From the Director
It’s the end of Doctoberfest, and the start of November! Or Mo-vember for those who plan on supporting Men’s Health through fundraising and the growth of cheesy facial hair (or thinking about it, fearless chief Hostler!) Thank you for your participation in Doctoberfest, from trivia to We Care Wednesdays to nominating your colleagues for caring awards..great month overall. Looking forward to sending our donations to the charities of YOUR choice.
RECRUITMENT is underway! Thank you to all who are giving tours, hanging out, doing ‘MyTake’, going to dinners and generally schmoozing with the applicants. They really do come here for you, so I am very excited to show off how amazing our Duke family is.
Great turnout at the first Zaas House Party. Many thanks to Madi, Jen and Lynsey for their amazing planning, set up, clean up, etc. And for those who had to work, there was fun as well (See attached picture for Halloween Night Float). And kudos to those who ‘took one for the team’ by being on call for ‘Fall Back’ extra hour night.
What else is going on? Check MedHub for your ITE scores – advisors will discuss with you at your upcoming meetings. For SARs, ABIM registration is just around the corner as well.
It is getting closer and closer to Turkeybowl. Good news is that we can hire the refs from the Duke game as I hear they have some time on their hands. Both the Jets and the Marines are currently practicing the 8 laterals, knee down touchdown play as we speak.
This week’s pubmed from the program goes to Marc Samsky for his paper “Liver function tests in patients with acute heart failure and associated outcomes: Insights from ASCEND-HF
European Journal of Heart Failure” accepted to the European Journal of Heart Failure
Congratulations to Jonathan Buggey and his wife on the birth of Avery Harper Buggey, 6lbs 10oz!!
Have a great week!
Aimee
What did I read this week?
Submitted by: Dr. Christopher Hostler
Giroir BP and GR Wilensky. Reforming the Veterans Health Administration – beyond palliation of symptoms. NEJM 2015; 373: 1693-1695.
Cameron has moved on from Goodnight, Goodnight, Construction Site much to my chagrin (I’ve grown quite accustomed to seeing the excavator’s smiling face every night), so I decided to read an actual article from some journal about medicine from New England. With Veteran’s Day around the corner, I felt it appropriate to discuss the NEJM’s recent article from Health Policy Institute at Texas Medical Center entitled “Reforming the Veterans Health Administration – Beyond Palliation of Symptoms,” as this article outlines some of the changes that will be coming down the pipe over the next several years at VA.
For those of you who haven’t been living off the grid for the last several years, you’ve probably heard about the nationwide waitlist issues and administrative shenanigans that have colored the public’s view of VA care. While some of the issues are naturally sensationalized, there is no doubt that significant problems were brought to the forefront. In the beginning of September, an independent investigative panel issued their report to Secretary of VA Bob McDonald which recommended several areas of improvement including providing more exam rooms, increasing staff:patient ratios, eliminating administrative silos, and granting greater authority to service chiefs over the management of their resources. This article notes that these changes don’t go far enough and recommends some additional changes, many of which we’re already seeing at VA. For example, HPI recommends updating our EMR to provide greater connectivity across all aspects of medical care. I know, I know, I too am hesitant to move away from CPRS (say what you will, but it is a powerful if barebones EMR). While I doubt CPRS is going anywhere anytime soon, the Department of Defense did just contract with Cerner, Leidos, and Accenture to update their own medical record system and given the push to provide greater connectivity between DoD and VA, I wouldn’t be surprised if the VA moved towards a commercially available system over the next decade.
Another change recommended by HPI is a movement towards providing more outpatient than inpatient care for our veterans. The majority of veterans enrolled in VA health care receive less than half of their care from VA, so the age-old concept of VA providing comprehensive health care has gone by the wayside for some. Those of you who have clinic at the VA may have heard about the Choice program, where essentially VA is farming out outpatient subspecialty care to the community for veterans for whom we cannot provide timely care. The great thing about this program is that it relieves some of the pressure from the VA system to provide all resources for our veterans while ensuring that we get records of their outpatient care (this will be required for reimbursement).
What I took away from this article is that VA has identified some of the problems that led up to appropriately poor press it received a few years ago, and appears to be making changes to correct those problems. We’ll see how successful these changes are over the next few years, but I’m confident that we’ll continue to adapt in order to provide the very best for those who have given their all in service to this country.
Thanks!
Chris
QI CORNER
Mark your calendars! The next meeting of the Patient Safety and Quality Committee is NEXT week on Thursday 11/12 at 5:30pm. Even if you've never made it to PSQC before, this will be a great meeting for you to join in as we hit the ground running on our very exciting council-wide QI project: We are tackling PAGING CULTURE!
The good...the glory of receiving a perfect text page with ALL the information you need
The bad...do you hear that HUC desk hold music in your sleep??
The ugly...that 7-digit numeric page you assumed couldn't be important? Oh yeah, your patient's coding.
With the full-blown support of Dr. Klotman and the Department of Medicine, we are building on prior work by several of our talented residents and hospitalists to design and implement real change. We are so excited to be doing a QI project that will touch each and every one of our daily lives here at work. So we hope you'll join us! Mark your calendars now:
PSQC meeting on PAGING
Thursday 11/12 at 5:30pm
Food provided!
CLINIC CORNER
This feature will return next week!
