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Sample records for portland medical center

  1. Assessment of diabetic teleretinal imaging program at the Portland Department of Veterans Affairs Medical Center.

    PubMed

    Tsan, Grace L; Hoban, Keely L; Jun, Weon; Riedel, Kevin J; Pedersen, Amy L; Hayes, John

    2015-01-01

    We conducted a retrospective chart review of 200 diabetic patients who had teleretinal imaging performed between January 1, 2010, and January 1, 2011, at Portland Department of Veterans Affairs (VA) Medical Center outpatient clinics to assess the effectiveness of the diabetic teleretinal imaging program. Twenty patients (10%) had diabetic retinopathy. Ninety percent of the available teleretinal imaging studies were of adequate quality for interpretation. In accordance with local VA policy at that time, all teleretinal imaging patients should have been referred for a dilated retinal examination the following year. Image readers referred 97.5% of the patients to eye clinics for subsequent eye examinations, but the imagers scheduled appointments for only 80% of these patients. The redundancy rate, i.e., patients who had an eye examination within the past 6 mo, was 11%; the duplicate recall rate, i.e., patients who had a second teleretinal imaging performed within 1 yr of the eye examination, was 37%. Rates of timely diabetic eye examinations at clinics with teleretinal imaging programs, particularly when teleretinal imaging and eye clinics were colocated at the same community-based outpatient clinic, were higher than those without a teleretinal imaging program. We concluded that the Portland VA Medical Center's teleretinal imaging program was successful in increasing the screening rate for diabetic retinopathy. PMID:26230276

  2. Demonstration Assessment of Light Emitting Diode (LED) Commercial Garage Lights In the Providence Portland Medical Center, Portland, Oregon

    SciTech Connect

    Ton, My K.; Richman, Eric E.; Gilbride, Theresa L.

    2008-11-11

    This U.S. Department of Energy GATEWAY Demonstration project studied the applicability of light-emitting diode (LED) luminaires for commercial parking garage applications. High-pressure sodium (HPS) area luminaires were replaced with new LED area luminaires. The project was supported under the U.S. Department of Energy (DOE) Solid State Lighting Program. Other participants in the demonstration project included Providence Portland Medical Center in Portland, Oregon, the Energy Trust of Oregon, and Lighting Sciences Group (LSG) Inc. Pacific Northwest National Laboratory (PNNL) conducted the measurements and analysis of the results. PNNL manages GATEWAY demonstrations for DOE and represents their perspective in the conduct of the work. Quantitative and qualitative measurements of light and electrical power were taken at the site for both HPS and LED light sources. Economic costs were estimated and garage users’ responses to the new light sources were gauged with a survey. Six LED luminaires were installed in the below-ground parking level A, replacing six existing 150W HPS lamps spread out over two rows of parking spaces. Illuminance measurements were taken at floor level approximately every 4 ft on a 60-ft x 40-ft grid to measure light output of these LED luminaires which were termed the “Version 1” luminaires. PNNL conducted power measurements of the circuit in the garage to which the 6 luminaires were connected and determined that they drew an average of 82 W per lamp. An improved LED luminaire, Version 2, was installed in Level B of the parking garage. Illuminance measurements were not made of this second luminaire on site due to higher traffic conditions, but photometric measurements of this lamp and Version 1 were made in an independent testing laboratory and power usage for Version 2 was also measured. Version 1 was found to produce 3600 lumens and Version 2 was found to produce 4700 lumens of light and to consume 78 Watts. Maximum and minimum light

  3. Building a Collaborative Educational Research Center: The Portland Public Schools & Portland State University Experience.

    ERIC Educational Resources Information Center

    Nave, Gary R.

    The Center for Urban Research in Education (CURE), jointly conceived by the Portland (Oregon) Public Schools and Portland State University, was established in 1987 by the Oregon State Legislature to explore solutions to the educational problems of at-risk student populations, especially those in urban settings. This paper shares the results of…

  4. DOE Center of Excellence in Medical Laser Applications. Final report

    SciTech Connect

    Jacques, S.L. )

    1998-01-01

    An engineering network of collaborating medical laser laboratories are developing laser and optical technologies for medical diagnosis and therapy and are translating the engineering into medical centers in Portland, OR, Houston, TX, and Galveston, TX. The Center includes the University of Texas M.D. Anderson Cancer Center, the University of Texas-Austin, Texas A and M University, Rice University, the University Texas Medical Branch-Galveston, Oregon Medical Laser Center (Providence St. Vincent Medical Center, Oregon Health Sciences University, and Oregon Graduate Institute, Portland, OR), and the University of Oregon. Diagnostics include reflectance, fluorescence, Raman IR, laser photoacoustics, optical coherence tomography, and several new video techniques for spectroscopy and imaging. Therapies include photocoagulation therapy, laser welding, pulsed laser ablation, and light-activated chemotherapy of cancer (photodynamic therapy, or PDT). Medical applications reaching the clinic include optical monitoring of hyperbilirubinemia in newborns, fluorescence detection of cervical dysplasia, laser thrombolysis of blood clots in heart attack and brain stroke, photothermal coagulation of benign prostate hyperplasia, and PDT for both veterinary and human cancer. New technologies include laser optoacoustic imaging of breast tumors and hemorrhage in head trauma and brain stroke, quality control monitoring of dosimetry during PDT for esophageal and lung cancer, polarization video reflectometry of skin cancer, laser welding of artificial tissue replacements, and feedback control of laser welding.

  5. Satellite medical centers project

    NASA Astrophysics Data System (ADS)

    Aggarwal, Arvind

    2002-08-01

    World class health care for common man at low affordable cost: anywhere, anytime The project envisages to set up a national network of satellite Medical centers. Each SMC would be manned by doctors, nurses and technicians, six doctors, six nurses, six technicians would be required to provide 24 hour cover, each SMC would operate 24 hours x 7 days. It would be equipped with the Digital telemedicine devices for capturing clinical patient information and investigations in the form of voice, images and data and create an audiovisual text file - a virtual Digital patient. Through the broad band connectivity the virtual patient can be sent to the central hub, manned by specialists, specialists from several specialists sitting together can view the virtual patient and provide a specialized opinion, they can see the virtual patient, see the examination on line through video conference or even PCs, talk to the patient and the doctor at the SMC and controlle capturing of information during examination and investigations of the patient at the SMC - thus creating a virtual Digital consultant at the SMC. Central hub shall be connected to the doctors and consultants in remote locations or tertiary care hospitals any where in the world, thus creating a virtual hub the hierarchical system shall provide upgradation of knowledge to thedoctors in central hub and smc and thus continued medical education and benefit the patient thru the world class treatment in the smc located at his door step. SMC shall be set up by franchisee who shall get safe business opportunity with high returns, patients shall get Low cost user friendly worldclass health care anywhere anytime, Doctors can get better meaningful selfemplyment with better earnings, flexibility of working time and place. SMC shall provide a wide variety of services from primary care to world class Global consultation for difficult patients.

  6. Portland Community College, Rock Creek: A Community Based Educational Shopping Center.

    ERIC Educational Resources Information Center

    De Bernardis, Amo

    An overview is presented of Portland Community College's plans to create the Rock Creek campus, scheduled to open in January 1976. The physical environment is considered to be an important factor in a student's cultural and aesthetic experience, and all facilities have been designed with this in mind. The philosophy guiding campus planning is one…

  7. Neurobehavioral deficits in Persian Gulf veterans: evidence from a population-based study. Portland Environmental Hazards Research Center.

    PubMed

    Anger, W K; Storzbach, D; Binder, L M; Campbell, K A; Rohlman, D S; McCauley, L; Kovera, C A; Davis, K L

    1999-03-01

    Reports of low-concentration nerve gas exposures during the Persian Gulf War have spurred concern about possible health consequences and refocused interest on the symptoms reported by many returning military veterans. The Portland Environmental Hazards Research Center is studying veterans from the Northwest USA who report persistent, unexplained "Persian Gulf" symptoms (cases) or who do not report those symptoms (controls). Of the first 101 veterans studied, cases differed substantially from controls on a broad range of psychological tests indicative of increased distress. A subgroup of cases was identified with objective deficits on neurobehavioral tests of memory, attention, and response speed. PMID:10217920

  8. Kennedy Space Center Medical Operations and Medical Kit

    NASA Technical Reports Server (NTRS)

    Scarpa, Philip

    2011-01-01

    This slide presentation reviews the emergency medical operations at Kennedy Space center, the KSC launch and landing contingency modes, the triage site, the medical kit, and the medications available.

  9. DOE Center of Excellence in Medical Laser Applications. Final report, December 1, 1994--November 30, 1997

    SciTech Connect

    Jacques, S.L.

    1998-01-01

    An engineering network of collaborating medical laser laboratories are developing laser and optical technologies for medical diagnosis and therapy and are translating the engineering into medical centers in Portland OR, Houston TX, and Galveston TX. The Center includes the University of Texas M.D. Anderson Cancer Center, the University of Texas-Austin, Texas A and M University, Rice University, the University Texas Medical Branch-Galveston, Oregon Medical Laser Center (Providence St. Vincent Medical Center, Oregon Health Sciences University, and Oregon Graduate Institute, Portland, OR), and the University of Oregon. Diagnostics include reflectance, fluorescence, Raman IR, laser photoacoustics, optical coherence tomography, and several new video techniques for spectroscopy and imaging. Therapies include photocoagulation therapy, laser welding, pulsed laser ablation, and light-activated chemotherapy of cancer (photodynamic therapy, or PDT). Medical applications reaching the clinic include optical monitoring of hyperbilirubinemia in newborns, fluorescence detection of cervical dysplasia, laser thrombolysis of blood clots in heart attack and brain stroke, photothermal coagulant of benign prostate hyperplasia, and PDT for both veterinary and human cancer. New technologies include laser optoacoustic imaging of breast tumors and hemorrhage in head trauma and brain stroke, quality control monitoring of dosimetry during PDT for esophageal and lung cancer, polarization video reflectometry of skin cancer, laser welding of artificial tissue replacements, and feedback control of laser welding.

  10. Patient-Centered Medical Homes in 2016.

    PubMed

    Tayloe, David T

    2016-01-01

    There is much information in the medical literature concerning the medical home concept. Each medical practice must utilize that literature to devise a system of care-a patient-centered medical home-that best meets the needs of patients, families, and practice staff. This article is Goldsboro Pediatrics' attempt to describe its system of care, its patient-centered medical home. PMID:27422953

  11. Reengineering Academic Medical Centers: Reengineering Academic Values?

    ERIC Educational Resources Information Center

    Korn, David

    1996-01-01

    Discussion of academic medical centers (AMCs) looks at: change due to heavy federal funding in recent decades; adverse consequences, including deemphasis on education in favor of research and clinical service delivery, and discrepancies between AMC internal and external labor markets; and challenges to medical education in research, education, and…

  12. Skylab Medical Data Center and Archives

    NASA Technical Reports Server (NTRS)

    Spross, F. R.

    1974-01-01

    The founding of the Skylab medical data center and archives as a central area to house medical data from space flights is described. Skylab program strip charts, various daily reports and summaries, experiment reports and logs, status report on Skylab data quality, raw data digital tapes, processed data microfilm, and other Skylab documents are housed in the data center. In addition, this memorandum describes how the data center acted as a central point for the coordination of preflight and postflight baseline data and how it served as coordinator for all data processing through computation and analysis. Also described is a catalog identifying Skylab medical experiments and all related data currently archived in the data center.

  13. Developing physician leaders in academic medical centers.

    PubMed

    Bachrach, D J

    1997-01-01

    While physicians have historically held positions of leadership in academic medical centers, there is an increasing trend that physicians will not only guide the clinical, curriculum and scientific direction of the institution, but its business direction as well. Physicians are assuming a greater role in business decision making and are found at the negotiating table with leaders from business, insurance and other integrated health care delivery systems. Physicians who lead "strategic business units" within the academic medical center are expected to acquire and demonstrate enhanced business acumen. There is an increasing demand for formal and informal training programs for physicians in academic medical centers in order to better prepare them for their evolving roles and responsibilities. These may include the pursuit of a second degree in business or health care management; intramurally conducted courses in leadership skill development, management, business and finance; or involvement in extramurally prepared and delivered training programs specifically geared toward physicians as conducted at major universities, often in their schools of business or public health. While part one of this series, which appeared in Volume 43, No. 6 of Medical Group Management Journal addressed, "The changing role of physician leaders at academic medical centers," part 2 will examine as a case study the faculty leadership development program at the University of Texas M.D. Anderson Cancer Center. These two articles were prepared by the author from his research into, and the presentation of a thesis entitled. "The importance of leadership training and development for physicians in academic medical centers in an increasingly complex health care environment," prepared for the Credentials Committee of the American College of Healthcare Executives in partial fulfillment of the requirements for Fellowship in this College.* PMID:10164266

  14. The Manned Spacecraft Center and medical technology

    NASA Technical Reports Server (NTRS)

    Johnston, R. S.; Pool, S. L.

    1974-01-01

    A number of medically oriented research and hardware development programs in support of manned space flights have been sponsored by NASA. Blood pressure measuring systems for use in spacecraft are considered. In some cases, complete new bioinstrumentation systems were necessary to accomplish a specific physiological study. Plans for medical research during the Skylab program are discussed along with general questions regarding space-borne health service systems and details concerning the Health Services Support Control Center.

  15. Patient Experience in Health Center Medical Homes.

    PubMed

    Cook, Nicole; Hollar, Lucas; Isaac, Emmanuel; Paul, Ludmilla; Amofah, Anthony; Shi, Leiyu

    2015-12-01

    The Human Resource and Services Administration, Bureau of Primary Health Care Health Center program was developed to provide comprehensive, community-based quality primary care services, with an emphasis on meeting the needs of medically underserved populations. Health Centers have been leaders in adopting innovative approaches to improve quality care delivery, including the patient centered medical home (PCMH) model. Engaging patients through patient experience assessment is an important component of PCMH evaluation and a vital activity that can help drive patient-centered quality improvement initiatives. A total of 488 patients from five Health Center PCMHs in south Florida were surveyed in order to improve understanding of patient experience in Health Center PCMHs and to identify quality improvement opportunities. Overall patients reported very positive experience with patient-centeredness including being treated with courtesy and respect (85 % responded "always") and communication with their provider in a way that was easy to understand (87.7 % responded "always"). Opportunities for improvement included patient goal setting, referrals for patients with health conditions to workshops or educational programs, contact with the Health Center via phone and appointment availability. After adjusting for patient characteristics, results suggest that some patient experience components may be modified by educational attainment, years of care and race/ethnicity of patients. Findings are useful for informing quality improvement initiatives that, in conjunction with other patient engagement strategies, support Health Centers' ongoing transformation as PCMHs. PMID:26026275

  16. The Biomedical Engineer in the Medical Center

    ERIC Educational Resources Information Center

    Furst, Emanuel

    1973-01-01

    Discusses the roles of engineers in medical centers, including technical support, instrument control and safety for the hospital, and teaching and research tasks. Indicates that engineering education should take responsibilities to prepare them to understand the human relations and organizational characteristics of their environment through course…

  17. Medical Center Farmers Markets: A Strategic Partner in the Patient-Centered Medical Home

    PubMed Central

    Rovniak, Liza S.; Kraschnewski, Jennifer L.; Morrison, Kathy J.; Dillon, Judith F.; Bates, Beth Y.

    2013-01-01

    Background The number of medical center–based farmers markets has increased in the past decade, but little is known about how such organizations contribute to the preventive health goals of the patient-centered medical home. Community Context In 2010, we started a seasonal farmers market at Penn State Hershey Medical Center to help support the institution’s commitment to the medical home. Methods We obtained descriptive data on the farmers market from hospital and market records and tracking information on the market’s Facebook and Twitter sites. We computed summary measures to characterize how the market has begun to meet the 6 standards of the 2011 National Committee for Quality Assurance’s report on the medical home. Outcome During the 2010 and 2011 seasons, 146 medical center volunteers from 40 departments formed 23 interprofessional teams that spent an average of 551 volunteer hours per season at the market, providing health screenings (n = 695) and speaking to customers (n = 636) about preventive health. Fifty-five nonmedical community health partners provided 208 hours of service at the market alongside medical center staff. Market programming contributed to 5 regional preventive health partnerships and created opportunities for interprofessional mentoring, student leadership, data management, development of social media skills, and grant-writing experience. The market contributed to all 6 medical home standards outlined by the National Committee for Quality Assurance. Interpretation Medical center markets can support medical home standards. With systematic tracking of the health effects and integration with electronic medical health records, markets hold potential to contribute to comprehensive patient-centered care. PMID:23906327

  18. Faculty Handbook. University of Portland.

    ERIC Educational Resources Information Center

    Portland Univ., OR.

    Various faculty services and policies are described in the Spring 1975 edition of the Portland handbook. Specific areas covered include: faculty fringe benefits, credit union, Academic Senate, library services, public relations and information, Instructional Media Center, Continuing Education Center, Computer Center, administrative services,…

  19. IMPACT OF AIR POLLUTION ON THE CONSUMPTION OF MEDICAL SERVICES COSTS OF HOSPITALIZATION IN THE PORTLAND METROPOLITAN AREA

    EPA Science Inventory

    The study was undertaken to ascertain the possibility of measuring from available data the impact of air pollution on the consumption of inpatient services which patients consume per hospital stay. The study area was the Portland, Oregon metropolitan area, and the period of study...

  20. [Medical education centers: strategies and purpose].

    PubMed

    Binetti, P

    1999-01-01

    The introduction of new didactic guidelines, for the graduate degrees in medicine and allied disciplines, is secondary to the new needs of the National Health Care System, and in part to the significant developments of science. It is not easy to meet this challenge. It is likewise not easy to channel coherently the required changes, with respect to the scientific, clinical and didactic goals. Paradoxically the same institutions that are in such great need of transformation, are also a significant part of the existing problem. In many countries, schools of medicine have developed centers for medical education that are geared toward the development and growth of students, teachers-tutors, and patients alike. Medical education has become more global, in an attempt to meet much needed communication needs, from both ends, teachers and students, as well as the recipients of care, patients. One major goal of such centers is the introduction of innovative didactic activities. There is indeed a new tendency toward the development of methodological tracks aiming at the acquisition and consolidation of a deeper and broader cultural knowledge. Amongst these initiatives there is the introduction of an evaluation of the teaching delivered, as well as the development of a multidisciplinary approach to didactics. The latter, is a prerequisite of an effective training directed toward the development of the concept of "team approach", whose ultimate goal is patient care. In Italy, at the Università Campus Biomedico, in Rome, one of the first of such centers of medical education has been developed. Its goal is to be both a learning organization, as well as a center for both research and clinical services. PMID:10687267

  1. 2. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 1) ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 1) FROM THE 'CAMPUS' GROUNDS; LOOKING SW. (Harms) - Veterans Administration Medical Center, Old State Route 13 West, Marion, Williamson County, IL

  2. 4. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 2 ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 2 & BUILDING 1) FROM THE 'CAMPUS' GROUNDS; LOOKING NE. (Harms) - Veterans Administration Medical Center, Old State Route 13 West, Marion, Williamson County, IL

  3. 3. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 2 ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 2 & BUILDING 1) FROM THE 'CAMPUS' GROUNDS; LOOKING NW. (Harms) - Veterans Administration Medical Center, Old State Route 13 West, Marion, Williamson County, IL

  4. Filmless radiology at Brooke Army Medical Center

    NASA Astrophysics Data System (ADS)

    Wilson, Dennis L.

    1997-05-01

    The hospital at Brooke Army Medical Center in San Antonio, Texas has an essentially filmless radiology department. Mammography is one of the few services still using film. The radiology department at Brooke takes advantage of a very capable Lockheed Martin PACS to achieve the filmless operation. The old hospital has been replaced by a new hospital, the new Brooke Army Medical Center. As a basis for predictions of activity at new Brooke, the activities at the old Brooke Army Medical Center were examined. The heart of the PACS at Brooke is the image server with an associated database. The image server has the performance required to keep the radiologist from returning to film for diagnosis. A directly connected workstation can present a full screen of images in less than two seconds, even during the busiest hour of the day for this large hospital. In addition the database is used to organize the workflow for the radiology examinations through the hospital. Information about the activity at the new Brooke hospital is used to predict the utilization of the short term storage and the long term storage. In particular, the time that an examination will be retained on the new Brooke short term storage is measured. The Brooke medical complex generates 384.8 exams per day on a typical weekday. The number of exams on a weekend is 40 percent of the exams on the weekday. The storage required is 18.3 gigabytes per day in the short term storage of the Image Storage Unit (ISU) and 9.7 gigabytes per day in the archive. The 256 gigabytes of the ISU will hold 11.7 weeks or about 2.5 months of exams. The archive will hold four years of exams in tow jukeboxes. A working year will have an effective 300 days of equivalent weekday radiology load. By ten years from now the hospital complex can be expected to handle to load that is estimated to be about 160 percent of the current load. With the changes in the storage of disks and archive media that will have occurred by that time, the

  5. NASA Johnson Space Center Medical Licensing Opportunities

    NASA Technical Reports Server (NTRS)

    Hernandez-Moya, Sonia

    2009-01-01

    This presentation reviews patented medical items that are available for licensing in the areas of Laboratory Technologies, Medical Devices, Medical Equipment and other technologies that are of interest to the medical community.

