Special Reports

Hospital Mergers Reinforce the Need for a Strong Resident Voice

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The 2013-2014 residency year has brought about a number of changes for CIR members as hospitals have merged and formed larger medical systems. In this issue of Vitals, we zero in on one hospital merger, between Mount Sinai Health System and Continuum Health Partners that embodies some of CIR’s greatest victories and greatest challenges—strong chapters of empowered residents with a real voice in their hospitals and residents trying to form new chapters and being met with resistance from their employers every step of the way.

The absorption of smaller hospitals into larger healthcare systems is nothing new but the rate at which it’s occurring has increased rapidly in recent years. According to the healthcare research firm Irving Levin Associates, 2009 saw 50 hospital mergers and acquisitions but in 2012, that number jumped to 105, and experts say this could be just the beginning of more consolidation and upheaval. 2013 was a big year for CIR members in this regard, as Continuum Health Partners, a New York City-based hospital network including Beth Israel and St. Luke’s-Roosevelt, merged with Mount Sinai Medical Center to form the Mount Sinai Health System – a mega
teaching institution with four hospitals and approximately 2200 residents on its payroll.

Residents at St Luke’s-Roosevelt have had a CIR chapter since 2001, residents at the Institute for Family Health just won their first CIR contract and Elmhurst residents are ready to start negotiating.

Merging hospital systems always argue that the move improves hospital efficiency and capacity to care for more patients. However, studies in recent years have shown that hospital mergers frequently lead to increased health care costs as larger hospitals are able to strengthen their negotiating power with insurance companies and raise their prices. There is also concern from the Federal Trade Commission about the legality of large scale hospital system mergers when it comes to the potential for monopolies within a community.

What is known for sure is that merger means change. The new Mount Sinai Health System has already closed down
the child and adolescent psychiatry inpatient unit at Mount Sinai Hospital and an inpatient medicine floor at Beth Israel Hospital. The new system has also begun to change graduate medical education, bringing all hospitals into the the Icahn School of Medicine affiliation, altering program oversight and rotation schedules.

Residents have a stake both in how patient care is provided and in the structure and oversight of their own training, but have not been given an opportunity to participate in any of the decision making. This disregard for the needs and expertise of residents has highlighted the ongoing lack of resident voice in the Mount Sinai Health System and inspired housestaff across all hospitals to organize to join CIR. One major challenge is the hospital’s claim that residents are students, not employees, and therefore do not have a right to unionize.

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CIR Vitals Spring 2014

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In This Issue:

Feature:
Hospital Mergers Reinforce the Need for a Strong Resident Voice
Residents are the Same as Med Students? No Way!
CIR Welcomes 800 New Members

President’s Report:
This is Our Moment

Around the Union:
New Contracts Deliver Better Salaries, Empower Residents to Improve Care
NYC Conference Promotes Just Culture and Patient Safety
Jackson Residents Roll Out Groundbreaking QI Projects

Innovations & Initiatives:
What’s Your QI IQ? Residents Revolutionizing Medicine
ACGME Selects Bronx Family Health Challenge Poster at Annual Conference

Perspectives:
Patients Lose When Resident Physicians Are Afraid to Unionize

Member Spotlight:
Mount Sinai Health System Residents Share Hopes and Concerns about Merger
CIR New Mexico Gets Technical to Reach the Uninsured

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Women in Medicine

The 2013 class of medical students has a special distinction. While women have been pursuing medicine in increasing numbers in the past several decades, this the first class that contains more women than men. The trend raises a number of questions about the future of the profession. 

How far do women physicians still have to go to gain parity with their male counterparts? 

A 2012 study by University of Michigan professor Dr. Reshman Jagsi found that over their careers, women doctors lose $350,000 to the gender wage gap. That study controlled for work hours, area of specialty, and all other career and life choices and found that women still made about $12,000 less each year than similarly qualified men doing the exact same type and amount of work.

