Stay tuned to officially welcome our new faculty!
Friday, February 27, 2015
New Pulmonary & Critical Care Medicine Faculty
We have some exciting news. Kern Medical Center has hired 2 pulmonary and critical care physician for the intensive care unit.
Stay tuned to officially welcome our new faculty!
Stay tuned to officially welcome our new faculty!
Thursday, February 26, 2015
National Patient Safety Goals
Below are the National Patient Goals for 2015 as stated by The Joint Commission, previously known as JCAHO (Joint Commission on Accreditation of Healthcare Organizations).
1. Identify patients correctly: Use at least two ways to identify patients.
2. Use medicines safely: Before a procedure, label medicines that are not labeled. Take extra care with patients who take medicines to thin their blood. Record and pass along correct information about a patient’s medicines. Update home med lists
3. Use alarms safely: Make improvements to ensure that alarms on medical equipment are heard and responded to on time
4. Prevent infection: Use the hand cleaning guidelines from the Centers for Disease Control and Prevention or the World Health Organization. Use proven guidelines to prevent infection of the blood from central lines. Use proven guidelines to prevent infection after surgery. Use proven guidelines to prevent infections of the urinary tract that are caused by catheters
5. Identify patient safety risks: Find out which patients are most likely to try to commit suicide.
6. Prevent mistakes in surgery: Make sure that the correct surgery is done on the correct patient and at the correct place on the patient’s body. Mark the correct place on the patient’s body where the surgery is to be done. Pause before the surgery to make sure that a mistake is not being made. TIME OUT
1. Identify patients correctly: Use at least two ways to identify patients.
2. Use medicines safely: Before a procedure, label medicines that are not labeled. Take extra care with patients who take medicines to thin their blood. Record and pass along correct information about a patient’s medicines. Update home med lists
3. Use alarms safely: Make improvements to ensure that alarms on medical equipment are heard and responded to on time
4. Prevent infection: Use the hand cleaning guidelines from the Centers for Disease Control and Prevention or the World Health Organization. Use proven guidelines to prevent infection of the blood from central lines. Use proven guidelines to prevent infection after surgery. Use proven guidelines to prevent infections of the urinary tract that are caused by catheters
5. Identify patient safety risks: Find out which patients are most likely to try to commit suicide.
6. Prevent mistakes in surgery: Make sure that the correct surgery is done on the correct patient and at the correct place on the patient’s body. Mark the correct place on the patient’s body where the surgery is to be done. Pause before the surgery to make sure that a mistake is not being made. TIME OUT
Tuesday, February 24, 2015
Rotation Goals and Objectives
Ladies and gentlemen,
Please download the updated Rotation Goals and Objectives (previously on evalue).
The goals and objectives are PGY level specific for those rotations you do more than once in residency. They also reflect the ACGME 6 Core Competencies.
The Journal Club Curriculum and Research Curriculum have also been updated and uploaded.
This post will always be available under the resources and acgme labels. We also added it in the link box on the right of the website
Please download the updated Rotation Goals and Objectives (previously on evalue).
The goals and objectives are PGY level specific for those rotations you do more than once in residency. They also reflect the ACGME 6 Core Competencies.
The Journal Club Curriculum and Research Curriculum have also been updated and uploaded.
This post will always be available under the resources and acgme labels. We also added it in the link box on the right of the website
Patient Care
Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.
Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.
Medical Knowledge
Residents must be able to demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.
Residents must be able to demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.
Practice-Based Learning and Improvement
Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices.
Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices.
Interpersonal and Communication Skills
Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, patients’ families, and professional associates.
Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, patients’ families, and professional associates.
Professionalism
Residents must be able to demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
Residents must be able to demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
Systems-Based Practice
Residents must be able to demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.
Residents must be able to demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.
Transition of Care- Patient Signouts
Acronym for Effective Signouts
Senior residents: you must observe your interns method for signouts at least twice a rotation and provide constructive feedback afterwards. Additionally, you are responsible for signing out all sick patients to the on call senior.
It is stongly encouraged for interns and seniors to identify sick and new patients and consider joint evaluation at bedside during signouts.
SIGNOUT?
o S: Is this patient particularly Sick or DNR
o I: Identifying data and demographic info about patient
o G: General hospital course for the patient
o N: New events or occurrences of the day
o O: Overall Health status
o U: Upcoming possibilities and things to watch for
o T: Tasks that need to be completed prior to next handoff
o ?: Any questions?
