Healthcare Leadership in Quality (HLQ)

Penn Radiology HLQ Track - Alumni

 

Hossein Nejadnik, MD
Class of 2024 

Coulter Cranston, MD
Class of 2024 

Nnamdi Udeh, MD

Class of 2023

Executive Mentor: Friedrich Knollman

Project Title: Optimization of Whole-Body CT Technique for Trauma at PPMC

Cathal O'Leary, MD

Class of 2023

Executive Mentor: Nikhil Mull, MD, Director of Center for Evidence Based Practice

Capstone Mentor: Friedrich Knollmann, MD, PhD, Chair, Department of Medical Imaging at Penn Presbyterian Medical Center

Project Title: Reducing Low Quality CT PE Studies

Nathaniel Linna, MD

Class of 2022

Executive Mentor: David Horowitz, MD: Chief Medical Officer, Clinical Practices of the University of Pennsylvania

Capstone Mentors: Hanna Zafar, MD and Chuck Kahn, MD, MS, FACR

Project Title: Decreasing Inappropriate and Outside of Guideline MSK MR Lumbar Spine Orders

Rupal Parikh, MD

Class of 2022

Executive Mentor: Neil Fishman, MD, Chief Medical Officer, Penn Medicine

Project Title: Virtual Follow-up of Patients with Percutaneous Abscess Drains in Interventional Radiology

Track Highlights:

• Unique opportunity for inter-disciplinary collaboration with peers and leaders across the institution during the 2-year longitudinal curriculum
• Formal training on approach to improving quality and safety in health care using proven QI methodology
• Resident’s specific QI project enables real time implementation of QI methodology and leading and collaborating with a multidisciplinary team

The most valuable part of my HLQ experience thus far has been learning how to navigate the QI methods to be set-up for a successful project. As I implemented the PDSA cycle initially, I learned quickly that my initial project plan was skewed to a problem that no longer existed. I back tracked in curating a new project plan and re-implemented the QI methods learned which engaging feedback from my departmental and executive mentors to pursue a different, but related quality issue with more stakeholder interest.

Gregory Parker, MD

Class of 2022

Executive Mentors: Hanna Zafar, MD and Chuck Kahn, MD, MS, FACR

Project Title: Decreasing Inappropriate and Outside of Guideline MSK MR Lumbar Spine Orders

Yadiel Sanchez-Padilla, MD

Class of 2022

Executive Mentor: TBD

Project Title: TIA Pathway
It is a project that aims to evaluate the use of MRI in the initial evaluation of patients presenting with TIA symptoms in the ED at the Hospital of The University of Pennsylvania. The goal is to see if using an MRI first approach rather than traditional evaluation with CT, will decrease overall LOS, decrease inpatient admissions, and overall decrease imaging utilization. 

Jessica Fried, MD

Class of 2020 (Assistant Professor, Abdominal Imaging and Cross Sectional Interventional Radiology, Department of Radiology, Michigan Medicine)

Executive Mentor: Pat Sullivan, PhD, Chief Quality Officer, Penn Medicine

Project Title: Rapid Oncology MR Access Pathway

Project Description:Thoracic oncology patients are a unique population with a high risk of metastatic disease to the central nervous system, which confers increased morbidity and mortality. These patients frequently present to clinic or by telephone with new symptoms concerning for metastatic disease to the brain or spine; however, it can be difficult or impossible to schedule same-day MRI to rule-out brain or spine metastases, resulting in these patients being referred to the Emergency Department for expedited imaging workup.

The Rapid Oncology MR Access Project involved the creation of a specialized pathway with reserved scanner slots and fit-for-purpose rapid-imaging protocols to provide protected same day imaging access to these high risk patients. The goals of this project were to reduce unnecessary ER visits for these patients presenting with concerning symptoms for CNS metastases and to decrease time to diagnosis for this population who can benefit from early intervention.

