- College of Medicine Faculty News Internal Medicine Residency Residents
Resident physicians, pharmacists and allied health trainees who care for Central Floridians gathered May 8 at the UCF College of Medicine to share their research into making that care even better.
The event was sponsored by the UCF-HCA Florida Healthcare Internal Medicine residency program, which provides care to patients at the Orlando VA Medical Center and HCA Florida Osceola Hospital. The residency is the inaugural program of the UCF-HCA Florida Health Graduate Medical Education Consortium, which by this summer will be training more than 720 residents and fellows across the state. Quality improvement and research are a key component of that training as UCF, HCA and the VA are committed to creating physicians who are passionate about improving the quality of patient care.
“Today is both a celebration and a recommitment — not just to data and outcomes, but to curiosity, persistence, teamwork and the humility to keep asking, ‘How can we do better?’” said Dr. Abdo Asmar, the College of Medicine faculty member who leads the residency program. The event included poster and oral presentations and plenary remarks on leadership from former VA Secretary Robert McDonald.
QI projects included solutions to a wide range of patient care issues, including foot and wound care for diabetics, better transitions from the hospital to home for those suffering from opioid overdoses, and better ways to empower pharmacists to recognize possible negative drug interactions. “Quality improvement is a priority because it delivers better care to our patients,” said Dr. Shamol Williams, an academic physician at the Orlando VA who organized the event.
Improving Care Through Better Processes
Dr. Danielle Pesavento, a podiatrist, focused her QI project on better ways to care for diabetic foot ulcerations – the leading cause of non-traumatic foot amputations.
Her study found that as patients returned to the VA over time, they saw different physicians who were documenting their wounds in different ways. So providers seeing a patent for the first time might not have sufficient data to determine if the wound was getting worse and required a new course of treatment.
Dr. Pesavento developed standards, trained nurses and worked with VA policies to create a system where photos are taken of the patient’s foot wounds at every visit that include a ruler for scale and other details. The photos also were shared with patients, so they could see their progress and become more dedicated to following treatment protocols.
“Our largest goal is to prevent limb loss,” she said. “Getting patients to wear diabetic shoes or insoles can sometimes be a challenge. But when patients see the pictures of their wound, they become more aware of their condition and are more compliant with recommendations.
The QI forum began with the inaugural internal medicine program and has now expanded to interdisciplinary healthcare specialists. Dr. Faddel Chouman is a resident in the UCF-HCA psychiatry residency that cares for patients at the VA and HCA Florida Osceola Hospital, and will become chief resident of the program this summer. Dr. Chouman said he chose psychiatry because the specialty gives him the opportunity to spend time and talk to patients, to get to know them as people.
His study looked at better ways to care for patients in acute stress and anxiety. He created a system that taught patients how to do diaphragmatic breathing, also known as belly breathing, which reduces blood pressure, slows heart rate and increases relaxation. Teaching the system – both in person and in Zoom sessions at the psychiatric ward, allowed patients to reduce their anti-anxiety medications and help themselves in stressful situations, he said. “It is so impactful to be caring for veterans,” he said. “They – especially the men — often feel they don’t have anyone to talk to. When they can open up to someone it is powerful.”
Speakers at the forum reminded residents that it takes courage to identify areas where clinics and hospitals can improve their care and then take action to address those needs. Timothy Cook, medical director and CEO of the Orlando VA, urged physicians to “run toward the gunfire, walk yourself toward the problem.”
McDonald, who also served as Chairman, President and CEO of Proctor & Gamble, told the young healthcare providers they have a special role to play as medical leaders. “Leadership is not a title,” he said. “It’s a responsibility. All of us, on any given day, the opportunity to affect the left of another person.”
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- HCA Florida Osceola Hospital internal medicine residency Orland VA Medical Center UCF-HCA Graduate Medical Education Consortium