2014 january evaluation summaries - baptist health south ... · cme conference evaluation summaries...

Continuing Medical Education Department CME Conference Evaluation Summaries

January 2014

January 13 Radiology Grand Rounds: Radiology Re-Engineering for an Electronic and Flattened World

Scores 4.8

14 Caring for Kids with Cancer - Overview of the Division of Quality of Life and Palliative Care

5.0

16 Cardiovascular Conference: Is This Marathon Running Killing Me? 4.9

23 Risk Management and Patient Safety: Cultural Awareness & Medical Care and Simulation Training

4.9

30 Cardiovascular Conference: High-yield Vascular Medicine for Practicing Cardiologists

4.9

Symposiums 11/1 Thirty-second Annual Echocardiography Symposium 7

12/6 2013 Miami Neuro Symposium

CONTINUING MEDICAL EDUCATION EVALUATION SUMMARY

Conference Title: Radiology Grand Rounds: Radiology Re-Engineering for an Electronic and Flattened World: Radiology as Value Innovator Conference Director: Margaret Chaneles, M.D. Date: Monday, January 13, 2014 Time: 6:00 – 7:30 p.m. Location: Baptist Hospital, 5BCVI and Webcast

Scoring Key: 5 - Strongly Agree 4 - Agree 3 - Neutral 2 - Disagree 1 - Strongly Disagree N/A- Not applicable for my practice

1. As a result of attending this conference, to what extent do you agree that you will be better able to:

Establish how radiology must leverage and exploit the opportunities presented by inevitable transition to an electronic-based practice.

4.8

Demonstrate why radiology must address increasing expectations of patients and healthcare practitioners in the modern electronic-based information environment.

4.8

Illustrate how and why radiology must redefine and re-engineer itself in order to fully take advantage of the electronic-based practice.

4.8

Discuss the impact these changes in practice management can have on quality, workflow efficiency, and productivity.

4.8

Implement strategies to avoid marginalization and commoditization. 4.8

Scoring Key: 5 - Excellent 4 - Very Good 3 - Good 2 - Fair 1 – Poor N/A- Not applicable

2. Effectiveness of learning aids used (audio-visual, etc.) if applicable. 4.8

3. Conference content. 5.0

4. Effectiveness of the speaker:

Paul J. Chang, M.D., FSIIM 5.0

Total Average: 4.8

5. Was this conference fair, balanced and without commercial bias? Yes 14 No 0 No response 3

How many patients will you see in your practice next week that will likely be impacted by what you learned at this activity?

Number of Patients: 1-5 6-10 Over 10 No Answer Not applicable to my

practice

Respondents: 0 1 4 5 7

Percent (rounded): 0% 6% 24% 29% 41%

What do you intend to do differently in the treatment of your patients as a result of what you learned at this conference? What new strategies will you apply in your practice of patient care?

Innovate. I plan to spend more time with hospital radiologist. Follow-up with Dr. Chang’s recommendations.

If you do not plan to implement any new strategies learned at this conference, please list any barriers or obstacles that might keep you from doing so:

None listed. List topics related to this lecture that you want to learn more about:

Peripheral vascular imaging.

Comments: Excellent. (4) Interesting. Eye-opening. Fun lecture.

Baptist Hospital -Live Attendance: 22 Physicians: 17 BHSF Employees: 2 Other: 3


Conference Title: Caring for Kids with Cancer - Overview of the Division of Quality of Life and Palliative Care: An Emphasis on Decision Making and Advance Care Planning Conference Director: Doured Daghistani, M.D. Date: Tuesday, January 14, 2014 Time: 6:00 – 7:30 p.m. Location: Baptist Hospital, Auditorium



Describe World Health Organization’s (WHO) definition of palliative care for children and analyze background and national perspective on palliative oncology care.

5.0

Review the St. Jude Children’s Research Hospital’s palliative care initiative, and its implementation of the Individualized Care Planning and Coordination (ICPC) model.

5.0

Analyze recent research findings concerning decision making and advance care planning in palliative care.

5.0

Implement evidence-based recommendations for pediatric palliative and end-of-life quality care to ensure patients receive optimum care in their individual case.

5.0





Justin N. Baker, M.D., FAAP, FAAHPM 5.0

Total Average: 5.0




practice


Percent (rounded): 27% 7% 3% 23% 40%


Involve PALS when needed. Ability to explain palliative/hospice model in pediatric context. Seen early referral/consults for PPCS. Ask different questions. Integrate ideas relating to Family Advisory Council. Remember the importance of being present with patients. Add triggers for palliative care. Think more about palliative care.


None listed.

List topics related to this lecture that you want to learn more about: Pain management and end of life care. Psychiatric manifestations. New standards of care in pediatric oncology. Anything palliative.

Comments:

Excellent conference. (3) Excellent topic and innovative field. Excellent presentation. Excellent speaker and message. Excellent speaker. Kept me interested in a topic I thought I knew something about, but had no interest in.

Turns out I had it backwards.

Baptist Hospital -Live Attendance: 57 Physicians: 30 Psychologists: 7 BHSF Employees: 22 Other: 5


Conference Title: Cardiovascular Conference Series: Is This Marathon Running Killing Me? Conference Director: Jonathan Roberts, M.D. Date: Thursday, January 16, 2014 Time: 12 Noon – 1:00 p.m. Location: Baptist Hospital, 5BCVI, Videoconferenced to South Miami Heart Center, Conference Room, West Kendall Baptist Hospital, Classroom 3, Homestead Hospital, Physicians’ Lounge and Live Webcast



Estimate the sudden death rate during marathon participation. 4.9

Discuss the possible source of elevated troponin levels in marathoners. 4.9

Explain why coronary artery calcium scores could be higher in distance runners. 4.9

Assess the risk of CAD in athletes to prevent exercise-related cardiac events in adults. 4.9





Paul D. Thompson, M.D. 5.0

Total Average: 4.9




practice


Percent (rounded): 16% 11% 14% 30% 30%


Tell kids to exercise judiciously.


Confusing conculsions. List topics related to this lecture that you want to learn more about:

None listed.

Comments: Good lecture. (2) Outstanding. Excellent talk. Excellent question and answer session. Very practical and easy to understand.

Baptist Hospital -Live Attendance: 44 Physicians: 13 BHSF Employees: 30 Other: 1

TotalAttendance: 65 Physicians: 17 BHSF Employees: 47 Other: 1

South Miami Hospital -VC Attendance: 4 Physicians: 0 BHSF Employees: 4 Other: 0

West Kendall Hospital -VC Attendance: 3 Physicians: 0 BHSF Employees: 3 Other: 0

Homestead Hospital -VC Attendance: 12 Physicians: 3 BHSF Employees: 9 Other: 0

WebcastAttendance: 2 Physicians: 1 BHSF Employees: 1 Other:


Conference Title: Risk Management and Patient Safety: Simulation Training, Cultural Awareness and Medical Care

Conference Coordinators: Gerri Schimmel, M.S. & Yvonne Zawodny, R.N. Date: Thursday, January 23, 2014 Time: 6:00 - 8:00 p.m. Location: Baptist Hospital, Auditorium, Videoconferenced to Homestead Hospital, Mango Room, Mariners Hospital, Executive Conference Room



Explain the importance of crisis resource management communication techniques and consider the impact on delivery of safe, quality care.

4.9

Appreciate the importance of delivering culturally and linguistically appropriate medical care. 4.9

Explain the legal ramifications of transculturally appropriate medical care. 4.9

Utilize language access services with limited English proficiency (LEP) patients to help deliver appropriate medical care.

4.9

Implement the triadic interview process appropriately. 4.9




4. Effectiveness of the speakers:

Maria Victoria Lopez Beecham, M.D. 5.0

Ian Nisonson, M.D., FACS 5.0

Total Average: 4.9




practice


Percent (rounded): 21% 15% 33% 5% 23%


Pay more attention to cultural diversity. (6) Listen more. (3) Effective communication. (2) Focus on my communication skills. Simulation is learning without harm. Form the first impression in 20 seconds. AIDET training module. Tell the patient “Thank you for your trust.” Take more time to speak with parents and listen before talking.

