Slide 2 Hospitalists, scholarly activity, quality improvement,
and research Hospitalists Best Practices Conference February 19,
2010 J Rush Pierce Jr, MD, MPH Slide 3 Agenda Are hospitalists
interested in research? What kind of research do (can) hospitalists
do? What is the IRB and how should hospitalists relate to it?
Questions for discussion Slide 4 Predictors of selecting academic
medicine as a career Completion of graduate degree or fellowship
training Participation in research and publication while in medical
school or fellowship Desire to teach or conduct research Influence
of a mentor J Gen Intern Med 2006; 21:12221229. Slide 5 Themes
related to remaining an academic physician Early exposure to
research Mentoring Personal and social factors Career support as
junior faculty Medical Education 2009: 43: 335341 Slide 6 Types of
research by hospitalists the hospitalist model itself clinical
approach to hospitalized patients implementation of best practices
care transitions improving patient safety J Gen Intern Med 2008;
23(8):126972 Slide 7 Strategies for success SHARP model (Univ
Michigan) Protected time Mentorship Epidemiologic and statistical
support Collaborative opportunities with subspecialists Recruitment
of fellowship trained hospitalists Journal of Hospital Medicine
2008;3:308313 Slide 8 Collaborative in-patient medical service
(CIMS) - Hopkins Journal of Hospital Medicine 2008;3:314318. Slide
9 UNM Hospitalist research interest Slide 10 UNM hospitalist
research experience Slide 11 UNM Hospitalist research confidence
Slide 12 Perceived UNM institutional support Slide 13 What would
help at UNM? Slide 14 Case Reports Resources (ACP Website) What
types of patients? Rare conditions, unusual presentation of common
illness, esp instructive, unusual complication, unusual aspect of
management Relative role of faculty Where to present and where to
publish Slide 15 Case Reports - tips Keep list of potential pts
Identify early who will take lead Do brief literature review first
Draft an abstract early Get the patient's permission Get the
patient's phone number Bug the resident/student often! Be aware of
meeting deadlines for abstracts Slide 16 Case reports - meetings
MEETING NM Chapter of ACP SHM SGIM WAFMR/WSCI ABSTRACT DEADLINE
mid-August early January early February late summer Slide 17 Case
reports where to publish General journals (South Med J, Amer J Med
Science) Specialty journals (J Amer Geriatrics Soc, etc) Case
report specific journals J Medical Case Reports
http://jmedicalcasereports.com/ http://jmedicalcasereports.com/ J
Case Reports in Medicine http://www.hindawi.com/journals/crm/
http://www.hindawi.com/journals/crm/ Slide 18 Case reports topics
for discussion Guidelines for order of authorship Role of IRB
Meetings and travel Section expectation Slide 19 Curriculum
Development Type of projects: New curriculum New technique New
program Resources Where to present/publish Usually coupled with
survey of satisfaction, perceived confidence, and/or objective
measures of knowledge transfer Slide 20 Curriculum Development -
tips Keep a list of ideas Keep records! Decide on objective
measurements before hand; think about a survey Get library to help
with lit review Often involve several faculty divide up roles Slide
21 Surveys - tips Demographics Two basic types of questions: is
there a difference, is there an association? Look for surveys
previously done Get help early Design strategies to improve
participation Plan on submitting to IRB Slide 22 IRB What is IRB
and what is its role? When do I need to submit to IRB? What is
HIPPA waiver and when do I need it? Do I need to be trained?
http://hsc.unm.edu/som/research/HRRC/HRRCHomePage.shtml Slide 23
IRB submission Exempt vs. expedited vs. full review Getting ready:
Research protocol on the wiki Getting the correct forms Submitting
the forms Your role as PI Slide 24 Quality Improvement The nature
of QI Measure quality, design an intervention, remeasure quality,
refine the intervention QI in medicine What is scientific research
and when is QI research? Slide 25 QI projects in the hospital
getting started Read lit beforehand (how to measure, what
interventions have been done, problems) Decide how you will get
baseline measurements Write down planned metrics and interventions
Discuss with management Get necessary partners on board Role of IRB
Slide 26 QI projects: resources SHM
http://www.hospitalmedicine.org/http://www.hospitalmedicine.org/
AHRQ http://www.ahrq.gov/http://www.ahrq.gov/ ACEBP
http://www.acestar.uthscsa.edu/Research.htm
http://www.acestar.uthscsa.edu/Research.htm UNMHSC CTSC for
statistical support http://hsc.unm.edu/research/ctsc/PSU.shtml
Slide 27 QI Projects - tips Assume that you will publish Keep good
records! Read the SQUIRE Guidelines Work in a group and assign
roles Talk to the IRB; anticipate time for approval Slide 28 IRB
Practical Tips Look at website to determine if your proposal is
exempt. Key issues: No interventions, just chart review
De-identified data Talk (in person) with a HRRC support person
about your proposal Listen to the HRRC support person Write
protocol Fill out forms Dont argue, you will lose Make all
suggested changes Slide 29 Discussion questions QI and Role of IRB;
PI training Case reports: (guidelines for order of authorship, role
of IRB, meetings and travel, Section expectation) Statistical and
epidemiologic help Dept support for research activities (travel to
meetings, infrastructure, seed grants) How to provide mentoring
