strategic and dedicated institutional resources are needed to encourage racial and ethnic minority medical students to explore careers in academic medicine.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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.

  3. Correlations between Academic Achievement and Anxiety and Depression in Medical Students Experiencing Integrated Curriculum Reform

    Directory of Open Access Journals (Sweden)

    Yi-Chun Yeh

    2007-08-01

    Full Text Available This study aimed to examine the correlations between academic achievement and levels of anxiety and depression in medical students who were experiencing curriculum reform. The differences in academic achievement and the directions of correlations between academic achievement and anxiety and depression among the medical students with different levels of anxiety and depression were also examined. Grade 1 students from graduate-entry program and grade 3 students from undergraduate-entry program in their first semester of the new curriculum were recruited to complete the Zung's Anxiety and Depression Scale twice to examine their levels of anxiety and depression. Their academic achievement ratings in the four blocks of the first semester of the new curriculum were collected. The results indicated that no significant correlation was found between academic achievement and global anxiety and depression. However, by dividing the medical students into low, moderate and high level anxiety or depression groups, those who had poorer academic achievement in the first learning block were more likely to have higher levels of depression in the first psychologic assessment. Among the medical students who were in the high anxiety level group in the first psychologic assessment, those who had more severe anxiety had poorer academic achievement in the fourth learning block. Among the medical students who were in the low anxiety level group in the second psychologic assessment, those who had more severe anxiety had better academic achievement in the fourth learning block. Among the medical students who were in the moderate anxiety level group in the second psychologic assessment, those who had more severe anxiety had poorer academic achievement in the second learning block. Among the medical students who were in the high depression level group in the second psychologic assessment, those who had more severe depression had poorer academic achievement in the fourth

  4. The relationship between critical thinking skills with creativity and academic achievement in students Qom University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Davood Mohammadi

    2016-04-01

    Full Text Available Introduction: Critical thinking improves students’ problem solving ability and is one of the main outputs of academic centers. It has an important role in medical sciences as the students studying these branches of science are getting ready to attend clinical work. Critical thinking helps to convey skills from class to clinic. This study aimed at investigating the relationship between critical thinking skills with creativity and academic achievement in students Qom University of Medical Sciences. Methods: In this descriptive­- correlation study was conducted on 303 students in Qom University of Medical Sciences were  selected through stratified random sampling method with considering gender. Data were collected through two standard questionnaires on critical thinking skills CCTST form(B and creativity Abedi. Data were analyzed using descriptive statistics methods, Pearson correlation and independent t-test, and multiple regression analysis. Results: The results of Pearson correlation test showed that there was significant positive relationship between critical thinking skills with creativity(P=0/000, r=0/267. But There was no a significant relationship between critical thinking skills with academic achievement(P=0/284, r=0/081 and creativity with academic achieveme (P=0/741, r=0/025. According to independent t-test results, there was no significant difference between male and female students’ average scores in critical thinking skills and creativity. But there was a significant difference between male and female students’ in academic achievement. Also multiple regression analysis revealed that only creativity predicted critical thinking skills significantly Conclusion: Critical thinking skills improving the process can improve students' creativity level. critical thinking skills affects creativity. Such relationship is increasingly important in students of medicine and health sciences

  5. 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

  6. Perceptions of pre-clerkship medical students and academic advisors about sleep deprivation and its relationship to academic performance: a cross-sectional perspective from Saudi Arabia

    OpenAIRE

    AlFakhri, Lama; Sarraj, Jumana; Kherallah, Shouq; Kuhail, Khulood; Obeidat, Akef; Abu-Zaid, Ahmed

    2015-01-01

    Background The medical student population is believed to be at an increased risk for sleep deprivation. Little is known about students? perceptions towards sleep deprivation and its relationship to academic performance. The aim of study is to explore the perceptions of medical students and their academic advisors about sleep deprivation and its relationship to academic performance. Methods The study took place at Alfaisal University, College of Medicine, Riyadh, Saudi Arabia. An online, anony...

  7. The Absent Interpreter in Administrative Detention Center Medical Units.

    Science.gov (United States)

    Rondeau-Lutz, Murielle; Weber, Jean-Christophe

    2017-03-01

    The particular situation of the French administrative detention center (ADC) medical units appears to be an exemplary case to study the difficulties facing medical practice. Indeed, the starting point of our inquiry was an amazing observation that needed to be addressed and understood: why are professional interpreters so seldom requested in ADC medical units, where one would expect that they would be "naturally" present? Aiming to fully explore the meanings of the "absent interpreter", this article takes into account the possible meanings of this situation: the recourse to professional interpreters in France is far from expected given cumulative evidence of its benefits; perceptions of illegal immigrants and medical habitus itself may both hamper the use of a third party; the ADCs are a very stressful place for healthcare professionals, with conflicting missions, political issues enmeshed with medical goals, and heavy affective burden that may lead to self-protection. Silencing voices of suffering others might be seen as the hidden indecent truth of the "absent interpreter". These reflections open a window to a larger issue with regard to the full range of medicine: what are the place, the role and the function of patient's words and narratives in contemporary medicine? The highly invested somatic perspective and its political corollary giving primacy to bare life harbor potential risks of obscuring speeches and undervaluing narratives.

  8. A model for training medical student innovators: the Harvard Medical School Center for Primary Care Abundance Agents of Change program.