  6. Jackson Park Hospital Green Building Medical Center

    SciTech Connect

    William Dorsey; Nelson Vasquez

    2010-03-31

    Jackson Park Hospital completed the construction of a new Medical Office Building on its campus this spring. The new building construction has adopted the City of Chicago's recent focus on protecting the environment, and conserving energy and resources, with the introduction of green building codes. Located in a poor, inner city neighborhood on the South side of Chicago, Jackson Park Hospital has chosen green building strategies to help make the area a better place to live and work. The new green building houses the hospital's Family Medicine Residency Program and Specialty Medical Offices. The residency program has been vital in attracting new, young physicians to this medically underserved area. The new outpatient center will also help to allure needed medical providers to the community. The facility also has areas designated to women's health and community education. The Community Education Conference Room will provide learning opportunities to area residents. Emphasis will be placed on conserving resources and protecting our environment, as well as providing information on healthcare access and preventive medicine. The new Medical Office Building was constructed with numerous energy saving features. The exterior cladding of the building is an innovative, locally-manufactured precast concrete panel system with integral insulation that achieves an R-value in excess of building code requirements. The roof is a 'green roof' covered by native plantings, lessening the impact solar heat gain on the building, and reducing air conditioning requirements. The windows are low-E, tinted, and insulated to reduce cooling requirements in summer and heating requirements in winter. The main entrance has an air lock to prevent unconditioned air from entering the building and impacting interior air temperatures. Since much of the traffic in and out of the office building comes from the adjacent Jackson Park Hospital, a pedestrian bridge connects the two buildings, further

  7. Replacing the academic medical center's teaching hospital.

    PubMed

    Reves, J G; Smith, Stuart; Greenberg, Ray; Johnson, Donald

    2005-11-01

    Addressing the need for updated teaching hospital facilities is one of the most significant issues that an academic medical center faces. The authors describe the process they underwent in deciding to build a new facility at the Medical University of South Carolina (MUSC). Initial issues included whether or not the teaching hospital would continue to play a role in clinical education and whether to replace or renovate the existing facility. Once the decision to build was reached, MUSC had to choose between an on-campus or distant site for the new hospital and determine what the function of the old hospital would be. The authors examine these questions and discuss the factors involved in different stages of decision making, in order to provide the academic medicine community guidance in negotiating similar situations. Open communication within MUSC and with the greater community was a key component of the success of the enterprise to date. The authors argue that decisions concerning site, size, and focus of the hospital must be made by developing university-wide and community consensus among many different constituencies. The most important elements in the success at MUSC were having unified leadership, incorporating constituent input, engaging an external consultant, remaining unfazed by unanticipated challenges, and adhering to a realistic, aggressive timetable. The authors share their strategies for identifying and successfully managing these complex and potentially divisive aspects of building a new teaching hospital. PMID:16249296

  8. The need of community health centers for international medical graduates.

    PubMed Central

    Baer, L D; Konrad, T R; Miller, J S

    1999-01-01

    OBJECTIVES: This study sought to determine whether community health centers need international medical graduates to fill staff positions. METHODS: The authors surveyed 100 community health center administrators to learn about their perceptions of international medical graduates. RESULTS: Nationally, about one quarter of community health centers depend on international medical graduates to fill physician vacancies; most of these centers foresee unfilled positions in the event of a cutback. CONCLUSIONS: Policies calling for a national reduction in the supply of international medical graduates need to be balanced by an understanding of these individuals' role in reducing local physician shortages. PMID:10511843

  9. A sustainable medical center in Texas

    SciTech Connect

    Pfeiffer, P.L.; Miller, B.

    1999-07-01

    The purpose of this presentation is to demonstrate how one can successfully integrate many sustainable features into the construction and operation of a mid-sized medical clinic located in the hot/humid piney woods of east Texas for a moderate increase over normal construction costs. The subject project, known as The Texas Specialist Center, has enjoyed the predicted energy and green building results. It is a 6,300 square foot stand alone clinic located in Lufkin, Texas for a client with multiple chemical sensitivities. Green features include passive solar design for heating and cooling, enhanced natural ventilation (including the use of natural thermal siphons within the building), cool communities site planning (to reduce the urban heat island effect), extensive use of daylighting and energy-efficient artificial lighting, photovoltaics to provide security system and computer operations back-up, careful attention to material selections for low toxicity and high indoor air quality, use of regionally appropriate building materials and systems, an extensive rainwater collection system, and xeriscape landscaping principals. It was constructed in 1996 and has been under full operation for two years. Actual energy consumption data will be presented and the above Green design strategies will be elaborated upon.

  10. 1. AERIAL VIEW, LOOKING WEST OF 'THE BIRMINGHAM MEDICAL CENTER,' ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. AERIAL VIEW, LOOKING WEST OF 'THE BIRMINGHAM MEDICAL CENTER,' WITH HILLMAN HOSPITAL, THE FIVE-STORY BUILDING (CENTER RIGHT AT 20TH STREET AND SIXTH AVENUE SOUTH), JEFFERSON TOWER (CENTER LEFT AT 20TH STREET AND SEVENTH AVENUE SOUTH, AND THE MANY HOSPITALS AND TEACHING FACILITIES OF THE UNIVERSITY OF ALABAMA AT BIRMINGHAM MEDICAL CENTER. - Hillman Hospital, 600 Block Westside Twentieth Street South, Birmingham, Jefferson County, AL

  11. 75 FR 22438 - Proposed Information Collection (Health Resource Center Medical Center Payment Form) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-28

    ... medical care copayment online. DATES: Written comments and recommendations on the proposed collection of... 10-0505 will be used to allow claimants with medical care copayment debts to pay online with a credit... AFFAIRS Proposed Information Collection (Health Resource Center Medical Center Payment Form)...

  12. The new reality: academic medical centers partner with the community.

    PubMed

    Scott, K

    1996-11-01

    As academic medical centers face a price-sensitive market dominated by managed care, their survival, says Association of American Medical Colleges' Robert Dickler, will depend on the combination of strategies they use in response. HSL looks at three centers' solution--building alliances to secure patient bases, focusing on expanding primary care capabilities, and downsizing and reorganizing for greater cost savings. PMID:10162189

  13. Children's Medications: A Guide for Schools and Day Care Centers.

    ERIC Educational Resources Information Center

    Bates, Richard D.; Nahata, Milap C.

    Noting the lack of reference sources available on the use of medications in schools and day care centers, this book was created to help school and day care center personnel become more aware of the medicine being given to children at home and at school. Using detailed medication charts, the book answers questions about how to administer medicines…

  14. An Artist in the University Medical Center. Review.

    ERIC Educational Resources Information Center

    James, A. Everette, Jr.

    1991-01-01

    Reviews "An Artist in the University Medical Center" (M. Lesser, New Orleans: Tulane University Press, 1989), in which the artist captures the human side of the complex Tulane Medical Center in New Orleans (Louisiana). The interplay of drawings, etchings, watercolors, and prose conveys traditions of nurturing in the hospital. (SLD)

  15. Assessing the Academic Medical Center as a Supportive Learning Community

    ERIC Educational Resources Information Center

    Gannon, Sam C.

    2011-01-01

    Academic medical centers are well-known for their emphasis on teaching, research and public service; however, like most large, bureaucratic organizations, they oftentimes suffer from an inability to learn as an organization. The role of the research administrator in the academic medical center has grown over time as the profession itself has…

  16. The Stanford University Medical Center and the Federal Government.

    ERIC Educational Resources Information Center

    Rosenzweig, Robert M.; And Others

    The Stanford University Medical Center consists of three main units: a medical school, a set of outpatient clinics, and a hospital. Financing of the center's functions cannot be carried out without federal support, and a network of relationships with government agencies has emerged. The impact of these relationships was discussed with key…

  17. Lessons learned: mobile device encryption in the academic medical center.

    PubMed

    Kusche, Kristopher P

    2009-01-01

    The academic medical center is faced with the unique challenge of meeting the multi-faceted needs of both a modern healthcare organization and an academic institution, The need for security to protect patient information must be balanced by the academic freedoms expected in the college setting. The Albany Medical Center, consisting of the Albany Medical College and the Albany Medical Center Hospital, was challenged with implementing a solution that would preserve the availability, integrity and confidentiality of business, patient and research data stored on mobile devices. To solve this problem, Albany Medical Center implemented a mobile encryption suite across the enterprise. Such an implementation comes with complexities, from performance across multiple generations of computers and operating systems, to diversity of application use mode and end user adoption, all of which requires thoughtful policy and standards creation, understanding of regulations, and a willingness and ability to work through such diverse needs. PMID:19382736

  18. [SOROKA UNIVERSITY MEDICAL CENTER: THE ROAD TO LEADERSHIP IN QUALITY OF MEDICAL CARE, SERVICE AND RESEARCH].

    PubMed

    Davidson, Ehud; Sheiner, Eyal

    2016-02-01

    Soroka University Medical Center is a tertiary hospital, and the sole medical center in the Negev, the southern part of Israel. Soroka has invested in quality, service and research. The region has developed joint programs in order to advance the quality of medical care whilst optimizing the utilization of available resources. In this editorial we describe the path to leadership in quality of medical care, service and research. PMID:27215117

  19. Research support in an academic medical center.

    PubMed

    Cheek, Fern M

    2010-01-01

    In 2003, the Prior Health Sciences Library (Prior Library) at The Ohio State University (OSU) explored the possibility of providing specialized support to biomedical, nursing, and allied health researchers by adding a research librarian position. The decision came about after the Medical Library Association (MLA) investigated how libraries could provide enhanced support to medical researchers. This article describes how the research librarian position was developed and how it continues to evolve. PMID:20391163

  20. Johnson Space Center Health and Medical Technical Authority

    NASA Technical Reports Server (NTRS)

    Fogarty, Jennifer A.

    2010-01-01

    1.HMTA responsibilities: a) Assure program/project compliance with Agency health and medical requirements at identified key decision points. b) Certify that programs/projects comply with Agency health and medical requirements prior to spaceflight missions. c) Assure technical excellence. 2. Designation of applicable NASA Centers for HMTA implementation and Chief Medical Officer (CMO) appointment. 3. Center CMO responsible for HMTA implementation for programs and projects at the center. JSC HMTA captured in "JSC HMTA Implementation Plan". 4. Establishes specifics of dissenting opinion process consistent with NASA procedural requirements.

  1. Photocopy of print in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of print in the Fitzsimons Army Medical Center Real Property Book (green cloth cover), probably south side. - Fitzsimons General Hospital, Female Dormitory, Southeast Corner of West McCloskey Avenue & North Seventh Street, Aurora, Adams County, CO

  2. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), south side. - Fitzsimons General Hospital, Infirmary, Northwest Corner of East Bushnell Avenue & South Page Street, Aurora, Adams County, CO

  3. Photocopy of photograph from the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph from the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Semi-Infirmary Tubercular Ward, Southeast Corner of East Harlow Avenue & South Page Street, Aurora, Adams County, CO

  4. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), south side. - Fitzsimons General Hospital, Tubercular Ward, Southwest Corner of East Bushnell Avenue & South Page Street, Aurora, Adams County, CO

  5. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover), probably south side. - Fitzsimons General Hospital, Officers' Garage, West Pennington Avenue, West of Building 129, Aurora, Adams County, CO

  6. Photocopy of photograph from Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph from Fitzsimons Army Medical Center real property book (green cloth cover), south and west sides. - Fitzsimons General Hospital, Gymnasium, Northeast Corner of East Harlow Avenue & North Page Street, Aurora, Adams County, CO

  7. Photocopy of photograph from the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph from the Fitzsimons Army Medical Center real property book (green cloth cover), showing east side and north sides. - Fitzsimons General Hospital, Transformer House, North Page Street, immediately North of Building No. 217, Aurora, Adams County, CO

  8. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), showing south and east sides. - Fitzsimons General Hospital, Ice Plant, Southwest Corner of East I Avenue & North Thirteenth Street, Aurora, Adams County, CO

  9. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover), south and east sides. - Fitzsimons General Hospital, Storage Sheds, Northeast Corner of West Pennington Avenue & North Eighth Street, Aurora, Adams County, CO

  10. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover) south and east sides. - Fitzsimons General Hospital, Nurses' Garage, East of Building No. 121, Aurora, Adams County, CO

  11. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), showing south side. - Fitzsimons General Hospital, Laboratory Annex, Northwest Corner of East McCloskey Avenue & North Twelfth Street, Aurora, Adams County, CO

  12. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), west and north sides of the southern wing. - Fitzsimons General Hospital, Laundry, Southeast corner of East Harlow Avenue & South Twelfth Street, Aurora, Adams County, CO

  13. Photocopy of print from the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of print from the Fitzsimons Army Medical Center Real Property Book (green cloth cover). - Fitzsimons General Hospital, Tool House, West Pennington Avenue, North of Building No. 140, Aurora, Adams County, CO

  14. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), north side. - Fitzsimons General Hospital, Administration Building, Southeast Corner of West McAfee Avenue & South Eighth Street, Aurora, Adams County, CO

  15. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), showing south and west sides. - Fitzsimons General Hospital, Power House, Northwest Corner of East Harlow Avenue & North Page Street, Aurora, Adams County, CO

  16. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), showing southwest corner of building 732. - Fitzsimons General Hospital, Storehouses, Northwest Corner of East Harlow Avenue & North Thirteenth Street, Aurora, Adams County, CO

  17. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Ambulent Tubercular Ward, Southeast Corner of East Bushnell Avenue & South Hickey Street, Aurora, Adams County, CO

  18. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Artesian Well, East McCloskey Avenue, East of Building No. 231, Aurora, Adams County, CO

  19. Photocopy of photograph from the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph from the Fitzsimons Army Medical Center real property book (green cloth cover), probably southwest side. - Fitzsimons General Hospital, Operating Pavilion, West McAfee Avenue, East of Building No. 507, Aurora, Adams County, CO

  20. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover), south and east sides. - Fitzsimons General Hospital, Post Exchange Garage, North Eighth Street, North of Building No. 143, Aurora, Adams County, CO

  1. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), east and south sides. - Fitzsimons General Hospital, Workshop Building, East Harlow Avenue, immediately East of Building No. 529, Aurora, Adams County, CO

  2. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), probably south and west sides. - Fitzsimons General Hospital, Nurses' Quarters, Southeast Corner of West McAfee Avenue & South Hickey Street, Aurora, Adams County, CO

  3. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover), south sides. - Fitzsimons General Hospital, Officer Recreation Building, West Harlow Avenue, immediately East of Building 118, Aurora, Adams County, CO

  4. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover), looking east. - Fitzsimons General Hospital, Tennis Courts, Northeast Corner of East McCloskey Avenue & North Hickey Street, Aurora, Adams County, CO

  5. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover), probably south and west sides. - Fitzsimons General Hospital, Utilities Storeroom, West Pennington Avenue, East of Building No. 145, Aurora, Adams County, CO

  6. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover). - Fitzsimons General Hospital, Post Exchange Garage, Northwest Corner of West Pennington Avenue & North Eighth Street, Aurora, Adams County, CO

  7. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), showing west side. - Fitzsimons General Hospital, Fire Equipment House, North Page Street, North of Building No. 228, Aurora, Adams County, CO

  8. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), south and east sides. - Fitzsimons General Hospital, Nurses' Quarters, Southwest Corner of West Harlow Avenue, & South Eighth Street, Aurora, Adams County, CO

  9. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover), south side. - Fitzsimons General Hospital, Office Building, Northwest Corner of West McCloskey Avenue & North Tenth Street, Aurora, Adams County, CO

  10. Photocopy of photograph from the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph from the Fitzsimons Army Medical Center real property book (green cloth cover), showing east side. - Fitzsimons General Hospital, Transformer House, North Page Street, immediately North of Building No. 216, Aurora, Adams County, CO

  11. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), showing south and west sides. - Fitzsimons General Hospital, Salvage Building, Northeast Corner of East I Avenue & North Page Street, Aurora, Adams County, CO

  12. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth clover), west side. - Fitzsimons General Hospital, Motor Transport Dispatcher's Office, Northeast Corner of East Harlow Avenue & North Tenth Street, Aurora, Adams County, CO

  13. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Storehouse, East Harlow Avenue, immediately South of Building 201, Aurora, Adams County, CO

  14. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover) - Fitzsimons General Hospital, Quartermaster Store House, Northwest Corner of East I Avenue & North Twelfth Street, Aurora, Adams County, CO

  15. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), east and south sides. - Fitzsimons General Hospital, Pharmacy & Prophylactic Station, Northwest Corner of West McAfee Avenue & South Eighth Street, Aurora, Adams County, CO

  16. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover), east side. - Fitzsimons General Hospital, Shops Building, Northwest Corner of West Pennington Avenue, & North Tenth Street, Aurora, Adams County, CO

  17. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), east and north sides. - Fitzsimons General Hospital, Wagon Shed with Office, Southeast Corner of East J Avenue & North Tenth Street, Aurora, Adams County, CO

  18. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover), south and east sides. - Fitzsimons General Hospital, Nurses Quarters No. 3, Northwest Corner of West Harlow Avenue & North Seventh Street, Aurora, Adams County, CO

  19. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover). - Fitzsimons General Hospital, Greenhouse, West Pennington Avenue, East of Building No. 139, Aurora, Adams County, CO

  20. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Semi-Infirmary Turbercular Ward, Northwest Corner of Charlie Kelly Boulevard & South Hickey Street, Aurora, Adams County, CO

  1. Medical Informatics in Academic Health Science Centers.

    ERIC Educational Resources Information Center

    Frisse, Mark E.

    1992-01-01

    An analysis of the state of medical informatics, the application of computer and information technology to biomedicine, looks at trends and concerns, including integration of traditionally distinct enterprises (clinical information systems, financial information, scholarly support activities, infrastructures); informatics career choice and…

  2. Characterizing customers at medical center farmers’ markets1

    PubMed Central

    Kraschnewski, Jennifer L.; George, Daniel R.; Rovniak, Liza S.; Monroe, Diana L.; Fiordalis, Elizabeth; Bates, Erica

    2014-01-01

    Approximately 100 farmers’ markets operate on medical center campuses. Although these venues can uniquely serve community health needs, little is known about customer characteristics and outreach efforts. Intercept survey of markets and market customers between August 2010-October 2011 at three medical centers in different geographic regions of the US: Duke University Medical Center, Cleveland Clinic, and Penn State Hershey Medical Center were conducted. Markets reported serving 180–2000 customers per week and conducting preventive medicine education sessions and community health programs. Customers (n=585) across markets were similar in sociodemographic characteristics – most were middle-aged, white, and female, who were employees of their respective medical center. Health behaviors of customers were similar to national data. The surveyed medical center farmers’ markets currently serve mostly employees; however, markets have significant potential for community outreach efforts in preventive medicine. If farmers’ markets can broaden their reach to more diverse populations, they may play an important role in contributing to community health. PMID:24421001

  3. Jackson Park Hospital Green Building Medical Center

    SciTech Connect

    Dorsey, William; Vasquez, Nelson

    2010-05-01

    Jackson Park Hospital completed the construction of a new Medical Office Building on its campus this spring. The new building construction has adopted the City of Chicago's recent focus on protecting the environment, and conserving energy and resources, with the introduction of green building codes. Located in a poor, inner city neighborhood on the South side of Chicago, Jackson Park Hospital has chosen green building strategies to help make the area a better place to live and work.

  4. Benefits of Student-Centered Tandem Teaching in Medical English.

    PubMed

    Antić, Zorica

    2015-01-01

    This paper addresses some of the key notions about English for special purposes with special regard to English for medical purposes. The content was determined by observations and based on authors' professional experience. The starting point of a medical English course is a thorough analysis of students' needs, which is then used in course design and definition of appropriate learning goals. The student is at the center of learning and it is necessary to establish a positive cooperation between students and teachers. As medical English course is highly context-based, the inclusion of medical teachers can offer many opportunities for a successful learning process. PMID:26506766

  5. The Center for Healthy Weight: an academic medical center response to childhood obesity

    PubMed Central

    Robinson, T N; Kemby, K M

    2012-01-01

    Childhood obesity represents a worldwide medical and public health challenge. Academic medical centers cannot avoid the effects of the obesity epidemic, and must adopt strategies for their academic, clinical and public policy responses to childhood obesity. The Center for Healthy Weight at Stanford University and Lucile Packard Children's Hospital at Stanford provides an example and model of one such strategy. The design provides both breadth and depth through six cores: Research, Patient Care, Community Programs, Advocating for Public Policy Change, Training and Professional Education, and the Healthy Hospital Initiative. The Center and its cores are designed to facilitate interdisciplinary collaboration across the university, medical school, children's hospital and surrounding community. The foci of these cores are likely to be relevant to almost any academic medical center's mission and functions. PMID:25089192

  6. The Six Sigma initiative at Mount Sinai Medical Center.

    PubMed

    Chassin, Robert

    2008-01-01

    Lean Six Sigma, in various forms, has been used widely in many Fortune 500 companies. Motorola, General Electric, Sony, American Express, and Bechtel all use Six Sigma to improve quality and performance. While the impact of this methodology has been documented extensively by the press in manufacturing and transactional settings, less evidence is available regarding its utility in health care environments. Mount Sinai Medical Center initiated a Six Sigma program in 2000 to determine its applicability and value in a large academic medical center. This article discusses Mount Sinai Medical Center's experience adapting this methodology to improve both patient care and business processes and outcomes. We present an overview of Six Sigma, and offer examples of projects undertaken using this data-driven approach to performance improvement. Lastly, the article provides insights and lessons learned regarding this organization-wide experience. PMID:18306249

  7. STOR: From Pilot Project to Medical Center Implementation

    PubMed Central

    Henke, J.; Whiting-O'Keefe, Q.E.; Whiting, A.; Schaffner, R.; Schnake, R.; Goldstein, R.; Abrego, J.

    1988-01-01

    Summary Time Oriented Record (STOR) is a clinical information system operating at the University of California San Francisco Medical Center (UCSF). It provides two major services: on-line display of clinical information in the hospitals and clinics and an ambulatory medical record that partially replaces the traditional paper medical record for outpatient patient visits. In 1985 STOR was approved for clinic-wide implementation in the UCSF ambulatory care clinics. The implementation will be completed in September 1989. STOR captures clinical data directly from clinicians via hand written notations and ancillary data from other UCSF computers via a local area network. Development on STOR is continuing in order to meet the changing and diversified environment of inpatient and outpatient practices found in a university medical center.

