a n n u a l r e p o r t ay 2 0 1 4 ( 2 0 1 3 - 2 0 1 4 ) annual re… · g r a d u a t e m e d i c...

D i v i s i o n o f E D u c a t i o n

A n n u A l R e p o R t A Y 2 0 1 4 ( 2 0 1 3 - 2 0 1 4 )

G r a D u a t E M E D i c a l E D u c a t i o n

Introduction..................................................................................................................................................p.3Academic Year 2014: At a Glance............................................................................................................p.3

Resident Scholarly Work.........................................................................................................................p.10

Summary and Schedule of Program Reviews......................................................................................p.7

GME Finance Update.......................................................................................................................................p.11Growth.........................................................................................................................................................p.12Updates in 2014........................................................................................................................................p.12Priorities for 2015..............................................................................................................................................p.13

Appendix......................................................................................................................................................p.14Summary.....................................................................................................................................................p.13

Match Summary...........................................................................................................................................p.8Resident Involvement in Patient Safety and Quality........................................................................p.9

LVHN Central Venous Catheter Course Update......................................................................................p.10

Challenges and Improvements in GME......................................................................................................p.4

Submitted from the Division of Education, Office of Graduate Medical Education by:Elaine Donoghue, MDACGME Designated Institutional Official

David Stein, DODirector of Osteopathic Medical Education

Margaret Hadinger, EdD, MSDirector, Medical Education

Table of Contents

2 | G r a d u a t e M e d i c a l E d u c a t i o n

This report covers academic year 2014 ending in June 2014. The Graduate Medical Education community at Lehigh Valley Health Network continues to develop and implement policies and learning strategies that achieve accreditation requirements and that prepare our resident physicians to serve the Lehigh Valley community and beyond. The Graduate Medical Education Committee (GMEC) and the Division of Education provides the institutional oversight and leadership required to achieve these ends.

GMEC Mission – to offer graduate medical education programs in which physicians in training develop personal, clinical, and professional competence under the guidance and supervision of the faculty and staff. GMEC provides oversight of GME and professional peer support.

GMEC Vision – to develop the strategies and mechanisms needed to ensure that LVHN’s graduate medical education programs have adequate educational, financial, and human resources to demonstrate measurable improvements in learning and patient outcomes.

GMEC Strategy – GMEC’s strategy is based on organiza-tional objectives, American Osteopathic Association (AOA) standards, and the Accreditation Council for Graduate Medical Education (ACGME)’s definition of “institutional competency,” which includes an organization’s ability to:

- Gather and analyze data from the educational and clinical environments. - Ensure resident education in patient safety and quality of care.

- Lead program and academic innovations.

- Predict and trend performance.

- Develop, align and implement policies and procedures that impact graduate medical education programs.

- Create conditions that promote collaboration and knowledge sharing and transfer.

We are pleased to provide the following 2014 Graduate Medical Education report highlighting evidence of ongoing strengths, opportunities and the larger trends affecting Lehigh Valley Health Network’s Graduate Medical Educa-tion programs.

Academic Year 2014: At a Glance

Introduction

243 10 85 17 4 214

Medical residents and

fellows

Non-medical residents and

fellows

Visiting residents

Total accredited residency programs

Osteopathic (AOA)

accredited programs

Dually (ACGME/AOA)

accredited programs

Allopathic (ACGME)

accredited programs

A n n u a l R e p o r t A Y 2 0 1 4 | 3

Challenges and Improvements in GMEClinical Learning Environment Review:

The Next Accreditation System (NAS) of the ACGME calls for a Clinical Learning Environment Review (CLER) that will occur up to every 18 months once fully established. On February 18, 2014, LVHN hosted our first CLER visit which included network executive leadership, program directors, resident, fellows, and other faculty who met with the CLER site visiting team. During the meeting, answers were sampled using an anonymous audience response system to three key questions related to1) institutional infrastructure, 2) GME leadership and faculty engagement, 3) resident engagement in patient safety and quality improvement. This meeting was fact finding for the ACGME and will be used to develop benchmarks and strategies to help institutions improve their efforts in these areas. Response to the visit report was optional, but LVHN submitted a plan which is being implemented. The six major areas are patient safety, health care quality, care transitions, supervision, duty hours and fatigue management, and profes-sionalism. Future site visits may occur every eighteen months and the lead time for scheduling future visits is relatively short thus creating a need for “ever ready” posture. An outline of the plan is discussed at the end of this report.

New and Developing Programs:

A Sports Medicine fellowship offered by the Department of Family Medicine was approved in May 2014 and has begun recruiting. The newer programs including the Nephrology, Hematology/Oncology and Hospice/Palliative Care fellowships and the Pediatric residency program continued to mature. Plastic Surgery continues to transition from a fellowship to an integrated residency program.

Recruiting Efforts:

In FY14, LVHN had 2,718 applicants for all programs combined and hosted a total of 954 interviews. LVHN was well-repre-sented at The Commonwealth Medical College’s Residency Fair in April, with program staff and residents from Surgery, Internal Medicine and Pediatrics participating. In addition, the Emergency Medicine Department visited The Commonwealth Medical College twice for Procedural Days. Osteopathic recruit-ment efforts included representation from the Departments of Medicine and Family Medicine at Philadelphia College of Osteopathic Medicine and Edward Via Virginia College of Osteopathic Medicine Hospital Day events in March and April, respectively. The Family Medicine department attended recruiting fairs at the American Association of Family Practice (AAFP) National Conference of Family Medicine Residents and Students in Kansas City and the Family Medicine Educational Consortium (FMEC) in Washington, DC.