Remain alert to possible barriers of communication. Try to remove the computer from between me and the patient. Explain more clearly why I am doing what I am doing. Continue to make eye contact and be personable and smile. Utilization of post-interview when using an interpreter, as well as triage pre-interview. Get the patient dressed before giving them the final speech. Adopt a more attentive interaction to better bridge cultural divide.



Electronic records versus time constraints. Crisis resource management. Cultural issues dealing with Voodoo religion. Legal implications of not providing culturally sensitive care. Communication conference should be a requirement for all physicians. Culturally relevant prevention and harm reduction models.

Comments:

Excellent presentation. (5) The conference was comprehensive, informative and entertaining. Nice incorporation of both parts of this program. Wonderful conference. Very important and timely. Nicely done. Homestead audio visual run poorly.

Baptist Hospital -Live Attendance: 55 Physicians: 37 Psychologists: 5 Podiatrists: 3 BHSF Employees: 16 Other: 2

TotalAttendance: 63 Physicians: 39 Psychologists: 5 Podiatrists: 3 BHSF Employees: 22 Other: 2

Mariners Hospital -VC Attendance: 2 Physicians: 1 BHSF Employees: 1 Other: 0


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Conference Title: Cardiovascular Conference Series: High-yield Vascular Medicine for Practicing Cardiologists Conference Director: Jonathan Roberts, M.D. Date: Thursday, January 30, 2014 Time: 12 Noon – 1:00 p.m. Location: Baptist Hospital, 5BCVI, Videoconferenced to South Miami Heart Center, Conference Room, West Kendall Baptist Hospital, Classroom 3, Homestead Hospital, Physicians’ Lounge and Live Webcast



Implement evidence-based recommendations for the diagnosis and management of disease of the thoracic aorta.

4.9

Effectively identify cases of fibromuscular dysplasia, review ultrasound assessment and initiate appropriate treatment.

4.9





Ian Del Conde Pozzi, M.D. 4.9

Total Average: 4.9




practice


Percent (rounded): 13% 0% 8% 54% 25%


Ultrasound renal arteries to assess contour and velocity more closely. Check blood pressure bilateral more consistently. Consider fibromuscular dysplasia.



Pediatric vascular. Comments:

Fantastic presentation.

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Baptist Hospital -Live Attendance: 35 Physicians: 14 BHSF Employees: 21 Other:

TotalAttendance: 50 Physicians: 24 BHSF Employees: 26 Other: 0

South Miami Hospital -VC Attendance: 3 Physicians: 0 BHSF Employees: 3 Other: 0


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CONTINUING MEDICAL EDUCATION DEPARTMENT Thirty-second Annual Echocardiography Symposium

Friday, November 1, 2013

Physicians Attended: 138 Physicians Responded: 121

FACULTY EVALUATION: Hemodynamics in the Echo Lab Gerard Aurigemma, M.D. 4.8

Echo Evaluation of Right Heart Anatomy and Function Steven Lester, M.D. 4.6

Disease of the Aorta: Marfan Syndrome and Connective Tissue Disorders Robert Siegel, M.D. 4.7

Quantification of Mitral Regurgitation: From Jets to 4D Vena Contracta Effective Regurgitant Orifice Area

William Stewart, M.D.

4.5

Spectrum of Aortic Stenosis: 2013 and Beyond Bijoy Khandheria, M.D. 4.6

Unforgettable Cases from Aurora Healthcare: Your Diagnosis Please? Bijoy Khandheria, M.D. 4.5

Cardio Oncology: Impact on Systolic/Diastolic Metrics Bijoy Khandheria, M.D. 4.6

When, Where and How Should I be Using Contrast Echo Mani Vannan, MBBS 4.5

Hypertrophic Cardiomyopathy Steven Lester, M.D. 4.8

Constriction, Restriction and Tamponade Gerard Aurigemma, M.D. 4.8

Cardiac Resynchronization: What Does/Can Echo Offer Mani Vannan, MBBS 4.1

The Role of Echo in TAVR: Guidance, Complications and Outcomes Robert Siegel, M.D. 4.6

Intraprocedural TEE for Mitral Regurgitation William Stewart, M.D. 4.5

Introduction to Cardiac Mechanics in the XXI Century Humberto Machado, M.D. 4.1

Speckle, Torsion and 4D Strain Rick Meece, RDCS, RCS, RCIS, FASE 4.3

Diastolic Stress Echo: Utility in the Patient with Dyspnea Steven Lester, M.D. 4.8

Endocarditis in Native and Prosthetic Valves Mani Vannan, MBBS 4.5

Total Average 4.5 Was this symposium fair, balanced, and free of commercial bias? Yes 105

No 0 No Answer 16

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EDUCATIONAL OBJECTIVES:

Assess cardiovascular hemodynamic as an extremely important component of managing patients with cardiac diseases. 4.6

Identify an accurate and reliable echocardiographic parameter for right ventricular functional assessment. 4.5

Recognize the wide spectrum of differential diagnoses in diseases of the aorta. 4.7

Explore the role of genetics and current novel therapeutic approaches in order to provide patients with appropriate counseling and clinical follow-up. 4.4

Accurately assess mitral regurgitation for clinical decision-making and outcome prediction. 4.6

Accurately diagnose patients with severe symptomatic aortic stenosis. 4.7

Examine the role of echocardiography in the diagnoses and treatment of complex cases. 4.4

Recognize the critical role of the cardio-oncologist for the effective care of cancer patients. 4.5

Recognize indications for the use of echocardiographic contrast agents. 4.5

Utilize transthoracic echocardiography to assess the phenotypic manifestations and clinical 4.4

Identify the valuable history of a systemic disorder which can predispose to either constrictive pericarditis or restrictive Cardiomyopathy. 4.6

Evaluate the role of echocardiography in cardiac resynchronization therapy. 4.4

Examine the role of echocardiography in the assessment and guidance of transcatheter aortic 4.6

Describe the evolving roles of intraprocedural TEE during transcatheter mitral valve procedures. 4.5

Describe the framework for representing mechanical deformation and contraction of the cardiac ventricles. 4.2

Utilize transthoracic and transesophageal echocardiography to provide 3D reconstructions, as well as a real-time rendering (4D) of the heart. 4.3

Describe how diastolic dysfunction has shown significant correlation with exercise capacity and exercise induced dyspnea. 4.7

Analyze the complications of infective endocarditis and determine optimal therapeutic approach. 4.5

Total Average 4.5

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Friday, November 1, 2013

Non-Physicians Attended: 264 Non-Physicians Responded: 211

FACULTY EVALUATION: Hemodynamics in the Echo Lab Gerard Aurigemma, M.D. 4.7

Echo Evaluation of Right Heart Anatomy and Function Steven Lester, M.D. 4.7

Disease of the Aorta: Marfan Syndrome and Connective Tissue Disorders Robert Siegel, M.D. 4.8

Quantification of Mitral Regurgitation: From Jets to 4D Vena Contracta Effective Regurgitant Orifice Area

William Stewart, M.D.

