Weekly Announcements

Chief Selection 2023-24 - Nominate residents for categorical Internal Medicine Chief here. Deadline 8/22/2021.

Hem/Onc wards re-design - INPUT NEEDED!!! Please fill out the survey here to help us understand how we can best utilize residents who were previously assigned to the Hem/Onc ward service (closing 10/3). Please complete by 8/23 so we can continue to discuss and build on these ideas.

Interested in Improving Ridgeway Transfer Process - One of our hospitalists Lindsay Huber is working on a QI project to work on the transfer process to Ridgeway. She is looking for one to two residents to be a part of her team. If you are interested please email her at ander2ly@ucmail.uc.edu.

COVID Vaccine Requirement - UC Health requires all residents to be fully vaccinated against COVID. Additional information is available here or on The link. DEADLINE SEPTEMBER 10th.

1) Scan and save your vaccination proof on your computer.

2) Click this link (desktop) or this link (mobile phone with TheLink installed)

3) Log in with your UC Health log-in (or EPIC log-in).

4) Click on “Documents” on the left side of the ReadySet page.

5) Click “Upload Document”. “Select file.” Select Immunications from drop down. Enter an “Upload Comment”: “COVID Vaccine”.

9) Click “Upload”.

COVID Vaccines for Inpatients - We are starting a QI project to improve our inpatient covid-19 vaccination rates. Currently, according to most recent data, only 40.5% of our inpatients are vaccinated, and of those eligible, a dismal 4.6% of those patients are being administered the vaccine. Our current goal is to improve our inpatient vaccination rates from 4.5% to 25%. Have questions or want to get more involved? Email either Dr. Brave Nguyen or Dr. Danielle Weber for more!

To overcome these barriers, we will try to address each issue separately.

1. Patient hesitancy/refusal is generally steeped in fear/misinformation. We would like to mitigate that by providing educational material and creating a standardized script that frames the discussion in a manner that is informative, but not coercive. For example, asking a patient "Would you like the vaccine?" is likely less effective than saying, "We would like to offer you the vaccine, and here's why". We are creating the educational material on the vaccine that will be given to the patient, with the goal of it being informative while still easy to read and follow. Standardized script in framing that discussion is also under review.

2. Inadequate screening is a big barrier. Currently there is no consistency in this process. Pharmacy is unable to screen every single patient. We are asking that as residents/attendings are reviewing their patient list to identify potential discharges, to also assess their covid-19 vaccination status, and offer the vaccine to the patient prior to discharge. If the patient agrees to the vaccine, it can be ordered in EPIC if you type in "covid-19 vaccine", which will then prompt pharmacy to administer it. FYI the covid vaccination status should be visible on the patient's story board, but I recommend adding covid vaccine history into their “My List”? It is called “Covid Imm Status” as this allows you to review this in a list form.

3. There are only a handful of pharmacists each day that can administer the J&J vaccine. Nurses are currently not allowed to administer. This is problematic especially on the weekends when the pharmacists are short staffed. As such, if a weekend discharge is anticipated, we are asking that the attendings/residents screen that patient on Friday so that they can receive the vaccine before the weekend.

Questions that may be asked by patients:

1. Is the J&J vaccine effective against the delta variant? Based on the Sisonke covid-19 trial, J&J was found to show 71% efficacy against delta with 96.2% protection rate against mortality.

2. Risk of thrombosis with the J&J vaccine? Exceedingly low. 28 cases out of 9 million doses administered. Risk of thrombosis from a COVID-19 infection is significantly greater.

3. Side effects? Fatigue, fever/chills, muscle aches, pain or swelling at site of injection. Vast majority of side effects are self-limiting and subside within a day or two.

Wards Data

Data: Oct 2019-June 2020 with some gaps in collection particularly around COVID

HO AM census:

• Average 10.2

• Mode 10

• Median 10

• Min 3

Total subspecialty NF admits:

• Average 4.2

• Mode 3

• Median 4

• Min 0

• Max 11

Data: July 2020-June 2021 for new patients in the morning for color teams. New patient here is defined as a NF, ICU bumpout, handoff.

• Average 1.5-2 depending on team

• Mode 0-1 depending on team

• Median 1-2 depending on team

• Min 0 for all teams

• Max 6-7 depending on team

Long call: the average for long call admits is 2. 

Upcoming Week
Education/Event Calendar

Monday:

UC: Exploring our Patient’s Context by Dr. Anna Goroncy.

VA: ECG review in 507

Tuesday:

UC/VA: Palliative care discussion with Dr. Ana Flores.

Wednesday:

MGR: Our own Dr. Danielle Weber will be presenting on “Engaging Interdisciplinary Teams for Quality Improvement”

Thursday:

AHD: Acute Respiratory Failure

Weesner: AKI

Friday:

UC: Med Ed Pathway Discussion with Dr. Ben Kinnear and Dr. Rita Schlanger

VA: Feedback Friday

Resident Photos

Shout Outs!

to the VA wards interns for doing a great job tucking in their patients, even when the senior resident is off!

to Lajja Patel for quickly mastering CPRS, coming up with great plans for admits, having a great attitude on nights and overall killing it on VA nights!

to the VA nights seniors for all the hard work this week!

To Abby Samuels for being an amazing senior, great mentor, with great patience.

To Jackson Hearn, JT Barnes and the Orange team for an amazingly educational noon report this week!

To Rich Hajjar for a fantastic review of GDMT in Heart Failure today. #ARNI4HFpEF

Things to Do in Cincinnati

Western & Southern Open: The Western & Southern Open is back at the Lindner Family Tennis Center. The oldest tennis tournament to be played in its original city, the first ball to hit the court in the W&S Open (originally the Cincinnati Masters) was in 1899, when the matches were held at the current-day site of Xavier University. Today, the Mason-based open features more than a week's worth of men’s and women’s tennis matches, with players competing for $5 million and $2.8 million in prize money, respectively. And if you don't care about tennis, don't worry: There's plenty of food, drink and entertainment to keep you busy. Through Aug. 22. Single-session tickets start at $24 for the qualifying rounds with prices and packages going up from there. Lindner Family Tennis Center, 5460 Courseview Drive, Mason, wsopen.com.

Summermusik: Women in Musik: Nicknamed “Summermusik Under the Stars,” Cincinnati Chamber Orchestra’s summer festival returns from pandemic shutdown with performances running through Aug. 20 at outdoor venues throughout the city. Summermusik’s final mainstage concert on Aug. 20 continues to highlight women with three CCO premieres of works by Reena Esmail, Gabriella Smith and Jessie Montgomery, whose composition “Banner” opened the Cincinnati Symphony Orchestra’s 2020-21 virtual season. 8 p.m. Aug. 20. $37-$47. Seasongood Pavilion, 1600 Art Museum Drive, Eden Park, ccocincinnati.org.

Official Resident’s Guide to Cincy Food and Drink is here!