Costas T. Lambrew Research Retreat 2024

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  Variations Exist in Hospital and Patient-Reported Outcomes Following Total Hip Arthroplasty According to Biological Sex

  Catherine Call, Andrew Lachance, Thomas Zink, Henry Stoddard, Callahan Sturgeon, George Babikian, Adam Rana, and Brian J. McGrory

  Introduction

  • The effect of biological sex on the outcomes of THA remains unclear.

  • Average combined data may mask sex-related variation and obscure clinically relevant differences in outcomes.

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  The Association of Season of Surgery and Patient Reported Outcomes Following Total Hip Arthroplasty

  Catherine M. Call, Andrew Lachance, Zachary Radford, Henry Stoddard, Callahan Sturgeon, George Babikian, Adam Rana, and Brian J. McGrory

  Introduction

  • Understanding the impact of situational variables on surgical recovery can improve outcomes in total hip arthroplasty (THA).

  • Literature examining hospital outcomes by season remains inconclusive, with limited focus on patient experience.

  • The aim of this study was to investigate if there were differences in hospital and patient-reported outcomes measures (PROMS) after THA depending on the season in an area with 4 distinct seasons.

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  Effect of Telemedicine Consults on Time to Initiation of Therapeutic Hypothermia in a Rural State

  Alexa Craig, Leah M. Seften, and Anya K. Cutler

  Background

  • To receive therapeutic hypothermia (TH), neonates must be transferred within the first 6 hours of life to a center that offers TH treatment

  • In rural states, timely identification of neonatal encephalopathy (NE) is challenging due to the large geographic distances

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  An Assessment of the Needs of Maine Primary Care Providers Relating to Tobacco Prevention, Assessment, and Treatment of LGBTQIA+ Youth and Young Adults

  Logan Gerchman, Sarah M. Gabrielson, Toni Eimicke, and Brandy Brown

  Most primary care providers in Maine ask youth about tobacco use but don’t adjust strategies for LGBTQIA+ youth.

  Most want LGBTQIA+ specific resources for smoking prevention and cessation.

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  Increasing Equitable Access to Pediatric Specialty Care in Maine Through Implementation of eConsults

  David Ireland, Rachel Rockers, Sarah M. Gabrielson, Anya K. Cutler, Laura J. Faherty, and Genevieve Whiting

  Introduction

  •Barriers to accessing pediatric specialty care exist for many and are not experienced equally by all.

  •eConsults are an asynchronous provider-provider referral modality to obtain low-barrier specialist input in place of some face-to-face (F2F) visits.

  •We evaluated sociodemographic factors associated with referral to and receipt of specialist input before and after eConsult implementation at MaineHealth to examine equity implications.

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  Risky Business: Creating a Process to Review Accuracy of American Society of Anesthesia (ASA) Classification and to Improve Overall Quality Risk Adjustment of Surgical Patients

  Jane Kinney, Sonja Orff, Robyn Begin, Nicholas Flavin, Eira Hyrkas, Christopher Adams, and Ian Neilson

  Through interdisciplinary education and the creation of an audit process, we have observed a 30.6% reduction in the number of ASA assignment misclassifications.

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  Healthcare Enabled by Artificial Intelligence in Real-time

  Felistas Mazhude, Robert S. Kramer, Qingchu Jin, Paul Terwilliger, Alan Hicks, Tyler Kelting, Douglas Sawyer, and Jaime Rabb

  INTRODUCTION: The HEART (Healthcare Enabled by Artificial Intelligence in Real-Time) Project pioneers developing real-time machine learning (ML) predictive analytics to address the need to improve outcomes during recovery from open heart surgery. Our broad objective is to enhance patient outcomes by developing, validating and deploying predictive algorithms into the hands of clinical teams as an early warning and guidance system, allowing care teams an opportunity to be proactive.

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  A HUMAN CENTERED APPROACH: Solving Unmet Care Needs at MaineHealth

  Carla Muniz

  INTRODUCTION: MaineHealth Innovation builds connections to drive diversity of thought, educates to produce creative problem-solvers and funds to accelerate ideas. By leveraging the ideas, insights and expertise of all care team members to develop novel solutions to our unmet care needs, we are working together so our communities are the healthiest in America.

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  Improving and Standardizing Pediatric Asthma Care Across MaineHealth Using the Validated Hospital Asthma Severity Scoring (HASS) Tool

  Sean Patterson, Leah Marie Seften, Anya Cutler, Alexa Craig, Anne Coates, and Noah Diminick

  Objective: To assess if an inter-professional educational intervention can improve the accuracy and inter-rater reliability of the HASS.

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  Characteristics Associated with Persistent Opioid Use Following Total Joint Arthroplasty

  Meredith Peck, Blaire Beers-Mulroy, Janelle Richard, Robert Krulee, Henry Stoddard, Kristin Kostka, John DiPalazzo, and Aurora Quaye

  Introduction: Recent data from the Centers for Medicare & Medicaid Services (CMS) Medicare/Medicaid Part B National Summary project that the demand for total joint arthroplasties will grow upwards of 500% by 2060.2 This increased demand is due to many factors, including a growing aging population, an increased prevalence of osteoarthritis, and advances in surgical techniques facilitated by improved technology resulting in enhanced outcomes and prosthetic longevity.

