Stanford Resident/Fellow Quality Improvement & Patient Safety Symposium

The eighth annual Stanford Resident/Fellow Quality Improvement & Patient Safety Symposium was held virtually on May 9, 2022 amidst the COVID-19 pandemic. Stanford neurology residents and fellows were involved in 3 of the 32 projects. One project led by neurology residents was recognized with a Top 10 award. This project focused on improving stroke codes in the pediatric emergency department. Additional details about the Symposium can be found here.

Streamlining Pediatric Stroke Codes in the Pediatric Emergency Department
Ria Pal, MD, Katherine Xiong, MD, Rachel Walsh, MD, Sarah Lee, MD

Ultrasound-guided Lumbar Puncture: Trainee Education and Clinical Implementation
David Rogawski, MD, PhD, Connie Wu, MD, Kenneth Leung, MD, Sarada Sakamuri, MD

Increasing Outpatient Goals of Care Discussions in the Resident Neurology Clinic
Trevor Rafferty, MD, Jacqueline Summers, MD, Carl Gold, MD, MS

The seventh annual Stanford Resident/Fellow Quality Improvement & Patient Safety Symposium was held virtually on May 17, 2021 amidst the COVID-19 pandemic. Stanford neurology residents and fellows were involved in 10 of the 45 projects. Two projects led by neurology residents were recognized with Top 10 awards. One award-winning focused on improving documentation of seizure events in pediatrics patients. The other award-winning project examined the barriers to effective real-time feedback in neurology. Additional details about the Symposium can be found here.

Implementation of a Pediatric Status Epilepticus Pathway to Improve Quality Care
Katherine Xiong, MD, Prathyusha Teeyagura, MSBI Amelia Sperber, MSN, RN, CNS, CPNP-PC, Courtney Wusthoff, MD, William Gallentine, DO

Improving Documentation of Seizure Events at Lucile Packard Children’s Hospital
Katherine Xiong, MD, Amelia Sperber, MSN, RN, CNS, CPNP-PC, Prathyusha Teeyagura, MSBI, William Gallentine, DO, Courtney Wusthoff, MD

Bite Injury Prevention in Patients Undergoing Motor Evoked Potentials
Shahla Moghbel, DO, Leslie Lee, MD, Scheherazade Le, MD, Sungho K Cho, MD, Richard Jaffe, MD, Sarah Stone, MD, Jaime Lopez, MD

Could it be Motor Neuron Disease? A Comparison of Clinical and Electrodiagnostic Impressions in Patients with Peripheral Nerve Hyperexcitability
Joy Lin, MD, Sarada Sakamuri, MD

Traversing the Tracheostomy: Improving the Elective Tracheostomy Pathway for Patients with Neuromuscular Diseases
Shefali Dujari, MD, Jacqueline Hayes Albarran, RRT-ACCS, RRT-NPS, RCP, Angie Murkins, NP, Tiffany Sun, BSN, RN, Sarah Stranberg, MA, CCC-SLP, Michelle Cao, DO, Jennifer Lee, MD

Improving the Efficiency and Safety of Neuro ICU to Floor Patient Transfer Process
Anna Janas, MD, PhD, Angie Murkins, NP, Christina Mijalski, MD, Zachary Threlkeld, MD

An Evidence Based Approach to Imaging Dizzy Patients in the ED
Richard Baron, MD, Shefali Dujari, MD, Laurel Jakubowski, MD, Erica Von Stein, MD, Kirsten Fisher, MD, Diana Slawski, MD, Kristen Steenerson, MD, Brian Scott, MD

Improving Multi-directional, Real-time Feedback in Neurology Residency
Jingjing (Jenny) Chen, MD, MBA, Brian Scott, MD

Increasing Outpatient Goals of Care Discussions in the Resident Neurology Clinic
Trevor Rafferty, MD, Jacqueline Summers, MD, Jingjing Chen MD, MBA, Carl Gold MD, MS

Identifying Delays in Neurological Care due to COVID-19
Phuong Hoang, MD, PhD, Connie Wu, MD, Sandra Mobley, DNP, Lironn Kraler MD

The sixth annual Stanford Resident/Fellow Quality Improvement & Patient Safety Symposium was held virtually on May 18, 2020 amidst the COVID-19 pandemic. Stanford neurology residents and fellows were involved in 13 of the 46 projects. Three projects led by neurology residents were recognized with Top 10 awards. The award-winning projects included a workflow redesign for safely transferring patients out of the Neurocritical Care unit, an analysis of the implemention of teleneurology, and a critical evaluation of a national inpatient neurology quality measure. A neurosurgery-led project that included a neurology resident also won a Multidisciplinary award. Additional details can be found here.

