GRADUATE MEDICAL EDUCATION COMMITTEE
CC 3
Greenville Health System
8:00 AM – 10:00 AM, Thursday, 3/26/2015
GMEC Responsibilities Legend
AO- Accreditation Oversight of Programs
C&E- Curriculum and Evaluation
Minutes
ATTENDANCE:
GME Admin:
House Staff:
Family Medicine:
Sports Medicine:
Surgery:
MIS:
Colorectal:
Vascular
Internal Medicine:
Med/Peds:
OB/GYN:
Ortho:
OSM/Total Joint:
Peds:
Dev Peds:
Psychiatry:
Child Psych.:
Emergency:
Quality:
Education Assessment:
Academic Develop:
Guests:
☒Edward W. Bray III, MD
☒Laura Copeland, MD
☒Vincent Green, MD
☒Irfan Asif, MD
☒Dane Smith
☒Alfredo Carbonell, DO
☐Jay Crockett, MD
☒Chris Carsten, MD
☐J Michael Fuller, MD
☐Russ Kolarik, MD
☒Sharon Keiser
☐Scott Porter, MD
☐Richard Hawkins, MD
☒Kerry Sease, MD
☒Desmond Kelly, MD
☒Julius Earle, MD
☐Kenneth Rogers, MD
☒Camiron Pfennig, MD
☐Robert Mobley Jr, MD
☒Ryan Otto,
☐Brenda Thames
☒Latonya Garrett
☒Catherine Garner
☒Ann Griffith
☐Shannon Burgess, MD
COM- Communication with Medical Staff
☒Derek Payne
☐Richard Gurich, MD
☐Franklin Sease, MD
☐David Cull, MD
C/PD- Communication w/Program Directors
DH - Duty Hours & Related Issues
IA Mgmt- Institutional Accreditation Mgmt.
Inno- Innovative Projects/Experimentation
IRP- Internal Review Process & Reporting
PC- Program Changes prior to ACGME
PQ- Patient Safety & Quality
☐Mark Call, MD
☐William Schmidt, MD
☒Jeffrey Elder, MD
☐Kyle Jeray, MD
☐Brian Burnikel, MD
☐Jennifer Hudson, MD
☐John Williams, MD
☐Ben Griffeth, MD
☐Peter Tilkemeier, MD
R&C- Reductions & Closures
RC/B- Resident Compensation/Benefits
☐Thomas Wheeler III, MD
RS- Resident Supervision
R Stats- Resident Status
☐Jon Lucas, MD
VI- Vendor Interactions
CLE- Clinical Learning Environment
☐Melissa Janse, MD
☐Greg Hawkins
☒Rob Morgan, MD
☒Don Reichert
☒Megan Reichert
☒Kristen Hauck
DIALOGUE
Welcome & Review Minutes
Dr. Edward Bray
Duty Hours Report Review
Dr. Edward Bray
Dr. Bray called the meeting to order at 8:15 am. January minutes were approved. The
February 26, 2015 meeting was cancelled due to inclement weather.
Dr. Bray introduced and welcomed Dr. Vincent Green who is the interim Program Director
for the Family Medicine Residency.
Dr. Bray reported no issues with the duty hours.
OUTCOME/
ASSIGNMENTS
Minutes were approved
GMEC
CODE
IA Mgmt
AO
C/PD
DH
IA Mgmt
AO
PQ
House Senate Report
Dr. Laura Copeland
Dr. Copeland reported that Ms. Kristen Hauck of Quality and Risk Management spoke to the
House Staff Senate regarding event reporting processes and improvements. In addition, they
discussed House Staff Award nominations. She asked everyone to encourage all house staff
to participate in nomination process.
Event Reporting:
Kristen Hauck
Ms. Hauk, who stated that she has recently replaced Sharon Dunning as Quality and Risk
Management, reported on resident event reporting. Ms. Hauk stated that the trend is up in
reporting 40-50 events a month which is good. In comparison, she adds that the residents
are reporting more than the attending physicians. Ms. Hauk will continue to meet with the
House Senate to address concerns with event reporting such as the lab order concerns.
Ms. Hauk explained that her department is comprised of 4 people that have work list
(certain areas or locations). Ms. Hauk stated in order to receive reports you have to be
added as a physician manager, ancillary managers, or a consult. Some physicians have
requested to be notified only if the event has a high rating. Ms. Hauk plans to send all
program directors access to look at event reporting and work with them to ensure they are
receiving appropriate feedback.
