Transcript Popular Links - UNC School of Medicine

Academy of Educators
Quarterly Meeting
Tuesday, September 24, 2013
5:30-6:45pm Bondurant G030
Agenda
 Welcome by Julie Byerley, MD, MPH, Vice Dean for Medical Education
 Introduction of AOE and proposed By-law changes - Beat Steiner, MD
 Overview of upcoming events and workshops - Todd Zakrajsek, PhD
 Service and Education updates - Cheryl McNeil, MD & Michael Meyers, MD
 EPIC talk - Ryan Madanick, MD
 Scholarship talk - Kevin Biese, MD
AOE Welcome by Julie Byerley, MD, MPH
Vice Dean for Medical Education
Draft Bylaw Changes
Beat Steiner, MD
Change #1: Different Term Length and Structure for AOE faculty leaders.
 3 year term (President Elect, President, Past President)
 Funding for President Elect and President
 Immediate Past President is on AOE Executive Committee
 Rationale:
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Presence of Executive Director and full time staff person
New title differentiates elected faculty leaders from executive directors
Create more leadership opportunities within AOE
Ensure ongoing creativity and innovation within AOE
Draft Bylaw Changes
Beat Steiner, MD
Change #2: Membership Requirements
 Each member will be required to participate in 8 AOE events over the course of 2
years
 Assure appropriate and accessible offerings for AHEC and other faculty who have
a hard time coming to AOE seminars
 Reminder for AOE members who fall behind on completion of requirements
 Rationale:
 Make AOE membership meaningful
 Ensure an active and engaged membership that contributes to the educational
mission of the school
New in the AOE
Todd Zakrajsek, PhD
 Foundational Workshop Sessions
 Advanced Workshop Sessions
 Visiting Professors
 Residency Discussions
 AOE Banquet
 Others???
AOE-UNC School of Medicine
Mike Meyers, M.D.
Cheryl McNeil, M.D.
09/24/13
Background
 Balance between service and education can be
challenging for trainees
 Impact on education
 Accreditation issue for programs
NEJM. 2013;368:6.
Background
 Institutions have commonly relied on residents for
tasks not requiring a physician
 Ancillary services have improved this
 Problems remain
 Increased documentation needs significant issue now
 Inpatient and outpatient
Background
Activity
% of Time
Direct Patient Care
12
Indirect Patient Care
64
Educational Activities
15
Misc
9
Computer Use
J Gen Int Med. 2013;28:1042.
40%
UNC House Staff Survey
 Distributed to all house staff (n=~730) in March 2013
 Goal to generate list of things residents identify as
areas for institutional attention/improvement
 ~25 things identified by residents as potential issues
 5 point Likert scale (How significantly does each of the
following impact our work as a resident at UNC)
Results
 362 responded
 Top Problems Identified
 Having to personally obtain outside records instead of a having a
system
 Medication reconciliation
 Waiting for pages to be returned (instead of moving toward txt
system and/or personal phones)
 Waiting for nurse to come to phone instead of pages being made
to personal phones nurses carry
 Inefficiency of ordering in CPOE
 Night-time pages for non-urgent issues (medication reviews, etc)
that could wait until day shift
Next Steps
 AOE endorsement for addressing this issue with the
hospital administration?
http://www.polleverywhere.com/multiple_choice_polls/E3
x2NH1qh5SK0Zc
 Separate AOE committee?
http://www.polleverywhere.com/multiple_choice_polls/zSj
ivSmL2I0Phb2
Interested in Participating?
http://www.polleverywhere.com/free_text_polls/arvIxcuLc
j3c0oD
What about Medical Students?
Students are
unable to
contribute to
the team’s
main burden
of work
Residents
Studentsspend
are
the unable
majority
toof
their time in
document
documenting
the EMR in
the EMR
Students spend
increasing
percentage of
clinical time away
from patient care
More and more
didactic and
simulation time
needs to be set
aside to make up
for lack of practical
experience
Students are
passive instead of
active in team
work. Residents
interact with
students less.
Students are not
getting enough
real experience to
become
competent
What if Students Could Document?
At least in theory, students should be able to
legally directly populate the following sections of
any encounter: Medications, Allergies, Past Med
Hx, Soc Hx, Fam Hx, and Review of Systems.
This would increase their usefulness to the team
while unburdening the residents/ faculty,
creating more opportunity for them to be
included meaningfully in the work of the team.
Next Steps to Getting Students
Access to Meaningful Use
Ryan Madanick is our AOE liaison to the EPIC team.
He is actively working on this issue and Deb Bynum is
also researching how this was legally implemented
through EPIC at other campuses.
Besides working with EPIC, what are other ways to
get the students more meaningfully involved in
patients care?
Discuss…..
http://www.polleverywhere.com/free_text_polls/O9
M9Yz2LqfM1SSk
EPIC: Medical Student Training
Presented by Ryan Madanick, MD
 8-hour class: 4 Ambulatory, 4 Inpatient
EPIC: Medical Student Training
 8-hour class: 4 Ambulatory, 4 Inpatient
 MS4 (c/o ‘14): Only if needed
EPIC: Medical Student Training
 8-hour class: 4 Ambulatory, 4 Inpatient
 MS4 (c/o ‘14): Only if needed
 MS3: Training for all between 2/17 & 3/31/14
 Schedule not final
 PMs & some weekend training
 Release students from clinical responsibilities
EPIC: Medical Student Training
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8-hour class: 4 Ambulatory, 4 Inpatient
MS4 (c/o ‘14): Only if needed
MS3: Training for all between 2/17 & 3/31/14
MS2: Training for all between 4/14 & 6/28/14
EPIC: Medical Student Training
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8-hour class: 4 Ambulatory, 4 Inpatient
MS4 (c/o ‘14): Only if needed
MS3: Training for all between 2/17 & 3/31/14
MS2: Training for all between 4/14 & 6/28/14
MS1: View only access, still in discussion
EPIC: Medical Student Training
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8-hour class: 4 Ambulatory, 4 Inpatient
MS4 (c/o ‘14): Only if needed
MS3: Training for all between 2/17 & 3/31/14
MS2: Training for all between 4/14 & 6/28/14
MS1: View only access, still in discussion
Stork (OB):
 Likely modified training
 Timing?
EPIC: Medical Student Notes
 Will be part of Epic record, not legal record
 Viewable once signed
 Routing for review, not co-signature
 No use of macros
 “Type” of note
 Recommended changing type from “Medical Student”
to specific type (e.g., H&P)
EPIC: Medical Student Orders
 Students able to enter orders
 Orders to be “pended” & routed for signature
EPIC: Medical Students as
SuperUsers
 Dr. Dent working to create a course
 Will require signed agreement from student
Scholarship in the AOE
Kevin Biese, MD
 Basics of Scholarship Workshop Series
 IRB, Basic Survey Construction, Qualitative Analysis, Basic
Quantitative Analysis
 Half-day writing seminar
 Botanical Gardens(?), food
 Expanded AOE Banquet
 Team-based scholarship projects
 Data Analyst Support
Thank you for your continuous
support of the AOE