Resident Evaluation:

GMEC has developed and implemented a policy to ensure timely feedback of residents. The goal is that core faculty members complete 75% of their evaluations assigned to them within 30 days of a resident’s completion of a rotation. Evaluation compli-ance will continue to be a focus area for GMEC. In addition, the conversion of evaluation forms into milestones linked forms is an ongoing process. In AY14, departments met the following compliance percentages:

Cardiology Fellowship

Colon/Rectal Surgery Dermatology

Emergency Medicine

Family Medicine

General Surgery

Hematology/Oncology*

Hospice/Palliative Medicine

Internal Medicine

Transitional Year

Nephrology*

Obstetrics/Gynecology

Pediatrics

Plastic Surgery

Surgical Critical Care

86.25%

83.33%

93.00%

86.30%

99.62%

87.89%

55.00%

95.60%

97.00%

97.00%

55.00%

80.49%

89.09%

87.89%

66.67%

*Smaller fellowships have extensive interface with their faculty and provide ongoing verbal feedback with periodic formal written evaluations.


DepartmentCardiology FellowshipDermatologyEmergency MedicineFamily MedicineGeneral SurgeryHospice/Palliative MedicineInternal MedicineTransitional YearNephrologyObstetrics/GynecologyPediatricsPlastic Surgery

Resident Orientation 2014:

Resident orientation meets many needs with regard to common program requirements. This year’s common orientation included the standard HR orientation for all employees, plus additional talks on AIDET/HEAT/service recovery; cultural competency/interpreter services; stress reactivity; TeamSTEPPS; handovers; professionalism, licensure and malpractice; corporate compliance; where to find help; disciplinary policy; Lehigh Valley Resident Association; duty hours; competencies; social media, network employee benefits; resident research opportunities; and overview of the SELECT program.

80 HR000000200000

Call000000000000

Days Off001070300700

Night Float000000000000

24+0021

100000330

Short Break–10004

101200000

200

Short Break–8 021140000180

IHI Open School Modules:

LVHN purchased a subscription to the IHI Open School online modules that include patient safety and quality. Those modules were made available to the residents in spring and some residencies are specifically assigning courses for FY14. These modules are hosted in an outside learning management system.

650 63 91% 23% 70%

Total lessons completed by

residents

Residents who completed at least one

lesson

Average score of the lessons

Courses taken related

to quality improvement

Courses taken related to

patient safety

Resident Duty Hours Tracking:

GMEC elected in AY12 to track the directive that residents “should have 10 hours off between clinical duties” with awareness that the regulations state “must have 8 hours off.” In FY14, under the direction of DIO Dr. William Bond, the GME office undertook a re-evaluation of how duty hours were being reported via the New Innovations Residency Management Suite. With input from each of the residency and fellowship programs, the mechanisms for entering and reporting duty hours were standardized. Beginning in FY15, this standard reporting mechanism will now be used, with the expectation that this new system will standardize understanding of how duty hour violations are reported and will enable the DIO to run reports of duty hour violations across LVHN as an institution.

A n n u a l R e p o r t A Y 2 0 1 4 | 5

Data Repository Project:

The LVHN Scholarly Works repository was launched in fall of 2012 by Library Services. The institutional repository is a great way for LVHN residents and faculty to have their work visible to the public and other academic colleagues. These can include peer reviewed works and also includes lectures given at meetings, abstracts, posters, and articles. The process for tagging works as “resident” works involves manual tagging and we plan to encourage more submission to the repository, as well as thorough resident labeling.

We have 291 items labeled as resident or fellow works with resident or fellow involvement from 2005- present, with 62 items labeled as works with resident or fellow involvement in CY14 (as of access 8-22-14). A report with links to the actual works can be found at: http://scholarlyworks.lvhn.org/fellows-residents/

Support for Research in GME:

The Lehigh Valley Health Network Office of Research and Innovation (NORI) provides resources, infrastructure, tools, and managerial support to Principal Investigators and their research teams as they pursue, execute, and deliver high quality research. NORI facilitates the standardization, coordination, and delivery of administrative activities that must occur prior to the execution of a research project, the detailed financial and regulatory management activities that occur throughout the conduct of a research project, and the oversight of the personnel working with the PI in order to ensure the proper execution of research.

NORI also offers a lecture series to residents and fellows regarding research study design and analysis. These lectures are conducted annually by the Research Design Team, which currently consists of two biostatisticians. The biostatisticians are available, upon request, to meet with investigators to discuss their research ideas, help design their studies, and analyze their data. During FY14, the Research Design Team received 27 new requests for assistance with resident/fellow research studies

Faculty Development:

In FY14, DOE created a brief e-Learning module on Teaching in an Outpatient Setting. DOE also developed additional modules on Giving Effective Feedback and Being an Effective Preceptor. The following course offerings were transitioned to the residency programs in FY14:

1. Resident as Teacher & Leader SeriesIn FY14, the Resident as Teacher & Leader Series was shifted from a DOE-led series to sessions offered by individual residency programs for their respective residents.

2. Baseline AssessmentsFor the summer of 2014, baseline assessments were shifted from a DOE-led assessment series to sessions offered by individual residency programs for their respective residents.


Summary and Schedule of Program ReviewsGoing forward as we move into the Next Accreditation System (NAS) of the ACGME, programs will be evaluated every 10 years with a site visit. Early site visits can occur sooner based on annual data being submitted by the programs. The institution will have Clinical Learning Environment Review (CLER) data submission and site visits every 18 months.

