UNIVERSITY OF SOUTH FLORIDA Internal Medicine Residency Program 2022- 2-23 ANNUAL REPORT
MISSION STATEMENT Our mission is to develop our residents into physicianleaders who have a strong foundation in patient care and medical knowledge but are also skilled in teaching, scholarly activity, leadership, and quality improvement. 2 OUR PROGRA M
PROGRAM AIMS 1. Equip graduates with the knowledge and clinical skills for excellence in the practice of medicine in their careers. 2. Expose residents to a variety of training sites and embrace the educational opportunities that arise from the diverse pathology and patient populations. 3. Promote individualization of the program to ensure graduate achieve the learning necessary for intended roles/practice 4. Ensure residents will graduate as educators of students, colleagues, patients, and themselves 5. Enhance professional development by providing residents with opportunities for scholarly activity, leadership, medical education and/or quality improvement & patient safety. 6. Conduct residency training in an environment that is collegial, supportive, open to growth and development, and awareness of resident well-being 3 OUR PROGRAM
CURRICULUM 4 TEACHING & LEARNING Academic Half Day – Dr. Mai leading a small group of PGY2’s in the Teaching to Teach workshop
ACADEMIC HALF DAY 2022-2023 TOPICS Workshops: • Professionalism • Intern Bootcamp (PGY1) • Teaching to Teach (PGY2) • End of Life/Palliative (PGY1 + PGY3) • Cultural Humility QI/PS • Mock Root Cause Analysis • Health Disparities Data Review Simulations: • ACLS and BLS (PGY2) • POCUS • Procedure Training/Senior Skills Workshop (PGY1) 5 Scholars Council: • Letter to Editor Workshop • Evidence Based Med Principles • Abstract Writing Workshop Board Review: • Hematology • Infectious Disease – Part 1 • Infectious Disease – Part 2 • Endocrinology – Part 2 • Nephrology – Part 1 • Nephrology – Part 2 Business/Practice of Medicine: • Compliant Level of Care Designation (PGY1) • Clinical Documentation & Improvement for Residents (PGY1) • Contract Negotiation (PGY3) • Billing & Coding • Litigation Avoidance/Mock Deposition (PGY2/3) • Filling out Death Certificates Forums • Alumni Tips for Boards (PGY3) • Evaluation Training for Evaluators • Pre-Med Mentorship Opportunity CURRICULUM
RESEARCH EDUCATION • Resident attendance and poster presentations at most major academic conferences throughout the country. • Goal to send out regular research newsletters with the upcoming conferences and abstract submission deadlines. • Evidence-Based Medicine didactics to help develop a systematic approach on how to approach and appraise current research. • Goal to continue to go through Evidence-Based Medicine topics throughout the year • Resident Research Guide • Currently being developed to help residents improve their research skills and get connected with research mentors throughout USF - PGY4 Academic & Research Chief, Dr. Naga CURRICULUM - RESEARCH
7 LETTER TO THE EDITOR WORKSHOP CURRICULUM – RESEARCH
JAHVA Outpatient Didactics (Current) • 7:30 AM – 10:30 AM: focus on QI lecture/exercise/project • 10:30 AM – 11:00/11:15 AM: focus on outpatient case presented by either PGY2 or PGY3 during the first Friday didactic session of the CC block • 10:30 AM- 11:00/11:15 AM: focus on New England Journal of Medicine Board Review Questions AND lecture given by Dr. Ramsakal • Topics taught by Dr. Ramaskal during the second Friday didactic session of CC block • Outpatient diabetes management • Acid-Base review • Antibiotics (part I) • Antibiotics (part II) • 11:15 AM- 11:45 AM: focus on wrap-up and completion of view alerts Outpatient topics presented by PGY3 resident since April 2022 1. Hyperlipidemia 2. Dyspnea 3. Thoracic aortic aneurysms 4. Vitamin D deficiency 5. COPD 6. Vaccinations in the primary care setting 7. Management of seizures in primary care 8. Chronic cough 9. Heart failure 10. Hormone replacement therapy Friday AM Didactics Schedule Sample 0730-0830 GEMBA/ Process Map Presentation 0830-0900 Define Slides (2 -Slides) 0900-1000 Waste Identification Slides/Teams Prep for Tollgate 1000-1030 Tollgate Meeting with Dr. Nehaul 1030-1100 Resident Driven Lecture 1100-1200 View Alerts JAHVA CC dates with planned lecture CURRICULUM
JAHVA Outpatient Didactics (Upcoming Changes/Goals) 1. Implement shift from PGY3 to PGY2 as leaders of outpatient case presentation. Will eventually transition to PGY1- directed outpatient case presentations starting following the academic year. 2. Possible transition from Dr. Ramsakal to Dr. Mazzarolo “Whiteboard DDx Lecture Series” starting in April 2023. Following dates under consideration: 4/28, 5/5, 5/19, 6/2, 6/16, 6/30 3. Pilot Journal Review Starting April 2023 in place of outpatient case presentation -PGY3, VA Outpatient Chief, Dr. Cavalaris JAHVA CC dates in process April 2023 schedule changes Transition to Dr. Mazzarolo dates CURRICULUM