  8. Student perceptions of a patient- centered medical training curriculum

    PubMed Central

    Gallentine, Ashley; Salinas-Miranda, Abraham A.; Shaffer-Hudkins, Emily; Hinojosa, Sara; Monroe, Alicia

    2014-01-01

    Objectives To evaluate a patient-centered medical training curriculum, the SELECT program, through perceptions of the inaugural student cohort. Methods Data were collected from two focus groups conducted in the university setting, comprised of fifteen first-year medical students who participated in the SELECT program during its inaugural year. A questioning protocol was used to guide the focus group discussion, which was transcribed and hand-coded through thematic analyses. Results Various themes related to patient-centered care were identified. Students noted changes in their attitudes towards interacting with patients in an empowering and educative manner as a result of communication and motivational interviewing exercises. Additionally, they recognized certain external, structural barriers as well as internal conflict between pragmatism and emotional intelligence that could potentially hinder patient-centered care. The impact of family dynamics and social support on quality of life and health outcomes was acknowledged. Students also emphasized the value of collaborating with multiple health professionals. Lastly, students provided suggestions for program improvement, namely additional simulations, more education regarding other healthcare professionals’ roles, more standardized experiences, and application of principles to acute and primary care. Conclusions Upon completion of the first year of the SELECT program, students gained an appreciation for patient-centered care and various factors and skills that facilitate such care. Additionally, they experienced a dissonance between didactic concepts from the curriculum and observed medical practices. This study highlights the educational benefits of a patient-centered medical curriculum and provides suggestions for future improvement. PMID:25341218

  9. An Unsuccessful Experience with Computerized Medical Records in an Academic Medical Center.

    ERIC Educational Resources Information Center

    Dambro, Mark R.; And Others

    1988-01-01

    Experience with the Computer Stored Ambulatory Record (COSTAR), a computerized medical records system, installed at a large primary care clinic at a university medical center is reported. Use of the system was terminated because clinic revenues could not cover operating costs. (Author/MLW)

  10. Effectively implementing FDA medication alerts utilizing patient centered medical home clinical pharmacists.

    PubMed

    Arenz, Barbara J; Diez, Heidi L; Bostwick, Jolene R; Kales, Helen C; Zivin, Kara; Dalack, Gregory W; Fluent, Tom E; Standiford, Connie J; Stano, Claire; Mi Choe, Hae

    2016-03-01

    FDA medication alerts can be successfully implemented within patient centered medical home (PCMH) clinics utilizing clinical pharmacists. Targeted selection of high-risk patients from an electronic database allows PCMH pharmacists to prioritize assessments. Trusting relationships between PCMH clinical pharmacists and primary care providers facilitates high response rates to pharmacist recommendations. This health system approach led by PCMH pharmacists provides a framework for proactive responses to FDA safety alerts and medication related quality measure improvement. PMID:27001101

  11. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), east and south sides of building no. 715, now the south wing of building no. 508. - Fitzsimons General Hospital, Nurses' Mess & Kitchen, Nurses' Recreation, West McAfee Avenue, North of Building 507, Aurora, Adams County, CO

  12. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), south and west sides of buildings no. 719, now the north wing of building no. 508. - Fitzsimons General Hospital, Nurses' Mess & Kitchen, Nurses' Recreation, West McAfee Avenue, North of Building 507, Aurora, Adams County, CO

  13. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), probably west and north sides. - Fitzsimons General Hospital, Officer Patient's Mess & Kitchen, Northeast Corner of West McAfee Avenue & South Hickey Street, Aurora, Adams County, CO

  14. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), north and east sides of the east/west wing. - Fitzsimons General Hospital, General Mess & Kitchen, Southwest Corner of East McAfee Avenue & South Twelfth Street, Aurora, Adams County, CO

  15. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), showing part of east side and most of north side. - Fitzsimons General Hospital, Quartermaster's Storehouse, Southwest Corner of East I Avenue & North Twelfth Street, Aurora, Adams County, CO

  16. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), south side. - Fitzsimons General Hospital, Red Cross Building, South Eighth Street Bounded by West McAfee Avenue on South & West Harlow Avenue on North, Aurora, Adams County, CO

  17. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover). Photograph of south side before perpendicular wing added. - Fitzsimons General Hospital, Carpenter Shop Building, Southwest Corner of West I Avenue, & North Tenth Street, Aurora, Adams County, CO

  18. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), south and north sides. - Fitzsimons General Hospital, Physiotherapy & Electrocardiograph Department Building, North of Building No. 516, East of corridor connecting Building No. 511 to Building No. 515, Aurora, Adams County, CO

  19. Claretian Medical Center Task Analysis. Worker Education Program.

    ERIC Educational Resources Information Center

    Union of Needletrades, Industrial and Textile Employees.

    This task analysis for positions at the Claretian Medical Center in southeast Chicago was developed to improve communication and customer service in the workplace. The task analysis was prepared through clinic tours, employee interviews, and supervisor questionnaires. It is used for the purpose of curriculum development for onsite instruction in…

  20. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover). Photograph taken before Sept. 29, 1934 when the revised Real Property form on building 257 was completed. - Fitzsimons General Hospital, Building 257, North side of East O'Neill Avenue, between Tenth & Twelfth Streets, Aurora, Adams County, CO

  1. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property Book (green cloth cover). Photograph taken before Sept 29, 1934 when the revised Real Property form on building 255 was completed. - Fitzsimons General Hopital, Building 255, North side of East O'Niell Avenue, between Tenth & Twelfth Streets, Aurora, Adams County, CO

  2. Photocopy of photograph in the Fitzsimons Army Medical Center Real ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in the Fitzsimons Army Medical Center Real Property Book (green cloth cover). Photograph taken before Sept. 29, 1934 when the revised Real Property form on building 256 was completed. - Fitzsimons General Hospital, Building 256, North side of East O'Niell Avenue, between Tenth & Twelfth Streets, Aurora, Adams County, CO

  3. Photocopy of postcard from Fitzsimons Army Medical Center public affairs ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of postcard from Fitzsimons Army Medical Center public affairs office, building 120, showing building 215 in the 1940's before the top of the smokestack blew off. Photograph shows north side and corner of west side. - Fitzsimons General Hospital, Power House, Northwest Corner of East Harlow Avenue & North Page Street, Aurora, Adams County, CO

  4. Photocopy of photograph in Fitzsimons Army Medical Center Real Property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center Real Property book (green cloth cover), showing east and most of south sides. - Fitzsimons General Hospital, Assembly Hall School, Northeast Corner of West McCloskey Avenue & North Tenth Street, Aurora, Adams County, CO

  5. The 'Adventist advantage'. Glendale Adventist Medical Center distinguishes itself.

    PubMed

    Botvin, Judith D

    2002-01-01

    Glendale Adventist Medical Center, Glendale, Calif., adopted an image-building campaign to differentiate the 450-bed hospital from its neighbors. This included the headline "Adventist Advantage," used in a series of sophisticated ads, printed in gold. In all their efforts, marketers consider the sensibilities of the sizable Armenian, Korean, Hispanic and Chinese populations. PMID:12134406

  6. Photocopy of post card from Fitzsimons Army Medical Center Public ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of post card from Fitzsimons Army Medical Center Public Affairs Office, building 120. Photograph by Rocky Mountain photo. CO was no copyrighted and is , therefore, in the public domain. - Fitzsimons General Hospital, Memorial Tablet, West McAfee, South of Building No. 524, Aurora, Adams County, CO

  7. The impact of the IRB on medical centers.

    PubMed

    Lee, A S; Thompson, J H

    1981-01-01

    The role of the IRB in a Medical Center is presented with respect to investigations of medical device safety and effectiveness involving human subjects. The prime points presented and discussed are: the reasons (governmental, social, economic, legal-liability, scientific and moral) for the existence of an IRB; the analytical and descriptive documentation which should always precede experimentation; the concepts governing an application to a "typical" IRB; a practical, detailed outline of some special facts and circumstances typically most important to an IRB; and, the question of confidentiality of trade secrets. PMID:10251107

  8. The changes involved in patient-centered medical home transformation.

    PubMed

    Wagner, Edward H; Coleman, Katie; Reid, Robert J; Phillips, Kathryn; Abrams, Melinda K; Sugarman, Jonathan R

    2012-06-01

    In 2007, the major primary care professional societies collaboratively introduced a new model of primary care: the patient-centered medical home (PCMH). The published document outlines the basic attributes and expectations of a PCMH but not with the specificity needed to help interested clinicians and administrators make the necessary changes to their practice. To identify the specific changes required to become a medical home, the authors reviewed literature and sought the opinions of two multi-stakeholder groups. This article describes the eight consensus change concepts and 32 key changes that emerged from this process, and the evidence supporting their inclusion. PMID:22608865

  9. [Patient-centered medicine for tuberculosis medical services].

    PubMed

    Fujita, Akira; Narita, Tomoyo

    2012-12-01

    The 2011 edition of Specific Guiding Principles for Tuberculosis Prevention calls for a streamlined medical services system capable of providing medical care that is customized to the patient's needs. The new 21st Century Japanese version of the Directly Observed Treatment Short Course (DOTS) expands the indication of DOTS to all tuberculosis (TB) patients in need of treatment. Hospital DOTS consists of comprehensive, patient-centered support provided by a DOTS care team. For DOTS in the field, health care providers should select optimal administration support based on patient profiles and local circumstances. In accordance with medical fee revisions for 2012, basic inpatient fees have been raised and new standards for TB hospitals have been established, the result of efforts made by the Japanese Society for Tuberculosis and other associated groups. It is important that the medical care system be improved so that patients can actively engage themselves as a member of the team, for the ultimate goal of practicing patient-centered medicine. We have organized this symposium to explore the best ways for practicing patient-centered medicine in treating TB. It is our sincere hope that this symposium will lead to improved medical treatment for TB patients. 1. Providing patient-centered TB service via utilization of collaborative care pathway: Akiko MATSUOKA (Hiroshima Prefectural Tobu Public Health Center) We have been using two types of collaborative care pathway as one of the means of providing patient-centered TB services since 2008. The first is the clinical pathway, which is mainly used by TB specialist doctors to communicate with local practitioners on future treatment plan (e.g. medication and treatment duration) of patients. The clinical pathway was first piloted in Onomichi district and its use was later expanded to the whole of Hiroshima prefecture. The second is the regional care pathway, which is used to share treatment progress, test results and other

  10. Computer Assisted Multi-Center Creation of Medical Knowledge Bases

    PubMed Central

    Giuse, Nunzia Bettinsoli; Giuse, Dario A.; Miller, Randolph A.

    1988-01-01

    Computer programs which support different aspects of medical care have been developed in recent years. Their capabilities range from diagnosis to medical imaging, and include hospital management systems and therapy prescription. In spite of their diversity these systems have one commonality: their reliance on a large body of medical knowledge in computer-readable form. This knowledge enables such programs to draw inferences, validate hypotheses, and in general to perform their intended task. As has been clear to developers of such systems, however, the creation and maintenance of medical knowledge bases are very expensive. Practical and economical difficulties encountered during this long-term process have discouraged most attempts. This paper discusses knowledge base creation and maintenance, with special emphasis on medical applications. We first describe the methods currently used and their limitations. We then present our recent work on developing tools and methodologies which will assist in the process of creating a medical knowledge base. We focus, in particular, on the possibility of multi-center creation of the knowledge base.

  11. Photocopy of photograph from Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph from Fitzsimons Army Medical Center real property book (green cloth cover), showing building 225's west and a north sides. This photograph is included because it shows how the west side of building 221 looked before the corridor between buildings 220 and 221 was added and because building 225 was built to the same plan as building 221. - Fitzsimons General Hospital, Hospital Corps Barracks, East Harlow Street, East of Building No. 220, Aurora, Adams County, CO

  12. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), apparently showing west side of building 732. In 1921, buildings 732 and 733 were combined and it is assumed that this photograph, which was taken after 1921, shows the section added to make buildings 732 and 733 once continuous building. - Fitzsimons General Hospital, Storehouses, Northwest Corner of East Harlow Avenue & North Thirteenth Street, Aurora, Adams County, CO

  13. Energy use baselining study for the National Naval Medical Center

    SciTech Connect

    Parker, G.B.; Halverson, M.A.

    1992-04-01

    This report provides an energy consumption profile for fourteen buildings at the National Naval Medical Center (NNMC) in Bethesda, Maryland. Recommendations are also made for viable energy efficiency projects funded with assistance from the servicing utility (Potomic Electric Power Company) in the form of rebates and incentives available in their Demand Side Management (DSM) program and through Shared Energy Savings (SES) projects. This report also provides estimates of costs and potential energy savings of the recommended projects.

  14. Best practice in unbilled account management: one medical center's story.

    PubMed

    Menaker, Debra; Miller, Joshua

    2016-02-01

    After implementing its new electronic health record, a large metropolitan academic medical center (AMC) decided to optimize its supporting business systems, beginning with billing. By identifying problems and taking the following corrective actions immediately, the AMC significantly reduced the number and average age of its unbilled accounts: Realigning system automation to improve routing efficiency. Facilitating interdisciplinary collaboration to better identify and correct the root causes of issues. Ensuring transparent data reporting by setting up different ways of viewing the underlying information. PMID:26999975

  15. Understanding and improving inpatient mortality in academic medical centers.

    PubMed

    Behal, Raj; Finn, Jeannine

    2009-12-01

    The purpose of this article is to describe factors contributing to potentially preventable mortality in academic medical centers and the organizational characteristics associated with success in reducing mortality. Sixteen U.S. academic medical centers that wished to improve risk-adjusted inpatient mortality rates requested a consultation that included interviews with physicians, nurses, and hospital leaders; review of medical records; and evaluation of systems and processes of care. The assessments took place on-site; they identified key factors contributing to preventable mortality, and each hospital received specific recommendations. Changes in observed mortality and in the ratio of observed to expected mortality were measured from 2002 to final follow-up in 2007. Evaluations determined each hospital's success factors and key barriers to improvement. The key factors contributing to preventable mortality were delays in responding to deteriorating patients, suboptimal critical care, hospital-acquired infections, postoperative complications, medical errors, and community issues such as the availability of hospice care. Of the 16 hospitals, 12 were able to reduce their mortality index. The five hospitals that had the greatest improvement in mortality were the only hospitals with a broad level of engagement among hospital and physician leaders, including the department chairs. In the hospitals whose performance did not improve, the department chairs were not engaged in the process. The academic medical centers that focused on mortality reduction and had engagement of physicians, especially department chairs, were able to achieve meaningful reductions in hospital mortality. The necessary ingredients for achieving meaningful improvement in clinical outcomes included good data, a sound method for change, and physician leadership. PMID:19940569

  16. Succession planning in an academic medical center nursing service.

    PubMed

    Barginere, Cynthia; Franco, Samantha; Wallace, Lynne

    2013-01-01

    Succession planning is of strategic importance in any industry. It ensures the smooth transition from leader to leader and the ability of the organization to maintain the forward momentum as well as meet its operational and financial goals. Health care and nursing are no exception. In the complex and challenging world of health care today, leadership is critical to an organization's success and leadership succession is a key strategy used to ensure continuity of leadership and development of talent from within the organization. At Rush University Medical Center, a 667-bed academic medical center providing tertiary care to adults and children, the need for a focus on succession planning for the nursing leadership team is apparent as key leaders come to the end of their careers and consider retirement. It has become apparent that to secure the legacy and continue the extraordinary history of nursing excellence, care must be taken to grow talent from within and take the opportunity to leverage the mentoring opportunities before the retirement of many key leaders. To ensure a smooth leadership transition, nursing leadership and human resources partner at Rush University Medical Center to implement a systematic approach to leadership succession planning. PMID:23222756

  17. Geriatric education centers address medication issues affecting older adults.

    PubMed Central

    Kahl, A; Blandford, D H; Krueger, K; Zwick, D I

    1992-01-01

    Serious problems have been identified in the prescribing of medications for elderly patients and use of prescription and nonprescription drugs by older persons. Overuse, underuse, and inappropriate use of drugs by the elderly have been widely documented, and the harmful consequences have been described. This paper reviews information concerning the need for action to improve health professionals' knowledge and skills with respect to drugs and the elderly and activities being undertaken by geriatric education centers (GECs) to enhance these capacities. Grant support for the centers from the Health Resources and Services Administration, a Public Health Service component agency, began in 1983. In fiscal year 1992 there are 31 centers operating in 26 States. The centers are multi-institutional and conduct four types of educational activities. These include review of pharmacological issues for multidisciplinary groups, specialized training for pharmacists, discipline-specific programs focusing on medication issues, and activities aimed at educating the public. Examples of the GECs' educational activities are given. PMID:1738807

  18. School-Based Health Centers and the Patient-Centered Medical Home. Position Statement

    ERIC Educational Resources Information Center

    National Assembly on School-Based Health Care, 2010

    2010-01-01

    The patient-centered medical home (PCMH) is an innovative care delivery model designed to provide comprehensive primary care services to people of all ages by fostering partnerships between patients, families, health care providers and the community. National Assembly on School-Based Health Care (NASBHC) recommends practices and policies that…

  19. An academic medical center under prolonged rocket attack--organizational, medical, and financial considerations.

    PubMed

    Bar-El, Yaron; Michaelson, Moshe; Hyames, Gila; Skorecki, Karl; Reisner, Shimon A; Beyar, Rafael

    2009-09-01

    The Rambam Medical Center, the major academic health center in northern Israel, serving a population of two million and providing specialized tertiary care, was exposed to an unprecedented experience during the Second Lebanon War in the summer of 2006. For more than one month, it was subjected to continuous rocket attacks, but it continued to provide emergency and routine medical services to the civilian population and also served the military personnel who were evacuated from the battlefront. To accomplish the goals of serving the population while itself being under fire, the Rambam Medical Center had to undertake major organizational decisions, which included maximizing safety within the hospital by shifting patients and departments, ensuring that the hospital was properly fortified, managing the health professional teams' work schedules, and providing needed services for the families of employees. The Rambam Medical Center's Level I trauma center expertise included multidisciplinary teams and extensive collaborations; modern imaging modalities usually reserved for peacetime medical practice were frequently used. The function of the hospital teams during the war was efficient and smooth, based on the long-term actions taken to prepare for disasters and wartime conditions. Routine hospital services continued, although at 60% of normal occupancy. Financial losses incurred were primarily due to the decrease in revenue-generating activity. The two most important components of managing the hospital under these conditions are (1) the ability to arrive at prompt and meaningful decisions with respect to the organizational and medical hospital operations and (2) the leadership and management of the professional staff and teams. PMID:19707058

  20. The Prescribed Pediatric Center: A Medical Day Treatment Program for Children with Complex Medical Conditions.

    ERIC Educational Resources Information Center

    Ruppert, Elizabeth S.; Karst, Thomas O.; Brogan, Mark G.

    1998-01-01

    The Prescribed Pediatric Center (Toledo, Ohio) is a community-based, multidisciplinary program for infants and children with chronic, complex medical conditions. This article describes program beginnings; the planning process; and the program's growth, development, and components. Initial program evaluation indicates positive effects on some…

  1. Design for Medical Education. The Development and Planning of a Medical College and Care Center.

    ERIC Educational Resources Information Center

    Peery, Thomas M.; Green, Alan C.

    Planning and design procedures which one medical education center employed in translating its educational objectives, philosophy and techniques into laboratory, classroom and clinic facilities are described. Basic planning considerations included--(1) determination of the curriculum, (2) facility utilization rate, (3) housing of research…

  2. Interpersonal Communications Curriculum. Claretian Medical Center for the Worker Education Program of Northeastern Illinois University, Chicago Teacher's Center.

    ERIC Educational Resources Information Center

    Estes, Florence S.

    This teaching guide contains the materials required to teach a 6-week course in interpersonal communications that was developed for the workers of a Chicago medical center through a partnership involving the medical center, its employees, their union, and Northeastern Illinois University. Based on the student-centered philosophy of teaching, the…

  3. Evaluation of Intravenous Medication Errors with Smart Infusion Pumps in an Academic Medical Center

    PubMed Central

    Ohashi, Kumiko; Dykes, Patricia; McIntosh, Kathleen; Buckley, Elizabeth; Wien, Matt; Bates, David W.

    2013-01-01

    While some published research indicates a fairly high frequency of Intravenous (IV) medication errors associated with the use of smart infusion pumps, the generalizability of these results are uncertain. Additionally, the lack of a standardized methodology for measuring these errors is an issue. In this study we iteratively developed a web-based data collection tool to capture IV medication errors using a participatory design approach with interdisciplinary experts. Using the developed tool, a prevalence study was then conducted in an academic medical center. The results showed that the tool was easy to use and effectively captured all IV medication errors. Through the prevalence study, violation errors of hospital policy were found that could potentially place patients at risk, but no critical errors known to contribute to patient harm were noted. PMID:24551395

  4. A cryptologic based trust center for medical images.

    PubMed Central

    Wong, S T

    1996-01-01

    OBJECTIVE: To investigate practical solutions that can integrate cryptographic techniques and picture archiving and communication systems (PACS) to improve the security of medical images. DESIGN: The PACS at the University of California San Francisco Medical Center consolidate images and associated data from various scanners into a centralized data archive and transmit them to remote display stations for review and consultation purposes. The purpose of this study is to investigate the model of a digital trust center that integrates cryptographic algorithms and protocols seamlessly into such a digital radiology environment to improve the security of medical images. MEASUREMENTS: The timing performance of encryption, decryption, and transmission of the cryptographic protocols over 81 volumetric PACS datasets has been measured. Lossless data compression is also applied before the encryption. The transmission performance is measured against three types of networks of different bandwidths: narrow-band Integrated Services Digital Network, Ethernet, and OC-3c Asynchronous Transfer Mode. RESULTS: The proposed digital trust center provides a cryptosystem solution to protect the confidentiality and to determine the authenticity of digital images in hospitals. The results of this study indicate that diagnostic images such as x-rays and magnetic resonance images could be routinely encrypted in PACS. However, applying encryption in teleradiology and PACS is a tradeoff between communications performance and security measures. CONCLUSION: Many people are uncertain about how to integrate cryptographic algorithms coherently into existing operations of the clinical enterprise. This paper describes a centralized cryptosystem architecture to ensure image data authenticity in a digital radiology department. The system performance has been evaluated in a hospital-integrated PACS environment. PMID:8930857

  5. Promoting cancer screening within the patient centered medical home.

    PubMed

    Sarfaty, Mona; Wender, Richard; Smith, Robert

    2011-01-01

    While consensus has grown that primary care is the essential access point in a high-performing health care system, the current model of primary care underperforms in both chronic disease management and prevention. The Patient Centered Medical Home model (PCMH) is at the center of efforts to reinvent primary care practice, and is regarded as the most promising approach to addressing the burden of chronic disease, improving health outcomes, and reducing health spending. However, the potential for the medical home to improve the delivery of cancer screening (and preventive services in general) has received limited attention in both conceptualization and practice. Medical home demonstrations to date have included few evidence-based preventive services in their outcome measures, and few have evaluated the effect of different payment models. Decreasing use of hospitals and emergency rooms and an emphasis on improving chronic care represent improvements in effective delivery of healthcare, but leave opportunities for reducing the burden of cancer untouched. Data confirm that what does or does not happen in the primary care setting has a substantial impact on cancer outcomes. Insofar as cancer is the leading cause of death before age 80, the PCMH model must prioritize adherence to cancer screening according to recommended guidelines, and systems, financial incentives, and reimbursements must be aligned to achieve that goal. This article explores capacities that are needed in the medical home model to facilitate the integration of cancer screening and other preventive services. These capacities include improved patient access and communication, health risk assessments, periodic preventive health exams, use of registries that store cancer risk information and screening history, ability to track and follow up on tests and referrals, feedback on performance, and payment models that reward cancer screening. PMID:22086728

  6. A suicide prevention advisory group at an academic medical center.

    PubMed

    Hough, D; Lewis, P

    2000-02-01

    During a 15-month period, there were seven suicides among patients who were in active treatment or who had been seen recently by providers in the Department of Psychiatry of Tripler Army Medical Center, Honolulu, Hawaii. As a result, a Suicide Prevention Advisory Group was formed to identify possible causes and make recommendations aimed at improving the identification and treatment of suicidal patients. The group made 11 specific recommendations. No known suicides occurred during the 22 months after the implementation of the Suicide Prevention Advisory Group's recommendations. PMID:10709368

  7. A suicide prevention advisory group at an academic medical center.

    PubMed

    Hough, David; Lewis, Philip

    2010-05-01

    During a 15-month period, there were seven suicides among patients who were in active treatment or who had been seen recently by providers in the Department of Psychiatry of Tripler Army Medical Center, Honolulu, Hawaii. As a result, a Suicide Prevention Advisory Group (SPAG) was formed to identify possible causes and make recommendations aimed at improving the identification and treatment of suicidal patients. The group made 11 specific recommendations. No known suicides occurred during the 22 months after the implementation of the Suicide Prevention Advisory Group's recommendations. PMID:20486507

  8. Case study: a data warehouse for an academic medical center.

    PubMed

    Einbinder, J S; Scully, K W; Pates, R D; Schubart, J R; Reynolds, R E

    2001-01-01

    The clinical data repository (CDR) is a frequently updated relational data warehouse that provides users with direct access to detailed, flexible, and rapid retrospective views of clinical, administrative, and financial patient data for the University of Virginia Health System. This article presents a case study of the CDR, detailing its five-year history and focusing on the unique role of data warehousing in an academic medical center. Specifically, the CDR must support multiple missions, including research and education, in addition to administration and management. Users include not only analysts and administrators but clinicians, researchers, and students. PMID:11452578

  9. Photocopy of photograph in Fitzsimons Army Medical Center real property ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover). In that book, this photograph appears for building 706 was renumbered 353 and subsequently 202. The building in the photograph resembles building 204 more than it does building 202, but all Fitzsimons Real Property records indicate that the building in the photograph, showing west side, is early photograph of building 202. - Fitzsimons General Hospital, Motor Transport Garage, Northwest Corner of East Harlow Avenue, & North Twelfth Street, Aurora, Adams County, CO

  10. Cancer Research Institute, Loma Linda University Medical Center

    SciTech Connect

    1994-08-01

    The Department of Energy (DOE) has prepared an Environmental Assessment (EA) DOE/EA-0975, evaluating the construction, equipping and operation of the Cancer Research Institute (CRI) at the Loma Linda University Medical Center (LLUMC) on its campus in Loma Linda, California. Based on the analysis in the EA, the DOE has determined that the proposed action does not constitute a major federal action significantly affecting the quality of the human environment within the meaning of the National Environmental Policy Act of 1969 (NEPA). Therefore, the preparation of an Environmental Impact Statement is not required. This document describes alternatives, the affected environment and environmental consequences of the proposed action.

