January 25, 2021

From Dr. Sachit Balsari: Climate And Human Health Fellowship

We are hiring our next Climate and Human Health Fellow at Beth Israel Deaconess Medical Center.

The two-year fellowship offered to US board eligible or board certified EM physicians, is jointly hosted with Harvard’s Center for Climate, Health and the Global Environment, and the Harvard FXB Center for Health and Human Rights, and seeks to train national physician leaders in Climate and Human Health research and advocacy.

The intensive program includes a master’s degree in public health or public policy at Harvard; internships at National Institute of Environmental Health Sciences (NIEHS); opportunities to learn and engage in advocacy on the Hill; and training to lead independent research at the intersection of climate change, human health, and policy.

Fellows will participate in the academic life of the affiliated Centers at Harvard and will have the opportunity to develop expertise in one of several domains including climate-related migration, adaptation, and health system resilience.
 
Visit https://lnkd.in/geTTddY to learn more! 
 

From Dr. Alex Koyfman: EMDocs Articles

Senior Residents: If interested in writing for EMDocs.net, email akoyfman8@gmail.com for more information!

From Dr. Oz Sayan: ITE Review

ITE Review continues!

For all residents (PGY2-4) who scored under 30th percentile on the 2020 ITE, we will ask that you attend a mandatory 50% (or 12) ITE Wednesday Evening Sessions and view the remaining 12 ITE session asynchronously via ZOOM recordings.   All other residents can use the ITE Review Session as another tool to study – no mandatory attendance. 

We will continue at 8:30PM-10:30PM via ZOOM.  They will be every Wednesday Evening until February 17, 2021.  I have attached the schedule. 

Zoom Info:

https://nyph.zoom.us/j/96952981627?pwd=UDNGdWpNVlFlZHRGYk5ZUHUzTG55QT09

Meeting ID: 969 5298 1627

Passcode: 384908

Campus Announcements

From Dr. Kiran Pandit: Undergraduate Med Ed Analysis

If any of the EM residents are interested in education research at the UME level, Dr. Pandit is starting a qualitative analysis of some of the student reflections from the third-year student EM experience over the last couple of years.  Please reach out to Dr. Pandit (kbp9@cumc.columbia.edu) if interested.
 

From Dr. James Kenny: Palliative Care Training

Hi all,
 
We have additional space on 2/2/21 if someone would like to join the Palliative Care training session.  The initial focus will be on communication skills training, emphasizing how to best facilitate goals of care discussions and deliver serious news. Our hope is that this will lead to additional collaborative projects with Palliative Care in the future.  
 
The initial session will be in person on 2/2 at the Vagelos Education Center from 9a-5p. If you are interested in becoming part of this initial group, please email Lily Abrukin (la2645@cumc.columbia.edu) or James Kenny (jfk2143@cumc.columbia.edu) and I for further information.

From Dr. Ed Suh: Pulse Ox Information

Hi everyone, I wanted to clarify some confusion about discharging patients with COVID or CLI and make you all aware of another resource we have at our disposal. 

 

All ED patients, age 18 and up, being discharged with COVID/CLI are eligible to receive a pulse oximeter to measure their oxygen levels at home. 

 

Patients with risk factors for poor outcome that you are clinically more concerned about should be enrolled in the Remote Care Program. This program involves regular telephone follow-up by Columbia PAs over a several day period. You can enroll patients in this program even if their COVID PCR results are pending!

 

Patients without risk factors that you are less concerned about can be offered enrollment in the “MyCare” Program, which is a smartphone app (an extension to Epic’s MyChart/Connect) that contains a daily symptom / O2 saturation log. This log will be reviewed by a physician assistant daily, although not in real time. This is available in English and Spanish.

  • Patients who have COVID PCR pending: The Follow-Up NP will initiate enrollment of the patient in MyCare only if the PCR is positive. (This has already been happening at Milstein.)
  • Patients who are known COVID PCR+: You can initiate the process for enrolling into the program before discharge simply by entering an Epic order.
 
The process for doing the above should be identical at the Milstein, Allen, and soon at the CHONY ED as well.
  1. To give a pulse oximeter: Enter the “Pulse Oximeter” order in the Dispo tab. The nurse should provide the patient with the device, some training, and a paper brochure with instructions on use and interpretation. (The same instructions that are available from the COVID Discharge Instructions set to copy into the AVS).
  2. To enroll in the Remote Care Program: Enter the “Remote Care Program” order in the Dispo tab. You only need to confirm the patient’s telephone number.
  3. To invite the patient to enroll in MyCare: Enter the “MyCare” (“Connect MyCare Home Monitoring”) order in the Dispo tab. As long as the patient’s email address is in the system, they will receive an email invitation to download the application and sign up for the service.
Because patients may not be tech savvy enough to complete MyCare enrollment on their own at home, a Patient Navigator will call the patient in the next day or two to help walk the patient through the enrollment process, if desired. You do not need to enter a separate Patient Navigator order, as this is being captured on the back end.
 
Please let me know if you have any questions going forward on these programs!
 

From Drs. Devjani Das, Lauren Curato, and Lauren Titone: EM Clerkship Commencing

Med students have arrived at Columbia! Here are some updates to be aware of:

  • These are “third year” Columbia Medical students that rotate with us for two weeks. Many of these students have never rotated or shadowed in the ED (or ANY clinical area) before. 

  • They are expected to work directly with the attending (or PGY4 if working in Area Blue) and see patients independently (about 2-3 per shift). This is not a shadowing experience. Please encourage them to observe and get involved in resuscitations, codes, intubations etc but otherwise they should be seeing their own patients and presenting directly to the attending or PGY4 if in Area Blue. If any issues arise regarding staffing of the MCY students please reach out to us directly.