A Novel Goals of Care Communication Curriculum for Neurology Residents Improves Confidence and Skills
Tarini Goyal, MD, Sylvia Bereknyei Merrell, DrPH, Barbette Weimer-Elder, PhD, RN, Merisa Kline, MHA, Carl A. Gold, MD, MS

Analyzing Impact of an Institutional Protocol for MRI in Patients with Legacy Cardiac Rhythm Devices
Collin J. Culbertson MD, Laurel Jakubowski MD, Jingjing Chen MD MBA, Max Wintermark MD, Paul Wang MD, Angela Tsiperfal MS RN ACNP CNS, Rosalie Geronimo DNP RN NEA-BC CNL, Teresa Nelson, Connie Lund, Carl A. Gold MD MS

Decreasing ED Visits for Breakthrough Seizures in Patients Established with the Epilepsy Clinic
Erica Von Stein MD, Aditya Joshi MD, Katherine Werbaneth MD, Dominic Hovsepian MD,
Laurice Yang MD MHA

Evaluation of seizure risk in neonates after cardiopulmonary bypass in the absence of deep hypothermic cardiac arrest
Rebecca Levy MD PhD, Elizabeth Mayne MD PhD, Amanda G Sandoval Karamian MD, Mehreen Iqbal MD, Natasha Purington MD, Rajani Kaimal MD, Kathleen Ryan MD, Courtney Wusthoff MD

Implementation and Evaluation of Neurology Residency Program Changes on Well-being During COVID-19 Pandemic
Sara Pavitt MD, Jingjing (Jenny) Chen MD MBA, Shefali Dujari MD, Rebecca Miller-Kuhlmann MD, Nirali Vora MD

Improving Bedside Care and Cognitive Assessment of Adult Epilepsy Monitoring Unit (EMU) Patients
Wendy Chen MD, Victoria Liu MD, Kimford Meador MD, Scheherazade Le MD

Improving provider-nursing communication on an inpatient neurosurgery unit
Leean Rodolfich MSN RN, Thomas Wilson MD, Josh Dodson RN, Jesus Navoa PA, Corrine Petrushonis RN-BC, Sammita Satyanarayan MD, Angel Shew MPH, Aaron Sy MS

Improving the efficiency and safety of Neuro-ICU to floor patient transfers
Anna Janas MD PhD, Angie Murkins NP, Lili Velickovic Ostojic MD, Christina Mijalski MD, Zachary Threlkeld MD

Increasing New Patient Access to Neurology Clinics using Patient-Initiated Late Cancellations
Tarini Goyal MD, Chitra Venkatasubramanian MD, Neelam Goyal MD, Nina Bozinov MD, Nick Quiroz, Maram Mohamed, Suzanne Pritchard, Cessa Heinzmann

Measuring the Quality of a Quality Measure
Shefali Dujari MD, Santosh Gummidipundi MS, Zihuai He PhD, Carl A. Gold MD MS

Methods to address challenges in implementing teleneurology during COVID-19
Jessica Ng MD, Monica Liu BS, Hilary Wang MD MBA, Sammita Satyanarayan MD, Jingjing (Jenny) Chen MD MBA, Laurice Yang MD MHA

Streamlining ICU care for ALS patients receiving tracheostomy and gastrostomy
Connie Wu MD, Nick M Murray MD, Eric Bernier RN Christine Wachira DNP, RN, MPA, NE-BC, Francesca Heinzmann BS, Leslie Bennett RN, Neelam Goyal MD, Michelle Cao DO, Karen Hirsch MD, Zachary Threlkeld MD

Ultrasound Training for Lumbar Puncture in Neurology
Eric Rider MD, Sarada Sakamuri MD

The fifth annual Stanford Resident/Fellow Quality Improvement & Patient Safety Symposium was held on May 13, 2019. Stanford neurology residents and fellows were involved in 20 of the 84 projects, second only to internal medicine. Six projects led by neurology residents and fellows were recognized with awards or honorable mentions, the most by any department. A project to reduce ICU length of stay in patients with intracerebral hemorrhage won the Best Multidisciplinary Project award. Award-winning projects also included an epilepsy curriculum for neurology residents, a workflow redesign for ambulatory lumbar punctures, and process improvement for bedside care of pediatric epilepsy monitoring unit patients. Curricula covering goals of care communication skills and medicolegal topics received Honorable Mentions. Additional details can be found here.