Accredited Programs

Colon/Rectal Surgery

Emergency Medicine

Family Medicine

Internal Medicine

Cardiovascular Disease

Nephrology

Hematology/Oncology

OBGYN

Pediatrics

Plastic Surgery

Plastic Surgery –IntegratedSurgery

Surgery


Hospice/Palliative Medicine

Transitional Year

Osteopathic Internship/ Medicine

Emergency Medical Services

Dermatology

Sports Medicine

Sponsoring Institution

Status

Continued Accreditation


Continued Accreditation with WarningContinued Accreditation


Initial Accreditation










Continuing Approval

Continuing Approval

Continuing Approval



Effective Date

09/21/2012

02/10/2012

10/10/2012

01/24/2014

01/24/2014

07/01/2012

07/01/2012

10/13/2011

07/15/2014

10/03/2008

05/01/2014

11/01/2012

11/01/2012

05/15/2014

05/21/2008

09/2011

2004

08/2010

07/01/2012

N/A

ACGME/AOA Site Visit Date (self-study)

03/01/2020 SS

02/01/2022 (ACGME)08/20/16 (AOA

10/01/2018 SS

10/01/2015 SS

10/01/2015 SS

07/01/2015 Next SV

07/01/2015 Next SV

12/01/2021 SS

07/01/2024 SS

10/01/2019 SS

10/01/2019 SS

11/01/2021 SS

11/01/2021 SS

10/01/2015 SS

05/01/2018 SS

N/A

N/A

N/A

05/01/2016 Next SV

10/01/2023

Osteopathic Site Visit Date

N/A

08/2016

07/2015

05/2015

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

Cycle Length

4

10

NAS

NAS

NAS

3

3

10

3

10

N/A

10

10

3

10

N/A

N/A

N/A

3

10

Internal Review Timeline

09/11/2014

02/01/2020

10/01/2016

N/A

N/A

N/A

N/A

10/01/2019

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

Osteopathic Internal Review

N/A

02/2014

tbd

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

# Citations

0

01AOA

6

0

1

0

0

0

1

0

N/A

1

0

0

1

0

0

0

0

2

A n n u a l R e p o r t A Y 2 0 1 4 | 7

Match Summary 2014For the Match that occurred in AY14 (2013-2014), culminating in residents commencing at LVHN the summer of 2014:

Combined Allopathic, Osteopathic, & Sub-Specialties Matches

Allopathic Match (NRMP)

Match from LCME Schools (All Matches) Match from Osteopathic Medical Schools (DO Match)

LVHN Clerkship Rotations:

2,718 954 86 93 30% 23%47%

Applicants from U.S. medical

schools

Applicant interviews conducted

Medical match positions avail-able (excluding

dental residency positions)

Match positions available

(including dental residency

positions)

Matches from allopathic accredited

medical schools

Matches from international

medical schools

Matches from osteopathic accredited

medical schools

U.S. Osteopathic schools, 47%

U.S. Allopathic schools, 30%International medical schools, 23%

U.S. Osteopathic schools, 26%

U.S. Allopathic schools, 41%International medical schools, 33%

Non-PA schools, 66%Pennsylvania schools, 34%

Non-PA schools, 71%Pennsylvania schools, 29%

35% of matching residents (n=34) did at least one clerkship or elective experience at LVHN. These residents completed a total of 74 rotations made up of third year clerkships and fourth year electives at LVHN.

Drexel University School of Medicine, 2Jefferson Medical College, 1Penn State College of Medicine, 1Temple University, 4Commonwealth Medical College, 2


Resident Involvement in Quality and Patient SafetyGoing forward as we move into the Next Accreditation System (NAS) of the ACGME, programs will be evaluated every 10 years with a site visit. Early site visits can occur sooner based on annual data being submitted by the programs. The institution will have Clinical Learning Environment Review (CLER) data submission and site visits every 18 months.

Program

Cardiology

Dental

Dermatology

Emergency Medicine

Family Medicine

Hematology/ Oncology

HPM

Internal Medicine

Nephrology

Ob/Gyn

Surgery, Colon Rectal

Surgery, General

Surgery, Plastic


Pediatrics

Transitional Care

Total

# of Residents Performing a Case Review

15

7

6

20

18

1

0

17

4

21

2

20

4

1

0

0

136

# of Residents Assigned a

Case Review

15

7

6

20

18

1

0

17

4

21

2

20

4

1

0

0

136

% of Residents Completing a Case Review

100%

100%

100%

100%

100%

100%

0%

100%

100%

100%

100%

100%

100%

100%

0%

0%

100%

Nature of Case Review

M&M Chart Review

Chart Review

Grand Rounds

M&M

Chronic PT Chart ReviewM&M

Chart Review

Chronic PT Chart

M&M

M&M

M&M

M&M and QA

M&M

M&M

N/A

N/A

-

# of Senior Residents Participating in a PI

Project

5

0

2

13

6

2

1

17

1

5

0

0

0

0

1

14

67

# of Senior Residents

5

7

2

13

6

2

1

17

2

5

2

5

1

1

6

14

89

% of Residents Completing a PI

project

100%

N/A

100%

100%

100%

100%

100%

100%

50%

100%

0%

0%

0%

0%

0%

100%

95%

Documentation Method (A3, PPT, Paper)

Paper

N/A

N/A

Paper

PI Project Upload to NI

PPT

Paper

PPT

PPT

PPT

N/A

N/A

N/A

N/A

N/A

PPT

-

A n n u a l R e p o r t A Y 2 0 1 4 | 9

Resident Scholarly Work

LVHN Central Venous Catheter Course UpdateLVHN has experienced an uptick in Central Line Associated Bloodstream infections. This uptick is believed to be due to special cause variation that is likely related to the maintenance process and long catheter dwell times. A multidisciplinary and interprofessional group is actively working on process improvement in this area. The CVC course is one piece of maintaining both mechanical and infectious safety for this procedure. The course has reached a point of significant refinement and was well received as noted below.