Current State • Chief Resident Lead Board Review from 7:45-8:00 am • QI senior resident lead short presentations on outpatient management of a topic • USPSTF Updates • HTN • NASH/NAFLD • Osteoporosis • PEAC modules throughout the year • Longitudinal QI and discharge clinic for all residents - PGY3 Morsani/HP Chief, Dr. Bilodeau Gandre Future State • Selecting senior residents from each group to champion leading Board Review during the block • Continuing QI senior residents leading outpatient management presentations • Incorporating Yale curriculum and quizzes into AM learning for QI groups • Continuing longitudinal discharge clinic and QI • Incorporating fellow lead specialty lectures into QI learning • Teaching QI principles and background during the first half of each academic year Morsani/HP Outpatient Didactics (Current) CURRICULUM
Ideal State • Faculty lead board review each Friday for more nuanced discussion of tips/tricks for board questions • Continue Senior lead and Fellow lead presentations on outpatient management of a topic • Continue PEAC learning modules • Have residents participate in meetings with the TGH QI committees to present projects for the Morsani and HP clinic, or to gather data on quality metrics that may need projects to be worked on Morsani/HP Outpatient Didactics (Current) CURRICULUM
In the academic half day, PGY3 Dr. Perez -Melendez, mentored by Dr. Mateja, led a Workshop on Cultural Humility 12 Introduction to Cultural Humility in Healthcare • A new workshop was developed for the resident didactics curriculum for 2022 -2023. • The purpose of this workshop was to define culture humility and share with our residents the building blocks to develop cultural humility. • The residents were divided into smaller groups to encourage dialogue and create a safe environment to share about different cultures and traditions. • We also used the opportunity to introduce and discuss health disparities. This lead to the second portion of our didactics in which a case was presented and we sought to address some of the possible barriers to healthcare this individual was facing or would face. • Lastly, our goal is not only to ensure our residents are aware about cultural humility, health disparities, but to share with them the resources our hospital has to address our patient’s social and health needs. CURRICULUM - DISPARITIES
USF Morsani and Healthpark Primary Care Healthcare Screening Data and Care Gaps • Topic: • Discuss most recent breast cancer and colon cancer screening data for USF Morsani and Healthpark from 2019-2021 during resident didactics • Identify racial demographics and disparities within colon cancer and breast cancer screening data • Demonstrate care gap management within the health care system to ensure proper follow-up and documentation of healthcare screening tests • Goals: • Raise awareness of racial disparities and healthcare gaps that have worsened during the global COVID-19 pandemic in Morsani and Healthpark resident clinics • Promote resident education in systems-based practice and maintain compliance of healthcare screenings PGY3, Dr. Soto Del Valle 0.0% 20.0% 40.0% 60.0% 80.0% Not adherent Adherent Colorectal Cancer Screening Adherence 0.0% 20.0% 40.0% 60.0% 80.0% 100.0% Not adherent Adherent Breast Cancer Screening Adherence USF Morsani and HP Patient Cancer Screening Adherence 2019-2021 41.4% 42.9% 36.3% 46.0% 35.0% 28.8% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% African… White Hispanic/Latino Asian AI/Pacific… Other Percent of Patients Race Percentage of Racial Groups Adherent to Colorectal Cancer Screening 23.3% 21.4% 15.6% 27.1% 7.7% 15.4% 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% African… White Hispanic/Latino Asian AI/Pacific… Other Percent of Patients Race Percentage Adherent of Racial Groups to Breast Cancer Screening CURRICULUM - DISPARITIES
14 CURRICULUM - SIMULATION SIMULATION ACCOMPLISHMENTS & GOALS Code Blue Sims! • Weekly VA sessions, biweekly at TGH • Expanding target audience of simulations to include prelims and med-peds residents • Sessions scheduled to more closely reflect upcoming ICU location • Long term goal for PGY-1s and 2s for 1 session per 6 months, and one session at each location • Adapting session topics and scope based on resident and facility feedback • Incorporation of VAD ACLS, more focus on rhythm identification and transcutaneous pacing with the Zolls - Dr. Roberts PGY3 Sim Chief
