Tracking and Improving Bedside Procedures Through Standardized Documentation

Proposal and Goals: We propose to create a standardized electronic procedure note that will replace all documentation for bedside procedures without sedation. ◦Makes notes legible and easily identified ◦Allows uniform tracking of metrics necessary to identify outcomes from a procedure (blood loss, specimens, post-procedure studies, complications) 2.The procedure note will be created in such a way as to allow specialized procedures to be added over time with minor customization to improve physician/nursing work flows and increase efficiency ◦Allows procedures to be sorted and tracked by type ◦Will be constructed to allow attaching CPT codes to patient charts via documentation 3. We propose using this procedure note to create a running database of all bedside procedures ◦Can be utilized by existing software (Qlik) to query all procedure notes to create large anonymized patient listshttps://jdc.jefferson.edu/patientsafetyposters/1071/thumbnail.jp

The Unique Contribution of Behavioral Scientists to Medical Education: The Top Ten Competencies

Understandably, the focus of most physicians is primarily on the biomedical-What is this disease or injury? Behavioral scientists from various disciplines in medical education generally have a broader approach-Who is this person with these symptoms and what is their story? Since behavioral scientists are often alone among U. S. residency faculty, physicians may fail to recognize the value of their approach to medical resident training. This review identifies and describes the top areas of expertise that behavioral scientists bring to medical education and how their training prepares them to think differently than other medical educators. In the course of identifying each competency, this review will emphasize the ways in which their skills and techniques are the origin of subtle impact in their teaching encounters, explore ways of targeting that impact, and discuss examples of this impact

A Guide to Introducing and Integrating Reflective Practices in Medical Education.

It is a significant challenge for any medical education program to provide adequate training in medical knowledge. It can be just as daunting to include appropriate opportunity to learn about and manage the emotional impact of illness experiences, the healing process, and provider-patient relationships. While there may be only a few basic changes to the core of medical knowledge, advances in medical practice regularly have an impact on the nature of patient care. Life-long learning is essential to maintain one\u27s competence. However, everything doctors and other medical professionals learn about relationships with patients during their training is relevant for the rest of their career. One primary source of this learning are reflective practices. However, there is no guide or description of or comparison among the distinguishing characteristics of reflective processes. In addition, there are no criteria for the selection or integration of reflective processes in medical training or beyond. This article proposes understanding reflection as a complex, three-level process and identifies dimensions which differentiate a variety of reflective process activities. The discussion includes considerations for selecting which activities might be usefully incorporated in education curricula, and identifies conditions of medical training cultures that will support successful integration

Filling the Void: A Low Cost, High-Yield Method to Addressing Incidental Findings in Trauma Patients

In this study we: Report the incidence of incidental findings in a suburban trauma center treating primarily blunt and elderly trauma Propose simple solutions to increase the rate of disclosure to patientshttps://jdc.jefferson.edu/patientsafetyposters/1070/thumbnail.jp

Stripes Induced by Orbital Ordering in Layered Manganites

Spin-charge-orbital ordered structures in doped layered manganites are investigated using an orbital-degenerate double-exchange model tightly coupled to Jahn-Teller distortions. In the ferromagnetic phase, unexpected diagonal stripes at $x$=$1/m$ ($m$=integer) are observed, as in recent experiments. These stripes are induced by the orbital degree of freedom, which forms a staggered pattern in the background. A $\pi$-shift in the orbital order across stripes is identified, analogous to the $\pi$-shift in spin order across stripes in cuprates. At $x$=1/4 and 1/3, another non-magnetic phase with diagonal static charge stripes is stabilized at intermediate values of the $t_{\rm 2g}$-spins exchange coupling.Comment: reordering of figure

Stripe order, depinning, and fluctuations in La1.875_{1.875}Ba0.125_{0.125}CuO4_{4} and La1.875_{1.875}Ba0.075_{0.075}Sr0.050_{0.050}CuO4_{4}

We present a neutron scattering study of stripe correlations measured on a single crystal of La$_{1.875}$Ba$_{0.125}$CuO$_{4}$. Within the low-temperature-tetragonal (LTT) phase, superlattice peaks indicative of spin and charge stripe order are observed below 50 K. For excitation energies $\hbar\omega\le12$ meV, we have characterized the magnetic excitations that emerge from the incommensurate magnetic superlattice peaks. In the ordered state, these excitations are similar to spin waves. Following these excitations as a function of temperature, we find that there is relatively little change in the {\bf Q}-integrated dynamical spin susceptibility for $\hbar\omega\sim10$ meV as stripe order disappears and then as the structure transforms from LTT to the low-temperature-orthorhombic (LTO) phase. The {\bf Q}-integrated signal at lower energies changes more dramatically through these transitions, as it must in a transformation from an ordered to a disordered state. We argue that the continuous evolution through the transitions provides direct evidence that the incommensurate spin excitations in the disordered state are an indicator of dynamical charge stripes. An interesting feature of the thermal evolution is a variation in the incommensurability of the magnetic scattering. Similar behavior is observed in measurements on a single crystal of La$_{1.875}$Ba$_{0.075}$Sr$_{0.050}$CuO$_{4}$; maps of the scattered intensity in a region centered on the antiferromagnetic wave vector and measured at $\hbar\omega=4$ meV are well reproduced by a model of disordered stripes with a temperature-dependent mixture of stripe spacings. We discuss the relevance of our results to understanding the magnetic excitations in cuprate superconductors.Comment: 12 pages, 11 figures, 1 tabl