Silent Bias: Challenges, Obstacles, and Strategies for Leadership Development in Academic Medicine-Lessons From Oral Histories of Women Professors at the University of Kansas.

Purpose: Despite dramatic increases in female learners and junior faculty, a significant gap remains in female leadership in academic medicine. To assess challenges and obstacles encountered, strategies for academic success, and lessons learned for leadership development, the authors conducted an in-depth study of women full professors.

Method: The authors used a qualitative oral history approach, interviewing 87% of the cohort of female full professors at one Midwestern medical school in 2013 using a pretested, open-ended, semistructured interview guide.

Improved Knowledge, Attitudes, and Behaviors After Implementation of TeamSTEPPS Training in an Academic Emergency Department: A Pilot Report.

TeamSTEPPS is a validated, formal patient safety curriculum created by the Agency for Healthcare Research and Quality (AHRQ) for the development of high-functioning multidisciplinary teams. TeamSTEPPS was implemented in an academic emergency department (ED), including all ED hospital staff as well as physicians and residents. It was hypothesized that extensive interprofessional education combined with implementation of specific tools would increase knowledge of TeamSTEPPS principles, attitudes, and behaviors.

Reduction of venous thromboembolism (VTE) in hospitalized patients: aligning continuing education with interprofessional team-based quality improvement in an academic medical center.

Problem: Despite clear prophylactic guidelines and national quality emphasis, a minority of hospitalized patients receive appropriate prophylaxis for venous thromboembolism (VTE). Data from the University of Kansas Hospital (KUH) revealed an unacceptably high incidence of VTE.

Approach: The authors aligned continuing education with quality improvement through formation of an interprofessional, multidisciplinary team to develop strategic educational and system operational plans to decrease VTE incidence.

Aligning academic continuing medical education with quality improvement: a model for the 21st century.

The recent health care quality improvement (QI) movement has called for significant changes to the way that health care is delivered and taught in academic medical centers (AMCs). This movement also has affected academic continuing medical education (CME). In January 2011, to better align the CME and QI efforts of AMCs, the Association of American Medical Colleges (AAMC) launched a pilot initiative called Aligning and Educating for Quality (ae4Q).

Aligning clinical compensation with clinical productivity: design and implementation of the financial value unit (FVU) system in an academic department of internal medicine.

A new metric was developed and implemented at the University of Kansas School of Medicine Department of Internal Medicine, the financial value unit (FVU). This metric analyzes faculty clinical compensation compared with clinical work productivity as a transparent means to decrease the physician compensation variability and compensate faculty equitably for clinical work.The FVU is the ratio of individual faculty clinical compensation compared with their total work relative value units (wRVUs) generated divided by Medical Group Management Association (MGMA) salary to wRVUs of a similar MGMA physician.

Millennial health care: change you can believe in.

A millennium is 1,000 years. In little over a decade after the beginning of the new millennium in 2000, remarkable changes have occurred in health-care education and health-care delivery. A new millennial generation of students, trainees, junior faculty, and young practicing physicians has come of age.

Characteristics of quality and patient safety curricula in major teaching hospitals.

The authors recently discovered 2 quality and patient safety curricula for internal medicine and general surgery residents in major teaching hospitals: an infrequent formal curriculum developed by the university and a positive informal curriculum found in the teaching hospital. A hidden curriculum was postulated. These data were gathered through applied qualitative research methodology.

Is there a relationship between high-quality performance in major teaching hospitals and residents' knowledge of quality and patient safety?

Purpose: The relationship of the quality of teaching hospitals' clinical performance to resident education in quality and patient safety is unclear. The authors studied residents' knowledge of these areas in major teaching hospitals with higher- and lower-quality performance rankings. They assessed the presence of formal and informal quality curricula to determine whether programmatic differences exist.

The relationship between evidence-based practices and survival in patients requiring prolonged mechanical ventilation in academic medical centers.