Senior residents: you must observe your interns method for signouts at least twice a rotation and provide constructive feedback afterwards. Additionally, you are responsible for signing out all sick patients to the on call senior.
It is stongly encouraged for interns and seniors to identify sick and new patients and consider joint evaluation at bedside during signouts.
SIGNOUT?
o S: Is this patient particularly Sick or DNR
o I: Identifying data and demographic info about patient
o G: General hospital course for the patient
o N: New events or occurrences of the day
o O: Overall Health status
o U: Upcoming possibilities and things to watch for
o T: Tasks that need to be completed prior to next handoff
o ?: Any questions?
Thursday, February 12, 2015
Monday, February 9, 2015
New Rotation Announcements - Sub-Specialties, Sepsis, and more.
Attention Residents:
The following were discussed during the faculty meeting today, please pay close attention:
The following were discussed during the faculty meeting today, please pay close attention:
- If as a primary team it is decided that you will not institute the recommendations of a specialist, please document the reason.
- ex: nephrology consulted and recommends diuresis but as a primary team you decide that this may not be beneficial to the patient due to hypotension, please note it in your progress note.
- Antibiotics are recommended within 1 hour of recognizing sepsis. When evaluation patients in the ED and recognizing sepsis, place your first dose of antibiotics in the ACTIVE ORDERS, not the delayed orders. Contact the nurse and inform them as they don't get automatic print outs of orders.
- When placing critical orders (imaging, labs, medication, etc) in ED patients. Place them in the ACTIVE orders so they are available to nursing staff immediately.
- There will be a specialty evaluation committee on 2/24/15. The objective is to evaluate the medicine specialty services. If you have any recommendations, suggestions or concerns regarding any of the medicine sub-specialties, please post (anonymously if you'd like) in the comments below.
- Please make sure that there are Internal Medicine Consults placed when seeing patients.
Saturday, February 7, 2015
ACGME Core Competencies & Milestones
- ACGME has 6 core competencies for every resident physician to meet prior to graduating.
- The ACGME milestones are used as a system for programs to evaluate residents and promote residents based on the 6 core competencies.
- The Clinical Competence Committee (CCC) meets semi-annually and evaluates each resident's progression through the milestones
- Milestones are graded on a 1 - 5 scale with 1 being "critically deficient" to 5 being "aspirational."
Click links below for more details
Patient Care (PC)
Medical Knowledge (MK)
Practice Based Learning and Improvement (PBLI)
Interpersonal and Communication Skills (ICS)
Professionalism (PROF)
Systems Based Practice -working with health care system (SBP)
1. Gathers and synthesizes essential and accurate information to define each patient's clinical problem: monthly eval, chart review, miniCEX
2. Develops and achieves comprehensive management plan for each patient: monthly eval, chart review
3. Manages patients with progressive responsibility and independence: monthly eval, chart review
4. Skill in performing procedures: Met 5 required procedures
5. Request and provides consultative care: monthly eval, chart review
6. Clinical Knowledge: monthly eval, Peer review
7. Knowledge of diagnostic Testing and procedures: monthly eval, chart review
8. Works effectively within an interprofessional team: peer eval, nursing eval, patient survey
9. Recognizes system error and advocates for system improvement: monthly eval
10. Identifies forces that impact the cost of health care, and advocates for, and practices cost effective care: monthly eval
11. Transitions patients effectively within and across health care delivery systems: montlhy eval
12. Monitors practice with a goal of improvement: self eval
13. Learns and improves via performance audit: quality data (i.e. pap smears, mammograms, diabetes checklist, pcoft)
14. Learns and improves via feedback: monthly eval, peer review
15. Learns and improves at the point of care: monthly eval
16. Has professional and respectful interactions with patients, caregivers and members of interprofessional team: monthly eval, nursing eval, patient survey
17. Accepts Responsibility and follow through on tasks: monthly eval, patient survey
18. Responds to each patient's unique characteristics and need: monthly eval, nursing eval
19. Exhibits integrity and ethical behavior in professional conduct: monthly eval, peer review, nursing eval
20. Communicates effectively with patients and caregivers: monthly eval, peer review, patient survey
21. Communicates effectively in interprofessional teams: monthly eval, peer review, nursing eval, patient survey
