{"id":4775,"date":"2016-05-25T00:00:00","date_gmt":"2016-05-25T06:00:00","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/2016\/05\/25\/uch-providers-plunge-into-department-of-medicine-shark-tank\/"},"modified":"2024-12-23T14:57:39","modified_gmt":"2024-12-23T21:57:39","slug":"uch-providers-plunge-into-department-of-medicine-shark-tank","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/uch-providers-plunge-into-department-of-medicine-shark-tank\/","title":{"rendered":"UCH providers plunge into Department of Medicine \u201cShark Tank\u201d"},"content":{"rendered":"<div style=\"margin-top: 0px; margin-bottom: 0px;\" class=\"sharethis-inline-share-buttons\" ><\/div><p>A half-dozen individuals sat at a long table as contestants pitched their ideas. They listened without interrupting to each of four presentations. At the conclusion, they fired questions and probed for more details. At the end of the two-hour session only one of the four was left standing, judged most worthy of the additional support needed to nurture a germ of an idea to full growth.<\/p>\n<p>The contestants had plunged into a version of the hit television reality show \u201cThe Shark Tank.\u201d They were not entrepreneurs with dreams of making millions on their products, but rather clinicians fixed on finding ways to improve the quality and safety of patient care while managing resources efficiently. The \u201csharks\u201d they sought to convince were a group of leaders representing University of Colorado Hospital, Children\u2019s Hospital Colorado, the University of Colorado School of Medicine and University Physicians, Inc. <em>(see box)<\/em>.<\/p>\n<figure style=\"width: 300px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/1970\/01\/28144835\/EXT_052516_Shark20Tank20Intro.webp\" alt=\"Shark Tank Intro \" width=\"300\" height=\"200\" \/><figcaption class=\"wp-caption-text\">Heidi Wald of the Department of Medicine (front of room) introduces the first \u201cShark Tank\u201d contestant.<\/figcaption><\/figure>\n<p>The drama unfolded May 9 in a conference room of Academic Office One on the Anschutz Medical Campus. The presenters were four finalists in a competition sponsored by CU\u2019s Department of Medicine. The challenge: develop and present a project concept guided by the principles of the American Board of Internal Medicine Foundation\u2019s \u201c<a href=\"https:\/\/abimfoundation.org\/what-we-do\/choosing-wisely\" target=\"_blank\" rel=\"noopener\">Choosing Wisely Campaign<\/a>\u201d and the <a href=\"https:\/\/www.acponline.org\/clinical-information\/high-value-care\" target=\"_blank\" rel=\"noopener\">American College of Physicians\u2019 \u201cHigh Value Care\u201d<\/a> initiative. Both aim to trim the estimated $750 billion the United States spends annually on wasted care.<\/p>\n<p>After the presentations and a period for deliberation, the judges selected a project developed by residents in the Hospitalist Training Program that aims to increase the appropriate placement and removal of intravenous catheters. The prize: a year of support from the Department of Medicine in developing and implementing the concept.<\/p>\n<figure style=\"width: 300px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/1970\/01\/28144834\/EXT_052516_Shark20Tank20Judges.webp\" alt=\"Shark Tank Judges \" width=\"300\" height=\"228\" \/><figcaption class=\"wp-caption-text\">Shark Tank judges listen to presentation. Left to right: UCH Chief Nursing Officer Carolyn Sanders and physician leaders Jeff Glasheen, Christina Finlayson, and Dan Hyman.<\/figcaption><\/figure>\n<p>\u201cThe judges felt this idea showed the greatest potential,\u201d said Heidi Wald, MD, MSPH, vice chair for quality for the Department of Medicine, who developed the \u201cShark Tank\u201d idea. \u201cThe Department of Medicine is excited to partner with you.\u201d Wald said that the judges selected a project from gastroenterologist <a href=\"https:\/\/www.cumedicine.us\/providers\/medicine\/paul-menard-katcher\" target=\"_blank\" rel=\"noopener\">Paul Menard-Katcher, MD<\/a>, on minimizing inappropriate use of proton pump inhibitors in the outpatient setting as an \u201chonorable mention.\u201d<\/p>\n<p><strong>Timely idea<\/strong><\/p>\n<p>Wald noted that the winning team can expect support from the hospital\u2019s Patient Services Department \u2013 and with good reason. With careful attention and monitoring, central lines effectively deliver medications and fluids, but they can spawn infections that are harmful to patients and costly to treat. In addition, the Centers for Medicare and Medicaid Services (CMS) will not reimburse hospitals for the care required to treat central line-associated bloodstream infections (CLABSIs).<\/p>\n<figure style=\"width: 300px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/1970\/01\/28144834\/EXT_052516_Shark20Tank20Questions.webp\" alt=\"Shark Tank Questions \" width=\"300\" height=\"133\" \/><figcaption class=\"wp-caption-text\">Hospitalist Training Program residents (from left) Jeremy Hua, Dale Shamburger and Isaac Hernandez answer questions from judges about their project.<\/figcaption><\/figure>\n<p>\u201cThe hospital has a stake in making this idea work,\u201d said Raven Astrom, PhD, quality improvement clinical specialist with the Department of Medicine. \u201cInfections are on everyone\u2019s mind in health care.\u201d<\/p>\n<p>The concept came from observation, said Isaac Hernandez, MD, a second-year hospitalist resident who presented his idea at the Shark Tank event. He noted that central lines can also increase the risk of deep-vein thromboses (DVTs). During his hospital shifts last fall, he began noticing instances of what seemed to be unnecessary use of PICCs (peripherally inserted central catheters). Hernandez said he saw examples of DVTs caused by PICCs and worried about the lines being placed for convenient access to a vein rather than for true clinical need. He said he also saw inconsistencies in the ways units use PICCs and other central lines.