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  • September 15, 2022 6:17 AM | Anonymous

    Approximately 50 organizations came together this weekend at ACS headquarters in Chicago to develop recommendations addressing firearm violence in the US. The summit builds on the work stemming from the inaugural Medical Summit on Firearm Injury Prevention in 2019.

    Learn more

  • September 06, 2022 3:36 PM | Anonymous

    David L. Feldman, MD, MBA, FACS, Chief Medical Officer, The Doctors Company and TDC Group

    Despite more than 20 years of focus on patient safety, many hospitals and healthcare professionals still struggle to create an environment that engenders patient safety and reduces harm. Many medical professionals encounter a confusing array of programs and tools that are touted as necessary, such as team training, simulation, root cause analyses, and efforts to promote a just culture. They struggle with deciding where to focus and whether to recruit support from senior leadership or buy-in from other clinicians. At TDC Group, we believe there are four elements to creating a culture of safety, and everything begins with mutual respect. We then focus on optimizing how people, teams, and systems function, understanding how people think to keep them engaged during training, and finally, being sure that all providers are viewed through a just-culture lens. To help us explore each of these areas, I asked four experts for their stories from the trenches for the TDC Group Leading Voices in Healthcare podcast series. Each of these longtime patient safety leaders has deep experience in organizational change.

    Building Mutual Respect in a Culture of Safety

    When I interviewed Michael Brodman, MD, Professor and Chair Emeritus in the Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine and Senior Vice President for Professional Excellence, Mount Sinai Health System, New York, NY, he described some of the wakeup calls that showed him the connection between mutual respect and patient safety. One happened years ago: “We did a survey on the labor floor. And this was shocking: 75 percent of the nurses said that if they saw a doctor doing something wrong, they wouldn’t say something,” because “they were afraid that somebody would yell at them or they’d get fired.” But after five-plus years of work on the institution’s culture, that figure had dropped to between 10 and 15 percent: “Basically, the point was, the nurses felt comfortable working on the floor.” Dr. Brodman says that when the labor floor team “created a just, level playing field, morale went up, and not surprisingly, adverse outcomes went down.”

    To hear more of the story behind the creation of the Mount Sinai Code of Professionalism, listen to my conversation with Dr. Brodman.

    High-Performance Teams—Crucial for a Culture of Safety

    Once upon a time, Michael Leitman, MD, Professor of Surgery and Medical Education and Dean for Graduate Medical Education at the Icahn School of Medicine at Mount Sinai, New York, NY, traveled with his team into the then-unknown world of TeamSTEPPS® training when they decamped from Mount Sinai Beth Israel in New York to Virginia for a week.

    Dr. Leitman told me some of what he’s learned about high-performance teams over his years as a surgeon, as an institutional leader, and as a medical educator. His experiences highlight the value of performing a readiness assessment prior to training, the struggle to overcome team member skepticism, and the value of reaching medical professionals early in their careers. He thinks that residents need to understand that "essential to patient safety is teamwork and interprofessional performance. It’s just part of the way we practice caring in hospitals—with the complexity of healthcare being what it is, that is just essential.”

    To continue your journey with your own high-performance team, listen to my conversation with Dr. Leitman.

    To Build a Culture of Safety, Use Human Factors Engineering

    Amish Aghera, MD, emergency medicine physician and the Director for the Center for Clinical Simulation and Safety and the Simulation Fellowship at Maimonides Medical Center in Brooklyn, NY, had what he described as “an existential moment” when testing revealed that medical residents were retaining a lower proportion of his training content than he’d hoped. He thought, “Am I just bad at this thing? Are our residents bad? And you know, the truth was neither. It just has to do with how we think as human beings.” From there, seeking training methods “to keep people engaged,” Dr. Aghera honed his skills in simulation training, and then in human factors engineering, which creates physical workspaces and workflows to support clinical decision making, teamwork, and patient safety. Dr. Aghera describes a variety of potential system interventions that institutions can consider, from the very low-tech to the innovative high-tech.

    Dr. Aghera also addressed the necessity of considering large-scale organizational factors to make change: “Who are the people who are going to get things moving at a higher administrative level . . . and who are you going to work with? Who’s that working coalition, so to speak?” To learn more about simulation training, human factors engineering, and organizational change, listen to my interview with Dr. Aghera.

