Nicholas Yeisley, a fourth-year student at the School of Medicine, has been selected to serve as student liaison to the Association of American Medical Colleges (AAMC) Integrating Quality steering committee.
The group serves an advisory role for the AAMC to provide recommendations and feedback regarding high-value initiatives relating to quality of patient care. It focuses on activities to promote a culture of quality care, and patient safety strategies and resources.
Yeisley has been a member of the national organization’s Office of Student Representatives (OSR). He was selected to serve a one-year term as the sole student liaison to the Integrating Quality committee beginning this summer.
He has also had leadership opportunities through the American Medical Association’s Medical Student Section, including his current role as chairperson of the regional executive board.
“I am personally interested in quality improvement and translational research and thought being on the steering committee would be a great way to learn,” Yeisley said. “A personal goal is to share insights on quality improvement and translational research with the rest of the OSR and our medical students at UMKC so that we all can learn more about medical careers enriched in quality improvement.”
During the past three years, Yeisley has worked with Stefanie Ellison, M.D., professor of emergency medicine and associate dean for learning initiatives, on a Community Home Health Initiative. The project is to develop a survey that will help determine if important social history questions are being missed in standard emergency room visits. The inquiries would focus on topics such as home environment, finances, literacy and disabilities. Yeisley has also helped coordinate an annual opioid overdose training program for fellow trainees.
He said he plans to take the next year off from medical school to complete an accelerated MPH program at Johns Hopkins University.
“I want to continue gaining skills toward quality improvement and translational research in the context of public and community health,” he said.
For Arif Kamal, M.D., ’05, physician quality and outcomes officer for the Duke Cancer Institute in Durham, North Carolina, research is as much about solving a problem as it is discovery.
“Sometimes we face a problem and have no idea how to solve it,” said Kamal, winner of the 2019 E. Grey Dimond, M.D., Take Wing Award. “We have to discover the solution, and that may require performing foundational basic science research, or conducting a big clinical drug trial. Or we may discover that we have a solution, but it hasn’t been implemented because of cost or other barriers, so we have to innovate and collaborate to make the solution accessible and affordable.”
Kamal received the School of Medicine’s prestigious alumni award on May 20 at the annual Take Wing lectureship and award ceremony. The honor is given to a graduate who has demonstrated excellence in his or her chosen field and exceeded the expectations of peers in the practice of medicine, academic medicine or research.
After giving the noon lecture and accepting the award, he also spoke to faculty, students and their families at the 2019 graduation ceremony at the Kauffman Center.
Kamal describes his approach on conducting health services research as being “agnostic at the outset toward what’s needed to solve any particular problem.”
Kamal’s desire to broaden his skills and the ways he can approach a problem led him to earn a master’s in health science in clinical research in 2015 and a master’s in business administration in 2016. Besides his Cancer Center post at Duke, Kamal is an associate professor of medicine, business administration and population health science.
Kamal distinguished himself in palliative care, developing innovative ways to find out and provide what’s really important to patients at the end of their life. His desire to research and improve palliative care stemmed from his own mother’s battle with breast cancer, when he saw very personally how her care could have been better.
He started Duke’s outpatient palliative care program for cancer patients seven years ago, and the Cancer Center’s “total pain approach” has helped develop and administer therapies for long-term relief of distress that affects patients with a serious illness. The focus is on identifying and addressing physical and emotional drivers of distress well before the end of life, when people historically have thought of palliative care.
Now, Kamal’s team is working on smartphone apps to engage patients with serious illnesses and their caregivers in their own care, day to day. One such app would monitor opioid use.
“We fundamentally believe that patients don’t want to be addicted, that they want to responsibly use opioids and that clinicians want to responsibly prescribe them,” Kamal said. “But there’s not actually a way, for example, to monitor what people are doing at home. So, we’re creating an app to record how and what they’re using and how that corresponds with pain scores, to make sure they’re getting the right amount, and not too much or too little.”
And to put that app into people’s hands takes a team.
“We’re working with some commercial payers and several parts of the university, from data science to graphics and programming, to our addiction and pain management experts, to palliative care and patients and caregivers, to identify what the right characteristics for the app will be.”
Kamal, originally from Warrensburg, Missouri, said his appreciation for teamwork was fostered by the UMKC School of Medicine’s docent system and frequent clinical exposure to the many types of medical practice.
“And I got my start in research there,” he said. “My first published paper was with Dr. Agostino Molteni,” in Nutrition Research in 2004.
Kamal and his wife, Jennifer Maguire, M.D. ’07, have two small children, and Kamal said they enjoy returning to the Kansas City area frequently. That included a return to receive the Take Wing Award.
