Utilization of Real-time 3D Transesophageal Echocardiography in an Urban Academic Medical Center

2014 ◽  
Vol 5 (2) ◽  
pp. 9-14
Author(s):  
Lili Zhang ◽  
Elaine Y Lin ◽  
Dron Bhandari ◽  
Mohan Pamerla ◽  
George K Lui ◽  
...  
Keyword(s):  
Transesophageal Echocardiography ◽  
Real Time ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical ◽  
3D Transesophageal Echocardiography

Using Real-Time Locating Systems to Optimize Endoscope Use at a Large Academic Medical Center

2020 ◽  
Vol 44 (4) ◽  
Author(s):  
Jason C. Troutner ◽  
Matthew V. Harrell ◽  
Mark T. Seelen ◽  
Bethany J. Daily ◽  
Wilton C. Levine
Keyword(s):  
Real Time ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical

scholarly journals A real-time spatiotemporal AI model analyzes skill in open surgical videos

2021 ◽  
Author(s):  
Serena Yeung ◽  
Emmett Goodman ◽  
Krishna Patel ◽  
Yilun Zhang ◽  
William Locke ◽  
...  
Keyword(s):  
Real Time ◽  
Medical Center ◽  
Academic Medical Center ◽  
Building Blocks ◽  
Dominant Form ◽  
Hand Motion ◽  
Academic Medical ◽  
Data Limitations ◽  
Invasive Techniques ◽  
Surgical Videos

Abstract Open procedures represent the dominant form of surgery worldwide. Artificial intelligence (AI) has the potential to optimize surgical practice and improve patient outcomes, but efforts have focused primarily on minimally invasive techniques. Our work overcomes existing data limitations for training AI models by curating, from YouTube, the largest dataset of open surgical videos to date: 1997 videos from 23 surgical procedures uploaded from 50 countries. Using this dataset, we developed a multi-task AI model capable of real-time understanding of surgical behaviors, hands, and tools—the building blocks of procedural flow and surgeon skill—across both space and time. We show that our model generalizes across diverse surgery types and environments. Illustrating this generalizability, we directly applied our YouTube-trained model to analyze open surgeries prospectively collected at an academic medical center and identified kinematic descriptors of surgical skill related to efficiency of hand motion. Our Annotated Videos of Open Surgery (AVOS) dataset and trained model will be made available for further development of surgical AI.

scholarly journals Evaluation of a Disease State Stewardship Intervention for Urinary Tract Infections at an Academic Medical Center

2020 ◽  
Vol 41 (S1) ◽  
pp. s226-s226
Author(s):  
Xhilda Xhemali ◽  
Derek Forster ◽  
Bryant Clemons ◽  
Sarah Cotner ◽  
Jeremy VanHoose ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Real Time ◽  
Urinary Tract Infections ◽  
Guideline Adherence ◽  
Medical Center ◽  
Academic Medical Center ◽  
Disease State ◽  
Academic Medical ◽  
Before And After ◽  
Tract Infections

Background: Urinary tract infections (UTIs) are often misdiagnosed and mismanaged. Disease state stewardship initiatives targeting UTIs through the development of institutional guidelines and real-time prospective audit and feedback (PAAF) on provider management may have a significant impact on the overuse of antimicrobials. Objective: Our study evaluated the effectiveness of a UTI focused disease state stewardship intervention by assessing institutional guideline adherence before and after implementation. Methods: This retrospective quasi-experimental study was conducted at a tertiary-care academic medical center. Patients >18 years of age receiving antimicrobials for a UTI were included. A previously performed retrospective review of UTI management from September-November 2017 was used as the baseline. The UTI management guideline was implemented in July 2018, and service lines were educated. A PAAF initiative began in June 2019, whereby the antimicrobial stewardship team performed daily reviews of patients receiving antimicrobials for UTIs. Data was collected on their management, and providers were contacted in real time with recommendations based on the institutional guideline. Patients reviewed June–October 2019 were included in the postimplementation analysis. Patients were excluded if they were pregnant, underwent a urological procedure with risk of mucosal bleeding, or were an outside hospital transfer already on UTI therapy. The primary outcome of this study was to evaluate guideline adherence before and after the implementation of PAAF for the management of UTIs. Results: In total, 198 patients in the preintervention group and 246 in the PAAF group were included. The emergency department was the primary ordering service of urinalyses (60.1% vs 66.1%; P = .2287) in both periods and altered mental status as the main indication for testing (35.2% vs 31.3%; P = .5465). Treatment of asymptomatic bacteriuria and pyuria decreased significantly between the 2 periods: 74.8% versus 36.2% (P = .0001). Appropriate ordering of urinalyses (33.8% vs 68.3%; P = .0001) and urine cultures (29.3% vs 61.0%; P = .0001) also improved in the PAAF group. Recommendations made during PAAF included therapy discontinuation (66.7%), antimicrobial therapy change (15.5%), or duration modification (15.5%), and 59.5% of first interventions were accepted. Overall guideline compliance significantly improved from 13.1% in the preintervention period to 26.1% in the PAAF period (P = .0011). Conclusions: A UTI disease state intervention was associated with significant reductions in the treatment of asymptomatic presentations as well as an improvement in overall guideline adherence. We believe that this approach represents a powerful stewardship strategy for decreasing unnecessary antimicrobial usage.Funding: NoneDisclosures: None

