Mayo Clinic office visit. Patient safety. An interview with Prathibha Varkey, M.D., M.P.H.
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Biomedical subjects
Publications and source records attributed to Prathibha Varkey.
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Telemedicine combines telecommunication technology and medicine to increase access to health care services for patients living in remote areas and enhance the efficiency of delivering that care. This article describes the results of a Mayo Clinic pilot study on the use of telemedicine in an occupational medicine clinic for Mayo Clinic employees and their dependents. The study involved 21 patients who came for initial evaluations for work-related problems or injuries, follow-up visits, visits for acute problems such as low-back pain, and periodic health evaluations. It found that patients and providers were comfortable with the technology after a short training session and satisfied with the outcomes of the visits. More rigorous research evaluating the applications of telemedicine in occupational health care is needed.
OBJECTIVES: The objective of this study was to evaluate the effectiveness of a modified aging game to enhance medical students' attitudes toward caring for elderly patients, enhance empathy for elderly patients, and improve general attitudes toward the elderly. DESIGN: Preintervention and postintervention study PARTICIPANTS AND SETTING: All 84 students from 2 first-year medical school classes INTERVENTION: The aging game takes place over a period of 3 hours with a group of 10 to 12 students and 5 to 6 facilitators, and includes experiential learning about polypharmacy, medication cost, loss of functional status, semi-independent living, and living in a long-term care facility. MEASUREMENTS: Scores obtained through a modified Maxwell and Sullivan questionnaire, and the Aging Semantic Differential (ASD). RESULTS: There was a statistically significant improvement in 6 of the 8 attitudes toward caring for elderly and a statistically significant increase in empathy towards elderly patients following the aging game. There was a statistically significant change on 23 out of 32 ASD questions. There was no evidence of differences in the scores from pre-course to post-course by gender age group, interest in Family/Internal Medicine, or prior geriatric experience. Following the game, 77 (93%) of the students said they would take the course if not mandatory (P = .0001). A majority stated the aging game added significantly (61.5%) or moderately (37.3%) to their knowledge and skills in patient care for the elderly. CONCLUSION: A simulation experience like the aging game is an effective method of increasing the empathy and attitudes toward caring for the elderly early in the medical school curriculum. Longitudinal assessment of the effect of the aging game in maintaining the positive effect on empathy and attitudes toward caring for the elderly and especially in clinical practice needs to be done.
Mayo Clinic has a long-standing reputation as a leader in the basic and clinical sciences. However, there is little in the published literature about Mayo Clinic's contributions to the delivery of health care services. This article is an overview of what Mayo brought to health care delivery between the 1860s and the 1980s, highlighting some of the lesser-known innovations that have influenced health care delivery on a national and international level such as the development of group practice and medical specialties, the creation of medical records, the use of allied health care providers, and facility design.
The events surrounding September 11, 2001, and its aftermath have compelled the public health and medical community to face the hitherto unfamiliar reality of bioterrorism. Physicians and public health personnel are frontline soldiers in this new form of warfare. This article provides a general overview of the pathophysiology, clinical presentation, diagnosis, and management of patients infected with the 6 highest priority agents that could potentially be used in bioterrorism. The diseases discussed include anthrax, smallpox, tularemia, plague, botulism, and viral hemorrhagic fevers. Despite the unpredictable nature of bioterrorism, disaster preparedness and knowledge of essential diagnostic and epidemiological principles can contribute substantially toward combating this new threat.
Seven learners, including 2 preventive medicine fellows, 2 family medicine residents, 1 internal medicine resident, and 2 master's-level nursing students participated in an experiential 4-week quality improvement rotation at a major academic medical center. Together they worked on a quality improvement project that resulted in enhanced medication reconciliation in a preventive medicine clinic. Learner knowledge measured on the QI Knowledge Application Tool increased from an average of 2.33 before the start of the rotation to 3.43 (P = .043) by the end of the rotation. At the conclusion, all learners said they were confident or very confident that they could make a change to improve health care in a local setting. Although this pilot supports the feasibility and potential benefits of interdisciplinary quality improvement education, further research is necessary to explore strategies to implement the same on a larger scale, and to examine the impact on patient outcomes.
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On May 6, 1998, the Olmsted County Public Health Department initiated an investigation into an outbreak of diarrheal illness that had occurred among people who swam frequently at a local swimming pool. Interviews of swimmers and microbiological testing of stool samples and swimming pool filter material were conducted to determine the source of the outbreak. Twenty-six of 206 swimmers interviewed had illnesses that met the case definition. The most common symptoms were diarrhea (100 percent), abdominal cramps (81 percent), and nausea (77 percent). The median duration of symptoms was nine days. Four cases of cryptosporidiosis were confirmed by stool analysis. The outbreak was found to be associated with swimming at the pool. Public awareness-including an understanding that recreational water facilities should be avoided during diarrheal illness-and proper pool hygiene are vital in preventing cryptosporidiosis outbreaks. Health care providers also must consider testing specifically for cryptosporidiosis when a patient presents with persistent diarrhea.