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Improving the Safety of Patient HandoversBy INSIDE Duke Medicine

Patients who must be moved from the OR to an ICU are at increased risk for adverse events because of their vulnerable medical conditions and the complexity of coordination and communication between various caregivers during the handover. A group of enterprising clinicians at the Durham VA have been working

together to make the handover process run more smoothly.

“As with so many problems in life, communication is the root cause of most difficulties that occur during patient handovers,” said Jonathan Mark, M.D., Professor of Anesthesiology at Duke, and Chief of Anesthesiology Service at the Durham VA. “We took this on because we recognized opportunities to provide safer care and help patients by doing our jobs more reliably and more efficiently.”

The Durham VA Patient Safety Center of Inquiry (PSCI) successfully renewed their grant from the VA National Center for Patient Safety, with funding through Oct. 1, 2011.

The $600,000 grant will support their new project, “Designing a Safer OR to ICU Patient Handover.”

The PSCI will be building on techniques they’ve developed which utilize high fidelity medical simulation as a training tool for nurse-physician teams and physiologic and clinical monitoring of patients. Their goal is to re-engineer the OR to ICU transfer process and improve patient safety through the design and implementation of a standardized handover tool and a structured handover process.

The PSCI is led by VA anesthesiologists Jonathan Mark, M.D., Becky Schroeder, M.D., and Atilio Barbeito, M.D., and members of the Duke Human Simulation and Patient Safety Center, Jeff Taekman, M.D., Melanie Wright, Ph.D., and Noa Segall, Ph.D.

The growing multidisciplinary research group includes a cardiothoracic surgeon (Zane Atkins, M.D.), VA informatics consultant (Sally Kellum RN, MSN), quality improvement nurse (Dawn Rogers, RN), consultants from the Duke Fuqua School of Business Center for Leadership and Ethics (Sim Sitkin, Ph.D. and James Emery, Ph.D.), and technical support staff (Gene Hobbs, Becky Perfect). The PSCI will be recruiting a Program Support Manager to operate and run the VA high fidelity

Stories continue on page 4.

NewsTuesday, December 15, 2009 • Volume 11, Issue 48

You and a guest are invited to attend the

Department of Anesthesiology

Annual Holiday Party

Saturday, December 19, 20097 p.m. - 10 p.m.

Durham Marriott Hotel201 Foster Street

Please RSVP by December 5, 2009 to AnesEvts@notes.duke.edu

medical simulator and manage day-to-day administration of the Durham PSCI activities. Responsibilities includes budgetary, personnel, communication, and workload coordination duties, as well as data collection, record management, assisting with IRB/R&D compliance regulations, administering surveys, obtaining informed consent from staff, and assisting with analytical observations of direct and simulated patient care activities.

Watch the video at http://insidedukemedicine.org/news/improving-the-safety-of-patient-handovers/

Holiday Party AccommodationsParking vouchers will be available at the registration table at the Departmental Holiday Party December 19th for the parking garage. Also, if anyone wants to stay at the hotel, the rate is $79.

Save The DateThe Resident Practice Orals will take place on Monday, January 25th from 4-6 pm. Please mark your calendars.

THIS MonTH In THe DePArTMenT of AneSTHeSIology

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December 2009MonDAy TUeSDAy WeDneSDAy THUrSDAy frIDAy14 15 16 17 18

7:15-8:00 a.m., RM203-Pain ClinicMRC Pain Conference

2:30-3:30 p.m., VAMCVA EchocardiographyConference

4:30-6 p.m., 6686-HAFSResident Evaluation Commit-tee Meeting

5-6 p.m., 5685-HAFSDepartment Research Conference 5:30-6:30 p.m., 5680A-HAFSPerioperative Leadership Group Meeting

5-6 p.m., 5685-HAFSCT Conference

5-6 p.m. 6686-HAFSGVTCCM Conference: “Malignant Hyperthermia and Lumbee Indians: Should I Run a Non-Triggering Anesthetic?” - Aaron Sandler, MD

6:15-7:15 a.m., 5685-HAFSCT Anesthesia Fellow/Faculty Preceptor Seminar

6:30 a.m., 2001DNResident Conference Lecture: “Off-site Anesthesia Tech-niques” - John Keifer, MD

7:15 a.m., 2001DNGrand Rounds: “Analgesic Adjuncts” - Ashraf Habib, MD

7:15-8:00 a.m., RM203-Pain ClinicMRC Pain Journal Club

12:00-12:45 p.m., 2003DNCritical Care Grand Rounds: “Transfusion Related Acute Lung Injury & Transfusion Con-siderations” - Ian Welsby, MD

4-5 p.m., 5680A-HAFSPediatric Conference: CANCELLED - Faculty Meet-ing

Don’t forget, the 2009 Department Holiday Party is tomorrow, Saturday, Decem-ber 19, 2009 at the Durham Marriott Hotel, Downtown Durham from 7 to 10 p.m.