Similarly, in a number of studies, women report a high rate of gender-based discrimination and sexual harassment, compared with their male counterparts, and in some cases, harassment affected women’s choices of specialties and ranking of programs. According to a 2000 survey of more than 3000 full-time faculty members at 24 randomly selected U.S. medical schools, about half of the female faculty experienced some form of sexual harassment.

Will medicine and medical education need to undergo a culture shift? 

In “Changing the Culture of Academic Medicine” Dr. Linda Pololi examines the medicine though the lens of female faculty. Interviews with these physicians revealed a number of disturbing observations, among them:

  •  Faculty who profess a love of teaching, research and clinical practice experience a high level of burnout, contemplate leaving academic medicine and would not recommend to others that they become physicians.
  •  Faculty note an erosion of idealism among medical students and wonder what the implications are for their future practice of medicine.
  •  Faculty also reported a startling level of unethical behavior among medical researchers.

CIR members’ responses to a 2012 survey on resident values corroborate those findings. Of the 324 respondents, 83 percent of the women respondents said they had witnessed colleagues lose sight of values they once held. Female residents rated burnout and quality of life as their number two concern when thinking about their future in medicine. Male residents rated it fourth.

How can we develop leadership that matches the demographics of the profession? 

While women may start to surpass men in the early stages of the medical career, physician leadership is still male dominated. One other key concern in Dr. Pololi’s research is the advancement of women to leadership positions. Women still represent a small fraction of physician leaders in both academic medicine and the healthcare industry yet the record numbers of female medical students show this fact is not due to pipeline issues. How can we ensure that the growth of women in the profession continues up the leadership chain?

These questions raise many concerns about the future of the profession for all physicians. CIR Vitals found that doctors and policymakers are working hard to find legislative, collective bargaining and professional development solutions to these challenges.

Gender Equity in Academic Medicine: What are the Remedies? 

According to the U.S. Census Bureau, in 2011, women who worked full time earned, on average, only 77 cents for every dollar men earned. The figures are even worse for women of color. African-American women earned only approximately 64 cents and Latinas only 55 cents for each dollar earned by a white male.

Women physicians are no exception. While women have made great strides in academic medicine, the persistent gender wage gap is hard to ignore. While there are no legislative or policy prescriptions that specifically address gender inequities in medicine, there are some national and local remedies that apply to all workplaces.

The Lilly Ledbetter Fair Pay Act 

The Lilly Ledbetter Act, signed by President Obama in January 2009, makes clear that pay discrimination claims on the basis of sex, race, national origin, age, religion and disability “accrue” whenever an employee receives a discriminatory paycheck, as well as when a discriminatory pay decision or practice is adopted.

Ledbetter was one of the few female supervisors at a Goodyear Tire plant in Alabama, where she worked for

close to 20 years. She filed a complaint after learning that her male colleagues were getting paid much higher salaries for doing the same work that she did. While she won back pay initially, the case was overturned by a higher court, and the Supreme Court ruled that employees cannot challenge ongoing pay discrimination if the employer’s original discriminatory pay decision occurred more than 180 days earlier, even when the employee continues to receive paychecks that have been discriminatorily reduced. The 2009 Act restores longstanding anti-discrimination provisions dating back to the Civil Rights Act of 1964.

The Paycheck Fairness Act 

This bill, introduced by Senator Barbara Mikulski (D-MD) and Representative Rosa DeLauro (D-CT), would make it harder for employers to hide pay discrimination, help train women and girls about salary negotiation, support government collection of critical wage data, and reward employers that have good pay practices. The bill has been introduced multiple times in both chambers but has been blocked by House GOP members.

The Employment Non- Discrimination Act (ENDA) 

ENDA would prohibit employment discrimination based on sexual orientation and gender identity in most American workplaces. The legislation is scheduled for a vote in the House and the Senate this fall. If passed, it would extend fair employment practices to gay, lesbian, bisexual and transgender people.

 


Harnessing the Power of Collective Bargaining to Change Residency Culture

CIR members understand the power that comes with the ability to advocate for themselves and their patients through collective bargaining. In addition to negotiating over concerns such as salaries, work conditions and availability of medical equipment, many housestaff have used their bargaining power to help establish a more equitable workplace.