Dr. Sease and Dr. Keiser report that they are not able to see events reported for residents.
Ms. Hauk stated that the reports could not be assigned by reporter but by the department
as a consult.
Dr. Earle stated that the residents are discouraged from reporting because they never get
any feedback to support reporting. Ms. Hauk stated that all events are reviewed by their
office and they can work toward providing supportive feedback to residents.
Dr. Smith asked if it is realistic to expect feedback from the 12,000 yearly reports? Ms.
Hauk reported that this is a requirement of Quality and Risk Management and that they
already have databases that can be shared.
Dr. Bray stated that a number of programs have received letters for continued ACGME
accreditation. However, he added that the Colorectal Surgery Program was denied approval
by ACGME. The denial letter stated that there was concern regarding faculty research
studies and/or publications. Dr. Bray added that there were five pages of citations that
read as if the program was already in place. Dr. Bray reported that the program may reapply after two years they will not have to address all of the citations issued. Dr. Smith
stated that they are planning to re-apply sooner than in two years.
ACGME Communications
Dr. Edward Bray
Completed Accreditations:
Ortho Surgery
Ortho SM
Pediatric Medicine
DV Peds.
Internal Med
IA Mgmt
AO
C/PD
Ms. Hauk will be
provided a list of
program directors that
coincide with their
programs from the
GME office.
DH
IA Mgmt
AO
PQ
Inno
Colorectal Surgery will
address citations and
re-apply for ACGME
accreditation.
IA Mgmt
AO
Gen Surgery
Vascular Surg.
Family Meds
PC Sport Med
Colorectal Surg. (denied)
2
Business in Medicine:
Workshops and Disability
Insurance
Don Reichert
Dr. Bray introduced Don and Megan Reichert of Capital Design Associates, Inc. to speak
about Business in Medicine and Disability Insurance opportunities. Dr. Bray stated that this
program has already been vetted and approved by Human Resources.
Mr. Reichert, President of Capital Design Associates, Inc. introduced his company and
reported the 25 year history and involvement with GHS with approximately $5 million dollars
in fund raising and product services to many physicians, employees and upper
management. He stated that his company has been asked to provide a series of business
workshops as well as a supplemental insurance offer to the residents. Mr. Reichert
explained the disability insurance option for residents offered via Standard Insurance
Company based in Portland, Oregon. He stated that the program is already being offered
at USC-Columbia and Wake Forrest.
Mr. Reichert provided an information booklet explaining the science, benefits and major
brand market comparison of the supplemental disability program such as:
1. Guaranteed Standard Issue
2. Non-cancellable and guaranteed renewable (rates never changes)
3. Own Occupation Specialty
4. It is a unisex policy no 40% premium increase for women
5. Superior product as it relates to pricing
6. Senior residents have 62 days after graduation to participate
7. There has to be 15% participation/enrollment for the option to be available to
maintain the low price
Meagan Reichert stated that she would be the contact person for this product and will
facilitate all resident enrollments of the disability option and the workshops. She reported
that they have already scheduled the Business in Medicine workshops for April and May.
She asked that the supplemental insurance departmental meetings take place prior to the
workshops to ensure the best possible participation. Ms. Reichert stated that the informative
meetings would only require about 15 minutes to explore the opportunity. Ms. Reichert
provided an electronic business card via text (89800 Megan) and all of her contact
information will populate.
Dr. Carbonell questioned the history of Standard Insurance Company and its’ stability? Mr.
Reichert answered that the company has been in business for a long time. It is as wellknown and as large as your major brands on the west coast carrier that specializes in the
medical field.
Dr. Sease asked if pricing sheets will be made available during the individual meetings with
the residents? Mr. Reichert answered yes, but there are slightly different ratings for different
specialties.
Ann Griffith stated that following dates are available for the Business in Medicine
Workshops also being provided by Capital Design Associates, Inc. and asked that the
program directors choose from the following dates:
April- 15th, 17th, 22nd or 24th (no evening session on 22nd)
Topic: A Doctor’s Lament: Why At This Stage Of My Career Am I Saving More, Working
Longer And Retiring On A Lower Budget.
May- 13th, 15th, 20th, or 22nd
Physician Financial Independence: A Best/Worst Case Scenario
Program Directors will
choose times for their
residents to attend the
Business in Medicine
workshops and
Supplemental Insurance
meetings.
IA Mgmt
AO
C&E
Inno
C/PD
RC/B
3
Business in Medicine:
Workshops and Disability
Insurance- Cont’d.
