Staff memo gets M&M message to wider audience
Staff memo gets M&M message to wider audience
Below is a typical M&M Monday Memo from Cedars Sinai Medical Center in Los Angeles. It serves two purposes. It is the moderator’s summary about the previous week’s conference. It is narrative and addresses issues raised at the conference.
It also is used as a vehicle for extending the discussions at the conference through the use of Q/A e-mails:
M&M Monday Memo for Dec. 3, 2001 Comments, Observations and Insights from the Surgical Morbidity and Mortality Conference at the Cedars-Sinai Medical CenterAfter Thursday’s conference, my mail covered the spectrum of the surgical literature from the bound, hallowed pages of The Journal of the American College of Surgeons to the folded tabloid pages of General Surgery News.
Both publications had central articles on many issues surrounding our weekly conference. One, by Dr. William Silen writing in the Journal of the American College of Surgeons, is a scathing assessment of current surgical education, leading to the conclusion that "current trainees are the recipients of an extremely bad educational experience."
The other was by Dr. Barry McKernan writing in General Surgery News. Dr. McKernan calls for a "new" educational model that would allow questioning, develop independent thinking, develop an ethic of cooperation, remain flexible, welcome change and focus on relevancy to practice.
Our conference allows questioning, develops independent thinking among our residents, develops a spirit of attending/resident cooperation, is flexible and focuses on issues relevant to practice. I will invite both Dr. Silen and Dr. McKernan to one of our meetings, because I think we have this "new" educational model of Dr. McKernan that can reverse the disheartening trends outlined by Dr. Silen.
Now to the e-mails. I am sorry that I cannot answer each e-mail received. An attending surgeon writes: "The presentation on myocardial dysfunction was a bit peripheral to the case. Do we have to discuss myocardial depression after a GSW as a surgical complication?"
The M&M moderator responds: The discussion of this case was among the most enlightening we have had at our conference. Keep in mind that our profession is grounded in basic physiology. Although I questioned the categorization of this case, there was no question that the issue was worth discussing. The resident had spent quite a bit of time in preparing what most attendees thought was a good review of this emerging concept.
An attending surgeon wrote: "I did not understand the point made about approaching the duodenum laterally in the fistula case."
The M&M moderator responds: The surgeon who made this comment is an "anatomic strategist." If the anterior approach to the abdomen was difficult, the speaker recommended a retroperitoneal approach, much like the retro-peritoneal approach to an abdominal aortic aneurysm.
An attending surgeon wrote: "Are the residents aware of the department of medical photography? The description of the abdomen in the fistula case, while I am sure it was accurate, was tough to envision."
The M&M moderator responds: Photodocumentation would have made the case presentation more understandable. The resident staff will be reminded of the availability of this service.
Reminder: The second M&M Matrix examination will be given on Thursday, Dec. 13 at 0715 hrs. All M&M attendees are invited. n
EMTALA audio conference
The conference will outline a new report that puts a national spotlight on inadequate emergency department (ED) on-call coverage. There is a growing trend of specialists refusing to take call for the ED, partly due to increased liability risks for medical malpractice and violations of EMTALA. If you don't take steps to ensure appropriate on-call coverage for your ED, you're at risk for violations and adverse outcomes. This program also will update you on any legislative efforts to compel managed care plans to reimburse hospitals for EMTALA-related services.
Each participant can earn FREE CE or CME for one low facility fee. Invite as many participants as you wish to listen to the EMTALA Update 2002 audio conference for just $249 for AHC subscribers and $299 for nonsubscribers, and each participant will have the opportunity to earn 1 nursing contact hour or 1 AMA Category 1 CME credit. For more information, or to register, call American Health Consultants' customer service department at (800) 688-2421 or (404) 262-5476, go on-line at www.ahcpub.com, or e-mail [email protected].
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