Improvements in clinical, laboratory, and Epic workflow to eliminate errors in diagnostic lumbar punctures
Nina Bozinov, MD, Lucas B. Kipp, MD, William Flores, CLS, Josephine Cabrera Aranda, CLS, Rahul Guli, Victoria Fitch, Marites Lazzareschi, RN, CRRN, ACM, Sujinder Johal, CLS, Esterlita Bengil, CLS, Pablito Ang, CLS, Isabelle Yi, RN, Stephanie Ogamba, MS-HCA, Rocio Serrano, MA, Dana Gonzales, BSN, RN, CNOR, Amanda Johnson, RN, Marlianne Asuncion, Olga F. Goldberg, MD

Creating an institutional protocol for MRI in patients with legacy cardiac rhythm devices
Collin Culbertson, MD, Max Wintermark, MD, Paul Wang, MD, Angela Tsiperfal, MS, RN, ACNP-BC, CNS, Teresa Nelson, RT, Connie Lund, RT, Carl A. Gold, MD, MS

Improving resident communication with patients about medication side effects
Shefali Dujari, MD, Hilary Wang, MD, Ruth Hua, MD, Anahita Dua, MD, Benjamin Weia, MD, Justin Slade, MD, Lisa Shieh, MD

A novel curriculum to improve neurology residents goals of care communication skills
Tarini Goyal, MD, Barbette Weimer-Elder, PhD, RN, Merisa Kline, MHA, Sylvia Bereknyei Merrell, DrPH, Carl A. Gold, MD, MS

Continuous EEG for seizure detection in neonates after cardiac bypass without deep hypothermic cardiac arrest
Rebecca Levy, MD, PhD, Natasha Purington, MS, Rajani Kaimal, Mehreen Iqbal, MD, Elizabeth Mayne, MD, PhD, Amanda G. Sandoval Karamian, MD Kathleen Ryan, MD Courtney J. Wusthoff, MD

Curriculum development for neurology residents during the epilepsy rotation
Yi Li, MD, Aditya Joshi, MD, Dominic A Hovsepian, MD, Zahra Sadat-Hossieny, MD, Kevin Graber, MD, Scheherazade Le, MD

Reducing duration and cost of anti-hypertensive infusions in critically ill patients with intracerebral hemorrhage
Adam MacLellan, MD, Hans Ang, PharmD, BCCCP, Elizabeth Fox, CNS, AG-ACNP; Kassi Kronfeld, MD, MS. Nick Murray, MD, Alicia Wilson, BSN, Karen Hirsch, MD, Zachary Threlkeld, MD

Improving bedside care of pediatric epilepsy monitoring unit patients
Sara Pavitt, MD, Alison Carley, RN and the LPCH Brain and Behavior Nursing Group, Gustavo Chavarria-Ortiz, MD, Brenda Porter, MD, Juliet Knowles, MD, PhD

Creation and implementation of a standardized tool to improve inpatient consult communication
Sara Pavitt, MD, Anne McHugh, MD, Kevin Chi, MD, Kim Hoang, MD, Elizabeth Lippner, MD, Kiran Mudambi, MD, Katelyn Saarela, MD, Hannah Basset, MD, Rachel Goldstein, MD, Jennifer Tsai, MD, Nivedita Srinivas, MD

Improving the inpatient MRI experience through pre-procedure patient education
Sara Pavitt, MD, Amanda Sandoval, MD, Prateek Thatikunta, MD, Theodora Bruun, BA, Max Wintermark, MD, Carl A. Gold, MD, MS

Improving scheduling and efficiency in neurodiagnostic lab
David Post, MD, Sri Muppidi, MD, Laurice Yang, MD, MHA

Reduction of wait time from central check-in to destination in outpatient neurology clinic
Ashley Rawls, MD, Laurice Yang, Christopher Locke, Jong-Mi Lee, Morgan Pennington, Amy Alcantara

Utilizing novel two-way communication methods to understand peri-urgent communication
Sammita Satyanarayan, MD, Ron Li, MD, Amy Chang, MD, Neel Chari, MD, Karen Li, MD, Lyndly Tamura, MD, Katie Kvam, MD, Christopher Sharp, MD

Improving delay in detection and treatment of intermittent focal and subclinical seizures
Samuel Spiegel, MD, Thuy Nguyen, MD, Katherine Werbaneth, MD

A medical legal curriculum for residents to increase physician comfort in patient interactions
Kate Therkelson, MD, Laurice Yang, MD

