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Multisite Medicine Consults/Co-management Project

Multisite Medicine Consults/Co-management Project. Emily Wang, Chris Moreland, Mike Shoffeitt , Bret Simon and Luci Leykum. Objectives. To identify the questions posed in Medicine consults/co-management (MCC) requests at academic medical centers

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Multisite Medicine Consults/Co-management Project

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  1. Multisite Medicine Consults/Co-management Project Emily Wang, Chris Moreland, Mike Shoffeitt, Bret Simon and LuciLeykum

  2. Objectives • To identify the questions posed in Medicine consults/co-management (MCC) requests at academic medical centers • To refine the MCC curriculum to ensure coverage of adequate breadth of knowledge required to train Internal Medicine residents in MCC

  3. Background • Consultation experience required by ACGME • Not necessarily as a MCC rotation • MCC part of core of IM practice • What questions are asked of IM consultants? • And what additional issues do we address?

  4. Data Collection • Consult Data • 2 weeks every 3 months for one year= 8 weeks • Flexible time frame at each institution • Collecting consults daily 24/7 • Staff physicians will preferentially enter data

  5. Data Collection (cont) • Consult Data • # of consult requests, date/time • Service requesting consult • Reason for requested consult • Other issues addressed not specifically requested by consultant (e.g., bacteremia addressed during consult for diabetes) • Whether pt transferred to medicine • How often topic is addressed on inpatient medicine ward service • Whether consultant verbally discussed findings with requestor team

  6. Data Collection (cont) • Institutional Data • Type of hospital, # beds • Associated with a residency • MCCS rotation length, frequency • # residents, fellows • Formal curriculum or teaching plan • Coverage of MCCS and by whom • Associated pre-op clinics • Other resident responsibilities while on MCCS • Separate co-management services • Faculty staffing MCCS • POC for the initial consult

  7. Timeline • 2010: idea discussed at research meeting • 2010-2012 • Abstract and objectives defined • IRB submission and approval: exempt status due to QI • Initial data collection via Surveymonkey • https://www.surveymonkey.com/s/Hospital_Consults • Discussion and refinement of survey by perioperative experts within and outside of our institution

  8. Timeline (cont) • 2012-2013 • Recruitment of academic centers nationwide by convenience sample with regional selection • Mass General • University of Michigan • Johns Hopkins • University of Colorado at Denver • Denver Health • UCSF • UC Davis • Columbia

  9. Timeline (and cont…) • 2012-2013: participant conference call • Further survey refinement • Separate IRB submissions at each academic institution • Addressed academic product authorship • 1-2 PIs per institution, all staff assisting with consult data collection member of the “Medicine Consult Consortium” • 2013-2014 • 1:1 participant calls for baseline program demographics, follow-up on IRB progress • 2014: Start consult data collection…soon hopefully

  10. Future Plans • Manuscript with multi-site consult data collection, analysis • Possible descriptive paper about MCCS variation (and similarities) across programs • Data shared with all institutions and possible further products or ideas resulting from this project

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