Tag Archives: Graduate Medical Ed.

SOM, TMC participate in Best Practices for Better Care initiative

Alan Salkind, M.D., (right) professor of internal medicine, meets with his group working on the preventable hospital readmissions component of the Best Practices for Better Care initiative on June 26 at Truman Medical Center. Best Practices for Better Care is a multi-year campaign to improve patient care and quality at teaching hospitals and health systems in the United States.

The UMKC School of Medicine and Truman Medical Centers (TMC) have joined medical schools and teaching hospitals around the country in a multi-year initiative aimed to improve the quality and safety of health care. The initiative, Best Practices for Better Care, is sponsored by the Association of American Medical Colleges (AAMC), University HealthSystem Consortium (UHC), an alliance of academic medical centers, and the Centers for Medicare and Medicaid Services through their Partnership for Patients Program.

Best Practices for Better Care will help put patient safety and quality methods into widespread use at teaching hospitals and health systems in the United States, combining academic medicine, education, research and clinical care. The goal is to put the power and skills of the academic medical center behind solving some of the common patient quality and safety problems through education, research, and clinical care.

The School identified this as an important initiative and was very excited to participate,” said Jill Moormeier, M.D., M.P.H., associate dean of Graduate Medical Education, who is coordinating the efforts by the School of Medicine with TMC. “We are a really good location to do stuff like this. Our students and residents are intimately involved in the care of patients and patient outcomes.”

The initiative began in June 2011 with participating medical schools and teaching hospitals gathering data during its first year.

The campaign recently released a progress report to the participating organizations that showed most hospital systems have in place well-established systems to improve patient care in the United States. But, Moormeier said, it was also clear there is some work to be done in educating students, residents and faculty in quality improvement.

Participating institutions, according to the AAMC, have committed to teaching quality and patient safety to the next generation of doctors; ensure safer surgery through use of surgical checklists; reduce infections from central lines using proven protocols; reduce hospital readmissions for high-risk patients; and research, evaluate, and share new and improved practices.

The School of Medicine and TMC will first tackle the preventable hospital readmissions component. Alan Salkind, M.D., professor of internal medicine, will be leading this endeavor.

According to Salkind, nearly 20 percent of Medicare hospitalizations are followed by readmission within 30 days, with 75 percent of these considered preventable. Readmissions within 30 days account for $15 billion of excess Medicare spending.

“Common reasons leading to hospital readmission are inadequate explanation to the patient about how to use medications after hospital discharge, recognition of warning signs that warrant a call to the patient’s physician, and lack of a timely post-discharge physician visit, all of which are preventable by clearly conveying information to patients and confirming understanding before discharge from the hospital,” Salkind said. “Another important objective of this project is to teach students and physicians the elements of discharging a patient from the hospital with appropriate and understandable instructions for their continued care.

“We want to determine and then fix the pitfalls in our discharge process that lead to preventable readmissions to the hospital. We will share that information with other medical schools and hospitals to develop best practices that reduce hospital readmissions.”

This project is scheduled to last for about six months, but as the School and TMC gather data, it may be extended. The campaign is ongoing.

John A. Spertus, M.D., M.P.H., F.A.C.C., Lauer/Missouri Endowed Chair and professor of internal medicine, and Shauna Roberts, M.D., ’84, professor of internal medicine, are members of Research on Care Community (ROCC), the research division of the Best Practices for Better Care initiative, established to serve as a home for academic leaders and their teams. Through webinars, peer-to-peer learning and other resources, members of ROCC will share strategies for building institutional effectiveness and implementation research.


Assistant surgeon general presents Health Care Policy Grand Rounds Lecture

Rear Adm. Patrick O’Carroll, M.D., M.P.H., assistant surgeon general of the United States

Rear Adm. Patrick O’Carroll, M.D., M.P.H., visited the School of Medicine on June 5 to deliver his lecture titled “Public Health and Prevention in the Age of Healthcare Reform,” as part of the Health Care Policy Grand Rounds Lecture series presented by the Department of Biomedical and Health Informatics.

O’Carroll is an assistant surgeon general of the United States, the regional health administrator for U.S. Public Health Service Region X, and an affiliate professor at the University of Washington schools of Public Health and Medicine. He has also worked at the Centers for Disease Control and Prevention, giving him a unique perspective on issues of public health and ways to prevent disease, said Bill Lafferty, M.D., Merl & Muriel Hicklin/Missouri Endowed Chair in Medicine during his introduction of O’Carroll.

