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![Good academics in Emergency
Medicine training program
Dr.Venugopalan P P
DA,DNB,MNAMS,MEM[GWU]
Director ,Aster DM Health care Ltd.
Deputy Director ,MIMS Academy,
Founder & Executive Director ANGELS –Active Network Group of Emergency
Life Savers
India, Kerala](https://image.slidesharecdn.com/goodacademicsinemergencytrainingprogam-140928233055-phpapp01/75/DNB-EM-Good-academics-in-emergency-training-progam-1-2048.jpg)
![Acad Emerg Med. 2000 Nov;7(11):1204-22.
Promoting patient safety and preventing medical error in emergency departments.
Schenkel S.
Author information
Abstract
An estimated 108,000 people die each year from potentially preventable iatrogenic injury. One in 50 hospitalized patients experiences a preventable adverse event. Up to 3% of these injuries and
events take place in emergency departments. With long and detailed training, morbidity and mortality conferences, and an emphasis on practitioner responsibility, medicine has traditionally faced the
challenges of medical error and patient safety through an approach focused almost exclusively on individual practitioners. Yet no matter how well trained and how careful health care providers are,
individuals will make mistakes because they are human. In general medicine, the study of adverse drug events has led the way to new methods of error detection and error prevention. A combination
of chart reviews, incident logs, observation, and peer solicitation has provided a quantitative tool to demonstrate the effectiveness of interventions such as computer order entry and pharmacist order
review. In emergency medicine (EM), error detection has focused on subjects of high liability: missed myocardial infarctions, missed appendicitis, and misreading of radiographs. Some system-level
efforts in error prevention have focused on teamwork, on strengthening communication between pharmacists and emergency physicians, on automating drug dosing and distribution, and on
rationalizing shifts. This article reviews the definitions, detection, and presentation of error in medicine and EM. Based on review of the current literature, recommendations are offered to enhance the
likelihood of reduction of error in EM practice.
PMID:
11073469
[PubMed - indexed for MEDLINE]
•108000 preventable deaths from iatrogenic injuries per year
•1 in 50 hospitalized patients experiences preventable adverse events
•3% from ER](https://image.slidesharecdn.com/goodacademicsinemergencytrainingprogam-140928233055-phpapp01/75/DNB-EM-Good-academics-in-emergency-training-progam-7-2048.jpg)
![Life support courses
• BLS[Basic life support]
• ACLS[Advanced life
support]
• PALS[Pediatric advanced
life support]
• NALS[Neonatal Advanced
Life support ]
• ITLS [International
Trauma life support]
• ATLS[Advanced Trauma
life Support]](https://image.slidesharecdn.com/goodacademicsinemergencytrainingprogam-140928233055-phpapp01/75/DNB-EM-Good-academics-in-emergency-training-progam-13-2048.jpg)
![Focused training Programs
• BDLS[Basic Disaster Life
support ]
• ADLS[Advanced Disaster
Life Support]
• ATULS[Advanced Trauma
Ultrasound Life
Support]
• HAZMAT
• ECHO and Ultrasound
• Wound care management](https://image.slidesharecdn.com/goodacademicsinemergencytrainingprogam-140928233055-phpapp01/75/DNB-EM-Good-academics-in-emergency-training-progam-14-2048.jpg)
Uploaded byDr.Venugopalan Poovathum Parambil
DNB EM :Good academics in emergency training progam
An expert discusses strategies for implementing a good academic emergency medicine training program. Key aspects include: - Strong selection process and induction training to prepare students. - Focused clinical rotations, electives, life support courses, procedures, and skills training to build proficiency. - Daily teaching, case discussions, bedside learning and faculty coverage to mentor students. - Evaluations, research, workshops and conferences to assess progress and support continued learning. - Exit exams to ensure students have achieved expected competencies before completing the program.
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DNB EM :Good academics in emergency training progam
- 1. Good academics inEmergency Medicine training program Dr.Venugopalan P P DA,DNB,MNAMS,MEM[GWU] Director ,Aster DM Health care Ltd. Deputy Director ,MIMS Academy, Founder & Executive Director ANGELS –Active Network Group of Emergency Life Savers India, Kerala
- 2. Focus • DNBEmergency medicine • Strategies to make good teaching schedule • Implementation of program • A good start , strong progression and excellent exit • Contents and beyond ….. • Students expectations Faculty expectation
- 3. Emergency Medicine Initialevaluation, treatment and disposition of any person at any time for any symptom, event or disorder deemed by the person or someone acting on his or her behalf to require expeditious medical, surgical or psychiatric attention. ACEM
- 4. Emergency Physician •A specialist who has been trained to engage in the immediate initial recognition, evaluation and disposition of patient with acute illness and injury.. Specialists who doesn’t passionate and spend time in ER will not understand the “issue and challenges” of emergency medicine
- 5. MCI • July21st 2009 • Primary specialty • Rapid growth • Need of the Nation • Need of health care system National Board of examination officially declared DNB program in November 2013
- 6. Triage Cueing Affectivestate Fatigue & Shift work Long waiting time For Bed Medication errors Assessment-Diagnosis-Triage Treatment-Management-Disposition Admit Discharge EMS ED Design Patient Presentation Information Gap Over crowding Report Delay Lab errors Orphaned Pt Resource Constrain Team work problem Authority Gradient Transition of Care Sense Making Radiology Error Cognitive properties of the mind Violation producing factors Procedural factors Inadequate Discharge Plan Follow up failures Sources of Failures and Errors in ED
