MedEd

What’s Wrong with Our “Big Data” on the Wards?

by Frank Zadravecz, MPH Across industries, Big Data is widely believed to offer a higher form of intelligence and knowledge that can generate insights that were previously impossible. However, the current cacophony of patient alarms we experience on the wards is not as informative for medical providers as we would hope. Are these alarms adding noise to otherwise informative Big Data? In the June 2015 issue of The Hospitalist, Karen Appold highlights the unique position that hospitalists hold in the fight against the overwhelming number of alarms generated by patient bedside monitors. In an interview with Ms. Appold, Vladmir Cadet of the ECRI Institute frames alarm load in the context of our current healthcare system, and suggests that alarm fatigue has become an enterprise-wide issue potentially due to sector-wide implementation of error-prone systems. The presence of non-specific alarm settings on our wards hints that alarm mismanagement may be rooted deeper…

Improving Patient Care as a Trainee

by Monica Shah Patient safety has always been a priority for me, but it is only recently that I became aware of the many issues that threaten quality of care for patients. As a medical student, I vividly remember shadowing at the hospital and being shocked at what I saw. I walked through patient rooms and heard loud beeps going off, the constant chatter of hospital staff, and the automatic entrance into patients’ rooms without even a knock. I wondered whether all of the disruptions and commotion impacted patient recovery in the hospital and after discharge. After pondering this, I decided that I wanted to take action and see what I, as a medical student, could do to improve daily inpatient conditions. In order to begin addressing my vision, I knew I needed to find the right mentor in the right location. As a medical student, I feel like my…

The First Two Years – Pathways and Patient Outcomes

By Frank Zadravecz, MPH The first two years of our medical curriculum are an introduction to the human body’s normal and pathophysiology, and an attempt to untangle the complex pathways involved in the interactions between self and non-self. We hope to make connections between our physical exam findings and the physiologic pathways we have at our educational foundation. We begin to realize that there is a fine line to walk when treating a patient – altering the inputs of a single system can drastically affect the outputs of another. If we place patient outcomes in the context of the dance that occurs in clinical care for patients on the wards, similar to the downstream effects of disrupting biological pathways in illness, there is a multifactorial system underlying hospitalized patient outcomes. Prior to medical school I worked for several years as a population health epidemiologist in the Democratic Republic of Congo…

If You Are a Doctor, You Are a Teacher.

To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art—if they desire to learn it—without fee and covenant -HIPPOCRATIC OATH Mrs. Truman, my fourth grade teacher, was given an apple by the other students. I put a human heart on her desk. Mrs. Truman was the first person I told of my dream to become a doctor. She didn’t knock my dream, or encourage me to broaden my choices, but let me enjoy my vision, and inspired and encouraged my path. She opened the idea to explore the human body, and not simply in books. Reading about the heart was one thing, but Mrs. Truman…

Why We Should Care about Alarm Fatigue

by Mimi Zander When I arrived back at the Children's Hospital of Philadelphia (CHOP) after my first year of medical school, I knew what was awaiting me: thousands of alarms from physiologic monitors, most of them inconsequential, lined up neatly in spreadsheets, splattered all over research databases, lighting up on video screens, chirping down hallways and up elevators. Of course, they were incessantly firing at the bedside, but when patient care is video recorded for Dr. Bonafide's research study on alarm fatigue, those patient care hours turn into data points that live on hard drives and servers waiting to be classified, annotated, and cataloged by a team of research assistants, including me. I began working at the CHOP while attending the University of Pennsylvania’s post-baccalaureate premed program. What started as a temporary summer research position, turned into an almost three year endeavor. The pilot that I helped design uses video…
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