Department Blog - October 2019

Sarah B. Dubbs, MD, has authored an activity eligible for CME credit through Medscape: "Minimizing the Impact of imAEs and Maximizing Efficacy in the Emergency Department." The goal of this activity is to educate clinicians treating patients with cancer, including those in the emergency department, on how to recognize and manage immune-mediated adverse events (imAEs) related to the use of immune checkpoint inhibitors. Access is free with registration.

Daniel L. Lemkin, MD, Benoit Stryckman, MA, and Zachary D.W. Dezman, MD, among other authors, have an in-press article titled “Integrating a safety smart list into the electronic health record decreases intensive care unit length of stay and cost” prepublished online in the Journal of Critical Care.

Dr. Dezman writes, "This paper shows the impact of a preventative-care checklist for critically ill patients. It reminds physicians to administer prophylactic medications and remove lines and catheters as soon as it is safe for patients. The checklist will dynamically update to reflect the patient's status (e.g., it won't ask the physician to remove a central line that was already removed). It was designed to work in any type of critical care unit (adults or children, surgical and medical patients) and is integrated into our EHR.

The more that the clinicians used the checklist, the more likely the patient was to be downgraded sooner from the ICU compared to regular care. There was a decrease in days where the patient was on a breathing machine and a trend towards fewer cases of ventilator-associated pneumonia. There was a corresponding decrease in costs. There was no change in mortality associated with checklist use.

We are currently working towards getting more clinician engagement and measuring the impact of the checklist as it is used more and more."