15 INTERN PROCEDURE TRAINING CURRICULUM - SIMULATION
16 PGY2 CODE BLUE TRAINING CURRICULUM - SIMULATION
POCUS ACCOMPLISHMENTS & GOALS • Expanded scope of noon conference education based on resident interest • Including more organ systems and more focus on direct practice • Expanding clinic access POCUS • Health Park and Morsani now with Butterflies, VA coming soon! • Joined multidisciplinary group to expand and standardize POCUS education and documentation across specialties • Includes IM, Pulm Crit, Gen Surg, Trauma, ER, NICU, Med-Peds; Peds, Rads, Anesthesia, and more coming soon! • Long term goal of expanding and standardizing POCUS education across GME - Dr. Roberts PGY3 Sim Chief CURRICULUM - SIMULATION
18 YEAR END PROCEDURE TRAININ G CURRICULUM - SIMULATION
19 CURRICULUM - SIMULATION
20 POCUS WORKSHOP CURRICULUM - SIMULATION
21 BOARD STUDY SESSIONS Weekly study sessions of board preparation with a primary focus on areas that need improvement based on the program’s ITE results. Study sessions focus on helping develop a comprehensive learning approach to preparing for the boards which include independent learning, board basics, board review videos, MKSAP questions, and UWORLD questions. CURRICULUM – BOARD PREP
22 Year PGY 2 PGY 3 All Years Program Score Percentile Program Score Percentile Program Score Percentile 2022 2021 72 (Natl avg 68%) 66 73 (Natl avg = 70%) 60 2020 73 (Natl avg 66%) 62 75 (Natl Avg = 70%) 56 72 95 2019 73 (Natl Av = 70%) 62 75 (Natl Av = 73%) 56 74 91 2018 70 59 76 70 74 91 2017 70 56 75 65 73 87 IN -TRAINING EXAM CURRICULUM – BOARD PREP
23 CURRICULUM – WORK HOURS Per Month Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun ACGME 24+ 0 0 0 0 0 0 0 0 0 0 1 0 ACGME 80 Hour 0 1 0 0 0 0 1 0 0 0 0 0 ACGME Day Off 2 0 1 0 0 0 3 1 1 0 1 2 ACGME Short Break 3 3 4 1 3 1 4 6 2 4 3 8 Per Rotation DM:CARD:CONS ULTS-TGH DM:IM:CARD WARD-TGH DM:IM:CORJAHVA DM:IM:ER OVERFLOWJAHVA DM:IM:ER OVERFLOWTGH DM:IM:FLEXJAHVA DM:IM:HEALTH PARK CC-TGH DM:IM:HOUSEO FFICER-JAHVA DM:IM:HOUSEO FFICER-MCC DM:IM:MORSA NI CC-TGH DM:IM:VA CCJAHVA DM:IM:WARD TEAM 1-JAHVA DM:IM:WARD TEAM 2-JAHVA DM:IM:WARD TEAM 3-JAHVA DM:IM:WARD TEAM 4-JAHVA DM:IM:WARD TEAM 5-JAHVA DM:IM:WARD TEAM A-TGH DM:IM:WARD TEAM B-TGH DM:IM:WARD TEAM C-TGH DM:IM:WARD TEAM D-TGH DM:IM:WARD TEAM E-TGH DM:PULM:MIC U-TGH ACGME 24+ 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ACGME 80 Hour 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 ACGME Day Off 0 2 0 1 1 1 0 0 1 0 1 0 0 0 1 1 0 2 0 0 1 1 ACGME Short Break 0 0 2 1 0 0 3 0 0 0 0 5 5 5 4 2 4 0 7 1 1 0 0 2 4 6 8 10 12 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Total Violations by Month for AY 22-23 ACGME 24+ ACGME 80 Hour ACGME Call ACGME Day Off ACGME Short Break WORK HOUR VIOLATIONS
ON THE SPOT EVALUATIONS 24 TGH VA Moffitt other TGH Card Consults TGH Cards Echo (Imaging) TGH Critical Care Cs TGH Endo Consults TGH ER TGH GI Consults TGH Gynecology Clinic TGH Hem/Onc Consults TGH Hospitalist TGH ID TGH Nephro TGH Neuro Consults TGH Optho TGH Palliative TGH Psychiatry TGH Pulm Consults TGH Radiology TGH Rheum TGH Stroke TGH Hepatology VA Ambulatory Clinic VA Card Consults VA Derm Clinic VA Endo VA Endo Consults VA ER VA GI Ambulatory VA GI Consults VA Hospitalist VA ID VA Nephro VA Neuro Clinic VA Neuro Consults VA Neuro Consults (Bay Pines) VA Ophtho VA Ortho (PMR) VA Psychiatry (Bay Pines) VA Pulm Consults VA Radiology VA Rheum Clinic VA Subspecialty Clinic VA Urgent Care VA Women's Health MCC BMT and Cell Therapy MCC Heme Amb Clinic MCC ID MCC Onc Amb Clinic MCC Onc Endo Clinic MCC Palliative MCC Pulm Consults Brandon Ambulatory (MedPeds) Kennedy Ambulatory Morsani Allergy Morsani GI Continuity Clinic: Once per block (can be CC attending or subspecialty attending) Morsani CC VA CC HP CC This academic year, in a initiative to increase feedback conversations in electives and clinic blocks, we started an “On the Spot” formative evaluation form. Residents brought to faculty to gain feedback even on one half day, one consult, one clinic visit on the following rotations. We saw great improvement in feedback conversations. We anticipate the dip in October was due to Hurricane Ian impacting the end of some rotations when residents were planning to get feedback. In the first half of the year 370 evaluations were submitted. CURRICULUM – EVALUATION
25 CURRICULUM – EVALUATION ON THE SPOT EVALUATIONS SUBMITTED 78 74 66 38 64 61 85 58 53 47 38 23 July August September October November December January February March April May June
26 QUALITY & SAFETY QUALITY IMPROVEMENT & PATIENT SAFETY PGY4 QI/PS Chief Dr. Algarin Troia and rising QI chief, PGY3 Dr. Bildodeau hosting a simulated RCA in the Academic Half Day
