Wing of Zock “Chart Review” Blog Carnival January 2013 Edition

Compiled by Jennifer Salopek and Sarah Sonies

Tomorrow’s Health

What better way to start off a new year than with a blog post about a new baby? In his December 11 post, USF Health’s Steve Klasko, MD, writes about why academic medicine matters: because physicians at teaching hospitals try new things in a continuous quest to provide better care for their patients. Read the post to learn about the long-awaited arrival of Baby Raven Coniglio and the crucial role that the team at USF Health played.

VISION

In a December 12 post that now seems eerily prescient of the tragedy that occurred in Newtown, Connecticut, two days later, Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of Mount Sinai School of Medicine, authors “Resilience: Critical for a Healthy Life.” In the post, Dr. Charney references the Aurora movie-theater shooter and the Empire State building gunman as he notes:

So often we focus on the mental conditions and environmental stressors that may have influenced the perpetrators of horrendous violence. Likewise, in the immediate aftermath of a horrific event—be it violence, an accident, or a devastating natural disaster—the media reports on the nightmares, sleeplessness, anxiety, and other classic sequelae experienced by the trauma survivors. Too rarely, though, do we explore the mental and emotional recovery of trauma survivors, and that of the family, friends, and colleagues who were affected by a victim’s death or lifelong disabilities.

He writes that recovery is facilitated by resilience, and that “[d]rawing on social networks, emulating role models, and facing your fears are among the most successful strategies for fostering resilience in times of adversity.”

The Doctor’s Tablet

“The Hospitalist Will See You Now” is the December 4 post by Matthew S. Robbins, MD, on the blog published by the Einstein School of Medicine. Dr. Robbins relates the history of the hospitalist movement and notes that, while they have brought many benefits, many patients bemoan the loss of the personal relationship with their doctors when hospitalized. He reports that hospitalists have now moved into one of the “last fields of intensely personalized medicine: neurology.”

It may be jarring to our patients not to be met by their neurologists when the patients go to the hospital with breakthrough seizures, falls, strokes or disease exacerbation.

Nonetheless, patients and practitioners must adapt to changes in medical care, and hospital-based medicine is no exception. It might not be old fashioned, but if hospitalists can deliver care that is better and more cost-effective, and communication among inpatient and outpatient practitioners is maintained, then the model will continue its success and diversify into even more specialties.

Educate the Young

David Mayer, MD, vice president for quality and safety at MedStar Health, devotes his December 17 post to “Using Healthcare Human Factors to Keep Patients Safe.” Mayer, who was formerly affiliated with the University of Illinois Medical Center in Chicago, reports on a presentation by former CMS director Don Berwick on engineering lessons that should be adopted in health care. He writes:

Human factors engineering expertise is being invited into the safety and quality conversation more and more today. Similar to that of patients and families, this set of eyes and knowledge has also been lacking from discussions that lead to meaningful change in our care systems.

Life as a Healthcare CIO

In this blog, John D. Halamka, MD, chief information officer of Beth Israel Deaconess Medical Center and a professor at Harvard Medical School, writes about his experiences and interactions with infrastructure, applications, policies, management, and governance. His December 17 post, “Creating a Mature Security Program,” addresses the need for organizations to create cultures of compliance that go beyond security technologies. That culture “includes education, incident responses, and documented discussion that demonstrate an organization and its staff consider security and privacy as part of their duty and daily work lives.”

Aspiring Docs Diaries

In his December 3 post titled “Good Bye,” first-year Harvard Medical School student Devon Taylor says his final, emotional farewell to his “body” from human anatomy class, with whom he spent many weeks in his first semester of medical school. This individual had donated his body to science in order for students to better learn how the body works. Taylor spent seven weeks getting to know the donor’s body on a very intimate level, viewing nearly every muscle, vein, and nerve. But how does one say goodbye to someone we know so well, but hardly know at all?

For me, not knowing who he was or what he meant to other people makes it that much more difficult to say goodbye … I feel so close to him because I know what his liver looks like, but I feel so distant because I just recently learned his age, which is the only thing of any substance I really know about him. Today I will say goodbye to my donor, who I will not give a false name to (like Mr. X), nor will I arbitrarily assign any other attribute to. I will just thank him for his amazing gift to me and my group. I will thank him for his contribution to medicine.

Dean Katz’s Blog

The events that occurred December 14 in Newtown, Conn., have re-opened national debates about the state of gun control and mental health treatment and education in the United States. This post by Paul Katz, MD, Dean of Rowan Medical School at Cooper University, explores what the medical education community can do to prevent tragedies such as this. Katz makes a call for better mental health education and understanding of gun violence, citing the problem of gun violence nationally; with two weeks left in 2012, Camden, NJ, has had 67 homicides, up from its national record. Katz writes,

Let us promote expanded behavioral and mental health services to provide care to those at risk for perpetrating the kinds of acts just witnessed. As providers, let us have the courage to speak up about the patients and families for whom we care and who we believe may injure others … Let us, as the educators we must be, provide curricula and educational experiences that will permit our learners to understand gun violence to the same extent that they know diabetes and heart failure.

SCOPE Medical Blog

A December 19 post on the blog from the Stanford School of Medicine highlights the launch of a new open-source medical journal that leverages crowdsourcing to make scientific research more readily available to the general public. The initiative, spearheaded by Stanford neurosurgeon John Adler, MD, aims to increase researchers’ ability to have their findings published more quickly. The open-source journal, Curēus (pronounced “curious”) will allow publishing in a matter of days, instead of weeks and months.

Vector

The blog from Boston Children’s Hospital highlights various innovative practices from the hospital and its current and former physicians. Eugenia Chan, MD, MPH, and Eric Fleegler, MD, MPH, both worked at Boston Children’s Hospital, met at a conference and worked together to develop a system to actively monitor children with ADHD.

The Integrated Clinical Information Sharing System (ICISS), which monitors patients with ADHD and their changing medication responses. Parents, teachers and coaches fill out web surveys about the child’s symptoms and behavior. A physician can log in and have instant access to this information in graphical form–without having to spend 10 minutes of valuable appointment time asking basic questions about how the child has fared.

Chart Review is our new monthly feature where the editors at Wing of Zock highlight our favorite blog posts from the previous month. We focus on blogs about academic medicine, whether from the perspective of student, resident, faculty member, dean, or hospital CEO. Medical schools and teaching hospitals provide fertile ground for innovative responses to health care challenges. We are pleased to highlight some of the best here, and hope you will send us your favorites as well. Send your nominations to Managing Editor Jennifer Salopek at jsalopek@aamc.org.

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