Weekly Update

September 28, 2020

General Announcements

From the Chiefs: Holiday Request Form

It’s that time of year! Please submit your preferences for the upcoming holidays. 

Just a reminder that if you are on vacation, elective, anesthesia, toxicology etc, this will count as your holiday off. 

PLEASE SUBMIT BY SEPTEMBER 30!

https://forms.gle/Ac9T7XoETytn8eiU6

From CC Montgomery: Columbia Res Room

Dear Residents, 

In an effort to maintain a neat and orderly resident room, please be advised that all items on top of the locker will be tossed next Thursday, September 30th by 9am. To prevent any of your valuables from being thrown out, please be sure to remove them by next week. 

Thank you!

 From Dr. Helen Ouyang: Journal Club on Health Reporting
  
Have you ever read newspaper articles on health care and thought they didn’t accurately reflect our work in the ED? Or maybe you found a magazine story inspiring, placing what you do in a larger context. Ever wonder how medical research is translated and distilled to patients and policy-makers? If any of this is true, or if you want to hang out with your colleagues and get in a lively discussion about health care, please come to our very first Journal Club on Health Reporting on Oct 6th at 8 pm.  

By reading and discussing articles in lay publications, we will learn how media shapes health care issues. As the pandemic magnified, media influences so much of what and how the public thinks, which inevitably affects our roles. We must pay attention to it.

For our first session, we’ll explore the clinical response to the Covid pandemic. Here are links to the articles, PDFs also attached. I promise that you will find them engaging.

This is supposed to be fun and will hopefully also stimulate some thinking and good conversation. All are welcome! Zoom link to follow.
 
And, we won’t have time to discuss them, but these two first-person accounts are too beautiful not to share. They’re about the pandemic, race and racism, the upcoming election… everything that’s been in the news for the last several months. 
https://www.vanityfair.com/culture/2020/08/jesmyn-ward-on-husbands-death-and-grief-during-covid
 
Grab a beverage and meet us on Zoom!
Helen, Manish, Phong, Emerson

From Dr. Duncan Grossman: “The COVID Project”

A group of fellow NYC residents and I are putting together a city-wide project that I hope you’ll be interested in.

It’s called, “The COVID Project.” It is going to be a compilation of creative pieces from emergency medicine residents all around the city that reflect on our time as EM residents during the COVID surge.

These may take the form of journal entries, short stories, poems, essays, photos, drawings, or any other creative pieces that you would be comfortable creating for this project. Whatever your artistic medium may be, feel free to submit it. (Probably can’t take interpretive dance at this time… Apologies.)

You may focus on a particular patient, a moment on the subway, home life, family life. Your stories may be insightful, or funny, or benign, or (of course) tragic. Whatever moves you.

We’re not sure what final form this will take – Maimo did a similar project before that became a small book for our its residents but who knows, we can dream a bit bigger, perhaps.

Please email your piece (along with your name, PGY, and program) to covidprojectnyc@gmail.com. We’d be happy to share your piece anonymously, just leave some contact info so we can reach out to you if needed.

We’ll be accepting submissions until December 1st.

Thank you. Please keep up the amazing work. Be happy, be safe.

From the Chiefs: PGY3 and PGY4 Morning Reports

Please check the morning report schedule and reach out to your faculty mentor before giving morning report.

From Dr. Mark Curato: Post-Residency Career Plans

Resident Career Survey is Now OPEN:
 
We are part of a group studying factors influencing EM resident career choices. We’re working with some other big programs (UCLA, Davis, UW, Iowa, Rush, Michigan, and Pitt). 
 
We’re joining after the project has already begun (and the other programs are getting to 100% participation from their residents), so I ask that you please take the survey at your earliest convenience. Your answers are confidential. Participation is voluntary, but I do hope that we can have 100% participation.
 
It should only take a few minutes. The survey link has been emailed to you.
 
We do really appreciate your participation, THANKS!

From the Chiefs: Schedule Requests

Please request at least 10 weeks ahead (as noted in our handbook) using the form on our website if you need a guaranteed day off (subject to review and approval). All other requests cannot be promised. 

2020 Annual Hospital Training (AHT 2020)

Get ready to complete your mandatory annual hospital training!

Access the 2020 Annual Hospital Training (AHT20) in the NYP Learning Center. This year’s launch is earlier than in prior years to allow more time for completing the training and learning the critical competencies. Completion of AHT20 is required by all graduate staff. Compliance is mandatory for you to work and for NYP to meet regulatory requirements. Failure to complete this in a timely manner will lead to your CWID account being disabled.