After sixteen months of pilot data collection and three PDSA cycles, the pathway has proven successful by these benchmarks without compromising the financial interests or operational efficiency of the Department of Radiology. A sustainability plan has been identified and the Cancer Service Line and Department of Radiology have agreed to expand the availability of this pathway to all Cancer Service Line providers and patients in the Spring/Summer of 2020.

Teresa Martin-Carreras, MD

Class of 2020 (MSK Imager, Orlando Health System)

Executive Mentor: Keith Kasper, Senior Vice President and Chief Financial Officer, Penn Medicine

Project Title: Improved Uniform Communication and Documentation of Adverse Events in CT and MRI

Project Mentor: Hanna M. Zafar, M.D., M.H.S.

Project Description:Prior to the implementation of this project there was no uniform policy for the documentation of contrast-related adverse events in our department. Radiology departments should have a streamlined workflow in place to recognize, treat, and document these events due to the inherent risks of contrast-related extravasations and allergic-like events. This quality improvement project assessed how the development of standardized progress note templates in the electronic medical record (EMR) affected the consistency of radiologist documentation of initial patient evaluation following contrast-related adverse events, with special attention to contrast extravasations and allergic-like reactions.

Shaun McLaughlin, MD, MS

Class of 2021 (Clinical Instructor, Department of Radiology, Division of Interventional Radiology, Geisinger Commonwealth School of Medicine)

Executive Mentor: Neil Ravitz, MBA, Chief Operating Officer, Department of Orthopaedic Surgery, Penn Medicine

Project Title: Development of evidence-based guidelines for bone marrow biopsy requests in IR: A retrospective comparison of the outcomes of 2800 biopsies done at the bedside versus under image guidance

Project Description: At our institution bone marrow (BM) biopsies have traditionally been performed bedside by the Heme/Onc service with local anesthesia. Because this can be technically challenging and painful, particularly in morbidly obese patients, in 2014 the IR service agreed to offer image-guided BM biopsies with sedation for select patients with either an elevated BMI or sedation requirement. This study tracked the utilization of this service from 2014–17. It also compared diagnostic rates between bedside and fluoroscopic guided BM biopsies to define decision criteria for determining which patients might benefit most from image guidance.

Sarah Thomas, MD

Executive Mentor: Dr. Ronald Barg, MD. Executive Director of Clinical Care Associates, Penn Primary Care, Penn Medicine

Project Title: Implementation of ‘Macro Recommendation’ in the Musculoskeletal Division of the Department of Radiology

Track Highlights: The track begins with two weeks of didactics spanning topics from quality improvement to healthcare finance to human factors engineering. Learning from and forming relationships with residents across the health system is an important part of that initial experience.

I have met with my executive mentor several times in person and by phone over this past year. I spent a day shadowing him in his executive role and learned so much about the challenges of ensuring success of numerous primary care clinics across the Delaware Valley. He has given me invaluable advice on my project, career path, and personal challenges as well.

My capstone project involves improving documentation and follow up of incidental findings in musculoskeletal CT and MRI reports. My team will be working to incorporate language into our current reporting structure that allows clear follow up recommendations for incidental lesions and tracking to ensure follow up is completed in an attempt to increase referrer satisfaction and patient outcomes.

Stephanie Wu, MD

Executive Mentor: Phil Okala, Chief Operating Officer for the Philadelphia Region of Penn Medicine

Project Title: Improving the Radiographic Evaluation of Acute Fractures with Musculoskeletal Pain Markers

Project Description: Understanding a patient’s location of focal musculoskeletal (MSK) pain is an important factor in the radiographic evaluation for acute fractures. However, a patient’s clinical symptoms can be difficult to ascertain due to limited clinical information provided or limited time to search the medical record. The goal of this project was to increase the availability of information on a patient’s MSK symptoms through utilization of pain markers (BB skin markers) corresponding to a patient’s area of acute focal pain. An online simulation of cases with and without the pain marker demonstrated that MSK pain markers are associated with statistically significant shorter turnaround times and improved diagnostic accuracy.

Award: Selected as the 13th annual Sridhar Charagundla lecture presentation at the Penn Radiology Pendergrass Research Symposium.

