Department Of Academic Medical Center Research Articles

Implementation of a Scholarly Activity Program in a Small Academic Medical Center Department.

Small departments within academic medical centers have fewer numbers of clinicians, less time devoted to research, and fewer staff with senior faculty academic ranks available as mentors. This report describes the rationale behind Mayo Clinic's Department of Dental Specialties' scholarly activity program, implemented to combine mentorship with scholarship provided in a variety of formats. Program objectives focused on providing mentorship, disseminating existing scholarship, and bringing a diversity of scholarly activities into departmental mainstream.

Impact of an innovative partnership in patient care between an academic medical center department of pharmacy and a school of pharmacy.

Pharmacy departments and schools of pharmacy have long held professional affiliations. However, the success of each entity is often not interdependent and aligned. In 2010, our institutions found ourselves in a position where the complementary motivations of each aligned to support a more meaningful and committed engagement, leading to the development of the Partnership in Patient Care. The impact of the partnership was evaluated 7 years postimplementation, and both the successes realized and the lessons learned are described. The partnership provided many advantages to our pharmacy department and the school of pharmacy. This initial iteration of the partnership was a strong proof of concept that an intentional approach to the relationship between a school of pharmacy and a pharmacy department can lead to substantive improvements in a wide array of meaningful outcomes. We experienced an increase in the number of student rotation months completed, growth in the American Society of Health-System Pharmacists-accredited residency programs, and enhanced clinical services. However, the partnership was not without challenges. For instance, lack of a formalized tracking method made certain outcomes difficult to track. The purposeful establishment of the Partnership in Patient Care, built on the needs of a school of pharmacy and an academic medical center pharmacy department, allowed our institutions to develop an intertwined mission and vision. Over the initial years of the partnership, many successes were realized and lessons were learned. Both the successes and the challenges are serving as the foundation for future iterations of the partnership.

Psychiatry department response to the Boston Marathon bombings within a level-1 trauma center.

In this article we present how the consultation-liaison and psychology divisions of an academic medical center's Department of Psychiatry responded in the first week after the Boston Marathon bombings, specifically in the context of disaster response guidelines and evidence-based approaches to acute trauma. Since the department had to address several complicated matters at multiple levels within the hospital system, we highlight unexpected issues unique to this particular event as they arose within the primary domains of our involvement. This article aims to (1) provide a descriptive analysis of how we enacted disaster and trauma guidelines and evidence-based care within a hospital setting, (2) shed light on the unique and unexpected administrative and systemic issues encountered in our response, and (3) discuss lessons learned, including opportunities to improve trauma-related care.

Management of donors and blood products reactive for hepatitis B virus DNA

Vox SanguinisVolume 91, Issue 4 p. 281-281 Management of donors and blood products reactive for hepatitis B virus DNA H. W. Reesink, H. W. Reesink Sanquin Blood Bank North-West and Sanquin Diagnostic Services and Academic Medical Center Department of Gastroenterology and Hepatology Amsterdam, The Netherlands E-mail: h.reesink@sanquin.nl and h.w.reesink@amc.nlSearch for more papers by this authorJ.-P. Allain, J.-P. Allain University of Cambridge Cambridge, UK E-mail: jpa1000@cam.ac.ukSearch for more papers by this author H. W. Reesink, H. W. Reesink Sanquin Blood Bank North-West and Sanquin Diagnostic Services and Academic Medical Center Department of Gastroenterology and Hepatology Amsterdam, The Netherlands E-mail: h.reesink@sanquin.nl and h.w.reesink@amc.nlSearch for more papers by this authorJ.-P. Allain, J.-P. Allain University of Cambridge Cambridge, UK E-mail: jpa1000@cam.ac.ukSearch for more papers by this author First published: 20 November 2006 https://doi.org/10.1111/j.1423-0410.2006.00843.xCitations: 3Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume91, Issue4November 2006Pages 281-281 RelatedInformation

