Weekly Update

March 22, 2020

General Announcements

EM family,

We are having a zoom forum tomorrow at 6pm with our chairs (Drs. Mills and Sharma), operational leaders, program leaders and residents.  I know the COVID messaging is evolving daily and we are all here to support one another.  

We thought it would be important to get together to provide information and an opportunity to ask questions and share your insights.

Please make every attempt to be there if you can.  Here’s the information:

Topic: Resident Forum

Time: Mar 22, 2020 06:00 PM Eastern Time (US and Canada)

Join Zoom Meeting

https://weillcornell.zoom.us/j/176139856

Coronavirus Updates

Given the rapidly evolving response to COVID19, it can be challenging to stay current.  Below are the most critical updates from NYP and GME. 

Please see the COVID19 Updates page for additional information and resources. 

NEW WHS SICK/EXPOSED/ QUARANTINED GUIDANCE (3/18/2020)

NYP ED MANAGEMENT ALGORITHM

NYP COVID19 TRAVEL GUIDANCE AND FAQs

NYP COVID19 CLINICAL BULLETIN #5

NP COVID19 FAQs 2.28.2020

 

Campus Announcements

Drs. Leah Bralow and Jimmy Truong: Medical Education Opportunity

Hi Residents,

We are writing to offer an exciting educational and career advancement opportunity. Drs. Truong and Bralow, in conjunction with the NYPEM Residency and Columbia Department of Emergency Medicine, are offering a $2000 Teaching Fellowship Grant Award to the one resident who embodies the character, scholarship, and motivation to help advance education in our department. The Grant Award shall assist with covering expenses to send the recipient to the ACEP/CORD Teaching Fellowship for Residents. 

The ACEP/CORD Teaching Fellowship course is a great learning and networking experience. Anyone interested in Medical Education is encouraged to take the course. You will be immersed in curriculum development, instructional system design, teaching theory, asynchronous learning, social networking and best of all, get to network with a great group of likeminded residents and faculty from around the world who are just as enthusiastic as you are about medical education. 

Course Information:

ACEP/CORD Teaching Fellowship for Residents
August 6-8, 2020
Hotel and Registration to be covered by the Grant. 

To apply for the $2000 Teaching Fellowship Grant Award, you must:

  1. Be a PGY-2 or PGY-3 resident in good standing with an ITE score in the top 33% of your residency class.

  2. Provide a statement of interest which includes qualifications and future career aspirations. 

  3. Submit a proposal for a scholarly project geared towards advancement of education in the department (250-word limit)

  4. Attest that you will complete your scholarly project by the end of your final year of residency (with Drs. Truong and Bralow as your mentors). 

Important Deadlines:

Please send applications to Leah Bralow (lmh2166@cumc.columbia.edu), Manish Garg (mg4179@cumc.columbia.edu) and Jimmy Truong (jt2979@cumc.columbia.edu).

Application deadline April 4

Selection of winner will be announced April 21

 Thank you for all you do,

Jimmy and Leah

Dr. Lorna Breen: Followup Orders

We have confirmed that routine cultures and final imaging reads will automatically go into the NP follow up basket and we do not need to place follow up orders for them any longer.

While we appreciate the carefulness of those who have been doing so, the NPs have shared that it actually increases their work load as each result has two follow up orders that need to be checked.

Hopefully this new work flow will be more efficient for all. Please let us know if you have any questions, concerns or points of clarification.

Dr. Nick Gavin: Milstein to Allen Transfer

PPOC will begin identifying patients who are appropriate for admission to the Allen Hospital based on the attached clinical exclusion criteria. We are seeking to revamp this process as it will offload work from the Milstein Hospitalist team, help with Milstein ED crowding, and enhance quality of care for this cohort of patients.

When the PPOC nurses identify patients, they will be reaching out to the clinical team. During the day, when available, the care coordinators will be communicating with patients, but overnight, it will be the physicians and physician assistants caring for patients who will be responsible for approaching the patient about admission to the Allen.

The most important thing to express to patients is that the median wait for a Milstein bed has recently been 25 hours. This means that 50% of patients actually wait longer than that. When initiated, the transport to the Allen floor bed should be completed within 3 hours. Other key messaging is that Columbia Doctors follow patients at the Allen and patients typically have a better experience at the Allen Hospital.

Please see attached for the full process map, some ideas for scripting as you approach patients, and for the formal clinical exclusion criteria.

Thanks and please provide any and all feedback as this commences.

From Dr. Ken Wong:  Orienting off-service rotators

Senior residents: please ask the rotator if it’s his or her first or second shift, and (if so) give a brief orientation at perhaps 7:45.  This is a shared responsibility with the attending. 
 