Reducing Stanford ED utilization for breakthrough seizures in patients with epilepsy
Erica Von Stein, MD, Aditya Joshi, MD, Katherine Werbaneth, MD, Dominic Hovsepian, MD, Laurice Yang, MD, MHA

Improving neurology patient knowledge of medications at discharge
Hilary Wang, MD, Phyo Aung, Pharm D., Leslie Bennett, RN, MSN, Olga Goldberg, MD, Victor Tamayo, RN, BSN, CNRN, Noah Wachtel, RN, Brian Scott, MD

Quantifying the burden of unfilled clinic appointment slots created by late-notice cancellations
Hilary Wang, MD, Nicole Batino, Laurice Yang, MD, MHA

Developing an outpatient neurology resident curriculum and entrusted professional activities (EPAs)
Katherine Werbaneth, MD, Prateek Thatikunta, MD, Teresa Wu, MD, Sarada Sakamuri, MD, Rebecca Miller-Kuhlmann, MD, Scheherazade Le, MD

Building and implementing an interdisciplinary protocol for brain code
JoJo Yang, MD, Anna Janas MD PhD, Karley Mariano NP, Lindsey Rasmussen MD, Sarah Lee MD

The fourth annual Stanford Resident/Fellow Quality Improvement & Patient Safety Symposium was held on May 14, 2018. Stanford neurology residents and fellows were involved in 20 of the 75 projects, more than any other department. Neurology was recognized for this achievement with the "Top Departmental Submission" award. The Neurology Resident Quality Improvement Curriculum and a project focusing on oral chemotherapy safety were among the Top 10 Posters.

Improving Oral Chemotherapy Safety in Adult Neuro-Oncology
Tresa McGranahan MD PhD ; Megan Gershon, RN; Justine Pena, RN, MSN; Chamnjot Bains, RN; Seema Nagpal, MD

A Quality Improvement Curriculum for Neurology Residents - 18-Month Posttest Update
Alexander Frolov, MD, Nina Bozinov, MD, Rebecca Miller-Kuhlmann, MD, Lironn Kraler, MD, Carl Gold, MD, MS, Kathryn Kvam, MD

A Wellness and Mentoring Program for Neurology Trainees and Faculty
Amanda Sandoval Karamian, MD; Nicholas Murray, MD; Nina Bozinov, MD; Tresa McGranahan, MD; Maryam Sarah Hamidi, PhD; Shefali Dujari, MD; Rebecca Miller-Kuhlmann, MD

Effectiveness of In-person and Internet-based Interventions for Caregivers of Patients with Dementia
Shefali Dujari, MD; Jennie Clark, MA; Truman Cowles, BSN, RN; Sarah Phoenix, MSW; Christina Wyss-Coray, RN; Pauline Marchon, RN; Lu Tian, ScD, MS; Sharon J. Sha, MD, MS

Ensuring Appropriate Delivery of Artificial Nutrition in Stroke Patients with Dysphagia
Hilary H. Wang, MD, MBA; Emily Latmier, RN, BSN, CEN, MS(c); Eric Bernier, MSN, RN; Carl A. Gold, MD, MS

Evaluation of Human Botulism Immune Globulin Intravenous (BIG-IV) utilization for the treatment of infant botulism
Joshua Robinson, PharmD; Qian-Zhou (JoJo) Yang, MD; Jeffrey Moss, PharmD; Hayden Schwenk, MD, MPH

Expanding Access to MRI for Patients with Cardiac Rhythm Devices Presenting with Acute Neurological Conditions
Collin J. Culbertson, MD; Carl A. Gold, MD, MS

Impact of smart-phone messaging on inpatient resident-nursing communication
Sammita Satyanarayan, MD; Kathryn Kvam, MD; Cliff Schmiesing, MD; Christopher Sharp, MD; Yaron Simler; Angel Shaw; Elisa Nguyen, RN

Implementation and Performance of Targeted Temperature Management for Cardiac Arrest Patients
Kassi Kronfeld, MD; Chitra Venkatasubramanian, MD; Liz Kim, MSN, AG-ACNP-BC, ACNS-BC, CCRN, FAHA; Anna Finley-Caulfield, MD

Improving neurologists adherence to guidelines on prevention of complications of systemic oral corticosteroid therapy
Verena C. Samara, MD; Srikanth Muppidi, MD

Increasing access to annual influenza vaccination for pediatric neuromuscular patients at Stanford Children's Health
Jenna Klotz, MD; Crystal Bailey ; Melissa Cowart; Jessica Guzman, RN ; Samantha Rogers, RN ; Carolina Tesi Rocha, MD

