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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.
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
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.
6 | G r a d u a t e M e d i c a l E d u c a t i o n
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
Surgical Critical Care
Hospice/Palliative Medicine
Transitional Year
Osteopathic Internship/ Medicine
Emergency Medical Services
Dermatology
Sports Medicine
Sponsoring Institution
Status
Continued Accreditation
Continued Accreditation
Continued Accreditation with WarningContinued Accreditation
Continued Accreditation
Initial Accreditation
Initial Accreditation
Continued Accreditation
Continued Accreditation
Continued Accreditation
Continued Accreditation
Continued Accreditation
Continued Accreditation
Continued Accreditation
Continued Accreditation
Continuing Approval
Continuing Approval
Continuing Approval
Initial Accreditation
Continued Accreditation
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
8 | G r a d u a t e M e d i c a l E d u c a t i o n
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
Surgical Critical Care
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.
1 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
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
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
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
Surgical Critical Care
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
1 6 | G r a d u a t e M e d i c a l E d u c a t i o n
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
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