Many of the contract benefits focus on the challenges faced by residents who begin families during their training. For women

who wish to have children, deciding whether to conceive during residency can be a difficult decision. It’s often a choice between delaying training, managing the hectic work schedule and possibly damaging relationships if their programs are unsupportive or, on the other hand, postponing motherhood and risking lowered fertility, pregnancy complications and reliance on technology.

From maternity leave to child care, residents have used the power of collective bargaining to begin to change the culture of residency that makes the decision all the more difficult.

In Boston, residents at Cambridge Health Alliance have negotiated six months of maternity leave to help foster a culture where residents can take leave without fear of repercussions. Boston Medical Center housestaff negotiated for a new mother room that features pumping machines, a refrigerator and a couch. Residents also have access to the Parents in a Pinch program, which provides affordable backup childcare when regular childcare options fall through.

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CIR Members Confront Superstorm Sandy, a Disaster of Historic Proportions

On October 28, 2012 Superstorm Sandy hit the New York/New Jersey region, causing devastation and disruptions to millions along its path. Residents at CIR hospitals were on the frontlines of patient care and many lost access to their places of residence or were displaced entirely by the closing down of their hospitals. Though the storm represented a profound test of our safety net, CIR residents and fellows—working with nurses, attending physicians and all the other members of the healthcare team—rose to the occasion, providing compassionate care under punishing and complex conditions. The following articles represent just a few of the stories of CIR members illustrating their challenges, triumphs and reflections in the aftermath of the storm. Residents from three hospitals share their experiences Robert Wood Johnson (NJ); St. John’s Episcopal (NY); Bellevue Hospital (NY); A Message from HHC President Alan D. Aviles


RWJ: Hope in the Midst of the Storm

Dr. Chris Mendoza, Emergency Medicine, PGY 2, Robert Wood Johnson University Hospital (UMDNJ)

People who go into emergency medicine—doctors, nurses, techs—most of us go into it with the ability to thrive in chaotic, hectic situations. After Sandy, the day-to-day moaning and groaning about the job disappeared and everyone put on their working hats because we knew we were going to be there for several days in a row.When it comes to disasters, emergency personnel are essential. More than anything, our preparation included clarifying our schedules. Everyone needed to know where they were going to be and where their colleagues would be.

The hospital administrators were amazing—they opened up the atrium, a space about half the size of a football field, to patients, their families and staff, and provided cots and a warm place for people to sleep. It was overcrowded, but most people were just happy to be somewhere that had heat. I’m always impressed by the job that a lot of the people I work with do, especially under these kinds of circumstances. Read More



A Night to Remember, Hurricane Sandy and the Trauma that Unfolded

The day of the hurricane proved to be much tougher than I originally anticipated. I expected a storm outside and calm inside, but when it rains it pours. There was no transportation and roads were closed down. Even the ambulances weren’t operating the day of the storm. Some of the homes near the hospital had flooded and many of their cars were completely totaled. I hadn’t fully grasped the enormity of this hurricane and its effects on the Rockaways and how our proximity to the water would affect so much.

After a hectic day of bedside procedures, inpatient needs, and a bustling emergency department, a young patient was dropped off at the hospital the night the storm hit. He had sustained a gunshot wound to the abdomen. His vitals were stable at the time, but he was in and out of consciousness. He was 16 years old. When he arrived, the main power to the hospital had gone out, and we were dependent on emergency generators. As the frantic scene unfolded before my eyes, I tried calling the attending surgeon, but the phone lines were down. Read More


DR. Marc Manseau Psychiatry, PGY 4 Bellevue Hospital Center, New York

Inside the Bellevue Evacuation – One Resident’s Story

As the storm raged outside, I sat in my relatively unscathed apartment and neighborhood in Brooklyn watching and reading in horror as one catastrophe after another fell upon the medical center where I had spent the past three-plus years working and learning.

