Karen M Moody, Maria Chang Swartz, Zachary Gresham, Martha Askins, Laura Cahalan, Christine Geistkemper, Amy Heaton, Ruitao Lin, Melissa Melo, Alakh Rajan, Madeline Smith, Priti Tewari, Keyana Williams, Cheng-Han Yang, Rhonda Robert
{"title":"A Virtual Wellness Program to Enhance Well-being for Pediatric Oncology Staff during the COVID-19 Pandemic.","authors":"Karen M Moody, Maria Chang Swartz, Zachary Gresham, Martha Askins, Laura Cahalan, Christine Geistkemper, Amy Heaton, Ruitao Lin, Melissa Melo, Alakh Rajan, Madeline Smith, Priti Tewari, Keyana Williams, Cheng-Han Yang, Rhonda Robert","doi":"10.52519/ACEQI.25.1.1.a18","DOIUrl":"10.52519/ACEQI.25.1.1.a18","url":null,"abstract":"<p><p>In response to the COVID-19 global health crisis and mandated social isolation, Pediatric leadership at MD Anderson Children's Cancer Hospital was concerned for the psychological impact on its workforce and encouraged wellness programming. A grassroots wellness taskforce was assembled for the Division of Pediatrics. The task force's primary mission was to promote the well-being of clinicians and non-clinical staff members through a broadly accessible, sustainable, and effective virtual wellness program. Guided by the Stanford Model for Professional Fulfillment, a virtual program entitled, \"Weekly Wellness Webex\" for Pediatrics staff was launched. Weekly Wellness Webex is a 1-hour live-streamed program with varied thematic content promoting personal resilience through healthy behaviors and self-care such as mindfulness, nutrition and exercise, and a culture of wellness through games, group art projects, and activities that highlighted diversity and inclusion. The program was evaluated and modified based on data collected from a confidential electronic evaluation program sent to the staff at three separate timepoints over 18 months. We performed descriptive statistical analyses and used manual coding to analyze the free-text qualitative data received from the evaluations. Sixty-nine program sessions and 3 participant evaluations were conducted between March 2020 and September 2021. Of 300 total staff, 114 participated in the wellness program representing 38% of the Division of Pediatrics. In addition, 125 (41.6%) completed a survey. Most participants found the program helpful (84% on the first evaluation and 100% on the 2nd and 3rd evaluations) and 69.4% (95% CI 62.9-75.9%) experienced decreased COVID-19-related distress after attending the program. The mean decrease in distress after participation in the wellness program was 1.67 (SD 2.2) on a 10-point scale. On the quantitative and qualitative analysis, improved personal well-being and increased social connections emerged as the main program benefits. This virtual wellness program successfully decreased COVID-19 related distress and was perceived as helpful to pediatric oncology healthcare staff. Participants of the program endorsed increased social connectivity, improved well-being, and decreased distress. This program was successfully implemented during the pandemic and has been sustained.</p>","PeriodicalId":520864,"journal":{"name":"Advances in cancer education and quality improvement","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acsa M Zavala, Jagtar Singh Heir, Juan P Cata, Lei Feng, Jose M Soliz
{"title":"The Impact of Fellowship Training on Peer-Reviewed Publication Productivity in Academic Anesthesiologists as Evaluated by the h-Index.","authors":"Acsa M Zavala, Jagtar Singh Heir, Juan P Cata, Lei Feng, Jose M Soliz","doi":"10.52519/aceqi.25.1.1.a8","DOIUrl":"10.52519/aceqi.25.1.1.a8","url":null,"abstract":"<p><strong>Background: </strong>The effect of anesthesiology fellowships on scholarly contributions has been minimally studied. In this study we analyzed differences in h-index between fellowship-trained and non-fellowship-trained anesthesiologists, as well as by type of fellowship, academic rank, and years in practice.</p><p><strong>Methods: </strong>All anesthesiologists on staff between September 1, 2021, and August 31, 2022, were included in this study. The variables collected were fellowship training status, h-index, total number of publications, years in practice, academic rank, and years at the institution. For analysis, the anesthesiologists were divided into 2 groups: those with fellowship training and those without.</p><p><strong>Results: </strong>Among 78 anesthesiologists, 40 were not fellowship-trained and 38 were, with 10 types of anesthesiology fellowships identified. The h-index and number of publications did not differ between fellowship-trained and non-fellowship-trained anesthesiologists, and the number of publications per years in practice did not differ by fellowship type. The number of publications per years in practice was higher in the fellowship-trained group than in the non-fellowship-trained group (1.2 ± 1.1 vs. 0.71 ± 0.6; P = .04), as was the number of publications per years in practice at our institution (1.5 ± 1.1 compared with 0.9 ± 0.9; P = .0093).</p><p><strong>Conclusion: </strong>Fellowship training among academic anesthesiologists was not associated with a difference in h-index. However, fellowship training was associated with a higher number of publications per years in practice. Further research could elucidate the usefulness of h-index to support career development and contributions of anesthesiologists in academia.</p>","PeriodicalId":520864,"journal":{"name":"Advances in cancer education and quality improvement","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brittany C Fields, Timothy E Newhook, Heather A Lillemoe, Jessica E Maxwell, Jose M Soliz, Keyuri U Popat, Christina L Roland, Jean-Nicolas Vauthey, Matthew H G Katz, Ching-Wei D Tzeng
