Monday, May 22, 2017

UVA-VCU Clinical Case Conference Spring 2017

Today we had the pleasure of visiting the University of Virginia for our combined spring clinical case conference. The previous case conference, in the Fall of 2016, was hosted at VCU. Today's event was at the Colonnade Club of the University  of  Virginia.

The topics of the day: Leishmaniasis in an immigrant (VCU) and Listeriosis in an immunocompromised patient (UVA).

The purpose? To share cases, engage in clinical discussion, meet colleagues and learn something new. Perfect.

A few images from earlier today are below.

Dr. Scott Anderson- VCU

Colonnade Club

The Rotunda- University of Virginia

Thursday, May 18, 2017

Pagers vs Smartphones: Which One is Superior?

How would you rather be contacted for clinical matters? By pager or directly to your smartphone?

This intriguing article suggests that direct clinical communication by dedicated smartphone, rather than pager, resulted in quicker response and intervention times by the residents .  The study did not assess clinical outcomes.

This all sounds fine and well, particularly in this age of  hyper-availability and hyper-responsiveness.

As we move towards more consult requests via smartphones, I just do not want to get messages in text speak! " R U available 4 Sepsis Cnslt?"


As some suggest, in this NY Times article, U can't talk to Ur professor like this.

Friday, May 12, 2017

Congratulations Nadia Masroor and Dr. Dan Markley- Newly Minted Master of Public Health Graduates

Kudos to Dr. Dan Markley (3rd year infectious diseases/hospital epidemiology fellow) and Nadia Masroor, who received their Master in Public Health degrees today from the Virginia Commonwealth University. Making us proud!

Dr. Markley will join my team as an Assistant Professor, with clinical responsibilities at the Richmond McGuire Veterans Administration Medical Center. Nadia will continue as the full time project and research coordinator for the VCU Health Hospital Infection Prevention Program.

Thank you both, for your stellar work, and for being part of my team.


Monday, May 8, 2017

VCU in National Hospital Spotlight- American Hospital Association

Below is a quick clip from the American Hospital Association National Hospital Week video that spotlights VCU. 

I make a mercifully short appearance.

Saturday, May 6, 2017

2nd Annual VCU Infection Control Conference- Images

Yesterday (5/5/2017) we had the great honor and pleasure of hosting the 2nd Annual VCU Infection Control Conference at the Hilton Hotel and Spa, Short Pump, Virginia. The conference was a smashing success with over 160 guests, many from area hospitals.

Invited guest speakers were Linda Green, FR, MPS, FAPIC, President Elect of APIC, who gave a phenomenal lecture of the future of infection prevention. Also, Judie Bringhurst MSN, RN of UNC Chapel Hill delivered a masterful presentation on high level disinfection.

Of, course, our own team, including, Kaila Cooper, Michele Fleming, Ginger Vanhoozer and Dr. Mike Stevens rounded out the program along with a spirited panel discussion and a poster session. Select units and teams were formally recognized with awards for innovation and excellence in infection control outcomes and collaboration.

The purpose? To engage, raise awareness, educate and to recognize the infection prevention collaborators at VCU health. The momentum must never slow down. 

We are deeply indebted to all of the conference organizers, particularly Joni Greer of VCU Nursing Education and Professional Development. 

I am already looking to next year's event.

Images are below.

Linda Greene RN, MPS, FAPIC- President Elect of aPIC

Mike Stevens MD, MPH

VCU Infection Prevention Team with Linda Green and Judie Bringhurst (left of center-front row)

A tough question for the expert panel!

Monday, May 1, 2017

Patient Throughput- The New Holy Grail of Medicine

Maximizing patient throughput may be the new Holy Grail of hospital medicine. I hear a lot of talk about patient throughput, almost on a daily basis. Throughput First! Seemingly the sacred tenet of modern hospital medicine, after first do no harm. 

Maximizing throughput will require robust, evidence based standardization- including safety checklists, safety huddles, interdisciplinary rounds, and ensuring the availability of appropriate case management and support teams (example staffing the floors with social workers and making invasive procedure floor teams available 7 days a week).

This is not a pipe dream. A recent article on patient throughput in the ICU highlights that a structured process can maximize efficiency and not compromise safety.

All of this takes time, effort, accountability, institutional will and money. How could it not? Cutting costs and cutting corners will result in harm.

The resources must match our aspirational goals.

Monday, April 24, 2017

Accountability: The Elephant in the Infection Prevention Room

When infection risk is not fully minimized, this may not always be a systems failure, as I have previously written. I still stand by that. Accountability, for many, is the elephant in the infection prevention room.

Accountability, in my opinion, is one of the most critical components of patient safety. It is also one of the most challenging to uphold, particularly as many of us tend to avoid tough feedback conversations with colleagues.  

Like data collection and feedback, accountability can also be structured and formalized, as summarized in this report from Johns Hopkins University.  This formalized, transparent accountability structure calls for escalating levels of review corresponding to the numbers of months that an entity has missed a performance goal for a measure. Higher level leaders know the goal, know their role, and and ensure that lower level leaders have the skills, resources, time, and feedback (data) to improve. Making performance expectations clear and subject to formalized reviews makes the feedback process more objective, less personal and easier to execute.

Safety works best when it is standardized. Standardization takes effort and oversight. Optionalism is a major barrier to standardization in healthcare. 

Structured accountability can halt optionalism. 

Time to move forward.