From the Director
Hi everyone,
What a great week! Loving Doctoberfest! And thanks for answering the questions...more to come this week. Plus, our winners from the last question will be announced tonight.
First, a belated thanks to our chiefs,
Jeff, Jason, and Nicole as well as
Larry Greenblatt and Julia Gamble for organizing the group to go the
DBAP for Durham's project homeless connect. It's a great event and we are proud that the following residents were able to participate:
Ivan Harnden, Mandy George, Carter Davis, and Lindsay Boole.
A star went this week for patient care to intern
Laura Musselwhite! Great job. I also heard kudos about
Iris Vance from pulmonary, and also to
Kevin Trulock and Alex Fanaroff for great work at the VA. Keep sending these to me...I know you are all working hard and doing great things.
Also, thanks to the
Klotmans for hosting a fun night on Friday - it was a good opportunity to mingle with division chiefs, fellowship directors, and you and your significant others! We look forward to inviting ourselves over again.
Last, glad to see everyone out and about on a nice fall weekend.
Kevin Parrott was off kicking butt in a triathlon. Some of us watched the awesome Duke - UNC game (great intern turnout spotted at the game), and this morning I got to see
Meredith Edwards, Carling Ursem and the "
Mrs Kevin Shah" (Kevin, don't kill me for that.
Brian Miller, stop laughing) running the
rambling rose women's half Marathon. Also spotted were
Carissa from 8300,
Cecily Peterson and Hope Uronis. Great job everyone.
This week's pubmed from the program goes to
Laura Musselwhite! (
Shared monocyte subset phenotypes in HIV-1 infection and in uninfected subjects with acute coronary syndromes. )Funderburg NT,
Zidar DA, Shive C, Lioi A, Mudd J,
Musselwhite LW, Simon DI, Costa MA, Rodriguez B, Sieg SF, Lederman MM. Blood. 2012 Oct 11. Great work.
David Zidar, a co author,was a former cards fellow here, and my co-resident.
Have a great week. Bring in those stuffed animals, sign up for tours and dinners! See. You at the kickoff on Thursday!
Aimee
QI Corner (by George Cheely, Jr, MD)
As the battle for Erwin Road heats up between the Marines and the Jets, so does the news about our fight for quality!
Getting our Knowledge on about Patient Centered Care
Tiffany Christensen will speak about patient advocacy at Duke for the 10/24/12 QI Noon Conference. Please note, food fighting is not part of the Quality fight. Unless there is pudding for lunch.
Stamping out disease with vaccinations
Vaccinations ARE part of the Quality fight. And we're rockin'. It took us until December to hit 100% as a program last year, but we're on pace to shatter that mark. Awesome job!
Boosting morale with 3GT
This week concluded our 14 days of 3 Good Things. Thanks to all who stuck with us through and through. We laughed. We cried. We celebrated the glory of the pumpkin. The Chiefs and Program Directors swapped 3GTs nightly. The wordle from those emails is below:
Aligning priorities with the hospital through GME Incentives
We knew CA-UTI was a pretty aggressive target from the outset, but we're still satisfying patients (HCAHPS) and providing excellent Evidence-Based Care with the best of 'em. **
Trainee Performance Incentive Plan
Monitoring our own performance through OUR balanced scorecard
To our knowledge, we're the only program with a BSC (a monthly update on how we're doing on a few select measures)! These are measures that are important to us as a program and that we'd like to improve--if you'd like to see other measures just email George, Ryan, or Jon. **
Balanced Score Card
** Color Scheme Primer (or why we love Blue): Red = below the median for our peer hospitals, Yellow = between the median and the top quartile for our peer hospitals, Green = between the top quartile and the top decile for our peer hospitals, and Blue = above the top decile for our peer hospitals **
What Did I Read This Week (by Aimee Zaas, MD)
[box] Perioperative Mischief: the price of academic misconduct by Vineet Chopra and Kim Eagle. AJM October 2012; vol 125 ; 953-55 [/box]
Why did I read this: the title was very interesting and I am hoping to find ways to get you all more experience with peri operative care.
What did I learn: the main researcher who set into motion the practice of peri op beta blockade was discredited. There is great commentary in the article about the "tsunami" effect of bad data spawning more trials and directing others research. Also, about our willingness to push evidence into areas that it maybe doesn't belong (such as beta blockade in non cardiac surgery). So, lots of risk and downsides.
So, what do we do?. The authors recommend:
1. Use peri op beta blockers in cardiac surgery for pts with known cardiac disease who are already on therapy or or those with documented ischemia facing high risk surgery.
