The Pulse, 1995, V9 N9, Winter

Dreyer Medical Clinic, Aurora, IL: An issue of The Pulse, a publication for Dreyer Medical Clinic patients. This was a newsletter published for patients reporting on Dreyer news, events, classes, and staffing updates.https://institutionalrepository.aah.org/alldocuments/2065/thumbnail.jp

Development of American Society for Gastrointestinal Endoscopy standards for training in advanced endoscopy within dedicated advanced endoscopy fellowship programs

Background and aims:Training in interventional endoscopy is offered by nonaccredited advanced endoscopy fellowship programs (AEFPs). The number of these programs has increased dramatically with a concurrent increase in the breadth and complexity of interventional endoscopy procedures. Accreditation is governed by competency-based education, yet what constitutes a high-quality nonaccredited AEFP has not been defined. Using an evidence-based consensus process, we aimed to establish standards for AEFPs. Methods:The RAND UCLA appropriateness method, a well-described modified Delphi process to develop quality indicators, was used. A task force established by the American Society for Gastrointestinal Endoscopy drafted potential quality indicators (structure, process, and outcome) in 6 categories: activity preceding training; structure of AEFPs; training in ERCP, EUS, and EMR; and luminal stent placement. Three rounds of iterative feedback from 20 experts were conducted. Round 0 involved discussion of project details. In round 1, experts independently ranked proposed quality indicators on a 9-point interval scale ranging from highly inappropriate (1) to highly appropriate (9). Next, proposed quality indicators were discussed and reworded in a group meeting followed by round 2, in which experts independently reranked proposed quality indicators and provided benchmarks (when applicable). The median score for each quality indicator was calculated. Mean absolute deviation from the median was calculated, and appropriateness of potential quality indicators was assessed using the BIOMED concerted action on appropriateness definition, P value method, and interpercentile range adjusted for symmetry definition. A quality indicator was deemed appropriate if the median score was ≥7 and met criteria for appropriateness using all 3 defined statistical methods. Results:Of 89 proposed quality indicators, 37 statements met criteria as appropriate for a quality indicator (activity preceding training, 2; structure of AEFPs, 10; training in ERCP, 7; training in EUS, 8; training in EMR, 7; luminal stent placement, 3). Minimum thresholds were defined for 19 relevant quality indicators for number of trainers, procedures during fellowship, and procedures before assessment of competence. Among the final appropriate quality indicators were that all trainees should undergo qualitative and quantitative competence assessments using validated tools at least quarterly with documented feedback throughout the training period and that trainees should track outcomes and relevant quality metrics for specific procedures. Conclusions:This consensus process using validated methodology established standards for an AEFP in an effort to ensure adequate training in the most commonly taught interventional endoscopic procedures (ERCP, EUS, EMR, and luminal stent placement) during fellowship. An important component of an AEFP is the use of competency-based assessments that are compliant with the Accreditation Council for Graduate Medical Education\u27s Next Accreditation System, with the goal of ensuring that trainees achieve specific milestones in their progression to achieving cognitive and technical competency

Standardized clinical infectious diseases pharmacy care delivery and antimicrobial stewardship program management within a large, integrated healthcare system

Purpose:Infectious Diseases (ID) pharmacy expertise is crucial for the success of antimicrobial stewardship (AMS) efforts. As health systems expand due to mergers and acquisitions, ID pharmacy teams strive to deliver consistent care across the enterprise. This report describes the fusion of multiple AMS practice models during the integration of health systems to optimize and standardize care delivery. Summary:The merger of two large, community hospital systems necessitated the recalibration of services of both legacy antimicrobial stewardship programs (ASPs). While there was agreement that ID pharmacists perform daily prospective audit and feedback of antimicrobials and respond to diagnostics and cultures, the prioritization of practices across the enterprise that retained allowances for individual hospital nuance was paramount. The result was a practice model dedicated to consistent patient care regardless of geographic location, socioeconomic status, or reliance on a single ID pharmacist\u27s availability. Additionally, the team coordinates the system ASP, in collaboration with medical staff. This includes implementation of stewardship initiatives, formulary management and guideline and document control. Lastly, ID pharmacists serve as a resource for prescribers and pharmacy staff and leadership. Conclusion:The development of a standardized ID pharmacy practice model delivered through a hybrid of remote and in-person coverage addressed disparities in clinical services, education and ASP management. Complexities such as care gaps during leave are reconciled with this process while maintaining the minimum expectations of every ID pharmacist. This was especially crucial to establish consistent patient care across state lines with the rise of virtual services and inability to develop on-site rapport

Efficacy and safety of immune checkpoint inhibitors in metastatic penile squamous cell carcinoma: A retrospective multicenter analysis

Penile squamous cell carcinoma (PSCC) is a rare malignancy, and first-line therapy typically involves cisplatin-based chemotherapy. However, these regimens are often unsuitable for patients with poor performance status or advanced age due to their toxicity. This retrospective, multicenter study evaluated patients with metastatic PSCC who received immune checkpoint inhibitor (ICI) therapy between 2017 and 2024. A total of 10 patients met the inclusion criteria. The median age was 75 years, and 50% had an ECOG performance status of 2 or higher. The objective response rate (ORR) was 30%, and the disease control rate (DCR) was 40%. The duration of response and disease control was over 12 months and 8 months respectively in all patients with response or disease control. The median progression-free survival (PFS) was 2.82 months, and the median overall survival (OS) was 4.32 months. PD-L1 and HPV-positive patients had a 67% response rate (n = 2/3). No patients experienced severe immune-related adverse events (irAEs). This multicenter retrospective analysis suggests that ICI monotherapy may be a promising treatment option for patients with advanced PSCC who are either ineligible for first-line platinum-based chemotherapy or who have progressed after platinum-based chemotherapy, including those with poor performance status. Further studies are needed to confirm these findings and identify baseline patient characteristics that may optimize selection criteria

Nursing Now, 2009 September - October

Advocate Christ Medical Center and Hope Children\u27s Hospital, Oak Lawn, IL: Internal newsletter publication written by nurses for nurses and published 6 times a year (bi-monthly). The mission of NURSING Now was to communicate, educate and motivate CMC nursing professionals towards continued excellence.https://institutionalrepository.aah.org/alldocuments/2152/thumbnail.jp

Heartbeat, 1999 December

Dreyer Medical Clinic, Aurora, IL: An issue of Dreyer Heartbeat. This was an employee newsletter published by the marketing department, reporting on news, events, and staffing updates at Dreyer Medical Clinic.https://institutionalrepository.aah.org/alldocuments/1961/thumbnail.jp

Dreyer Heartbeat, 1994 August-September

Dreyer Medical Clinic, Aurora, IL: An issue of Dreyer Heartbeat. This was an employee newsletter published by the marketing department, reporting on news, events, and staffing updates at Dreyer Medical Clinic.https://institutionalrepository.aah.org/alldocuments/1915/thumbnail.jp

Heartbeat, 2004 August

Dreyer Medical Clinic, Aurora, IL: An issue of Dreyer Heartbeat. This was an employee newsletter published by the marketing department, reporting on news, events, and staffing updates at Dreyer Medical Clinic.https://institutionalrepository.aah.org/alldocuments/2020/thumbnail.jp

Heartbeat, 1997 August

Dreyer Medical Clinic, Aurora, IL: An issue of Dreyer Heartbeat. This was an employee newsletter published by the marketing department, reporting on news, events, and staffing updates at Dreyer Medical Clinic.https://institutionalrepository.aah.org/alldocuments/1937/thumbnail.jp