Residents at LVHN are encouraged to participate in research across multiple domains. Below is a summary of resident research activities per program that resulted in peer-reviewed abstracts, posters, presentations and manuscripts:

The following are comments written by residents regarding what they found most useful during the course:

- The hands-on nature of it is far better than just watching a video. Also repeating the procedure multiple times for each site- Simulation on mannequin multiple times- Hands on experience- Having small group to faculty ratio was very helpful in getting individual attention. - The facilitators knew procedure were very knowledgeable and- Actually using the real equipment and practicing on the dummies with sterile technique- Hands-on practice really helped make me feel comfortable to perform this in the hospital.- The interactive feedback seems invaluable- The teacher-student ratio was very beneficial. It helped a lot to be in small groups and get individualized training.- Allowing us to familiarize ourselves with the actual kits used for CVC placement. Giving us an opportunity to place a PIV on a simulated patient as many of us do not have this opportunity in medical school. Having residents talk us through each individually- Hands-on practice really helped make me feel comfortable to perform this in the hospital.

Program

PediatricsDermatologyEmergency MedicineInternal MedicineTransitionalGeneral SurgeryPlastic SurgeryColon/Rectal SurgerySurgical Critical CareOb/GynDentalFamily MedicineHPMNephrologyCardiologyHematology/OncologyTotals

# Resident Peer Reviewed Abstract/Poster/Oral Presentation

31333171422200030490

99

Resident Peer Reviewed Manuscripts Published

0490000004000401

22

80% 96% 60% 95% 80% 19%100%

Average pre-test score

High score on pre-test

Low score on pre-test

Average post-test score

Low score on post-test

Average change from pre- to

post-test

High score on post-test

1 0 | G r a d u a t e M e d i c a l E d u c a t i o n

GME Finance UpdateResident Salaries:

Our resident salaries continue to be comparable to others in the region. In FY14, resident salaries increased 1% across all PGY years.

2013 AAMC HSS Northeast Region50th Percentile (Median) Salaries in US$

53,14455,26257,84660,25662,95166,698

FY14 LVHN Resident Base Salaries in US$

53,47956,19158,80361,95364,90867,862

Total Dental ResidentsTotal Allopathic & Osteopathic Resident FTEs 1st Cap: 12/31/1996 1st Cap Adjustment (New Family Practice Program) Section 5506 AdjustmentTotal 1st CapAmount over CapSection 422 CapLesser of Amount over Cap or Section 422 CapAllowable FTEs: 1st Cap on Allopathic & Osteopathic FTEs 2nd Cap on Allopathic & Osteopathic FTEs Dental Residents Total Allowable and Funded

91.2218.0022.00

162.87

131.22= 31.6525.00

3.90

131.22

25.00

131.2225.003.90

160.12

PGY Level

PGY1PGY2PGY3PGY4PGY5PGY6 & up

Medical Education Funding from Medicare Cost Report (for AY14, based on IME calculation):

Total Dental ResidentsTotal Allopathic & Osteopathic Resident FTEs 1st Cap: 12/31/1996 1st Cap Adjustment (New Family Practice Program) Section 5506 AdjustmentTotal 1st CapAmount over CapSection 422 CapLesser of Amount over Cap or Section 422 CapAllowable FTEs: 1st Cap on Allopathic & Osteopathic FTEs 2nd Cap on Allopathic & Osteopathic FTEs Dental Residents Total Allowable and Funded

0.0041.670.00

63.12

41.67= 21.4516.00

2.88

41.67

16.00

41.6716.002.88

60.55

LVH

MHC

Note: Rotating residents (both into and out of LVHN) impact the FTE counts above.

A n n u a l R e p o r t A Y 2 0 1 4 | 1 1

GrowthThis growth includes the anticipated addition of two additional positions within the new Sports Medicine Fellowship, begin-ning in FY15. The graph below does not include off cycle residents or the impact of residents rotating in as visitors from outside institutions.

AY2011 - AY2016: Number of Residents and Fellow Positions Approved by Accrediting Bodies

AY2011 AY2012 AY2013 AY2014 AY2015 (Current)

AY2016 (Projected)

215228

235 243252 256

Updates in 2014Leadership:

In June 2014, William Bond, MD left LVHN for a new career opportunity and Elaine Donoghue, MD was appointed the new Designated Institutional Officer. Margaret Hadinger, EdD has served as the Interim Manager of GME and was also promoted to the Director of Medical Education. The Office of Graduate Medical Education (OGME) has participated in the DOE restructuring development and implementation process which has resulted in separation of UME and GME staffing but continued collabora-tion. Current efforts are underway to recruit for the Manager of GME.

Operational Efficiency:

Recent changes in staffing have made efficient use of GME FTE support imperative. Our efforts will include: - Maximizing use of the website for recruiting to maintain low recruiting expense. - Continuing applications for Section 5506 redistribution slots to attempt to secure new revenue. - Minimizing process redundancy between the programs and the OGME to ensure maximum efficiency.

Next Accreditation System (NAS):

The NAS metrics include board pass rates, program attrition rates (changes in program director, faculty and residents), bench-marked resident and faculty survey data, case log data, progress toward milestones and summary data on scholarly output. In particular the reporting of milestone competencies will entail significantly increased data reporting. Many residency and fellowship programs made substantial progress in fulfilling these reporting requirements in advance of the deadlines.

The OGME will attempt to support these processes, while acknowledging that the milestones are specialty specific. The OGME continues to work with our instructional technology support team in the DOE to assess the capabilities of New Innovations to meet this need and share best practice across residencies.


Priorities for 2015Patient Safety Improvements:

In response to the CLER visit report, GME will focus on supporting resident involvement in patient safety improvements. These efforts will work to increase the number of patient safety reports filed by residents, increase resident participation in root cause analysis and continue to support resident involvement in quality improvement projects. These outcome measures will be tracked. We will also focus on improving transitions of care including shift changes during a patient’s hospitalization, internal transfers between patient care services, and admission/discharge interfaces. Strategies will include examining best practices and exploring mechanisms within the Epic system to facilitate safe transfers of care.