4.6

Spectrum of Aortic Stenosis: 2013 and Beyond Bijoy Khandheria, M.D. 4.7

Unforgettable Cases from Aurora Healthcare: Your Diagnosis Please? Bijoy Khandheria, M.D. 4.7

Cardio Oncology: Impact on Systolic/Diastolic Metrics Bijoy Khandheria, M.D. 4.7

When, Where and How Should I be Using Contrast Echo Mani Vannan, MBBS 4.7

Hypertrophic Cardiomyopathy Steven Lester, M.D. 4.8

Constriction, Restriction and Tamponade Gerard Aurigemma, M.D. 4.8

Cardiac Resynchronization: What Does/Can Echo Offer Mani Vannan, MBBS 4.4

The Role of Echo in TAVR: Guidance, Complications and Outcomes Robert Siegel, M.D. 4.6

Intraprocedural TEE for Mitral Regurgitation William Stewart, M.D. 4.7

Introduction to Cardiac Mechanics in the XXI Century Humberto Machado, M.D. 4.5

Speckle, Torsion and 4D Strain Rick Meece, RDCS, RCS, RCIS, FASE 4.6

Diastolic Stress Echo: Utility in the Patient with Dyspnea Steven Lester, M.D. 4.7

Endocarditis in Native and Prosthetic Valves Mani Vannan, MBBS 4.7


No 0 No Answer 36

15


Assess cardiovascular hemodynamic as an extremely important component of managing patients with cardiac diseases. 4.6

Identify an accurate and reliable echocardiographic parameter for right ventricular functional assessment. 4.6

Recognize the wide spectrum of differential diagnoses in diseases of the aorta. 4.6

Explore the role of genetics and current novel therapeutic approaches in order to provide patients with appropriate counseling and clinical follow-up. 4.5

Accurately assess mitral regurgitation for clinical decision-making and outcome prediction. 4.6

Accurately diagnose patients with severe symptomatic aortic stenosis. 4.7

Examine the role of echocardiography in the diagnoses and treatment of complex cases. 4.6

Recognize the critical role of the cardio-oncologist for the effective care of cancer patients. 4.6

Recognize indications for the use of echocardiographic contrast agents. 4.6

Utilize transthoracic echocardiography to assess the phenotypic manifestations and clinical 4.5

Identify the valuable history of a systemic disorder which can predispose to either constrictive pericarditis or restrictive Cardiomyopathy. 4.6

Evaluate the role of echocardiography in cardiac resynchronization therapy. 4.3

Examine the role of echocardiography in the assessment and guidance of transcatheter aortic 4.6

Describe the evolving roles of intraprocedural TEE during transcatheter mitral valve procedures. 4.6

Describe the framework for representing mechanical deformation and contraction of the cardiac ventricles. 4.5

Utilize transthoracic and transesophageal echocardiography to provide 3D reconstructions, as well as a real-time rendering (4D) of the heart. 4.5

Describe how diastolic dysfunction has shown significant correlation with exercise capacity and exercise induced dyspnea. 4.7

Analyze the complications of infective endocarditis and determine optimal therapeutic approach. 4.7

Total Average 4.6

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Saturday, November 2, 2013


FACULTY EVALUATION: Systolic Function: Beyond Ejection Fraction Gerard Aurigemma, M.D. 4.8

Echocardiography in Diastolic Failure Steven Lester, M.D. 4.8

The Role of Myocardial Strain Imaging in Practice: Applications and Challenges Mani Vannan, MBBS 4.2

Mitral Regurgitation: Grading and Timing of Intervention Robert Siegel, M.D. 4.8

Stress and the Heart Gerard Aurigemma, M.D. 4.8

Great Moments in Echo: The Cleveland Clinic Experience William Stewart, M.D. 4.6

CRT and Lead Placement and 3D Mapping Versus 4D Speckleb Tracking Rick Meece, RDCS, RCS, RCIS, FASE 4.4


No 0 No Answer 4


Examine noninvasive techniques for assessing systolic function that can provide the same information as invasive. 4.6

Explain why diastolic assessment is now a routine part of any complete echocardiographic report. 4.7

Describe how strain echocardiography will be a potential diagnostic/prognostic tool to detect risk in patients with cardiovascular disease. 4.3

Implement echocardiography as an essential diagnostic tool for establishing etiology and hemodynamic consequences of mitral regurgitation. 4.7

Describe the advantages of using stress echocardiography to assess heart disease severity. 4.6

Track the contributions of echocardiography in intraoperative valve surgery, mitral valve repair and transcatheter valve procedures. 4.5

Utilize cardiac resynchronization therapy to effectively treat patients with medically refractory heart failure. 4.4

Total Average 4.5

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Saturday, November 2, 2013


FACULTY EVALUATION: Systolic Function: Beyond Ejection Fraction Gerard Aurigemma, M.D. 4.8

Echocardiography in Diastolic Failure Steven Lester, M.D. 4.8

The Role of Myocardial Strain Imaging in Practice: Applications and Challenges Mani Vannan, MBBS 4.5

Mitral Regurgitation: Grading and Timing of Intervention Robert Siegel, M.D. 4.7

Stress and the Heart Gerard Aurigemma, M.D. 4.8

Great Moments in Echo: The Cleveland Clinic Experience William Stewart, M.D. 4.7

CRT and Lead Placement and 3D Mapping Versus 4D Speckleb Tracking Rick Meece, RDCS, RCS, RCIS, FASE 4.6


No 0 No Answer 16


Examine noninvasive techniques for assessing systolic function that can provide the same information as invasive. 4.7

Explain why diastolic assessment is now a routine part of any complete echocardiographic report. 4.8

Describe how strain echocardiography will be a potential diagnostic/prognostic tool to detect risk in patients with cardiovascular disease. 4.5

Implement echocardiography as an essential diagnostic tool for establishing etiology and hemodynamic consequences of mitral regurgitation. 4.8

Describe the advantages of using stress echocardiography to assess heart disease severity. 4.7

Track the contributions of echocardiography in intraoperative valve surgery, mitral valve repair and transcatheter valve procedures. 4.7

Utilize cardiac resynchronization therapy to effectively treat patients with medically refractory heart failure. 4.5

Total Average 4.7

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CONTINUING MEDICA L EDUCATION DEPARTMENT Thirty-second Annual Echocardiography Symposium

November 1-2, 2013

Overall Evaluation Summary Physicians Attended: 138

Physicians Responded: 110

How many patients will you see in your practice next week that will likely be impacted by what you learned at this symposium?

24 0-10(22%) 27 10-15 (25%) 16 15-20(15%) 10 20-25 (9%) 15 Over 25 (13%) 18 No Answer(16%)

Participation in this learning activity has: Increased my knowledge 106 Yes 0 No 4 No Answer

Improved my competence 100 Yes 8 No 2 No Answer

Enhanced my performance 103 Yes 4 No 3 No Answer

Ensured that my patients will have improved outcomes 95 Yes 12 No 3 No Answer

This educational activity has contributed to my professional effectiveness and improved my ability to: Scoring Key: 5 – Strongly Agree 4 – Agree 3 - Neutral 2 - Disagree 1 – Strongly Disagree Treat/manage patients 4.5

Communicate with patients 4.1

Total Average 4.3

Scoring Key: 5 - Excellent 4 - Very Good 3 - Good 2 - Fair 1 - Poor

1. Overall impression of symposium. 4.6

How did you hear about this meeting? (40%) Mail (44) (35%) Email (38) (11%) Internet (12)

Baptist Health (5) Google (4) CME Broker (1)

(8%) Poster (9) (2%) DCMA (2) (17%) Other (19)

Previous attendee (9) Colleague (4)

(5%) No Answer (5)

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Yes No No Answer

Have you attended this symposium in the past? (78) 71% (31) 28% (1) 1%

Would you attend this symposium again next year? (100) 91% (7) 6% (3) 3%

Would you recommend this symposium to a colleague? (105) 95% (3) 3% (2) 2%

Will not need Echo CME next year. If construction not completed I will not return. Uneven presentation. Poor audiovisuals. Facilities were poor. Construction and dust everywhere.

1. What do you intend to do differently in the treatment of your patients as a result of what you learned at this symposium? What new strategies will you apply in your practice of patient care?