22. Appropriate utilization and completion of health records: PCOFT, Problem/Med List, unapproved abbreviations, delinquent records
3. Manages patients with progressive responsibility and independence: monthly eval, chart review
4. Skill in performing procedures: Met 5 required procedures
5. Request and provides consultative care: monthly eval, chart review
6. Clinical Knowledge: monthly eval, Peer review
7. Knowledge of diagnostic Testing and procedures: monthly eval, chart review
8. Works effectively within an interprofessional team: peer eval, nursing eval, patient survey
9. Recognizes system error and advocates for system improvement: monthly eval
10. Identifies forces that impact the cost of health care, and advocates for, and practices cost effective care: monthly eval
11. Transitions patients effectively within and across health care delivery systems: montlhy eval
12. Monitors practice with a goal of improvement: self eval
13. Learns and improves via performance audit: quality data (i.e. pap smears, mammograms, diabetes checklist, pcoft)
14. Learns and improves via feedback: monthly eval, peer review
15. Learns and improves at the point of care: monthly eval
16. Has professional and respectful interactions with patients, caregivers and members of interprofessional team: monthly eval, nursing eval, patient survey
17. Accepts Responsibility and follow through on tasks: monthly eval, patient survey
18. Responds to each patient's unique characteristics and need: monthly eval, nursing eval
19. Exhibits integrity and ethical behavior in professional conduct: monthly eval, peer review, nursing eval
20. Communicates effectively with patients and caregivers: monthly eval, peer review, patient survey
21. Communicates effectively in interprofessional teams: monthly eval, peer review, nursing eval, patient survey
22. Appropriate utilization and completion of health records: PCOFT, Problem/Med List, unapproved abbreviations, delinquent records
Friday, February 6, 2015
Continuity Clinic Evaluations
Many of you already know this but for those who don't, please note the following ways you are evaluated in continuity clinic:
- Mini-Cex which includes faculty bedside evaluation of residents
- Nursing evaluation
- Chart Audits
- Dan Burke Bedside Behavioral Science evaluation
Diagnostic Cardiac Catheterizations at KMC
Please note that we do have the ability to perform diagnostic cardiac caths at KMC and have for quite some time. Of note there were 50 caths done last year.
Our cath lab has receive a makeover is fully operational for at least 3 weeks now.
Our cath lab has receive a makeover is fully operational for at least 3 weeks now.
Thursday, February 5, 2015
A Message From Glenn Goldis, Chief Medical Officer
From: Glenn Goldis, MD, CMO
Date: February 5, 2015
Subject: Confidential Communication
In response to ACGME process improvement recommendations, I would like to begin extending my availability to any of our Residents who wish to have a “safe place” to discuss sensitive issues or topics that affect the learning environment and your experience as a Resident at KMC.
Therefore, please know that effective immediately, I am available to discuss any personal or professional issues you may wish to share. I hope to use any learning from our discussions to improve the process, operations, or function of our facility and the Residency program itself. Any topic is “fair game” and held in the strictest of confidence.
Thank you in advance for your willingness to work with me toward improving the academic and clinical services we offer here at KMC.
If you would like to arrange a time to speak with me, please contact Tracy Subriar:
Office: 661-326-2718 or
E-mail: subriart@kernmedctr.com
Glenn Goldis, MD, MMM
Chief Medical Officer
Chief Academic Officer/DIO
Kern Medical Center
1700 Mt. Vernon Ave.
Bakersfield, CA 93306
Goldisg1@kernmedctr.com
(949) 445-4758 (cell)
(661) 326-2123 (office)
Weekend Call Schedule and Dr. Duggal Endocrine
Ladies and gentlemen,
Please note the weekend call schedule has been updated on Amion to reflect the changes.
Additionally for those of you on ambulatory care, pay attention to the subspecialty schedule regarding the Endocrine rotation with Dr. Duggal.
No longer are the days set for Tuesday and Friday.
Each week the endocrine rotation days are different so that we can accommodate the Family Practice Program.
Please note the weekend call schedule has been updated on Amion to reflect the changes.
Additionally for those of you on ambulatory care, pay attention to the subspecialty schedule regarding the Endocrine rotation with Dr. Duggal.
No longer are the days set for Tuesday and Friday.
Each week the endocrine rotation days are different so that we can accommodate the Family Practice Program.
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