  11. Forensic neuropsychological evaluations in an academic medical center.

    PubMed

    Schwarz, Lauren; Schrift, Michael; Pliskin, Neil

    2009-01-01

    Within the expanding field of clinical neuropsychology, the subspecialty of forensic neuropsychology has developed. Currently, there is considerable diversity within the discipline as to how practitioners approach test selection, reports, and number of hours billed. How individuals handle these issues is subject to debate, but what is clear is that there are no specific guidelines as to how to conduct these evaluations. The current study provides an introduction to the issues faced by clinical neuropsychologists completing forensic evaluations. In addition, the authors present how the relevant issues are addressed in one neuropsychology service housed within a university-affiliated academic medical center. PMID:19333065

  12. An Integrated Model of Care: A Visit to The SPARK Center, a Program of Boston Medical Center

    ERIC Educational Resources Information Center

    Griest, Christa

    2010-01-01

    This article features The SPARK Center, a program of Boston Medical Center, located in Mattapan, Massachusetts. The Center has pioneered a whole-child approach to address the multi-dimensional needs of Boston's most at-risk children, recognizing that vulnerable children need more than educational supports to flourish. The Center's integrated model…

  13. Photodynamic research at Baylor University Medical Center Dallas, Texas

    NASA Astrophysics Data System (ADS)

    Gulliya, Kirpal S.; Matthews, James Lester; Sogandares-Bernal, Franklin M.; Aronoff, Billie L.; Judy, Millard M.

    1993-03-01

    We received our first CO2 laser at Baylor University Medical Center in December 1974, following a trip to Israel in January of that year. Discussion with the customs office of the propriety of charging an 18% import tax lasted for nine months. We lost that argument. Baylor has been using lasers of many types for many procedures since that time. About ten years ago, through the kindness of Tom Dougherty and Roswell Park, we started working with photodynamic therapy, first with hematoporphyrin I and later with dihematoporphyrin ether (II). In February 1984, we were invited to a conference at Los Alamos, New Mexico, U.S.A. on medical applications of the free electron laser as part of the Star Wars Program. A grant application from Baylor was approved that November, but funding did not start for many months. This funding contributed to the development of a new research center as part of Baylor Research Institute. Many of the projects investigated at Baylor dealt with applications of the free electron laser (FEL), after it became available. A staff was assembled and many projects are still ongoing. I would like to outline those which are in some way related to photodynamic therapy.

  14. IAIMS at Columbia-Presbyterian Medical Center: accomplishments and challenges.

    PubMed Central

    Roderer, N K; Clayton, P D

    1992-01-01

    The concept of "one-stop information shopping" is becoming a reality at Columbia-Presbyterian Medical Center. Our goal is to provide access from a single workstation to clinical, research, and library resources; university and hospital administrative systems; and utility functions such as word processing and mail. We have created new organizational units and installed a network of workstations that can access a variety of resources and systems on any of seventy-two different host computers/servers. In November 1991, 2,600 different individuals used the clinical information system, 700 different individuals used the library resources, and 900 different individuals used hospital administrative systems via the network. Over the past four years, our efforts have cost the equivalent of $23 million or approximately 0.5% of the total medical center budget. Even small improvements in productivity and in the quality of work of individuals who use the system could justify these expenditures. The challenges we still face include the provision of additional easy-to-use applications and development of equitable methods for financial support. PMID:1326368

  15. Measuring physicians' productivity in a Veterans' Affairs Medical Center.

    PubMed

    Coleman, David L; Moran, Eileen; Serfilippi, Delchi; Mulinski, Paul; Rosenthal, Ronnie; Gordon, Bruce; Mogielnicki, R Peter

    2003-07-01

    The mission of the Department of Veterans Affairs includes patient care, education, research, and backup to the Department of Defense. Because the measurement of physicians' productivity must reflect both institutional goals and market forces, the authors designed a productivity model that uses measures of clinical workload and academic activities commensurate with the VA's investments in these activities. The productivity model evaluates four domains of physicians' activity: clinical work, education, research, and administration. Examples of the application of the productivity model in the evaluation of VA-paid physician-staff and in the composition of contracts for clinical services are provided. The proposed model is a relatively simple strategy for measuring a broad range of the work of academic physicians in VA medical centers. The model provides incentives for documentation of resident supervision and participation in administrative activities required for effective and efficient clinical care. In addition, the model can aid in determining resource distribution among clinical services and permits comparison with non-VA health care systems. A strategy for modifying the model to incorporate measures of quality of clinical care, research, education, and administration is proposed. The model has been a useful part of the process to ensure the optimum use of resources and to meet clinical and academic institutional goals. The activities and accomplishments used to define physician productivity will have a substantial influence on the character of the medical profession, the vitality of medical education and research, and the cost and quality of health care. PMID:12857686

  16. An analytics approach to designing patient centered medical homes.

    PubMed

    Ajorlou, Saeede; Shams, Issac; Yang, Kai

    2015-03-01

    Recently the patient centered medical home (PCMH) model has become a popular team based approach focused on delivering more streamlined care to patients. In current practices of medical homes, a clinical based prediction frame is recommended because it can help match the portfolio capacity of PCMH teams with the actual load generated by a set of patients. Without such balances in clinical supply and demand, issues such as excessive under and over utilization of physicians, long waiting time for receiving the appropriate treatment, and non-continuity of care will eliminate many advantages of the medical home strategy. In this paper, by using the hierarchical generalized linear model with multivariate responses, we develop a clinical workload prediction model for care portfolio demands in a Bayesian framework. The model allows for heterogeneous variances and unstructured covariance matrices for nested random effects that arise through complex hierarchical care systems. We show that using a multivariate approach substantially enhances the precision of workload predictions at both primary and non primary care levels. We also demonstrate that care demands depend not only on patient demographics but also on other utilization factors, such as length of stay. Our analyses of a recent data from Veteran Health Administration further indicate that risk adjustment for patient health conditions can considerably improve the prediction power of the model. PMID:24942633

  17. Publications in academic medical centers: technology-facilitated culture clash.

    PubMed

    Berner, Eta S

    2014-05-01

    Academic culture has a set of norms, expectations, and values that are sometimes tacit and sometimes very explicit. In medical school and other health professions educational settings, probably the most common norm includes placing a high value on peer-reviewed research publications, which are seen as the major evidence of scholarly productivity. Other features of academic culture include encouraging junior faculty and graduate students to share their research results at professional conferences and lecturing with slides as a major way to convey information. Major values that faculty share with journal editors include responsible conduct of research and proper attribution of others' words and ideas. Medical school faculty also value technology and are often quick to embrace technological advances that can assist them in their teaching and research. This article addresses the effects of technology on three aspects of academic culture: education, presentations at professional meetings, and research publications.The technologies discussed include online instruction, dissemination of conference proceedings on the Internet, plagiarism-detection software, and new technologies deployed by the National Center for Biotechnology Information, the home of PubMed. The author describes how the ease of deploying new technologies without faculty changing their norms and behavior in the areas of teaching and research can lead to conflicts of values among key stakeholders in the academic medical community, including faculty, journal editors, and professional associations. The implications of these conflicts and strategies for managing them are discussed. PMID:24667517

  18. Spectrum of tablet computer use by medical students and residents at an academic medical center

    PubMed Central

    2015-01-01

    Introduction. The value of tablet computer use in medical education is an area of considerable interest, with preliminary investigations showing that the majority of medical trainees feel that tablet computers added value to the curriculum. This study investigated potential differences in tablet computer use between medical students and resident physicians. Materials & Methods. Data collection for this survey was accomplished with an anonymous online questionnaire shared with the medical students and residents at Southern Illinois University School of Medicine (SIU-SOM) in July and August of 2012. Results. There were 76 medical student responses (26% response rate) and 66 resident/fellow responses to this survey (21% response rate). Residents/fellows were more likely to use tablet computers several times daily than medical students (32% vs. 20%, p = 0.035). The most common reported uses were for accessing medical reference applications (46%), e-Books (45%), and board study (32%). Residents were more likely than students to use a tablet computer to access an electronic medical record (41% vs. 21%, p = 0.010), review radiology images (27% vs. 12%, p = 0.019), and enter patient care orders (26% vs. 3%, p < 0.001). Discussion. This study shows a high prevalence and frequency of tablet computer use among physicians in training at this academic medical center. Most residents and students use tablet computers to access medical references, e-Books, and to study for board exams. Residents were more likely to use tablet computers to complete clinical tasks. Conclusions. Tablet computer use among medical students and resident physicians was common in this survey. All learners used tablet computers for point of care references and board study. Resident physicians were more likely to use tablet computers to access the EMR, enter patient care orders, and review radiology studies. This difference is likely due to the differing educational and professional demands placed on

  19. An academic medical center's response to widespread computer failure.

    PubMed

    Genes, Nicholas; Chary, Michael; Chason, Kevin W

    2013-01-01

    As hospitals incorporate information technology (IT), their operations become increasingly vulnerable to technological breakdowns and attacks. Proper emergency management and business continuity planning require an approach to identify, mitigate, and work through IT downtime. Hospitals can prepare for these disasters by reviewing case studies. This case study details the disruption of computer operations at Mount Sinai Medical Center (MSMC), an urban academic teaching hospital. The events, and MSMC's response, are narrated and the impact on hospital operations is analyzed. MSMC's disaster management strategy prevented computer failure from compromising patient care, although walkouts and time-to-disposition in the emergency department (ED) notably increased. This incident highlights the importance of disaster preparedness and mitigation. It also demonstrates the value of using operational data to evaluate hospital responses to disasters. Quantifying normal hospital functions, just as with a patient's vital signs, may help quantitatively evaluate and improve disaster management and business continuity planning. PMID:24352930

  20. A special issue on the patient-centered medical home.

    PubMed

    Blount, Alexander

    2010-12-01

    This special issue on the Patient-Centered Medical Home (PCMH) reflects its times. At the present time, the PCMH is an aspirational model with a few pilots functioning well around the country. How long the current period of idealism, fueled by the energy of early adopters, the consensus of diverse stakeholders, and the dollars of the Affordable Care Act will continue is anybody's guess. Representing the thinking of some of the best minds in the field, the articles in this issue have an aspirational and idealistic tone as much as a descriptive and analytic one. A year ago the balance would have been tipped more toward idealism and model building and a year from now it would, in all likelihood, tip more toward model description and analysis. The authors in this volume have been personally responsible for helping to move behavioral health to a more central position in the PCMH model. PMID:21299276

  1. 78 FR 16679 - Center for Drug Evaluation and Research Medical Policy Council; Request for Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-18

    ... HUMAN SERVICES Food and Drug Administration Center for Drug Evaluation and Research Medical Policy... interested organizations, on medical policy issues that may be considered by the CDER Medical Policy Council (Council) in FDA's Center for Drug Evaluation and Research (CDER). These comments will help the...

  2. Top 10 Lessons Learned from Electronic Medical Record Implementation in a Large Academic Medical Center

    PubMed Central

    Rizer, Milisa K.; Kaufman, Beth; Sieck, Cynthia J.; Hefner, Jennifer L.; McAlearney, Ann Scheck

    2015-01-01

    Electronic medical record (EMR) implementation efforts face many challenges, including individual and organizational barriers and concerns about loss of productivity during the process. These issues may be particularly complex in large and diverse settings with multiple specialties providing inpatient and outpatient care. This case report provides an example of a successful EMR implementation that emphasizes the importance of flexibility and adaptability on the part of the implementation team. It also presents the top 10 lessons learned from this EMR implementation in a large midwestern academic medical center. Included are five overarching lessons related to leadership, initial approach, training, support, and optimization as well as five lessons related to the EMR system itself that are particularly important elements of a successful implementation. PMID:26396558

  3. Top 10 Lessons Learned from Electronic Medical Record Implementation in a Large Academic Medical Center.

    PubMed

    Rizer, Milisa K; Kaufman, Beth; Sieck, Cynthia J; Hefner, Jennifer L; McAlearney, Ann Scheck

    2015-01-01

    Electronic medical record (EMR) implementation efforts face many challenges, including individual and organizational barriers and concerns about loss of productivity during the process. These issues may be particularly complex in large and diverse settings with multiple specialties providing inpatient and outpatient care. This case report provides an example of a successful EMR implementation that emphasizes the importance of flexibility and adaptability on the part of the implementation team. It also presents the top 10 lessons learned from this EMR implementation in a large midwestern academic medical center. Included are five overarching lessons related to leadership, initial approach, training, support, and optimization as well as five lessons related to the EMR system itself that are particularly important elements of a successful implementation. PMID:26396558

  4. Vitamin D Deficiency Treatment Patterns in Academic Urban Medical Center

    PubMed Central

    Chandler, Paulette D.; Giovannucci, Edward L.; Williams, Michelle A.; LeBoff, Meryl S.; Bates, David W.; Hicks, LeRoi S.

    2014-01-01

    OBJECTIVE Assess racial/ethnic and sex differences in treatment of vitamin D deficiency with high dose ergocalciferol (‘vitamin D2’) or other forms of vitamin D in a northeastern U.S. ambulatory clinic of an academic urban medical center. STUDY DESIGN Cross-sectional observational review of electronic medication prescribing records of patients with 25-hydroxyvitamin D (25OHD) deficiency (25OHD < 20 ng/ml) from 2004–2008. METHODS Using multivariable logistic regression adjusting for patients’ demographics, and Elixhauser comorbidity score, we examined the association of sex and race/ethnicity with prescription for at least one dose of vitamin D. RESULTS Among 2,140 patients without renal disease and tested for 25OHD deficiency (25OHD < 20 ng/ml), 66.2% received no vitamin D prescription for vitamin D deficiency. Blacks and Hispanics received vitamin D prescriptions at a higher frequency than whites, 37.8% 38.4% and 30.9%, respectively, p=0.003. The vitamin D prescription rate for women versus men was 26.3% and 7.5%, respectively, p=0.04. In a fully adjusted model, no difference in prescription likelihood for blacks and whites [OR=1.18 95% CI, 0.88–1.58; p=0.29] or Hispanics and whites was noted [OR=1.01 95% CI, 0.70–1.45;p=0.73]. Similarly, fully adjusted model showed no difference in prescription likelihood for females and males [OR=1.23 95% CI, 0.93–1.63; p=0.12]. CONCLUSIONS Among primary care patients with vitamin D deficiency, vitamin D supplementation was low and white patients were less likely to receive vitamin D treatment than blacks or Hispanics. Interventions to correct the high prevalence of vitamin D deficiency should address the markedly low rate of vitamin D prescribing when 25OHD levels are measured. PMID:25328637

  5. Nonstandard Programs: the University of Pittsburgh Medical Center's next frontier in graduate medical education.

    PubMed

    Kroboth, Frank J; Zerega, W Dennis; Patel, Rita M; Barnes, Barbara E; Webster, Marshall W

    2011-02-01

    The University of Pittsburgh Medical Center has seen continuous growth in the number and types of graduate training programs not accredited by the Accreditation Council for Graduate Medical Education (ACGME), the American Board of Medical Specialties, or the American Osteopathic Association. For the purposes of ensuring best educational products and of controlling unrecognized competition with our accredited programs, a sequential process of centralized oversight of these nonstandard programs was undertaken. The first step involved programs whose fellows were hired and tracked like accredited fellows (i.e., not instructors). The basic process began with consensus among leadership, writing of policy with consultation as necessary, establishment of a registry of programs and graduates, and a committee to allow sharing of best practices and dissemination of policy. The second step applied the same process to instructor-level programs. Whereas the previous group of programs was made subject to ACGME regulations, more latitude in duty hours and progressive responsibility were allowed for instructor programs. The final step, in progress, is extending a similar but modified approach to short-duration clinical experiences and observerships. The outcomes of these efforts have been the creation of a centralized organizational structure, policies to guide this structure, an accurate registry of a surprising number of training programs, and a rolling record of all graduates from these programs. Included in the process is a mechanism that ensures that core program directors and department chairs specifically review the impact of new programs on core programs before allowing their creation. PMID:21169779

  6. Public Health Potential of Farmers’ Markets on Medical Center Campuses: A Case Study From Penn State Milton S. Hershey Medical Center

    PubMed Central

    Kraschnewski, Jennifer L.; Rovniak, Liza S.

    2011-01-01

    There are currently 7175 farmers’ markets in the United States, and these organizations are increasingly viewed as one facet of the solution to national health problems. There has been a recent trend toward establishing markets on medical center campuses, and such partnerships can augment a medical center's ability to serve community health. However, to our knowledge no studies have described the emergence of a market at a medical center, the barriers and challenges such an initiative has faced, or the nature of programming it may foster. We provide a qualitative description of the process of starting a seasonal, once-a-week, producers-only market at the Pennsylvania State Hershey Medical Center, and we call for greater public health attention to these emerging community spaces. PMID:22021298

  7. Behavioral anchors: building a medical center on solid foundations.

    PubMed

    Doordan, Martin L; Stupak, Ronald J

    2005-01-01

    Construction of new facilities in the healthcare arena is an ongoing, almost daily, occurrence. The desire to build wisely and effectively is evidenced at the Anne Arundel Medical Center which has attracted healthcare executives from all over the country who come to view, analyze, and experience the beauty, utility and interdependencies of the buildings and facilities that constitute "the AAMC campus." However, too often these executive visitors and benchmarking experts tend to focus on the technical, architectural, engineering, concrete aspects of the hospital, while naively overlooking and/or giving short shrift to the more critical behavioral dynamics of the construction process. The ultimate success of any building project requires a clear understanding by the leadership of "where people are coming from," so that both the design and the development of the final product can be brought under the synthesizing umbrella of patient care, clinical excellence, individual safety, and community responsibility. Not only must the leadership determine and drive the strategic thrust toward the final outcome; in addition, they must make sure that they allow significant colleagues to be actively, operationally, and symbolically engaged in a process that ends up in a structural outcome that everyone is proud to own, to see, and to inhabit. PMID:16521615

  8. Enriching Patient-Centered Medical Homes Through Peer Support

    PubMed Central

    Daaleman, Timothy P.; Fisher, Edwin B.

    2015-01-01

    Peer supporters are recognized by various designations—community health workers, promotores de salud, lay health advisers—and are community members who work for pay or as volunteers in association with health care systems or nonprofit community organizations and often share ethnicity, language, and socioeconomic status with the mentees that they serve. Although emerging evidence demonstrates the efficacy of peer support at the community level, the adoption and implementation of this resource into patient-centered medical homes (PCMHs) is still under development. To accelerate that integration, this article addresses three major elements of peer support interventions: the functions and features of peer support, a framework and programmatic strategies for implementation, and fiscal models that would support the sustained viability of peer support programs within PCMHs. Key functions of peer support include assistance in daily management of health-related behaviors, social and emotional support, linkage to clinical care, and longitudinal or ongoing support. An organizational model of innovation implementation provides a useful framework for determining how to implement and evaluate peer support programs in PCMHs. Programmatic strategies that can be useful in developing peer support programs within PCMHs include peer coaching or mentoring, group self-management training, and programs designed around the telephone and information technology. Fiscal models for peer support programs include linkages with hospital or health care systems, service- or community-based nonprofit organizations, and partnerships between health care systems and community groups. Peer support promises to enrich PCMHs by activating patients in their self-care, providing culturally sensitive outreach, and opening the way for partnerships with community-based organizations. PMID:26304975

  9. Accountable care organization readiness and academic medical centers.

    PubMed

    Berkowitz, Scott A; Pahira, Jennifer J

    2014-09-01

    As academic medical centers (AMCs) consider becoming accountable care organizations (ACOs) under Medicare, they must assess their readiness for this transition. Of the 253 Medicare ACOs prior to 2014, 51 (20%) are AMCs. Three critical components of ACO readiness are institutional and ACO structure, leadership, and governance; robust information technology and analytic systems; and care coordination and management to improve care delivery and health at the population level. All of these must be viewed through the lens of unique AMC mission-driven goals.There is clear benefit to developing and maintaining a centralized internal leadership when it comes to driving change within an ACO, yet there is also the need for broad stakeholder involvement. Other important structural features are an extensive primary care foundation; concomitant operation of a managed care plan or risk-bearing entity; or maintaining a close relationship with post-acute-care or skilled nursing facilities, which provide valuable expertise in coordinating care across the continuum. ACOs also require comprehensive and integrated data and analytic systems that provide meaningful population data to inform care teams in real time, promote quality improvement, and monitor spending trends. AMCs will require proven care coordination and management strategies within a population health framework and deployment of an innovative workforce.AMC core functions of providing high-quality subspecialty and primary care, generating new knowledge, and training future health care leaders can be well aligned with a transition to an ACO model. Further study of results from Medicare-related ACO programs and commercial ACOs will help define best practices. PMID:24979282

  10. Enriching Patient-Centered Medical Homes Through Peer Support.

    PubMed

    Daaleman, Timothy P; Fisher, Edwin B

    2015-08-01

    Peer supporters are recognized by various designations-community health workers, promotores de salud, lay health advisers-and are community members who work for pay or as volunteers in association with health care systems or nonprofit community organizations and often share ethnicity, language, and socioeconomic status with the mentees that they serve. Although emerging evidence demonstrates the efficacy of peer support at the community level, the adoption and implementation of this resource into patient-centered medical homes (PCMHs) is still under development. To accelerate that integration, this article addresses three major elements of peer support interventions: the functions and features of peer support, a framework and programmatic strategies for implementation, and fiscal models that would support the sustained viability of peer support programs within PCMHs. Key functions of peer support include assistance in daily management of health-related behaviors, social and emotional support, linkage to clinical care, and longitudinal or ongoing support. An organizational model of innovation implementation provides a useful framework for determining how to implement and evaluate peer support programs in PCMHs. Programmatic strategies that can be useful in developing peer support programs within PCMHs include peer coaching or mentoring, group self-management training, and programs designed around the telephone and information technology. Fiscal models for peer support programs include linkages with hospital or health care systems, service- or community-based nonprofit organizations, and partnerships between health care systems and community groups. Peer support promises to enrich PCMHs by activating patients in their self-care, providing culturally sensitive outreach, and opening the way for partnerships with community-based organizations. PMID:26304975

  11. Energy savings through retrofits in a large medical center

    SciTech Connect

    Hutchins, P.F.

