Analyzing Patient Satisfaction and Improved Physician-Patient Communication Using Introductory Brochures

AIM: Assess how the use of introductory brochures added to patient satisfaction at time of discharge. Also, assess whether the brochure helped foster improved physician-patient communication.https://jdc.jefferson.edu/patientsafetyposters/1003/thumbnail.jp

Should we Set a Formalized Discharge Instruction Education Standard?

Smart AIM: With a more formalized discharge instruction evaluation process for PGY-1s, discharge instructions for specific diagnoses will have less error in a year’s time.https://jdc.jefferson.edu/patientsafetyposters/1035/thumbnail.jp

Development and Validation of a Prediction Model for Stroke, Cardiac, and Mortality Risk After Non-Cardiac Surgery.

Background: Commonly used cardiovascular risk calculators do not provide risk estimation of stroke, a major postoperative complication with high morbidity and mortality. We developed and validated an accurate cardiovascular risk prediction tool for stroke, major cardiac complications (myocardial infarction or cardiac arrest), and mortality after non-cardiac surgery. Methods and Results: This retrospective cohort study included 1 165 750 surgical patients over a 4-year period (2007-2010) from the American College of Surgeons National Surgical Quality Improvement Program Database. A predictive model was developed with the following preoperative conditions: age, history of coronary artery disease, history of stroke, emergency surgery, preoperative serum sodium (≤130 mEq/L, \u3e146 mEq/L), creatinine \u3e1.8 mg/dL, hematocrit ≤27%, American Society of Anesthesiologists physical status class, and type of surgery. The model was trained using American College of Surgeons National Surgical Quality Improvement Program data from 2007 to 2009 (n=809 880) and tested using data from 2010 (n=355 870). Risk models were developed using multivariate logistic regression. The outcomes were postoperative 30-day stroke, major cardiovascular events (myocardial infarction, cardiac arrest, or stroke), and 30-day mortality. Major cardiac complications occurred in 0.66% (n=5332) of patients (myocardial infarction, 0.28%; cardiac arrest, 0.41%), postoperative stroke in 0.25% (n=2005); 30-day mortality was 1.66% (n=13 484). The risk prediction model had high predictive accuracy with area under the receiver operating characteristic curve for stroke (training cohort=0.869, validation cohort=0.876), major cardiovascular events (training cohort=0.871, validation cohort=0.868), and 30-day mortality (training cohort=0.922, validation cohort=0.925). Surgery types, history of stroke, and coronary artery disease are significant risk factors for stroke and major cardiac complications. Conclusions: Postoperative stroke, major cardiac complications, and 30-day mortality can be predicted with high accuracy using this web-based predictive model

Evaluating the Efficacy of a Nursing-Driven versus Provider-Driven Heparin Protocol

At Thomas Jefferson University Hospital patients who require heparin infusions are monitored either by nursing alone or the resident and the nurse together. This project aims to determine: Which protocol more efficiently shortens the time to therapeutic? Are patients therapeutic longer under a certain protocol? Do more patients under either protocol suffer from bleeding complications

The TJUH Hospital Medicine COVID19 Emergency Taskforce: A guiding light during the surge of spring 2020

What’s the Problem? In mid March 2020 a highly infectious and deadly disease appeared in Philadelphia that no American physician had ever treated before. The challenge of disseminating reliable and relevant information about a novel and dangerous pathogen across practice areas cannot be understated. Usual practices for communication and leadership are not designed to manage this kind of challenge

A Case of Eosinophilic Granulomatosis with Polyangiitis

INTRODUCTION Eosinophilic granulomatosis with polyangiitis (eGPA) is a small- and medium-sized-vessel vasculitis with multi-organ manifestations. Given the rarity of eGPA, patients are often misdiagnosed for decades and may initially present with life-threatening manifestations of late-stage disease. Therefore, it is important to raise awareness of this condition and its associated signs and symptoms. This case report serves to describe a classic presentation of a patient with eGPA, as well as to delineate the diagnostic workup, acute management, and early outpatient follow-up required. KEY POINTS Given the life-threatening complications of this rare condition, it is important to raise awareness about eGPA. This is a classic presentation of eGPA in a patient with a decades-long asthma history, eosinophilia, new lung and gastrointestinal manifestations, and systemic symptoms. His serologies were significant for positive C-ANCA of anti-PR-3 specificity. His clinical course included screening for gastrointestinal, renal, and cardiac involvement as well as initiating steroid therapy, plasmapheresis, and rituximab