Newsletter

Upcoming CME Events

IU Health CME Events

To attend virtual events or add to your calendar visit https://live.iuhcpe.org/

 

Thurs, Dec. 28^th, 8:00am-9:00am - IU Health CME/CEU Virtual Learning Event - Stroke Town Hall Updates in Stroke: Expanded Treatment Eligibility for Acute Ischemic Stroke

Jason Mackey, MD and Richard (Rick) Scheer, MD

 

Tues, Jan. 9^th, 12:00pm-1:00pm - IU Health CME Virtual Learning Event - Pediatric/Adult Formula Formulary Updates 2024

Charles P.B. Vanderpool, MD and Wendy K. Cruse, MMSc, RDN, CSPCC, CLS, LD

 

Wed, Jan. 10^th, 12:00pm-1:00pm – Understanding Asthma Care: A Review of Pharmacotherapy in Adults Based on GINA Guidelines 2023 (In-Person/Virtual)

Dan Reyes, Pharm. D

Location: Bloomington, Health Sciences Bldg 2631 E. Discovery Parkway, Room C1023A

 

Thurs, Jan. 11^th, 1:00pm-3:00pm - Riley Error Prevention Training

 

Fri, Jan. 12^th, 12:00pm-1:00pm – Bridging the Gap to Increase Patient Satisfaction in Moderate to Severe Atopic Dermatitis: Understanding the Role and Clinical Utility of Targeted Therapy

Johnathon Silverberg, MD

 

Wed, Jan. 17^th, 12:00pm-1:00pm - IU Health CME/CEU Virtual Learning Event - Stroke Town Hall Updates in Stroke: Expanded Treatment Eligibility for Acute Ischemic Stroke

Jason Mackey, MD and Richard (Rick) Scheer, MD

 

Wed, Jan. 17^th, 12:00-1:00pm – Breast Reconstruction

Elizabeth Lucich, MD

 

Fri, Jan. 19^th, 12:00-1:00pm – Fecal Transplant

Monika Fischer, MD, MSc, FACG, AGAF

 

Wed, Jan. 24^th, 12:00pm-1:00pm – Too Much of a Good Thnig: A Poison Center Perspective on Serotonin Toxicity

Amber Cummins, Pharm. D, CSPI

 

Fri, Jan. 27^th, 12:00pm-1:00pm – Intestine Transplant Program

Richard Mangus, MD, MS, FACS

 

Wed, Jan. 31^st, 12:00pm-1:00pm - Riley Perioperative Research Conference (In-Person/Virtual)

Location: ROC RLLC

 

To view previously recorded presentations from the On Demand Videos and earn CME's Click here

To view the list of your completed CME's Click here

Visit The Center for Physician Education - Main Page (iuhcpe.org)

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Announcements

Quality and Safety Update from Michele Saysana, MD, CMO

• CLABSIs have increased considerably throughout November, and we have already had 2 CLABSIs this month. We need to stay extremely diligent on the appropriate use of lines and need to remove lines as soon as it is safe to do so. Historically December is a challenging month for CLABSIs, so please do your part to prevent CLABSI. I am counting on your partnership and collaboration with our care team colleagues to prevent CLABSI.
• Congratulations on exceeding our mortality metrics in October. Your collaboration with our hospice partners ensured those who were referred to hospice were able to get enrolled in hospice in a timely manner. In addition, our ability to have good goals of care conversations with patients allows us to better understand their wishes, which ultimately helps us better provide care to them.
• We launched a new Sepsis Alert in Cerner on Nov. 14 for medical-surgical beds. When a patient screens positive for systemic inflammatory response syndrome, sepsis or septic shock, our nursing team receives an alert. Please remember that an alert does not mean we automatically order blood and urine cultures. Please take a moment to think about what the patient really needs to prevent unnecessary cultures and antibiotics.  

Updated visitor restrictions for No Information Status patients

The AAHC has updated the visitor policy for No Information Status patients to be consistent with IU Health visitor restriction guidelines. Effective Friday Dec. 1, no information patients may have up to 4 approved visitors. The AAHC has not made any additional adjustments to the policy at this time. If your units or departments have more restrictive visitation policies, please continue to follow your unit/department's policy on visitation.

Imaging Studies for Eskenazi patients will be in the cloud

Click here to view Job Aid for instructions on how to access Eskenazi studies in the IU Health Synapse Radiology.  

New Goals of Care global auto text are now available in Cerner

• EM providers are asked to use for every admitted patient > 75 years old.

          GAT: =goals_of_care_emergency_medicine.

• Hospitalist - Council will be asked to continue using the recently implemented auto text to support GOC discussions with patients >= 75 with severe sepsis/shock.

          GAT: =goals_of_care_hospitalist

• Neurosurgery - Council approved the clinical population of Traumatic Brain Injury patients to focus on Goals of Care.

          GAT: =goals_of_care

 

 

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Clinical Council Updates

OB/GYN Council

• Urine Drug Screen: The council reviewed the new urine drug testing policy going into effect at the Riley Maternity Tower.  The updates hope to be more equitable by removing indications for toxicology testing that were not highly associated with drug use or risk of withdrawal in baby.  The policy may be adopted at the site level if desired.