The lecture outlined the 10 most effective public health interventions of the 20th century. These included vaccines, motor-vehicle safety, safer work places, control of infectious disease – huge improvements in infant mortality, for example – a decline in heart disease and stroke mortality, safer and healthier foods, healthier mothers and babies, family planning, fluoridation of drinking water, and reduction in tobacco use – still the No. 1 cause of preventable mortality.

O’Carroll stressed the importance of prevention when it comes to public health outcomes. “Medicine can be thought of as a reaction if a system fails,” he said.

Preventative care is practiced on multiple levels. At the individual level, it includes wellness visits and new private plans. At the business level, there’s workplace health, for example, and at the state level, there are many initiatives regarding community health plans. More than 12 federal agencies have developed a National Prevention and Health Promotion Strategy and a Prevention and Public Health Fund.

O’Carroll also discussed the Affordable Care Act, the Consumer Bill of Rights, and the CDC’s bioterrorism preparedness and response initiative.

Throughout his lecture, O’Carroll acknowledged the challenges of public health because its boundaries constantly change. “There are multiple disciplines and cultures, and sometimes an uncomfortable blend of science, action, research, policy, advocacy and government,” he said. Although, there is one aspect that O’Carroll emphasized as a top priority.

“The upstream causes of death are what we need to be working on,” O’Carroll said. “Because, A) It’s the right place to go; it prevents disease in the first place and prevents human suffering, and B) it prevents the visit to the doctor and keeps this incredible cost curve, that I mentioned being unsustainable, from breaking the bank.”

Emergency medicine, CPR expert presents McNabney lecture

(Left to right) Mark Steele, M.D., F.A.C.E.P., ’80, professor of emergency medicine, associate dean of TMC programs, and chief medical officer at TMC; Joseph Salomone, M.D., associate professor of emergency medicine; Joseph Waeckerle, M.D., clinical professor of medicine, Kendall McNabney, M.D., the namesake of the lectureship and founder of the Department of Emergency Medicine; Ray Fowler, M.D., F.A.C.P., the featured speaker; and Matthew Gratton, M.D., associate professor of emergency medicine and chair of the Department of Emergency Medicine gather during the 2012 McNabney Lectureship on May 31 at the School of Medicine.

Ray Fowler, M.D., F.A.C.P., presented the 2012 McNabney Lectureship on May 31 at the School of Medicine. The lectureship honors Kendall McNabney, M.D., who founded the Department of Emergency Medicine at Truman Medical Center and the UMKC School of Medicine in 1973. McNabney was also the first and longest serving chair of EM at the School and was the head of trauma services for many years.

Matthew Gratton, M.D., associate professor and chair of the Department of Emergency Medicine, who has been with the department since 1983, welcomed McNabney to the lecture and spoke about his great effect on EM in Kansas City before introducing Fowler.

Fowler’s lecture titled, “The Past, Present and Future of Cardiopulmonary Resuscitation,” focused on studies and trials of the Dallas arm of the Resuscitation Outcomes Consortium (ROC), for which Fowler is co-principle investigator.

Fowler has been involved in EMS as a leading educator, medical supervisor and political advocate for more than three decades. He currently serves as co-chief in the Section on EMS, Disaster Medicine, and Homeland Security for Southwestern Medical Center. He is chief of EMS Operations for the Dallas Area BioTel EMS System and an attending EM faculty member at Parkland Memorial Hospital in Dallas, Texas.

In addition to serving as president of the Georgia College of Emergency Physicians and as a perennial member (since 1980) of the State of Georgia EMS Advisory Council, he was the second elected president of the National Association of EMS Physicians. He was also a co-founder and senior faculty member of the National EMS Medical Director’s Course, helped found and was national program director of International Trauma Life Support, and was a member of the initial steering committee of the National Association of EMS Physicians.

During his lecture at the School of Medicine, Fowler stressed the importance of compression fraction – the number of seconds per minute of doing compressions – and its role in determining survival in patients with out-of-hospital ventricular fibrillation. Fowler also mentioned that evidence shows the ideal compression fraction is 40 seconds of every minute. These discoveries have increased the survival rate in cardiac arrest patients, “the sickest patients you will ever have,” according to Fowler.