Pay more attention to diastolic function. (6) Use of echo contrast. (5) Improve our echo quality and completeness. (4) Approach severe mitral regurgitation differently. (4) Strain imaging. (4) Diastolic stress echo. (3) More detailed echo analysis. (2) Be more aggressive diagnostically with patients with dyspnea. Better echoes and interpretations for better management. Use more tissue Doppler. Look into new techniques. Use more percutaneous aortic valve replacement and mitral valve repair. Better insight into diagnosis and treatment. Use more contrast in hypertrophic cardiomyopathy (HCM). Better patient care. Mitral regurgitation assessment by 3-4 techniques. Aorta size and use of Losartan and history. Add hemodynamic data to my echo reports. TAVR. Improved decision making in valve cases. Implement TAPSE and tissue Doppler to assess the pulmonary artery pressure that does not

demonstrate any tricuspid regurgitation. Be aware of certain infrequent cardiac cases such as dissection cardiomyopathy. Insist on tissue Doppler as part of every exam. Consider aortic dissection as a treatment. Look for low flow aortic stenosis. Adhere to most recent guidelines. Routine protocols and follow-up intervals. Recommendation on therapy both mescal/surgical in advancing echocardiographic

techniques.

2. If you do not plan to implement any new strategies learned at this symposium, please list any barriers or obstacles that might keep you from doing so.

Poor reimbursement for new technologies. (3) Need an updated echo machine. Money. Cost of contrast. Hospital policy. Expense on new equipment. HMO will not authorize.

3. Suggested topics and/or speakers you would like for future symposiums related to Echocardiography. 3D echo and strain but from basics to advanced. (2)

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Speakers: Steven Lester, Robert Siegel, William Stewart, Aurigemma, Vannan, Khandheria. Diastology – Klein. Stress echo. Athletic heart. Reimbursement. Favor of TTE over TEE. Practical echocardiography today for an average community hospital. More diastolic heart failure. More restrictive and constructive pericarditis stenosis echo. More on echo utility in timing of valve surgery and prosthetic valve function. More show and tell type of cases needed. Contrast echo. Echo findings important to address or change management of patients. Nuclear cardiology. More practical and common problems. Topics more directed to clinical cardiologists. Practical, how to strain imaging. Studies that deal with the overuse of echo in hospital practice. Pharmacology and echo findings. Congenital heart disease in adults. Dr. Heidi Connolly. Intra-cardiac echo. Valve surgery/robotic mitral valve repair. Echo pitfalls. Stem cell implantation into heart. Pulmonary hypertension pulmonic stenosis. Right ventricular dysfunction.

4. Comments: Excellent conference. (11) Outstanding speakers. (4) Good presentation. (2) Very informative. (2) Consistently great conference. Excellent topics. Again, a successful conference. Excellent lectures and review. Best echo conference. Every lecture is not to be missed. This is better that 5 other subspecialty

meetings I attend. Visiting experts from around the country show their experience making this an extremely

authoritative conference. Some should come back every 1-2 years to talk about their results. Dr. Lester gave exceptional presentations. A little too technical for community physicians. 20 minutes is too short for speakers of this caliber. The conference always runs late. The first day was too long. Presentations should be shorter, more concise and highlight recent updates. Improve the audiovisual equipment. Need more topics with presentations available on the website. I would like to be able to follow along with lectures on my iPad, but not all the lectures were

there. This year parking was a problem. Dr. Vannan needs to use pointer on screen not on the computer. (3)

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CONTINUING MEDICA L EDUCATION DEPARTMENT Thirty-second Annual Echocardiography Symposium

November 1-2, 2013

Overall Evaluation Summary Non-Physicians Attended: 264

Non-Physicians Responded: 170

How many patients will you see in your practice next week that will likely be impacted by what you learned at this symposium?

34 0-10(20%) 26 10-15 (15%) 29 15-20(17%) 12 20-25 (7%) 41 Over 25 (24%) 28 No Answer(16%)

Participation in this learning activity has: Increased my knowledge 166 Yes 0 No 4 No Answer

Improved my competence 160 Yes 4 No 6 No Answer

Enhanced my performance 158 Yes 3 No 9 No Answer

Ensured that my patients will have improved outcomes 155 Yes 5 No 10 No Answer

This educational activity has contributed to my professional effectiveness and improved my ability to: Scoring Key: 5 – Strongly Agree 4 – Agree 3 - Neutral 2 - Disagree 1 – Strongly Disagree Treat/manage patients 4.5


Total Average 4.5



How did you hear about this meeting? (41%) Email (70) (34%) Mail (57) (6%) Internet (10)

Baptist Health (8) Google Yahoo Cath lab digest CCI

(4%) Poster (6) (3%) DCMA (5) (3%) LinkedIn (5)

22 (1%) Twitter (2) (1%) Facebook (1) (28%) Other (47)

Colleague (17) Past attendee (11) Dade Medical (6) Miami Dade (4) Dr. Machado

(6%) No Answer (10)

Yes No No Answer



Would you recommend this symposium to a colleague? (162) 95% (1) 1% (7) 4%

It depends on where it is going to take place. Too much cost and I live out of state. At other symposiums, lunch has been more organized.

5. What do you intend to do differently in the treatment of your patients as a result of what you learned at this symposium? What new strategies will you apply in your practice of patient care?

Use more contrast echo. (10) I will apply new procedures. (8) Will do closer evaluation of right heart anatomy. (7) Pay more attention to diastolic function parameters. (3) Look at hypertrophic cardiomyopathy (HCM) differently. (2) Use vena cava 3D contrast for mitral regurgitation (MR). (2) Include pulmonary vein flow for diastolic dysfunction for those studies that indicate possible

diastolic dysfunction. (2) Take a different approach with new techniques learned. (2) Better differentiate between constrictive and restrictive. (2) Perform post stress echo, Doppler and TDI to assess for diastolic dysfunction. (2) Focus more on the small details. More tissue Doppler. Do more research to increase my knowledge in areas I’m not familiar with. PV flow in diagnosis of sever MVR. Implement quantitative MR evaluations. More MR methods Use more 3D echo. More educated to interpret echo. Proximal isovelocity surface area (Pisa) was informative, already doing it but will implement into

all valves. I intend to talk to the cardiologist in our practice to implement certain changes in order to

prevent and assess accurately our patients. Diastolic dysfunction techniques. Pay more attention to hemodynamic values. More accurate and detailed cardiovascular evaluation. If tricuspid regurgitation (TR) not visible do a bubble study. Interpretation of Aortic stenosis, with different ejection fraction (EF) and grading. Oncology education. 4D echoes. Won’t catheterize aortic dissection patients. Have guidelines posted. Encourage our techs on the importance and proper use of the myriad of techniques used in all

exams and how to apply appropriately.

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Perform required protocols by interpreting doctors. Adding MPAP measurements to reports. Follow chemo patient every three weeks for three months. Use additional methods to confirm study. Use of contrast to identify compacted versus non-compacted myocardium. Right ventricular free wall TDI. Better assessments and follow-up. Left atrial volumes. Circumferential strain. Cardiac resynchronization. Do things more routinely verses just when requested. Further analysis of left ventricle diastolic function, exercise testing, perhaps strain. LA volume using Simpson (SIMP). Do all three measurements, LA volume, EE and A wave comparison for diastolic failure. Aortic stenosis low flow low gradient application. To understand all measuring for aortic stenosis. Quantitate MR more. More pulmonary veins Doppler.

6. If you do not plan to implement any new strategies learned at this symposium, please list any barriers or

obstacles that might keep you from doing so. We don’t have strain/speckle on our machine. (5) Cost factor. (3) Reimbursements. (3) Time factor. (3) Outdated equipment. (2) Limited software. (2) Obama care. Lack of job opportunities for new sonographers. Education of employees. Hospital rules. Do not use contrast.