First, NYU-Tisch Hospital was evacuated emergently as the storm surge flooded the basement and the backup generators failed. Then, before NYU’s email system went dark, I learned that the research animal facilities were compromised. I pictured years of hard work and numerous experiments on the verge of breakthrough going down the drain. Next, I learned that Bellevue was running on backup generators and was initiating a partial evacuation.

Bellevue is the heart and soul of the NYU psychiatry residency program. A public hospital with over 300 psychiatric beds and one of the busiest psychiatric emergency rooms, it provides care for some of the sickest, most disadvantaged people in the city, country and world. Read More


A Message from HHC President Alan D. Aviles

To HHC Physician Residents and Members of the CIR/SEIU

In the years that I have been President of HHC, I have witnessed with pride the accomplishments we have made. In those years, we have deepened our dedication to the mission of caring for all who come to us. We have touched the lives of millions of patients who needed us. We have made healthcare safer. We have helped our city to become healthier. And in those years, every employee and every physician resident has played a role in helping HHC to become a great and important organization.

But I have never been more proud than I have been in the weeks during and following Superstorm Sandy. During the storm, I witnessed how HHC residents repeatedly put patients and patient care first, ahead of their own personal concerns.

As we continue to move ahead with the restoration of HHC, it is important to recognize the immense contributions that members of the CIR/SEIU made before, during, and after Hurricane Sandy. Simply put, under the most stressful circumstances, your dedicated efforts made all the difference.

I thank every single resident who works at an HHC hospital. Each of you has helped to lift us, to help us stand a bit taller. All of you make HHC great. You are all heroes.

Sandy was a powerful storm and for many of us, a personal challenge. But, united and strong, we are HHC. We shall rise.

Sincerely,

Alan D. Aviles

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A Long History of CIR Political Advocacy

CIR members have been enthusiastic advocates in 2012 – for healthcare reform, paid sick days for workers, and living wage laws, all policies that help patients lead healthier lives. As we head into election season, take a look back at some of the other issues that residents have been involved in throughout CIR’s history.

1982 In the midst of the nuclear arms race between the United States and the Soviet Union, CIR members were on a race of their own: to stop the spread of nuclear weapons and end nuclear testing. Throughout the 1980s, CIR members passed petitions, joined letter-writing campaigns, and aligned with Physicians for Social Responsibility, a group that continues advocating for nuclear disarmament to this day. CIR members were among one million people who marched in New York City on June 12, 1982 in the largest anti-nuclear arms demonstration to date, and in 1983 CIR President Dr. Terry Fitzgerald testified before the Nuclear Regulatory Commission about the dangers to patient care following a potential nuclear disaster.
1983CIR partnered with other labor unions in establishing the Labor Committee Against Apartheid to assist black trade unionists in South Africa to gain rights and representation and to call for an end to apartheid. The CIR House of Delegates also voted that year to suspend CIR business with any institutions with ties to the South African government, and two years later CIR joined a march of thousands protesting apartheid and demanding the release of Nelson Mandela.

Dr. Barry Kistnasamy (center) from the National Medical and Dental Association of South Africa standing with former CIR President Dr. Shelly Falik (right) and former Executive Director John Ronches.

1988As the AIDS crisis grew throughout the 1980s, residents were in the thick of the battles over how best to care for patients. CIR members at University Hospital in Newark successfully lobbied to end the practice of “patient dumping” following sharp increases in the number of AIDS patients being transferred to the hospital from other New Jersey communities, thus putting a strain on the care that Newark doctors were able to provide. Meanwhile, across the country at Highland Hospital in Oakland, residents led a rally to help defeat Proposition 102, a ballot initiative which sought to track and record the names of patients who tested HIV positive and would allow for employers and insurance companies to fire or deny coverage to persons with AIDS. The controversial measure had gained support nearing Election Day, but as residents spoke about the dangers of such a law and vowed their noncompliance should it pass, public favor quickly swung the other way, and Proposition 102 was defeated by a wide margin.

Highland Housestaff in Oakland, CA signed a pledge of non-compliance to demonstrate their opposition to Proposition 102 in 1988.

