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Professionalism Programs and Cardiovascular Risk Management Strategies

Added on March 20, 2014 in General News, Press Releases, JCR Success Stories
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(Oak Brook, Ill.) Joint Commission Resources today announced the release of the April 2014 issue of The Joint Commission Journal on Quality and Patient Safety. The issue features two articles on innovative approaches to address the kinds of unprofessional behavior that undermine a culture of safety as well as an article on cardiovascular risk management strategies. 

A Professionalism Committee–based program at the University of Pennsylvania Health System, Philadelphia, integrates information from patient and staff complaints as well as general behavioral concerns to enable interventions before a situation requires disciplinary action. The model, as described in an article by Rebecca M. Speck, Ph.D., M.P.H. and co-authors may help other hospitals and health systems to improve professionalism.

The development of the Center for Professionalism and Peer Support (CPPS) at Brigham and Women’s Hospital, Boston, was traced in an article by Jo Shapiro, M.D., FACS; Anthony Whittemore, M.D., FACS; and Lawrence C. Tsen, M.D. The CPPS includes a code of conduct; mandatory educational programs; and a robust reporting, assessment, and management process for handling concerns regarding professionalism lapses.

In an accompanying editorial, William Martinez, M.D., M.S. and colleagues commended “the authors of both articles for sharing their work in defining frameworks for measuring unprofessional behavior, increasing their colleagues’ willingness to report such behaviors, and taking thoughtful action in response.”

Cardiovascular risk management strategies used by 11 physician organizations in California that were recognized by the California Right Care Initiative as “top-performing physician organizations” were analyzed by Hector P. Rodriguez, Ph.D. and co-authors. The authors reported that the organizations routinely used interdisciplinary team approaches, shared medical appointments, or telephonic strategies for managing cardiovascular risks. 

In a related editorial, Thomas S. Bodenheimer, M.D., M.P.H., FACP remarked that regardless of which strategies primary care practices employ, “they can benefit greatly by gaining the inspiration, hopefulness, and concrete lessons coming from visits to primary care’s bright spots.”

The complete list of articles from the April 2014 issue:

Ambulatory Care
Editorial: Find the “Bright Spots”
Thomas S. Bodenheimer, M.D., M.P.H., FACP
 
As Good As It Gets? Managing Risks of Cardiovascular Disease in California’s Top-Performing Physician Organizations
Hector P. Rodriguez, Ph.D., M.P.H.; Susan L. Ivey, M.D., M.H.S.A.; Brian J. Raffetto, M.D., M.P.H.; Jennifer Vaughn, M.P.H.; Margae Knox; Hattie Rees Hanley, M.P.P.; Carol M. Mangione, M.D., M.S.P.H.; Stephen M. Shortell, Ph.D., M.B.A., M.P.H.
 
The care management strategies used by 11 physician organizations to control diabetes and cardiovascular risks included interdisciplinary team approaches, shared medical appointments, and telephonic strategies. Implementation barriers included limited organizational capacity for change, and facilitators included routine use of reliable data to guide improvement.
Safety Culture

Editorial: Programs for Promoting Professionalism: Questions to Guide Next Steps 
William Martinez, M.D., M.S.; James W. Pichert, Ph.D.; Gerald B. Hickson, M.D.; William O. Cooper, M.D., M.P.H.

Development of a Professionalism Committee Approach to Address Unprofessional Medical Staff Behavior at an Academic Medical Center  
Rebecca M. Speck, Ph.D., M.P.H.; Jody J. Foster, M.D., M.B.A.; Victoria A. Mulhern; Sean V. Burke, J.D.; Patricia G. Sullivan, Ph.D.; Lee A. Fleisher, M.D.
 
Each of the three large teaching hospitals within the University of Pennsylvania Health System has a Professionalism Committee that reports to its respective Medical Executive Committee. The committees integrate information from patient and staff complaints, as well as general behavioral concerns, to enable interventions before a situation requires disciplinary action.  
 
Instituting a Culture of Professionalism: The Establishment of a Center for Professionalism and Peer Support  
Jo Shapiro, M.D., FACS; Anthony Whittemore, M.D., FACS; Lawrence C. Tsen, M.D.
 
There is growing recognition that an environment in which professionalism is not embraced or where expectations of acceptable behaviors are not clear and enforced can result in medical errors, adverse events, and unsafe work conditions. The Center for Professionalism and Peer Support at Brigham and Women’s Hospital, Boston, includes a code of conduct; mandatory educational programs; and a robust reporting, assessment and management process for handling concerns regarding professionalism lapses.
Performance Improvement
 
Improving the Performance of Nutrition Screening Through a Series of Quality Improvement Initiatives
Su Lin Lim, Ph.D.; Sow Chun Ng, Dip Nurs, M.H.S.M.; Jamie Lye, B.Sc.; Wai Chiong Loke, M.B.B.S., M.B.A.; Maree Ferguson, M.B.A., Ph.D.; Lynne Daniels, M.Sc., Ph.D.
 
The effect of a series of quality improvement initiatives, described in a plan-do-check-act format, on patients at risk for malnutrition was assessed at National University Hospital, Singapore. The hospitalwide implementation plan entailed minimal costs; nutrition screening training, audits and feedback were carried out as part of routine care.
Rapid Response Systems
 
Physician Attitudes Toward Family-Activated Medical Emergency Teams for Hospitalized Children
Breah Paciotti, M.P.H.; Kathryn E. Roberts, RN, M.S.N., CNS, CCRN, CCNS; Kathleen M. Tibbetts, M.S.; Christine Weirich Paine, M.P.H.; Ron Keren, M.D., M.P.H.; Frances K. Barg, Ph.D.; John H. Holmes, Ph.D.; Christopher P. Bonafide, M.D., M.S.C.E.
 
In the first in-depth analysis of physicians’ attitudes toward family-activated medical emergency teams (FAMETs), interviews and surveys were conducted at The Children’s Hospital of Philadelphia. The physicians valued the input of families but had concerns that prevented them from endorsing FAMET use, including lack of evidence on effectiveness, misuse of limited ICU resources, threat to therapeutic relationships, and the burden on families. Physicians’ concerns about unintended consequences may aid decision makers in addressing potential barriers for uptake by physicians.
 

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