Faculty Development:

Innovative institutional faculty development offerings will be explored to overcome the barriers to attending traditional faculty development seminars. These approaches might include brief videotaped modules available through the TLC system with discussion boards. Other innovations could include peer faculty mentoring or using medical educators to do structured faculty observation and feedback. We will continue to offer faculty development seminars at a variety of times and locations to optimize attendance, and we will explore interdisciplinary faculty development to foster innovative collaborations.

GME will collaborate with our UME partners on faculty development. We will also work to foster our teachers obtaining faculty appointments with University of South Florida Morsani College of Medicine and being promoted as they develop their scholarly portfolio.

Outcomes measures will include the number of faculty development offerings that are utilized, feedback obtained through resident/fellow evaluation of faculty, and numbers of faculty appointments and promotions processed. Feedback will be obtained from faculty during this process.

Epic Implementation and Optimization:

The implementation of the Epic electronic health record will create dramatic changes in the delivery of health care at LVHN and will create opportunities to foster resident medical education. It will be easier to provide residents with feedback on their practice patterns and types of patients seen. Opportunities to improve transitions of care using the Epic system will be explored.Education about ICD-10 will also be provided to all residents/fellows in the network as part of the transformation of the current coding system.

Transitions of Care:

The implementation of systems to ensure seamless transfers of patient care during resident shift changes, and during patient admissions, transfers or discharges will be a priority. This system will be integrated into Epic to increase efficiency.

Next Accreditation System Support:

We will continue to support resident and fellow programs as they transition to the NAS and to milestone systems of evaluation by sharing best practices.

Health Disparities:

Futher support education on the root causes of health care disparities and methods to reduce or eliminate them will be integrated.

SummaryGME at LVHN remains dynamic and focused on providing high quality education to provide our residents and fellows with the knowledge, skills and attitudes to practice the highest quality of medicine. Expansion of our fellowships and residencies in addition to improving existing programs continues to be supported. The OGME will coordinate our educational efforts with the network efforts to achieve the Triple Aim of improved quality, patient centered care and better cost. We will use the informa-tion obtained from the CLER visit, opportunities created by EPIC implementation, and energy created by GMEC collaboration to achieve our goals in the upcoming year.

A n n u a l R e p o r t A Y 2 0 1 4 | 1 3

GME Demographics

# medical residents/fellows # non-medical residents/fellows# visiting residents# total accredited residency programs# allopathic (ACGME) accredited programs# osteopathic (AOA) accredited programs# dually (ACGME/AOA) accredited programs# re-accredited/continued programs# new program(s) applied for# of medical & non-medical graduates

Resident Recruitment and Match Data

# U.S. medical school applicants# applicant interviews conducted # medical match positions available% from allopathic accredited medical schools% from osteopathic medical schools% from international medical schools% from Pennsylvania medical schools

GME Program Development

Resident satisfaction survey (ACGME survey) Participation rate (full report on page 15)# residents contributing to publications# residents contributing to poster presentations

Faculty Development (DOE-provided)

# faculty development workshops offered# attendees# resident as teacher workshops offered**# attendees

AY11 AY12 AY13 AY14

215 228 235 243- - - 1073 81 79 8515 17 18 1710 12 13 145 5 5 42 2 2 22 5 5 43 2 0 181 87 94 102

1782 2360 2193 2718658 879 816 95479 81 84 86 * 49% 50% 41% 30%35% 33% 43% 47%16% 17% 16% 23%30% 33% 47% 37%

94% 90% 93% 98%28 30 39 22 53 15 70 99

78 40 22 78401 239 358 40112 13 5 12273 291 178 273

* The available medical match positions do not include dental medicine residency positions.** In 2012, the Resident as Teacher Leader program began shifting teaching responsibilities to the Lehigh Valley ResidentsAssociation so that the program may become more resident-lead and resident-focused.

Appendix

GME Policies

Policies Revised or Approved during AY14

- Faculty Evaluation of Residents- Life Support Provider Status- Institutional Agreements- Internal Review GME Policy No: 2005.8- Loss of LVHN-Owned Portable Computing Devices- GTA and Appendices- Moonlighting and Other Professional Activities Outside the Program

- GTA and Appendices- Eligibility, Selection, Recruitment, and Appointment of Residents- Conflict of Interest- Effect of Leave- Evaluation and Promotion- International Rotations- USMLE Step III- Transitions of Care (newly proposed policy)

Policies Revisions Scheduled


Institution Means at-a-glance Residents' overall evaluation of the program

Institution Mean National Mean

Duty Hours% ProgramCompliant

ProgramMean

% NationalCompliant

NationalMean

80 hours 95% 4.7 95% 4.71 day free in 7 97% 4.8 98% 4.9In-house call every 3rd night 100% 5.0 100% 5.0Night float no more than 6 nights 100% 5.0 99% 5.08 hours between duty periods (differs by level of training) 98% 4.7 97% 4.7Continuous hours scheduled (differs by level of training) 99% 4.8 97% 4.8

Reasons for exceeding duty hours:Patient needs 8%Paperwork 8%Additional Ed. Experience 4%

Cover someone else's work 2%Night float 1%Schedule conflict 2%Other 1%

Faculty% ProgramCompliant

ProgramMean

% NationalCompliant

NationalMean

Sufficient supervision 95% 4.4 92% 4.3Appropriate level of supervision 97% 4.7 96% 4.6Sufficient instruction 90% 4.3 86% 4.2Faculty and staff interested in residency education 88% 4.3 85% 4.3Faculty and staff create environment of inquiry 80% 4.2 79% 4.1