2000 Sharps injuries and the threat of exposure to blood borne pathogens are still a serious concern for healthcare workers today. But imagine our hospital world without needleless devices! That was the case in most U.S. hospitals before passage of a federal law in 2000 that required hospitals to purchase retractable, blunt and other safe equipment where available and appropriate for the procedure to be performed. That law took years of advocacy to pass and CIR members, joining with SEIU, were at the forefront of the campaign. In the 12 years since, sharps injuries have fallen dramatically.
2008Faced with the problem of San Francisco’s only trauma center and acute-care facility being shut down unless rebuilt to meet seismic standards, residents at San Francisco General Hospital rallied to help pass Proposition A, a ballot initiative seeking to raise $887 million to save the hospital. They wrote letters, phone banked, and knocked on doors to help spread information about the initiative and why it was so important to keep SFGH’s doors open – and safe – for all San Francisco residents. CIR’s efforts paid off on Election Day, as Proposition A passed by a landslide.

ENT residents Drs. Betty Tsai and Matthew Russell turned out to support San Francisco General Hospital.

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From Emergency Medicine Doc to Congressional Candidate

Dr. Raul Ruiz, an emergency medicine doctor, is running for congress in Coachella, CA.

When Dr. Raul Ruiz was 17 years old, he walked from business to business in southern California’s Coachella Valley asking for business owners to contribute to his college education. In exchange for their donations, he signed a contract with community members promising to come back and work as a doctor in his hometown.

Dr. Ruiz made good on his promise. He graduated from UCLA and then became the first Latino to hold three degrees from Harvard: an MD, an MPH and a Masters in Public Policy from Harvard’s Kennedy School of Government. He completed his residency in Emergency Medicine at the University of Pittsburgh before returning to his hometown in 2007.

He now works as an emergency medicine physician at Eisenhower Medical Center in Rancho Mirage, CA and is running for Congress against Rep. Mary Bono Mack, the Republican incumbent who took over the office after her husband, Sonny Bono, died in a skiing accident in 1998.

Born in Mexico and raised in Coachella, CA, where his parents worked as farmworkers, Dr. Ruiz saw the gaping needs in the community from a very young age. “We lived in a trailer for the first few years of my life, and that was considered a luxury – there were a lot of farmworkers who lived out of cardboard boxes to protect them from the heat,” he said.

Today, in the emergency department, he sees the fallout of the country’s economic crisis, in patients who have lost their jobs, insurance, and even their homes.

“A lot of students have come up to me in tears because they’ve had to defer their education to work and pay for their college education and help their family, and a lot of the seniors are really concerned about losing their quality of life and their health care,” Dr. Ruiz said. “And my father told me never to complain unless I’m going to be part of the solution, and I’m running for Congress to stand up for the people of this district, to make sure that they are taken care of.

“We have one of the worst crises in the state of California – not only in the inability of the residents to afford health care, but also in the lack of infrastructure and physicians to take care of them. We have one doctor per 9,000 residents in our underserved areas, and the medically-appropriate ratio according to HHS is one to 2,000 residents,” he said. He founded the Coachella Valley Health Initiative to address the problem, as well as a pre-med mentorship program for students from underserved communities who want to become doctors.

Dr. Ruiz is using his campaign as an opportunity to highlight the importance of Medicare and Medi-Cal (California’s Medicaid system) in his community.

“One of the starkest issues in this election is the ‘Ryan plan’ and the fact that Bono Mack has voted twice to turn Medicare into a coupon-like voucher system which would eliminate the guarantees of Medicare and essentially put the burden of healthcare costs on the shoulders of our seniors.

“The way we’re going to save Medicare is by prioritizing our seniors, not health insurance companies, and by decreasing overall healthcare costs,” Dr. Ruiz said.

He also stressed that caring for patients means addressing the factors that are preventing them from being healthy, from jobs to housing to education.

“First and foremost, we want to take care of our patients, but in order to take care of patients, we need to also address the social context in which they live . . . . That is why we need to get out of our comfort zone and go beyond the exam room and into the community and start addressing those other social determinants of health by being community advocates and taking on leadership positions in the community,” he stressed.