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  Machine Learning Approaches for Neurological Risk Stratification Within 6 Hours Of Cardiac Arrest

  Richard R. Riker, Qingchu Jin, Hunter Williams, Teresa May, David Seder, and Raimond L. Winslow

  Background:

  • Prognostication of neurological outcome should be delayed at least 72 hours after cardiac arrest. Early stratification of risk severity provides important information enabling improved medical decision making, research enrollment, and precision medicine approaches.

  • We propose that electroencephalography (EEG)-derived indices are valid biomarkers of severity of neurological injury very early after cardiac arrest.

  • This study was designed to assess the relative impact of early clinical data and processed EEG indices in the first 6 hours after recovery of spontaneous circulation (ROSC) after cardiac arrest.

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  A Continuous Objective Shivering Monitor During Targeted Temperature Management After Cardiac Arrest

  Richard R. Riker, Erica Schlichting, David Seder, Mary Weatherbee, David J Gagnon, and Teresa May

  Background:

  • Shivering during targeted temperature management (TTM) after cardiac arrest is stressful and linked to cerebral metabolic crisis.

  • Few publications report shivering incidence, timing, or severity during TTM, and shivering treatment recommendations conflict.

  • To evaluate multimodal shivering assessments, we studied patients during TTM managed with surface cooling, moderate analgosedation, surface counterwarming, and intermittent neuromuscular blockade (NMB) and evaluated surface electromyographic (EMG) power in decibels using the Medtronic bispectral index (BIS) monitor.

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  Support for Transgender/Non-binary Youth during Transition from Pediatric to Adult Care

  Emily Roop, Kathryn Diamond-Falk, and Brandy Brown

  Survey of transgender/non-binary youth and parent/guardians identified unmet communication and role definition needs during healthcare transition (HCT)

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  A Novel Needs Assessment in Rural Maine to Explore the Obstetric Care Workforce within the Maine Rural Maternity & Obstetrics Strategies (RMOMS) Network

  Katherine Simmonds, Brianna Keefe-Oats, Louisa Smith, Jeni Stolow, Dora Ann Mills, Lori Travis, Caroline Zimmerman, and Erica Swan

  Introduction

  • Since 1970, 12+ obstetric units in Maine have closed, with 6 of those closures in the last decade

  • In 2022, Maine was awarded a HRSA RMOMS grant to strengthen the system of maternity care in rural Maine

  • The MaineHealth RMOMS grant team partnered with the Roux Institute at Northeastern University to do an obstetric workforce assessment at all Maine rural birthing hospitals

  • The purpose was to observe and explore services, patterns, resources gaps, and other facility characteristics

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  Reproducibility of Maine Ongoing Outreach Simulation Education (MOOSE) Program in Level I Rural Delivery Hospitals

  Allison Zanno, Jeffrey Holmes, Micheline Chipman, Anya K. Cutler, Leah M. Seften, Mary Ottolini, Alexa Craig, Leah Mallory, and Misty Melendi

  Introduction

  • Simulation provides an opportunity to practice neonatal resuscitation program (NRP®) guidelines with high acuity, low occurrence events

  • Rural hospitals with low birth volumes have infrequent opportunities to maintain skills needed to adequately perform neonatal resuscitation

  • With limited clinical opportunities, it is essential to provide ongoing training and education that allow teams to practice these skills

  • Training environment includes a facilitated debrief allowing for feedback on performance and areas of improvement

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  Statewide Needs Assessment of Neonatal Readiness at Delivery Hospitals in Maine

  Allison Zanno, Jay Kerecman, Ann Boomer, Leah M. Seften, Anya K. Cutler, Alexa Craig, and Misty Melendi

  Background

  • Neonatal mortality is higher in hospitals with low birth rates

  • More than two-thirds of hospitals deliver less than one neonate per day in Maine

  • Identification of neonatal preparedness is lacking and will assist in prioritization of education and outreach initiatives to delivery hospitals

  • Our objective was to engage stakeholders to understand current neonatal readiness at delivery hospitals across the state and identify barriers to and helpful resources for improving neonatal care delivery

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  The Impact of Birth Volume on Neonatal Resuscitation Practices in Neonates Treated with Therapeutic Hypothermia

  Allison Zanno, Matthew Ryzewski, Leah M. Seften, Anya K. Cutler, Whittney Barkhuff, Deirdre O Reilly, Jay Kerecman, Alexa Craig, and Misty Melendi

  Background

  • Neonatal resuscitation is a high acuity, low-occurrence (HALO) event

  • Clinicians in hospitals with low birth volumes lack regular opportunities to maintain Neonatal Resuscitation Program (NRP®) skills due to low birth volumes

  • Data used for this analysis was provided through the Northeast Regional Hypothermia Consortium of neonates who received therapeutic hypothermia at four northern New England tertiary care centers

  • We investigated differences in resuscitative practices in hospitals with varied birth volumes.