VA Inpatient QI/PS Update Accomplishments to date: • 10 Quali-TEAs (Team Event Analysis, miniature RCA^2 from non-sentinel JPSR events) • 2 QI/QA conferences (Quality Improvement/Quality Assurance case discussions ~ M&M) • 7 Q-TIPS (quick hit QI topic reviews at noon conference) • 2 IHI National Forum poster presentations • Ongoing Proactive Risk Assessment/HFMEA (Healthcare Failure Mode and Effect Analysis) of JAHVA New Bed Tower with SimLEARN and JAHVA simulation center • 2 Influenza Vaccination Team Challenges QUALITY & SAFETY
Flu shot team challenge Ongoing Initiatives: • Medicine Team Challenges (Vaccinations) • Decreasing Inpatient Hypoglycemic Events • Decreasing Hospital-Associated Venous Thromboembolism • Decreasing Pre-procedural NPO times • IPSE (Interprofessional Education ) lecture series, total of 8 sessions per every internal medicine clerkship cohort (part 1 with intro to patient safety lecture then human factors engineering, part 2 with pharmacy tracer and environment of care/room of horrors simulation). QUALITY & SAFETY
VA Inpatient QI/PS Update Patient Safety & Quality Improvement Goals for 2023 • Ongoing proactive risk assessments with New Bed Tower activation • Increasing Trainee Event Reporting through JPSR • Continued growth of Quali-TEA, increased coordination with handoffs to process owners QUALITY & SAFETY
30 VA COR Projects (ROTATION) (VA Site, Faculty Lead = Drs. Melzer and Reiss) Continuity Clinic Projects (VA Site, Faculty Lead = Dr. Cummings; HP/Morsani Site, Faculty Lead = Dr. Oxner) Individual QI initiatives or Leadership Roles PGY 3 Babu, A. ROTATION 3/2023 - REDUCING PRE-PROCEDURE NPO TIME VA = Statin use in Diabetics Bilodeau, J. Morsani/HP = Increasing cologuard for screening VA Projects : Reducing missed VTE Prophylaxis, Reducing pre-procedure NPO time, simulations for new bed tower to reduce safety events (tied to RRT/Code Blue) Brown, B. VA = Improved continuity project. Improve TDAP rate in clinics Calderon, O. Morsani/HP = Increasing cologuard for screening Cavalaris, Charlie Improvement Initiative to Improve User Friendliness of Neuromuscular Blocking Orders in the MICU VA = Project to improve Shingrix vaccination, Project on Medication Reconcilliation FOBT ordering in the inpatient environment (TGH, Gomez Esquivel), Barriers to H Pylori erradication (VA Faculty, Blonski) Cavallari, Cristiana VA = Improving view alerts, Program to increase screening for proeteinuria DeNarvaez, E. ROTATION 9/2022 - REDUCING PRE-PROCEDURE NPO TIME VA = Understanding reason for visit prior to visit Dickinson, E. ROTATION 12/2022 - REDUCING PRE-PROCEDURE NPO TIME VA = improving vaccination rates Enciso, J. VA = improving medication compliance and patient screenings. VA : outpatient and inpatient optimization of heart failure to reduce readmissions Gandre, J. VA = increasing LST notes, patient education campaign to improve flue and covid shots, VA = COPD orderset to reduce 90 day readmissions Gidanian, S. VA = Increase TDAP vaccination rates, improving patient continuity with residents Goodman, S. Morsani/HP = Increasing cologuard for screening Attitudes towards COVID vaccination in patients with autoimmune inflammatory rheumatc diseases Graves, A. VA = Improving continuity in the clinic, improving RTC process Jordan, A. ROTATION 10/2022 - REDUCING PRE-PROCEDURE NPO TIME VA = Improving continuity in the clinic Lewellen, C. Morsani/HP = Increasing cologuard for screening Marks, J. ROTATION 4/2023 - VTE PROPHYLAXIS PROJECT & DIABETES ORDER SET PROJECT Morsani/HP = Increasing cologuard for screening Mathew, M. Morsani/HP = Increasing cologuard for screening Millis, C. Morsani/HP = Increasing cologuard for screening. Primary care follow up metrics/testing Nazef, C. Morsani/HP = Increasing cologuard for screening Ouellette, M. Morsani/HP = Increasing cologuard for screening Evaluation of effectiveness of Palliative care curriculum during residency Patel, V. VA = Project to improve Shingrix vaccination, Project on Medication Reconcilliation Presentations at IHI for : primary care hypertension project. Perez-Melendez, Y. Optimization of paralytic instructions at the VA Radisic, A. Morsani/HP = Increasing cologuard for screening Improving COVID vaccine rates among VA Rheum patients Roberts, A. VA = Improving accuracy of medication reconcilliation CDI resident Committee - Reducing number of doc queries to teaching teams (TGH, Dr. Maier), Utilization of POCUS on teaching teams and how formal education affects utilization (TGH, Kapadia) Rodriguez Camacho, A. ROTATION 4/2023 - VTE PROPHYLAXIS PROJECT Morsani/HP = Increasing cologuard for screening Rybolt, L. ROTATION 