2. Start early if you are going to start...I.e weeks before and titrate.
3. Improve our oversight of trials
An interesting short editorial, but one that we should be aware of.
[hr]
From the Chief Residents
Grand Rounds
| Date |
Division |
Speaker |
Title |
| 26-Oct-12 |
Gastroenterology |
Dr. Joanne Wilson |
GI Disorders Women/IBS |
Noon Conference
| Day |
Date |
Topic |
Lecturer |
Time |
Vendor |
Room |
| Monday |
10/22 |
Cognitive Analysis |
David Gordon |
12:00 |
The Pita Pit |
2002 |
| Tuesday |
10/23 |
Blood Smears |
Murat Arcasoy |
12:00 |
Bullock's BBQ |
2002 |
| Wednesday |
10/24 |
QI/Patient Safety Conference |
Jon Bae |
12:00 |
Chick-fil-A |
2002 |
| Thursday |
10/25 |
Acute Liver Failure |
Alastair Smith |
12:00 |
Papa John's |
2001 |
| Friday |
10/26 |
Research Conference |
Chiefs |
12:00 |
Panera Bread |
2002 |
Turkey Bowl Practice
Time and place for practice each week: Sunday @ 330 at Forest Hills Park.
Halloween Party (submitted by Nick Rohrhoff, MD)
Join us for the Halloween Party on Friday 10.26.12 at West End Wine Bar, 601 West Main St. #East in Downtown Durham! Hosted by the Intern Class Council so you can plan on food, fun and frights. Costumes are required for entry, VA Badges are not. See you there! [divider]
From the Residency Office
DoctoberFest:
Thanks for Giving Me a Name!
"I am writing from my secure bunker, somewhere deep within an undisclosed location, to share with you all that I have officially been granted approval by my captors to use my new name. By popular vote - and dispensation by program leadership - you may address me as
Mr. Human Genome".
Now, if I could be granted one wish - PLEASE release me so that I too can celebrate with my beloved Dukee's after the AWESOME game last night. GO DUKE !!
Stuffed Animal and Baby Blanket Drive – 10/22-10/31 (submitted by Human Genome)
Now that I have a name, PLEASE help me by collecting stuffed animal and baby blanket donations for patients of the Duke NICU and their families. We will also accept cash donations that will be used to purchase new baby blankets and stuffed animals. Please bring all donations to the MedRes Office (Duke North, Room 8254) no later than
October 31st. We can accept only
new stuffed animals, but we can take new and
gently used baby blankets.
Thank you for your help for this wonderful cause!
Recruitment Kick off at Tylers next Thursday evening at 6:30pm!!
There will be a special debut video displayed that was created this week highlighting our program; we are all very excited to see the final product. This is a great opportunity to spread enthusiasm and excitement about the next three months of recruitment! Please make sure you have responded to your evite !
DINNER SIGN-UPS: We are still in need of a few interns, drivers, partners, and residents in general to sign up for recruitment dinners the month of November! These dinners are extremely important and are an incredible opportunity for the applicants to see if they connect with the culture of our program. Also, you get a delicious and free meal, does it get any better?
We greatly appreciate all who have already signed up! Please note that an open line means an open spot. If the Intern spaces have already been filled, you are more than welcome to sign up on any of the resident lines. Also, if you wish to bring a partner or spouse, just make sure to write their name on a separate line. If you have any questions or you want to sign up but can’t make it over, please simply email or call Erin at 919.681.146
TOURS: Tours are another vital part of each recruitment day! We now have sign-up sheets posted in the main office along with the dinner sign-up sheets. We will need 6 residents who are willing to give a tour each day. Again, an ENORMOUS THANK YOU for your willingness to be a part of such an important season. We can’t do this without your help!
Stead Groups - What You May Not Know:
This week we are highlighting the Smith Society, which is led by
Susanna Naggie, MD.
Our Stead Society is named after
Dr. David Smith (known as DT to his friends and colleagues); born in SC in1898 he started medical school at Johns Hopkins School of Medicine in 1918; when the great influenza epidemic struck Baltimore later that year classes were dismissed so that the students could fill in for physicians due to the high rate of illness in first responders including physicians. He completed his medical degree in 1922 and completed an internship in pediatrics at JHU before taking a job as a research assistant at the Rockefeller Institute of Medical Research. While in NYC Dr. Smith developed pulmonary hemorrhage from pulmonary tuberculosis, an infection that would later define his career.
