Weekly Update

May 24, 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, forwarded from Dr. Curato:

Every pateint with your name on it needs a progress note.
1. Every chart must contain closure:
For Admitted Patients: Open a “handoff” note which contains the ED-PASS document.
For Discharged Patients: Open a progress note and use the “.RESDISPO” smartphrase, which is now live. (The only possible exception would be in area D if the patient is immediately discharged and the disposition is clear in the provider note, such as a suture removal).

2. Every patient who is signed-out must have progress notes containing the smartphrase “.RESHANDOFF1” from the offgoing resident and “.RESHANDOFF2” from the oncoming resident.
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.

From Dr. Betty Chang: Trauma Activation Guidelines and Roles at Columbia.

Notice the similarities between criteria for a Columbia Trauma Code and a Cornell Level I Trauma; Columbia Trauma Alert Criteria are similar to Cornell Level II Trauma Activations. Both Trauma Codes and Alerts go to the DART room but surgery is only activated for Trauma Codes. Please see the attachments for details on resident roles and responsibilites AND for case examples.

Trauma Activation Guidelines -Milstein Final. May 2021

Milstein Trauma

From Dr. Joyce Kuo: Camp Nejeda Physician Opportunity

Please see the attachment for information on doing a 1-2 week elective as camp physician. Camp Nejeda is “a large summer camp for children with Type 1 Diabetes in NJ.”

From Dr. Ouyang: Journal Club on Health Reporting This Wednesday!

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)

From Dr. Shah: Mattu EKG Competition

Amal Mattu is sharing his 9th Annual ECG Competition to all programs that would like to test their ability to interpret ECGs. Answers will be posted on www.ECGWeekly.com and will be FREE open access.

To get a copy of this years questions please download them from https://spaces.hightail.com/receive/wRJKi5sQoJ

From Dr. Shah: EMRA Awards / Grants

Please consider applying for an EMRA award/grant. Deadline is July 15.

https://www.emra.org/be-involved/awards/

Making Care Better: May Message of the Month