The impact of documentation burden on patient care and surgeon satisfaction

Abstract Background Measuring antimicrobial consumption data is a foundation of antimicrobial stewardship programs. There is data to support antimicrobial scorecard utilization to improve antibiotic use in the outpatient setting. There is a lack of data on the impact of an antimicrobial scorecard for hospitalists. Our objective was to improve antibiotic prescribing amongst the hospitalist service through the development of an antimicrobial scorecard. Methods Conducted in a 451-bed teaching hospital amongst 22 full time hospitalists. The antimicrobial scorecard for 2019 was distributed in two phases. In October 2019, baseline antibiotic prescribing data (January – September 2019) was distributed. In January 2020, a second scorecard was distributed (October – December 2019) to assess the impact of the scorecard. The scorecard distributed via e-mail to physicians included: Antibiotic days of therapy/1,000 patient care days (corrected for attending census), route of antibiotic prescribing (% intravenous (IV) vs % oral (PO)) and percentage of patients prescribed piperacillin-tazobactam (PT) for greater than 3 days. Hospitalists received their data in rank order amongst their peers. Along with the antimicrobial scorecard, recommendations from the antimicrobial stewardship team were included for hospitalists to improve their antibiotic prescribing for these initiatives. Hospitalists demographics (years of practice and gender) were collected. Descriptive statistics were utilized to analyze pre and post data. Results Sixteen (16) out of 22 (73%) hospitalists improved their antibiotic prescribing from pre- to post-scorecard (χ 2(1)=3.68, p = 0.055). The median antibiotic days of therapy/1,000 patient care days decreased from 661 pre-scorecard to 618 post-scorecard (p = 0.043). The median PT use greater than 3 days also decreased significantly, from 18% pre-scorecard to 11% post-scorecard (p = 0.0025). There was no change in % of IV antibiotic prescribing and no correlation between years of experience or gender to antibiotic prescribing. Conclusion Providing antimicrobial scorecards to our hospitalist service resulted in a significant decrease in antibiotic days of therapy/1,000 patient care days and PT prescribing beyond 3 days. Disclosures All Authors: No reported disclosures

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Telemedicine Experience of General Surgery Trainees: Impact on Patient Care and Education

The American Surgeon ◽

10.1177/00031348211023402 ◽

2021 ◽

pp. 000313482110234

Author(s):

Brandon J Nakashima ◽

Navpreet Kaur ◽

Chelsey Wongjirad ◽

Kenji Inaba ◽

Mohd Raashid Sheikh

Keyword(s):

Patient Care ◽

Surgical Training ◽

General Surgery ◽

Southern California ◽

University Of Southern California ◽

General Surgery Residency ◽

Surgical Training Program ◽

Current Utilization ◽

Surgery Resident ◽

The Impact

Objective The COVID-19 pandemic has had a significant impact on patient care, including the increased utilization of contact-free clinic visits using telemedicine. We looked to assess current utilization of, experience with, and opinions regarding telemedicine by general surgery residents at an academic university–based surgical training program. Design A response-anonymous 19-question survey was electronically distributed to all general surgery residents at a single academic university–based general surgery residency program. Setting University of Southern California (USC) general surgery residency participants: Voluntarily participating general surgery residents at the University of Southern California. Results The response rate from USC general surgery residents was 100%. A majority of residents (76%) had utilized either video- or telephone-based visits during their careers. No resident had undergone formal training to provide telemedicine, although most residents indicated a desire for training (57.1%) and acknowledged that telemedicine should be a part of surgical training (75.6%). A wide variety of opinions regarding the educational experience of residents participating in telemedicine visits was elicited. Conclusions The COVID-19 pandemic brought telemedicine to the forefront as an integral part of future patient care, including for surgical patients. Additional investigations into nationwide telemedicine exposure and practice among United States general surgery residencies is imperative, and the impact of the implementation of telemedicine curricula on general surgery resident telemedicine utilization, comfort with telemedicine technology, and patient outcomes are further warranted. Competencies Practice-based learning, systems-based practice, interpersonal and communication skills

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Building capacity for implementation—the KT Challenge

Implementation Science Communications ◽

10.1186/s43058-021-00186-x ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Agnes T. Black ◽

Marla Steinberg ◽

Amanda E. Chisholm ◽

Kristi Coldwell ◽

Alison M. Hoens ◽

...