1/2023 - REDUCING PRE-PROCEDURE NPO TIME Morsani/HP = Increasing cologuard for screening Schoenfeld, D. ROTATION 10/2022 - REDUCING PRE-PROCEDURE NPO TIME VA = improve communication of intended visit, appropriate medication reconcillation Smith, J. Morsani/HP = Increasing cologuard for screening CDI Resident Committee - Reduce doc query burden. Presented at SHM. Dr. Mcintosh advisor Soto Del Valle, F. ROTATION 2/2023 - REDUCING PRE-PROCEDURE NPO TIME Morsani/HP = Increasing cologuard for screening Health disparities - colon cancer/breast cancer screening rates Suddreth, H. Morsani/HP = Increasing cologuard for screening COVID 19 Algorithms inpatient and outpatient for TGH (Dr. Lakshmi) Wang, Chen VA = influenza, COVID19 vaccine projects. Screening DM nephropathy Wood, B. ROTATION 6/23 - REDUCING PRE-PROCEDURE NPO TIME VA = Project to improve Shingrix vaccination, Project on Medication Reconcilliation Attitudes to COVID vaccination in patients with rheum conditions Wright, W. VA = Improving continuity in the clinic Improving FIT to colonoscopy (VA), H pylori erradication barriers (VA), POCUS QUALITY & SAFETY Curriulum assessment (Kapadia) PGY3 QI PROJECTS
31 VA COR Projects (ROTATION) (VA Site, Faculty Lead = Drs. Melzer and Reiss) Continuity Clinic Projects (VA Site, Faculty Lead = Dr. Cummings; HP/Morsani Site, Faculty Lead = Dr. Oxner) Individual QI initiatives or Leadership Roles PGY 2 Baviriseaty, N. ROTATION 8/2022 - IMPROVE OSA SCREENING WITH STOP-BANG REMINDER VA = Project to improve Shingrix vaccination, Project on Medication Reconcilliation SGLT2i project, heart failure and cardiac rehab project Breton, K. VA = Project to improve Shingrix vaccination, Project on Medication Reconcilliation Casals, L. Morsani/HP = Increasing cologuard for screening Using code blue simulation to improve resident comfort with ACLS Daas, R. Morsani/HP = Increasing cologuard for screening Docobo, A. VA = Statin use in Diabetics Dodd, T. Morsani/HP = Increasing cologuard for screening Drapeau, J. VA = Improving continuity of care Eichelberger, S. ROTATION 11/2022 - REDUCING PRE-PROCEDURE NPO TIME Morsani/HP = Increasing cologuard for screening GME Patient Safety Council Member, USHHERS program. Cardiac amyloid referral project Gomes, K. Morsani/HP = Increasing cologuard for screening Gross, C. Morsani/HP = Increasing cologuard for screening Vaccine improvement ACP grant to reduce vaccine hesitancy, DN2 Guide (Dr. Shiroky), Nutrition education project. SGLT2i project Hadar, A. VA = Improving quality of med rec Hubbard, J. ROTATION 4/2023 - VTE PROPHYLAXIS PROJECT Morsani/HP = Increasing cologuard for screening John, J. VA = Statin use in Diabetics Kumar, A. Morsani/HP = Increasing cologuard for screening Mehio, M. VA = improving continuity of care, and DTAP vaccination efforts Miller, N. Morsani/HP = Increasing cologuard for screening Analyzing diagnostic utility of FOBT, H pylori eradiction testing project Money, D. VA = microalbumin screening and view alert standardization Patel, B. VA = med rec disgrepancy project Patel, P. VA = Project to improve Shingrix vaccination, Project on Medication Reconcilliation Paulino, L. ROTATION 9/22 REDUCING PRE-PROCEDURE NPO TIMES Morsani/HP = Increasing cologuard for screening Pinizzotto, A. VA = View alert project H pylori erradication barriers Ponnaganti, B. Morsani/HP = Increasing cologuard for screening H pylori erradication barriers, Signout project for interns Pullukkara, J. VA = Statin use in Diabetics Rainer, C. Morsani/HP = Increasing cologuard for screening Rivera Sepulveda, R. Morsani/HP = Increasing cologuard for screening H pylori eradication testing Romes, E. ROTATION 4/2023 - VTE PROPHYLAXIS PROJECT VA = Statin use in Diabetics Samuel, K. VA = Statin use in Diabetics Segarra, D ROTATION 8/2022 - REDUCING PRE-PROCEDURE NPO TIME Morsani/HP = Increasing cologuard for screening Shahin, A. Morsani/HP = Increasing cologuard for screening Attitudes towards COVID vaccination among patients with rheumatologic illnesses Shakfeh, K. VA = view alert project and screening for diabetic nephropathy Stowers, C. Morsani/HP = Increasing cologuard for screening Uche, L. Morsani/HP = Increasing cologuard for screening Vasavada, R. Morsani/HP = Increasing cologuard for screening VA NPO screening time project, H pylori eradication projecT Wasef, D. ROTATION 9/2022 - REDUCING PRE-PROCEDURE NPO TIME VA = view alert project and screening for diabetic nephropathy QUALITY & SAFETY PGY2 QI PROJECTS