    Just Culture Enables a Culture of Safety

    Elizabeth Duthie, RN, PhD, told me, “I always like to tell clinicians who are joining us that we expect that despite their best well-intentioned efforts, that errors are going to occur. Because that’s what happens to humans.” Dr. Duthie, Director of Patient Safety at Montefiore Medical Center, Bronx, NY, discusses how important a just culture is to creating a culture of safety. “If something bad happens, we want to learn from it,” she says—and in the absence of a just culture, many risks and near-misses go unreported. Dr. Duthie emphasizes that clinicians and staff need to experience psychological safety to report, and also to see the benefits of reporting risks. This includes knowing they can count on reliable follow-up: “When they put in an event report and it goes into a black hole and they never hear back from it, it says to them, ‘What I have to say doesn’t matter.’”

    While just culture has always been critical to safety culture, many are particularly aware of this need today, given the recent criminal conviction of a former nurse for a medical error, which Dr. Duthie and I discussed. To learn more about the journey to a just culture, listen to my interview with Dr. Duthie.

    The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

     

  • August 02, 2022 11:05 AM | Anonymous

    David L. Feldman, MD, MBA, FACS
    Chief Medical Officer, The Doctors Company and TDC Group; Senior Vice President, Healthcare Risk Advisors

    Early in the pandemic, I heard an obstetrician say that a medical setting was the last place many patients were willing to go. As a result, he was checking on prenatal patients using telemedicine. With questions about standard of care in mind, I gathered obstetric leaders into a meeting group where providers discussed ways to safely utilize phone and video modalities to continue prenatal care beyond the pandemic. Would this modality, necessary in a time of crisis, be continued in the “new normal”?

    Surgical specialties present an unexpected number of opportunities for remote care, from consultative conversations all the way through postoperative evaluations. For instance, many post-op evaluations can relocate to the telemedicine space, where questions like how the wound looks and drain output can be evaluated.

    Such uses of telemedicine, when appropriate, improve the patient experience, and sometimes patient safety. After all, post-op patients don’t want to leave home, and sometimes safety is an issue. I know I’m not the only one who has ever made a house call during icy weather. If we use good clinical judgment, we can offer a version of the post-op house call to some patients with arguably comparable or improved patient safety.

    Read the complete article

  • July 29, 2022 11:08 AM | Anonymous

    The Chapter, along with MSSNY and 14 Specialty Societies, sent a letter urging the Governor to veto the wrongful death lawsuit expansion bill:

    “Our respective associations, which together represent tens of thousands of physicians across the state of New York providing care to hundreds of thousands of New Yorkers each year, urge you to recommend a veto of the above-referenced legislation that would exponentially expand damages and lawsuits for ‘wrongful death’ by including compensation for grief or anguish. The explosive increase in liability costs that expansions like this bill would necessitate would cause significant damage to our healthcare safety net, driving physicians out of state, and exacerbate the already challenging patient access to care issues we face."

    Access a copy of the letter

  • July 27, 2022 11:36 AM | Anonymous

    Read the entire issue

    President Biden Chooses ACS Fellow to Direct NCI

    Renowned cancer surgeon Monica M. Bertagnolli, MD, FACS, from Boston, MA, is slated to become the 16th director of the National Cancer Institute.

    Deadline Is Next Week for Late-Breaking Abstract Submission

    Time is running out to submit your late-breaking abstract for Clinical Congress 2022, October 16–20 in San Diego, CA. The deadline to submit is Monday, August 1.

    COVID Variant Fuels Rise in Cases, New Vaccine Option Coming Soon

    The Omicron BA.5 variant has led to a spike in the number of cases, hospitalizations, and deaths from COVID-19 in the US. Meanwhile, the US Centers for Disease Control and Prevention has recommended the Novavax vaccine as a primary series option in adults.

  • July 20, 2022 4:35 PM | Anonymous

    Anywhere from 10 to 30 percent of those who contracted COVID-19 suffer chronic aftereffects—some lasting many months after the initial diagnosis—and now face increased risk of thromboembolic disease, cardiovascular complications, hepatic and renal impairment, and systemic inflammatory response syndrome.

    Peter Kolbert, Senior Vice President of Claim and Litigation Services for Healthcare Risk Advisors, part of TDC Group, and Dr. Zijian Chen, Assistant Professor of Medicine at the Icahn School of Medicine at Mount Sinai and Medical Director of Mount Sinai’s Center for Post-COVID Care, discuss the effects of long COVID.

    Access the article

  • July 19, 2022 10:26 AM | Anonymous

    Parag Mehta, MD - MSSNY President

    Not very long ago, New York’s physicians and other health care workers were cheered as heroes for their efforts to combat the COVID-19 pandemic. They risked their lives for their patients. They risked the lives of their loved ones as they provided this care.  