Evaluation% ProgramCompliant

ProgramMean

% NationalCompliant

NationalMean

Able to access evaluations 100% 5.0 99% 4.9Opportunity to evaluate faculty members 100% 5.0 99% 5.0Satisfied that evaluations of faculty are confidential 87% 4.2 85% 4.3Opportunity to evaluate program 99% 5.0 98% 4.9Satisfied that evaluations of program are confidential 86% 4.3 86% 4.3Satisfied that program uses evaluations to improve 75% 4.1 73% 4.0Satisfied with feedback after assignments 74% 4.0 71% 3.9

Educational Content% ProgramCompliant

ProgramMean

% NationalCompliant

NationalMean

Provided goals and objectives for assignments 97% 4.9 95% 4.8Instructed how to manage fatigue 95% 4.8 93% 4.7Satisfied with opportunities for scholarly activities 76% 4.0 76% 4.0Appropriate balance for education 86% 4.2 81% 4.2Education (not) compromised by service obligations 70% 3.9 71% 3.9Supervisors delegate appropriately 99% 4.5 99% 4.6Provided data about practice habits 62% 3.5 59% 3.4See patients across variety of settings 93% 4.7 95% 4.8

Resources % ProgramCompliant / % Yes*

ProgramMean

% NationalCompliant / %

Yes*National

MeanAccess to reference materials 100% 5.0 99% 5.0Use electronic medical records in hospital* 94% 4.8 96% 4.9Use electronic medical records in ambulatory setting* 95% 4.8 95% 4.8Electronic medical records integrated across settings* 60% 3.7 81% 4.5Electronic medical records effective 88% 3.5 94% 4.0Provided a way to transition care when fatigued 76% 4.1 80% 4.2Satisfied with process to deal with problems and concerns 82% 4.2 80% 4.1Education (not) compromised by other trainees 91% 4.4 91% 4.5Residents can raise concerns without fear 86% 4.3 80% 4.2

PatientSafety/Teamwork

% ProgramCompliant

ProgramMean

% NationalCompliant

NationalMean

Tell patients of respective roles of faculty and residents 99% 4.5 99% 4.5Culture reinforces patient safety responsibility 99% 4.5 99% 4.5Participated in quality improvement 83% 4.3 83% 4.3Information (not) lost during shift changes or patient transfers

98% 3.9 97% 4.0

Work in interprofessional teams 98% 4.5 98% 4.6Effectively work in interprofessional teams 100% 4.3 99% 4.3

Total Percentage of Compliance by Category

© 2014 Accreditation Council for Graduate Medical Education (ACGME) *Response options are Yes or No. These responses are not included in the Program Means and are not considered non-compliant responses.Percentages

may not add to 100% due to rounding.

2013-2014 ACGME Resident Survey - page 1

410724 Lehigh Valley Health Network - Aggregated Program Data

Programs Surveyed

Residents Responded

Response Rate

15

220 / 22498%

Survey taken: January 2014 - June 2014

Appendix - ACGME Survey Results

A n n u a l R e p o r t A Y 2 0 1 4 | 1 5

Residency Programs

Family Medicine

Emergency Medicine

Internal Medicine (Categorical)

Obstetrics/Gynecology

Pediatrics

General Surgery (Categorical)

General Surgery (Preliminary)

Plastic Surgery

Dermatology

Fellowship Programs

Nephrology

Hematology/Oncology

Hospice Palliative Medicine

Cardiovascular Disease


Colon Rectal Surgey

Total Number of Graduates

7

13

17

5

0

5

1

1

2

Total Number of Graduates

2

0

1

5

1

2

# of Graduates Who Stayed at

LVHN

3

1

1

1

N/A

0

1

0

1

# of Graduates Who Stayed at

LVHN

1

0

0

0

0

0

Board Passage Rate

Medical boards- 86%Osteo written and practical - 100%93%

100%

94%

N/A

Qualifying exam - 100%Certification exam - 79%N/A

100%

100%

Board Passage Rate

100%

N/A

Boards are every other year. Results not available yet.100%

100%

75%

Appendix - Graduation, Fellowship, and Board Passage Rates

# of Graduates Progressing to

Fellowships

1

2

3

1

1

4

0

1

0

# of Graduates Progressing to

Fellowships

0

0

0

0

0

0


l e H i g H v a l l e y H e a l t H n e t w o r K

Hematology/ oncology administrative FellowsHip

pediatrics

RESIDENTS 2013-2014

FELLOWS 2013-2014

President

courtney edwards m.d.Vice President

patrick Hickey d.o.Secretary

stuart Hartman d.o.Cardiology

courtney Bennett d.o.Family Medicine

rebecca royce-Hickey d.o.Internal Medicine

dan makowski d.o.OB/GYN

daniel gomez m.d.Surgery

patrick duffy m.d.Transitional Year

chris custer m.d.Dental

eric turner d.m.d.Dermatology

stephen Hemperly d.o.Pediatrics

Hillary roth m.d.Emergency Medicine

colin donnelly d.o.

emergency medicine

general surgery

internal medicine Family medicine

dental

oBstetrics/ gynecology

transitional year

clinical pastoral care

pHarmacysurgical critical care

emergency medical services

cardiovascular disease

nepHrology colon/ rectal surgery Hospice palliative medicine

plastic surgeryleHigH valley

residents’ association

2013 - 2014 oFFicers

Kayla Long D.O.PGY52166

dermatology

Richard Chow D.O.PGY16042

Ross Cohen D.O.PGY16046

Tanner Folster D.O.PGY16047

Mitchell Gesell D.O.PGY16048

Kyli Krape D.O.PGY16049

Michael Low M.D.PGY16041

Clifford Masom M.D.PGY16038

Greg Monaghan M.D.PGY16040

Matthew Niehaus D.O.PGY16050

Lauren Porter D.O.PGY16051

Stephanie Smith M.D.PGY16039

Tracy Bishop D.O.PGY16052

Michael Wagner D.O.PGY16053

Deirdre Warner D.O.PGY15054

Blake Bailey D.O.PGY25034

Steven Berk D.O.PGY25035

Andre Burckhart D.O.PGY25036

Alan Cherney M.D.PGY25051

Nicole Elliott D.O.PGY25037

Eric Eustice D.O.PGY25038

Jared Kohlhepp M.D.PGY25047

Adam Leonetti D.O.PGY25039

Mark Lundquist M.D.PGY25044

Todd Remaley D.O.PGY25040

Rolando Rios M.D.PGY23916

Ryan Rogers D.O.PGY25041

Ryan Surmaitis D.O.PGY25042

Isamu Yoshioka M.D.PGY25049

Katie Ahmadzadeh D.O.