32 VA COR Projects (ROTATION) (VA Site, Faculty Lead = Drs. Melzer and Reiss) Continuity Clinic Projects (VA Site, Faculty Lead = Dr. Cummings; HP/Morsani Site, Faculty Lead = Dr. Oxner) Individual QI initiatives or Leadership Roles PGY 1 Abels, Josh (P) JAN 2023 COR ROTATION Abraham, Abel VA = Project to improve Shingrix vaccination, Project on Medication Reconcilliation Adi, Vishnu DO (P) JUNE 2023 COR ROTATION Ayoubi, Yasmin (P) JAN 2023 COR ROTATION Coughlan, Sarah DO Morsani/HP = Increasing cologuard for screening DiGennaro, Jeremy DO Morsani/HP = Increasing cologuard for screening Drucker, David (P) APRIL 2023 - COR ROTATION Emenogu, Oluwasegun (P) MARCH 2023 - COR ROTATION Gosnell, Heather DO VA = Project to improve Shingrix vaccination, Project on Medication Reconcilliation Graeter, Allison VA = Statin project Hammonds, Jalen DO VA = Project to improve Shingrix vaccination, Project on Medication Reconcilliation Herald, Joseph "Blake" VA = microalbumin screening Herman, Tim VA = view alert improvement project Kaldas, David VA = view alert improvement project, screening DM nephropathy Karivelil, Mathew VA = view alert improvement project, screening DM nephropathy Kocab, Maria VA = reason for visit project, statins in diabetics project Discharge summary template project with Dr. Peek Kodia, Rishabh (P) FEB 2023 - COR ROTATION Koelmeyer, Himara Morsani/HP = Increasing cologuard for screening Kohn, Alison (P) May 2023 - COR ROTATION Kulkarni, Shruti Morsani/HP = Increasing cologuard for screening Larkins, Victoria (P) JULY 2022 - COR ROTATION Lazo, Andrew Morsani/HP = Increasing cologuard for screening Liu, Zhiyu Morsani/HP = Increasing cologuard for screening Logemann, JerryRay (P) JUNE 2023 COR ROTATION Makovich, Zachary Morsani/HP = Increasing cologuard for screening Martin, Daniel (P) May 2023 - COR ROTATION Massanet, Nicholas VA = designing the RTC work flow. TDAP education inititaive Menezes, Kim (P) NOVEMBER 2022 - COR ROTATION Monestime, Harry DO Morsani/HP = Increasing cologuard for screening Pearce, Richard Morsani/HP = Increasing cologuard for screening Peterson, John (P) OCTOBER 2022 - COR ROTATION Pressendo, Lisa VA = statin project, improving RTC Ranspach, Peter VA = continuity of care, improve TDAP administration Rinaldi, Joe (P) JULY 2022 - COR ROTATION Rodriguez, Camilo DO Morsani/HP = Increasing cologuard for screening Rooney, Kelsey Morsani/HP = Increasing cologuard for screening Sachs, Vincent DO Morsani/HP = Increasing cologuard for screening Salvat, Aleida VA = Statin in diabetics, and improving documentation for reason for visit Seepaulsing, Nathan Morsani/HP = Increasing cologuard for screening Shafiq, Leila va = improving residency continuity in the clinic Shaw, Robert COR ROTATION - project on reducing aspiration events Morsani/HP = Increasing cologuard for screening Improving vaccination rates .QI award at ACP national meeting Shultz, Josh VA = improving residency continuity in the clinic, TDAP vaccination project Strang, Lauren Morsani/HP = Increasing cologuard for screening Taylor, Eric (P) MARCH 2023 - COR ROTATION Wagner, Nick (P) NOVEMBER 2022 - COR ROTATION Walker, Chelsea VA = improve communiation with nursing staff and decrease view alerts Wasanwala, Huzaifa VA = med rec project, shingrix project Weisman, Sydney Morsani/HP = Increasing cologuard for screening Wettenstein, Zachary Morsani/HP = Increasing cologuard for screening QUALITY & SAFETY Zhao, Dekuang "DK" DO (P) APRIL 2023 - COR ROTATION PGY1 QI PROJECTS
USHERSS PROGRAM GME wide initiative we are participating in Resident engagement in patient safety Conduct safety huddles within program Enhance resident’s knowledge of safety events and how to report System approach to escalating patient safety concerns Monthly Meetings and Discussions Internal Medicine Residency Program GME - Sammy Eichelberger PGY2 QUALITY & SAFETY
34 RCA Attendance outside of Simulated in the Academic Half Day Date of attendance at Simulated RCA in academic half day PGY 3 Babu, A. 12/16/22 Bilodeau, J. 11/18/22 Brown, B. 1/6/23 Calderon, O. 12/9/22 Cavalaris, Charlie didactics vacation Cavallari, Cristiana 11/18/22 DeNarvaez, E. 12/16/22 Dickinson, E. 11/18/22 Enciso, J. As well as VA CCU RCA - Issue with transition from outpatient to inpatient 12/16/22 Gandre, J. TGH QI rotation,additionals RCA's related to fall, bovie burn 11/18/22 Gidanian, S. 1/6/23 Goodman, S. 12/16/22 Graves, A. 1/6/23 Jordan, A. 1/6/23 Lewellen, C. 11/18/22 Marks, J. 1/6/23 Mathew, M. 12/9/22 Millis, C. VA ICU RCA 3/2023 12/16/22 Nazef, C. 12/16/22 Ouellette, M. 1/6/23 Patel, V. 12/9/22 Perez -Melendez, Y. 1/6/23 Radisic, A. 1/6/23 Roberts, A. 1/6/23 Rodriguez Camacho, A. 11/18/22 Rybolt, L. 12/16/22 Schoenfeld, D. 12/16/22 Smith, J. 1/6/23 Soto Del Valle, F. TGH QI rotation - RCA - improve code response time after an event in bayshore pavillon. 