The deadline for completing AHT20 is Friday, December 4, 2020.

Instructions for completion can be found here. 

From the Munira Persad: BLS/ACLS Recertifications

Please see the attached documents regarding BLS/ACLS (Re)Certification. 

Residency Leadership guidance will be coming shortly to answer questions residents have about certifying or recertifying.

AHA COVID Interim Guidance

BLS/ACLS NYP Sign-Up Information

Campus Announcements

From Dr. Betty Chang: Columbia Patient Flow 

We are looking for a handful of frontline people to give us recommendations on patient flow / patient care areas pertaining to Covid/Flu isolation.  

If you are interested, please email me (bcc2134@cumc.columbia.edu) ASAP.  We hope to start discussion immediately (tentative zoom date for that is Tuesday, 10A, next week 9/29)  

From Dr. Bernard Chang: the IMPROVE Study

Dear Team

We are excited to finally launch our study on long-term clinician physical and psychological health (called IMPROVE) led by our team here in Columbia Emergency Medicine. This study, funded by the National Institutes of Health, will be one of the largest longitudinal studies on emergency provider mental and physical health and could lead to significant changes in how EDs operate, while providing evidence for staffing/scheduling and patient-flow innovations to improve both clinician well-being and patient outcomes. 

We designed our study to be respectful of your time, minimally disruptive given your busy schedules, while also recognizing you with a bunch of goodies 🙂 Please read below for details and how to sign up if interested.  (Of note, this is a different study from Dr. Laurel Mayer’s study on mental health. There is no problem in participating in both studies.)

We are looking for full time emergency department nurses, physicians, nurse practitioners, and physician assistants to participate in this study.  The study baseline visit will involve: 

  • answering questions (electronically) about your demographics, health history, thoughts, behaviors, and sleep (about 15 minutes)  
  • wearing an activity monitor on your wrist to assess physical activity and sleep during a 2-week period  (Fitbit watch)
  • taking Home Blood Pressure (HBP) readings daily (in the morning and at night) during a 2-week period 
  • sharing your work schedule during the 2-week assessment period (while at Columbia)
 

Study participation and annual follow-up will continue over 3 years and the two-week burst assessments described above will be repeated at years 1, 2 and 3.  Compensation for participation is available:

1) up to $600 ($150 at baseline and annually for 3 years)

2) A Fitbit Inspire HR to keep 

3) A bluetooth enabled blood pressure device (the Omron 5 Series BP7250) to keep. 

Please note that participation or decision not to participate in this study has no bearing or influence on your evaluation or status as an employee at New York Presbyterian or CUIMC. The data will be collected in a confidential manner and no identifiable information will be shared with non-study personnel.  

If you wish to view the electronic consent and information sheet to learn more about the study, please click on the following link:  

 

https://tinyurl.com/ImproveStudyEligibility

Thank you so much for considering and look forward to sharing the results of this study with you all. Sending you all my best and thank you again for all your hard work at our ED!  

Warmly,

Bernard

From Columbia Housestaff Quality Council

Interested in improving healthcare quality, safety, and equity at Columbia? 

The Columbia Houstaff Quality Council, made up of residents from each department, is looking for EM residents representatives. The council serves as a liaison between Columbia-NYP housestaff, the GME leadership, the hospital administration, and the hospital quality and patient infrastructure.

The council meets the first Thursday of each month at 6:30PM. Level of involvement depends on interest level.

Contact Averill Guo (adg7008@nyp.org) or Sanskriti Varma (sav9046@nyp.org) if you are interested or would like more information.

From Dr. Mahesh Polavarapu: EM/Radiology QI Project

Hi All!

There is a collaborative QI Project with Radiology that is about to kick-off looking at CT Utilization in the ED. It’s been identified by both departments as a great opportunity for resident involvement and should easily meet requirements for scholarly activity.  The scope is rather large with potential for multiple publications so I wanted to see if (and how many ) residents could use the project as their scholarly activity. To help, I created a rough estimate of scope (below). Let me know when you have the chance.

Best,
Mahesh

SCOPE OF PROJECT

  1. Talk to departmental research team about project (10hrs)
    1. IRB Approval?
  1.       If so, all participants need to complete IRB Training
    1. Funding availability
  1.       And how to apply for funding
    1. How do we develop a validated questionnaire?
  1.       Through the grad school?
        1. If so, what’s the process
    1. How do we get data analyzed?
    2. Potential forums for presenting results
  1.       Determine applicable timelines
  1. Develop Validated Questionnaire (15-20hrs)
  2. Develop Appropriateness Criteria from ED Perspective (10-15hrs)
  3. On-board study participants to project (5-10hrs)
  4. Chart mining and collection of study data (50hrs)
  5. Study analysis (10-15hrs)
    1. More if there is no external help for this
  2. Prepare and present data within the department (10hrs)
  3. Abstract writing (5-10hrs)
  4. Manuscript Writing and Submission (15-20hrs)

Total Projected EM Hours for Scholarly Activity Completion 130-160hrs

From Dr. James Kenny: McGraths

We are now down to only 4 McGraths in the ED from baseline of about 15 a couple of months ago. 