21 22 23 24 25

7:15-8:00 a.m., RM203-Pain ClinicMRC Pain Conference

2:30-3:30 p.m., VAMCVA EchocardiographyConference

5-6 p.m., 5685-HAFSCT Conference

5-6 p.m. 6686-HAFSGVTCCM Conference: NO CONFERENCE

6:15-7:15 a.m., 5685-HAFSCT Anesthesia Fellow/Faculty Preceptor Seminar

6:30 a.m., 2001DNResident Conference Lecture: NO LECTURE

7:15 a.m., 2001DNGrand Rounds: NO LECTURE

5 p.m., Chen Conf. RoomNeuroradiology Conference

7:15-8:00 a.m., RM203-Pain ClinicMRC Pain Journal Club

12:00-12:45 p.m., 2003DNCritical Care Conference

4-5 p.m., 5680A-HAFSPediatric Conference

28 29 30 31 January 1, 20107:15-8:00 a.m., RM203-Pain ClinicMRC Pain Conference

2:30-3:30 p.m., VAMCVA EchocardiographyConference

5-6 p.m., 5685-HAFSCT Conference

5-6 p.m. 6686-HAFSGVTCCM Conference NO CONFERENCE

6:15-7:15 a.m., 5685-HAFSCT Anesthesia Fellow/Faculty Preceptor Seminar

6:30 a.m., 2001DNResident Conference Lecture: “ECT Therapy” - Richard Weiner, MD, PhD

7:15 a.m., 2001DNGrand Rounds: “The Exit Pro-cedure” - Terrence Allen, MD

7:15-8:00 a.m., RM203-Pain ClinicMRC Pain Journal Club

12:00-12:45 p.m., 2003DNCritical Care Grand Rounds

4-5 p.m., 5680A-HAFSPediatric Conference

4 5 6 7 8

7:15-8:00 a.m., RM203-Pain ClinicMRC Pain Conference

2:30-3:30 p.m., VAMCVA EchocardiographyConference

5-6 p.m., 5685-HAFSCT Conference

5-6 p.m. 6686-HAFSGVTCCM Conference: “Update on Perioperative An-ticoagulation for Non-Cardiac Surgery” - Ian Welsby, MD

6:15-7:15 a.m., 5685-HAFSCT Anesthesia Fellow/Faculty Preceptor Seminar

6:30 a.m., 2001DNResident Conference Lecture: “Placental Transfer of Drugs” - Cathleen Peterson-Layne, MD

7:15 a.m., 2001DNGrand Rounds

7:15-8:00 a.m., RM203-Pain ClinicMRC Pain Journal Club

12:00-12:45 p.m., 2003DNCritical Care Conference

4-5 p.m., 5680A-HAFSPediatric Conference

Upcoming events:2009 Department Holiday Party: December 19, 2009 | Durham Marriott Hotel | Durham, NC2010 Academic evening: Tuesday, May 18, 2010. Please mark your calendars.2010 resident graduation Banquet: Saturday, June 12, 2010 | Hope Valley Country Club | Durham, NC

HappyHolidays

HappyNew Years

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AneSTHeSIology CMe ACTIVITIeS

Departmental CMe Activities

4th Annual Winter Anesthesia and Critical Care reviewfebruary 28-March 5, 2010 | The Canyons resort, Park City, UTfor more information, contact Katherine Siler: siler006@mc.duke.edu.

Winter Conference special rate for all Duke faculty & CRNAs: $200 for CRNAs, $250 for faculty. Must register by December 31. See Katherine Siler for registration form.

This five-day course will focus on reviewing concepts and new advances in pain management, regional anesthesia, critical care, cardiac anesthesia and pediatric anesthesia.

Carolina Cadaver CourseMay 22-23, 2010 | The Duke School of nursing, Durham, nCfor more information, contact Kate Shaw: katerahere@gmail.com.

This activity is designed to educate or refresh the knowledge of practicing anesthesiologists, critical care specialists, and certified registered nurse anesthetists (CRNAs) in the anatomical requirements, techniques, and side effects of ultrasound-guided regional anesthesia and peripheral nerve blockade.

3rd Annual emerging Technologies in the orJune 6-9, 2010 | Disney’s yacht and Beach Club resort, lake Buena Vista, flfor more information, contact Katherine Siler: siler006@mc.duke.edu.

13th Annual Duke Cardiothoracic Update and Tee review CourseAugust 5-8, 2010 | Sea Pines resort, Hilton Head Island, SCfor more information, contact Jaime Cooke: jca24@notes.duke.edu.

Mark your calendars for another year of cutting-edge research and updated information designed for medical personnel of all skill levels. NEW FOR THIS YEAR! Critical Care Track!

Ultrasound guided regional Anesthesia Preceptorship Course2009-2010 Dates Available | Duke University Medical Center, Durham, nCfor more information, contact Katherine Siler: siler006@mc.duke.edu.

