Weekly Update

May 17, 2021

Reminder for Seniors about Morning Report

Please remember to check the morning report schedule and e-mail your assigned mentor 2-3 days before hand with what you are planning on discussing.

If you are running late, please try to e-mail/text your mentor, especially if the attending is joining via Zoom.

Documentation Update from Cornell (but get in the habit on both campuses):

-Use the “.resmdm” template for your Assessment and Plan section of the note
-Stay tuned for a standard .resdispo note that Dr. Scofi is working on – will let you know when this is live
-All patients should have a re-evaluation documented in their chart:

If admitting the patient, the provider signout note is sufficient.
If you are discharging a patient create the following dot phrase (.resdispo) and use it in a reevaluation note:

Resident Disposition Note
Authored By: @ME@
@VITALSBRIEF@
Management in ED: ***
Clinical Reassessment with Repeat Exam: ***
Disposition: ***
Plan for Follow-Up Care:***
@ME@
Seniors: Please remind off-service residents, especially on their first day, about documentation expectations.

Elective Request Form Update from Dr. Mark Curato:

We’ve made a significant improvement to the way you request and schedule your electives. You no longer need to use the MedForm form. Now, you’ll use this form, which will also be linked on the nypem.net site.

The process is now MUCH easier for you.

Your end of the bargain is that the deadlines must be observed. You should not expect a reminder or nudge when your elective is approaching. Rather, if you fail to get your elective submitted and approved on-time you may just hear from the chiefs to let you know that you’re being scheduled for an EM block instead.

A few details/tips:

Craft thoughtful learning objectives with your faculty preceptor so as to maximize your chances of approval.
All electives now include a learning objective related to culturally responsive medicine, which is clearly described on the form.
We will push your evaluation to your preceptor after your elective, so you don’t need to worry about that; your only job is to show up, learn, meet your learning objectives, and have fun!
At this moment, NYP still prohibits “away” rotations. This is out of the hands of residency leadership. If you have a compelling case for an exception we will be glad to submit the formal request to GME for you. Their deadline for that is 120 days prior to proposed elective (and you should definitely have a back-up “home” elective in mind.)

We’re happy to field any questions!

Campus Announcements

From Dr. Laurie Malia: New Epic update - including updated LiveOnNY referral info

1.Starting May 12th, a new buprenorphine panel will be available in Epic.

To access the panel, search for “buprenorphine” under Orders.
Select the option “Buprenorphine for OUD – for ED Induction Patients Only.” Then select the appropriate COWS score and follow the algorithm outlined in the guideline.

2. Referrals to LiveOnNY for organ procurement can be made electronically on Epic instead of a manual phone call.

Referral for organ procurement should be made within ONE HOUR of the following events:
- All deaths
- Mechanically ventilated patients that are Anticipating Withdrawal or Limiting Treatment
- Mechanically ventilated patients being evaluated for Brain Death
- Mechanically ventilated patients with Brain Injury and GCS <=5
To make the referral, click on the blue link in the BPA below, which is triggered by the above criteria.
If you run into any issues with the electronic referral, you can still call LiveOnNY at 1-800-GIFT-4-NY or 1-800-443-8469.

3. Coming Soon – Urinalysis with Reflex to Culture on Quicklist

Already available as of March 8 if you search Urinalysis within orders box (urinalysis with reflex to culture panel will populate)
This order will soon replace all urine orders (other than point of care) on the quicklist
Reflex to culture or a urine culture order will populate once you select the patient type (see below)
This is an enterprise wide initiative to decrease overutilization of urine cultures

From Dr. Chris Kim: Uploading Outside Imaging at Columbia:

Attached is a guide for uploading outside imaging at Columbia.

Columbia Resident Opeartions Committee Meeting:

Please join Mary Kate and Emerson for a Resident Operations Committee Meeting on Wednesday 5/19, right after conference at 1 pm. Special Guest Dr. Tedeschi will be joining us to conduct a Mass Casualty Incident tabletop exercise. We will also be discussing ideas for projects going forward.

Zoom Info For Columbia ROC meeting:

Topic: Columbia Resident Operations Committee

Time: May 19, 2021 12:00 PM Eastern Time (US and Canada)

Join Zoom Meeting
https://nyph.zoom.us/j/99903087116?pwd=cFRuWkpGdWtSblhNVDAyOEN2eDJXdz09

Meeting ID: 999 0308 7116
Passcode: 745781
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From Dr. Ouyang: Journal Club on Health Reporting:

The next Journal Club on Health Reporting will take place on Wednesday, May 26th at 1 pm. We will do a special session as part of the department’s “Wilderness, Environmental and Disaster Medicine” medical student course that Dr. Tedeschi runs. To give everyone time to read the articles, I am sending them out in advance. I hope everyone who is free can join. Your insights and perspectives will surely be appreciated by the students. Zoom link to follow.

1. Hurricane Maria in Puerto Rico: Death Counts, Public Health Research, and the Media

NY Times Study on Death Toll in Puerto Rico

NEJM original research article

The New Yorker Comment on NEJM Research Article

NPR Segment on NEJM Research Article

2. Hurricane Harvey in Houston, TX: EMS Response During Disasters

“Lost in the Storm” by Sheri Fink (The NY Times Magazine)

3. Climbing Everest: Role of Doctors and Performance-Enhancing Drugs in Mountaineering

“Climbing’s Little Helper” by Devon O’Neil (Outside Magazine)

4. NGO Health Facility in Uganda: Ethics in Global Health Work

“A Missionary on Trial” by Ariel Levy (The New Yorker)