Integrative Medicine in Child Neurology: what do providers think and what do they want to learn?
Amanda G Sandoval Karamian, MD; Ann Ming Yeh, MD; Courtney J Wusthoff, MD

"More than just code status": Neurology Resident Experiences with Goals of Care Communication
Tarini Goyal, MD, Brittany N. Hasty, MD, Sylvia Bereknyei Merrell, DrPH, Carl A. Gold, MD, MS

Neurology Resident Education With Acute Stroke Simulation Improves Code Readiness
Catherine Legault, MD, FRCPC; Nirali Vora, MD

Non-adherence to World Health Organization Guidelines is Common in Prion Safety Precautions Among Top Neurological Institutions
Katherine Werbaneth, MD; Praveen Tummalapalli; Lironn Kraler, MD; Carl Gold, MD MS

Optimizing Communication Between Pediatric Residents and Fellows During Inpatient Consultation Requests
Sara Pavitt, MD; Hannah Bassett, MD; Kevin Chi, MD; Rachel Goldstein, MD; Kim Hoang, MD; Elizabeth Lippner, MD; Anne McHugh, MD; Kiran Mudambi, MD; Katelyn Saarela, MD; Nivedita Srinivas, MD

Quality improvement in the novel "Stroke Code Extended" protocol using gap analysis of delayed door-to-CT image to effectively treat acute stroke patients up to 24 hours
Shefali Dujari, MD; Catherine Legault, MD; Eric Bernier, MSN, RN; Nikita Joshi, MD; Sam H Shen, MD, MBA; Alexei M Wagner, MD, MBA; Patrice Callagy, RN; Greg Albers, MD; Nirali Vora, MD

Quantifying and addressing workplace violence in the neurology outpatient setting
Hilary H. Wang, MD, MBA; Jacqueline Keeling, RN; Michele Blazek; Laurice T. Yang, MD, MHA

Resident Safety Council: Culture of Safety Project
Kathleen Kan, MD; Vanessa Kennedy; Nina Bozinov; Erna Forgo; Steven Chinn, DPS MS MBA

Use of EMR templates reduces medical errors in patients with infantile spasms
Jonathan D. Santoro, MD; Amanda Sandoval, MD; Maura Ruzhnikov, MD; Elise Brimble, MSc, MS; Whitney Chadwick, MD; Courtney J. Wusthoff, MD

The third annual Stanford Resident/Fellow Quality Improvement & Patient Safety Symposium was held on May 15, 2017. Neurology residents were involved in 7 projects among the 38 overall. Two neurology projects, one focusing on evaluation of swallowing function in patients with strokes and another optimizing evaluation of pregnant women with strokes, were awarded as Top 10 Posters.

A Quality Improvement Curriculum for Neurology Residents
Rebecca Miller-Kuhlmann, MD, Lironn Kraler, MD, Alex Frolov, MD, Nina Bozinov, MD, Carl Gold, MD, Kathryn Kvam, MD

Dysphagia Delaying Discharge in Acute Stroke Patients
Jennifer Shum, MD, Katherine Werbaneth, MD, Justin Ruey Tse, MD, Sandra Deane, MS, CCC-SLP, BCS-S, Maria Larrenaga, MA, CCC-SLP, MBS-IMP, Nirali Vora, MD

How Do Residents Reach Nurses?
Kelly Fedoruk, MD, Adam X Sang, MD, Hilary H Wang, MD, Jessica X Yu, MD, Rebecca K Miller-Kuhlmann, MD, Haley Manella, MD, Michael Genualdi, MD, Lisa Shieh, MD PhD FHM

Implementation of a Stroke Navigator: Using the EHR to improve patient care and clinical documentation
Kassi Kronfeld, MD, Addason McCaslin, MD, Brian Schenone, RN, Kyle Hobbs, MD

Improving ICU Transfer Quality Using Standardized Documentation for Neurology Patients
Addason McCaslin MD, Aditya Joshi MD, Kassi Kronfeld MD, Nick Murray MD, Kyle Hobbs MD

Standardization of Labor and Delivery Stroke Codes to Reduce Time to Initial CT Scan
Nina Bozinov, MD, Bryan Lanzman, MD, Maurice Druzin, MD, Sarah Lee, MD

Variability of Human Prion Disease Policies and Procedures in Leading US Neurological Institutions
Praveen Tummalapalli, BS, Katherine Werbaneth, MD, Carl A. Gold, MD, MS

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Stanford Resident/Fellow Quality Improvement & Patient Safety Symposium