7. Suggested topics and/or speakers you would like for future symposiums related to Echocardiography. Assessment of adult congenital heart disease. (7) More on 3D echo. (4) Diastolic function. (3) More 3D. (2) Infant and pediatric echo. (2) How does cardiac resynchronization therapy (CRT) work? (2) 4D echo. (2) Intracardiac echo (ICE). (2) IAC accreditation overview and protocols. Mitral stenosis Aortic valve prolapse. Applying 3D strain imaging to daily practice in echo lab. Randy Martin, Itzak Kronzon and Fergenbaum. Current medications in management of atrial fibrillation, CAD, congestive heart failure (CHF). Would like to hear more about echo lab accreditation. The impact of echo with the health care act. Dr. Aurigemma. Dr. Khanderia. Transoperative echo. 3D cases on transthoracic and transesophageal procedures. Tissue Doppler echo machine comparison. Pathologies. Strain imaging to evaluate and follow-up chemotherapy patients. Dr. Robert Siegel is an excellent speaker. How a new sonographer can get their foot in the door and gain experience.

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Intraoperative assessment; loading conditions, anesthesia, surgical aspects. Wall motion abnormalities. Correct ordering diagnosis by PPCP to better know and assess patient. A women presenter. Terry Rey Wolds, Sydney Edelman, Frederick Krenkav. Have a set aside time/talk of unusual echocardiograms for everyone to guess the diagnosis. Local hospital present cases at end of sessions. Live demonstrations and how to sessions. Have some of the vendors give classes on how the techniques can and should be used. Atrial and ventricular septal defect repairs. Chemo patients. Future technologies. Stress echo as a prognosis tool when evaluating patient with congenital heart disease. Mild, moderate and sever pulmonary embolism. Pericardial effusion without tamponade findings. More robotic and minimal invasive mitral replacements.

8. Comments: Excellent. (8) Educational. (8) Great conference. (5) Great location. (5) Good speakers. (3) Dr. Lester, Dr. Stewart and Dr. Khanderia had outstanding lectures. (2) I was mostly impressed with Dr. Lester’s lectures and most of the lectures of other presenters. (2) The lunch was delicious. (2) All of the topics were very good. (2) The symposium was much enriched and enhanced my knowledge. Great staff. Well put together. Very good overall. Good number of credits. Always a pleasure to come. Top of the heap educators, never a let down. One of the best I’ve been to and I’ve been to 32 of these. This year’s speakers were awesome, brilliant and not boring at all. Keep up the good work, your staff is wonderful. I was very impressed with the quality of the speakers. The presentations were extremely

informative. I received many answers to questions I had. Great first experience. I will definitely be back. A great seminar with great and useful information. Every symposium I learn a new technique. Thank you for another great year. Thank you Christine Baldwin. I liked it, it was really interesting. Would you be able to create a micro-computerized system to be connected with tablets with

the computers of the speakers? Remind speakers they are speaking to echo cardiographers and cardiologists. They need to

give a better introduction on how and why things are done and then expand. On Friday there were not enough chairs available. Air condition did not work well. Could do smaller group presentations/panels. I would like to obtain a recording of the symposium. A little too cold. The Trump needs to install better gradual closing doors. Workbooks would be a great addition. Move back to Biltmore. Audio visual was poor. Clips didn’t work. Speaker thought he had a pointer and didn’t. (2) Lower the lights so can read the echoes better. (2) Would rather have two days starting at 8 a.m. until 3 p.m. since traffic is so bad at 6 p.m. (5)

25

CONTINUING MEDICAL EDUCATION DEPARTMENT Inaugural Miami Neuro Nursing Symposium

December 5, 2013

Attended: 138 Responded: 132

FACULTY EVALUATION: Please rate the effectiveness of the presenters in meeting their educational objectives:

5- Excellent 4- Very Good 3- Good 2-Fair 1-Poor Stroke Clinical Decision-making and Management Utilizing Imaging Lori Massaro, MSN, CRNP, ACNP-BC 4.9 Discuss various diagnostic adjunctive modalities currently used in imaging the stroke patient. 4.9 Compare the benefits of MRI and CT imaging in acute stroke diagnosis. 4.9

Hypothermia Management in Neuro Patients Mary Kay Bader, MSN, CCNS, FAHA 5.0 Correlate the pathophysiology of neurologic injury to the benefits of mild hypothermia in the

treatment of neurologic disorders. 5.0

Describe the practical techniques of therapeutic hypothermia. 5.0 Explain the potential benefits and complications during the process of cooling and

rewarming. 5.0

Psychogenic Non-epileptic Seizures Shaun Smart, M.D. 4.9 Recognize the pathophysiology and clinical presentation of a psychogenic non-epileptic

seizure (PNES) patient. 4.9

Describe diagnostic and treatment approaches for PNES. 4.9 What’s Hot and What’s Not in the Treatment of Aneurysmal SAH Mary Kay Bader, MSN, CCNS, FAHA 5.0 • Identify the pathophysiological changes following aneurysmal subarachnoid hemorrhage

(SAH). 5.0

• Examine the pathology, clinical presentation and potential complications associated with SAH. 5.0

• Effectively coordinate team interventions to care for the patient with aneurysmal SAH by applying evidence-based approaches proven to optimize patient outcome. 5.0

Neurointerventional Overview: Case Studies in Care of the NIVR Rosanne Starr, MSN, ARNP, ACNP-BC 4.8

• Explain patient selection criteria for acute stroke intervention candidates. 4.8

• Summarize pre- and post-procedure care of the intracranial stent implantation patient. 4.8

Vasospasms Kendra Menzies Kent, MS, RN-BC, CCRN, CNRN, SCRN 4.9 • Describe the physiology of vasospasms and the diagnostic studies to identify them. 4.9 • Identify the presenting signs of vasospasms and the timing of the symptoms following SAH. 4.9 • Compare approaches to prevent and treat vasospasms including interventional and

medical management and current research. 4.9

Anticoagulation and Reversal: Practical Application for Nursing

Erika Dittmar, Pharm.D, BCPS and Sylvia Marrero, Pharm.D, C.Ph. 4.6 Discuss the oral anticoagulant and antiplatelet medications used in the care of stroke

patients 4.7

Implement strategies for anticoagulant reversal in stroke patients. 4.7 Recognize important considerations for utilization of oral anticoagulant and antiplatelet

medications when caring for stroke patients. 4.6

26

9. What do you intend to do differently as a result of what you learned at this symposium? Apply what I learned. (11) Monitor neuro patient temperatures more closely. (5) Pay attention to vasospasms 4-14 days. (5) Better management of neuro trauma patients. (3) I know the importance of hypothermia treatment. (3) Better understanding of protocols we use. (2) Focus on best-evidence practices. (2) Be more sensitive to underlying cause of psychogenic non-epileptic seizures (PNES) in our patients. (2) I will share my knowledge about the different generalized and psychogenic seizures. (2) More careful neuro assessment. (2) Teach my updated information at college. (2) Teach about hemorrhagic stoker along with ischemic. Investigate use of Cleviprex. Be careful about fluids and shivering. Enhanced knowledge for stroke patient’s chart review. Research cooling patient more. I plan to implement this information for our seizure patients. Initially no warnings for infarct/stroke. Immediate appropriate treatment, prevention/quick transfer service not available at Mariner’s Hospital. Added vast knowledge to improve patient outcomes. Evaluate hypothermia protocol. Management of neuro patients in ICU. Do not give benzo of the seizure is under 5 minutes. Get a better history from patients and coordinate care with others. Improve focus on post brain injury chills/fevers. Perform careful assessment and provide/suggest the best interventions. Evaluate the indications of Ativan for acute epileptic spells. Monitor lab compare with patient level of consciousness, follow-up neuro checks. More neuro interventional overview imaging. Dr. Aiken on rehabilitation of post-stroke recovery. Improve clinical practice. I am more aware of seizures versus PNES. Follow-up on anticoagulant reversal agents. Implement better beside protocols. Reversal of bleed protocols. Better assessment of early symptoms of subarachnoid hemorrhage (SAH). Refer seizure patients and recurrent episodes out earlier.