  • Medical students SHOULD NOT see patients with confirmed COVID-19 or symptoms concerning for active infection (as much as is reasonably possible). This is a firm request from the medical school. 

  • Please encourage students to be in proper PPE (N95 + Eye Protection) at all times. If you notice a student does not have the appropriate PPE or theirs is broken/soiled please reach out to the nurse managers to get them a new properly fitting mask, eye shield etc.

  • You will encounter students on shift on most Tuesdays and Thursdays-Sundays. They should not be told to go to a different area in the ER during their shift. We are limiting the schedule to one student per clinical area. If you have a basic procedure (I&D, lac repair, etc), please encourage the students to participate in that procedure.

  • PGY4s: These students will be presenting to you, as any junior resident would, in Area Blue. You will follow these patients and write a note. At the end of every shift, the student will hand you a feedback card with a QR code. Scan the QR code with your smartphone and it will take you to a 4 question Qualtrics survey. Please, please, please fill these out in real time. Then sign the card and hand back to the student. Please also provide as much verbal and direct feedback as possible throughout their shift. 

  • PGY3s: The students will be shadowing you during your critical care shifts from 3p-8p. They will not be seeing these patients primarily so should not be writing notes on them, they are only shadowing you. Please encourage and involve them in the resuscitation process for patients that you see. This will be the most exciting part for them! At the end of their shift, the student will hand you a feedback card with a QR code. Scan the QR code with your smartphone and it will take you to a 2 question Qualtrics survey. Please, please, please fill these out in real time. Then sign the card and hand back to the student. Please also provide as much verbal and direct feedback as possible throughout their shift. 

  • PGY1s/PGY2s: The students should not be presenting to you directly on any patients. However, please feel free to involve them in any case, imaging study, procedure, etc. that you think may be interesting to them. Remember, a lot of these students have never been in the clinical area so everything is new and exciting for them!

We thank you in advance for the time and effort you put into Medical Student Education. This clerkship has been approved and supported by the medical school due to your dedication, hard work and to the valuable learning experience they see in our department! Here is a link to a great resource that your colleagues have put together on tips for teaching medical students (thanks Vineet, Jess and Taylor!). These students will see and listen to everything you do and say, so please show them how great it is to be an EM physician!

 

From Dr. Jenny Castillo:  Workplace Violence

Please contact Dr. Castillo (jlc2298@cumc.columbia.edu) if you’re interested in participating in a project on workplace violence.  A copy of her proposal can be found here.

From Dr. Helen Ouyang: Upcoming Journal Club on Health Reporting

Our next Journal Club on Health Reporting will be the evening of Tuesday, January 26th, likely at 8pm again.
It’ll be on the very relevant topic of… Covid-19 vaccines! 
 
Articles and Zoom link to follow. If you come across something (news stories, podcasts, etc) in the lay press that you would like to be included, please send along. 
 
Thank you,
Helen, Manish, Phong, Emerson
From Dr. Stefan Flores: CUIMC Diversity Day
 
Just a heads up to block the date for our first CUIMC diversity day on Feb 3rd, @ 4-6 pm.
The purpose of the event is to serve as an inaugural day to recruit prospective residents from all departments, including Emergency medicine, surgery, medicine, pediatrics that are BIPOC, LGBTQ ,and those from historically under-represented backgrounds. Considering interview season is currently underway, this will allow for them to revisit the institution virtually.
The event will be warm and informal and intend to highlight that our institution values diversity and anti-racism. It will allow students to connect with all faculty and residents including those who identify as BIPOC /LGBTQ throughout the institution , and a small talk from our keynote speaker!
 
PLEASE Save the date- We need diverse representation from ALL backgrounds, especially those within the DEI committee!
Considering the day is only 2 months away, we want to advertise and let students know ASAP.
  
More to come, but we would love help/input from anyone including the residents, considering we need to showcase why this program is worth coming to! 
 
 
Thanks, 
Stefan/Almaz/Chloe and the DEI committee

From Dr. Rama Rao: Non-Binary ED Patients

Please take a moment to fill out the following survey regarding the care of our transgender and gender non-binary patients in the ED.  Thank you!

https://redcap.link/b3ctuokg

From Dr. Dave Bodnar: ED Pass Note

We have slimmed it down so it now is much easier to read and complete (Examples below). Please remind the residents that this note must be completed prior to bed request for Internal Medicine admissions. Please let me know (djb9004@med.cornell.edu) if there are any questions.

ED-PASS Sign-Out
@DATE@ (this stamps both the date and time into the note) 
@ME@
Author Contact Number: *** 
ED Course (Including Pertinent Labs, Radiology and Consult Discussions): ***
Working ED Diagnosis / Reason for Admission:  *** 
Any Non-Clinical Psycho/Social Issues: ***

From Dr. Daniel Golden: QIPS

Join our Council!! Opportunities now exist to learn how to perform Quality Improvement projects, obtain leadership positions, take part in scholarly projects, network, and make a difference! 

The amount you participate is up to you. Contact Dan Golden at dag9164@nyp.org or call/text 347-573-1681 if interested!

MCB Message of the Month

January 27, 2020

MOCK ORAL BOARD

Time

Topic

Speaker

NYPEM Leadership and Faculty
Introduction, logistics, and mid-day questions

Dr. Mike DeFilippo

Shout out to Dr. DeFilippo for crushing some busy night shifts in the Columbia ED. He was been carrying the board (Mike doesn't skip back day) and even took a notification. Great job in picking up patients, writing notes, dispo-ing patients, and using POCUS to help steer clinical decision making. #Scanimal

Chief on Call

Ahmed Shaikh, M.D. 
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