    1997-06-01

    A 600,000-square-foot medical center in the southeastern United States is presently undergoing major renovations which will result in savings of energy use and costs. The current project, funded for FY96 includes a number of modifications to the Heating and Cooling Plant and the hospital itself. These upgrades include: (1) High efficiency chillers, (2) Cooling tower replacement, (3) High efficiency condenser and chilled water pump motors, (4) New chilled water and condenser pumps and piping, (5) Condenser water reset controls, (6) Electricity demand reduction using gas-fired absorption chiller, (7) Secondary chilled water variable speed flow, (8) Boiler controls improvements, (9) Feedwater pump replacements, (10) Repair of air-side economizer HVAC system, (11) New 2x4 parabolic troffers with T-8 lamps and electronic ballasts, and (12) DDC controls. The current hospital energy use was modeled using Trane`s TRACE 600{reg_sign} computer simulation program to agree with recent historical energy use data. A second model was created implementing the energy conservation improvements listed above to quantify the associated energy and cost savings. Additional energy saving ideas were evaluated for cost effectiveness. These are: (1) New unattended boilers, (2) Boiler pressure reduction, (3) Boiler economizer, (4) Additional boiler controls, (5) Exhaust air heat recovery, (6) Domestic hot water decentralization, (7) Desiccant cooling, (8) Supply air reduction scheduling, (9) Compact fluorescents, (10) Variable air volume HVAC systems, and (11) Occupancy sensors. Another interesting aspect of this project was an evaluation of harmonic distortion due to electronic ballasts. Direct field measurements were made on similar lighting circuits to compare the harmonic currents generated by electronic and magnetic ballasts. A graphical as well as quantitative analysis is presented.

  12. The Patient-Centered Medical Neighborhood: Transformation of Specialty Care.

    PubMed

    Spatz, Christin; Bricker, Patricia; Gabbay, Robert

    2014-01-01

    The growing need for coordinated care of those with medically complex diseases is becoming more important in today's health care system, wherein reimbursement changes are driving methods to improve quality and cost. This article discusses the 6 key processes that, according to the American College of Physicians, define an effective medical neighborhood; the evidence supporting the need for this coordinated system; and pilot medical neighborhood strategies being implemented. PMID:23966551

  13. Medical Automation System at the Marshall Space Flight Center

    NASA Technical Reports Server (NTRS)

    Spraul, J. H.

    1970-01-01

    A computer system is reported for scheduling and coordinating physical examinations for groups of people who work with chemicals, lasers, X-rays, isotopic sources, toxic fuels, adhesives, and exotic metals. Complete medical data on the examined population are continuously updated for a broad medical master file. Statistical methods are employed to project progressive changes in the health status of these employees for possible clinical interventions.

  14. Medication Practices at Center Of Hospital and Nursing Home Proposals: Discharge and Pharmacy Requirements to Change.

    PubMed

    Barlas, Stephen

    2016-04-01

    Rules proposed by the Centers for Medicare and Medicaid Services would change discharge policies at hospitals and long-term care facilities and update conditions of participation with a focus on medication reconciliation and pharmacist responsibilities. PMID:27069341

  15. Smartphones in medicine: emerging practices in an academic medical center.

    PubMed

    Johnson, Angela C; El Hajj, Stephanie C; Perret, J Nelson; Caffery, Terrell S; Jones, Glenn N; Musso, Mandi W

    2015-01-01

    Advances in mobile phone technology now provide a myriad of resources to physicians' fingertips. However, the medical profession continues to struggle with potential for misuse of these devices. There is a need for better understanding of physicians' uses of smartphones in order to establish guidelines for appropriate and professional behavior. The purpose of the current study was to survey physicians' and medical students' practices concerning smartphone use in the healthcare setting. Physicians and medical students were asked to complete anonymous surveys regarding uses of smartphones within the past month in various healthcare settings. Overall, the participants reported distinctly different patterns in the uses they made of their phones in different settings (P<.001), with most individuals engaging in most behaviors while on break but few using their smartphones while with patients or during procedures. It appears that physicians and medical students make decisions about using their smartphones according to some combination of three considerations: degree of relevance to patient care, the appropriateness of the behavior in front of patients, and the issue of how disruptive that behavior may be. PMID:25526706

  16. Development of a Patient-Centered Antipsychotic Medication Adherence Intervention

    ERIC Educational Resources Information Center

    Pyne, Jeffrey M.; Fischer, Ellen P.; Gilmore, LaNissa; McSweeney, Jean C.; Stewart, Katharine E.; Mittal, Dinesh; Bost, James E.; Valenstein, Marcia

    2014-01-01

    Objective: A substantial gap exists between patients and their mental health providers about patient's perceived barriers, facilitators, and motivators (BFMs) for taking antipsychotic medications. This article describes how we used an intervention mapping (IM) framework coupled with qualitative and quantitative item-selection methods to…

  17. Dealing with the flood crisis of 1993. A medical center's account.

    PubMed

    Ramsey, D S

    1994-01-01

    On Saturday, 10 July 1993, Iowans were assaulted by the greatest natural disaster in the state's history when virtually all rain-swollen rivers and creeks in the Midwest spilled over their banks. In Des Moines, the Iowa Methodist Medical Center was suddenly surrounded by flood waters and stripped of power, water, computer, and telephone communication. Striving to deliver quality patient care in the face of the crisis, medical staff, administrators, and employees at the center achieved recovery in record time. PMID:10134872

  18. 75 FR 44304 - Noise Exposure Map Notice, Portland International Airport, Portland, OR

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-28

    ... Noise Exposure Map Notice, Portland International Airport, Portland, OR AGENCY: Federal Aviation... determination that the noise exposure maps submitted by Port of Portland for Portland International Airport... the FAA's determination on the noise exposure maps is July 21, 2010. FOR FURTHER INFORMATION...

  19. 77 FR 15263 - Security Zone; Portland Rose Festival on Willamette River; Portland, OR

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-15

    ... SECURITY Coast Guard 33 CFR Part 165 Security Zone; Portland Rose Festival on Willamette River; Portland... will enforce the Portland Rose Festival Security Zone in 33 CFR 165.1312 from 11 a.m. on June 6, 2012..., including the public vessels present on the Willamette River during the Portland Rose festival. During...

  20. Changing Economics of Health Care Are Devastating Academic Medical Centers.

    ERIC Educational Resources Information Center

    van der Werf, Martin

    1999-01-01

    Once a financially healthy part of American universities, many academic health centers are struggling to survive. Many are merging with for-profit chains or declaring bankruptcy. The advance of managed care and insurance companies focusing on reducing costs appears to be affecting teaching hospitals more than community hospitals. (MSE)

  1. Trend of knowledge production of research centers in the field of medical sciences in iran.

    PubMed

    Falahat, K; Eftekhari, Mb; Habibi, E; Djalalinia, Sh; Peykari, N; Owlia, P; Malekafzali, H; Ghanei, M; Mojarrab, Sh

    2013-01-01

    Establishment of medical research centers at universities and health-related organizations and annually evaluation of their research activities was one of the strategic policies which followed by governmental organization in last decade in order to strengthening the connections between health research system and health system. The aim of this study is to scrutinize the role of medical research centers in medical science production in Iran. This study is a cross sectional which has been performed based on existing reports on national scientometrics and evaluation results of research performance of medical research centers between years 2001 to 2010. During last decade number of medical research centers increased from 53 in 2001 to 359 in 2010. Simultaneous scientific output of medical research centers has been increased especially articles indexed in ISI (web of science). Proper policy implementation in the field of health research system during last decades led to improving capacity building and growth knowledge production of medical science in recent years in Iran. The process embedding research into the health systems requires planning up until research products improves health outcomes and health equity in country. PMID:23865017

  2. Developing a frenotomy policy at one medical center: a case study approach.

    PubMed

    Masaitis, N S; Kaempf, J W

    1996-09-01

    The objective of this study was to change procedures in our medical center regarding frenotomy for ankyloglossia (tongue-tie). The medical and breastfeeding outcomes of 36 fullterm infants who received frenotomies were studied. The information was used to develop frenotomy eligibility standards that would guide other physicians and insure timely treatment to avoid breastfeeding cessation. PMID:9025430

  3. A Podiatric Medical Residency Program in an Academic Health Science Center

    ERIC Educational Resources Information Center

    Bogy, Louis T.; And Others

    1977-01-01

    The podiatric medical residency program in the Health Science Center at San Antonio provides an intensive exposure for the newly graduated podiatrist to practice in a multidisciplinary environment. Residents become more familiar with general medical and surgical diseases and disorders as well as podiatric pathology. (LBH)

  4. Medication Adherence among Adolescents in a School-Based Health Center

    ERIC Educational Resources Information Center

    Mears, Cynthia J.; Charlebois, Nicole M.; Holl, Jane L.

    2006-01-01

    School-based health centers are an integral part of the health care delivery system for low-income children. Medication adherence for these patients may be challenging because the student is often responsible for bringing home the prescription and receiving the instructions. This study assesses medication fill, initiation, and adherence rates…

  5. The Medical Library and Media Center of Keio University in Tokyo: report on a visit.

    PubMed Central

    Accart, J P

    1995-01-01

    The Medical Library and Media Center at Keio University in Tokyo offers many facilities to its users: access to medical information within a large catalog of monographs and journals, online searching and CD-ROM databases, and a dynamic interlibrary loan service. This article is a report of a professional visit to the library on September 30, 1993. PMID:7703947

  6. PROJECT HEAD START MEDICAL--A GUIDE FOR DIRECTION OF CHILD DEVELOPMENT CENTERS.

    ERIC Educational Resources Information Center

    Office of Economic Opportunity, Washington, DC.

    HEALTH SERVICES OF PROJECT HEAD START CHILD DEVELOPMENT CENTERS PROVIDE--A MEDICAL EVALUATION OF EACH CHILD INCLUDING MEDICAL HISTORY, DEVELOPMENTAL ASSESSMENT, AND PHYSICAL EXAMINATION, SCREENING TESTS FOR VISION, HEARING, SPEECH, AND TUBERCULOSIS, LABORATORY TESTS OF URINE FOR ALBUMIN AND TESTS OF SUGAR AND BLOOD FOR ANEMIA, DENTAL ASSESSMENT,…

  7. The University of New Mexico Medical Center Library's Health Information Services Outreach Program.

    ERIC Educational Resources Information Center

    Chamberlin, Susan B.; And Others

    Begun in 1980, the University of New Mexico Medical Center Library's statewide Outreach Program is a composite of many services and projects designed to meet the medical and health information needs of the state's diverse and scattered population. The only major biomedical library in New Mexico, the Library has built the program on existing…

  8. Managing Information in the Academic Medical Center: Building an Integrated Information Environment.

    ERIC Educational Resources Information Center

    Fuller, Sherrilynne; And Others

    1995-01-01

    A program designed by the National Library of Medicine and the Association of American Medical Colleges to help academic medical centers develop appropriate information systems is described. The characteristics of such an integrated information environment, technical and organizational structures necessary for creating it, and the librarian's role…

  9. Equipment for nuclear medical centers, production capabilities of Rosatom enterprises

    SciTech Connect

    Gavrish, Yu. N.; Koloskov, S. A.; Smirnov, V. P.; Strokach, A. P.

    2015-12-15

    Analysis of the capabilities of the State Corporation Rosatom enterprises on the development and production of diagnostic and therapeutic equipment for nuclear medicine centers is presented. Prospects of the development of accelerator equipment for the production of a wide range of radioisotope products are shown, and the trends of its development are determined. A comparative analysis of the technical parameters of domestic tomographs and devices for brachytherapy with foreign counterparts is given.

  10. Equipment for nuclear medical centers, production capabilities of Rosatom enterprises

    NASA Astrophysics Data System (ADS)

    Gavrish, Yu. N.; Koloskov, S. A.; Smirnov, V. P.; Strokach, A. P.

    2015-12-01

    Analysis of the capabilities of the State Corporation Rosatom enterprises on the development and production of diagnostic and therapeutic equipment for nuclear medicine centers is presented. Prospects of the development of accelerator equipment for the production of a wide range of radioisotope products are shown, and the trends of its development are determined. A comparative analysis of the technical parameters of domestic tomographs and devices for brachytherapy with foreign counterparts is given.

  11. City of Faith Medical and Research Center, Tulsa, Oklahoma.

    PubMed

    1984-01-01

    The gold towers of the City of Faith command the viewer's attention as they soar into the Tulsa sky. Built by Evangelist Oral Roberts, the City of Faith combines a 60-story clinic and diagnostic center, a 30-story full-service hospital and a 20-story research center on one 80-acre site adjacent to the Oral Roberts University campus. Due in part to their futuristic architectural features, the campus and the City of Faith are one of the top tourist attractions in Oklahoma. Construction began in early 1978. The clinic, first opened in June 1981 with nine physicians, is now staffed with more than 80, all with faculty appointments to the Oral Roberts School of Medicine. The hospital accepted its first patient in November, 1981 and is currently certified for 294 beds (final plans call for a total of 777). The research center began operations last June and focuses on cancer, heart disease, arthritis, diabetes and geriatrics. Built entirely through contributions from followers of the Oral Roberts Ministries, the debt-free City of Faith is expected to cost more than $500 million when completed in 1988. PMID:10267423

  12. Dealing with the stress of an HIV-positive diagnosis at an Army medical center.

    PubMed

    Rothberg, J M; Bain, M W; Boggiano, W; Cline, W R; Grace, W C; Holloway, H C; Rock, N L

    1990-03-01

    Following mandatory military-wide testing for the human immunodeficiency virus (HIV), Army medical facilities have gained extensive experience with HIV-positive persons who undergo special stresses as a result of their affiliation with the military. The consequences of evacuation to medical centers for evaluation of HIV status are presented and the impact of this process on the medical center staff are considered. This paper is a description of one system designed to evaluate, treat, and support HIV-positive soldiers and their families. PMID:2107473

  13. Implementing a medication safety and poison prevention program at a senior center.

    PubMed

    Gershman, Jennifer A

    2013-10-01

    The Institute for Safe Medication Practices encourages pharmacists to assist in preventing medication misuse. The purpose of this article is to discuss a medication-safety education session conducted by a pharmacy professor, the faculty advisor to the American Society of Consultant Pharmacists university student chapter and students in a pharmacovigilance rotation, which was conducted at a local senior center. The author attended a train-the-trainer Webinar and then educated the pharmacy students. Participants at the senior center were taught about poison prevention, drug interactions, and appropriate drug disposal through an interactive format. We plan to continue the medication safety program at the senior center as a longitudinal project to promote patient safety. Pharmacists should be encouraged to play an active role in community outreach programs. PMID:24129222

  14. Factors associated with a patient-centered medical home among children with behavioral health conditions.

    PubMed

    Knapp, Caprice; Woodworth, Lindsey; Fernandez-Baca, Daniel; Baron-Lee, Jacqueline; Thompson, Lindsay; Hinojosa, Melanie

    2013-11-01

    At some point in their lives, nearly one-half of all American children will have a behavioral health condition. Many will not receive the care they need from a fragmented health delivery system. The patient-centered medical home is a promising model to improve their care; however, little evidence exists. Our study aim was to examine the association between several behavioral health indicators and having a patient-centered medical home. 91,642 children's parents or guardians completed the 2007 National Survey of Children's Health. An indicator for patient-centered medical home was included in the dataset. Descriptive statistics, bivariate tests, and multivariate regression models were used in the analyses. Children in the sample were mostly Male (52 %), White (78 %), non-Hispanic (87 %), and did not have a special health care need (80 %). 6.2 % of the sample had at least one behavioral health condition. Conditions ranged from ADHD (6 %) to Autism Spectrum Disorder (ASD) (1 %). Frequency of having a patient-centered medical home also varied for children with a behavioral health condition (49 % of children with ADHD and 33 % of children with ASD). Frequency of having a patient-centered medical home decreased with multiple behavioral health conditions. Higher severity of depression, anxiety, and conduct disorder were associated with a decreased likelihood of a patient-centered medical home. Results from our study can be used to target patient-centered medical home interventions toward children with one or more behavioral health conditions and consider that children with depression, anxiety, and conduct disorder are more vulnerable to these disparities. PMID:23108741

  15. PASTE: patient-centered SMS text tagging in a medication management system

    PubMed Central

    Johnson, Kevin B; Denny, Joshua C

    2011-01-01

    Objective To evaluate the performance of a system that extracts medication information and administration-related actions from patient short message service (SMS) messages. Design Mobile technologies provide a platform for electronic patient-centered medication management. MyMediHealth (MMH) is a medication management system that includes a medication scheduler, a medication administration record, and a reminder engine that sends text messages to cell phones. The object of this work was to extend MMH to allow two-way interaction using mobile phone-based SMS technology. Unprompted text-message communication with patients using natural language could engage patients in their healthcare, but presents unique natural language processing challenges. The authors developed a new functional component of MMH, the Patient-centered Automated SMS Tagging Engine (PASTE). The PASTE web service uses natural language processing methods, custom lexicons, and existing knowledge sources to extract and tag medication information from patient text messages. Measurements A pilot evaluation of PASTE was completed using 130 medication messages anonymously submitted by 16 volunteers via a website. System output was compared with manually tagged messages. Results Verified medication names, medication terms, and action terms reached high F-measures of 91.3%, 94.7%, and 90.4%, respectively. The overall medication name F-measure was 79.8%, and the medication action term F-measure was 90%. Conclusion Other studies have demonstrated systems that successfully extract medication information from clinical documents using semantic tagging, regular expression-based approaches, or a combination of both approaches. This evaluation demonstrates the feasibility of extracting medication information from patient-generated medication messages. PMID:21984605

  16. Predictors of early faculty attrition at one Academic Medical Center

    PubMed Central

    2014-01-01

    Background Faculty turnover threatens the research, teaching and clinical missions of medical schools. We measured early attrition among newly-hired medical school faculty and identified personal and institutional factors associated with early attrition. Methods This retrospective cohort study identified faculty hired during the 2005–2006 academic year at one school. Three-year attrition rates were measured. A 40-question electronic survey measured demographics, career satisfaction, faculty responsibilities, institutional/departmental support, and reasons for resignation. Odds ratios (ORs) and 95 percent confidence intervals (95% CI) identified variables associated with early attrition. Results Of 139 faculty, 34% (95% CI = 26-42%) resigned within three years of hire. Attrition was associated with: perceived failure of the Department Chair to foster a climate of teaching, research, and service (OR = 6.03; 95% CI: 1.84, 19.69), inclusiveness, respect, and open communication (OR = 3.21; 95% CI: 1.04, 9.98). Lack of professional development of the faculty member (OR = 3.84; 95% CI: 1.25, 11.81); institutional recognition and support for excellence in teaching (OR = 2.96; 95% CI: 0.78, 11.19) and clinical care (OR = 3.87; 95% CI: 1.04, 14.41); and >50% of professional time devoted to patient care (OR = 3.93; 95% CI: 1.29, 11.93) predicted attrition. Gender, race, ethnicity, academic degree, department type and tenure status did not predict early attrition. Of still-active faculty, an additional 27 (48.2%, 95% CI: 35.8, 61.0) reported considering resignation within the 5 years. Conclusions In this pilot study, one-third of new faculty resigned within 3 years of hire. Greater awareness of predictors of early attrition may help schools identify threats to faculty career satisfaction and retention. PMID:24512629

  17. Conflict of interest issues pertinent to Veterans Affairs Medical Centers.

    PubMed

    Hanna, Jennifer; Simiele, Ernest; Lawson, D Curtis; Tyler, Douglas

    2011-09-01

    Conflicts of interest exist when an arrangement potentially exerts inappropriate influence on decision making or professional judgment, or is perceived to do so, and can thus damage the public trust and undermine the integrity of those decisions. Concerns regarding financial conflicts of interest in the medical arena have reached their height as of late, given that physicians now function in a milieu of complex and delicate relationships with pharmaceutical, biotechnology, and medical device industries. Even when such relationships do not correlate with actual compromise of judgment or patient care, it threatens the credibility of both the health care professional and the institution because of the social perception of the effect of these relationships. Although most institutions in the Western world set forth a code of ethics and conflict-of-interest policies to be followed under threat of termination, the Veterans Health Administration (VHA) presents itself as a unique environment in which conflicts of interest are subject to governmental laws, violation of which may not only result in employment-related discipline, but may be sanctioned by civil and criminal penalties. Moreover, these provisions are developed by a national authoritative organization rather than being institution-specific guidelines. Given that many academic physicians working within the VHA may also have a component of their practice in a University setting, it becomes important to understand the differences in policy between these contexts so as not to threaten the public trust in the veracity of decisions made and, therefore, maintain the integrity of the relationship between physician and patient. This article will review aspects of conflict-of-interest policies in the realm of research, financial relationships, foreign travel, and vendor contracting that are particular to the VHA and make it a unique environment to function in as a physician and scientist. PMID:21872117

  18. Publication and reporting of clinical trial results: cross sectional analysis across academic medical centers

    PubMed Central

    Chen, Ruijun; Desai, Nihar R; Ross, Joseph S; Zhang, Weiwei; Chau, Katherine H; Wayda, Brian; Murugiah, Karthik; Lu, Daniel Y; Mittal, Amit

    2016-01-01

    Objective To determine rates of publication and reporting of results within two years for all completed clinical trials registered in ClinicalTrials.gov across leading academic medical centers in the United States. Design Cross sectional analysis. Setting Academic medical centers in the United States. Participants Academic medical centers with 40 or more completed interventional trials registered on ClinicalTrials.gov. Methods Using the Aggregate Analysis of ClinicalTrials.gov database and manual review, we identified all interventional clinical trials registered on ClinicalTrials.gov with a primary completion date between October 2007 and September 2010 and with a lead investigator affiliated with an academic medical center. Main outcome measures The proportion of trials that disseminated results, defined as publication or reporting of results on ClinicalTrials.gov, overall and within 24 months of study completion. Results We identified 4347 interventional clinical trials across 51 academic medical centers. Among the trials, 1005 (23%) enrolled more than 100 patients, 1216 (28%) were double blind, and 2169 (50%) were phase II through IV. Overall, academic medical centers disseminated results for 2892 (66%) trials, with 1560 (35.9%) achieving this within 24 months of study completion. The proportion of clinical trials with results disseminated within 24 months of study completion ranged from 16.2% (6/37) to 55.3% (57/103) across academic medical centers. The proportion of clinical trials published within 24 months of study completion ranged from 10.8% (4/37) to 40.3% (31/77) across academic medical centers, whereas results reporting on ClinicalTrials.gov ranged from 1.6% (2/122) to 40.7% (72/177). Conclusions Despite the ethical mandate and expressed values and mission of academic institutions, there is poor performance and noticeable variation in the dissemination of clinical trial results across leading academic medical centers. PMID:26888209

  19. Anthropogenic carbon dioxide in the Portland metropolitan region

    NASA Astrophysics Data System (ADS)

    Rice, A. L.; Bostrom, G. A.; Brooks, M. K.; Hill, L.; Shandas, V.