    Science.gov (United States)

    Duong, David B; Sullivan, Erin E; Minter-Jordan, Myechia; Giesen, Lindsay; Ellner, Andrew L

    2016-01-01

    In 2013, the Harvard Medical School Center for Primary Care established the Abundance Agents of Change (AoC) program to promote interprofessional learning and innovation, increase partnership between 15 academic and community health centers (CHCs) in Boston's most under-served communities, and increase medical student interest in primary care careers. The AoC is modeled in the form of a 'grants challenge', offering $20,000 to interprofessional student teams to develop an innovative solution that addresses a healthcare delivery need identified by CHCs. The program's initial two years were characterized by a four-stage process which included working with CHCs and crafting a request for proposals, forming interprofessional 20 student teams comprising students from across and outside of Harvard University, training students using a systems-based innovation curriculum, and performing program evaluation. Our evaluation data from cohorts 1 and 2 of the AoC program demonstrate that we succeeded in training students as innovators and members of interprofessional teams. We also learned valuable lessons regarding creating better alignment with CHC priorities, extending the program cycle from 12 to 18 months, and changing the way funding is disbursed to 25 students, which will be incorporated in later versions of the program. Based on our experience and evaluation data, we believe that this program is a replicable way to train students as innovators and members of interprofessional teams to address the current complex healthcare environment.

  9. A structural model of stress, motivation, and academic performance in medical students.

    Science.gov (United States)

    Park, Jangho; Chung, Seockhoon; An, Hoyoung; Park, Seungjin; Lee, Chul; Kim, Seong Yoon; Lee, Jae-Dam; Kim, Ki-Soo

    2012-06-01

    The purpose of the present study was 1) to identify factors that may influence academic stress in medical students and 2) to investigate the causal relationships among these variables with path analysis. One hundred sixty medical students participated in the present study. Psychological parameters were assessed with the Medical Stress Scale, Minnesota Multiphasic Personality Inventory, Hamilton Depression Scale, Beck Depression Inventory, and Academic Motivation Scale. Linear regression and path analysis were used to examine the relationships among variables. Significant correlations were noted between several factors and Medical Stress scores. Specifically, Hamilton Depression Scale scores (β=0.26, p=0.03) and amotivation (β=0.20, p=0.01) and extrinsically identified regulation (β=0.27, pAcademic Motivation Scale had independent and significant influences on Medical Stress Scale scores. A path analysis model indicated that stress, motivation, and academic performance formed a triangular feedback loop. Moreover, depression was associated with both stress and motivation, and personality was associated with motivation. The triangular feedback-loop structure in the present study indicated that actions that promote motivation benefit from interventions against stress and depression. Moreover, stress management increases motivation in students. Therefore, strategies designed to reduce academic pressures in medical students should consider these factors. Additional studies should focus on the relationship between motivation and depression.

  10. A Structural Model of Stress, Motivation, and Academic Performance in Medical Students

    Science.gov (United States)

    Park, Jangho; An, Hoyoung; Park, Seungjin; Lee, Chul; Kim, Seong Yoon; Lee, Jae-Dam; Kim, Ki-Soo

    2012-01-01

    Objective The purpose of the present study was 1) to identify factors that may influence academic stress in medical students and 2) to investigate the causal relationships among these variables with path analysis. Methods One hundred sixty medical students participated in the present study. Psychological parameters were assessed with the Medical Stress Scale, Minnesota Multiphasic Personality Inventory, Hamilton Depression Scale, Beck Depression Inventory, and Academic Motivation Scale. Linear regression and path analysis were used to examine the relationships among variables. Results Significant correlations were noted between several factors and Medical Stress scores. Specifically, Hamilton Depression Scale scores (β=0.26, p=0.03) and amotivation (β=0.20, p=0.01) and extrinsically identified regulation (β=0.27, pAcademic Motivation Scale had independent and significant influences on Medical Stress Scale scores. A path analysis model indicated that stress, motivation, and academic performance formed a triangular feedback loop. Moreover, depression was associated with both stress and motivation, and personality was associated with motivation. Conclusion The triangular feedback-loop structure in the present study indicated that actions that promote motivation benefit from interventions against stress and depression. Moreover, stress management increases motivation in students. Therefore, strategies designed to reduce academic pressures in medical students should consider these factors. Additional studies should focus on the relationship between motivation and depression. PMID:22707964

  11. Benefits of personality characteristics and self-efficacy in the perceived academic achievement of medical students

    NARCIS (Netherlands)

    Guntern, Sabine; Korpershoek, Hanke; van der Werf, Greetje

    2017-01-01

    This study investigates the joint impact of personality characteristics and self‐efficacy on the perceived academic achievement of medical students on top of their prior high school performance. The sample consisted of medical students in their pre‐clinical years. The students’ grade point average

  12. Benefits of Personality Characteristics and Self-Efficacy in the Perceived Academic Achievement of Medical Students

    Science.gov (United States)

    Guntern, Sabine; Korpershoek, Hanke; van der Werf, Greetje

    2017-01-01

    This study investigates the joint impact of personality characteristics and self-efficacy on the perceived academic achievement of medical students on top of their prior high school performance. The sample consisted of medical students in their pre-clinical years. The students' grade point average scores at high school were included as control…

  13. Prescribing pharmacists in the ambulatory care setting: Experience at the University of North Carolina Medical Center.

    Science.gov (United States)

    Hawes, Emily M; Misita, Caron; Burkhart, Jena Ivey; McKnight, Lauren; Deyo, Zachariah M; Lee, Ruth-Ann; Howard, Caroline; Eckel, Stephen F

    2016-09-15

    The prescribing authorities, clinical activities, and productivity documentation strategies of ambulatory care clinic-based pharmacists pr