Project title: Quantification and reduction of OR electricity and HVAC usage during non-clinical periods.
Background: Improving skills in clinical medicine requires life-long deliberate practice in which feedback and regular self-assessment play crucial roles (1, 2). Our current educational models lack a systematic way for trainees to receive follow-up information on the patients they cared for, thereby omitting a critical ingredient in improving clinical reasoning and cost-conscious decision-making. In the 2012-2013 ACGME survey, only 40% of UCSF Internal Medicine residents felt they were given data to show their personal clinical effectiveness.
*Please see attached document for full proposal, including figures.
Integrating Values, Knowledge and Tools of Healthcare Value into a Comprehensive GME Quality Improvement Toolkit
The intent of the project is to provide prostate cancer patients access to to information about their disease, and its various treatments in a format that makes it understandable. Prostate cancer can be very complex, and hard to understand initially. The diagnosis in itself can be overwhelming, and the numerous options available for work-up, and treatment can even make it even more overwhelming.
To develop and implement a patient cost support advocate program to help patients navigate affordability resources for their IV biologics infused at UCSF Infusion centers. Creating an interactive educational process for patients to learn about options of reducing their out of pocket burden when obtaining their medications. Potential impact of this role would generate funds utilizing the copayment assistance programs, and bring in $400-$1000 per infusion. With Rheumatology and GI practice alone, there were 391 patients, over a 12 month period, utilizing the infusion center for their bio
Project Overview: We propose the development of an interactive, reflective monthly teaching conference focusing on high value care and its implementation. The conference audience is University of California San Francisco (UCSF) Internal Medicine residents, medical students and faculty at San Francisco General Hospital (SFGH). SFGH is an academically affiliated public hospital and Level One trauma center providing care for an ethnically and socioeconomically diverse patient population including the poor, uninsured families, immigrants, and elderly. Approximately half of the students in the UCSF School of Medicine work and learn at SFGH on Internal Medicine rotations over the course of their third and fourth years of medical school, and all 180 UCSF Internal Medicine residents rotate at SFGH, with approximately one third of the residents on rotation at any one time. The interactive conference will be supplemented with specified team, service and hospital wide metric dashboards displayed both during the conference and on a secure website for later review. Our goal is to collaboratively create and implement system-based solutions designed to promote evidence-based, cost-conscious and patient centered care in the safety net.
The Head and Neck Oncology and Facial Plastics and Reconstructive divisions of the UCSF Department of Otolaryngology Head and Neck Surgery (OHNS) perform over 100 oncologic ablative surgeries with microvascular reconstruction per year. The majority of these patients are referred from outside the San Francisco area due to the complexity of the surgery, the coordination of pre- and post-operative care, and the need for a multi-disciplinary team approach.
We developed a protocol for preop PO administration of acetaminophen, celecoxib and gabapentin. Patients report lower pain scores and need less hydromorphone, and we save 10,000 USD/month on IV acetaminophen.
Background
- IV acetaminophen has been confirmed to be effective to reduce pain scores and reduce opioid consumption, but is very expensive (33 USD/1g).PO acetaminophen costs only 10 cents
- Celecoxib provides excellent pain reduction (NNT 1.7) without impairing platelet function, but is only available PO
Colace is used in the majority of our inpatients and, to my understanding, does not have evidence to support its effectiveness. Senna and miralax are effective alternatives with evidence. The VA ACE service comments that colace may worsen constipation in elderly patients who are also taking senna. Reducing colace prescribing would also reduce polypharmacy.