Keyword(s):

Health Care ◽

Patient Care ◽

Health Care Professionals ◽

Qualitative Data ◽

Practice Change ◽

Evidence Based ◽

Science Literature ◽

Health Care Settings ◽

Improvement Programs ◽

The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change. Methods The evaluation used a mixed-methods retrospective pre-post design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, 6 months into implementation, and at the end of the 2-year funded projects) to measure KT capacity (knowledge, skills, and confidence) and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analyzed using non-parametric statistics. Results Participants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. Conclusions The KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

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Pediatric Endocrinology in the Time of COVID-19: Considerations for the Rapid Implementation of Telemedicine and Management of Pediatric Endocrine Conditions

Hormone Research in Paediatrics ◽

10.1159/000513060 ◽

2020 ◽

Vol 93 (6) ◽

pp. 343-350

Author(s):

Molly O. Regelmann ◽

Rushika Conroy ◽

Evgenia Gourgari ◽

Anshu Gupta ◽

Ines Guttmann-Bauman ◽

...

Keyword(s):

Patient Care ◽

Care Patient ◽

The Novel ◽

Patient Privacy ◽

Pediatric Endocrinology ◽

Quality Of Patient Care ◽

Care Outcomes ◽

Novel Coronavirus ◽

The Impact

Background: Pediatric endocrine practices had to rapidly transition to telemedicine care at the onset of the novel coronavirus disease 2019 (COVID-19) pandemic. For many, it was an abrupt introduction to providing virtual healthcare, with concerns related to quality of patient care, patient privacy, productivity, and compensation, as workflows had to change. Summary: The review summarizes the common adaptations for telemedicine during the pandemic with respect to the practice of pediatric endocrinology and discusses the benefits and potential barriers to telemedicine. Key Messages: With adjustments to practice, telemedicine has allowed providers to deliver care to their patients during the COVID-19 pandemic. The broader implementation of telemedicine in pediatric endocrinology practice has the potential for expanding patient access. Research assessing the impact of telemedicine on patient care outcomes in those with pediatric endocrinology conditions will be necessary to justify its continued use beyond the COVID-19 pandemic.

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A mixed methods study to evaluate the impact of a student-run clinic on undergraduate medical education

BMC Medical Education ◽

10.1186/s12909-021-02621-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nathan G. Rockey ◽

Taylor M. Weiskittel ◽

Katharine E. Linder ◽

Jennifer L. Ridgeway ◽

Mark L. Wieland

Keyword(s):

Mixed Methods ◽

Patient Care ◽

Social Factors ◽

Healthcare Access ◽

Community Services ◽

Student Understanding ◽

Learning Objectives ◽

Barriers To Healthcare ◽

The Impact ◽

Barriers To Healthcare Access

Abstract Background The purpose of this study was to evaluate the extent to which a longitudinal student-run clinic (SRC) is meeting its stated learning objectives, including providing critical community services and developing physicians who more fully appreciate the social factors affecting their patients’ health. Methods This was a mixed methods program evaluation of an SRC at Mayo Clinic Alix School of Medicine (MCASOM). A survey was conducted of medical students who had participated in the clinic and seven interviews and three focus groups were conducted with SRC patients, students, faculty, staff, and board members. Transcripts were coded for systematic themes and sub-themes. Major themes were reported. Survey and interview data were integrated by comparing findings and discussing areas of convergence or divergence in order to more fully understand program success and potential areas for improvement. Results Greater than 85% of student survey respondents (N = 90) agreed or strongly agreed that the SRC met each of its objectives: to provide a vital community service, to explore social determinants of health (SDH), to understand barriers to healthcare access and to practice patience-centered examination. Qualitative data revealed that the SRC contextualized authentic patient care experiences early in students’ medical school careers, but the depth of learning was variable between students. Furthermore, exposure to SDH through the program did not necessarily translate to student understanding of the impact of these social factors on patient’s health nor did it clearly influence students’ future practice goals. Conclusions The MCASOM SRC experience met core learning objectives, but opportunities to improve long-term impact on students were identified. Participation in the SRC enabled students to engage in patient care early in training that is representative of future practices. SRCs are an avenue by which students can gain exposure to real-world applications of SDH and barriers to healthcare access, but additional focus on faculty development and intentional reflection may be needed to translate this exposure to actionable student understanding of social factors that impact patient care.

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The Impact of Routine Admission Chest X-Ray Films on Patient Care

Investigative Radiology ◽

10.1097/00004424-198509000-00024 ◽

1985 ◽

Vol 20 (6) ◽

pp. 644-646 ◽

Cited By ~ 1

Author(s):

F. Allan Hubbell ◽

Sheldon Greenfield ◽

Judy L. Tyler ◽

Kota Chetty ◽

Frederic A. Wyle

Keyword(s):

Patient Care ◽

X Ray ◽

Chest X Ray ◽

The Impact

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