Rotators have gotten a welcome email and a handbook; chiefs also gave June in-person orientations.  However, a rotator’s first shift can be any one of about 12 times during a month, and nothing’s as good as on-shift instruction.  Focus your brief pointers on where to find things, the dispo note template, how to bed request after the dispo, and how to PFD and discharge a patient.  Please also go over PPE, early isolation guidance, and guidelines about high risk COVID19 situations.

THIS WILL BE INCREDIBLY IMPORTANT DURING THIS PANDEMIC, AS WE WANT TO KEEP EVERYONE SAFE WHILE IN THE ED.
 
 
 

From Dr. Lynn Jiang: Wellness

I hope this finds you doing well and staying safe!
 
I had an idea for a wellness related project and wanted to see if you’d be interested in helping me do this or participate.
Many healthcare providers are using the arts (drawing, photography, writing) to help process and meditate during this time. A lot of our colleagues are also sharing these works with others, which creates a stronger community with our colleagues and allows those outside the healthcare field a unique “insider’s perspective.” 
 
My idea is to essentially compile together everyone’s individual work. It can be any type of media as long as it is original work — think the photos we’re already posting or the work Cleavon’s shared. People can continue to share them on their own accounts, but the ultimate goal is to share it to a larger group too — at least via a joint email group, but also (if people are ok with it) by social media so that anyone can participate. Will definitely share a full compiled product at the end of all of this but if we have enough submissions, possibly a weekly update. Hopefully both the creation of pieces (and their viewing) will be helpful for those involved.
 
If you’re interested, please contact Lynn at lgj7001@med.cornell.edu.
 

From Dr. Sara Murphy:  ICU/CCU consults 

Here is the ppt and details of the QI project with ED/ICU/CCU project. The documents are pretty self-explanatory but I’m happy to clarify if needed. 
  1. Formalized Qualifications of Consult Levels
  2. Revised MICU CCU ED Consult Guidelines

MCB Message of the Month

Conference This Week

Welcome to the
NYP Class of 2024!!

Upcoming Residency Events

 

  • April 1st – PGY2 Retreat (postponed)
  • May 27th – 8 hr Theme and PGY4 Research Day
  • May 28th – Residency Retreat 
  • June 3rd – Graduation at the Central Park Boathouse 

To Dos

ALL

  • WEAR YOUR PPE ON SHIFT! Keep yourself safe always!
  • MedHub hours must be logged! 
  • Please fill-in your resident profile on nypem.net. It’s a great way to highlight your interests and things you’ve done during residency. https://nypem.net/meet-our-residents/
  • Remember– Away Electives require an application submitted 112 days in advance, while NYP electives are a minimum of 56 days. Instructions located here. 
  • Check out this career guide from the Academy for Women in Academic Emergency Medicine  https://issuu.com/saemonline/docs/saem_awaem_toolkit
  • Please be wise on social media use and don’t risk patients’ trust in the medical profession.  
  • Give time and action-specific instructions in the discharge papers.  “See your primary doctor soon” is much less informative than “See your primary doctor in the next four days, but return to the E.R. if your abdominal pain worsens or persists.”  

PGY4s

  • Get disability insurance before graduating residency.  Here’s one resource to start.
  • Educate yourself on potential job contract issues.  Here’s one article and another EM specific book.   
  • If a job requires your residency malpractice insurance history, email nog9010@nyp.org & mam9160@nyp.org to obtain the relevant documents.  
  • Remember to complete your EMS ride-alongs! You need 10 4-hour sessions to graduate!

PGY3s

PGY2s

  • < 4 months to leading notifications!  Start thinking big picture, and what you’d decide from the foot of the bed.  Create a mini-curriculum for yourself of resuscitation-related podcasts, EM:RAP episodes, etc.
  • If you have money to save after NYC costs and student loan repayment, consider putting it into NYP’s 403(b) or an IRA.  The “Roth” option is likely better when you’re a resident.  

PGY1s

  • Scroll down to 3. Publications and Educational Initiatives for some good EM resources!  Or check out this centralization of other EM resources including podcasts, books, apps and Qbanks.
  • Do you take public transportation sometimes to work?  Do you want to save 30% of that amount in tax savings over the next three years?  Take 15min to enroll in NYP’s Commuter Transit program.  
Opportunities

Chief on Call

Liza Hartofilis, M.D. – first call
EM Chiefs’ Cell:  917-410-1056
  • Please call and do not text/ email so we can address issues promptly.
  • If you do not hear back within 10 minutes, then call any of the other chiefs.