    2011-12-01

    The Portland metropolitan region, located in the Columbia River Gorge, is the most populous region in Oregon. Greenhouse gas emissions inventories for Multnomah County (population ~710k) estimate 2008 emissions to be 8.5 million metric tons carbon dioxide equivalent, of which CO2 is the dominant source. These inventories suggest that County-wide greenhouse gas emissions are near 1990 levels, despite a 22% growth in population. This contrasts with US National greenhouse gas emissions, which are estimated to have grown ~14% since 1990. Despite this apparent progress, there has been no validation of either emissions inventories for the Portland metropolitan region or their trends in time. We present more than two years of measurements of CO2 at three stationary locations in the Portland metropolitan region: a downtown location on the campus of Portland State University; a residential site in southeast Portland; and a rural station on Sauvie Island, located ~30km northwest of Portland in the Columbia River Gorge. Beginning in July 2009, continuous measurements of CO2 at the sites show considerable variability due to global and regional CO2 sources, sinks and boundary layer meteorology. Here we focus on the enhancement of in-city concentrations above the rural Sauvie Island site (CO2 excess), a difference which averages ~6ppm during upgorge wind conditions. The southeast Portland residential site shows a significant enhancement of ~5ppm in CO2 concentration throughout the day. The downtown site shows a substantial diurnal cycle in CO2 excess with 10-15ppm higher values during the day and negative values for CO2 excess during the early morning hours, the cause of which is not well understood. Both in-city sites show an increase in CO2 excess centered around 7-8 am and 5-6 pm during the two rush-hour periods. To examine spatial variability, measurements of street-level CO2 concentrations were obtained using a mobile instrument mounted in a bike trailer during a summer

  20. Underserved patients' perspectives on patient-centered primary care: does the patient-centered medical home model meet their needs?

    PubMed

    Mead, Holly; Andres, Ellie; Regenstein, Marsha

    2014-02-01

    The patient-centered medical home (PCMH) has gained significant interest as a delivery system model that can improve health care quality while reducing costs. This study uses focus groups to investigate underserved, chronically ill patients' preferences for care and develops a patient-centered framework of priorities. Seven major priorities were identified: (a) communication and partnership, (b) affordable care, (c) coordinated care, (d) personal responsibility, (e) accessible care, (f) education and support resources, and (g) the essential role of nonphysician providers in supporting their care. Using the framework, we analyzed the PCMH joint principals as developed by U.S. medical societies to identify where the PCMH model could be improved to better meet the needs of these patients. Four of the seven patient priorities were identified as not present in or supported by current PCMH joint principles. The study discusses how the PCMH model can better address the needs of low-income, disadvantaged patients. PMID:24288366

  1. What do clinicians want? Interest in integrative health services at a North Carolina academic medical center

    PubMed Central

    Kemper, Kathi J; Dirkse, Deborah; Eadie, Dee; Pennington, Melissa

    2007-01-01

    Background Use of complementary medicine is common, consumer driven and usually outpatient focused. We wished to determine interest among the medical staff at a North Carolina academic medical center in integrating diverse therapies and services into comprehensive care. Methods We conducted a cross sectional on-line survey of physicians, nurse practitioners and physician assistants at a tertiary care medical center in 2006. The survey contained questions on referrals and recommendations in the past year and interest in therapies or services if they were to be provided at the medical center in the future. Results Responses were received from 173 clinicians in 26 different departments, programs and centers. There was strong interest in offering several specific therapies: therapeutic exercise (77%), expert consultation about herbs and dietary supplements (69%), and massage (66%); there was even stronger interest in offering comprehensive treatment programs such as multidisciplinary pain management (84%), comprehensive nutritional assessment and advice (84%), obesity/healthy lifestyle promotion (80%), fit for life (exercise and lifestyle program, 76%), diabetes healthy lifestyle promotion (73%); and comprehensive psychological services for stress management, including hypnosis and biofeedback (73%). Conclusion There is strong interest among medical staff at an academic health center in comprehensive, integrated services for pain, obesity, and diabetes and in specific services in fitness, nutrition and stress management. Future studies will need to assess the cost-effectiveness of such services, as well as their financial sustainability and impact on patient satisfaction, health and quality of life. PMID:17291340

  2. Occupational exposure to formaldehyde in a medical center autopsy service

    SciTech Connect

    Coldiron, V.R.; Ward, J.B. Jr.; Trieff, N.M.; Janssen, H.E. Jr.; Smith, J.H.

    1983-07-01

    The formaldehyde exposures occurring in the autopsy service of a medical complex were evaluated as part of a study to detect genetically harmful effects of chemical exposures. Determination of time-weighted average (TWA) exposures and characterization of the patterns of exposure experienced by individuals with different work responsibilities in this occupational setting were sought. Both general area and breathing zone samples were evaluated. Estimated weekly time-weighted average exposures for pathologists, residents and technicians were determined to be between 0.61 and 1.32 parts per million with little difference between work roles. While the averages were similar, the patterns of exposure of technicians and physicians were different. Technicians were exposed to a baseline level of formaldehyde for a prolonged period of time. In contrast, physicians were exposed for shorter times but experienced higher levels during specific tasks, particularly tissue-sectioning and examination. Evaluations of work procedures and environmental conditions in autopsy services are recommended to reduce personnel exposure to formaldehyde vapor.

  3. Outsourcing your medical practice call center: how to choose a vendor to ensure regulatory compliance.

    PubMed

    Johnson, Bill

    2014-01-01

    Medical practices receive hundreds if not thousands of calls every week from patients, payers, pharmacies, and others. Outsourcing call centers can be a smart move to improve efficiency, lower costs, improve customer care, ensure proper payer management, and ensure regulatory compliance. This article discusses how to know when it's time to move to an outsourced call center, the benefits of making the move, how to choose the right call center, and how to make the transition. It also provides tips on how to manage the call center to ensure the objectives are being met. PMID:25807604

  4. Psychologists in medical schools and academic medical centers: over 100 years of growth, influence, and partnership.

    PubMed

    Robiner, William N; Dixon, Kim E; Miner, Jacob L; Hong, Barry A

    2014-04-01

    Psychologists have served on the faculties of medical schools for over 100 years. Psychologists serve in a number of different roles and make substantive contributions to medical schools' tripartite mission of research, education, and clinical service. This article provides an overview of the history of psychologists' involvement in medical schools, including their growing presence in and integration with diverse departments over time. We also report findings from a survey of medical school psychologists that explored their efforts in nonclinical areas (i.e., research, education, administration) as well as clinical endeavors (i.e., assessment, psychotherapy, consultation). As understanding of the linkage between behavioral and psychological factors and health status and treatment outcomes increases, the roles of psychologists in health care are likely to expand beyond mental health. An increasing focus on accountability-related to treatment outcomes and interprofessional research, education, and models of care delivery-will likely provide additional opportunities for psychologists within health care and professional education. The well-established alignment of psychologists' expertise and skills with the mission and complex organizational needs of medical schools augurs a partnership on course to grow stronger. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24588315

  5. Cancers in Eastern Libya: First results from Benghazi Medical Center

    PubMed Central

    Bodalal, Zuhir; Azzuz, Raouf; Bendardaf, Riyad

    2014-01-01

    AIM: To study the pattern of cancer incidence and determine the incidence rates in Eastern Libya (for the first time in a decade). METHODS: A hospital-based registry of cancer patients was formed using records from the primary oncology center in eastern Libya - focusing on those diagnosed in the year 2012. RESULTS: The most common malignancies in men were cancers of the colon (22.3%, n = 90), lung (20.3%, n = 82), prostate (16.1%, n = 65), pancreas (4.2%, n = 17) and liver (4.2%, n = 17). For women, they were found to be cancers of the breast (41.5%, n = 213), colon (16.4%, n = 84), uterus (8%, n = 41), ovary (5.5%, n = 28) and pancreas (3.1%, n = 16). Additionally age-standardized rates (ASR) were determined for Libya. The different cities and towns in eastern Libya were compared for any variation. The city of Beida in particular was found to have a remarkably high incidence of gastric cancer. The different findings were discussed and comparisons were made with past literature as well as the incidence rates for neighbouring countries. The incidence rates given for the eastern region showed differences from previously reported values (i.e., the rate of colon cancer was the highest in North Africa whereas other malignancies occurred less frequently). Potential explanations for the urban-rural difference as well as the difference in incidence rates were put forth. The significance of this study is that it establishes a baseline of cancer incidence which should be the backbone for any future national cancer plan in Libya. CONCLUSION: Proper surveillance programs need to be in place and healthcare policy should be adjusted to take into account the more prevalent and pressing cancers in society. PMID:24876750

  6. Improving Medication Knowledge among Older Adults with Heart Failure: A Patient-Centered Approach to Instruction Design

    ERIC Educational Resources Information Center

    Morrow, Daniel G.; Weiner, Michael; Young, James; Steinley, Douglas; Deer, Melissa; Murray, Michael D.

    2005-01-01

    Purpose: We investigated whether patient-centered instructions for chronic heart failure medications increase comprehension and memory for medication information in older adults diagnosed with chronic heart failure. Design and Methods: Patient-centered instructions for familiar and unfamiliar medications were compared with instructions for the…

  7. Managing information in the academic medical center: building an integrated information environment.

    PubMed

    Fuller, S; Braude, R M; Florance, V; Frisse, M E

    1995-10-01

    The strategic importance of integrated information systems and resources for academic medical centers should not be underestimated. Ten years ago, the National Library of Medicine in collaboration with the Association of Academic Medical Centers initiated the Integrated Advanced Information Management System (IAIMS) program to assist academic medical centers in defining a process for addressing deficiencies in their information environments. The authors give a brief history of the IAIMS program, and they describe both the characteristics of an integrated information environment and the technical and organizational structures necessary to create such an environment. Strategies some institutions have used to implement integrated information systems are also outlined. Finally, the authors discuss the role of librarians in integrated information system design. PMID:7575920

  8. A Human-Centered Approach to Medical Informatics for Medical Students, Residents, and Practicing Clinicians.

    ERIC Educational Resources Information Center

    Stahlhut, Richard W.; Gosbee, John W.; Gardner-Bonneau, Daryle J.

    1997-01-01

    Describes development of a curriculum in medical information science that focuses on practical problems in clinical medicine rather than details of information technology. Design was guided by identification of six key clinical challenges that must be addressed by practitioners in the near future and by examination of past failures of informatics…

  9. Results of an Institutional LGBT Climate Survey at an Academic Medical Center.

    PubMed

    Chester, Sean D; Ehrenfeld, Jesse M; Eckstrand, Kristen L

    2014-12-01

    The purpose of this study was to characterize the climate and culture experienced by lesbian, gay, bisexual, and transgender (LGBT) employees and students at one large academic medical center. An anonymous, online institutional climate survey was used to assess the attitudes and experiences of LGBT employees and students. There were 42 LGBT and 14 non-LGBT survey participants. Results revealed that a surprisingly large percentage of LGBT individuals experienced pressure to remain "closeted" and were harassed despite medical center policies of non-discrimination. Continuing training, inclusive policies and practices, and the development of mechanisms to address LGBT-specific harassment are necessary for improving institutional climate. PMID:26789861

  10. Access to patient-centered medical home among Ohio's Children with Special Health Care Needs.

    PubMed

    Conrey, Elizabeth J; Seidu, Dazar; Ryan, Norma J; Chapman, Dj Sam

    2013-06-01

    Medical homes deliver primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate and culturally effective. Children with special health care needs (CSHCN) require a wide range of support to maintain health, making medical home access particularly important. We sought to understand independent risk factors for lacking access. We analyzed Ohio, USA data from the National Survey of Children with Special Health Care Needs (2005-2006). Among CSHCN, 55.6% had medical home access. The proportion achieving each medical home component was highest for having a personal doctor/nurse and lowest for receiving coordinated care, family-centered care and referrals. Specific subsets of CSHCN were significantly and independently more likely to lack medical home access: Hispanic (AOR=3.08), moderate/high severity of difficulty (AOR=2.84), and any public insurance (AOR=1.60). Efforts to advance medical home access must give special attention to these CSHCN populations and improvements must be made to referral access, family-centered care, and care coordination. PMID:23242811

  11. [Urgency and acuity judgment systems before medical care (emergency telephone consultation center #7119, JTAS etc.)].

    PubMed

    Ishikawa, Hideki; Yoshida, Masashi; Sakamoto, Tetsuya

    2016-02-01

    Currently growing the demand of the emergency medical care in Japan, sharing the concept about medical urgency is needed in the whole society in order to maintain the emergency medical systems as social resources. The present conditions and challenges are outlined: Emergency Telephone Consultation Center in Tokyo Fire Department (established in June 2007) and on-site triage as representatives of "pre-hospital urgency determination systems", and JTAS (Japan Triage and Acuity System, introduced in April 2012) as a representative of "in-hospital, pre-examination urgency determination systems". PMID:26915257

  12. [Medical fault or professional negligence? Case studies in two recovery nutrition centers in Niger].

    PubMed

    Halidou Doudou, M; Manzo, M L; Guero, D

    2014-12-01

    In developing countries such as Niger, the risk of medical malpractice is ubiquitous in health, jeopardizing patient safety. The aim of this work was to contribute to patients' safety and respect of code of ethics and conduct in the exercise of the medical profession. The reported cases involved two children under 5 years who were admitted to nutrition rehabilitation centers, died as a result of medical malpractice. In Niger, there are no statistics on this phenomenon and a few cases found have always been considered "accident" or "fate." The establishment of an observatory collections of such information should improve their frequency, consequences and propose a prevention plan. PMID:25449444

  13. Evolution and Integration of Medical Laboratory Information System in an Asia National Medical Center

    NASA Astrophysics Data System (ADS)

    Cheng, Po-Hsun; Chen, Sao-Jie; Lai, Jin-Shin

    This work elucidates the evolution of three generations of the laboratory information system in the National Taiwan University Hospital, which were respectively implemented in an IBM Series/1 mini-computer, a client/server and a plug-and-play HL7 interface engine environment respectively. The experience of using the HL7 healthcare information exchange in the hospital information system, laboratory information system, and automatic medical instruments over the past two decades are illustrated and discussed. The latest design challenge in developing intelligent laboratory information services is to organize effectively distributed and heterogeneous medical instruments through the message gateways. Such experiences had spread to some governmental information systems for different purposes in Taiwan; besides, the healthcare information exchange standard, software reuse mechanism, and application service provider adopted in developing the plug-and-play laboratory information system are also illustrated.

  14. Involvement of Pharmacists in Medical Care in Emergency and Critical Care Centers.

    PubMed

    Imai, Toru; Yoshida, Yoshikazu

    2016-01-01

    Emergency and critical care centers provide multidisciplinary therapy for critically ill patients by centralizing the expertise and technology of many medical professionals. Because the patients' conditions vary, different drug treatments are administered along with surgery. Therefore, the role of pharmacists is important. Critically ill patients who receive high-level invasive treatment undergo physiological changes differing from their normal condition along with variable therapeutic effects and pharmacokinetics. Pharmacists are responsible for recommending the appropriate drug therapy using their knowledge of pharmacology and pharmacokinetics. Further, pharmacists need to determine the general condition of patients by understanding vital signs, blood gas analysis results, etc. It is therefore necessary to conduct consultations with physicians and nurses. The knowledge required for emergency medical treatment is not provided during systematic training in pharmaceutical education, meaning that pharmacists acquire it in the clinical setting through trial and error. To disseminate the knowledge of emergency medical care to pharmacy students, emergency care training has been started in a few facilities. I believe that medical facilities and universities need to conduct joint educational sessions on emergency medical care. Moreover, compared with other medical fields, there are fewer studies on emergency medical care. Research-oriented pharmacists must resolve this issue. This review introduces the work conducted by pharmacists for clinical student education and clinical research at the Emergency and Critical Care Center of Nihon University Itabashi Hospital and discusses future prospects. PMID:27374959

  15. The medical information needs of internists and pediatricians at an academic medical center.

    PubMed

    Woolf, S H; Benson, D A

    1989-10-01

    Medical information needs were examined in a survey of sixty-seven physicians selected from the faculty and housestaff at Johns Hopkins Hospital. A standardized questionnaire was administered personally by a medical informatics physician to collect data on information needs, attitudes, and previous experience with computers. The types of information most frequently required by both faculty and housestaff were treatment recommendations and differential diagnosis. The sources of reference information most commonly used were textbooks and colleagues. The information needs of housestaff differed significantly in several categories from those of faculty physicians. Housestaff more frequently needed information for patient care (P less than 0.05), and preferred the use of textbooks (P less than 0.01) and handbooks (P less than 0.001) as information sources. Faculty more frequently needed information for activities unrelated to patient care (P less than 0.01) and placed greater importance on basic science information (P less than 0.01). When asked to suggest references for online access, the respondents named 143 journals and textbooks, with journals overwhelmingly preferred over textbooks. Only one reference, the New England Journal of Medicine, was requested by a majority of the respondents. The importance of a broad understanding of physician information needs through improved data-collection techniques is discussed as a means of increasing the use of medical information systems. PMID:2790344

  16. MedReach: building an Area Health Education Center medical information outreach system for northwest Ohio.

    PubMed

    Steiner, Victoria; Hartmann, Jonathan; Ronau, Theodore

    2002-07-01

    In collaboration with regional partners in northwest Ohio, the Area Health Education Center (AHEC) program at the Medical College of Ohio (MCO) at Toledo is reaching out to underserved areas, helping to provide educational opportunities to health care professionals in these communities. This paper describes the development of MedReach, a medical information outreach system that connects regional AHEC sites to MCO via the Internet. MedReach provides physicians and other health care professionals access and support to search computerized textbooks and databases for current information on medical diagnoses, treatments, and research. A unique aspect of the MedReach project is that users are able to receive personal help with information retrieval by calling or emailing MCO's outreach librarian. Periodically, the AHEC program and the Mulford Library at MCO also sponsor an educational program, titled "Medical Applications of Computers," for regional practitioners. Current feedback on both the medical information outreach system and the educational program has been positive. PMID:12113517

  17. Three-Year Experience of an Academic Medical Center Ombuds Office.

    PubMed

    Raymond, John R; Layde, Peter M

    2016-03-01

    An ombuds is an individual who informally helps people or groups (visitors) resolve disputes and/or interpersonal conflicts as an alternative to formal dispute resolution mechanisms within an organization. Ombuds are nearly ubiquitous in many governmental, business, and educational settings but only recently have gained visibility at medical schools. Medical schools in the United States are increasingly establishing ombuds offices as part of comprehensive conflict management systems to address concerns of faculty, staff, students, and others. As of 2015, more than 35 medical schools in the United States have active ombuds Web pages. Despite the growing number of medical schools with ombuds offices, the literature on medical school ombuds offices is scant. In this article, the authors review the first three years of experience of the ombuds office at the Medical College of Wisconsin, a freestanding medical and graduate school with a large physician practice. The article is written from the perspective of the inaugural ombuds and the president who initiated the office. The authors discuss the rationale for, costs of, potential advantages of, and initial reactions of faculty, staff, and administration to having an ombuds office in an academic medical center. Important questions relevant to medical schools that are considering an ombuds office are discussed. The authors conclude that an ombuds office can be a useful complement to traditional approaches for conflict management, regulatory compliance, and identification of systemic issues. PMID:26675192

  18. [Current aspects of war surgery. From the trauma center to precarious medical care].

    PubMed

    Houdelette, P

    1997-01-01

    War, said Carl von Clausewitz, is a cameleon. In this century, each armed conflict has proved to be unique, particularly in its medical aspects, with its own features and teaching its won lessons. As recent events show, no conflict is a fact of the past. Medical care delivered to war casualties depend on the circumstances of the war, on the medical resources available, but also on the price that cultures or circumstances place on it. Everything separates these two paradigms; on the one hand the "precious" casualty of western armies whose medical support is organized in a concept (forward medical and surgical care, ultra-rapid medical evacuation) tailored to each case, and as close as possible to the medical care of a civilian trauma patient whose models remains the North-American ballistic wound managed in trauma centers; on the other hand, civilian victims, in large numbers, in poor and disorganized countries, often abandoned to their own fate or sorted by "epidemiological" triage, which guarantees a distribution, as efficient as possible, of limited medical care. In war, advanced medical care and precarious medicine may work side by side according to two logics which do not exclude one another and constantly improve. PMID:9297902

  19. Three-Year Experience of an Academic Medical Center Ombuds Office

    PubMed Central

    Layde, Peter M.

    2016-01-01

    An ombuds is an individual who informally helps people or groups (visitors) resolve disputes and/or interpersonal conflicts as an alternative to formal dispute resolution mechanisms within an organization. Ombuds are nearly ubiquitous in many governmental, business, and educational settings but only recently have gained visibility at medical schools. Medical schools in the United States are increasingly establishing ombuds offices as part of comprehensive conflict management systems to address concerns of faculty, staff, students, and others. As of 2015, more than 35 medical schools in the United States have active ombuds Web pages. Despite the growing number of medical schools with ombuds offices, the literature on medical school ombuds offices is scant. In this article, the authors review the first three years of experience of the ombuds office at the Medical College of Wisconsin, a freestanding medical and graduate school with a large physician practice. The article is written from the perspective of the inaugural ombuds and the president who initiated the office. The authors discuss the rationale for, costs of, potential advantages of, and initial reactions of faculty, staff, and administration to having an ombuds office in an academic medical center. Important questions relevant to medical schools that are considering an ombuds office are discussed. The authors conclude that an ombuds office can be a useful complement to traditional approaches for conflict management, regulatory compliance, and identification of systemic issues. PMID:26675192

  20. Undergoing Transformation to the Patient Centered Medical Home in Safety Net Health Centers: Perspectives from the Front Lines

    PubMed Central

    Quinn, Michael T.; Gunter, Kathryn E.; Nocon, Robert S.; Lewis, Sarah E.; Vable, Anusha M.; Tang, Hui; Park, Seo-Young; Casalino, Lawrence P.; Huang, Elbert S.; Birnberg, Jonathan; Burnet, Deborah L.; Summerfelt, W. Thomas; Chin, Marshall H.