In 1930 Dr. Davison (who instructed Dr. Smith in Pediatrics at JHU) would recruit Dr. Smith to Duke to take two jobs: Professor of Bacteriology and Associate Professor of Medicine. He attended regularly on the wards and consulted in pulmonary medicine, infectious diseases and nutritionaldiseases. He served as the acting Chairman of Medicine when Drs. Amoss and Frederic Hanes were traveling. He developed national recognition in tuberculosis, fungology, actinomycoses, and pellagra (research that he did in collaboration with his wife (Susan Gower Smith who was a Chemist by training, they discovered that niacin cured pellagra once a leading killer in the south). He was the first Chairman of Microbiology at Duke and was also the Chairman of the Department of Preventative Medicine. He is the original author of the medical mycologists "bible" Zinsser's Textbook of Bacteriology. He died in 1981 of an AMI, the last surviving member of the medical school's original group of departmental chairmen.
The Smith Society had a great showing for their first meeting, introducing our new interns to the Stead Society goals and our community service project. The Smith Society under the leadership of
Tara Weiselberg, Lauren Prats, and Scott Westphal has embarked on leading what we hope will be a longstanding relationship with the
City of Medicine Academy (CMA).
Tara is heading up the educational series of assemblies run by our fantastic housestaff on health related topics including “What’s wrong with the American Diet” and “Debunking Myths about HIV”. Although this is a huge undertaking that requires ongoing commitment from our program and our housestaff we are confident that a program like Duke can make it happen.
Scott is leading the mentoring and shadowing experience, which will include 8 CMA students per year. Each student will be paired with a Duke IM houseofficer to provide mentoring on career decision-making including decisions on college prep.
Lauren has been our go-to for other requests that come from students who have specific interests or projects. She recently helped two students, who had an interest in learning more about sickle cell anemia as part of a project for their AP Biology course by reaching out to
Dr. Laura DeCastro. Below is an email from the students after their visit. I believe this shows just how much impact we can have on this highly motivated group of students. The educational piece is really creative and the trailer for the coming documentary is touching. Please Enjoy and Please Participate when our housestaff leaders reach out for your involvement!! This initiative will only be successful if everyone pitches in.
Hello All! In my AP Biology class we were given the task to chose a genetic disorder and create an awareness campaign for it. My group (Toni M., Autumn B.) and I have decided to do a documentary! We started this journey nearly a month ago and now our final product is near! We have posted our public educational piece on Sickle Cell Disease, as well as posted a Trailer as a sneak preview of our final product- the documentary.
You can check out the video links below or take a peek at my AP Biology blog chickkylee.blog.com!
Trailer: CMA Sickle Cell Disease Campaign Initiative Documentary
http://youtu.be/lthQ5p767oI
CMA Sickle Cell Awareness Campaign Initiative (Part 1: Educational Piece)
http://youtu.be/T40sZbkxmZM
A Game of Jeopardy: It's A Sickle Cell Affair!
http://www.superteachertools.com/jeopardy/usergames/Sep201239/game1348784970.php
Thanks for your support! We hope to make this a campaign that will not be forgotten.
Stay tuned for our documentary release! Alana Lee, Toni M., Autumn B.
I would also like to recognize several of our faculty/fellows who took the time to answer questions from CMA students about medical diseases in their subspecialties:
Matt Ellis, Sarah Rivelli, Amber Atwater, and Juliessa Pavon. Thank you!!
Using the North Carolina Tobacco Quitline Referral Program
The Duke University Office of Continuing Medical Education began an effort earlier this year to engage the Duke Medicine Residents in the use of the NC Tobacco Quitline. Various sites at Duke have also begun efforts to use the Quitline, including the Duke Outpatient Medicine Resident Clinic. As result of these and other efforts in the Duke University Health System, the number of Quitline referrals has increased
from 110 in fiscal year 2011 to 344 thus far this year.
Great success so far!! A number of national organizations, including CMS and Joint Commission, are beginning to require and/or encourage better documentation of tobacco dependence and cessation efforts. Smoking cessation is one of the most impactful preventative healthcare interventions.
Targeting tobacco dependence by inclusion in the patient’s problem list, engaging patients to quit tobacco, considering smoking cessation drug therapy, and referring to the Quitline are highly effective strategies to help users quit. The Quitline is a telephone-based counseling service, is offered by the NC Tobacco Prevention and Control Branch, is evidence-based, is free to patients, and typically doubles quit rates. After determining the patient is interested in stopping tobacco use, the provider has several choices to refer their patients to the NC Tobacco Quitline: 1) tell them to call 1-800-QUITNOW, 2) complete a fax referral form available from the NC Quitline (
http://www.quitlinenc.com/docs/general-information/fax-referral-form.pdf?sfvrsn=6) complete an electronic PDF version of the fax referral form that is available through the Duke CME Office (
http://cme.mc.duke.edu/wysiwyg/downloads/2010-FAX-REFERRAL-eFORM_022712_distributed.pdf). In contrast to telling the patient to call 1-800-QUITNOW, use of the fax or electronic referral will automatically lead to a trained Quitline Coach contacting the patient by telephone and provide multiple counseling sessions – in English or Spanish. Typically, the Quitline Coach will contact the patient within several days after the referral form is submitted.