The usual process soon after an intubation is that the nurse will call the inventory analyst to exchange the airway box, but lately when the IA arrives the McGrath is missing. 

In order to limit losing more, we decided that the person intubating should hand the McGrath off to one of the nurses in the room (ideally either the patient’s nurse or resource nurse for the area) and they will hand off to the IA afterwards.

From Dr. Erica Olsen and Mariah Salerno: ED OnDemand Follow-Up Program

We want to inform you of an ED OnDemand Follow-Up w/ Coupon Code program that we are currently running in our CUMC emergency departments.

Program Description:

The program is intended for patients who are seen in the ED and discharged home, yet are identified as patients who would benefit from a free virtual follow-up appointment so that they do not need to physically come back into the ED. At the time of DC, the provider gives the Pt. a brochure and informs the Pt. that they are able to come back to the ED OR use the coupon code provided in the brochure to be seen Virtually for free.

Other Quick Tips:

  • The coupon code is good for ONE free virtual follow-up appointment.
  • The brochures are currently placed in the provider working rooms of Areas A, B, C, D and RME as well as in Allen.
  • The brochures are available in both English and Spanish.
  • The coupon codes in the Allen brochures are distinguished between the Peds and Adult patients.
From the Columbia EPIC team: Documentation Workflow
 
A reminder to all residents that when completing your primary provider note in Epic, you must click the box requiring a co-signature. 
 
Once the note has been assigned to the attending, sign your note (unless specifically asked not to by the attending. This workflow ensures that notes can be signed in a timely manner by attending. 
 
If you have questions, please feel free to reach out to the chiefs!
 
 
From Dr. Lynn Jiang: Weill Cornell-Bugando Medical Center Morning Report
 
Hello everyone,
 
In order to strengthen our global health curriculum while travel is suspended, we are implementing a recurring monthly collaborative morning report with our Tanzanian colleagues at Bugando Medical Center. 
 
This will occur at the morning report on the Cornell campus the FIRST THURSDAY of every month (ie next date October 1st). If you are assigned to this date, someone will reach out to you a few weeks before to help connect you with the Bugando team. They will be responsible for choosing a case and sending you the case information. Your responsibility will be guiding the presentation and discussion of this case, including possible differences in management depending on differing ER resources and setting. When available, the Bugando team will join the morning report real-time as well. 
 
If you have any questions, please feel free to contact Lynn Jiang at lgj7001@med.cornell.edu

MCB Message of the Month

September 30, 2020 - GI

Time

Topic

Speaker

  • 08:00 - 08:30
  • Vomiting in Children
Dr. Susan Fraymovich

WCMC PEM Attending

  • 08:30-09:00
  • GI Bleed
Dr. Lucy Willis

WCMC Emergency Attending

  • 09:00 - 10:00
  • EKG Workshop
NYPEM EKG Team
  • 10:00 - 10:30
  • Geriatric Abdominal Emergencies
Dr. Alexis Halpern

WCMC Emergency Attending

  • 10:30 - 11:00
  • Classic Abdominal CT Findings
Dr. Jasnit Makker

CUMC Radiology Attending

  • 11:00 - 12:00
  • PEC Town Hall
Program Evaluation Committee
ASYNCHRONOUS LEARNING
Tintinalli’s Emergency Medicine 9th Ed – Chapters 84-87 (WCM Library for residents)
 
 
CONFERENCE ATTENDANCE AND EVALUATION LINK
 
 
Please note the new attendance system for faculty to self-report hours attended at conference. We will no longer be manually collecting attendance and will rely on self-reporting. Thank you for your compliance with this new system.

ZOOM

Dr. DuBem Okeke

Congratulations to our PGY3 Dr. DuBem Okeke with a champagne tap. 🍾 *Meek voice* Flexin' on em! Way to go, Doctor Doobie!

Upcoming Residency Events

To Dos

ALL

PGY4s

PGY3s

PGY2s

  • Time to start dominating the board.  
  • 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

  • Ask questions constantly! Everyone is here to help!

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.