Lost in Translation: A Standardized, Interdepartmental Approach to Improve the Safety of Inpatient Transitions of Care

AIM: During the 2016-2017 academic year physician perception of favorability regarding inpatient interunit handoffs will meet the national HSOPS benchmark without negatively impacting patient bed flow. All ACGME training programs at Thomas Jefferson University Hospital will expose their new trainees to standardized handoff training during orientation in June 2017 as well as adapt a framework for monitoring trainee compliance and proficiency.https://jdc.jefferson.edu/patientsafetyposters/1028/thumbnail.jp

Understanding Differences in Medical Versus Surgical Patients Alerted by the Modified Early Warning Score (MEWS) at Jefferson Hospital

An Early Warning Score (EWS) is a risk-management tool to identify patients experiencing clinical deterioration early, therefore allowing timely treatment to occur. Although EWS scores are recommended for all in-patients, more data is available for patients under general medical services compared to surgical services. This study aims to understand differences between medical versus surgical in-patients who receive a red alert from the Modified Early Warning Score (MEWS) at Jefferson hospital. Patients who received a red MEWS alert during admission and discharged between June 2017 to March 2018 (N=812) were categorized as medical or surgical patients. Patient characteristics were compared using an independent samples t-test (age, alert count) or chi-square test (sex, race, admission source, insurance). Patient outcomes were compared using a binary logistic regression (in-hospital mortality, RRT, sepsis diagnosis, ICU transfer, intubation, discharge to hospice) or a Cox regression model (length of stay), controlling for age, sex, and race. Compared to medical patients, surgical patients were younger by 2.7 years (p=0.026) and more likely to have a Commercial and/or Medicare category of insurance (OR=1.568, p=0.005). Surgical patients were more likely to have ICU transfer (OR=1.487, p=0.013) and intubation post-alert (OR=2.470, p=0.006), while less likely to be discharged early (HR=0.675,

To Fib or Not to Fib: Misdiagnosis of Atrial Fibrillation on Telemetry Case Presentation and Root Cause Analysis

Case presentation, current practices of telemetry management, root cause analysis, goals for improvement, proposed intervention and next steps

Scale Dependence of Dark Energy Antigravity

We investigate the effects of negative pressure induced by dark energy (cosmological constant or quintessence) on the dynamics at various astrophysical scales. Negative pressure induces a repulsive term (antigravity) in Newton's law which dominates on large scales. Assuming a value of the cosmological constant consistent with the recent SnIa data we determine the critical scale $r_c$ beyond which antigravity dominates the dynamics ($r_c \sim 1Mpc$) and discuss some of the dynamical effects implied. We show that dynamically induced mass estimates on the scale of the Local Group and beyond are significantly modified due to negative pressure. We also briefly discuss possible dynamical tests (eg effects on local Hubble flow) that can be applied on relatively small scales (a few $Mpc$) to determine the density and equation of state of dark energy.Comment: Contributed talk at the 2nd Hellenic Cosmology Workshop at NOA (Athens) Jan. 2001.To appear in the proceedings. Based on work done in collaboration with M. Axenides and E. Florato

We Are What We Pre-Attend To Be: Piloting a Pre-Attendingship Rotation in Hospital Medicine

Problem Definition New-to-practice attendings (NPTAs) lack readiness for independent practice Graduated autonomy – understood but not structurally enforced in residency training Curricular expectations not explicitly defined despite experiential differences between graduate training levels of PGY2 and PGY3 internal medicine residents Although residents achieve competencies established by the ACGME prior to graduation, NTPAs feel unprepared suggesting opportunities to change the clinical learning environment to increasehttps://jdc.jefferson.edu/medposters/1022/thumbnail.jp

Taking the e out of Night MARe Rotation: Uncloaking Ghost Admissions via Teletracking and Reducing Paper Fatigue

Goal: To improve communication at admission for patients admitted from non-ED locations so that patient care delays are minimized and provider frustration decreases.https://jdc.jefferson.edu/patientsafetyposters/1015/thumbnail.jp

Norman Jaffe, MD, Oral History Interview, August 31, 2012

Major Topics Covered: Personal and educational background Working with Dr. Sidney Farber at the Sidney Farber Cancer Institute in Boston Cancer in pediatric patients; “total care” of pediatric patients; special challenges Research: solid tumors, osteosarcoma, eradicating metastasis with methotrexate The Department of Pediatric Oncology: history and evolution Pediatrics and survivorship Long-Term Surveillance Clinic Ski Rehabilitation Program International collaborationshttps://openworks.mdanderson.org/mchv_interviewsessions/1163/thumbnail.jp

Norman Jaffe, MD, Oral History Interview, April 20, 2012

Major Topics Covered: Personal and educational background Working with Dr. Sidney Farber at the Sidney Farber Cancer Institute in Boston Cancer in pediatric patients; “total care” of pediatric patients; special challenges Research: solid tumors, osteosarcoma, eradicating metastasis with methotrexate The Department of Pediatric Oncology: history and evolution Pediatrics and survivorship Long-Term Surveillance Clinic Ski Rehabilitation Program International collaborationshttps://openworks.mdanderson.org/mchv_interviewsessions/1161/thumbnail.jp

Norman Jaffe, MD, Oral History Interview, August 17, 2012

Major Topics Covered: Personal and educational background Working with Dr. Sidney Farber at the Sidney Farber Cancer Institute in Boston Cancer in pediatric patients; “total care” of pediatric patients; special challenges Research: solid tumors, osteosarcoma, eradicating metastasis with methotrexate The Department of Pediatric Oncology: history and evolution Pediatrics and survivorship Long-Term Surveillance Clinic Ski Rehabilitation Program International collaborationshttps://openworks.mdanderson.org/mchv_interviewsessions/1162/thumbnail.jp