10. Suggested topics and/or speakers you would like for future symposiums related to Neuro Nursing.

Mary Kay Bader and Dr. Aiken. (4) Headaches and migraines. (3) Jamelah Morton, ARNP. (3)

Neurological Complications (DI, SIADH, CSWS)

Kendra Menzies Kent, MS, RN-BC, CCRN, CNRN, SCRN 5.0

• Explain the laboratory findings in DI 5.0

• Compare and contrast the differential diagnosis of DI 5.0

Advances in Stroke Rehabilitation

Bradley Aiken, M.D. 5.0

• Explore the role of neuroplasticity in post-stroke recovery. 5.0

• Describe new and emerging technologies in neurological rehabilitation. 5.0 • Explain determining factors for admitting stroke patients to an acute inpatient rehabilitation

facility. 5.0

Total Average 4.9

Was this symposium fair, balanced, and free of commercial bias?

Yes 121 No 0 No Answer 11

27

Brain tumor surgery care. (3) Neuromuscular diseases. (2) Neuro image interpretation. (2) Rapid treatment for rural hospital settings. (2) Decrease or limit the pharmacological portion. (2) Kendra Kent. (2) Intracranial neoplasms types and treatments. Dr. Duane Campbell, Medical Director ate Lakeland Regional Medical Center. Comprehensive stroke center. Statin Management. Intracranial hemorrhage (ICH) management. Have a patient/family stroke survivor panel. Patricia DiNasso on Oral Health. A station for practicing skills. Evidence-based practices. Tissue plasminogen activator (tpA) administration and post tpA monitoring. Updates and innovations significant to neuro nursing. Cases of real patients who would like to share their experiences. Medical and nursing interventions to prevent secondary injury/complications. Experts on spinal cord injuries current and developing treatments. Neurosurgery discussion of spinal surgeries and/or craniotomy. Multidisciplinary approach to care. Scan results. Treatment prognosis. Treatment and care of in-patients and any new medications available for their care. Topics in regards to acute management of the various types of spinal cord pathology. Stroke review course. Hypothermia management in neuro patients. Rehabilitation topics more related to the nursing approach. A neurosurgeon or a neurosurgeon nurse practitioner. Sessions for neuro certification. Care and use of external ventricular drain (EVD). Frontal lobe injuries. Post-complications in stroke patients. Main types of brain tumors, treatment and prognosis. When to transition to end-of-life care. Brain neoplasms. Information on new anticoagulant agents. Pain management in neuro patients. Care of the stroke patient for the bedside RN with assessment lectures. Dr. Smart and Dr. Fuentes.

11. Comments.

Great speakers. (22) Excellent symposium. (18) Very informative. (14) Great content. (9) Well coordinated. (5) Great accommodations. (5) Food was excellent. (4) Clear presentations. (4) Well executed. (3) I like the variety of topics. (2) Very nicely done. (2) Dr. Aiken is an awesome speaker. (2) Dr. Smart had great videos. (2) Amazing conference. Information given was appropriate for nurses. Excellent presentation of basic understanding of medical/financial and emotional impact. Dr. Smart was very informative and had practical information. Friendly and approachable speakers. Conference seating was comfortable. Professional support staff. Breakfast selection was awesome. Anticoagulant and reversal agents talk would make a great handout. Good communication with registered participants prior to conference.

28

This was exceptional overall. Explain in simpler terms for pharmacists. Some of the talks had overlap. Anticoagulant and reversal agents talk was too much and not practical for bedside nurse. Less medical jargon. It was difficult to hear Rosanne Starr in the back of the room. Make the presentations more interactive, a lot of PowerPoint’s becomes never-ending. Some speakers were not conscious of the time. Media needs improvement. The topic with pharmacology was difficult to maintain attention to the speaker. Poor delivery of

information. (2) Maybe extend symposium to 2 days. Too much information in such a short time. (2) I would like to see some form of protein source served during breakfast and dessert during lunch. (2) After lunch have a more upbeat speaker, her talk was very monotone. (3) Great conference but the day is too long. End at 4 p.m. (4)

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CONTINUING MEDICAL EDUCATION DEPARTMENT 2013 Miami Neuro Symposium Friday, December 6, 2013



5- Excellent 4- Very Good 3- Good 2-Fair 1-Poor Session I: Knock Out Stroke

Imaging Assessment in Ischemic and Hemorrhagic Stroke

Kevin Abrams, M.D. 4.9

Implement the best approach to imaging assessment of suspected ischemic and hemorrhagic stroke patients considering benefits and limitations of CT, CTA and perfusion CT.

4.8

Interventional Management of Acute Ischemic Stroke Italo Linfante, M.D. 4.7

Cite the benefits of recanalization as a strong predictor of good outcome secondary to large vessel occlusion. 4.7

Unruptured Intracranial Aneurysms: How should they be managed? Guilherme Dabus, M.D. 4.8

Analyze and apply optimal treatment strategies for unruptured intracranial aneurysms considering the risks vs. benefits of treatment vs. non-treatment. 4.8

From Basic Science to Clinical Practice: Are Flow Diverters Here to Stay? Ricardo Hanel, M.D. 4.8

Evaluate non-surgical treatment methods for unruptured intracranial aneurysms, and discuss safety and efficacy compared to surgical treatment. 4.7

Flow Diversion: Large Clinical Experience from Mayo Clinic Ricardo Hanel, M.D. 4.8 Recognize indications for use of flow diverters considering an efficacy and safety

comparison study of flow diversion and standard endovascular approaches for the treatment of intracranial aneurysms.

4.8

Dural Arteriovenous Fistula: Why and How Should it be Treated? Guilherme Dabus, M.D. 4.8

Describe the natural history of dural arteriovenous fistula, and determine optimal treatment options. 4.7

Brain AVM Treatment: What Have We Learned So Far? Italo Linfante, M.D. 4.8

Explore technological advances that have improved the endovascular approach to the treatment of cerebral aneurysms and arteriovenous malformations. 4.8

Carotid Stenting and CEA: Have Our Practices Changed After CREST? James Benenati, M.D. 4.8

Review the recent findings of the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST), and discuss how clinical practice has changed as a result of these findings.

4.8

Prevention of Nosocomial Infections in the Neurocritical Care Unit Javier Provencio, M.D. 4.9

Identify important nosocomial infections in patients with neurological diseases. 4.8

Patient Safety in the Neuro ICU Romergryko Geocadin, M.D. 4.6

30 Recognize the importance of utilizing DVT chemoprophylaxis in the neurocritical care

patient. 4.7

Identify risk factors for ventilator-associated pneumonia in the neurocritical care unit. 4.6 Implement preventive and corrective measures to improve communication and reduce

medical errors in the neurocritical care setting. 4.7

Neurological Emergencies: The First 24-hours

Karel Fuentes, M.D. 4.8

Implement essential components in the evaluation, diagnosis and treatment of neurological emergencies in order to optimize patient outcomes. 4.8

Continuous EEG monitoring in the Neuro ICU

Jan Claassen, M.D. 4.7

• Implement recommended strategies for identification and monitoring of non-conclusive seizures (NCSz) in the neuro intensive care patient. 4.7

• Examine the prevalence of NCSz, and discuss patient outcomes. 4.7

Management of Status Epilepticus Jan Claassen, M.D. 4.8

• Implement evidence-based first-line and second-line strategies for the acute treatment of status epilepticus (SE) in critically ill patients considering the latest evidence-based treatment paradigm.

4.8

• Determine the optimal management of refractory SE, and assess expected outcomes. 4.8

Medical Management of Vasospasm after Subarachnoid Hemorrhage Javier Provencio, M.D. 4.9

• Explain the pathophysiology of cerebral vasospasm after subarachnoid hemorrhage. 4.8

• Recognize the limitations of current monitoring strategies and treatments. 4.9

• Explore current and emerging therapeutic interventions. 4.9

Total Average 4.8

Was this symposium fair, balanced, and free of commercial bias? There is a bias toward procedural management.