While the award recognizes career excellence, individual achievement and public service, in Kamal’s case, it also honors a vision for future innovations to reduce suffering and bring healing.
“I think what we’re fundamentally seeing is a reimagination of what it means to be a researcher in medicine,” he said. “Certainly that’s the path I’ve taken.”
Physicians carry the responsibility of serving as a patient advocate as well as a care giver, Sam Page, M.D., FASA, told students and faculty at the UMKC School of Medicine during the 2019 Vijay Babu Rayudu Quality Patient Safety Day.
“Being an advocate is part of your duty, it’s an obligation of being a doctor,” said Page, a 1992 med school graduate and former state legislator. “You have to advocate for the patient in front of you. And you’re obligated to advocate for patients at the population level.”
The former Missouri state representative was elected to the St. Louis County Council in 2014. An anesthesiologist at Mercy Hospital in St. Louis, he currently serves as St. Louis County Executive.
Page was the keynote speaker for the sixth-annual event. He spoke on professionalism through advocacy for patient safety, encouraging students to become involved in by engaging their elected officials and working with their state and national medical organizations.
“Everyone here who graduates from medical school, you have an obligation to engage your elected officials and communicate with them,” Page said. “If you are really interested in changing the world around you, there are things you can do.”
The day included student and resident/fellow poster presentations and oral presentations on research conducted in quality and patient safety. A series of morning faculty development workshops and discussions looked at topics surrounding transitions of patient care.
“We have seen some projects that have made an impact in the quality of care,” said Betty M. Drees, M.D., dean emerita, one of the Patient Safety Day organizers. “We feel we’re not only preparing physicians for the future, but these projects are making a direct impact during the time the students, residents and fellows are doing them.”
A record number of 47 abstracts were submitted. The top two student and top two resident/fellow abstracts were selected for oral presentations. The remaining submissions were included in poster presentations from which two students and two residents/fellows were selected as winners.
Taylor Carter, a sixth-year medical student, and Colin Phillips, a physician assistant student, were chosen to give oral presentations. Carter presented on “Cultivating culturally aware medical students: An analysis of the effectiveness of a two hour interactive course.” Phillips presented “Failing our youth: Under-documentation of electronic nicotine use in adolescents.”
In the resident/fellow category, Laith Derbas, M.D., was chosen to present “Improving Resident Confidence in ACLS,” and Thomas Odeny, M.D., presented “Improving documentation of meaningful smoking history at Truman Medical Center: a quality improvement project.”
Fourth-year medical student Sahaja Atluri and fifth-year student Chizitam Ibezim were chosen as the student poster presentation winners. Atluri presented the research poster on “Does Intensivist Management of Brain Dead Organ Donors result in Increased Organ Yield?” Ibezim presented a poster focused on “Fracture Liaison Service (FLS) in Safety-Net Hospital.”
Resident/fellow winners of the poster presentations were Robin Imperial, M.D., and Kathryn VanderVelde, M.D. Imperial presented a poster on “Improving interdisciplinary communication on general medicine wards through the use of a two-way HIPAA-compliant text messaging app.” VanderVelde presented “Optimization of Surgical Prophylaxis in Penicillin-Allergic Labeled Patients.”
James P. Bagian, M.D., P.E., a physician who developed a program to protect patients from hospital-based harm and a former NASA astronaut who flew two space shuttle missions, presented the keynote address on May 13 at the third annual Vijay Babu Rayudu Quality and Patient Safety Day.
The day-long event gave students, residents, fellows and faculty an opportunity to present their research and learn from experts in the field of patient safety. Following Bagian’s presentation, students and residents gave oral presentations on their work, and presented research posters in the School of Medicine lobby.
Bagian spoke on the need and process for developing and implementing proper procedures to improve patient safety. Currently the director of Center for Healthcare Engineering and Patient Safety at the University of Michigan, Bagian focuses on creating solutions to make health care safer, more effective and more efficient.
Bagian was named one of 50 experts leading the field of patient safety by Becker’s Hospital Review.
He served as the founding director of the Department of Veteran Affairs National Center for Patient Safety and was the first chief patient safety officer for the VA, where he developed numerous patient safety tools that have been adopted nationally and internationally. Bagian received the Innovations in American Government Award in 2001 from the John F. Kennedy School of Government at Harvard for his national program to protect patients from hospital-based harm.
During his 15-year career with NASA, Bagain was the first physician to successfully treat space motion sickness. His approach is now the standard of care for astronauts. He developed a high-altitude pressure suit and other crew survival equipment, and has served as an investigator and medical consultant on two space shuttle accident investigations.
Bagain has led efforts in standardizing pre-hospital combat rescue medical care across all major U.S. Air Force commands and is a founding member of a Department of Defense committee on casualty care that has reduced the mortality rate of service members injured in battle.
