Weekly Updates: February 18, 2013

By admin3

From the Director

Glad to see the "snowstorm" didn't dampen the amazing efforts at the 2013 Charity Auction! A huge thanks to Carling Ursem, Marianna Papademitriou, Jen Chung, Laura Caputo and Meredith Clement for planning and executing a spectacular event. Randy and Erin were huge helpers as well!  Between the silent auction and the live auction (with our favorite emcee Dr. G!) we raised over $17,000 to benefit Senior PharmAssist and the DOC patient fund. And Jason is bald to show for it! We had a great talk this week by Dr. Jessie Gaeta, who works for the Boston Healthcare for the Homeless.  If you are interested in contributing to the efforts to care for homeless individuals in Durham, please contact Larry Greenblatt. Thanks to everyone who joined us for watching Duke v UNC at Motorco! An ugly game, with a good result. We will be gearing up for March to be MiniCEx month.  Stay tuned for details.  Also thanks to our most recent ACRs...Newton Wiggins, Coral Day and Kathleen Kiernan.  Also congrats to SAR Jason Watts on his engagement! This week's pubmed from the program goes to Carling Ursem for her upcoming presentation at ASCO..."disparities in Breast Cancer Presentation and Treatment of Older Women, By Insurance Status", with mentor Gretchen Kimmick. Have a great week! Aimee [box]

What did I read this week (submitted by Dr. Jane Gagliardi)

EHRs: "Sloppy and paste" endures despite patient safety risk    [/box] On a busy Gen Med service this week, mostly I have read a lot of progress notes and patient medical records...and I have seen quite a bit of copying and pasting. It just so happens that over the last year, I have been increasingly passionate about this patient safety / quality issue that also turns out to be an education issue.  It turns out that there is evidence from cognitive processing theory that copying and pasting does not invoke or promote higher-level cognitive function.  From my position as Clerkship Director and as a medical educator in general, I am concerned that copying and pasting is detrimental not only to patient safety and quality of care, but also to the very process of learning.  How is a learner to figure out how to prioritize medical problems when the list is merely copied into the note rather than carefully considered and prioritized?  How do we know anyone has actually looked at those labs that are automatically incorporated into the complex progress notes? Almost a year ago I proposed disabling the "paste" function in the electronic medical record in the Duke University Health System.  I believe hospital leadership would have considered my proposal more seriously if not for the implementation of Maestro, a process that already had healthcare providers anxious about their efficiency and productivity. I wonder, though: what good is efficiency and productivity if patient care is not being accomplished accurately and thoroughly?  I myself refrain from copying and pasting in the medical record, but my own work has been reproduced...almost "going viral," as it were: I have rotated off clinical service only to find my very own assessments and plans copied verbatim for the subsequent 3, 4, 5 or even 10 days the patient is hospitalized.  There is nothing like showing up on Monday morning and seeing that the surgical procedure happened "yesterday" -- when, in fact, it actually took place, say, two Thursdays ago. The article I read this week was sent to me by medical librarian Connie Schardt, who co-directs the medical student Evidence-Based Medicine course with me and who is well aware of my dissatisfaction with copying and pasting.  She sent me the following article: EHRs: "Sloppy and paste" endures despite patient safety risk.  Written by Kevin O'Reilly, it can be found at http://www.ama-assn.org/amednews/2013/02/04/prl20204.htm I recognize that this article is something of a "newsflash" from a throwaway, but I like that it illustrates some obvious, common-sense concerns about copying and pasting in the medical record and also includes links at the end to some interesting articles addressing the same issue. I hope all of us will take a few minutes to think about what cost this widespread practice is having on the quality of our patient care...and our own learning. [divider]

From the Chief Residents

Grand Rounds

Date Speaker Title
22-Feb-13 Chief Residents Trivia Bowl

Noon Conference

Day Date Topic Lecturer Time Vendor
Monday 2/18 Evidence-Based   Hyperlipidemia Management Daniella Zipkin 12:00 The Picnic Basket
Tuesday 2/19 SAR   talks Krishn   Sharma, Jason Watts 12:00 Sushi
Wednesday 2/20 Heparin Induced Thrombocytopenia Gowthami Arepally 12:00 Rudino's
Thursday 2/21 SAR talks Newton   Wiggins,  Jon Menachem 12:00 Domino's
Friday 2/22 Medicine Research Conference David   Hsu, MD PhD 12:00 Panera

Trivia Night (Submitted by the Rankin Stead Society)

The Rankin Stead Society invites all Medicine residents, regardless of Stead group, to a special Trivia Night to be held on Wed, Feb 20, at the Carolina Ale House (3911 Durham-Chapel Hill Blvd).  The event will benefit a charity chosen by the Stead society that musters the highest trivia score.  The Stead groups will begin forming tables at 7pm and will cover your food and drink for the evening.  Trivia starts at 8pm.  To the highest scoring Stead team, we will provide $200 to donate to their local charity of choice.  Please come out and have fun for a good cause!

