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Academic Associate Program. BBB 490 and 491. Physician Director Judd E. Hollander, MD Research Coordinators Christine McCusker, RN Keara Sease, MAEd Faculty Roger Band, MD Angela Mills, MD Jesse Pines, MD Karin Rhodes, MD Dave Gaieski, MD Munish Goyal, MD Fellows/Med Students.
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Academic Associate Program BBB 490 and 491
Physician Director Judd E. Hollander, MD Research Coordinators Christine McCusker, RN Keara Sease, MAEd Faculty Roger Band, MD Angela Mills, MD Jesse Pines, MD Karin Rhodes, MD Dave Gaieski, MD Munish Goyal, MD Fellows/Med Students Physician Co-director Joe Zorc, MD Research Coordinators Marlena Kittick Faculty Jill Baren, MD Academic Associates Introductions
History of Program • Developed in 1994 at SUNY Stony Brook • student generated idea • Pre-Meds and Volunteering in ED • Opportunity to observe the ED • Participate in research • Earn recognition with Medical School Faculty • letters of recommendation
Program Description • BBB 490 • First semester program • Data collection • Didactic Classes • Examinations • BBB 491 • Data collection • Individual projects • Research seminars • Paper
Classes Thursday • Patient Oriented Research Modules • HIPAA Training • Orientation • Data collection • Research Ethics • Research Design Overview • Project Design • Seminar Series • Asking the study question • Preparing an introduction – selling your paper • Preparing the methods and results section 4:30-6:30ish 2:30-3:30
Program Materials • Survey completed at registration meeting • Phone list • Schedule • Copy of data forms and log • Pocket Card • Web Site • Orientation Manual • Slides • Other Materials
Attendance Policy • All your shifts must be covered • you • alternate • No unexcused absences allowed • Miss 2 and you Fail • When you switch • Person covering shift • e-mail Dr. Hollander and Jen (or Dr. Zorc/Marlena)
OK Not OK Dress Code • No jeans • No t-shirts • No cut-offs • No bandana’s • Dress professional • Examples
Confidentiality • Patients • Medical records • Conversations • Hallways, elevators, etc • Penn Students • Study Results
Confidentiality: HIPAA • Individually Identifiable Health Information • Info about health of an individual • Reasonable belief that the info can identify pt • Protected Health Information • All individually identifiable information • Includes oral communications
Confidentiality: HIPAA • Four Ways to Use PHI in Research • Use De-identified Data • Use limited data set • IRB Waiver of Authorization • No more than minimal risk • Research not practical otherwise or without access to PHI • Authorization
Confidentiality: HIPAA • Uses and Disclosures of PHI in Research • Preparation for Research • Inform pt that disclosure is sought for research • PHI will not be removed from health system • PHI is necessary for research purposes • Recruitment • Physician/health care professional caring for patient • Cover letter signed by physician • Researcher themselves, when others not practical
OSHA • Universal Precautions • when handling blood & body fluids everyone is assumed to be infectious • Always wear gloves when handling body fluids • available in every room of ED • dispose of in red bags • masks and goggles are available
Hand Washing • When entering and leaving ED • Before and after eating • After using restroom • Before and after patient contact • After contact with any materials used by patient • Be thorough when washing • soap, warm water, friction • don’t forget your nails
Who’s Who • Attending Physicians • Nurses • EM Residents • Rotating Residents • ED Technicians (paramedic) • Transport (EMT)
Study Enrollment • Criteria • Who should and shouldn’t be included in study • Inclusion/Exclusion • Consent • Inform patient of study • Willing to participate • Some studies require MD to obtain patient consent
Research Forms • Unique to each study • Academic Associate will complete form or ensure MD completes form properly • 10 minutes to complete • Time with resident recorded on the log • Cannot sign out form completion to next shift • Be sure to screen each form to ensure completeness • Must be placed in completed forms bin, not patient chart
ED Study Log • Sign in on log in ED • If not signed in did not work • Patient data entered for every study • time, full name, encounter #, study, qualify, resident name, form times, academic associate
Finding Patients • Chief complaint noted on computer screen • Review triage notes from computer • initial note per nurse • signs and symptoms • past history • Watch for ambulance patients to present
Patients that fit the criteria • Select correct data form for patient • Label forms with patient ID sticker • name, date, medical record #, date of birth • Never take phone number from chart
Operational Procedures • Determine who will be filling out forms • If being filled out by nurse or MD badger them • Determine who will be obtaining samples • Prepare necessary sampling and labeling materials in advance • Attempt to inform before initial labs are done • If timed study notify in advance of time due
Helpful Hints • Check in with fellow AA’s • Communicate with staff & remember patient care comes first • When time allows interact with staff • discuss studies • ask questions • Communicate with principal investigators
More Helpful Hints • Be aware of patients watching • Eat in lounge • If personal phone call is necessary use phone in lounge • If patients ask questions specific to their care ask nurse or MD to answer the question
Important Facts • Strict detail is paramount in assuring valid outcomes • Do not be afraid to ask questions • Patient care comes first • Professional behavior is essential • determines success in winning trust and cooperation • Patient and staff
Grades • Attendance and thoroughness in ED • Logs, peer evaluation, in-shift assessments • Study form completion • Interactions with Residents • Blood processing completion • Pts per encounter • Consent processes • Examinations • Participation in conferences • Involvement in study • Participation in conferences • Interim drafts of paper ** • Paper
Letters of recommendation • Program description & attendance • If you ask, I will write one • Description of Program • Objective measures of performance • Tests, attendance, enrollment rates • Personal assessment • Motivation, work ethic, whining
Class Dates – Spring 2007 • Today • January 25 – Data collection • February 1- Ethics • February 8 – DV (optional but encouraged) • February 15 – Midterm (3 PM) • February 22 – ED Crowding (optional, encouraged) • March 1 – Research Design • April 5 – Putting It Together • May 3 – Final (3 PM) http://www.uphs.upenn.edu/em/Research/academicassociates/
HUP Projects • ACS • Dissection/CTA • Sepsis • DV • Pee-Pee • Traumatic Brain Injury • Coming down the pike • STARS • Trauma bloods • Abdominal pain/ultrasound • ED crowding