Regions Emergency Regions Emergency Medicine Residency Medicine Residency

Retreat Retreat October 27, 2011October 27, 2011

Felix Ankel, MDFelix Ankel, MD

HistoryHistory

Accreditation 1995, 1999, Accreditation 1995, 1999, 2003, 20092003, 2009

108 graduates 1999-108 graduates 1999-presentpresent

138 residents 1996-present138 residents 1996-present

Mission:PAPEEMCEMission:PAPEEMCEProvide and promote excellence in Provide and promote excellence in

emergency medicine care and emergency medicine care and educationeducation

Patient centeredPatient centered Resident focusedResident focused Team orientedTeam oriented TransparencyTransparency ProfessionalismProfessionalism KnowledgeKnowledge SkillsSkills AttitudesAttitudes Core competenciesCore competencies Contribution to specialtyContribution to specialty

108 graduates 1999-108 graduates 1999-presentpresent

69 Minnesota: 15 HealthPartners, 10 EPPA, 9 69 Minnesota: 15 HealthPartners, 10 EPPA, 9 United, 6 Fairview-U, 6 North, 5 Abbott, 5 United, 6 Fairview-U, 6 North, 5 Abbott, 5 HealthEast, 5 Duluth, HealthEast, 5 Duluth, 2 Waconia, Shakopee, Rochester, New Ulm, 2 Waconia, Shakopee, Rochester, New Ulm, Princeton, Park-NicolletPrinceton, Park-Nicollet

38 out of state: 6 SD, 4 IA, 3 WA, 3 CA, 2 ND, 2 NE, 38 out of state: 6 SD, 4 IA, 3 WA, 3 CA, 2 ND, 2 NE, 2 CO, 2 IN, 2 WI, 2 MT, 2 UT, NH, NY, OR, VA, CT, 2 CO, 2 IN, 2 WI, 2 MT, 2 UT, NH, NY, OR, VA, CT, PA, AK, TXPA, AK, TX

16 Academic: 14 Regions, Wishard, Mayo16 Academic: 14 Regions, Wishard, Mayo 14 Hybrid: 7 Fairview-U, 6 North, Mercy-Iowa City14 Hybrid: 7 Fairview-U, 6 North, Mercy-Iowa City 73 Community73 Community 13 Fellows (3 toxicology, 2 critical care, 2 EMS, 13 Fellows (3 toxicology, 2 critical care, 2 EMS,

faculty development, simulation, informatics, faculty development, simulation, informatics, ultrasound, international, quality & pt safety)ultrasound, international, quality & pt safety)

138 residents (1996 - 138 residents (1996 - present)present)

39 medical schools39 medical schools 48 U of M48 U of M 9 UND9 UND 8 Iowa, Mayo8 Iowa, Mayo 7 MCW, USD, 7 MCW, USD, 6 UW, Creighton6 UW, Creighton 2 Nebraska, Loyola, Indiana, Kansas, 2 Nebraska, Loyola, Indiana, Kansas,

Chicago Med School, Colorado, Loma Chicago Med School, Colorado, Loma Linda, SLULinda, SLU

SUNY-Buffalo, Des Moines-COM, Nevada, SUNY-Buffalo, Des Moines-COM, Nevada, Vermont, Penn, Hawaii, East Carolina, Vermont, Penn, Hawaii, East Carolina, Arizona, Utah, Michigan State, SUNY-Arizona, Utah, Michigan State, SUNY-Syracuse, VA-COM, UCSF, Dartmouth, Yale, Syracuse, VA-COM, UCSF, Dartmouth, Yale, Tufts, Cincinnati, Morehouse, Florida, Nova-Tufts, Cincinnati, Morehouse, Florida, Nova-COM, Temple, LSU, UT-HoustonCOM, Temple, LSU, UT-Houston

29 Faculty (13 Different EM 29 Faculty (13 Different EM Residencies)Residencies)

Regions x 14Regions x 14 Henry Ford x 2Henry Ford x 2 Harvard Affiliated Harvard Affiliated

x 2x 2 Illinois x 2Illinois x 2 HCMCHCMC Brooke ArmyBrooke Army

St Vincent’sSt Vincent’s ChristChrist IndianaIndiana Boston Medical Boston Medical

CenterCenter Grand RapidsGrand Rapids MichiganMichigan ResurrectionResurrection

Residency Strategic Plan Residency Strategic Plan 2010-20152010-2015

4/21/0104/21/010

SWOT analysisSWOT analysis Review of strategic plans of department, Review of strategic plans of department,

hospital, IME, and healthplanhospital, IME, and healthplan Outcomes (Outcomes (qualityquality)) Knowledge translation (Knowledge translation (web 2.0web 2.0 and work and work

with librarians)with librarians) Procedural competencyProcedural competency Non-clinical training (Non-clinical training (longitudinal adminlongitudinal admin)) Benchmarks and scorecardsBenchmarks and scorecards Resources (Resources (wellness and resiliencewellness and resilience))

Program review 2011Program review 2011

3 most important aspects of the program3 most important aspects of the program

Strengths of the residencyStrengths of the residency

Areas of focusAreas of focus

What should the residency What should the residency continuecontinue doing? doing?

What should the residency What should the residency stopstop doing? doing?

What should the residency What should the residency startstart doing? doing?

Specific rotation commentsSpecific rotation comments

Other commentsOther comments

2010-20112010-2011 10 interns10 interns New procedural skills labNew procedural skills lab EMS fellow, EM-peds sponsorshipEMS fellow, EM-peds sponsorship Quality, international fellowship approvalQuality, international fellowship approval ROD, MSOD – longitudinal admin ROD, MSOD – longitudinal admin

experienceexperience Night float blockNight float block Hudson selective pilotHudson selective pilot Quality teamsQuality teams Recruitment boomRecruitment boom

2011-20122011-2012 Plastics moves from PGY1 to PGY2Plastics moves from PGY1 to PGY2 Tox moves from PGY2 to PGY1Tox moves from PGY2 to PGY1 Shift schedule moves to 9-hoursShift schedule moves to 9-hours Eliminate single EM resident/pod overnight.Eliminate single EM resident/pod overnight. ROD checklist developmentROD checklist development Quality project refinementQuality project refinement Patient satisfaction reports to residentsPatient satisfaction reports to residents Resident lounge renovationResident lounge renovation Methodist added as community siteMethodist added as community site No overnight intern call on SICU or OrthoNo overnight intern call on SICU or Ortho

ThoughtsThoughts

Caring for patients vs. treating Caring for patients vs. treating patientspatients

Complex Adaptive Systems (CAS), Complex Adaptive Systems (CAS), “Boids”“Boids”

Wisdom of Crowds, James SurowieckiWisdom of Crowds, James Surowiecki Drive, Dan PinkDrive, Dan Pink Edgeware, Brenda ZimmermanEdgeware, Brenda Zimmerman

Questions to considerQuestions to consider Web 2.0Web 2.0

– Consolidate and optimize current on line Consolidate and optimize current on line interactive resourcesinteractive resources

Longitudinal admin experienceLongitudinal admin experience– Determine strengths and areas to tweakDetermine strengths and areas to tweak

QI program designQI program design– Review, discuss progress and recommend Review, discuss progress and recommend

improvementimprovement Wellness and resilienceWellness and resilience

– Develop plan to maintain and improve Develop plan to maintain and improve current wellness and resiliencecurrent wellness and resilience

Questions to considerQuestions to consider