The 113th Congress Could See Increase of Physicians in Office

With health care representing more than 15% of the U.S. gross domestic product and healthcare reform taking center stage in politics, it’s not surprising that more physicians are stepping up to run for elected office. This election season:

  • 28 doctors are running in legislative races—17 incumbents and 11 hopefuls.
  • Among those already holding office, 18 of 20 are Republican. Seven of this year’s challengers are running on Democratic tickets.
  • Physicians in the 112th Congress largely represent districts in the south and west of the U.S.
  • As medical practitioners, they tend to hail from Ob-Gyn and other surgical specialties; there are also three family physicians, one anesthesiologist, one psychiatrist, and one emergency doctor.
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‘Doctors For America’ Educates and Empowers Physicians on the Affordable Care Act

Dr. Vivek Murthy

CIR leaders have teamed up with Doctors for America (DFA) to hold teach-ins on the Affordable Care Act in New York, New Jersey, and California. Doctors for America is a grassroots organization of 15,000 physicians in all 50 states that brings doctors together to influence health policy at the state and federal level. CIR spoke with Dr. Vivek Murthy, an internal medicine physician at Brigham and Women’s Hospital in Boston, Massachusetts, and president and co-founder of Doctors for America, about why 2012 is a critical time for physicians to get active.

Why is 2012 such a pivotal year?

This is a critical year because the fate of health reform will be impacted by the outcome of the elections. Right now we have a situation where there are many politicians who are trying to tear down parts of the Affordable Care Act, but there also are other politicians who don’t want to talk about healthcare. Our goal is to get them to talk about health care, to stand behind implementation of the Affordable Care Act [and] to work on further measures that we’re going to need to make sure that we get to that ultimate goal—a system where everyone has access to quality and affordable care.

What are the goals of the One Million Campaign?

The One Million Campaign is our campaign to bring information about the Affordable Care Act to over one million people during 2012. We’re doing this because there’s a lot of confusion about health reform, what it is and what it isn’t, and physicians have a particular asset when it comes to their ability to communicate to the public. They have credibility, [and] they’re trusted by the public on issues related to health care. It’s our opportunity to get out there, to help people understand what we need to be fighting for. And it’s also our opportunity to find each other, to build a community of physician advocates who can make a real impact on the political process as well as on shaping policy.

Do you have any advice for physicians who are not involved in politics or advocacy on where they can begin?

There are challenges to physicians getting involved in advocacy. Physicians are busy. They’re not just taking care of patients 9 to 5; they’re often working well beyond those hours. Getting involved can start with something as simple as educating yourself about health reform law. Another easy way to get involved is to look for activities in your home organization – whether that’s a subspecialty society or an advocacy organization like Doctors for America or the Committee of Interns and Residents. Whether it’s something as small as signing a petition or something as large as organizing physicians in your community, every bit of advocacy from physicians helps. We’re going to need the collective power of thousands of physician voices if we’re going to see health reform through, and especially for the next stages of reform that go beyond the ACA.

For more information on Doctors For America, visit their website at http://www.drsforamerica.org/

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CIR Members Educate Med Students on Advocacy During Residency

CIR partnered with the Latino Medical Student Association and the California Health Professional Student Alliance to host “Residents as Agents of Change” on March 13, 2012 at the University of California, Irvine.

UCI’s third- and fourth-year medical students and resident physicians gathered to hear a panel of five CIR members from LAC+USC Medical Center and Harbor-UCLA discuss their roles as physician advocates both inside and outside their hospitals. The panelists discussed bargaining directly with

LA County administrators over wages, benefits and working conditions; they also illustrated how participating in monthly labor-management meetings with top tier hospital administrators helped them to problem solve and innovate.

