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15. Easing the Transition From Medical School to Residency: Using Deliberate Practice to Improve Senior Medical Students’ Performance Responding to Urgent Pages From Registered Nurses

Author

Heidemann, Lauren A., primary, Kempner, Samantha, additional, Jones, Elizabeth, additional, Kobernik, Emily, additional, Stricklen, Amanda, additional, Ross, Rachel, additional, Wixson, Matthew, additional, Kim, Grace J., additional, and Morgan, Helen K., additional

Published
2022
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34. Site-specific Approach to Reducing Emergency Department Visits Following Surgery.

Author

Khalik, Hassaan Abdel, Stevens, Haley, Carlin, Arthur M., Stricklen, Amanda, Ross, Rachel, Pesta, Carl, Finks, Jonathan F., Ibrahim, Andrew, and Ghaferi, Amir A.

Abstract

Objective: The aim of this study was to explore the efficacy of current bariatric perioperative measures at reducing emergency department (ED) visits following bariatric surgery in the state of Michigan. Summary of Background Data: Many ED visits following bariatric surgery do not result in readmission and may be preventable. Little research exists evaluating the efficacy of perioperative measures aimed at reducing ED visits in this population. Therefore, understanding the driving factors behind these preventable ED visits may be a fruitful approach to prevention. Furthermore, evaluating the efficacy of current perioperative measures may shed light on how to achieve meaningful reductions in ED visits. Methods: We studied 48,035 eligible bariatric surgery patients across 37 Michigan Bariatric Surgical Collaborative (MBSC) sites between January 2012 and October 2015. Hospitals were ranked according to their risk- and reliability-adjusted ED visit rates. For hospitals in each ED visit rate tercile, several patient, surgery, and hospital summary characteristics were compared. We then studied whether a hospital's compliance with specific perioperative measures was significantly associated with reduced ED visit rates. Results: Only 3 of the 30 surgery, hospital, and patient summary characteristics studied were significant predictors of a hospital's ED visit rate: rate of sleeve gastrectomies, rate of readmissions, and rate of venous thromboembolism complications (P = 0.04, P = 0.0065, and P = 0.0047, respectively). Also, a hospital's compliance with the perioperative measures evaluated was not a significant predictor of ED visit rates (P = 0.12). Conclusions: Current practices aimed at reducing ED visits appear to be ineffective. Due to heterogeneity in patient populations and local infrastructure, a more tailored approach to ED visit reduction may be more successful. [ABSTRACT FROM AUTHOR]

Published
2018
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44. Understanding the Psychosocial Impact of Weight Loss Following Bariatric Surgery: A Qualitative Study.

Author

GRIAUZDE, DINA H., IBRAHIM, ANDREW M., FISHER, NATALIE, STRICKLEN, AMANDA, ROSS, RACHEL, and GHAFERI, AMIR A.

Subjects
*BARIATRIC surgery, *WEIGHT loss, *GASTRIC bypass, *QUALITATIVE research, *FAMILIES, *GASTRIC banding, *INTERPERSONAL relations
Abstract

Background: Bariatric surgery leads to changes in mental health, quality of life, and social functioning, yet these outcomes differ among individuals. In this study, we explore patients' psychosocial experiences following bariatric surgery and elucidate the individuallevel factors that might drive variation in psychosocial outcomes. Methods: Eleven semi-structured focus groups with Michigan Bariatric Surgery Collaborative (MBSC) patients (n=77) were included. Interviews were audio recorded, transcribed verbatim, and analyzed using a grounded theory approach. Data on participant demographic characteristics were abstracted from the MBSC clinical registry. Results: Most focus group participants were female (89%), white (64%), and married (65%). We identified three major themes: 1) change in self-perception, 2) change in perception by others, and 3) change in relationships. Each theme includes three subthemes, demonstrating a range of positive and negative psychosocial experiences. For example, weight loss led to increased self-confidence among many participants, while others described a loss of self-identity. Some noted improved relationships with family or friends, while others experienced worsening or even loss of relationships due to perceived jealousy. Conclusion: Weight loss following bariatric surgery leads to complex changes in self-perception and interpersonal relationships, which might be proximal mediators of commonly assessed mental health outcomes, such as depression. Individuals considering bariatric surgery might benefit from anticipatory guidance about these diverse experiences, and postsurgical longitudinal monitoring should include evaluation for adverse psychosocial events. [ABSTRACT FROM AUTHOR]

Published
2019

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