    Many physicians were sickened, and some died. Countless physicians continue to wear the emotional scars from these overwhelming circumstances. 

    However, the cheers are long forgotten.

    Now the physicians of New York face a potential new disaster, due to a well-intentioned — but egregiously harmful — bill recently passed by the New York state Legislature. 

    The recent legislation would exponentially increase the damages that are awardable under New York’s wrongful-death statute. One actuarial study concluded the increased damages and the new lawsuits this bill would trigger would increase liability insurance costs for New York’s doctors and hospitals by nearly 40 percent.

    Read the article

  • July 19, 2022 10:16 AM | Anonymous

    The American College of Surgeons (ACS) Division of Education invites academic and industry engineers, scientists, surgeons, and surgical educators to submit abstracts for presentation at the 2023 Annual ACS Surgeons and Engineers: A Dialogue on Surgical Simulation, a full-day meeting occurring on Wednesday, March 1, 2023, in Chicago, IL.

    Both original and previously presented abstracts are welcome.

    Visit the Call for Abstracts to review the abstract categories, requirements, and timeline and submit your abstracts.
  • July 15, 2022 10:10 AM | Anonymous

    The Committee on Resident Education is accepting applications for volunteers to serve on the committee. The committee’s mission is to address issues of resident education in surgery, including the educational environment, characteristics of the resident population, graduate surgical education curricular issues and competency, and faculty development as educators.

    To be eligible for consideration, please send a letter expressing your interest in becoming a member of this committee and an updated CV to Brad DeFabo Akin (bakin@facs.org) by August 15, 2022.

     

    Medical Student Travel Award to Clinical Congress – Deadline July 22

    The ACS Division of Member Services created an award for one medical student interested in surgery to attend four days at Clinical Congress 2022 in San Diego, CA. Registration and travel expenses will be reimbursed up to $2,000 (with applicable receipts). 

    Application Terms and Requirements:  

    • This award is only open to domestic medical student members transitioning into surgical residency 
    • Applicants must be a current member of the American College of Surgeons  
    • Applicants must be in their final year of medical school and matched into surgical residency program 
    • The award recipient must upgrade their medical student membership to residence status 
    • The awardee must join a RAS-ASC Committee of their choice and participate in conference calls leading up to Clinical Congress 2022 

    Application Process: Applications will be accepted online until 11:59 PM on Friday, July 22. Incomplete or late applications will not be considered.        

    Apply here: https://www.surveymonkey.com/r/MStravelaward2022                                                          
  • June 13, 2022 10:09 AM | Anonymous

     The legislative session ended the first week of June. Overall, the session was a success for the NY Chapter ACS resulting in the enactment of telehealth payment parity, maintaining funding for Physician Excess Medical Malpractice without any changes to eligibility, and helping to defeat inappropriate scope of practice expansions. The Chapter was able to secure passage in both the Senate and Assembly for Chest Wall Reconstruction (S.7881/A.8537) and Colorectal Cancer Screenings at 45 (S.906B/A.2085B).  Both bills now await signature from the Governor. The NY Chapter ACS also promoted prior authorization reforms which has helped to set stage and momentum for action in 2023.

    2022 Advocacy Day Target Issues:

    Prior Authorization Reform
    Support: Prior Authorization Proposed Gold Card Program (S.8299 RULES/A.9908A INSURANCE)  https://facs.quorum.us/campaign/40082/

    Support: Prior Authorization Utilization Review (S.6435A RULES /A.7129A INSURANCE) https://facs.quorum.us/campaign/40084/

    Support: Carter's Law - Give Kids a Chance (S.24 / A1943 Insurance Committees)  https://facs.quorum.us/campaign/31038/

    Trauma
    Call for a Study on the NYS Trauma System and Disaster Preparedness: https://facs.quorum.us/campaign/40091/

    Support: Stop the Bleed Training in High School Health Education Classes: https://facs.quorum.us/campaign/40087/

    Support: Stop the Bleed Kits in Schools (A.6462 Held for Consideration): https://facs.quorum.us/campaign/40098/

    Cancer
    Support: Provide Coverage for Chest Wall Reconstruction (S.7881/A.8537)   PASSED Awaits Gov. Signature  https://facs.quorum.us/campaign/40096/

    Support: Colorectal Cancer Screenings at 45 (S.906B/A.2085B)  PASSED Awaits Gov. Signature https://facs.quorum.us/campaign/39298/

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