He also stressed the importance of avoiding interruptions in compressions when administering CPR. This concept of Minimally Interrupted Cardiac Resuscitation (MICR) increased the survival-to-hospital discharge of patients with out-of-hospital cardiac arrest.

Fowler concluded with his vision for the future: “That all (who) can be prepared, would be. That all of us in clinical care sing as a well-rehearsed choir from the same sheets of music, and that research will light our paths as we maintain our commitment to the betterment of the human condition.”

Dr. Banderas appointed associate dean for Graduate Studies and Allied Health

Julie Banderas, Pharn.D.

The School of Medicine Dean’s Office has announced the appointment of Julie Banderas, Pharm.D., as assistant dean for Graduate Studies and Allied Health.

A tenured professor in the department of Biomedical and Health Informatics, Banderas has served as assistant dean for Graduate Studies since 2010. She has been actively involved in developing the School’s initial graduate programs and the corresponding operating procedures and administrative structures.

A member of the UMKC Graduate Council and Graduate Officers Committee, Banderas assumes the administrative duties as assistant dean of Allied Health Programs, which include the Master of Science in Anesthesia Program and the Master of Medical Science Physician Assistant Program that was recently approved the University of Missouri Board of Curators in April.

Banderas has taught clinical pharmacology at the School of Medicine for 18 years and also teaches courses in Responsible Conduct of Research for the School of Graduate Studies.

Youngblood Medical Skills Lab is host of open house

Nicole Fearing, M.D. (left), clinical assistant professor of surgery and medical director for the Youngblood Medical Skills Lab, works on the Baby Hal mannequin with Sara Bower Youngblood at the lab’s open house on Oct. 14.

More than 40 faculty, staff and students attended an open house for the Youngblood Medical Skills Laboratory at the UMKC School of Medicine on Oct. 14. The guest of honor was Sara Bower Youngblood, widow of James J. Youngblood, M.D., whose vision spearheaded development of the lab into an important component of the School of Medicine’s curriculum.

The open house celebrated the lab’s ongoing success and highlighted its future goals. The lab provides a safe training environment for future physicians to practice simulated procedures and also work with standardized patients in preparation for their medical boards.

“The best part about the day was that Mrs. Youngblood got to see how it all started and has blossomed,” said Nicole Fearing, M.D., clinical assistant professor of surgery and medical director for the YMSL. “The lab has grown to encompass the whole School of Medicine, Graduate Medical Education, interdisciplinary training, and a standardized patient program.”

Mrs. Youngblood accompanied members of the Youngblood Society on a facility tour, which included a labor and delivery simulation using the YMSL’s Noelle and Baby Hal mannequins. David Mundy, M.D., associate professor of OB/GYN, delivered an introduction and history of the lab, and lauded its continual development.

Since its opening in 2007, the YMSL has expanded its inventory of high-fidelity simulation mannequins and other procedural training models that are regularly used by UMKC medical students. In addition to hosting UMKC’s Standardized Patient Program and Master of Science in Anesthesia program, the lab annually trains hundreds of students in the AHA’s CPR and ACLS curriculum. An EMT and paramedic curriculum will debut in 2012.

MAFP inaugurates Dr. Shaffer as president

Todd Shaffer, M.D.
Todd Shaffer, M.D.

Todd D. Shaffer, M.D., M.B.A., F.A.A.F.P., professor of community and family medicine, became president of the Missouri Academy of Family Physicians on June 4 during the organization’s annual meeting at Lake Ozark, Mo.

Shaffer has served as director of the UMKC Family Medicine Residency Program since 2002 and has been a member of the Department of Community and Family Medicine faculty since 1995. He currently leads one of the largest residency programs in the country with 35 residents, three fellows and an integrated MBA program.

He has been a member of the MAFP Education Committee for more than 10 years and was its chairman since 2006-09. He was the MAFP Board Representative for District 7 (Kansas City) from 2004-09.

Shaffer received his undergraduate degree from UMKC and M.D. from the University of Missouri School of Medicine. He completed his residency in family medicine at the UMKC School of Medicine. He also earned his MBA in Physician Healthcare Leadership in a combined Rockhurst University/UMKC program.