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Background Advance care planning (ACP) is an ongoing conversation where healthcare professionals explore patients' and families' wishes in order to act within their best interests. The COVID19 pandemic continues to highlight the importance of timely ACP, namely while our patients have capacity. We noted that despite advancing age, accumulating co-morbidities and high clinical frailty scores (CFS); ACP discussions were not taking place within our elderly department. We aimed to increase ACP conversations and ensure documentation on ReSPECT forms to allow continuity within primary care. Methods 10 patients per ward were randomly selected. 69 patients met inclusion criteria (over 65 with CFS ≥5 or any patient with dementia). We reviewed electronic and paper records and defined evidence of ACP as ReSPECT form including preferred place of death (PPoD), or discussion with patient or relative in medical notes. We randomly selected a pilot ward and applied interventions over 4 weeks: • Small group teaching to junior doctors • Visiting ward MDTs to identify appropriate patients for ACP • Presenting baseline data to geriatricians • Visual aids from the palliative care team and prompt sheets for doctors. Results Prior to our interventions, 22% of our sample had evidence of advance care planning, 33% of discussions documented on ReSPECT form. Following our intervention period we reviewed medical notes on our pilot ward. 58% patients now had evidence of ACP, with 66% documented on a ReSPECT form. Conclusion We achieved a significant increase in advance care planning within our elderly medicine department, and are therefore better equipped to provide personalised care alongside our patients' wishes and values. Next steps: • Expanding teaching across the multi-disciplinary team • ACP 'champions' to highlight appropriate patients • Expansion of initial interventions across the department We hope to embed and maintain this change through education, training and inspiring others. [ABSTRACT FROM AUTHOR]

The first in-person Academic International Medicine Congress (AIM 2023) since the beginning of the COVID-19 Pandemic took place at Rutgers University in New Brunswick, NJ, almost exactly 4 years after a meeting at the same location had to be canceled due to the global calamity. Featuring 3 days packed with high quality continuing medical education content and leadership development sessions, AIM 2023 set several important records for our organization. Among the most important sessions was the half-day strategic leadership retreat, with a goal of charting ACAIM's path for the next 3-5 years. The main program featured more than 35 speakers and panelists, and offered more than 20 hours of continuing medical education credits. The scientific program included more than 30 abstracts and interesting case presentations. The AIM 2023 Gala and Awards Ceremonies were among the most attended attractions. This report includes a summary of key events and sessions from the AIM 2023 Congress, inclusive of published abstracts from the meeting. The following core competencies are addressed in this article: Interpersonal and communication skills, Professionalism, Practice-based learning and improvement, Systems based practice. [ABSTRACT FROM AUTHOR]

As 2 years have passed since the outbreak of coronavirus disease 2019 (COVID‐19), we had an examination of the measures taken at the perinatal medical and child centers during this period at 42 National University Hospital. The first questionnaire survey was conducted during March 17–25, 2022 and the second questionnaire survey was conducted during April 4–30, 2022. For the treatment of pregnant women with COVID‐19, a public health center‐coordinated triage system had been created and implemented in each region and prefecture. The issues related to the hospital management of pregnant women with COVID‐19 include the hindrances to the normal functioning of the center, the limited number of hospital beds and medical care systems as the beds were dedicated to patients with COVID‐19, and the problems associated with the mode of delivery. There were no set rules regarding the management of mothers and babies at delivery and thereafter. Initially, cesarean delivery was allowed in almost all cases to reduce the risk of exposure to medical staff. Furthermore, many institutions did not permit expressed breast milk feeding and direct breastfeeding during the quarantine period. The COVID‐19 pandemic has been created a shortage of healthcare delivery systems. It is expected that the emergence of new infectious diseases and pandemics will cause the same pressure on systems providing healthcare in the future. [ABSTRACT FROM AUTHOR]

One of the most essential steps in improving the quality of service delivery in the health service is the improvement of patients' medical record completeness. The aim of this study is to assess patient medical record completeness in the Saint Paul hospital department of surgery and assess the pattern of improvement in record completeness after intervention. surgical Patient charts were randomly reviewed with a standard patient chart completeness evaluation checklist prepared by the Federal Ministry of Health. Baseline data was collected in June 2019 and post intervention data was collected in November 2019. The schedule for intervention was carried out between July and October 2019. Interventions include modification of formats, continuous monitoring, and inclusion of chart completeness in the monthly morbidity and mortality conference, and establishment of a recognition system for best performing wards. A total of 253 and 273 medical charts were evaluated during baseline and post intervention. The Post intervention assessment showed 206 (75.5%) of records had admission notes completed, 205 (75%), the order sheet was completed in 218 (79.7%) and the discharge summary was completed in 217 (79.5%) of medical records. From nursing parameters, the medication sheet was completed in 177 (64.8%) and the nursing care plan was completed in 155 (56.8%) of medical records. When all six indicators were seen in aggregate, total medical record completeness showed a statistically significant improvement from 41% during base line to 72% post intervention (p < 0.05). Study has shown that small and persistent quality improvement interventions that focus on continuous evaluation, leadership engagement, and innovative strategies bring significant improvement in record completeness. [ABSTRACT FROM AUTHOR]