Evaluation of a measles virus multiplex, triple-target real-time RT-PCR in three specimen matrices at a U.S. academic medical center

2021 ◽  
Vol 136 ◽  
pp. 104757
Author(s):  
M. Jana Broadhurst ◽  
Natasha Garamani ◽  
Zoe Hahn ◽  
Becky Jiang ◽  
Jenna Weber ◽  
...  
Keyword(s):  
Real Time ◽  
Measles Virus ◽  
Medical Center ◽  
Academic Medical Center ◽  
Rt Pcr ◽  
Academic Medical

Decreasing time to treat using visual management tools.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 277-277
Author(s):  
Andrew Rothacker ◽  
Chad W. Cummings ◽  
Katherine Tullio ◽  
Alison Ibsen ◽  
Emily Elizabeth Monteleone ◽  
...  
Keyword(s):  
Real Time ◽  
Barriers To Care ◽  
Medical Center ◽  
Academic Medical Center ◽  
Time Data ◽  
Management Tools ◽  
Academic Medical ◽  
Treatment Type ◽  
Patient Database ◽  
Common Barriers

277 Background: Time between positive cancer diagnosis and first treatment (TTT) has lengthened significantly nationwide over the last decade. Decreased TTT has been shown to positively impact patient outcomes such as anxiety and stress, and in some situations, overall survival (OS). As such, TTT (measured in median days) is a major initiative for disease programs at our large academic medical center. Impacting TTT is challenging given the usual sources of data, which are retrospective. Further, engaging the teams around the data was difficult. The need to illustrate patient delays in real-time was identified. Methods: A patient database was created, along with a dashboard, using a visual software package to track patient activity. Information is extracted from the database into a dashboard, including the patient’s appointments, treatments, and barriers to care. The dashboard was constructed with graphics of historical TTT by month, TTT distribution by treatment type, TTT by provider, and a graphic of the most common barriers to treatment. Additionally, the dashboard identified patients who were not scheduled for treatment, and were represented by a symbol on an x/y-axis graph. The x-axis represents the unique patient, while the y-access represents the days from diagnosis, with the symbol incrementing each day the treatment is not scheduled. Results: The dashboard is used weekly to huddle with clinical and non-clinical teams. Patients with no scheduled treatment are easily identifiable on the dashboard, with a focus on minimizing all patient’s TTT. Patients with extended schedule are actively engaged to reschedule and reduce their TTT. The breast cancer program began using the dashboard in July 2017. The surgical TTT was 30 days (n = 34). Post-implementation of the dashboard and multi-disciplinary huddles, it was found in April 2018 the TTT was 26 days (n = 36). Conclusions: Combining real-time data with simple data visualization tools allows teams to identify barriers to care easily. The visual tools identify outliers and allow teams to communicate on scheduling challenges of each patient. In conjunction with the multi-disciplinary huddles, the dashboard allows teams to track progress of each patient to ensure timely scheduling and coordination.

scholarly journals Integration of Slack, a cloud-based team collaboration application, into research coordination: a research letter

2017 ◽  
Vol 24 (2) ◽  
pp. 252 ◽  
Author(s):  
Miriam Gofine ◽  
Sunday Clark
Keyword(s):  
Real Time ◽  
Medical Center ◽  
Academic Medical Center ◽  
Document Management ◽  
Team Collaboration ◽  
Research Teams ◽  
Google Docs ◽  
Academic Activities ◽  
Academic Medical ◽  
Research Coordinator

