Do you have qualtrics link LIsa mentioned? When do we fill those out?

I can the link it into the chat. You can fill it out as we go along or after if you take notes.

Qualtrics form - feedback will be shared with the presenters in the next few days: https://stanforduniversity.qualtrics.com/jfe/form/SV_1ENsboObKLjTx4i

Thank you!

Do you know what the stats on new pregnancy diagnosis for SHC is?

Paige, this was a resident driven project correct? wondering how/if it changed their view of improvement, waste, etc?

Hi Lauren, thank you so much for your question! We didn't quantify changes in view on waste but I can tell you that since we have started this project I have been stopped almost weekly by residents and attendings and other members of the clinical team with things they have. noticed or things they want to improve regarding waste i the clinic site. There are so many wonderful ideas and observations being shared and I think this project has led to a lot of enthusiasm and interest in waste reduction at all dermatoloy clinic sites that we plan to continue to build on.

Lauren - I will def let Paige chime in regarding impact on resident view, but wanted to add that from perspective of a dermatology attending, we faculty have been so postively impacted by our residents driving and seeing this project through - has given me and the faculty more hope that significant improvement can be achieved in a year, and in particular when our residents are the ones leading the way and engaged (and I feel like every QI endeavor would benefit from our residents helping us lead the way 🙂)!

Thank you Bernice! Bernice has been providing continuous and invaluable support for all the residents and this project from the very beginning - couldn't have done it without her🙂

Is this the .ACPDISCUSSSION?

smartphrase

Do you have separate clinic visit to do this or fit this in regular clinic visit?

Was wondering if you had thought about what you might measure as you move toward implementation

Hi Lauren - The reason we chose to focus on the advanced care planning smart phrase/documnetation tab is that there is a way to track individuals and their usage of this smartphrase by department. So, we plan to track usage across residents as well as by individual residents.

Ella, have you discussed with Paul and Lisa how this should change our approach to care and/or view of scores.

Definitely an important issue - What are the specifics for how you will measure impact going forward?

Geometric Mean LOS for DRG

geometric vs arithmetic

There is evidence for this in the surgey literature too, looking at footage from laparoscopy, but none in ED procedure or for airway managment

Great presentation. Do you plan to also look at impact on patient outcomes?

Yes, our intubations are linked to patient charts and we follow up on pt outcomes

this is a rare educational intervention that addresses all 4 levels of kirpatrick's model for learning evaluation. Most interventions are not tracked to pt level results

Excited to have both Dr. Hootman and Dr. Preiksaitis staying at Stanford for their respective fellowships next year!

@Zoe: great work on such an important initiative! Can I ask what inputs will fire the BPA, and will this be across the house?

Hi! I'm one of the other residents on the project. The BPA will get fired if patients flag as high risk with the readmission risk tool and as high mortality with the ACP tool.

Thank you!

The risk of readmission tool is just for medicine services right now is just for university general medicine services, but I believe the ACP tool is across many services.

Fantastic work and impact everyone, thank you for all of your hard work!