<\/p>\n<figure style=\"width: 300px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/1970\/01\/28144834\/EXT_052516_Isaac20Hernandez.webp\" alt=\"Isaac Hernandez \" width=\"300\" height=\"200\" \/><figcaption class=\"wp-caption-text\">Hernandez after a shift in AIP 2. He and his colleagues will soon begin work on implementing their concept of improving placement and removal of central lines.<\/figcaption><\/figure>\n<p>\u201cHigh-value care means utilizing good evidence-based practice for doing or not doing something and avoiding the overuse of care,\u201d Hernandez said. \u201cI felt we didn\u2019t have good evidence for the placement and removal of central lines.\u201d He noted in his presentation that the University of Michigan has developed a protocol for managing central lines that could serve as a model for UCH.<\/p>\n<p>Hernandez developed his Shark Tank concept with the help of <a href=\"https:\/\/www.cumedicine.us\/providers\/medicine\/darlene-tad-y\" target=\"_blank\" rel=\"noopener\">Darlene Tad-y, MD<\/a>, who is associate program director for the Internal Medicine Residency Program; and <a href=\"https:\/\/www.cumedicine.us\/providers\/medicine\/michelle-barron\" target=\"_blank\" rel=\"noopener\">Michelle Barron, MD<\/a>, medical director for infectious disease at UCH. Barron provided data on central-line infection rates at the hospital. His proposal was ultimately combined with another that focused on reducing the incidence of invasive line use. That one was submitted by a team led by Erin Bredenberg, MD, also a resident in the Hospitalist Training Program.<\/p>\n<p>Astrom said the project had other important aims, including building strong working relationships between residents and attending physicians, boosting hospital education about central lines, and improving the patient experience. \u201cThe time was right for all of this to come together,\u201d she said.<\/p>\n<p><strong>Lining up support<\/strong><\/p>\n<p>The project dovetails with separate efforts underway at UCH to monitor the use of central lines, said Chief Nursing Officer Carolyn Sanders, RN, PhD, who was one of the Shark Tank judges. She said the hospital plans in July to hire nurses dedicated to monitoring, managing and assessing central lines.<\/p>\n<figure style=\"width: 300px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/1970\/01\/28144833\/EXT_052516_Sharks.webp\" alt=\"Sharks\" width=\"300\" height=\"225\" \/><figcaption class=\"wp-caption-text\">Shark Tank judges and winners. Left to right: Jean Kutner, Jeff Glasheen, Carolyn Sanders, Jeremy Hua, Dale Shamburger, Christina Finlayson, Jennifer Wiler, Dan Hyman, Heidi Wald.<\/figcaption><\/figure>\n<p>\u201cThe Shark Tank project is an opportunity to build a partnership with the hospital,\u201d Sanders said. \u201cIt touches many patients whose lives we can improve.\u201d She also noted that UCHealth Northern Colorado and Colorado Springs already have IV teams that have helped their hospitals manage the lines appropriately and reduce infection rates, giving UCH another resource for improving the care it provides.<\/p>\n<p>Work on implementing the concept now begins in earnest, Astrom said. Hernandez and his colleagues will meet with the Department of Medicine Quality Program team June 1 to hear feedback from the Shark Tank judges, narrow the goals of the project, discuss how to measure outcomes, identify who will be involved in the work, and plot milestones along the one-year timeline.<\/p>\n<p>\u201cRight now the team has ideas, but they need support and the know-how to develop the project,\u201d Astrom said.<\/p>\n<p>Sanders said she was impressed with the \u201cShark Tank\u201d idea and its potential for stimulating change.<\/p>\n<p>\u201cIt was very well orchestrated, and the teams were all well prepared,\u201d she said. \u201cIt was good from the hospital side to see the Department of Medicine propose opportunities for improvement.\u201d<\/p>\n<hr \/>\n<p><strong>The Sharks<\/strong><br \/>\nThe six-judge Shark Tank panel:<\/p>\n<ul>\n<li>Christina Finlayson, MD, associate medical director, University Physicians, Inc.<\/li>\n<li>Jeff Glasheen, MD, chief quality officer, University of Colorado Hospital<\/li>\n<li>Dan Hyman, MD, chief quality officer, Children\u2019s Hospital Colorado<\/li>\n<li>Jean Kutner, MD, chief medical officer, University of Colorado Hospital<\/li>\n<li>Carolyn Sanders, RN, PhD, chief nursing officer, University of Colorado Hospital<\/li>\n<li>Jennifer Wiler, MD, vice chair and associate professor of Emergency Medicine, University of Colorado School of Medicine<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>A half-dozen individuals sat at a long table as contestants pitched their ideas. They listened without interrupting to each of four presentations. At the conclusion, they fired questions and probed for more details. At the end of the two-hour session only one of the four was left standing, judged most worthy of the additional support [&hellip;]<\/p>\n","protected":false},"author":2143,"featured_media":2659,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[259],"class_list":["post-4775","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-internal-medicine"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>UCH providers plunge into Department of Medicine \u201cShark Tank\u201d - UCHealth Today<\/title>\n<meta name=\"description\" content=\"A half-dozen individuals sat at a long table as contestants pitched their ideas. 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