Quality and Patient Safety Day is an annual event at the School of Medicine. It it established in memory of Vijay Babu Rayudu, a former student who died in 2007.
The Institute of Medicine’s 1999 “To Err is Human” report – often credited with sparking the awareness of what is now the growing field of patient safety – stated that 44,000 to 98,000 Americans die each year because of safety errors, which make up the eighth-leading cause of death in the United States and cost $29 billion per year.
The School of Medicine has dedicated increased emphasis and resources toward patient safety and quality outcomes research. April 11 marked the inaugural Vijay Babu Rayudu Quality and Patient Safety Day at the School of Medicine, giving students, residents, fellows and faculty an opportunity to present their research and learn from experts in the field. Tejal K. Gandhi, M.D., M.H.P., C.P.P.S, president of the National Patient Safety Foundation and the Lucian Leape Institute and associate professor of medicine at the Harvard School of Medicine, was the keynote speaker.
Vijay Babu Rayudu Endowed Chair of Patient Safety Peter Almenoff, M.D., introduced Ghandi and welcomed the Rayudu family members who were in the audience. Gandhi was formerly the executive director of Quality and Safety at Brigham and Women’s Hospital, and chief Quality and Safety officer at Partners Healthcare. In these roles, she led the efforts to standardize and implement patient safety best practices across hospital and health systems. Her lecture, “The Changing Landscape of Patient Safety” focused on five areas of patient safety as it relates to care across the continuum – hospitals, ambulatory care, outpatient care – patient-family engagement in care, the health care workforce, the need for increased transparency – with colleagues, between organizations and with patients and families – and metrics that matter.
“We need to use technology to help us deliver high quality, safe care in the complexity that we’re living in,” said Ghandi, whose research interests focus on reducing errors by using information systems. “We know that some technologies reduce errors significantly. Computerized physician order entry (results in a) 55 percent reduction in serious errors.”
Ghandi said there is an increased emphasis on certification and fellowship opportunities in the cutting-edge area of patient safety.
“Patient safety is more important than ever,” Ghandi said. “If we’re trying to care for patients across the population, reduce costs and all of these things, we need to have the safest care so that we are preventing complications and errors and all of the issues that are going to end up leading to worse care for our patients.”
Inaugural Vijay Babu Rayudu Quality and Patient Safety Day Presentations
Student Oral Presentations
Ryan Eckert, Rohit Saha ‑ Year 1 through 6 Baseline Knowledge, Skills, and Attitudes of Patient Safety
Evan Martin — Advanced Directive Initiative in Continuity Care Clinics
Peter Vayalil, Sagar Patel — Congestive Heart Failure (CHF) and Polypharmacy
Christopher Brett, Nicholas Gier — Follow up Contact Improves Patient Safety and Satisfaction in the TMC Medical Clinics
McKenzie Lutz — Increasing Diabetes Education in the TMC Internal Medicine Clinics by a Self-Administered Quiz
Student and Resident Poster Presentations
Apurva Bhatt, Peter Lazarz — MAKING THE SWEET CHANGE! An evaluation of the control of diabetes at the Sojourner Free Health Clinic
Meena Subramanian — Not Your Typical Carpal Tunnel: Levaquin Induced Neuropathy
Megan Litzau — Inaugural UMKC All Health Profession Schools Interprofessional Education Class: A Student Facilitator’s Perspective: “It is Everyone’s Role to Provide Safe Patient Care”
Nikolai Khromouchkine — Whole Exome Sequencing and the Potential to Improve Diagnostic Workup for Genetic Disease
Suzanne Miller — Review of Quality Improvement (QI) Curricula in Internal Medicine (IM) Residency Programs and Development of the UMKC IM QI Curriculum
Eva Omoscharka, Priya Skaria, Kamani Lankachandra — Importance of follow up in patients with Papaniculaou test findings of endometrial cells. A Truman Medical Center experience.
Hamid Zia — Improving Appropriateness of Blood Utilization through Prospective Review of Requests for Blood Products: The Role of Pathology Residents as Consultants
Beth Rosemergey, Suzan M. Lewis — Improving NCAQ Compliance by Instituting Point-of-Care Hemoglobin A1C Evaluation
Katie Jackson, Katie Barger — Depression Screening in Type 1 Diabetes
Faculty Oral Presentations
Peter Almenoff — Predicting potentially avoidable hospitalizations
Mamta Reddy — Building an Organizational Framework for Patient Safety and Systems Reliability
Brent Beasley — Tackling Sepsis Mortality in the SLHS
Shauna Roberts — Redesigning Systems and Processes of Care for Targeted Outcome Improvements