Moonlighting Opportunities in the ER (submitted by Michael Hocker, MD, Chief Emergency Department)
The Emergency Department is offering a new opportunity for residents to moonlight in the ER. Below is a brief summary:
"We would like to offer overnight shifts (7p-7a) in the ED CEU (11 Bed Observation unit) at $104/hr. These would be available Monday through Friday starting November 01, 2012. In order to participate in this moonlighting opportunity, residents need to be in good standing, either be a SAR or a JAR who has rotated through ICU and passed step 3 or fellow, abide by duty hour rules, and complete a TMSA. Those who are accepted will need to have a brief but formal orientation by Dean Harrison (our lead PA) Massung, staff assistant in the Department, will act as the central scheduler and will keep track of hours."
AMPATH Grand Rounds: Building Innovative Academic Global Health Partnerships in Western Kenya – October 23rd
The Academic Model Providing Access to Healthcare (AMPATH) Consortium was initially established by Indiana University as a strategic global health partnership between North American Universities, Moi University, and Moi Teaching and Referral Hospital in Kenya. AMPATH’s mission of care, research, and education is embraced by institutions worldwide, who partner with the Moi Hospital and University, allowing the Kenyan leaders to draw upon the resources and talents of North American academic health institutions to tackle the challenges of disease and poverty.
Developing Academic Leaders in Global Health
The Global Health Residency Pathway offers Duke internal medicine residents the opportunity to broaden their training to address health disparities in a resource-poor setting.
We are currently soliciting applications from Internal Medicine Residents for enrollment in July 2013. Application deadline is November 1, 2012.
Please see attached flyer for eligibility and application process. You can also visit us on the
Global Health Residency Pathway website.
2012 Global Health Medicine flyer
Please contact me at
cecelia.pezdek@duke.edu or 919-668-5976 if you have any questions.
Dates to Add to Your Calendars /Contact Information/Opportunities
Oct 25 Recruiting Kick Off Event (Tylers)
December 1 DoM Holiday Party
Opportunities
IM Flyer 2012+
Internal Medicine 2012 j
Useful links
Now that I have a name, PLEASE help me by collecting stuffed animal and baby blanket donations for patients of the Duke NICU and their families. We will also accept cash donations that will be used to purchase new baby blankets and stuffed animals. Please bring all donations to the MedRes Office (Duke North, Room 8254) no later than October 31st. We can accept only new stuffed animals, but we can take new and gently used baby blankets.
Thank you for your help for this wonderful cause!
Our Stead Society is named after Dr. David Smith (known as DT to his friends and colleagues); born in SC in1898 he started medical school at Johns Hopkins School of Medicine in 1918; when the great influenza epidemic struck Baltimore later that year classes were dismissed so that the students could fill in for physicians due to the high rate of illness in first responders including physicians. He completed his medical degree in 1922 and completed an internship in pediatrics at JHU before taking a job as a research assistant at the Rockefeller Institute of Medical Research. While in NYC Dr. Smith developed pulmonary hemorrhage from pulmonary tuberculosis, an infection that would later define his career.
In 1930 Dr. Davison (who instructed Dr. Smith in Pediatrics at JHU) would recruit Dr. Smith to Duke to take two jobs: Professor of Bacteriology and Associate Professor of Medicine. He attended regularly on the wards and consulted in pulmonary medicine, infectious diseases and nutritionaldiseases. He served as the acting Chairman of Medicine when Drs. Amoss and Frederic Hanes were traveling. He developed national recognition in tuberculosis, fungology, actinomycoses, and pellagra (research that he did in collaboration with his wife (Susan Gower Smith who was a Chemist by training, they discovered that niacin cured pellagra once a leading killer in the south). He was the first Chairman of Microbiology at Duke and was also the Chairman of the Department of Preventative Medicine. He is the original author of the medical mycologists "bible" Zinsser's Textbook of Bacteriology. He died in 1981 of an AMI, the last surviving member of the medical school's original group of departmental chairmen.