From supporting policies that increase healthcare access to backing measures that raise funds for equipment and facilities, CIR members highlighted initiatives that resulted in positive changes for their patients and their hospitals. Dr. Daman Samrao, LAC+USC pathology resident, talked about her role as the 2011 LAC-USC Patient Care Fund Co-Chair. For more than 30 years, resident representatives have used the fund to help fill the gap between scarce county resources and the needs of patients. Through the $1.2 million annual fund, housestaff have been able to purchase equipment and support innovative approaches to patient care.

The CIR leaders also shared how they have been able to foster a culture of activism within the medical community. It was importatn to connect decisions on Capitol Hill to impacts on patient care. They highlighted legislative advocacy for safe staffing levels and lobbying efforts to urge U.S.

Senators and Representatives to pass healthcare reform.

Residents felt it was a good step toward cultivating the next generation of physician advocates working to enhance patient care, influence policy and improve resident well-being.

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Residents Make an Impact through Housestaff Safety Councils

You guys can’t imagine how many unnecessary transfusions patients get,” said Dr. Say Salomon, an internal medicine resident at Woodhull Hospital in Brooklyn. “Transfusing blood is not a good thing. If you asked doctors if they would rather have a blood transfusion or an alternative means to get treatment, most of us would choose to get the alternative instead of blood, so why give our patients what we know might be harmful?”

That’s the question being asked by the Housestaff Safety Council as they tackle the issue of transfusion safety. Are there viable alternatives to blood transfusion, and do residents fully understand those options in order to lower the risk? The HSC is working to ensure that the answer is “yes.”

Woodhull’s Housestaff Safety Council is one in a growing trend among New York City HHC hospitals as residents take strides to improve patient safety and identify breakdowns in the system of care. Residents are on the hospital’s front lines, and many are working to make their voices heard in the ever-present debates over how to enhance care, safety and efficiency.

Dr. Rafael Hernandez, a former CIR Regional Vice President and internal medicine resident at Woodhull, helped initiate Woodhull’s Housestaff Safety Council when he and his colleagues decided that residents needed to have a say in the improvement of patient care.

“It’s really good for the residents, the patients, the hospital,” Dr. Hernandez said. “The administration sees us as allies. They listen to us.”
Woodhull’s Housestaff Safety Council is made up of residents, program directors, patient safety officers, and GME representatives all committed to interdepartmental cooperation towards increased patient safety. For projects such as Project RED (Re-engineered Discharge), an effort to lower readmission rates for patients with heart disease, this cooperation is key.

“Pharmacists know more about medication,” said Dr. Salomon. “Case managers know more about socio-economic factors. Nurses . . . tend to see the patient at the bedside more than we do. Everybody’s involved.” That involvement includes tracking readmission rates, educating patients on heart disease, and scheduling immediate follow-up appointments post-discharge.

“It’s not fair for our patients and our hospitals for us to close our eyes,” said Dr. Hernandez, noting that residents have knowledge of what goes on in their hospitals, ideas for new policies, and the commitment to make changes happen.

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Medical Students Train to be Physician Leaders

CIR’s work with medical student organizations continues to expand. Here are some highlights of leadershipbuilding activities that medical students have engaged in over the past year:

  • The American Medical Student Association’s (AMSA) Empowering Future Physicians’ conferences featured collaborations with CIR to train medical students in grassroots organizing skills and on the importance of addressing disruptive behavior from professionals for improving patient safety.
  • CIR delegate Dr. Elizabeth Homan Sandoval from Jackson Memorial Hospital led an advocacy workshop at last year’s Latino Medical Student Association (LMSA) national
    conference. CIR has also been invited to speak on Residency Life and Advocacy at this year’s SNMA national conference.
  • Following an official endorsement of the Occupy Wall Street movement, AMSA organized a demonstration of health professional students and practitioners in New York City who spoke out to promote health equity. Their voices were joined by virtual supporters from around the country, successfully taking a stand with the 99%.
  • Representatives from AMSA, LMSA, Student National Medical Association (SNMA), and Asian Pacific American Medical Student Association (APAMSA) attended the 2011 CIR National Convention.

Introducing Our New Medical Student Page
Medical students can find additional information, including resources, educational materials, residency advice and the popular video series “Ask a Resident” on the new med student page.
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