Executive Council Minutes (February 21, 2019)

Hi everyone,

Several residents have asked us to publish the minutes of our monthly Executive Council Meetings, which is a great idea. So here are the minutes from last Thursday’s meeting:

1. Interview season wrap up: Rank lists are in. Match Day is March 15. I’ll be vacationing in Europe, but we’ll post the names of the new interns once we have them.
2. Retreats: Being planned for late Spring, one for each class. The mornings will have educational content and the afternoons will have team-building and wellness activities. Contact the Chiefs with ideas and suggestions
3. Butterfly: We recently purchased a Butterfly probe for ultrasound education. The Butterfly is a handheld device which transmits ultrasound images to an iPhone. Dr. Sankey is working on a security system for the probe and phone, which will be housed in the Donaldson resident room. Special thanks to Cathy Gao and Hayley Israel for working with the Butterfly company and to the Boroughs family for providing funding!
4. Program Feedback: The PEC is evaluating the Chiefs, APDs, and Program Director. An online survey is being conducted, and the PEC met with residents last Thursday to solicit feedback. Formal meetings with leadership will be scheduled. Special thanks to the PEC for leading this initiative.
5. APDs: Preliminary feedback from the PEC revealed that many residents don’t know who all the APDs are or what roles they play in the program. The APDs are (in no special order): Seonaid Hay (VA, Wellness, leader of the MAC and Peer mentoring programs), Chris Sankey (Inpatient Education, Hospital Medicine Elective, Advisor to The Beeson Beat), Katie Gielissen (Ambulatory Education, Chair of Clinical Competency Committee), Manisha Juthani-Mehta (liaison to fellowship programs, career development), Alfred Lee (Co-Chair of the PEC). All APDs participate in weekly leadership meetings, serve as resident advisors (to ensure all trainees are meeting milestones required for promotion and graduation), and play key roles in intern recruitment. Additionally, Matt Grant is a core faculty member who advises the Physician Scientists (“short trackers”). The APDs are indispensable to our program’s success.
6. Fellowship and Career Development Nights: Led by Dr. Juthani-Mehta, these two important evenings are coming in the Spring, dates TBD. Fellowship night will be geared towards residents planning to apply to subspecialty fellowships and will include a panel of Program Directors. Career Development Night will be geared towards residents seeking non-fellowship positions, for example in Hospital Medicine, Primary Care, and industry.
7. Ambulatory Education Half Days: We had a frank discussion about concerns raised that some residents are disengaged during educational half-days. Issues included late arrival, frequent cell phone use, and unexcused absences, which understandably distressed visiting faculty who had devoted significant effort towards preparing and delivering educational content. Council members acknowledged that unprofessional behaviors reflect poorly on the program and are out of keeping with our typically high standards and behaviors. They also shared suggestions to alleviate future concerns, including more hand-on learning, inserting more frequent breaks during the half-day, and providing more time to prepare for afternoon clinic. Additional suggestions including asking the PEC to elicit feedback on Educational Half Days to address format, content, and the needs of different groups of learners. Residents are encouraged to provide feedback and/or join Dr. Gielissen’s Ambulatory Education Committee. We will share the professionalism concerns with the residents and anticipate that doing so will suffice to address the issues raised.
8. 28-hour call. Updates were provided on potential options for next year, including the creation of new day-night rotations (which would require adding night teams and moving residents off other rotations, such as electives) vs. changing admitting rules so new admissions stop coming after a set time such as 2AM. We are working with the MICU and Hospitalist leadership on admission rules and plan to pilot new structures soon. An upcoming meeting is planned with Oncology leadership to discuss overnight admissions on call nights. The 28-hour working group will re-convene in April to discuss options for next year. A concern was raised about whether visiting residents from other training programs are sufficiently prepared to cover nights on their own; this concern will be shared with Firm leadership.
9. Chief Residency Selection: the process is underway and we plan to announce the 2020-21 Chiefs in March. PGY2s interested in exploring the VA CRQS (Chief Resident for Quality and Safety) or the COE (Center of Excellence) positions are encouraged to speak to Drs. Naseema Merchant and Rebecca Brienza, respectively.
10. The Ball: All agreed that it was a big hit, although the dinner was bland. The question was raised as to whether we could spend less on dinner and have two parties instead. We can explore this option.
11. Arts Night: All agreed that it was a major hit (and thanks to the performers, the planners, and those who displayed their artwork). A request was made to see if we could get coverage next year so all residents can attend. We can explore this option.
12. Report start time: To address residents’ request to expand report access to trainees on non-East Pavilion Services, the Chiefs will pilot some 11A reports in the coming weeks. The goal is to see if more residents can attend report without disrupting other educational activities such as noon conference and teaching rounds.
13. Nursing feedback: in response to ACGME requirements, we are soliciting feedback on resident performance from non-physician staff, beginning with the nurses on 5-5 and 9-5. Feedback is intended to be formative. Residents should feel free to provide feedback on the feedback- is it helpful? How can it be improved? Are their ways for residents to provide feedback to nurses as well? The Council also suggested that we try to get more WOW Bucks to acknowledge great performance by the nursing staff.

Please feel free to share questions and comments. Our next Council meeting is in March after I return from vacation.

Respectfully submitted,

Mark S

PS The Butterfly’s arrival!

PPS A scene from “Fiddler On the Roof,” which reminds me of the Butterfly’s arrival: https://www.youtube.com/watch?v=ADHxzpRq83M

MDS