12/9/22 Suddreth, H. 12/9/22 Wang, Chen 11/18/22 Wood, B. 12/9/22 Wright, W. TGH QI elective RCA 11/18/22 RCA Attendance outside of Simulated in the Academic Half Day Date of attendance at Simulated RCA in academic half day PGY 2 Baviriseaty, N. 1/6/23 Breton, K. 12/9/22 Casals, L. 12/16/22 Daas, R. 12/16/22 Docobo, A. 12/16/22 Dodd, T. 12/9/22 Drapeau, J. 1/6/23 Eichelberger, S. 1/6/23 Gomes, K. 11/18/22 Gross, C. 1/6/23 Hadar, A. 12/9/22 Hubbard, J. While on COR participated in a rapid improvement event related to escalation of care 12/9/22 John, J. 12/16/22 Kumar, A. 11/18/22 Mehio, M. 1/6/23 Miller, N. 1/6/23 Money, D. vacation during session Patel, B. 12/9/22 Patel, P. 12/16/22 Paulino, L. 12/9/22 Pinizzotto, A. 11/18/22 Ponnaganti, B. 12/9/22 Pullukkara, J. RCA in Friday AM at VA sick Rainer, C. 11/18/22 Rivera Sepulveda, R. 12/9/22 Romes, E. RCA with a fellow 1/6/23 Samuel, K. RCA with a fellow on rheum block 12/16/22 Segarra, D 12/16/22 Shahin, A. 11/18/22 Shakfeh, K. VA clinic patients 11/18/22 Stowers, C. 1/6/23 Uche, L. Led a RCA on VA patient 12/9/22 Vasavada, R. RCA on a near miss related to transfer of a patient 12/16/22 Wasef, D. 11/18/22 QUALITY & SAFETY PGY3 RCA EXPERIENCE PGY2 RCA EXPERIENCE
35 RCA Attendance outside of Simulated in the Academic Half Day Date of attendance at Simulated RCA in academic half day PART OF COR ROTATION EXPERIENCE PGY 1 Abels, Josh (P) JAN 2023 COR Abraham, Abel 12/9/22 Adi, Vishnu DO (P) JUNE 2023 COR Ayoubi, Yasmin (P) JAN 2023 COR Coughlan, Sarah DO 11/18/22 DiGennaro, Jeremy DO 12/16/22 Drucker, David (P) APRIL 2023 - COR Emenogu, Oluwasegun (P) MAR 2023 - COR Gosnell, Heather DO Moffitt m&m April 2023 12/9/22 Graeter, Allison sick Hammonds, Jalen DO 12/16/22 Herald, Joseph "Blake" 11/18/22 Herman, Tim 11/18/22 Kaldas, David 11/18/22 Karivelil, Mathew 12/16/22 Kocab, Maria 2/2023 simulated rca in clinic 12/16/22 Kodia, Rishabh (P) FEB 2023 - COR Koelmeyer, Himara 1/6/23 Kohn, Alison (P) May 2023 - COR Kulkarni, Shruti 1/6/23 Larkins, Victoria (P) JULY 2022 - COR Lazo, Andrew 12/9/22 Liu, Zhiyu on parental leave Logemann, JerryRay (P) JUNE 2023 COR Makovich, Zachary 11/18/22 Martin, Daniel (P) MAY 2023 - COR Massanet, Nicholas 1/6/23 Menezes, Kim (P) NOV 2022 - COR Monestime, Harry DO 1/6/23 RCA Attendance outside of Simulated in the Academic Half Day Date of attendance at Simulated RCA in academic half day PART OF COR ROTATION EXPERIENCE Pearce, Richard RCA related to event not being able to hear code blue from ccu work room 11/18/22 Peterson, John (P) OCT 2022 - COR Pressendo, Lisa 12/16/22 Ranspach, Peter 1/6/23 Rinaldi, Joe (P) JULY 2022 - COR Rodriguez, Camilo DO 12/9/22 Rooney, Kelsey 12/16/22 Sachs, Vincent DO 11/18/22 Salvat, Aleida 12/16/22 Seepaulsing, Nathan 11/18/22 Shafiq, Leila 1/6/23 Shaw, Robert 1/6/23COR ROTATION Shultz, Josh RCA at the VA 1/6/23 Strang, Lauren 12/16/22 Taylor, Eric (P) MAR 2023 - COR Wagner, Nick (P) NOV 2022 - COR Walker, Chelsea 11/18/22 Wasanwala, Huzaifa TGH RCA fall 2022 12/9/22 Weisman, Sydney 11/18/22 Wettenstein, Zachary 12/9/22 Zhao, Dekuang "DK" DO (P) APRIL 2023 - COR QUALITY & SAFETY PGY1 RCA EXPERIENCE
HANDOFF TRAINING House-Officer orientation • Simulated mock pages and patient encounters • Survey project: 82% of survey respondents said House-Officer training and new follow-up sheet improved ability to stay organized • “I loved the HO follow-up sheet and used it every single night. It helped me feel organized and it was nice to be able to check things off a central list to ensure I was not forgetting to follow-up. It also prompted me to follow-up on labs/etc with nursing staff” Handoff Training • Defined “handoff” process at TGH, JAHVA, and Moffitt • Practiced handoffs in small groups • Developed a handoff guide to serve as a blueprint for questions -PGY2’s Dr. Eichelberger, Dr. Ponnaganti, Dr. Money QUALITY & SAFETY
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GRADUATE SUCCESS 38 TEACHING & LEARNING
ABIM SUCCESS 39 % Take Boards Board Pass Rate 2022 100% 94% 2021 100% 100% 2020 100% 100% 2019 100% 97% 2018 97% 97% 2017 100% 100% 2016 89% 100% Our residents receive resources in the form of MEDSTUDY, MKSAP, UWORLD to help with board preparation. In addition, during the PGY3 they submit a Board Study Plan in the Fall and the program hosts a 4 day board review in the Spring. This year we continued a Forum in the Friday Academic Half Day for the Third Year residents where recent Alumni can come and give their feedback on how they studied and prepared for the boards. GRADUATE SUCCESS
CURRICULUM 40 – BOARD PREP Chief Resident 13% Hospital Medicine 9% Primary Care 22% Fellowship 56% PGY3 CAREERS Chief Resident Hospital Medicine Primary Care Fellowship 59 % STAY USF/TGH VA/MOFFITT 7 2 % STAY IN FLORIDA