31

CONTINUING MEDICAL EDUCATION DEPARTMENT 2013 Miami Neuro Symposium

Friday, December 6, 2013



5- Excellent 4- Very Good 3- Good 2-Fair 1-Poor Session I: Knock Out Stroke

Imaging Assessment in Ischemic and Hemorrhagic Stroke

Kevin Abrams, M.D. 4.9

Implement the best approach to imaging assessment of suspected ischemic and hemorrhagic stroke patients considering benefits and limitations of CT, CTA and perfusion CT.

4.9

Interventional Management of Acute Ischemic Stroke Italo Linfante, M.D. 4.8

Cite the benefits of recanalization as a strong predictor of good outcome secondary to large vessel occlusion. 4.8

Unruptured Intracranial Aneurysms: How should they be managed? Guilherme Dabus, M.D. 4.9

Analyze and apply optimal treatment strategies for unruptured intracranial aneurysms considering the risks vs. benefits of treatment vs. non-treatment. 4.9

From Basic Science to Clinical Practice: Are Flow Diverters Here to Stay? Ricardo Hanel, M.D. 4.9

Evaluate non-surgical treatment methods for unruptured intracranial aneurysms, and discuss safety and efficacy compared to surgical treatment. 4.9

Flow Diversion: Large Clinical Experience from Mayo Clinic Ricardo Hanel, M.D. 4.9 Recognize indications for use of flow diverters considering an efficacy and safety

comparison study of flow diversion and standard endovascular approaches for the treatment of intracranial aneurysms.

4.9

Dural Arteriovenous Fistula: Why and How Should it be Treated? Guilherme Dabus, M.D. 4.9

Describe the natural history of dural arteriovenous fistula, and determine optimal treatment options. 4.9

Brain AVM Treatment: What Have We Learned So Far? Italo Linfante, M.D. 4.8

Explore technological advances that have improved the endovascular approach to the treatment of cerebral aneurysms and arteriovenous malformations. 4.8

Carotid Stenting and CEA: Have Our Practices Changed After CREST? James Benenati, M.D. 4.9

Review the recent findings of the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST), and discuss how clinical practice has changed as a result of these findings.

4.9

Prevention of Nosocomial Infections in the Neurocritical Care Unit Javier Provencio, M.D. 4.9

Identify important nosocomial infections in patients with neurological diseases. 4.9

Patient Safety in the Neuro ICU Romergryko Geocadin, M.D. 4.8

32 Recognize the importance of utilizing DVT chemoprophylaxis in the neurocritical care

patient. 4.6

Identify risk factors for ventilator-associated pneumonia in the neurocritical care unit. 4.8 Implement preventive and corrective measures to improve communication and reduce

medical errors in the neurocritical care setting. 4.7

Neurological Emergencies: The First 24-hours

Karel Fuentes, M.D. 4.9

Implement essential components in the evaluation, diagnosis and treatment of neurological emergencies in order to optimize patient outcomes. 4.9

Continuous EEG monitoring in the Neuro ICU

Jan Claassen, M.D. 4.8

• Implement recommended strategies for identification and monitoring of non-conclusive seizures (NCSz) in the neuro intensive care patient. 4.8

• Examine the prevalence of NCSz, and discuss patient outcomes. 4.8

Management of Status Epilepticus Jan Claassen, M.D. 4.9

• Implement evidence-based first-line and second-line strategies for the acute treatment of status epilepticus (SE) in critically ill patients considering the latest evidence-based treatment paradigm.

4.9

• Determine the optimal management of refractory SE, and assess expected outcomes. 4.9

Medical Management of Vasospasm after Subarachnoid Hemorrhage Javier Provencio, M.D. 4.9

• Explain the pathophysiology of cerebral vasospasm after subarachnoid hemorrhage. 5.0

• Recognize the limitations of current monitoring strategies and treatments. 4.9

• Explore current and emerging therapeutic interventions. 5.0

Total Average 4.9



33


Saturday, December 7, 2013



5- Excellent 4- Very Good 3- Good 2-Fair 1-Poor Session III: Brain Tumor Management

Multi-modal Brain Tumor Imaging Kevin Abrams, M.D. 4.9

• Cite the benefits and limitations of MR perfusion, MR spectroscopy and PET/CT in the evaluation of the brain tumor patient. 4.9

Seizures and Brain Tumors Alberto Pinzon, M.D. 4.7

• Identify tumors associated with secondary seizures (high frequency). 4.7

• Determine which antiepileptic drugs (AEDs) to use based on the most recent data. 4.8

• Examine indications for the use of prophylactic AEDs in treating patients with brain tumors. 4.8

Advancing Neurosurgery Through Image-guided Robotics Garnette Sutherland, M.D. 4.9

• Describe the challenges associated with translating MRI technology into the operating room. 4.9

• Identify the processes related to technology creation from concept to commercial entity. 4.9

• Recognize the advantages and challenges related to the integration of robotic technology into neurosurgery. 5.0

Surgery of Tumors in Eloquent Cortex Vitaly Siomin, M.D. 4.9

• Examine newer imaging techniques that better define the eloquent brain. 4.9

Discuss patient selection criteria for awake craniotomy. 4.9

Describe the technical aspects of surgery of the eloquent cortex. 4.9

State-of-the-Art Surgical Management of Skull Base Tumors Armando Basso, M.D. 4.8

• Define optimal surgical treatment approaches in difficult-to-manage skull base tumors. 4.8

Total Average 4.8



34


Saturday, December 7, 2013

Non- Physicians Attended: 50 Non-Physicians Responded: 41


5- Excellent 4- Very Good 3- Good 2-Fair 1-Poor Session III: Brain Tumor Management

Multi-modal Brain Tumor Imaging Kevin Abrams, M.D. 5.0

• Cite the benefits and limitations of MR perfusion, MR spectroscopy and PET/CT in the evaluation of the brain tumor patient. 5.0

Seizures and Brain Tumors Alberto Pinzon, M.D. 4.7

• Identify tumors associated with secondary seizures (high frequency). 4.7

• Determine which antiepileptic drugs (AEDs) to use based on the most recent data. 4.7

• Examine indications for the use of prophylactic AEDs in treating patients with brain tumors. 4.7

Advancing Neurosurgery Through Image-guided Robotics Garnette Sutherland, M.D. 5.0

• Describe the challenges associated with translating MRI technology into the operating room. 5.0

• Identify the processes related to technology creation from concept to commercial entity. 5.0

• Recognize the advantages and challenges related to the integration of robotic technology into neurosurgery. 5.0

Surgery of Tumors in Eloquent Cortex Vitaly Siomin, M.D. 5.0

• Examine newer imaging techniques that better define the eloquent brain. 4.9

Discuss patient selection criteria for awake craniotomy. 5.0

Describe the technical aspects of surgery of the eloquent cortex. 5.0

State-of-the-Art Surgical Management of Skull Base Tumors Armando Basso, M.D. 4.9

• Define optimal surgical treatment approaches in difficult-to-manage skull base tumors. 4.9

Total Average 4.9



35

2013 Miami Neuro Symposium

December 6-7, 2013

Overall Evaluation Summary Physicians Attended: 80 Physicians Responded: 57



2. Meeting Facilities.

Symposium Location 4.8

Symposium Check-in 4.9

Meeting Room 4.8

Total Average 4.8

How did you hear about this meeting?

(47%) Internet (27)

Baptist Health (10) Google (4) Radlist Medlinx.com CE Broker

(23%) Mail (13) (14%) Email (8) (19%) Other (11)

Colleagues (6) (5%) No Answer (3)

Yes No No Answer



Would you recommend this symposium to a colleague?

