Browsing by Subject "Internal Medicine"
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Item Bedside ultrasonography in clinical medicine(2016-10-21) Badamosi, RazaqItem Five things every internist should know about lung cancer ... and why(2015-04-24) Schiller, JoanItem Genomic medicine in internal medicine practice(2023-03-24) Gharavi, Ali G.Item The Impact of Portable Electronic Devices on Attending Rounding Behaviors of Inpatient Internal Medicine Teams at an Academic Medical Center(2014-02-04) Locke, Cameron; Suss, Adina; Barker, Blake; Moran, Brett; Wagner, JamesINTRODUCTION: The advancement of mobile technologies is changing the way medicine is practiced. Portable devices give health care professionals access to electronic resources and patient health records without restricting them to stationary computers. However, little exists in the literature on how these devices impact the rounding behavior of health care teams at academic medical centers. There is general concern that the EHR will compel caregivers to spend less time with their patients; there is significant evidence in a prior unpublished study to support this unintended consequence. In this study the authors sought to identify whether the availability of tablet computers to inpatient internal medicine teams would combine the best of both previous rounding behaviors. METHODS: Research was conducted over a period of 28 days, consisting of observation of internal medicine teams randomized into intervention, who were provided with tablet computers, and control groups. Two observers recorded behaviors on a standardized checklist, which included domains of patient care, EHR use, and distractions. RESULTS: 323 patient encounters were recorded in the context of eighteen health care teams, fourteen control (160 encounters) and four intervention (163 encounters). General characteristics of each arm of the study are summarized below: Variable Control Intervention p-value Tablet Used (y/n) 18.13% 50.31% < 0.0001 Tablet Use Count 0.29 1.18 < 0.0001 Total Tech Use Count 2.01 2.00 0.3637 Tablet Distraction Count 0 0.26 < 0.0001 Total Distraction Count 1.84 2.60 0.0045 % Rounds on Wards 34.38% 71.17% < 0.0001 Time per Patient (minutes) 12.37 10.62 0.0118 Time at Bedside (minutes) 3.28 3.71 0.6358 DISCUSSION: Tablet possession is associated with increased ward rounding with the same level of access to EHR as would be offered by room rounding, shorter time spent discussing each patient, but increased time spent at the patient's bedside. This constellation of findings may suggest increased efficiency. Intervention teams experienced more distractions than control teams, as is expected due to the increased amount of ward rounding. However, the tablets themselves contributed to the number of distractions. These results can shed light on the role that tablet computers will play as we enter the electronic age of medicine.Item Internal medicine telehealth for the future(2020-05-15) Ali, Sadia; Almandoz, Jaime; Thibodeau, Jennifer; Vemulapalli, RoopaItem The internist's role in the firearm public health crisis(2018-02-23) Brinker, StephanieItem [News Release](1968-12-11) Chappell, Frank W., Jr.; Fenley, BobItem [News Release](1970-02-20) Chappell, Frank W., Jr.; Weeks, JohnItem [News](1981-04-20) Rutherford, SusanItem [News](1975-06-06) Weeks, JohnItem [News](1980-05-07) Fenley, BobItem [News](1978-10-25) Harrell, AnnItem [News](1977-10-03) Fenley, BobItem [News](1988-02-05) Rutherford, SusanItem [News](1984-07-30) Williams, AnnItem The (past, present) and future of internal medicine: is there an exit from the Slough of despond?(2009-11-13) Goodenberger, Daniel M.Item Personal choice or predestined?: the road to specialty choice(2019-11-01) Sulistio, MelanieItem Simulation-based education in internal medicine(2014-06-27) Patel, HetalItem [Southwestern News](2003-02-03) Horton, RachelItem Standardization of Internal Jugular Central Venous Catheter Insertion Between Multiple Specialties with Simulation(2018-03-29) Weia, Benjamin Chun-Bang; Reed, W. Gary; Sulistio, Melanie; Phelps, EleanorBACKGROUND: Insertion of central venous catheters is a medical procedure with the risk of adverse outcomes. Between the different specialties at the University of Texas Southwestern Medical Center (UT Southwestern), there is a wide variation in the training and performance of the procedure. At other medical institutions, standardization of central venous catheter insertion decreased the frequency of adverse outcomes including failure, infection, pneumothorax, and arterial puncture. SPECIFIC AIM: Increase compliance with a standardized method for central venous catheter insertion among resident physicians in six departments at UT Southwestern to 95% as measured by a checklist by July 2019. METHODS: Consensus was achieved on a standardized method between six departments by a modified Delphi method. A training curriculum was created for the standardized method by following the Define-Measure-Analyze-Design-Validate (DMADV) framework. In designing the curriculum, strategies were utilized from implementation science, mastery-based learning, and simulation education. During the design phase, the curriculum was improved through two Plan-Do-Study-Act cycles with two pilot training sessions. RESULTS: Created a checklist for measuring compliance to the standardized method and a written exam for measuring knowledge required for the method. Designed multiple manuals and a video for learners and educators to standardize the training. CONCLUSION: A standardized method for inserting central venous catheters has been developed with consensus between multiple departments in a large academic institution. To introduce compliance with the method, a simulation-based training curriculum has been implemented. These achievements allow for the following phase of training resident physicians at UT Southwestern and measuring for an increase in compliance to the standardized method for central venous catheter insertion.