First Experience with a New Stapes Clip Piston in Stapedotomy

Hearing results after 23 implantations of a newly designed titanium-clip stapes piston prosthesis (the àWengen Clip Piston prosthesis) in patients with otosclerosis were evaluated. This new type of stapes piston was designed to avoid the crimping onto the incus in stapedotomy. This one clip fits all designs and enables solid fixation by clicking the prosthesis onto the long process of the incus without crimping. A retrospective pilot study was carried out by microcomputer of the preoperative and postoperative audiological results of patients in whom the titanium-clip stapes piston prosthesis was implanted. Ear, nose and throat department of Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 23 Patients underwent a stapedotomy for hearing improvement suffering from otosclerosis. implantations of a newly designed titanium-clip stapes piston prosthesis (the àWengen Clip Piston prosthesis) in patients with otosclerosis were evaluated. The stapedotomy was performed with the àWengen Clip Piston prosthesis. Pre and postoperative audiograms were used to evaluate the hearing gain improvement with the new stapes piston. Especially we looked at the airbone gap closure and the sensorineural hearing after the surgical procedure and compared these with the ones before surgery. The hearing results showed a closure of the pure-tone average air-bone gap to within 10 dB in 56.6% of cases (10 of 23 implantations) and to within 20 dB in 100% (23 of 23 implantations). A residual air-bone gap of greater than 20 dB was seen in the present pilot study. Postoperative overclosure of bone-conduction thresholds was discovered only for the frequency of 2 kHz. Sensorineural hearing loss greater than 10% did not occur, and there was no decline in the speech discrimination. The use of a newly designed titanium-clip stapes piston prosthesis with a diameter of 0.4 mm gives good results in cases of stapedotomy for otosclerosis. The titanium-clip design is a new development in the evolution of stapes piston prostheses. Surgical introduction, placement, and fixation are not always easy, depending on the anatomy of the middle ear and the thickness of the fixation area on the long process of the incus.

Developing Consultation Services in Hospital-Based Mental Health

Market forces influence the design and function of the health care delivery system. With Medicare and Medicaid entering the managed care business, systems of care that did not have to attend to market issues must now compete for business. Academic medical centers, buffered by alternative funding and a mission to teach, perform research, and provide clinical care, have been forced to “re-think” business (Neville, 1995). A strategic examination of core values and a creative commitment to cost containment are needed to meet both the clinical needs of complex cases and fiscal needs of the institutions. This paper describes the successful strategic planning and implementation process of one academic medical center's department of psychiatric occupational therapy to adapt to the changing health care marketplace.

Clinical assessment of malpractice case scenarios in an anesthesiology department

Study Objective: To determine whether anesthesiologists agree with each other when assessing actual malpractice clinical scenarios, whether their assessments comport with the actual malpractice verdicts, and whether they can accurately guess jury verdicts. Design: Survey study requesting anesthesiologists to review 12 malpractice case scenarios, administered twice. Setting: Academic medical center department of anesthesiology. Measurements and Main Results: Mean interphysician agreement, mean Likert values assessing relative negligence, mean agreement with jury verdicts, mean success at predicting actual jury verdicts for 12 actual jury verdict case scenarios. Respondent anesthesiologists appeared homogeneous by training and years of experience. They showed high (>80%) agreement among themselves in their assessments of the malpractice case scenarios over the two administrations ( p = 0.13). In addition, mean Likert values as to relative negligence assessments by respondent anesthesiologists were not significantly different between administrations by case ( p = 0.09 to 1.00). However, of the eight cases with complete or virtually complete agreement between respondent anesthesiologists, three (37.5%) disagreed with the verdict rendered by the actual juries. In addition, anesthesiologists showed significant disagreement (>30%) among themselves in four of the case scenarios, indicating there may not be agreement regarding the standard of care in these clinical circumstances. Finally, anesthesiologists predicted jury verdicts poorly, with success rates of 50% or less in seven of the 12 case scenarios. Conclusions: For this sample of homogeneous anesthesiologists who demonstrated high clinical agreement, it appears that the malpractice system may not be able to function on its own terms in adjudicating malpractice claims. Although there was agreement among respondent anesthesiologists, these assessments were in direct opposition to actual verdicts, a significant percentage of cases resulted in disagreements as to the appropriate standard of care, and anesthesiologists could not successfully predict jury verdicts. The malpractice system appears to be operating far from its theoretical ideal if these results could be applied more generally. Thus, in practice, the legal system, which is to provide an optimal level of injury deterrence, may be a poor method to limit patient injury, improve patient safety, and provide compensation to negligently injured patients in the health delivery system.

Wagons Ho: Forward on the managed care trail

This paper describes the impact of managed care on an academic medical center department of psychiatry. Like the pioneers before us, academic medical centers have often traveled wilderness paths, training new generations of psychiatrists and providing research about and new understandings of psychiatric illness; under assault from powerful competitive forces, we have all too often circled the wagons in an attempt to survive what we perceive as an onslaught. We describe the ways in which our academic medical center department of psychiatry has responded to managed care forces, in particular, the impact of managed care on residency training, inpatient services, outpatient psychotherapeutic and psychopharmacological care, and faculty morale. We describe how we have worked closely with our medical colleagues, formed new committees, and initiated forays into capitated arrangements. Despite difficult external circumstances, we have been able to survive, regroup, provide leadership, and continue with renewed purpose.