PGY34013

Sarfraz Alam M.D.PGY34006

Steven Crellin D.O.PGY34009

Leo Diaz, Jr. D.O.PGY34011

Stephanie DiGiambattista M.D.

PGY34012

Kasia Falkowska D.O.

PGY34026

Avinash Kambhampati D.O.

PGY34014

Kalif Kendig D.O.PGY34015

Elizabeth Moore D.O.PGY34018

Tom Nappe D.O.PGY34022

Aaron Ratner D.O.PGY34028

Jeff Reboul D.O.PGY34023

Brent Steinweg D.O.PGY34024

Douglas Sturm D.O.PGY34025

Jessica Weiland M.D.PGY34027

John Ashurst D.O.PGY43109

Stephanie Cohrac D.O.PGY43110

Rachel Cookson D.O.PGY43111

Megan Dambach D.O.PGY43112

Colin Donnelly D.O.PGY43113

Suprina Dorai M.D.PGY43115

Jessica Eygnor D.O.PGY43116

Steven Hardy M.D.PGY43117

Chadd Kraus D.O.PGY43119

Paul Myers, Jr. D.O.PGY43120

Benjamin Preiss D.O.PGY43122

Shaheen Shamji D.O.PGY43128

Christopher Ward M.D.

PGY43129

Michael Callander M.D.

PGY11414

Steven Godelman M.D.

PGY11257

Kristina Langenborg D.O.

PGY11941

Daniel Latta M.D.PGY11416

Thomas Nowakowski M.D.

PGY13104

Jonathan Perry M.D.PGY11494

Lauren Dudas M.D.PGY21400

Jaime Dutton M.D.PGY21409

Christian Eusebio M.D.

PGY25622

Priyal Patel M.D.PGY21491

Mark Perry M.D.PGY21459

Bharat Ranganath M.D.

PGY25125

Rafael Bustamante M.D.

PGY35133

Patrick Duffy M.D.PGY31187

Malia Eischen M.D.PGY33041

Meghan Good M.D.PGY34043

Victor Reis M.D.PGY33698

Shuja Shafqat M.D.PGY33694

Courtney Edwards M.D.

PGY41171

Victor Ha M.D.PGY41290

Lung-Ching Lee M.D.PGY41462

Andrew Michael M.D.PGY44092

Ahmed Nassar M.D.PGY41701

Joshua Gish M.D.PGY55621

Krista Goodman M.D.PGY51184

Haane Massarotti M.D.

PGY53105

Margaret Moore M.D.PGY55517

Anna Soltys M.D.PGY53043

Saba Ahmad M.D.PGY16055

Donyell Doram M.D.PGY16059

Philip Dunn D.O.PGY16060

Vahe Gyulnazaryan M.D.

PGY16061

Ronald Julia, Jr. M.D.PGY16063

Michael Kalil D.O.PGY16064

Rachel Lipner D.O.PGY16069

Katie Mastoris D.O.PGY16070

Matthew Miles D.O.PGY16074

Sarah Park D.O.PGY16076

Neiman Ramjattan D.O.

PGY16079

Ryan Rogers D.O.PGY16081

Arsha Sreedhar M.D.PGY16085

Matthew Sullivan D.O.PGY16086

Misbahuddin Syed M.D.

PGY16087

Daniel Tseytlin D.O.PGY16089

Samuel Adediran M.D.PGY25063

Melissa Auer D.O.PGY25065

Stephen Awuor M.D.PGY25066

Maura Bucciarelli D.O.PGY25067

Scott Drobnis M.D.PGY25069

Ryan Evans D.O.PGY25071

Brian Friel D.O.PGY25074

Patrick Hickey D.O.PGY25077

Liana Joa M.D.PGY25078

Christopher Kern D.O.PGY25097

Nicholas Kitsopoulos D.O.

PGY25099

Krishna Komanduri D.O.

PGY25100

Brian Miller D.O.PGY25102

Mira Mitry M.D.PGY25109

Gisela Rosario-Rosario M.D.

PGY25118

Gisela Vargas M.D.PGY25122

Carolyn Casey D.O.PGY34046

Michael Daniels D.O.PGY34050

Erin Deihl D.O.PGY34051

Charles Frankhouser M.D., MBA

PGY33040

Disa Grant D.O.PGY34052

Justin Guthier D.O.PGY34057

Stuart Hartman D.O.PGY34058

Rajesh Kumar M.D.PGY34059

Suchita Kumar M.D.PGY34060

Daniel Makowski D.O.PGY34062

Ranjit Nair M.D.PGY34066

Ashley Nelson M.D.PGY34067

Shital Patel M.D.PGY34068

Tuhama Rihani M.D.PGY34070

Hassam Saif M.D.PGY34074

Vladislav Valtsis D.O.PGY34079

Gina Verdetti D.O.PGY34080

Jocelyn Amaya M.D.PGY16090

Johane Gildade Boursiquot M.D.