Discussing errors and quality improvement is a tradition in academic health centers, particularly in morbidity and mortality conferences embedded in surgical training and during teaching rounds. Little, if any, attention is typically given to iatrogenic harms from structural racism, however. This article canvasses ways in which training programs recognize and address health care-generated harm from inequity and identifies areas for improvement. [ABSTRACT FROM AUTHOR]

Objective: We sought to determine how many abstracts presented at the 2012 and 2014 Medical Library Association (MLA) annual conferences were later published as full-text journal articles and which features of the abstract and first author influence the likelihood of future publication. To do so, we replicated a previous study on MLA conference abstracts presented in 2002 and 2003. The secondary objective was to compare the publication rates between the prior and current study. Methods: Presentations and posters delivered at the 2012 and 2014 MLA meetings were coded to identify factors associated with publication. Postconference publication of abstracts as journal articles was determined using a literature search and survey sent to first authors. Chi-squared tests were used to assess differences in the publication rate, and logistic regression was used to assess the influence of abstract factors on publication. Results: The combined publication rate for the 2012 and 2014 meetings was 21.8% (137/628 abstracts), which is a statistically significant decrease compared to the previously reported rate for 2002 and 2003 (27.6%, 122/442 abstracts). The odds that an abstract would later be published as a journal article increased if the abstract was multi- institutional or if it was research, specifically surveys or mixed methods research. Conclusions: The lower publication rate of MLA conference abstracts may be due to an increased number of program or nonresearch abstracts that were accepted or a more competitive peer review process for journals. MLA could increase the publication rate by encouraging and enabling multi-institutional research projects among its members. [ABSTRACT FROM AUTHOR]

Background: Drowning is a critical health problem worldwide, and the World Health Organization reported that about 360,000 people died due to drowning in 2015. More than half of these deaths are related to people under 25. Based on WHO, the highest rate of drowning deaths occurs among children aged 1 to 4 years, followed by children aged 5-9 years. This study aimed to determine the epidemiological factors as well as other factors affecting drowning in the age group under 18 years old in the pre-hospital emergency system of Mazandaran University of Medical Sciences, Iran. Method: This descriptive cross-sectional study was conducted to investigate mission forms of all under 18-year-old ones with drowning in the EMS center of Mazandaran from April to July 2023. Items such as age, sex, place of drowning, the result of the mission, and the time of the accident were extracted. Result: Of 127 children who were rescued after drowning accident, 87 cases (68.5%) were male. The mean age of drowned children was 12 years. The highest rate of drowning was recorded for the age group of 11-18 years (n=86, (67.7%), followed by 19 victims in the age group of 6-8 years (15%). About 17 children (13.4%) died before the ambulance arrived, and 9 (7.1%) were transferred to the medical center during cardiopulmonary resuscitation. The highest number of drowning cases belonged to the group who were transferred to the medical centers (n=74, 58.3%). The mean age of the deceased was 9 years old. Conclusion: Based on the findings, over one-fifth of the drowned children died before the ambulance arrived or received advanced cardiopulmonary resuscitation. Addressing the determinants of health affecting drowning requires a multi-sectoral approach and inevitably a multi-sectoral action plan to prevent drowning in Iran. Training is a critical component of preventing the risk of drowning in children. [ABSTRACT FROM AUTHOR]

Background: Academic Medical Centers (AMCs) are organizations that link three functions: providing highly specialized medical services, teaching activities and conducting research. The aim of the study was to provide an international comparison of the governance and organization models of AMCs. The analysis covered 10 European countries (Cyprus, Czechia, Denmark, Germany, Italy, Latvia, Netherlands, Norway, Poland, Spain) and Israel. Methods: The study has an explorative and descriptive character. The methods involved: (1) the creation of a conceptual framework; (2) the development of a dedicated questionnaire; (3) data collection and analysis. The data was collected based on purposive sampling. There were 26 respondents from 11 countries. Results: There is no standardized definition of AMCs across countries. Different types of hospital providers do link patientcare, teaching and research. Depending on the country and particular institution, the balance between these three functions, as well as the scope might vary a lot. The majority of the participating countries face either public or not-for-profit ownership for AMCs and medical faculties. However, the relationship between hospital and faculty varies substantially. Main internal governance challenges focus on lack of responsiveness to change and financial conflicts between the three core tasks. External challenges relate to financial sustainability and workforce shortages. Most respondents believe that in the nearby future the governance of AMCs will evolve to a more functionally integrated model of the three functions. Conclusions: The study fills the gap in the literature on organization and governance of European AMCs. Although, there are substantial differences in the models of governance across countries, many challenges are highly similar. This raises important questions for future research (e.g. focusing solely on one function) as well as policy (the potential for cross-national learning). Key messages:· There is no standardized definition of AMCs across countries and different types of organizations are used to link the three functions of providing patientcare, teaching activities and research. · Despite the organizational and legal differences, AMCs in different countries face similar challenges (nimbleness and financial conflicts between the three functions; health workforce shortages). [ABSTRACT FROM AUTHOR]