Identifying Inappropriate Dual Anti-Platelet Therapy (DAPT) Utilization in the Outpatient Setting

Background Problem Statement: Dual anti-platelet therapy (DAPT) is a cornerstone in management of many cardiovascular and cerebrovascular conditions; however, inappropriate and prolonged use can lead to increased bleeding risk. Despite guidelines on optimal DAPT duration for various clinical scenarios, a proportion of patients receive inappropriately extended courses of therapy, exposing them to unnecessary risk. Project AIM: We aim to (1) identify inappropriate DAPT use using established clinical guidelines at two academic primary care clinics and (2) develop and implement a targeted best practice advisory (BPA) in EPIC to address gaps in adherence to DAPT guidelines to enhance patient safety and quality of care

Early Immersion in Team-Based Event Review: Experiential Patient Safety Education for PGY 1 Internal Medicine Residents

INTRODUCTION: In recent years, there has been a national push to incorporate high-fidelity quality improvement and patient safety (QIPS) education into physician training programs. In fact, integration of robust patient safety education became an Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirement for residency programs in 2017. We developed a curriculum to not only fulfill the ACGME\u27s requirement but also provide PGY 1 internal medicine residents with the skills needed to become active participants in ongoing patient safety work throughout their training and careers. METHODS: Our patient safety curriculum was woven into residents\u27 existing protected educational time and supported by a standardized facilitator guide and participant workbook. It combined didactic prework with the review of recent near-miss or low-harm patient safety events, empowering residents to identify root causes and propose interventions. RESULTS: We successfully delivered our patient safety curriculum to 80 PGY 1 residents over the course of 2 academic years. Residents rated the curriculum as a valuable educational experience, and the event reviews they completed met most of the criteria for high-quality patient safety reviews according to the Strong String Assessment. DISCUSSION: Implementation of this standardized curriculum has allowed us to reliably and consistently incorporate experiential patient safety education into the first year of training for internal medicine residents. Unlike purely didactic sessions, our curriculum encourages active learning, building muscle memory for event reviews that enables future engagement in patient safety activities

1,000 conversations I\u27d rather have than that one: A qualitative study of prescriber experiences with opioids and the impact of a prescription drug monitoring program.

BACKGROUND: Prescription Drug Monitoring Programs (PDMPs) have shown impacts on a number of opioid-related outcomes but their role in clinician emotional experience of opioid prescribing has not been studied. OBJECTIVES: This study explores the impact of PDMPs on clinician attitudes toward and comfort with opioid prescribing, their satisfaction with patient interactions involving discussion of opioid prescriptions, and their recognition of opioid use disorder (OUD) and ability to refer patients to treatment. METHODS: Researchers conducted semi-structured interviews with five physicians and two nurse practitioners from a variety of specialties and practice environments. RESULTS: Many participants reported negative emotions surrounding opioid-related patient encounters, with decreased anxiety related to PDMP availability. These effects were less pronounced with clinicians who had greater opioid prescribing experience (either longer careers or higher-volume pain practices). Many participants felt uncomfortable around opioid prescribing. Data from the PDMP often changed prescribing practices, sometimes leading to greater comfort writing a prescription that might have felt riskier without PDMP data. Clinicians easily recognized patient behaviors, symptoms, and prescription requests suggesting that opioid-related adverse events were accumulating, but did not usually apply a label of OUD to these situations. PDMP findings occasionally contributed to a diagnosis and treatment referral for OUD. CONCLUSIONS: PDMP data is part of a nuanced approach to prescribing opioids. The objectivity of the data may be helpful in mitigating clinician negative emotions that are common around opioid therapy

Handoff Training in Undergraduate Medical Education – Identifying and Closing the Gaps

Objectives: Our study sought to assess differences in perceptions and the use of standardized handoff tools between medical students near completion of their third and fourth years of medical school at Sidney Kimmel Medical College. We hope to use this information to create targeted medical education interventions to better expose pre-clinical medical students to standardized handoff tools in the first and second years of medical school, before entering the wards.https://jdc.jefferson.edu/patientsafetyposters/1094/thumbnail.jp