Participants in the Duke Preceptorship will spend three days in the regional block area, operating rooms and on the floor with post surgery patients observing ul-trasound guided single shot nerve blocks and catheter techniques in a wide variety of clinical scenarios. They will learn how to set up the block area for maximum efficiency in the OR environment, improve their decision making ability and make choices in the performance of regional anesthesia. A one-on-one discussion with the Duke Faculty member reviewing cases, scanning techniques and the image library as well as covering handout materials will augment the preceptorship experience.

Visiting Preceptorship in Intraoperative Transesophageal echocardiography2009-2010 Dates Available | Duke University Medical Center, Durham, nCfor more information, contact Jaime C. Cooke: jca24@notes.duke.edu.

Participants in the Duke Intraoperative TEE Preceptorship spend one three-day session in the cardiac operating suites, observing techniques of intraoperative TEE and interpretation of images. Preceptors will participate in active discussions with cardiothoracic anesthesia faculty and fellows, and learn the basic TEE exam. They will also learn how to troubleshoot difficult cases and enhance their decision-making skills in the operating room. Cases will be reviewed with fellows and faculty and images from pathology libraries will be used to augment the preceptorship experience.

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THe BACK PAge

Holiday Classified Specials!Almost new Apple Macbook for sale (ONE yr old): Part No. MB403LL/A, White polycarbonate unibody, 13.3” LED-backlit glossy widescreen display, Mac OS X 10.5.8 (9L30) operating system, Multi-touch trackpad, 2.4 GHz Intel Core 2 Duo Processor, 2 GB 667 MHz DDR2 SDRAM (memory expandable to 4 GB), 3 MB L2 Cache, 800 MHz Bus speed, 160 GB Harddrive, 1280 x 800 32-bit color LCD display, One FireWire port, Two USB 2.0 ports, Built-in AirPort Extreme Wi-Fi (IEEE 802.11n), Built-in Bluetooth 2.0+ EDR module, iSight Camera, Full size keyboard, And more ...

Seller will include the following: 1. Apple Care Protection Plan: Almost two years remaining for an additional coverage outside of manufacturers warranty. Plan will end on 9/30/2011. Orig price $249. 2. iWork 2008: Apple’s version of Microsoft Office. Each word, database, powerpoint and etc document can be saved as a PC version which allows for compatibility when viewing on a PC com-puter. Orig price $79. 3. Un-opened Brand new HP Deskjet 3-in-one printer, scanner and copier (model number F4480), It scans up to 2400 x 1200 dpi, prints up to 28 ppm (black) and 22 ppm (color). Orig price $90. 4. Black Incase 13” hardshell case for White

MacBook. Orig price $49.99. ALL of the above for $1000 (price negotiable) contact Mercy Udoji at 615-715-3484 or mercy.udoji@duke.edu.

north Carolina food BankThis holiday season, the residents are gathering food and monetary contributions for the NC food bank. There will be boxes throughout the department in which to place food items. On the boxes will be a list of most-needed items, although any food/toiletry items are appreciated. If you would like to make a monetary donation, just send Stephanie McGuire an e-mail at stephanie.mcguire@duke.edu and she will pick it up from you whenever is convenient for you.

Thank you, in advance, for your generosity during the Holiday season.

early Time Card DeadlineDue to the upcoming holiday, all time cards for the pay period 27/09 will need to be turned in no later than Wednesday, December 16th at Noon. No exceptions can be made due to the holiday close. Please also be advised that time cards for pay period 01/10 will need to be turned in by December the 29th at Noon. Final confirmation on this will be forthcoming.

new Departmental research PublicationAllen BW, Stamler JS, Piantadosi CA. Hemoglobin, nitric oxide and molecular mechanisms of hypoxic vasodilation. Trends in Molecular Medicine 2009;15:452-460.

Professional Development SeminarsSpace is still available in the two professional development seminars listed below. To register, please visit our website http://facdev.medschool.duke.edu and select “upcoming events.”

Tuesday, December 15, 5:00-6:15 pm“responding to a grant review”David C. Steffens, MD, MHS Panelists: Sally Kornbluth, PhD, Gerard Blobe, MD, PhD, Laura P. Svetkey, MD, MHS School of Nursing Auditorium (room 1014).

• You’ve written a grant. You’ve gotten the pink sheet. This seminar will discuss strategies for responding to critiques and suggestions to optimize your chances for getting the re-submission funded.

December 14 - 20 Birthday WishesCaswell Arnold Dr. Terri MonkDr. David Wright Donald ThomasKeita Faulkner

Note: If you do not want your name listed here, please send a removal notice to keith010@mc.duke.edu.

December Baby!Willem and Heather Bok are proud parents to a beautiful baby girl! Kayden Elizabeth Bok, 8lbs, 13oz and 22 inches long. All are doing well.