Use of Standardized Patient Scenarios to Train Medical Assistants in an Ambulatory Rehabilitation Medicine Clinic

Objectives: To improve the efficiency of our outpatient Rehabilitation Medicine clinic without sacrificing high value/quality patient care. To clarify the responsibilities of the MA and identify areas of redundancy in the rooming process. To demonstrate the utility of in-situ simulation for MA training. To reduce the time it takes for MAs to complete all assigned tasks to 10 minutes or less per encounter in at least 50% of patient encounters within two months from the time of intervention. To potentially highlight other areas in which to improve clinic efficiency and overall patient satisfaction (e.g. front desk registration process, resident and attending physician encounters, clinic and exam room accessibility).https://jdc.jefferson.edu/patientsafetyposters/1051/thumbnail.jp

Got Diabetes? With Us, You\u27ll Have Complete Diabetic Care

AIM: By April 2016, we aim to improve Complete Diabetic Care of Thursday JHAP Clinic\u27s patients with diabetes by 50%. * These authors contributed equallyhttps://jdc.jefferson.edu/patientsafetyposters/1007/thumbnail.jp

Departmental Retreat: The Big Four and Integration

Fall is here, excitement is in the air, and we in the Department of Surgery have begun the journey towards clinical integration with our partners at Abington and Aria. On Saturday, September 24, 2016, nearly 100 attendees joined us in the Hamilton Building for our second Department of Surgery retreat in the last 18 months. This retreat differed from our first as we focused on two topics: The Big Four and Jefferson Health System Integration. The morning commenced with a reminder of our vision and mission statements, a review of the fiscal exigencies which prompted a need for change, and the charge to the participants. Dean David Nash then spoke on “Population Health: Is it the Secret Sauce?” and Dr. Anne Docimo, CMO, followed on the topic of “The Search for Value in the Healthcare Marketplace.” Next, Jasmine Arfaa, PhD, MHSA, and Terry Lynch (Press Ganey Associates) spoke on “The Patient Experience at Jefferson.” Finally, Mr. Neil Lubarsky, SVP for Finance, expertly discussed “Healthcare Cost Consciousness.” Following these four thought provoking talks, breakout sessions were held to encourage brainstorming and the prioritizing of our action plans. Following lunch, Hugh Lavery, SVP for Government Affairs, spoke on “Federal and State Landscapes.” President Steven Klasko, MD, MBA, speaking on his 3rd Anniversary at Jefferson (applause!) reviewed the numerous governance alterations that have taken place creating a more nimble and expansive Jefferson Health System. The half day retreat ended with a summary and action plan by each of the group facilitators. It was wonderful to sit in the same room with our colleagues from Jefferson, Methodist, Abington, Aria, and the Main Line. The interactions were robust, introductions were made, shared threats and opportunities were discussed, and…now the work begins! Soon, Jefferson’s Integration Management Office (JIMO) will nucleate surgical integration teams to help develop and implement changes to support our Jefferson Integration 2.0 goal. We will need timelines, milestones, and deliverables. Various project managers will be assigned. There is excitement in the air and hard work to do. We in the Department of Surgery have the opportunity to help lead this integration process. Recordings of the morning presentations are available at: jdc.Jefferson.edu/surgeryretrea

Clinical Impact of a Novel Interprofessional Dental and Pharmacy Student Tobacco Cessation Education Program on Dental Patients

Objectives: • To compare the difference between IPE care and standard care (SC) groups regarding dental patients\u27 perceptions of knowledge gained about tobacco cessation, intentions to quit tobacco use, and quit attempts at follow-up. • To evaluate perceptions of IPE care. Background: Based on the link between tobacco use and oral health and the frequent contact between dental providers and patients, the dental clinic is an ideal setting to address tobacco use.1 • Many dentists feel unprepared providing tobacco cessation education, particularly pharmacologic treatment options.1-3 • Pharmacists promote safe and effective pharmacologic treatment options for tobacco dependence and patients’ perceptions toward pharmacist-provided tobacco cessation education have been positive.4-6 • A novel interprofessional education (IPE) program involving dental and pharmacy students may address the need for tobacco cessation education in the dental clinic setting

Comparison of Online 6 Degree-of-Freedom Image Registration of Varian TrueBeam Cone-Beam CT and BrainLab ExacTrac X-Ray for Intracranial Radiosurgery.

PURPOSE: The study was aimed to compare online 6 degree-of-freedom image registrations of TrueBeam cone-beam computed tomography and BrainLab ExacTrac X-ray imaging systems for intracranial radiosurgery. METHODS: Phantom and patient studies were performed on a Varian TrueBeam STx linear accelerator (version 2.5), which is integrated with a BrainLab ExacTrac imaging system (version 6.1.1). The phantom study was based on a Rando head phantom and was designed to evaluate isocenter location dependence of the image registrations. Ten isocenters at various locations representing clinical treatment sites were selected in the phantom. Cone-beam computed tomography and ExacTrac X-ray images were taken when the phantom was located at each isocenter. The patient study included 34 patients. Cone-beam computed tomography and ExacTrac X-ray images were taken at each patient\u27s treatment position. The 6 degree-of-freedom image registrations were performed on cone-beam computed tomography and ExacTrac, and residual errors calculated from cone-beam computed tomography and ExacTrac were compared. RESULTS: In the phantom study, the average residual error differences (absolute values) between cone-beam computed tomography and ExacTrac image registrations were 0.17 ± 0.11 mm, 0.36 ± 0.20 mm, and 0.25 ± 0.11 mm in the vertical, longitudinal, and lateral directions, respectively. The average residual error differences in the rotation, roll, and pitch were 0.34° ± 0.08°, 0.13° ± 0.09°, and 0.12° ± 0.10°, respectively. In the patient study, the average residual error differences in the vertical, longitudinal, and lateral directions were 0.20 ± 0.16 mm, 0.30 ± 0.18 mm, 0.21 ± 0.18 mm, respectively. The average residual error differences in the rotation, roll, and pitch were 0.40°± 0.16°, 0.17° ± 0.13°, and 0.20° ± 0.14°, respectively. Overall, the average residual error differences wer