 

• Outpatient Cervical Ripening: The council reviewed a draft of an outpatient cervical ripening protocol and expressed interest in developing the protocol for practice.  The council discussed the benefits and concerns of the protocol and agreed to form a group to further develop the outpatient cervical ripening protocol. 

 

• Circumcision Consent: The Newborn Clinical Effectiveness Council developed and approved a standard circumcision consent for system use.  The consent was brought to the OB/Gyn council for endorsement and the council endorsed the use of the new consent.
  • DECISION: The council voted to endorse the use of the new standard Circumcision Consent for system use.

 

• HPV Genotype Testing: Melissa Randolph shared with the council the IU Health Pathology Laboratory will be launching a next generation HPV test to provide extended HPV genotyping results to providers.  The laboratory has created new testing algorithms that will guide providers who want to adopt Primary HPV screening, allowing choices and naming conventions of the HPV and Pap test to be more intuitive.  She shared the testing would use the same CPT codes and cost the same.  The council asked the testing meet the various registry requirements and suggested coordinating with population health to ensure we meet these requirements.  Click here to view the Clinical IS Update sheet, along with information on the testing. Please feel free to share this information with your colleagues.

 

• OB/GYN Pharmacy
  • Abrysvo RSV Vaccine: Heather Warhurst updated the council on the current state and availability of RSV vaccines.  The Abrysvo maternal vaccine can be administered between 32- and 36-weeks gestation between September and January. The vaccine should be received at least 14 days prior to the infants’ birth for development and transplacental transfer of maternal antibodies.  Abrysvo is available in the hospital pharmacies and is reimbursable. You can also order and administer in the clinic if that is more convenient.   Nirsevimab is not available this season and is not reimbursed inpatient but should be available for next year.  Both products are on formulary currently.  Heather recommended providers to offer Abrysvo to patients that desire neonatal coverage.

 

• Clinical IS & Technology
  • Opioid Tolerance Levels:  The council discussed the new Opioid Tolerance Levels order sets and voted to slowly adopt them throughout 2024.  The council agreed to add them to the order sets starting with highest usage first.
    • DECISION: The council voted to adopt the new Opioid Tolerance Levels order sets throughout 2024. Follow Up:  Bonnie Winn will update order sets based on usage and bring to council throughout 2024 as she works through them.

 

Peripheral Vascular Disease Council

2023 PVD Quality Council Goals: The Council reviewed progress towards the following goals: 

• Develop and implement a standard decision tree for patient selection of carotid stent techniques.
  • CMS recently finalized their statement. Due to the less restrictive requirements, it is recommended to develop a standard documentation approach with the creation of a dot phrase that can be copied and pasted into each patient’s EMR. SVS/Dartmouth is in the process of creating a tool to assist with documentation requirements.
  • Action Item: Quality team to share finalized tool and required documentation when available.

• Maintain system atherectomy utilization at or below the national average throughout 2023 Q 3-Q4.
  • Quarter 3: System utilization- 20% = National average: 20%
  • Quarter 4: System utilization-21% < National average -21.9%

• The council discussed certain clinical justifications for the use of atherectomy and the council’s role in keeping providers accountable to appropriate utilization.
  • Action Item:  Clinical Effectiveness, CVI, and council members to continue discussions offline to consider approach for 2024.

 

Imaging Clinical Council

Quality Care/Variation:

• Transgender Breast Screening Guidelines: Colleen Madden shared guidelines and answered questions regarding patient guidelines.

• Policy- Imaging of Pregnant Patients: Council approved the renewal of the system-wide policy & appendices with no changes.
  • Follow up: Policy workgroup asked to evaluate MRI education gap, workflow and screening forms, including recirculation of education to techs.

• 2024 Council Focus: Council discussed system initiatives and possible projects for 2024. A few suggested ideas included developing a quality scorecard, tracking adverse harm events, and compliance with standard imaging protocols.
  • Follow up: Council chairs will review opportunities provided and develop 2024 goals based on priority and impact.

• Clinical IS/ Technology: 
  • Order Set Requests: 
    • Council approved the proposal to add pediatrics to the inpatient/outpatient Hydration Orders for Patients at Risk of Contrast-Associated Acute Kidney Injury.
    • Council approved revisions to the adult inpatient/outpatient Hydration Orders for Contrast Media Induced Nephropathy Prevention.
  • System Imaging Collaborative: November meeting minutes are attached. The group is working on standardizing documents and the cleanup of unnecessary documents scanned into Synapse. 
    • Follow up: If providers have feedback on necessary documents, share with local operations director.

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New CDC CE Activities Will Be Listed in CDC TRAIN starting January 1, 2024

To improve your learning experience, CDC’s continuing education (CE) process is moving from Training and Continuing Education Online (TCEO) to CDC TRAIN. Beginning on January 1, 2024, new activities that offer CE from CDC will be listed in CDC TRAIN.

If you do not already have a CDC TRAIN account, please create one.

TCEO has been the primary system that provides access to CDC educational activities for CE. The move to one system will improve efficiency and make it easier for learners to access non-credit and for-credit activities, and earn CE in one place – CDC TRAIN!

Additional information is available at CDC Continuing Education Update. Instructions will also be available on both platforms, and a learner support team will be available to answer questions.

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