PGY16091

Christine Garnier D.O.PGY16094

Ryan Gates M.D.PGY16095

Sean Lewis D.O.PGY16097

Chelsea Marshall D.O.PGY16098

Marah Mattheus-Kairys M.D.

PGY14036

Gregory Cannon D.O.PGY25024

Jennifer Daly M.D.PGY25027

Tara Frankhouser D.O.PGY26093

Rebecca Royce-Hickey D.O.

PGY25031

David Vargas Martinez M.D.

PGY25032

Piya Bhowmick M.D.PGY34033

Veronica Brohm D.O.PGY34035

Vanessa DeOliveira Inacio M.D.

PGY34034

Ann Holmes D.O.PGY32230

Lindsay Pereira D.O.PGY35029

Holly Stone M.D.PGY34037

Jeffrey Wells D.O.PGY34038

Salman Bhatti M.D.PGY46009

Sumit Duggal M.D.PGY46006

Agei Enoh M.D.PGY46003

Sanjeev Nair M.D.PGY46007

Navin Subrayappa M.D.

PGY46004

Courtney Bennett D.O.PGY52085

Richard Massaro D.O.PGY52209

Raghunandan Muppidi M.D.

PGY55012

Yassir Nawaz M.D.PGY55014

Ataul Qureshi M.D.PGY55013

Adrian Bell D.O.PGY62084

Tahmeed Contractor M.D.

PGY64031

Christina Dunbar Matos D.O., M.P.H.

PGY62094

Jareer Farah M.D.PGY64030

Nitin Verma M.D.PGY64029

Stephen Hemperly D.O.

PGY23201

Kelly Reed D.O.PGY23202

Sean Branch D.O.PGY33680

Ryan Owen D.O.PGY31690

Christian Oram D.O.PGY43198

Luis Soro D.O.PGY44001

Sheila Aseto D.O.PGY16107

Christine Bender D.O.PGY16108

Tasha Desai D.O.PGY16109

Lauren Greenawald D.O.

PGY16119

Karoline Korah D.O.PGY16122

Patrick Philpot D.O.PGY16124

Dayla El Tawil M.D.PGY25015

Tonasha Johnson M.D.

PGY25017

Alexis Newton M.D.PGY25019

Eliana Piedrahita-Llano M.D.

PGY25020

Hillary Roth M.D.PGY25021

Nidhi Shah D.O.PGY25022

Robert Fromuth D.M.D.

PGY19676

Maxwell Johnson D.M.D.

PGY10250

John McGuire D.M.D.PGY12437

Richard Miller D.M.D.PGY10422

William Noll D.M.D.PGY13121

Andrea Onderdonk D.D.S.

PGY10423

Eric Turner D.M.D.PGY12438

Nathan Miller M.D.PGY11028

Jarom Gilstrap M.D.PGY41188

Ramon Garza III M.D.PGY51312

S. Travis Greathouse M.D.

PGY61943

Aedan Olaso M.D.PGY46034

Craig Mackaness D.O.PGY42206

Pradeep Dhakarwal M.D.

PGY55128

Anshul Kumar M.D.PGY55132

Christopher Buzas D.O.

PGY61106

Sachin Vaid M.D.PGY61444

Jessica Degiacomo Pharm.D.

PGY13695

Christine Lam Pharm.D.

PGY13696

Lorraine Dickey M.D.PGY47632

Arpine Saribekyan M.D.

PGY46010

Victoria Ivanukoff D.O.

PGY63108

Christine Saraceni D.O.

PGY43081

Laura Spranklin D.O.PGY46036

Jennifer Jozefiak M.H.A.

PGY12482

Joseph Hwang M.H.A.PGY21706

Danielle Austin M.D.PGY16134

Grazelda Kwakye-Ackah M.D.

PGY16125

Aminatu Lawal M.D.PGY16129

Adaobi Okonkwor M.D.

PGY16133

Matthew Romagano D.O.

PGY16126

Melodie Zamora M.D.PGY16130

Anmol Bhambhwani M.D.

PGY26135

Abbey Burger D.O.PGY26136

Amr El Haraki M.D.PGY25053

Helai Hesham M.D.PGY25057

Eunice Lee M.D.PGY25060

Bethany Beasley M.D.PGY34091

Irena Cabrera M.D.PGY34089

Daniel Gomez M.D.PGY34090

Michelle Huang M.D.PGY34088

Ana-LizaPascual M.D.

PGY31090

Angela Caswell-Monack D.O.

PGY43004

Karin Commeret M.D.

PGY41145

Courtney Downey D.O.

PGY43012

Adetola Louis-Jacques M.D.

PGY43013

Jose LuisTerrazas M.D.

PGY43016

Sallyann Cusma M.D.PGY16056

Christopher Custer M.D.

PGY16057

Yong He M.D.PGY16062

Kyeong Kim M.D.PGY16066

Paul Kitei M.D.PGY16067

Tyler McCambridge D.O.

PGY16072

Samir Mehta M.D.PGY16073

Ashley Miller M.D.PGY16075

Shreyas Patel M.D.PGY16077

Vishal Patel M.D.PGY16078

Saad Rasheed M.D.PGY16080

Michael Roux M.D.PGY16083

Jack Smith M.D.PGY16084

Penn Tong M.D.PGY16088

Christian Bennett2773

Susan Ferrell6329

Comfort Fordjour2926

Patrick McCormack1154

John Puleo1153

Vicki Reeser1749

A n n u a l R e p o r t A Y 2 0 1 4 | 1 7

Division of EducationLehigh Valley Health Network1247 S. Cedar Crest Blvd. 2nd Floor

a n n u a l r e p o r t ay 2 0 1 4 ( 2 0 1 3 - 2 0 1 4 ) annual re… · g r a d u a t e m e d i c...

Documents