 

Penn Medicine Healthcare Leadership in Quality Track
First Year Core Didactics Schedule

Track members always look forward to an exciting and challenging program schedule and this year is no different.

WEEK 1: Monday	Tuesday	Wednesday	Thursday	Friday
Reading & Movie Day	9:00 - 10:30 Overview of Track	9:00 - 11:00 Healthcare Quality Lee Fleisher	9:00 - 10:30 Impact of COVID-19 Pandemic PJ Brennan	9:00 - 10:00 Corporate IS Infrastructure Michael Restuccia
	10:30 - Noon Quality Improvement Methods Neha Patel	11:00 - Noon  Break	10:30 - 11:30 CPUP Quality and Safety Goals Patti Macolino	10:00 - 11:00 Innovation in Informatics Bill Hanson
		Noon - 2:30 Patient Safety Jen Myers, Justin Ziemba	11:30 - 12:30 Break	11:00 - Noon  Break
			12:30-2:00 Networking & To Err is Human Debrief	Noon - 1:30 Healthcare Informatics and Compliance Christine Vanzandbergen
		2:30 - 3:30 Human Factors in Healthcare Susan Regli		1:30 - 2:30 Data Gathering at Penn Eugene Gitelman
				2:30 - 3:30 Data Science Michael Draugelis
WEEK 2: Monday	Tuesday	Wednesday	Thursday	Friday
9:00 - 10:00 Healthcare Quality Measures Neha Patel	9:00 - 11:00 Healthcare Finance Primer Chad Johnston	8:30 - 4:00 Performance Improvement In Action Training (PIIA) Course Directors: Mike Posencheg Scott Falk Facilitators: Cynthia Line Erin Lightheart Scott Crespy Caitlin Friel Andrew Keser	8:30 - 4:00 Performance Improvement In Action Training (PIIA) Course Directors: Mike Posencheg Scott Falk Facilitators: Cynthia Line Erin Lightheart Scott Crespy Caitlin Friel Andrew Keser	9:00 - 10:30 Leadership Neil Ravitz
10:00 - Noon  Patient Reporting Measures Ilona Lorincz	11:00 - 12:30 The Revenue Cycle Tom McCormick			10:30 - 11:30 Track Resident Networking
Noon - 1:00 Break	12:30 - 1:00 Break			11:30 - 2:00 Debrief Neha Patel and Jia Lapointe
1:00 - 2:00 Ambulatory Performance Programs Ashley Hopkins	1:00 - 2:30 Center for Healthcare Innovation and QI IRB Shivan Mehta
2:00 - 3:00 Population Health David Horowitz	2:30 - 3:30 Innovation Accelerator David Resnick Michael Begley
3:00 - 4:00 Evidence Based QI Nikhil Mull

Penn Medicine Healthcare Leadership in Quality Track
Advanced Didactics Schedule

Monday	Tuesday	Wednesday	Thursday	Friday
	9:00 -10:00 Welcome Neha Patel	9:00 - Noon Advanced Data Measurement April Taylor Erin Lightheart	9:00 - 10:30 Healthcare Finance Chad Johnston	9:00 - 11:00 Risk Mitigation and Disclosure Keah Buck Pat Sullivan
	10:00 - 11:30 Quality Improvement Methods Neha Patel		10:30 - Noon Connected Health Srinath Adusumalli
	11:30 - Noon Capstone Project Report Out			11:00 - 12:00 Capstone Project Report Out
	Noon - 1:00 Break	Noon - 1:00 Break	Noon - 1:00 Break	Noon - 1:00 Break
	1:00 - 2:30 Leadership in Safety Justin Ziemba	12:30 - 1:30 QI Scholarship Jennifer Myers	1:00 - 4:00 Capstone Project Report Out	1:00 - 2:00 Capstone Project Report Out
	2:30 - 4:00 Capstone Project Report Out	2:00 - 4:00 Capstone Project Report Out		2:00 - 3:00 Debrief Neha Patel