    2013-01-01

    Objectives Safety Net Health Centers (SNHCs), which include Federally Qualified Health Centers (FQHCs) provide primary care for underserved, minority and low income patients. SNHCs across the country are in the process of adopting the Patient Centered Medical Home (PCMH) model, based on promising early implementation data from demonstration projects. However, previous demonstration projects have not focused on the safety net and we know little about PCMH transformation in SNHCs. Design This qualitative study characterizes early PCMH adoption experiences at SNHCs. Setting and Participants We interviewed 98 staff,(administrators, providers, and clinical staff) at 20 of 65 SNHCs, from five states, who were participating in the first of a five-year PCMH collaborative, the Safety Net Medical Home Initiative. Main Measures We conducted 30-45 minute, semi-structured telephone interviews. Interview questions addressed benefits anticipated, obstacles encountered, and lessons learned in transition to PCMH. Results Anticipated benefits for participating in the PCMH included improved staff satisfaction and patient care and outcomes. Obstacles included staff resistance and lack of financial support for PCMH functions. Lessons learned included involving a range of staff, anticipating resistance, and using data as frequent feedback. Conclusions SNHCs encounter unique challenges to PCMH implementation, including staff turnover and providing care for patients with complex needs. Staff resistance and turnover may be ameliorated through improved healthcare delivery strategies associated with the PCMH. Creating predictable and continuous funding streams may be more fundamental challenges to PCMH transformation. PMID:23914423

  1. 75 FR 20778 - Security Zone; Portland Rose Festival Fleet Week, Willamette River, Portland, OR

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-21

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA87 Security Zone; Portland Rose Festival Fleet Week... Hawthorne and Steel Bridges in Portland, Oregon during the Portland Rose Festival Fleet Week from June 2... Rose Festival Fleet Week, and there is insufficient time to publish a notice of proposed...

  2. 75 FR 20523 - Regulated Navigation Areas; Port of Portland Terminal 4, Willamette River, Portland, OR

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-20

    ..., Portland, OR'' in the Federal Register (74 FR 69047). We received one comment on the proposed rule. There... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA11 Regulated Navigation Areas; Port of Portland Terminal 4... establishing two Regulated Navigation Areas (RNA) at the Port of Portland Terminal 4 on the Willamette River...

  3. Developing a Sustainable Research Culture in an Independent Academic Medical Center

    ERIC Educational Resources Information Center

    Joyce, Jeffrey N.

    2013-01-01

    Independent academic medical centers (IAMC) are challenged to develop and support a research enterprise and maintain primary goals of healthcare delivery and financial solvency. Strategies for promoting translational research have been shown to be effective at institutions in the top level of federal funding, but not for smaller IAMCs. The…

  4. Veterans Affairs and Academic Medical Center Affiliations: The North Texas Experience

    ERIC Educational Resources Information Center

    Mohl, Paul Cecil; Hendrickse, William; Orsak, Catherine; Vermette, Heidi

    2009-01-01

    Objective: The authors review the more than 30-year history of the academic affiliation between the Department of Psychiatry at the University of Texas Southwestern Medical Center in Dallas and the Mental Health Service at the Veterans Affairs North Texas Health Care System. Methods: The authors interviewed individuals involved at various stages…

  5. Using a facilitation model to achieve patient-centered medical home recognition.

    PubMed

    Lane, Sandi J; Watkins, R W Chip

    2015-01-01

    This article describes how a facilitation model that included a partnership between a Community Care of North Carolina network and undergraduates at a regional university supported rural primary care practices in transforming their practices to become National Committee for Quality Assurance-recognized patient-centered medical homes. Health care management and preprofessional undergraduate students worked with 14 rural primary care practices to redesign practice processes and complete the patient-centered medical home application. Twelve of the practices participated in the evaluation of the student contribution. A semistructured interview guide containing questions about practice characteristics, student competencies, and the value of the student's contribution to their practice's achievement of patient-centered medical home recognition was used to interview practice managers or their designee. Analysis included item-descriptive statistics and qualitative analysis of narrative content. All 12 participating practices achieved 2011 National Committee for Quality Assurance patient-centered medical home recognition, with 4 practices achieving level 3, 5 practices achieving level 2, and 3 practices achieving level 1. The facilitation model using partnerships between health care agencies and universities might be an option for enhancing a practice's internal capacity for successful transformation and should be explored further. PMID:25909396

  6. Developing physician leaders in academic medical centers. Part 1: Their changing role.

    PubMed

    Bachrach, D J

    1996-01-01

    While physicians have historically held positions of leadership in academic medical centers, there is an increasing trend that physicians will not only guide the clinical, curriculum and scientific direction of the institution, but its business direction as well. Physicians are assuming a greater role in business decision making and are found at the negotiating table with leaders from business, insurance and other integrated health care delivery systems. Physicians who lead "strategic business units" within the academic medical center are expected to acquire and demonstrate enhanced business acumen. There is an increasing demand for formal and informal training programs for physicians in academic medical centers in order to better prepare them for their evolving roles and responsibilities. These may include the pursuit of a second degree in business or health care management, intramurally conducted courses in leadership skill development; management, business and finance; or involvement in extramurally prepared and delivered training programs specifically geared toward physicians as conducted at major universities, often in their schools of business or public health. This article article was prepared by the author from research into and presentation of a thesis entitled. "The Importance of Leadership Training And Development For Physicians In Academic Medical Centers In An Increasingly Complex Healthcare Environment, " prepared for the Credentials Committee of the American College of Healthcare Executives in partial fulfillment of the requirements for Fellowship in the College (ACHE). Part 2 will appear in the next issue of the Journal. PMID:10162876

  7. Program review of the USDA Center for Medical, Agricultural and Veterinary Entomology

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The USDA-ARS Center for Medical, Agricultural and Veterinary Entomology (CMAVE) has a history that starts in 1932 in Orlando to develop methods to control mosquitoes, including malaria vectors under conditions simulating those of the south Pacific jungles, and other insects affecting man and animals...

  8. A User-Centered Cooperative Information System for Medical Imaging Diagnosis.

    ERIC Educational Resources Information Center

    Gomez, Enrique J.; Quiles, Jose A.; Sanz, Marcos F.; del Pozo, Francisco

    1998-01-01

    Presents a cooperative information system for remote medical imaging diagnosis. General computer-supported cooperative work (CSCW) problems addressed are definition of a procedure for the design of user-centered cooperative systems (conceptual level); and improvement of user feedback and optimization of the communication bandwidth in highly…

  9. Impact of Institution of a Stroke Program Upon Referral Bias at a Rural Academic Medical Center

    ERIC Educational Resources Information Center

    Riggs, Jack E.; Libell, David P.; Brooks, Claudette E.; Hobbs, Gerald R.

    2005-01-01

    Context: Referral bias reflecting the preferential hospital transfer of patients with intracerebral hemorrhage (ICH) has been demonstrated as the major contributing factor for an observed high nonrisk-adjusted in-hospital crude acute stroke mortality rate at a rural academic medical center. Purpose: This study was done to assess the impact of a…

  10. WASTE MINIMIZATION OPPORTUNITY ASSESSMENT: OPTICAL FABRICATION LABORATORY - FITZSIMMONS ARMY MEDICAL CENTER

    EPA Science Inventory

    Under the Waste Reduction Evaluations at Federal Sites (WREAFS) program, RREL has taken the initiative to merge the experience and resources of the EPA with other Federal agencies. t the Fitzsimmons Army Medical Center (FAMC) in Aurora, Colorado, the Army and the EPA cooperated i...

  11. WASTE MINIMIZATION OPPORTUNITY ASSESSMENT: OPTICAL FABRICATION LABORATORY - FITZSIMMONS ARMY MEDICAL CENTER

    EPA Science Inventory

    Under the Waste Reduction Evaluations at Federal Sites (WREAFS) program, RREL has taken the initiative to merge the experience and resources of the EPA with other Federal agencies. At the Fitzsimmons Army Medical Center (FAMC) in Aurora, Colorado, the Army and the EPA cooperated ...

  12. Impact of Institution of a Stroke Program upon Referral Bias at a Rural Academic Medical Center

    ERIC Educational Resources Information Center

    Riggs, Jack E.; Libell, David P.; Brooks, Claudette E.; Hobbs, Gerald R.

    2005-01-01

    Context: Referral bias reflecting the preferential hospital transfer of patients with intracerebral hemorrhage (ICH) has been demonstrated as the major contributing factor for an observed high nonrisk-adjusted in-hospital crude acute stroke mortality rate at a rural academic medical center. Purpose: This study was done to assess the impact of a…

  13. 78 FR 10608 - David Grant United States Air Force Medical Center Specialty Care Travel Reimbursement...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

    ... appropriately trained provider within 4 weeks or sooner, if required, and within 1-hour travel time from the beneficiary's residence. The geographic area that represents 1-hour travel time surrounding an MTF is referred... of the Secretary David Grant United States Air Force Medical Center Specialty Care...

  14. The History of SHSAAMc: Student Health Services at Academic Medical Centers

    ERIC Educational Resources Information Center

    Veeser, Peggy Ingram; Hembree, Wylie; Bonner, Julia

    2008-01-01

    This article presents an historical review of the organization known as Student Health Services at Academic Medical Centers (SHSAAMc). The authors discuss characteristics of health service directors as well as the history of meetings, discussion, and leadership. The focus of the group is the healthcare needs of health professions students at…

  15. Crossing the Great Divide: Adoption of New Technologies, Therapeutics and Diagnostics at Academic Medical Centers

    ERIC Educational Resources Information Center

    DeMonaco, Harold J.; Koski, Greg

    2007-01-01

    The role of new technology in healthcare continues to expand from both the clinical and financial perspectives. Despite the importance of innovation, most academic medical centers do not have a clearly defined process for technology assessment. Recognizing the importance of new drugs, diagnostics and procedures in the care of patients and in the…

  16. Impact on Seniors of the Patient-Centered Medical Home: Evidence from a Pilot Study

    ERIC Educational Resources Information Center

    Fishman, Paul A.; Johnson, Eric A.; Coleman, Kathryn; Larson, Eric B.; Hsu, Clarissa; Ross, Tyler R.; Liss, David; Tufano, James; Reid, Robert J.

    2012-01-01

    Purpose: To assess the impact on health care cost and quality among seniors of a patient-centered medical home (PCMH) pilot at Group Health Cooperative, an integrated health care system in Washington State. Design and Methods: A prospective before-and-after evaluation of the experience of seniors receiving primary care services at 1 pilot clinic…

  17. Family-Centered Health Care for Medically Fragile Children: Principles and Practices.

    ERIC Educational Resources Information Center

    Nelkin, Valerie

    The booklet explains ten principles of family-centered health care and six components of community based programs for children with significant medical problems. The principles are: The child and the family have basic rights of self-determination and autonomy. Health care services should be family oriented and maximize family control. Service…

  18. Which Sexual Abuse Victims Receive a Forensic Medical Examination?: The Impact of Children's Advocacy Centers

    ERIC Educational Resources Information Center

    Walsh, Wendy A.; Cross, Theodore P.; Jones, Lisa M.; Simone, Monique; Kolko, David J.

    2007-01-01

    Objective: This study examines the impact of Children's Advocacy Centers (CAC) and other factors, such as the child's age, alleged penetration, and injury on the use of forensic medical examinations as part of the response to reported child sexual abuse. Methods: This analysis is part of a quasi-experimental study, the Multi-Site Evaluation of…

  19. Examining Health Information Technology Implementations: Case of the Patient-Centered Medical Home

    ERIC Educational Resources Information Center

    Behkami, Nima A.

    2012-01-01

    It has been shown that the use of Health Information Technology (HIT) is associated with reduced cost and increased quality of care. This dissertation examined the use of registries in Patient Centered Medical Home (PCMH) practices. A survey questionnaire was sent to a nationwide group of clinics certified for being a PCMH. They were asked to…

  20. Preparing Academic Medical Centers for the Clinical Learning Environment Review: Alliance of Independent Academic Medical Centers National Initiative IV Outcomes and Evaluation

    PubMed Central

    Wehbe-Janek, Hania; Markova, Tsveti; Polis, Rachael L.; Peters, Marguerite; Liu, Yang

    2016-01-01

    Background: Driven by changes to improve quality in patient care and population health while reducing costs, evolvement of the health system calls for restructuring health professionals' education and aligning it with the healthcare delivery system. In response to these changes, the Accreditation Council for Graduate Medical Education's Clinical Learning Environment Review (CLER) encourages the integration of health system leadership, faculty, and residents in restructuring graduate medical education (GME). Innovative approaches to achieving this restructuring and the CLER objectives are essential. Methods: The Alliance of Independent Academic Medical Centers National Initiative (NI) IV provided a multiinstitutional learning collaborative focused on supporting GME redesign. From October 2013 through March 2015, participants conducted relevant projects, attended onsite meetings, and participated in teleconferences and webinars addressing the CLER areas. Participants shared best practices, resources, and experiences. We designed a pre/post descriptive study to examine outcomes. Results: Thirty-three institutions completed NI IV, and at its conclusion, the majority reported greater CLER readiness compared with baseline. Twenty-two (88.0%) institutions reported that NI IV had a great impact on advancing their efforts in the CLER area of their project focus, and 15 (62.5%) reported a great impact in other CLER focus areas. Opportunities to share progress with other teams and the national group meetings were reported to contribute to teams' success. Conclusion: The NI IV learning collaborative prepared institutions for CLER, suggesting successful integration of the clinical and educational enterprises. We propose that national learning collaboratives of GME-sponsoring health systems enable advancement of their education mission, leading ultimately to better healthcare outcomes. This learning model may be generalizable to newfound programs for academic medical centers

  1. Is there a role for academic medical centers in emerging markets?

    PubMed

    Wiener, Charles M; Thompson, Steven J; Wu, Sandford; Chellappa, Mohan; Hasham, Salim

    2012-01-01

    Governments in emerging markets face mounting challenges in managing health spending, building capability and capacity, modernizing ageing infrastructure, and investing in skills and resources. One path to overcoming these challenges is to establish new public-private models of health care development and delivery based on United States academic medical centers, whose missions are to advance medical education and clinical delivery. Johns Hopkins Medicine is a participant in the collaboration developing between the Perdana University Hospital and the Perdana University Graduate School of Medicine in Malaysia. These two organizations comprise an academic health science center based on the United States model. The Perdana project provides constructive insights into the opportunities and challenges that governments, universities, and the private sector face when introducing new models of patient care that are integrated with medical education, clinical training, and biomedical research. PMID:23484425

  2. The Inflammatory Bowel Disease Specialty Medical Home: A New Model of Patient-centered Care.

    PubMed

    Regueiro, Miguel D; McAnallen, Sandra E; Greer, Julia B; Perkins, Stephen E; Ramalingam, S; Szigethy, Eva

    2016-08-01

    New models of health care have emerged over the past decade. Accountable care organizations and patient-centered medical homes are designed to improve the patient experience, enhance health care quality, and decrease cost. These models have been developed in the primary care domain and have yet to be tested in specialty care. Certain chronic diseases require principal care by a specialist or health care team. The specialty medical home would provide patient-centered care for specific populations of patients whose health care derives from a single chronic disease. This article defines the parameters for a specialty medical home and provides a specific payer-provider experience for the comprehensive care of an inflammatory bowel disease population. PMID:27135486

  3. An Advanced Pharmacy Practice Experience in a Student-Staffed Medication Therapy Management Call Center

    PubMed Central

    Hall, Anna M.; Roane, Teresa E.; Mistry, Reena

    2012-01-01

    Objective. To describe the implementation of an advanced pharmacy practice experience (APPE) in medication therapy management (MTM) designed to contribute to student pharmacists’ confidence and abilities in providing MTM. Design. Sixty-four student pharmacists provided MTM services during an APPE in a communication and care center. Assessment. Students conducted 1,495 comprehensive medication reviews (CMRs) identifying 6,056 medication-related problems. Ninety-eight percent of the students who completed a survey instrument (52 of 53) following the APPE expressed that they had the necessary knowledge and skills to provide MTM services. Most respondents felt that pharmacist participation in providing Medicare MTM could move the profession of pharmacy forward and that pharmacists will have some role in deciding the specific provisions of the Medicare MTM program (92% and 91%, respectively). Conclusion. Students completing the MTM APPE received patient-centered experiences that supplemented their confidence, knowledge, and skill in providing MTM services in the future. PMID:22919086

  4. 13. VIEW OF PORTLAND RESERVOIR NO. 2, LOOKING EAST FROM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    13. VIEW OF PORTLAND RESERVOIR NO. 2, LOOKING EAST FROM NORTHWEST CORNER OF RESERVOIR. POST OF ORIGINAL FENCE IS IN FOREGROUND - Portland Reservoir No. 2, 6007 Southeast Division Street, Portland, Multnomah County, OR

  5. 9. VIEW OF PORTLAND RESERVOIR NO. 2, LOOKING SOUTHWEST, SHOWING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. VIEW OF PORTLAND RESERVOIR NO. 2, LOOKING SOUTHWEST, SHOWING CHAIN-LINK FENCE IN FOREGROUND AND FOUNDATION STRUCTURE IN THE MIDDLE OF RESERVOIR BASIN - Portland Reservoir No. 2, 6007 Southeast Division Street, Portland, Multnomah County, OR

  6. 14. Photocopy of photograph (from Station 'L' office files, Portland, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. Photocopy of photograph (from Station 'L' office files, Portland, Oregon) Photographer unknown, c.1930 HISTORIC VIEW OF STEPHENS SUBSTATION - Portland General Electric Company, Station "L", 1841 Southeast Water Street, Portland, Multnomah County, OR

  7. Nurturing 21st century physician knowledge, skills and attitudes with medical home innovations: the Wright Center for Graduate Medical Education teaching health center curriculum experience

    PubMed Central

    Palamaner Subash Shantha, Ghanshyam; Gollamudi, Lakshmi Rani; Sheth, Jignesh; Ebersole, Brian; Gardner, Katlyn J.; Nardella, Julie; Ruddy, Meaghan P.; Meade, Lauren

    2015-01-01

    Purpose. The effect of patient centered medical home (PCMH) curriculum interventions on residents’ self-reported and demonstrated knowledge, skills and attitudes in PCMH competency arenas (KSA) is lacking in the literature. This study aimed to assess the impact of PCMH curricular innovations on the KSA of Internal Medicine residents. Methods. Twenty four (24) Internal Medicine residents—12 Traditional (TR) track residents and 12 Teaching Health Center (THC) track residents—began training in Academic Year (AY) 2011 at the Wright Center for Graduate Medical Education (WCGME). They were followed through AY2013, covering three years of training. PCMH curricular innovations were focally applied July 2011 until May 2012 to THC residents. These curricular innovations were spread program-wide in May 2012. Semi-annual, validated PCMH Clinician Assessments assessing KSA were started in AY2011 and were completed by all residents. Results. Mean KSA scores of TR residents were similar to those of THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than TR residents for most KSA. After program-wide implementation of PCMH innovations, mean scores of TR residents for all KSA improved and most became equalized to those of THC residents. Globally improved KSA scores of THC and TR residents were maintained through May 2014, with the majority of improvements above baseline and reaching statistical significance. Conclusions. PCMH curricular innovations inspired by Health Resources and Services Administration (HRSA’s) Teaching Health Center funded residency program expansion quickly and consistently improved the KSA of Internal Medicine residents. PMID:25699213

  8. Nurturing 21st century physician knowledge, skills and attitudes with medical home innovations: the Wright Center for Graduate Medical Education teaching health center curriculum experience.

    PubMed

    Thomas-Hemak, Linda; Palamaner Subash Shantha, Ghanshyam; Gollamudi, Lakshmi Rani; Sheth, Jignesh; Ebersole, Brian; Gardner, Katlyn J; Nardella, Julie; Ruddy, Meaghan P; Meade, Lauren

    2015-01-01

    Purpose. The effect of patient centered medical home (PCMH) curriculum interventions on residents' self-reported and demonstrated knowledge, skills and attitudes in PCMH competency arenas (KSA) is lacking in the literature. This study aimed to assess the impact of PCMH curricular innovations on the KSA of Internal Medicine residents. Methods. Twenty four (24) Internal Medicine residents-12 Traditional (TR) track residents and 12 Teaching Health Center (THC) track residents-began training in Academic Year (AY) 2011 at the Wright Center for Graduate Medical Education (WCGME). They were followed through AY2013, covering three years of training. PCMH curricular innovations were focally applied July 2011 until May 2012 to THC residents. These curricular innovations were spread program-wide in May 2012. Semi-annual, validated PCMH Clinician Assessments assessing KSA were started in AY2011 and were completed by all residents. Results. Mean KSA scores of TR residents were similar to those of THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than TR residents for most KSA. After program-wide implementation of PCMH innovations, mean scores of TR residents for all KSA improved and most became equalized to those of THC residents. Globally improved KSA scores of THC and TR residents were maintained through May 2014, with the majority of improvements above baseline and reaching statistical significance. Conclusions. PCMH curricular innovations inspired by Health Resources and Services Administration (HRSA's) Teaching Health Center funded residency program expansion quickly and consistently improved the KSA of Internal Medicine residents. PMID:25699213

  9. Development of a Hospital-based Massage Therapy Course at an Academic Medical Center

    PubMed Central

    Dion, Liza J.; Cutshall, Susanne M.; Rodgers, Nancy J.; Hauschulz, Jennifer L.; Dreyer, Nikol E.; Thomley, Barbara S.; Bauer, Brent

    2015-01-01

    Background: Massage therapy is offered increasingly in US medical facilities. Although the United States has many massage schools, their education differs, along with licensure and standards. As massage therapy in hospitals expands and proves its value, massage therapists need increased training and skills in working with patients who have various complex medical concerns, to provide safe and effective treatment. These services for hospitalized patients can impact patient experience substantially and provide additional treatment options for pain and anxiety, among other symptoms. The present article summarizes the initial development and description of a hospital-based massage therapy course at a Midwest medical center. Methods: A hospital-based massage therapy course was developed on the basis of clinical experience and knowledge from massage therapists working in the complex medical environment. This massage therapy course had three components in its educational experience: online learning, classroom study, and a 25-hr shadowing experience. The in-classroom study portion included an entire day in the simulation center. Results: The hospital-based massage therapy course addressed the educational needs of therapists transitioning to work with interdisciplinary medical teams and with patients who have complicated medical conditions. Feedback from students in the course indicated key learning opportunities and additional content that are needed to address the knowledge and skills necessary when providing massage therapy in a complex medical environment. Conclusions: The complexity of care in medical settings is increasing while the length of hospital stay is decreasing. For this reason, massage provided in the hospital requires more specialized training to work in these environments. This course provides an example initial step in how to address some of the educational needs of therapists who are transitioning to working in the complex medical environment. PMID

  10. Using a medical simulation center as an electronic health record usability laboratory

    PubMed Central

    Landman, Adam B; Redden, Lisa; Neri, Pamela; Poole, Stephen; Horsky, Jan; Raja, Ali S; Pozner, Charles N; Schiff, Gordon; Poon, Eric G