{"title":"Persistent Improvement in Opioid Perceptions and Prescribing for Cancer Surgery: 5-Year Follow-Up.","authors":"Brittany C Fields, Timothy E Newhook, Heather A Lillemoe, Jessica E Maxwell, Jose M Soliz, Keyuri U Popat, Christina L Roland, Jean-Nicolas Vauthey, Matthew H G Katz, Ching-Wei D Tzeng","doi":"10.52519/aceqi.25.1.1.a15","DOIUrl":"10.52519/aceqi.25.1.1.a15","url":null,"abstract":"<p><strong>Background and objectives: </strong>We previously reported that implementation of a department-wide opioid education program led to post-education improvements in opioid perceptions and prescription recommendations, with one-month and one-year retention. With ongoing programmatic and quality improvement efforts, we sought to re-evaluate the retention of these improvements five years after initial efforts.</p><p><strong>Methods: </strong>Attending surgeons, clinical fellows, and advanced practice providers were surveyed five years after implementation of a comprehensive, departmental opioid reduction framework in August 2018. This framework initially consisted of dedicated opioid education sessions and retrospective assessment of prescribing practices, and subsequently expanded over time to include prospective quality improvement and implementation studies, as well as integration of opioid stewardship measures into usual clinical care. Providers' perceptions of expected pain scores, opioid requirements, and ideal prescribing habits were assessed with the same survey administered at 1-month (2018) and 1-year post-initial education (2019).</p><p><strong>Results: </strong>Eighty-seven of 162 (53.7%) providers responded to the follow-up survey. More providers expressed strong agreement with the statement, \"After an inpatient procedure, a patient who has not required opioids for 24 hours before discharge should not receive a discharge opioid prescription.\" Significant decreases in the number of opioid pills providers would prescribe at discharge for five sample operations were also observed between 2018-2023. Stepwise decreases in opioid volume prescribed in both inpatient and outpatient settings were reported since the initial 2018 education sessions.</p><p><strong>Conclusions: </strong>Dedicated department-wide opioid education, ongoing quality improvement and prospective evaluation, and integration of opioid stewardship into clinical practice were associated with sustained improvement over five years in perceptions of postoperative pain management and decreased discharge opioid prescription recommendations.</p>","PeriodicalId":520864,"journal":{"name":"Advances in cancer education and quality improvement","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brittany C Fields, Timothy E Newhook, Heather A Lillemoe, Wei Qiao, Jose A Karam, Surena F Matin, Larissa A Meyer, Ching-Wei D Tzeng
{"title":"5x-Multiplier vs 3-Tier Model for Discharge Opioid Prescriptions After Intra-Abdominal Cancer Surgery: Randomized Clinical Trial Protocol.","authors":"Brittany C Fields, Timothy E Newhook, Heather A Lillemoe, Wei Qiao, Jose A Karam, Surena F Matin, Larissa A Meyer, Ching-Wei D Tzeng","doi":"10.52519/aceqi.25.1.1.a19","DOIUrl":"10.52519/aceqi.25.1.1.a19","url":null,"abstract":"<p><strong>Background: </strong>Surgeons provide up to 10% of total opioid prescriptions across all specialties, and more than one-third of surgeon-prescribed medications are opioids. Patient-reported opioid consumption and risk of persistent opioid use beyond the postoperative recovery period correlate with the initial opioid quantity prescribed at discharge. Interventions to reduce postoperative opioid prescribing have demonstrated no adverse effects on pain control or increased need for prescription refill; however, in the absence of standardized prescription protocols, opioid prescribing practices vary widely.</p><p><strong>Objective: </strong>The study objective is to identify the opioid prescribing model that provides the lowest oral morphine equivalents (OME) volume prescribed at discharge and OME consumed in the 14 days after discharge, with no adverse effect on refills and patient quality of life or satisfaction.</p><p><strong>Methods and analysis: </strong>This is a pragmatic single-center, multispecialty, double-arm phase II randomized clinical trial of two discharge opioid prescribing models. All adult (≥18 years) patients who undergo any one of five open abdominal oncologic operations (pancreatectomy, hepatectomy, retroperitoneal sarcoma resection, nephrectomy, or cytoreductive surgery for ovarian cancer) with curative intent and have a planned postoperative inpatient stay of at least 48 hours will be eligible. Patients will be stratified by their managing clinical service and randomized to receive a discharge opioid prescription based on either the 5x-multiplier algorithm or the 3-tier model. The co-primary outcomes are initial discharge OME volume and OME consumption in the 14 days after hospital discharge. Secondary outcomes include rates of patients with zero OME at discharge; rates of refill requests and completions, number of unused or leftover pills, persistent opioid use, and patient-reported quality-of-life metrics at various follow-up times; patient, prescriber, and oncologic factors predictive of persistent opioid use; and patient satisfaction. Each co-primary endpoint will be analyzed using two-sample t-test to compare means and linear regression models to assess differences between the two arms.</p><p><strong>Ethics and dissemination: </strong>This study was approved by the Institutional Review Board of The University of Texas MD Anderson Cancer Center (2023-0818). The study will evaluate the difference in initial discharge OME volume and in 14-day post-discharge OME consumption between two discharge opioid prescribing models. Upon completion of the data collection and analyses, a manuscript describing the study results will be submitted to a peer-reviewed journal for publication and dissemination. Trial Registration Number: NCT06232577.</p>","PeriodicalId":520864,"journal":{"name":"Advances in cancer education and quality improvement","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12201974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}