(56) 98%

(1) 2%

(0) 0%

Proceduralist bias. Scoring Key: 5 – Strongly Agree 4 – Agree 3 - Neutral 2 - Disagree 1 – Strongly Disagree Treat/manage patients 4.5


Manage my medical practice 4.3

36

Total Average 4.4

How many patients will you see in your practice next week that will likely be impacted by what you learned at this symposium? (53 responses to this question)

9 Not Applicable(16%) 20 1-5(35%) 13 6-10 (23%) 11 Over 10 (19%) 4 No Answer(7%)

12. What do you intend to do differently in the treatment of your patients as a result of what you learned at

this symposium? What new strategies will you apply in your practice of patient care? Better initial evaluation and be aware of the endovascular options available. (4) I will consider neuro-interventionalists more frequently in addition to neurosurgeons. (2) Refer neurologic emergencies to appropriate place. (2) Referral for surgery all patients with cerebral aneurysms. (2) Seizure management in brain tumor patients. (2) More electroencephalography (EEG). Better use of imaging tools for stroke and aneurysms. Make patients more aware of their symptoms and to follow the laws of preventative medicine. Consider magnetic resonance venography (MRV) in more patients with tinnitus who may have

fistulas. Encourage patient with carotid artery stenosis to have stenting. Secondary management of acute strokes. Treatment of seizures. Lower threshold for referral of aneurysm patients to Dr. Linfante or Dr. Dabus. Better awareness of stroke options. Increasing use of coils and stents for aneurysms. Screen for vascular malformations differently. Work-up and management for patients that have incidental findings or atypical hemorrhage. Infection prevention. Will use new recommendations. Give more information to my patient regarding their referrals and places they can go if they are

concerned about recurring headaches/neurological concerns. Be more knowledgeable and empathetic when dealing with patients that have suffered from

strokes, aneurysms and seizures. Get a more comprehensive clinical interview when dealing with neuro patients. Treatment of wide neck aneurysms. Listen to patients with complaints of headaches and tinnitus. Better knowledge of acute care. Provide patients with better information regarding their neurological treatment.

13. If you do not plan to implement any new strategies learned at this symposium, please list any barriers or

obstacles that might keep you from doing so. Reimbursement. Technology.

14. Suggested topics and/or speakers you would like for future symposiums related to Neuro. Pediatric topics. (2) Multiple sclerosis. (2) A more balanced approach such as medical management data/strategies. Stroke management review of latest research and studies. Neurodegenerative diseases. Parkinson’s disease management and therapy. More interventional. Brain tumors, nuclear markers and controversies in surgical treatment. Evaluation of acute dementia, vertigo and neuro-ophthalmology. Discuss carotid dissection and vertebral dissection treatment, management and diagnosis. Use of functional MRI in arteriovenous malformation (AVM) treatment.

37

I would like to hear about the psychological treatments what can be used with neuro patient that have a co-morbid psychological disorder.

Pediatric aneurysms. Edward Tobinick, M.D. in Boca Raton. Spinal cord injuries. Pathologies. Treatment of acute stroke, non-interventional. One day on neuro-oncology.

15. Comments: Great symposium. (5) Excellent symposium. (4) Well organized. Positive meeting. Lots of knowledge acquired at this symposium. A very helpful learning experience. I was pleasantly surprises with how good the talks and speakers were. Thank you. Well balanced symposium. Great lectures. Great slides. Excellent topics. Some speakers were forced to rush though their slides. Fewer case studies. If the slides are not online, there should be a paper copy. (2)

38

2013 Miami Neuro Symposium

December 6-7, 2013

Overall Evaluation Summary Non-Physicians Attended: 165 Non-Physicians Responded: 50



2. Meeting Facilities.

Symposium Location 4.9

Symposium Check-in 4.9

Meeting Room 4.7

Total Average 4.8

How did you hear about this meeting?

(36%) Email (18) (28%) Internet (14)

Baptist Health (7) Google (4) Speaker

(18%) Mail (9) (20%) Other (10)

Colleagues (5) Previous attendee (3)

(12%) No Answer (6)

Yes No No Answer



Would you recommend this symposium to a colleague?

(49) 98%

(0) 0%

(1) 2%

Only because I have to vary my type of credits for PA license. Scoring Key: 5 – Strongly Agree 4 – Agree 3 - Neutral 2 - Disagree 1 – Strongly Disagree Treat/manage patients 4.7


Manage my medical practice 4.5

Total Average 4.6

39

How many patients will you see in your practice next week that will likely be impacted by what you learned at this symposium? (53 responses to this question)

12 Not Applicable(24%) 11 1-5(22%) 8 6-10 (16%) 14 Over 10 (28%) 5 No Answer(10%)

16. What do you intend to do differently in the treatment of your patients as a result of what you learned at

this symposium? What new strategies will you apply in your practice of patient care? Consider immune depression and brain injury. (2) Use the evidence-based information to improve patient care. (2) Corticosteroids for self administered medication (SAM). Refer patent to Baptist Neuro/surgery. Prevention of neurological emergencies. Improve assessment skills and can provide recommendation to doctors to consider treatment

suggestions. Giving information for clinicians I work with to change policies/standards of care, how to

manage neuro patients. Monitoring systems/awareness of seizures. New/old drug recommendations. Possible arteriovenous malformation (AVM) resection post embolization. Create or improve protocols. Review standing orders sets to ensure they are up-to-date with current standards. Use of hypothermia. Changes in stroke management. Closer look at infections, especially UTIs. The application and innovation of equipment is great, so knowing helps us communicate with

colleagues. I will be better equipped to counsel in outcomes based on evidence presented at this

conference. The infection control measures reinforce good practice. Stressing to patients the importance of staying on anti-platelet therapy post procedure. Recognize resolution of symptoms requires evaluation- it may be a malignant symptom. Monitor for non-conclusive seizures in neuro ICU patients. Use of continuous electroencephalography (EEG). Continue to improve patient safety. Consider the higher risk of infection in neuro patients. The ability to communicate vascular procedures to patients and how they are performed and

typical outcomes. Improved my knowledge of implementation of endovascular procedures. Verify that patients with conversion disorder are seen by a psychologist. We are looking at beginning pipeline and redirection treatment for aneurysms, though no new

information learned. No new strategies to implement.

17. If you do not plan to implement any new strategies learned at this symposium, please list any barriers or obstacles that might keep you from doing so.

More specialized areas. The physicians I work with may be resistant to any change. Most of my patients are pediatrics.

18. Suggested topics and/or speakers you would like for future symposiums related to Neuro. Intracranial hypertension (ICP) management. (2) Dr. Ricardo Hanel. (2) Management of congenital abnormalities. Follow-up therapy anticoagulant in primary care. Information on lumbar drains for RNs. Brain tumor management for RNS. Dr. Dabus, Dr. Geocadin and Dr. Provencio.

40

Basic review of neuro anatomy in correlation with imaging studies for nursing, both cranial and spine.

Spinal cord. The latest process in paralysis research. Barth Greene from Miami, if he is still in practice. Headaches and migraines. Management of subdural/epidurals and ventilator management. Pediatric cerebrovascular disease. Hypothermia in neuro patients. Dr. Asma Zakaria, Neuro-intensivist from Houtson, Tx. Javier Provencio, M.D. Communicable diseases causing neurological changes. Reversal of anticoagulation for acute hemorrhages. External ventricular drain (EVD) placement, management and complications. Economics of neurological care and current reimbursement. Comparison of dehydrated alcohol embolization only treatment versus dehydrated

alcohol/onyx or onyx only embolization of aneurysms. Radiation dose reduction in pediatric CT. Intracranial standing. Dr. Robert Ferguson and intervention neuroradiologists from Cleveland, OH.

19. Comments: Excellent symposium. (4) Great and dynamic speakers. (2) Great informational update. (2) Really enjoyed the neurocritical care portion of the day. Nice conference. Very well balanced. Food was great, but please add a little protein to breakfast. Like the packet with note writing space. This venue is great. Very good, presentations were concise and informative. I would love 1.5 or 2 days for RNs, they seem to be more interested. Need diet coke for people who don’t drink coffee. Slides should not have such small print that it can not be seen. Need more seats – lots of people were sitting on the sides. (2)

2014 january evaluation summaries - baptist health south ... · cme conference evaluation summaries...

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