From the Chief Residents
Grand Rounds
Friday, November 6 - Rheumatology, Dr. Ankoor Shah
Noon Conference
| Date | Topic | Lecturer | Time | Vendor |
| 11/2/15 |
Recruitment-Lunch with Applicants |
|
12:00 | Nosh |
| 11/3/15 | MPeds Recruitment-Lunch with Applicants | Saladelia | ||
| 11/4/15 |
Building Wellness |
Jon Seskevich |
12:00 | China King |
| 11/5/15 |
PFT Interpretation |
Armando Bedoya |
12:00 | Mediterra |
| 11/6/15 |
Recruitment-Lunch with Applicants |
12:00 | Jason's Deli |
From the Residency Office
Subway coming to Duke Hospital Cafeteria!
RE: Construction of New Subway Store in Duke North Atrium Dining Room
DATE: 22 October 2015
In an effort to enhance our food services to the Duke family, we are excited to announce that we will be constructing a new Subway Store in the Duke North Atrium dining room. Construction begins on October 26 in our existing dining room seating space, located at the back wall of the Starbucks store in Duke North. As this project gets under way, construction barricades and walls will displace some of the current seating area. Please remember that additional seating is available outside the cafeteria in the long concourse leading to the Duke Medicine Pavilion.
It is anticipated that the project will be completed by the end of January 2016. When completed, the new Subway Store will be open 24 hours-per-day, seven days-per-week and offer a variety of hot and cold foods.
We understand that the Duke community may be inconvenienced throughout the duration of this project and we truly appreciate your patience as we continue to improve food services for our patients, their loved ones and each other.
Attention Medicine Residents!
We're excited to announce our next Department of Medicine book club event will be held on Wednesday, Dec. 2nd from 5:30 - 7:30 pm in the Searle Center Faculty Lounge. This time we'll be reading Abraham Verghese's book, Cutting for Stone, an award-winning novel about the orphaned twin children of a surgeon and his assistant in a war-torn Ethiopia, and how love, medicine, and family impact their decisions and lives.
As always, we have a limited number of copies available to those who would like to attend the event. If you are interested in attending, please email Laura Caputo at laura.caputo@duke.edu to reserve your copy while supplies last. We're excited to see you there!
BLS Blitz - November 2015
Just a reminder that the bi-annual BLS Blitz is coming up in November. The flier posted at the end of this blog has the dates. REMEMBER - Duke only holds BLS classes during the November and March blitz each yer, so if your BLS is expiring before March, PLEASE sign up for one of the dates in November!!
2015 Carolinas COPD Symposium
When: November 20th, 2015
Location: Cone Center, UNC Charlotte; Charlotte, NC
Registration Link: https://continuingeducation.dcri.duke.edu/2015-carolinas-chronic-obstructive-pulmonary-disease-copd-symposium
Cost: $50 for Healthcare Providers; $25 for Public Health Practitioners
Event Contacts: For registration questions, please contact dcri.cme@dm.duke.edu or 919‐401‐1200. For program questions,
please contact Roy Pleasants at roy.pleasants@duke.edu
Annual Call for New Ideas
The Journal of Graduate Medical Education is seeking brief articles on novel ideas in curricula, teaching, assessment, quality and safety, program evaluation, or other topics relevant to graduate medical education. Selected papers will be published in the July 2016 issue.
Criteria
New Ideas must describe an intervention that is novel.
The intervention must have been implemented at least once; longer implementation is preferable. While outcomes data may be preliminary; feasibility (effort, costs) and acceptability (to subjects) must be discussed.
Preliminary evidence should suggest the intervention is successful.
The intervention can be replicated in other specialties.
New Ideas manuscripts must
Follow required manuscript format
No more than 650 words
Organized into 3 parts:
Setting and Problem
Intervention (the “New Idea”)
Outcomes to Date
May include 1 figure or table
Descriptions should not include a literature review or references
Be submitted via the online editorial management system by 8:00 am CT, Monday, November 16, 2015.
Acceptance decisions will be communicated by January 31, 2016.
NOTES:
Due to the brevity of these submissions, manuscripts that are not accepted will not receive editor comments.
Manuscripts not following the required submission format and/or submission deadline will not be considered.
If you have additional questions, please contact the Journal office.
Opportunities for Wellness
Feeling down? Need to talk to someone?
All trainees at Duke have FREE access to Personal Assistance Services (PAS), which is the faculty/employee assistance program of Duke University. The staff of licensed professionals offer confidential assessment, short-term counseling, and referrals to help resolve a range of personal, work, and family problems. PAS services are available free of charge to Duke faculty and staff, and their immediate family members. An appointment to meet with a PAS counselor may be arranged by calling the PAS office at 919-416-1PAS (919-416-1727), Monday through Friday between 8:00 A.M. and 5:00 P.M. For assistance after hours, residents and fellows can call the Blood and Body Fluid Hotline (115 inside DUH, 919-684-1115 outside) for referral to behavioral health resources. Another resource is Duke Outpatient Psychiatry Referrals at (919) 684-0100 or 1-888-ASK-DUKE.
https://www.hr.duke.edu/pas/
Upcoming Dates and Events
November 26 - Turkey Bowl
December 12 - DOM Holiday Party
Useful links
https://intranet.dm.duke.edu/influenza/SitePages/Home.aspx
http://duke.exitcareoncall.com/
Main Internal Medicine Residency website
Main Curriculum website
Department of Medicine
Confidential Comment Line Note: ALL submissions are strictly confidential unless you chose to complete the optional section requesting a response
Opportunities
www.bidmc.org/CentersandDepartments/Departments/BIDHC
http://www.careermd.com/employers/latestbulletins.aspx