Graduate Careers 41 GRADUATE SUCCESS HOSPITAL MEDICINE Paola Algarin Troia – JAHVA Hospital Medicine Blake Brown – Memorial Healthcare System, FT Lauderdale Luke O’Neill – JAHVA Hospital Medicine Alan Roberts – U of Colorado David Schoenfeld – Moffitt Cancer Center CHIEF RESIDENT Jenna Bilodeau Gandre – Inpatient VA CRQS Juan Enciso – Inpatient VA CRQS Chris Millis – VA Research Chief Vandan Patel – VA Outpatient CRQS PRIMARY CARE Cristiana Cavallari – VA Primary Care Erika Dickinson – Baptist Health, Jacksonville FL Jason Gandre – VA Primary Care Andrew Graves – VA Primary Care Anna Radisic – USF HP/Morsani Anamarys Rodriguez Camacho -VA Primary Care Frank Soto del Valle – VA Primary Care
FELLOWSHIP MATCH DAY 42 GRADUATE SUCCESS ALLERGY & IMMUNOLOGY Chen Wang – NIH Hannah Shin – San Diego CARDIOLOGY Chase Lewellen – University of South Florida Jonathan Marks – University of South Florida Mevin Mathew – Brandon HCA Aubrey Schley – Indiana (Peds Cards) GASTROENTEROLOGY Azu Anudu – U Maryland Charlie Cavalaris – University of South Florida Omar Calderon – U Wisconsin Wes Wright – West Virginia U Yassin Naga – UN Las Vegas
43 GRADUATE SUCCESS HEMATOLOGY/ONCOLOGY Abida Babu – University of South Florida Aryanna Jordan– University of South Florida Kevin Parza– UF Jacksonville Yiseiry Perez Melendez – MUSC INFECTIOUS DISEASE Emilio de Narvaez – UC San Francisco Cilia Nazef– University of South Florida Hannah Suddreth – U Maryland Lauren Rybolt – University of South Florida HOSPICE & PALLIATIVE CARE Beatrice Wood – Honor Health - Arizona Michelle Ouellette – Beth Israel Rachel Eliach – U Michigan PULMONARY CRITICAL CARE Jorden Smith – University of South Florida RHEUMATOLOGY Sarah Goodman – Barnes Jewish Wash U
RECRUITING 45 THE NEXT CLASS TO JOIN OUR FAMILY
46 RECRUITMENT PIZZA PARTY RECRUITMENT
47 RECRUITMENT
DICE COMMITTEE HISTORICAL PERSPECTIVE 48 RECRUITMEN T v Fall 2019 • The inception of DICE was created through a meeting amongst various stakeholders within the department regarding diversity and our efforts here within the program v 2020-2021 • Facilitation of multiple virtual recruitment sessions with historically black colleges and universities & medical schools within Puerto Rico • Initiation of the Black/AA in Medicine affinity group amongst residents and faculty members within the same community v 2021-2022 • Expansion and strengthening of the USF IM admissions committee with a broader group to facilitate a more holistic/inclusive approach • Expansion of virtual recruitment sessions with historically black colleges and universities & medical schools within Puerto Rico • Expansion of affinity groups amongst LatinX/Hispanic residents and faculty members • Expansion of affinity groups amongst LGBTQ+ residents and faculty members • End of the year gathering amongst affinity groups and all residents/faculty members in the program v 2022-2023 • Continuing to expand virtual recruitment sessions with historically black colleges and universities, medical schools within Puerto Rico, medical schools with associated LGBTQ+ organizations, and medical schools with a high density of diversity per AAMC • Partnered with PSEP – Pre-Health Summer Enrichment Program • Conducted an in-person recruitment session at the FIU HWCOM Residency Fair • Creation of the USF Internal Medicine Night of Celebration; a virtual second look • Formation of 2 more affinity groups…Women in Medicine, Asian/Middle Eastern/Pacific Islander
DICE GOALS FOR 2023-2024 49 RECRUITMENT • DICE Kick Off Event – August 2024 • Attending national meetings – SNMA, LMSA • Moving the ”Night of Celebration” to a First look rather than a second look • DICE Day allows for residents, faculty, and staff to engage in the greater Tampa through meaningful service experiences while connecting with one another. This one-day experience will be partnered with a local organization in which participants will be able to spend part of their giving back • Strategically plan for the 1st or 3rd Saturday of November every year • DICE will partner with the Wellness Committee for a post-volunteer experience social gathering to recognize the efforts of those participating • Increase collaboration with TBSM • Tampa bay TEACH – public health teaching
RECRUITMENT STATISTICS – PROGRAM TIES 50 RECRUITMENT USF Students 30% Visiting 18% Signals 40% None 12% Program Ties, 33 Matched Student USF Students 14% Visiting 8% Signals 39% None 39% Program Ties, Applicants Ranked Top 140 visiting students 3% usf students 2% signals 18% none 77% Program Ties, All MD/DO Applicants
51 USF APPLICANT LUNCH RECRUITMENT