Don Reichert
Megan Reichert
Initial Assessments:
Dr. Rob Morgan
Dr. Pfennig disclosed that she offered this kind of supplemental insurance coverage to
residents before and that the feedback was positive.
Dr. Asif questioned about the workshops that are being offered discuss life afterwards,
planning, 401k etc.? Dr. Bray answered that all topics are a part of the curriculum and that
the workshops are free of charge and sponsored by Capital Design Associates, Inc.
Dr. Sease asked if these workshops will replace the current BMI lessons? Ann Griffith
answered yes. Ms. Griffith explained that there is a sub-committee working on curriculum
improvement for next year.
There were no further comments or questions.
Dr. Morgan reported results of the new resident simulation orientation survey and the focus
group facilitated a few months. This information was used to refine the SIMS Orientation.
Dr. Morgan reported that the following results:
Team Steps and Breaking Bad News was helpful. Residents would like more of this
training. Getting other professionals involved in Procedural Time Out training would provide
familiarity with unit staff. The IPASS simulation was not effective. Therefore, the generic
handoff simulation been eliminated; but, Ms. Griffith reminded us that transitions of care is
a CLER focus area that the CLER Sub-committee will require for our new residents.
Residents want more Procedural Skills. Kit familiarity was identified as a need and we plan
for an exhibit show and tale for this request. Residents suggested better guidance on the
AIDET simulation exercise. Residents requested simulation activity regarding Clinical Steps
for Death Pronouncement. For the combined Med School/GME lunch the residents
requested that tables be set up by specialty so they can meet those interested in their
specific specialty area. As a result of last year’s ACLS needs and the unsuccessful code
exercise, mock code simulation stations for ACLS will be added. We are working as an
organization to improve code training.
Dr. Morgan revealed the proposed 2015 SIMS
Orientation schedule:
Team Stepps
Sterile Gown and Gloves
Co-Team Practice
Aidet Procedural Time Out/ Death Pronouncement
Rapid Cycle
This schedule will require 4-6 faculty in the morning and in the afternoon. Dr. Morgan
stated that these trainings could be used as a baseline for various resident milestones.
As the ER reforms ACLS/PALS training will take it on in house from now on. Ms. Griffith
stated that with the new three-day schedule and shortened orientation time that some of
the Heart Association trainings may need to be completed after official start.
Program Directors will
choose times for their
residents to attend the
Business in Medicine
workshops and
Supplemental Insurance
meetings.
IA Mgmt
AO
C&E
Inno
C/PD
RC/B
IA Mgmt
AO
C&E
Inno
C/PD
A sub-committee will
review the need for a
1-2 day Orientation for
sub-specialty
fellowships.
Dr. Bray added that the process of Orientation has been shortened to just one week. No
large breakfast will be provided; he suggested departmental breakfast should be done so
the residents can facilitate important staff introductions (i.e. Vice Chair, Chairman and
Coordinators within their programs).
Dr. Carsten reported that Surgery Fellowships and Sub-Specialty start dates will move to
August 1st for next year. Dr. Bray added as more fellowships and sub-specialty programs
are added to GMEC that will start later we may have an additional two day Orientation.
4
Quality Interactions:
Ann Griffith
Ms. Griffith reported that Kinneil Coltman, Chief Executive Diversity Officer, who presented to
GMEC in January the new computer-based training on-line (CBT) for diversity and cross
cultural care, is willing to cover half of the cost associated with the program. Quality
Interactions will meet our traning needs regarding disparity CLER foci. Ms. Griffith reported
that additional reference materials and usage stats were sent out to the directors. Ms
Griffith requested that the Program Directors advise regarding whether or not to include this
training curriculum in the budget for 2015-16.
Dr. Kerry Sease motioned to approve the utilization of the program. Dr. Desmond Kelly 2 nd
the motion.
Academic Council Update
Derek Payne
Mr. Payne reported that last week’s Academic Council meeting was short. Mr. Payne
reported that an academic health center advisory committee has been established. The
GHS Research infrasture has begun processes for clinical trials management. Budget
due by April 6th. Dr. Asif asked about branding with the inclusion of the partnering
Universities and the Hospital? Mr. Payne stated that branding is an issue that is still
being addressed.