Background: Practitioners of epidemiology require efficient real-time communication and shared access to numerous documents in order to effectively manage a study. Much of this communication involves study logistics and does not require use of Protected Health Information. Slack is a team collaboration app; it archives all direct messages and group conversations, hosts documents internally, and integrates with the Google Docs application. Slack has both desktop and mobile applications, allowing users to communicate in real-time without the need to find email addresses or phone numbers or create contact lists. Method: We piloted the integration of Slack into our research team of one faculty member, one research coordinator, and approximately 20 research assistants. Statistics describing the app’s usage were calculated twelve months after its implementation. Results: Results indicating heavy usage by both research professionals and assistants are presented. our Slack group included a cumulative 51 users. Between October 2015 and November 2016, approximately 10,600 messages were sent through Slack; 53% were sent by RA’s and 47% were sent by us. Of the 106 files stored on Slack, 82% were uploaded by research staff. In a January 2016 survey, 100% of RA’s agreed or strongly agreed that Slack improved communication within the team. Conclusion: We demonstrate a model for integration of communication technology into academic activities by research teams. Slack is easily integrated into the workflow at an urban, academic medical center and is adopted by users as a highly effective tool for meeting research teams’ communication and document management needs. 

WiFi RFID demonstration for resource tracking in a statewide disaster drill

2011 ◽  
Vol 6 (3) ◽  
pp. 155-162 ◽  
Author(s):  
Stacey L. Cole, MBA ◽  
Javeed Siddiqui, MD, MPH ◽  
David J. Harry, PhD ◽  
Christian E. Sandrock, MD, MPH, FCCP
Keyword(s):  
Real Time ◽  
Radio Frequency Identification ◽  
Disaster Response ◽  
Medical Equipment ◽  
Medical Center ◽  
Academic Medical Center ◽  
Mutual Aid ◽  
Rfid System ◽  
Academic Medical ◽  
Resource Identification

Objective: To investigate the capabilities of Radio Frequency Identification (RFID) tracking of patients and medical equipment during a simulated disaster response scenario.Design: RFID infrastructure was deployed at two small rural hospitals, in one large academic medical center and in two vehicles. Several item types from the mutual aid equipment list were selected for tracking during the demonstration. A central database server was installed at the UC Davis Medical Center (UCDMC) that collected RFID information from all constituent sites. The system was tested during a statewide disaster drill. During the drill, volunteers at UCDMC were selected to locate assets using the traditional method of locating resources and then using the RFID system.Results: This study demonstrated the effectiveness of RFID infrastructure in real-time resource identification and tracking. Volunteers at UCDMC were able to locate assets substantially faster using RFID, demonstrating that real-time geolocation can be substantially more efficient and accurate than traditional manual methods. A mobile, Global Positioning System (GPS)- enabled RFID system was installed in a pediatric ambulance and connected to the central RFID database via secure cellular communication. This system is unique in that it provides for seamless region-wide tracking that adaptively uses and seamlessly integrates both outdoor cellular-based mobile tracking and indoor WiFi-based tracking.Conclusions: RFID tracking can provide a realtime picture of the medical situation across medical facilities and other critical locations, leading to a more coordinated deployment of resources. The RFID system deployed during this study demonstrated the potential to improve the ability to locate and track victims, healthcare professionals, and medical equipment during a region-wide disaster.

An assessment of transesophageal echocardiography studies rated as rarely appropriate tests for infective endocarditis at an academic medical center

2019 ◽  
Vol 36 (11) ◽  
pp. 2070-2077 ◽  
Author(s):  
Tomas Amuchastegui ◽  
David J. Hur ◽  
Nicole M. Lynn Fillipon ◽  
Maxwell D. Eder ◽  
Jason A. Bonomo ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Transesophageal Echocardiography ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical

Gender differences in career progress and satisfaction in an academic medical center

2002 ◽  
Vol 2 (3) ◽  
pp. 95-104 ◽  
Author(s):  
JoAnn Manson ◽  
Beverly Rockhill ◽  
Margery Resnick ◽  
Eleanor Shore ◽  
Carol Nadelson ◽  
...  
Keyword(s):  
Gender Differences ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical ◽  
Career Progress
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