Informational session on Fellowship Programs

Dr. Aimee Zaas and Dr. Bill Hargett will be leading an informational session on Fellowship Programs and the application process.  Important information and insights will be shared and it is a great opportunity for anyone who is interested in applying for Fellowship! Tuesday, Feb. 19th 5:30 – 6:30 p.m. Tuesday, Feb. 26th 5:30 - 6:30 p.m. Both sessions will be held in the MedRes Library and they are the same, so you should only plan on attending one. [divider]

From the Residency Office

Maestro Training

The Med Res Office is working hard to get everyone who needs Maestro training slotted into the schedule.  It is likely that you will receive an email generated by the training system as slots are filled.  Please retain this for your records, but in addition, your training dates will be added in to Amion/MedHub as well.

GME Month – Week 3!

PC Hand's On – End of Year Transitions

Tuesday, February 19th, 1pm AND 2pm, M410 Green Zone

Healthcare Reform - Presented by Kevin Schulman, MD

Thursday, February 21st, 6pm – 7:30pm, Medical Center Board Room

Kevin Schulman, MD, MBA  is a Professor of Medicine and the Gregory & Jeremy Mario Professor of Business Administration.  Dr. Schulman will address the latest in healthcare reform and the unresolved issues of:  access to care, the cost of health care and the sustainability of Federal entitlement programs (Medicare and Medicaid).

Now & Later: The Problem with Self Control - Presented by Dan Ariely

Friday, February 22nd, 7am – 8am, Duke North 2003

Dr. Ariely is the James B. Duke Professor of Behavioral Economics.  One of the challenges of human life is that what is good for us right now is often not what is good for us in the long term.  Dieting for example is not so much fun now, but good for the future, saving is not fun now but good for the future… medical testing, procrastination etc.   When we face such tradeoffs we often focus on the short term rather than our long terms goals and in the process get ourselves into trouble.   But wait!  There is hope.  By understanding where we fall short, there are methods we can use to overcome our natural (and less than desirable) inclinations.

(The TLA Workshop scheduled for Monday, February 18th has been cancelled. We apologize for any inconvenience.)

For additional information and registration, visit the GME Webpage and log in at:

https://gme.duke.edu/gme-month-february-2013

Trainees are eligible to enter a raffle for two tickets to the Duke vs Miami basketball game on March 2nd at 6 pm.  Names will be entered into the drawing once for EACH GME Month event they attend.

Dynamed (submitted by Daniel Ostrovsky, MD)

The Senior Editor of Dynamed has provided me a link to share with those colleagues who use the resource and miss its presence.  The link takes you directly to the Dynamed search page.  This link will work until 7/1/2012.  Please enjoy this with no strings attached, and feel free to share this link with anyone who might appreciate the resource. http://search.ebscohost.com/login.aspx?authtype=uid&group=dynamed&profile=dynamed&user=duke&password=dynamed However, if you agree that this is a resource worth having and you think it should be reconsidered as the library looks to allocate its expenditures, I would appreciate if you could send an email in support of Dynamed to Pat Thibodeau ( patricia.thibodeau@duke.edu ) Associate Dean for Library Services as well as Thomas Owens ( Thomas.Owens@duke.edu ) CMO, DUHS.  Again, you are in no way obligated to do this, but it might help, and I don't know if I will be able to get an extension on the free link! Daniel A. Ostrovsky, MD Assistant Professor of  Medicine and Pediatrics

Contact Information/Opportunities

MS Gulf Coast, IM Div of Pharmacoepi GIM Fellow Ad - 2013  

Upcoming Dates and Events

  • February 19 and 26:  Informational session on Fellowship Programs (5:30, Med Res Library)
  • February 20:  Trivia Night, 7:00 at the Carolina Ale House (hosted by the Rankin Stead Society)
  • March 12 & 19:  Duke Medical Oncology fellowship discussions, 4:00, Med Res Library
  • March 15:  MATCH DAY CELEBRATION at Dr.  Klotman’s!
  • March 25-28:  BLS Blitz  (registration:  blsblitz )
  • March 29:  Faculty Resident Research Grant Application Deadline
  • April 19:  Residency Program Pictures (rain date April 26)
  • April 28:  2nd Annual Stead Tread
  • June 4:  Resident Research Conference, Searle Center
  • June 8:  SAR Dinner, Hope Valley Country Club

Useful links

 

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