CLER Moment: Roadmap to
Milestones Tracking and
Spider-Gram Reporting
Dr. Kerry Sease
Dr. Sease shared how to track their milestones and convert evaluations in New
Innovations using the Spider-Gram. Dr. Sease began by illustrating how the program
worked via web interface. She stated that the program took all of our rotation
evaluations and converted them to a milestone CCC documents. New Innovations
reporting provides various evaluation assessments and the Program Director and/or
CCC can comment regarding the resident’s performance. New Innovations also provides
a base line for each resident with comparison to peers. Dr. Sease stated that she met
with all rotation directors and they all determined what milestones to utilize during
each rotation. Currently, the only negative is that a peer report cannot be pulled but
New Innovations is working on that improvement. Because the New Innovations site
was recently updated and the web design had changed, Dr. Sease extended an offer
to re-visit the processes with the Program Directors after she had familiarized herself
to the new changes within the software.
Dr. Garner, Executive Director of Nursing Practice and Academics at GHS announced
that various nurse quality circles are being implemented within all GHS units. The
quality circle teams have created a survival kit on every unit that will introduce new
residents to the unit and to where supplies are located. The unit teams are asking
that the residents stop by the nurse manager and get a 5-10 minute orientation to
the unit to ensure quality and safety. In addition, Dr. Garner stated that they have
reviewed patient satisfaction data to find that there is a fair amount of dissatisfaction
with physician communication. Some units have begun using interdisciplinary rounding
where the discharge primary nurse is involved and hears the discharge instructions
because the patient doesn’t hear pending labs or other specific instructions. This was
piloted in Greer and satisfaction increased from 74% to 90%. This interdiscioplinary
process has cut physician calls to clarify orders. Dr. Garner asked that residents check
in with nurse managers for their 5-10 minute orientation when assigned to a new area.
Unit Orientations:
Catherine Garner, PhD
The motion to utilize
the Quality Interactions
CBT program for
diversity and cross
cultural care passed
with no objections.
IA Mgmt
AO
C&E
Inno
IA Mgmt
AO
C&E
Dr. Sease to present
milestone tracking at a
later GMEC
IA Mgmt
AO
C&E
Inno
Residents to check in
with nurse managers
for 5-10 minute unit
orientation when
assigned to a new
area
IA Mgmt
AO
C&E
5
GME Expansion Approvals:
Dr. Edward Bray
Dates to Remember
Dr. Edward Bray
Other Business
Dr. Edward Bray
Dr. Bray reported that Joint Pediatric Genetics and Maternal-Fetal Medicine (MFM)
Fellowship have been approved by the Academic Council. He stated that GMEC needed
to vote for final approval. Dr. Earle motioned to approve the Joint Pediatric Genetic
Residency. Dr. Asif seconded the motion to approve.
Dr. Keiser motioned to approve MFM Fellowship. Dr. Smith seconded the motion to
approve MFM Fellowship.
GMEC approved both programs with no objections.
Dr. Bray praised the House Staff for good participation in the 2015 Employee Opinion
Survey that took place, March 9th - March 23rd.
Ramage Award Deadline - Wednesday, April 15th
AHME Institute National Meeting: May 13-15, 2015
2015 SC AHEC Chief Residents’ Seminar and Resident Scholarship Symposium, Myrtle
Beach June 7th-8th
Resident Graduation June 5th at 4 p. m. - Gunter Theatre; Reception at the Certus Loft
New Resident Orientation Start Date June 24th – 26th ; Wrap up on June 29th a.m.
There being no further business, the meeting adjourned at 9:45 AM.
Next Meeting:
4/23/2015; 8:00 AM in CC3.
IA Mgmt
AO
PC
C/PD
AO
IA Mgmt
Dr. Bray inquired about the Match reporting they only had one categorical position that did
not fill in Family Medicine but filled through SOAP.
He adds that there were two surgical preliminary positions that also filled. There were some
issues with SOAP this year that generated a lot of unwanted emails.
Dr. Sease raised a question concerning Epic reserving all conference room spaces for next
year. Dr. Sease asked for clarification and direction regarding the rumor of no GME training
locations for January, February, and March 2016. Derek Payne stated that there is no
need to panic; however, he and Dr. Youkey are working on space concerns and how these
space needs will be addressed for the first of January. Mr. Payne asked that the Program
Directors give him a couple of weeks to find solutions regarding EPIC take over of the
conference facility.
Adjourn
Dr. Edward Bray
GMEC voted for final
approval of the
Maternal-Fetal
Fellowship and Joint
Pediatric Genetic
Residency programs
C/PD
AO
IA Mgmt
Derek Payne will report
back to GMEC how
Epic Trainings will
affect classrooms and
conference room
spaces.
AO
IA Mgmt
C/PD
6