Chapters authored
The Importance of Post-Doctoral Program to GME in an Academic Medical Center
Continuous advancements in the medical field and the need to promote scientific evidence has increased the concern for educators to ensure that physician trainees are provided with the appropriate tools and experiences to develop the skills necessary to enhance scientific discovery. To address this requirement, the Accreditation Council for Graduate Medical Education (ACGME) implemented core competencies, inclusive of scholarly activity requirements, for accreditation of Graduate Medical Education (GME) programs. These changes have challenged institutions to educate differently and incorporate scholarly activity and research into their curriculum through novel and creative approaches. One such mechanism is the development of post-doctoral research programs which utilize research fellows to provide the necessary support for research productivity across multiple specialties. In the following chapter, the authors will provide some background information on the goals and function of the ACGME, detail the development of the new research requirements, the utilization of post-doctoral research fellows to support the scholarly activity requirement laid out by the ACGME, and potential measures of performance and success.
Part of the book: Contemporary Topics in Graduate Medical Education
Dangers of Peripheral Intravenous Catheterization: The Forgotten Tourniquet and Other Patient Safety Considerations
Intravenous catheterization is a widely used invasive procedure, with applications in both ambulatory and hospital settings. Due to its inherently invasive nature, intravenous (IV) therapy is associated with a number of potential complications, many of which are directly relevant to patient safety (PS). PIV-related morbidity may be due to mechanical or nonmechanical factors. The most frequent nonmechanical peripheral venous catheterization adverse events (PVCAEs) include insertion site pain, phlebitis, hematoma formation, and infusate extravasation. The most common mechanical PVCAE is catheter obstruction/occlusion and dislodgement. Significant complications can also occur with the administration of incorrect type or wrong amount of IV fluids. Moreover, simultaneous infusion of incompatible medications can result in infusate precipitation. Finally, less frequent but significant complications have been reported, including bloodstream and local infections, air embolization, nerve damage, arterial puncture, skin necrosis associated with vasopressor infusions, and limb-threatening forgotten tourniquet events. Taken together, the above complications can lead to substantial patient discomfort, unnecessary or prolonged hospitalization, increased costs, and additional downstream morbidity. Efforts to prevent PVCAEs and improve patient outcomes should involve thorough provider education, clinical vigilance by all involved healthcare providers, health service level strategies, as well as the proactive participation of all stakeholders, including patients and their families.
Part of the book: Vignettes in Patient Safety
Starting New Accreditation Council for Graduate Medical Education (ACGME) Residency Programs in a Teaching Hospital
Starting a new ACGME approved residency program can positively impact patient care, medical education, hospital operations, and the community as whole. This requires a significant amount of commitment, time, and preparation. The initial application and accreditation process should start early and requires a thorough understanding on the ACGME requirements. Building a new residency program involves collaboration among various stakeholders, starting with the teaching hospital, ACGME, and the Center of Medicare and Medicaid services (CMS). It is prudent to also consider the operational and logistical issues such as budget, faculty and administrative staff hire, faculty time for administrative duties, and educational space for faculty and residents. It is vital to recognize how the institution’s strengths and weaknesses match up to these requirements. A robust educational and clinical curriculum in line with ACGME’s core competencies and useful educational collaboration among various programs is critical for effective program. Recruiting and developing the appropriate faculty members is another important aspect for a successful program. The final challenge is recruiting residents that will fit well into the new residency program. Lastly, we discuss the challenges and tips to mitigate the risks of disappointment in the process of starting and creating a flagship residency program.
Part of the book: Contemporary Topics in Graduate Medical Education
Patient Safety: Preventing Patient Harm and Building Capacity for Patient Safety
Patient safety is a global public health concern. It is a health care discipline with ever evolving advancement and complexity resulting in consequential rise in patient harm. Since the pandemic, patient safety has been threatened even more by laying bare the inadequacies of health systems. Many unsafe care practices, risks, and errors contribute to patient harm and overall economic burden. These include medical, diagnostic, and radiation errors, healthcare associated infections, unsafe surgical procedures and transfusion practices, sepsis, venous thromboembolism, and falls. Although patient safety has become an integral part of the healthcare delivery model and resources have been dedicated towards it, much still needs to be achieved. An attitude of inclusivity for all care teams and anyone in contact with the patient, including the patients themselves, would enhance patient safety. Incorporating this attitude from educational infancy will allow for better identification of medical errors and inculcate critical analysis of process improvement. Implementing the ‘Just Culture’ by health care organizations can build the infrastructure to eliminate avoidable harm. To reduce avoidable harm and improve safety, a constant flow of information and knowledge should be available to mitigate the risks. Lastly, proper communication and effective leadership can play an imperative role to engage stakeholders and reduce harm.
Part of the book: Contemporary Topics in Patient Safety
Unlocking the Potential of Artificial Intelligence (AI) for Healthcare
View all chaptersThis book chapter examines the potential of artificial intelligence (AI) to improve healthcare. AI has become increasingly prominent in healthcare, providing the capability to automate tasks, analyze large patient data sets, and deliver quicker and more cost-effective healthcare. We focus on its various applications in healthcare including vital sign monitoring, glycemic control, radiology, and emergency room triage with point of care ultrasound (POCUS). We also address Ai’s ethical, legal, and privacy implications in healthcare such as data protection and safeguarding patient privacy. Finally, we explore the potential of AI in healthcare improvement in the future and investigate the current trends, opportunities, and evolving threats posed by AI in healthcare, as well as its implications for human-AI interfacing and job security. This book chapter provides an essential and comprehensive overview of the potential of AI in healthcare, providing a valuable resource for healthcare professionals and researchers in the field.
Part of the book: Artificial Intelligence in Medicine and Surgery