    2014-01-01

    Usability testing is increasingly being recognized as a way to increase the usability and safety of health information technology (HIT). Medical simulation centers can serve as testing environments for HIT usability studies. We integrated the quality assurance version of our emergency department (ED) electronic health record (EHR) into our medical simulation center and piloted a clinical care scenario in which emergency medicine resident physicians evaluated a simulated ED patient and documented electronically using the ED EHR. Meticulous planning and close collaboration with expert simulation staff was important for designing test scenarios, pilot testing, and running the sessions. Similarly, working with information systems teams was important for integration of the EHR. Electronic tools are needed to facilitate entry of fictitious clinical results while the simulation scenario is unfolding. EHRs can be successfully integrated into existing simulation centers, which may provide realistic environments for usability testing, training, and evaluation of human–computer interactions. PMID:24249778

  11. My personal experiences at the BEST Medical Center: A day in the clinic-the afternoon.

    PubMed

    Cohen, Philip R; Kurzrock, Razelle

    2016-01-01

    Dr. Ida Lystic is a gastroenterologist who recently began her new faculty position at the BEST (Byron Edwards and Samuel Thompson) Medical Center. After completing her MD degree at the prestigious Harvey Medical School (recently renamed the Harvey Provider School), she did her internal medicine residency and fellowship training at the OTHER (Owen T. Henry and Eugene Rutherford) Medical Center. Her morning in gastroenterology clinic was highlighted by: (1) being reprimanded by the clinic nurse manager for a patient who not only arrived early, before clinic had opened, but also neglected to schedule the anesthesiologist for his colonoscopy; (2) the continued challenges of LEGEND (also known as Lengthy and Excessively Graded Evaluation and Nomenclature for Diagnosis by her colleagues), the new electronic medical record system after the BEST discarded the SIMPLE (Succinct Input Making Patient's Lives Electronic) system; (3) a nurse's interruption of an office visit-once the egg timer on the examination room door ran out-because she had exceeded the allocated time for the appointment; and (4) her chairman's unanticipated arrival in the clinic to visit with the clinic nurse manager. In addition to seeing her patients, Dr. Lystic's afternoon is occupied by attending a LOST (Laboratory OverSight and Testing) Committee meeting and a visit from a wayfinding and signage specialist to depersonalize the doorpost plaques of the examination rooms. Her day ends with a demeaning email from her chairman regarding the poor results of the most recent patient satisfaction survey and being personally held accountable to develop solutions to improve not only her performance but also that of the clinic. Although Dr. Ida Lystic and the gastroenterology clinic at "the BEST Medical Center" are creations of the authors' imagination, the majority of the anecdotes mentioned in this essay are based on individual patients and their physicians, clinics in medical centers and their administration

  12. MiPLAN: a learner-centered model for bedside teaching in today's academic medical centers.

    PubMed

    Stickrath, Chad; Aagaard, Eva; Anderson, Mel

    2013-03-01

    Clinician educators and medical trainees face intense pressure to complete numerous patient care and teaching activities in a limited amount of time. To address the need for effective and efficient teaching methods for use in the inpatient setting, the authors used constructivist learning theory, the principles of adult learning, and their expertise as clinician educators to develop the MiPLAN model for bedside teaching. This three-part model is designed to enable clinical teachers to simultaneously provide care to patients while assessing learners, determining high-yield teaching topics, and providing feedback to learners.The "M" refers to a preparatory meeting between teacher and learners before engaging in patient care or educational activities. During this meeting, team members should become acquainted and the teacher should set goals and clarify expectations. The "i" refers to five behaviors for the teacher to adopt during learners' bedside presentations: introduction, in the moment, inspection, interruptions, and independent thought. "PLAN" is an algorithm to establish priorities for teaching subsequent to a learner's presentation: patient care, learners' questions, attending's agenda, and next steps.The authors suggest that the MiPLAN model can help clinical teachers gain more confidence in their ability to teach at the bedside and increase the frequency and quality of bedside teaching. They propose further research to assess the generalizability of this model to other institutions, settings, and specialties and to evaluate educational and patient outcomes. PMID:23348088

  13. Improving the Transition of Care in Patients Transferred Through the Ochsner Medical Center Transfer Center

    PubMed Central

    Amedee, Ronald G.; Maronge, Genevieve F.; Pinsky, William W.

    2012-01-01

    Background Patient transfers from other hospitals within the Ochsner Health System to the main campus are coordinated through a Transfer Center that was established in fall 2008. We analyzed the transfer process to assess distinct opportunities to enhance the overall transition of patient care. Methods We surveyed internal medicine residents and nocturnists to determine their satisfaction with transfers in terms of safety, efficiency, and usefulness of information provided at the time of transfer. After a kaizen event at which complementary goals for the institution and members of the study team were recognized and implemented, we resurveyed the group to evaluate improvement in the transfer process. Results The preintervention average satisfaction score was 1.18 (SD=0.46), while the postintervention score was 3.7 (SD=1.01). A t test showed a significant difference in the average scores between the preintervention and postintervention surveys (P<0.0001). Conclusions By including residents in the transfer calls (a result of the kaizen event), data were collected that facilitated fewer and higher quality handoffs that were performed in less time. In addition, the process resulted in increased awareness of the value of resident participation in institutional quality improvement projects. PMID:23267257

  14. A 5-year scientometric analysis of research centers affiliated to Tehran University of Medical Sciences

    PubMed Central

    Yazdani, Kamran; Rahimi-Movaghar, Afarin; Nedjat, Saharnaz; Ghalichi, Leila; Khalili, Malahat

    2015-01-01

    Background: Since Tehran University of Medical Sciences (TUMS) has the oldest and highest number of research centers among all Iranian medical universities, this study was conducted to evaluate scientific output of research centers affiliated to Tehran University of Medical Sciences (TUMS) using scientometric indices and the affecting factors. Moreover, a number of scientometric indicators were introduced. Methods: This cross-sectional study was performed to evaluate a 5-year scientific performance of research centers of TUMS. Data were collected through questionnaires, annual evaluation reports of the Ministry of Health, and also from Scopus database. We used appropriate measures of central tendency and variation for descriptive analyses. Moreover, uni-and multi-variable linear regression were used to evaluate the effect of independent factors on the scientific output of the centers. Results: The medians of the numbers of papers and books during a 5-year period were 150.5 and 2.5 respectively. The median of the "articles per researcher" was 19.1. Based on multiple linear regression, younger age centers (p=0.001), having a separate budget line (p=0.016), and number of research personnel (p<0.001) had a direct significant correlation with the number of articles while real properties had a reverse significant correlation with it (p=0.004). Conclusion: The results can help policy makers and research managers to allocate sufficient resources to improve current situation of the centers. Newly adopted and effective scientometric indices are is suggested to be used to evaluate scientific outputs and functions of these centers. PMID:26157724

  15. A management plan for hospitals and medical centers facing radiation incidents

    PubMed Central

    Davari, Fereshteh; Zahed, Arash

    2015-01-01

    Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary. PMID:26759575

  16. City of Portland: Businesses for an environmentally sustainable tomorrow

    SciTech Connect

    1995-12-01

    The sustainable business development program in Portland (OR) is known as BEST. BEST stands for Businesses for an Environmentally Sustainable Tomorrow. The Portland Energy Office operates BEST as a {open_quotes}one-stop service center{close_quotes} for business owners and managers. BEST provides information and assistance on resource efficient buildings and business practices. The results of BEST`s two years of operation have been generally impressive. Nearly 150 new or expanding businesses have been connected with utility design assistance programs. Businesses have also received assistance with water conservation, telecommuting, construction debris recycling, and alternative fuel vehicles. BEST has received local and national publicity and BEST services have been the topic at more than a dozen conferences, meetings, or other speaking engagements. A guidebook for communities wishing to start a similar program will be available in early 1996.

  17. Montefiore Medical Center in The Bronx, New York: improving health in an urban community.

    PubMed

    Foreman, Spencer

    2004-12-01

    The author calls on academic medical centers that serve urban communities to go beyond the traditional mission of patient care, teaching, and research by accepting responsibility to build community-based care systems that are capable of improving the health of underserved populations within their reach. The experience of Montefiore Medical Center in the Bronx, New York, is presented to illustrate the nature, scope, and complexity of the undertaking that is required. Eight initiatives are described: expanding the primary care network, creating The Children's Hospital at Montefiore and the Child Health Network, responding to the needs of other high-risk populations, integrating the network with health information technology, using care-management systems to improve quality, reinforcing ethical allocation of resources, building teaching and research into the network, and preserving community vitality. The author believes that the current health care environment offers opportunities that may help to stimulate change in the direction of community-based systems. Managed care provides financial incentives to academic centers that are willing to accept risk and responsibly manage the care of a defined community, and advanced information technologies can support them in that endeavor. The author concludes that for academic medical centers with the proper systems in place, accepting responsibility for the community is not only the right thing to do, it is the strategic thing to do. PMID:15563649

  18. Towards Interactive Medical Content Delivery Between Simulated Body Sensor Networks and Practical Data Center.

    PubMed

    Shi, Xiaobo; Li, Wei; Song, Jeungeun; Hossain, M Shamim; Mizanur Rahman, Sk Md; Alelaiwi, Abdulhameed

    2016-10-01

    With the development of IoT (Internet of Thing), big data analysis and cloud computing, traditional medical information system integrates with these new technologies. The establishment of cloud-based smart healthcare application gets more and more attention. In this paper, semi-physical simulation technology is applied to cloud-based smart healthcare system. The Body sensor network (BSN) of system transmit has two ways of data collection and transmission. The one is using practical BSN to collect data and transmitting it to the data center. The other is transmitting real medical data to practical data center by simulating BSN. In order to transmit real medical data to practical data center by simulating BSN under semi-physical simulation environment, this paper designs an OPNET packet structure, defines a gateway node model between simulating BSN and practical data center and builds a custom protocol stack. Moreover, this paper conducts a large amount of simulation on the real data transmission through simulation network connecting with practical network. The simulation result can provides a reference for parameter settings of fully practical network and reduces the cost of devices and personnel involved. PMID:27562482

  19. United States academic medical centers: priorities and challenges amid market transformation.

    PubMed

    Thompson, Irene M; Anason, Barbara

    2012-01-01

    United States academic medical centers (AMCs) have upheld their long-standing reputation for excellence by teaching and training the next generation of physicians, supporting medical research, providing world-class medical care, and offering breakthrough treatments for highly complex medical cases. In recent years, the pace and direction of change reshaping the American health care industry has created a set of new and profound challenges that AMC leaders must address in order to sustain their institutions. University HealthSystem Consortium (UHC) is an alliance of 116 leading nonprofit academic medical centers and 276 of their affiliated hospitals, all of which are focused on delivering world-class patient care. Formed in 1984, UHC fosters collaboration with and among its members through its renowned programs and services in the areas of comparative data and analytics, performance improvement, supply chain management, strategic research, and public policy. Each year, UHC surveys the executives of its member institutions to understand the issues they view as most critical to sustaining the viability and success of their organizations. The results of UHC's most recent 2011 member survey, coupled with a 2012 Strategic Health Perspectives Harris Interactive presentation, based in parton surveys of major health care industry stakeholders reveal the most important and relevant issues and opportunities that hospital leaders face today, as the United States health care delivery system undergoes a period of unprecedented transformation. PMID:23484431

  20. The Effects of Corporatization on Academic Medical Centers. How Will the Corporatization of Health Care Influence Health Professions Education?

    ERIC Educational Resources Information Center

    Dunn, Marvin R.

    Areas of agreement/conflict between academic medical centers and investor owned corporations are considered. Academic medical centers are part of the university system, which is responsible for education, research, and the related public good (e.g., nurturing of professions). Major areas for a potential confluence of interest between the academic…

  1. A model for training medical student innovators: the Harvard Medical School Center for Primary Care Abundance Agents of Change program

    PubMed Central

    Duong, David B.; Sullivan, Erin E.; Minter-Jordan, Myechia; Giesen, Lindsay; Ellner, Andrew L.

    2016-01-01

    Background In 2013, the Harvard Medical School Center for Primary Care established the Abundance Agents of Change (AoC) program to promote interprofessional learning and innovation, increase partnership between 15 academic and community health centers (CHCs) in Boston's most under-served communities, and increase medical student interest in primary care careers. Methods The AoC is modeled in the form of a ‘grants challenge’, offering $20,000 to interprofessional student teams to develop an innovative solution that addresses a healthcare delivery need identified by CHCs. The program's initial two years were characterized by a four-stage process which included working with CHCs and crafting a request for proposals, forming interprofessional 20 student teams comprising students from across and outside of Harvard University, training students using a systems-based innovation curriculum, and performing program evaluation. Results Our evaluation data from cohorts 1 and 2 of the AoC program demonstrate that we succeeded in training students as innovators and members of interprofessional teams. We also learned valuable lessons regarding creating better alignment with CHC priorities, extending the program cycle from 12 to 18 months, and changing the way funding is disbursed to 25 students, which will be incorporated in later versions of the program. Conclusions Based on our experience and evaluation data, we believe that this program is a replicable way to train students as innovators and members of interprofessional teams to address the current complex healthcare environment. PMID:27306994

  2. Medical diplomacy and global mental health: from community and national institutions to regional centers of excellence.

    PubMed

    Aggarwal, Neil Krishan; Kohrt, Brandon A

    2013-12-01

    We explore how regional medical diplomacy can increase funding for global mental health initiatives. Interventions for infectious diseases have dominated medical diplomacy by focusing on security concerns. The global mental health movement has adopted similar strategies, but unsuccessfully since mental illnesses do not cause international epidemics. Instead, realpolitik arguments may increase funding by prioritizing economic productivity and regional diplomacy based on cultural ties to advance mental health services and research at the community level. In South Asia, initiatives to train personnel and provide refugee services offer a foundation for regional centers of excellence. This model can be expanded elsewhere. PMID:23918068

  3. Diseases pattern among patients attending Holy Mosque (Haram) Medical Centers during Hajj 1434 (2013)

    PubMed Central

    Bakhsh, Abdulrahman R.; Sindy, Abdulfattah I.; Baljoon, Mostafa J.; Dhafar, Khalid O.; Gazzaz, Zohair J.; Baig, Mukhtiar; Deiab, Basma A.; Hothali, Fauzea T. Al

    2015-01-01

    Objective: To evaluate the diseases pattern among pilgrims attending the 2 Holy Mosque (Haram) Health Care Centers during the Hajj season 2013 (Hijra 1434). Methods: In this cross-sectional study, data was collected from 2 medical centers located in the Holy Mosque in Makkah city, Saudi Arabia, from the first of Dhul-Hijjah to sixteenth Dhul-Hijjah 1434. The present study was completed in 16 days (6th October to 21st October 2013). Results: Over 16 days, 1008 patients attended the medical centers during Hajj 1434, (2013), out of which 554 (55%) were males and 454 (45%) were females. Most of the patients were Egyptians (n=242, 24%), followed by Saudis (n=116, 11.5%), Pakistani (n=114, 11.3%), Turkish (n=50, 5%), and other nationalities (n=404). According to age distribution, mostly were in the 51-60 years age group (n=237, 23.5%), followed by other age groups. Out of 1008 patients, 842 (83.5%) patients were treated and subsequently discharged, while 166 patients (16.5%) were referred to the tertiary centers. According to the diseases pattern, most of the patients were suffering from respiratory problems (n=177, 17.6%) followed by skin diseases (n=158, 15.7%), gastrointestinal tract (GIT) diseases (n=133, 13.2%), and others. Conclusion: Most of the patients were suffering from respiratory problems followed by skin and GIT diseases, and <25% of patients were referred to tertiary care centers. PMID:26219447

  4. Patient Navigators: Agents of Creating Community-Nested Patient-Centered Medical Homes for Cancer Care

    PubMed Central

    Simon, Melissa A.; Samaras, Athena T.; Nonzee, Narissa J.; Hajjar, Nadia; Frankovich, Carmi; Bularzik, Charito; Murphy, Kara; Endress, Richard; Tom, Laura S.; Dong, XinQi

    2016-01-01

    Patient navigation is an internationally utilized, culturally grounded, and multifaceted strategy to optimize patients’ interface with the health-care team and system. The DuPage County Patient Navigation Collaborative (DPNC) is a campus–community partnership designed to improve access to care among uninsured breast and cervical cancer patients in DuPage County, IL. Importantly, the DPNC connects community-based social service delivery with the patient-centered medical home to achieve a community-nested patient-centered medical home model for cancer care. While the patient navigator experience has been qualitatively documented, the literature pertaining to patient navigation has largely focused on efficacy outcomes and program cost effectiveness. Here, we uniquely highlight stories of women enrolled in the DPNC, told from the perspective of patient navigators, to shed light on the myriad barriers that DPNC patients faced and document the strategies DPNC patient navigators implemented. PMID:27594792

  5. Retaining medical directors in community health centers. The importance of administrative relationships.

    PubMed

    Cochran, Christopher; Peltier, James W

    2003-01-01

    Physician retention has become a critical issue for maintaining the success of today's health care organizations. With many external factors--increasing malpractice premiums, lower reimbursement rates, and managed care controls--driving physicians out of the practice, it is imperative to understand how the internal functions of the organization can help maintain satisfaction in the workplace and prevent physicians from leaving (Reece, 2000; Taylor, 2002). This is especially important in Community and Migrant Health Centers (C/MHCs), federally supported health clinics providing care to low-income and uninsured patients in medically underserved communities and neighborhoods. In this study, we examine the medical directors' roles and responsibilities, their relationships with the C/MHC administrators, and whether these impact satisfaction and, ultimately retention in the centers. PMID:12856504

  6. Patient Navigators: Agents of Creating Community-Nested Patient-Centered Medical Homes for Cancer Care.

    PubMed

    Simon, Melissa A; Samaras, Athena T; Nonzee, Narissa J; Hajjar, Nadia; Frankovich, Carmi; Bularzik, Charito; Murphy, Kara; Endress, Richard; Tom, Laura S; Dong, XinQi

    2016-01-01

    Patient navigation is an internationally utilized, culturally grounded, and multifaceted strategy to optimize patients' interface with the health-care team and system. The DuPage County Patient Navigation Collaborative (DPNC) is a campus-community partnership designed to improve access to care among uninsured breast and cervical cancer patients in DuPage County, IL. Importantly, the DPNC connects community-based social service delivery with the patient-centered medical home to achieve a community-nested patient-centered medical home model for cancer care. While the patient navigator experience has been qualitatively documented, the literature pertaining to patient navigation has largely focused on efficacy outcomes and program cost effectiveness. Here, we uniquely highlight stories of women enrolled in the DPNC, told from the perspective of patient navigators, to shed light on the myriad barriers that DPNC patients faced and document the strategies DPNC patient navigators implemented. PMID:27594792

  7. Pathology service line: a model for accountable care organizations at an academic medical center.

    PubMed

    Sussman, Ira; Prystowsky, Michael B

    2012-05-01

    Accountable care is designed to manage the health of patients using a capitated cost model rather than fee for service. Pay for performance is an attempt to use quality and not service reduction as the way to decrease costs. Pathologists will have to demonstrate value to the system. This value will include (1) working with clinical colleagues to optimize testing protocols, (2) reducing unnecessary testing in both clinical and anatomic pathology, (3) guiding treatment by helping to personalize therapy, (4) designing laboratory information technology solutions that will promote and facilitate accurate, complete data mining, and (5) administering efficient cost-effective laboratories. The pathology service line was established to improve the efficiency of delivering pathology services and to provide more effective support of medical center programs. We have used this model effectively at the Montefiore Medical Center for the past 14 years. PMID:22333926

  8. St. Luke's Medical Center Global City--Global Trigger Tool (GTT) Project.

    PubMed

    Dizon, Alejandro C; Macaraig, Victor J; Magpusao, Eulalia C

    2016-01-01

    The Global Trigger Tool (GTT) was developed by the Institute of Healthcare Improvement (IHI), to identify and measure the rate of adverse events over time in a healthcare facility. It is a sampling methodology that utilizes "triggers" in the detection of random adverse events and harms and it also measures the adverse events overtime. The Quality and Patient Safety Group of St. Luke's Medical Center--Global City initiated the implementation of the Global Trigger Tool as a proactive solution using retrospective information gathered to address the growing challenge that adverse events and harms impose in the institution with the ultimate goat of improving patient safety. St. Luke's Medical Center Global City is the first and only hospital in the Philippines to implementand utilize the Global Trigger Tool. PMID:27180470

  9. Optimizing Dam Operations for Power and for Fish: an Overview of the US Department of Energy and US Army Corps of Engineers ADvanced Turbine Development R&D. A Pre-Conference Workshop at HydroVision 2006, Oregon Convention Center, Portland, Oregon July 31, 2006

    SciTech Connect

    Dauble, Dennis D.

    2006-08-01

    This booklet contains abstracts of presentations made at a preconference workshop on the US Department of Energy and US Army Corps of Engineers hydroturbine programs. The workshop was held in conjunction with Hydrovision 2006 July 31, 2006 at the Oregon Convention Center in Portland Oregon. The workshop was organized by the Corps of Engineers, PNNL, and the DOE Wind and Hydropower Program. Presenters gave overviews of the Corps' Turbine Survival Program and the history of the DOE Advanced Turbine Development Program. They also spoke on physical hydraulic models, biocriteria for safe fish passage, pressure investigations using the Sensor Fish Device, blade strike models, optimization of power plant operations, bioindex testing of turbine performance, approaches to measuring fish survival, a systems view of turbine performance, and the Turbine Survival Program design approach.

  10. Medical Student Volunteerism Addresses Patients' Social Needs: A Novel Approach to Patient-Centered Care

    PubMed Central

    Onyekere, Chinwe; Ross, Sandra; Namba, Alexa; Ross, Justin C.; Mann, Barry D.

    2016-01-01

    Background: Healthcare providers must be equipped to recognize and address patients' psychosocial needs to improve overall health outcomes. To give future healthcare providers the tools and training necessary to identify and address psychosocial issues, Lankenau Medical Center in partnership with the Philadelphia College of Osteopathic Medicine designed the Medical Student Advocate (MSA) program. Methods: The MSA program places volunteer second-year osteopathic medical students in care coordination teams at Lankenau Medical Associates, a primary care practice serving a diverse patient population in the Philadelphia, PA, region. As active members of the team, MSAs are referred high-risk patients who have resource needs such as food, employment, child care, and transportation. MSAs work collaboratively with patients and the multidisciplinary team to address patients' nonmedical needs. Results: From August 2013 to August 2015, 31 osteopathic medical students volunteered for the MSA program and served 369 patients with 720 identified needs. Faculty and participating medical students report that the MSA program provided an enhanced understanding of the holistic nature of patient care and a comprehensive view of patient needs. Conclusion: The MSA program provides students with a unique educational opportunity that encompasses early exposure to patient interaction, social determinants of health, population health, and interdisciplinary collaboration. Students develop skills to help them build patient relationships, understand the psychosocial factors shaping health outcomes, and engage with other healthcare professionals. This work in the preclinical years provides students with the knowledge to help them perform more effectively in the changing healthcare environment. PMID:27046404