- 7. Acad Emerg Med.2000 Nov;7(11):1204-22. Promoting patient safety and preventing medical error in emergency departments. Schenkel S. Author information Abstract An estimated 108,000 people die each year from potentially preventable iatrogenic injury. One in 50 hospitalized patients experiences a preventable adverse event. Up to 3% of these injuries and events take place in emergency departments. With long and detailed training, morbidity and mortality conferences, and an emphasis on practitioner responsibility, medicine has traditionally faced the challenges of medical error and patient safety through an approach focused almost exclusively on individual practitioners. Yet no matter how well trained and how careful health care providers are, individuals will make mistakes because they are human. In general medicine, the study of adverse drug events has led the way to new methods of error detection and error prevention. A combination of chart reviews, incident logs, observation, and peer solicitation has provided a quantitative tool to demonstrate the effectiveness of interventions such as computer order entry and pharmacist order review. In emergency medicine (EM), error detection has focused on subjects of high liability: missed myocardial infarctions, missed appendicitis, and misreading of radiographs. Some system-level efforts in error prevention have focused on teamwork, on strengthening communication between pharmacists and emergency physicians, on automating drug dosing and distribution, and on rationalizing shifts. This article reviews the definitions, detection, and presentation of error in medicine and EM. Based on review of the current literature, recommendations are offered to enhance the likelihood of reduction of error in EM practice. PMID: 11073469 [PubMed - indexed for MEDLINE] •108000 preventable deaths from iatrogenic injuries per year •1 in 50 hospitalized patients experiences preventable adverse events •3% from ER
- 8. Emergency Medicine Makepractice more stressful • Decision making • Dynamic nature • Errors in judgments • Communication • Unknown cases • Unexpected issues • Unlimited numbers • Exposed environment
- 9. How can weimplement a good academic program in EM?
- 10. Selection Induction Rotation Electives Examination and Exit CET Ice break EM allied specialties Reputed institutions Multiple and focused E M E R G N C Y M E D I C N E
- 11. Induct with warmintro • Introduction of EM and ER • Knowing entire hospital • Process and protocol • Team building and getting along • E Based learning
- 12. Induction • Communication • Presentation skills • Basic sciences • Research methodology • Life support courses
- 13. Life support courses • BLS[Basic life support] • ACLS[Advanced life support] • PALS[Pediatric advanced life support] • NALS[Neonatal Advanced Life support ] • ITLS [International Trauma life support] • ATLS[Advanced Trauma life Support]
- 14. Focused training Programs • BDLS[Basic Disaster Life support ] • ADLS[Advanced Disaster Life Support] • ATULS[Advanced Trauma Ultrasound Life Support] • HAZMAT • ECHO and Ultrasound • Wound care management
- 15. Daily case discussion • Daily rounds • Weekly grand rounds • Weekly academic clubs Early morning 2-4 am is highly potential for errors and wrong judgments
- 16. Morning reports •Focus on minor and major issues • Review codes • Follow up cases
- 17. Bedside teaching •Success of program • Discuss cases • Communication skills • Teaching skills • Equipment orientation • Team work • Paramedic education
- 18. Faculty coverage •24 hours faculty coverage • Every case is a chapter • Modulate students • Inculcate extra attitude • Free time – Simulations
- 19. Faculty as Learners Academic growth Inculcating Creativity Professional excellence Community engagements Strategic Planning
- 20. Procedures • Essentialprocedure to be accomplished • Expected numbers • Supervised • Self • Simulation based
- 21. Log book •Academic • Clinical • Procedure • Seminars • Conferences • Workshop • Special works Must be submitted and signed monthly basis
- 22. Thesis and research • Search topics • Department thrust areas • Institutional Research committee • Institutional ethics committee • Time bound execution • Presentable and publishable projects Beneficial for the student ,institution and Community
- 23. Evaluation • Clinicalskill • Decision making • Communication skill • Knowledge base • Presentation skill • Attitude and aptitude • Teaching skill • Strength and weakness Empower students
- 24. Monthly Modular system • Plan to cover entire curriculum in 36 module • Pre planed teaching schedule • Students presentations • Faculty presentations
- 25. Rotation • Definethe objective • Interactive • 360 degree feedback • Confidential report
- 26. Electives • Reputedcenters • Trauma centers • Burns centers • Pediatric and Obstetric institutions • Palliative care
- 27. Faculty and studentsexchange program • Regional • National • International
- 28. Public education •Basic life support • Trauma life support • Disaster managements • Public health • Stroke • First response training
- 29. Skill lab andsimulations
- 30. Workshops • MechanicalVentilation • ABG • Wound care • Ultrasound • Vascular access • Procedural sedation • Nerve blocks
- 31. Conferences and seminars • Regional • National • International Motivate students to prepare and submit abstracts
- 32. Mortality , Journals • Monthly Basis • Journal reviews • Medical News board in the department • E based groups to share recent advances
- 33. Medical Records •Prompt • Regular entry • Electronic records • Police intimation • Wound certificate • Reference letters • Photographs and Videos
- 34.
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- 38. Scope of socialmedia in emergency medicine
- 39. Exit exams •Written • Clinical Objective Eliminate personal bias Relevant Basic science OSCE Oral board style Monthly Yearly Final
- 41.
- 43. Thank you somuch ….. www.drvenu.net , www.emergencymedicinemims.com
- 44.