Studies suggest variable adoption of evidence-based practice guidelines. The authors hypothesized that compliance with guidelines for patients requiring mechanical ventilation would vary among academic medical centers and that this variation might be associated with survival. A total of 1463 intensive care unit cases receiving continuous mechanical ventilation for >96 hours were reviewed.

Aligning compensation with education: design and implementation of the Educational Value Unit (EVU) system in an academic internal medicine department.

The authors report the development of a new metric for distributing university funds to support faculty efforts in education in the department of internal medicine at the University of Kansas School of Medicine. In 2003, a committee defined the educational value unit (EVU), which describes and measures the specific types of educational work done by faculty members, such as core education, clinical teaching, and administration of educational programs. The specific work profile of each faculty member was delineated.

Pulmonary small lymphocytic lymphoma (mucosa-associated lymphoid tissue type) associated with pulmonary hyalinizing granuloma.

A case of pulmonary hyalinizing granuloma (PHG) and concomitant low-grade, small lymphocytic lymphoma of the lung is presented. This is the first occurrence of pulmonary lymphoma in patients with PHG ever reported. The infiltrates around a left lower lobe nodule with left pleural effusion and thickening seen on chest CT were histologically proven to be lymphomatous infiltrates of the lung, pleura, and chest wall muscle.

Lenercept (p55 tumor necrosis factor receptor fusion protein) in severe sepsis and early septic shock: a randomized, double-blind, placebo-controlled, multicenter phase III trial with 1,342 patients.

Objective: Phase III study to confirm a trend observed in a previous phase II study showing that a single dose of lenercept, human recombinant p55 tumor necrosis factor receptor-immunoglobulin G1 (TNFR55-IgG1) fusion protein, decreased mortality in patients with severe sepsis or early septic shock.

Design: Multicenter, double-blind, phase III, placebo-controlled, randomized study.

Setting: A total of 108 community and university-affiliated hospitals in the United States (60), Canada (6) and Europe (42).

Nutrition in chronic critical illness.

Nutritional management of patients with respiratory failure can be a model of nutritional management in chronically critically ill patients. This model requires recognition of the differing metabolic states of starvation and hypermetabolism. Starvation can result in malnutrition, with adverse effect on respiratory muscle strength, ventilatory drive, and immune defense mechanisms.

Invasive mechanical ventilation in exacerbations of chronic obstructive pulmonary disease.

Exacerbations of chronic obstructive pulmonary disease are appropriately treated when severe airflow obstruction does not respond to intensive therapy, including, at times, noninvasive mechanical ventilation. Ventilatory strategies include avoidance of the ventilatory complications of dynamic pulmonary hyperinflation with its resultant intrinsic positive end-expiratory pressure, thereby decreasing the risk of hypotension and barotrauma. Initial ventilator settings should include an expiratory flow rate between 8-10 L.

Continuous positive airway pressure: patients' and caregivers' learning needs and barriers to use.

Objective: To identify learning needs and factors related to postdischarge use of continuous positive airway pressure (CPAP) ventilation.

Design: Exploratory descriptive correlational.

Setting: Metropolitan and rural clinics.

Intermittent enteral feeding in mechanically ventilated patients. The effect on gastric pH and gastric cultures.

Objective: To evaluate the effect of intermittent (16 h/d) enteral feeding (IEF) on gastric pH and gastric microbial growth in mechanically ventilated patients.

Design: Prospective, case-controlled study.

Setting: Medical ICU and infectious disease research laboratory in a university hospital.

Acute respiratory failure in chronic obstructive pulmonary disease.

Clinically significant chronic obstructive pulmonary disease is a common and important disorder in the United States. As many as 15 million individuals suffer from chronic obstructive pulmonary disease, many of whom have disease requiring hospital or ICU admission. Acute respiratory failure in patients with chronic obstructive pulmonary disease is one of the most common causes of admission to the ICU for this patient population.

Enteral nutrition in patients with respiratory disease.

Nutritional assessment and management is an important therapeutic modality in patients with respiratory disease. Malnutrition adversely affects respiratory function. Nutritional therapy for the spontaneously breathing patient should include an appropriate diet plus the consideration of nutritional supplements.