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Analysis of Novice and Expert Rater Reliability for a Neonatal Resuscitation Program® Adherence Assessment Tool
Sophia Martens, Misty Melendi, Anya Cutler, Sierra Soghikian, Leah Marie Seften, Tara Palnitkar, Allison Zanno, and Leah Mallory
An NRP Adherence Assessment Tool used to evaluate efficacy of a telesimulation neonatal resuscitation training program demonstrated strong interrater reliability with both expert and novice raters.
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An Opt Out Tobacco Cessation Referral Process for a Cancer Care Network
Amy Litterini, David Spaulding, Tia Robbins, Brett Cropp, and Lauren Couture
Opt out tobacco cessation referrals should be standard of care.
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A Quality Improvement Project to Reduce Variation in Pediatric Asthma Care Using the Hospital Asthma Severity Scoring (HASS) Tool
Sean Patterson, Leah-Marie Seften, Rachel Williams, Noah Diminick, Anne Coates, and Laura Amar-Dolan
The aim of this project was to increase HASS score use to greater than 50%within one year and determine the impact of our interventions on the quality of asthma care and patient outcomes.
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Characterization of Contributors to Pleural Fluid Viscosity
YuJai Lin, Megan Rushmeyer, Christopher G. Roy, Shannon Donovan, Rachel Cutting, Matthew Buttarazzi, Charlotte Crist, Ted Sears, and J B. Zuckerman
Background: Pleural effusion is a common consequence of pulmonary disease and may result from a spectrum of conditions. This pilot study seeks to describe relationships between pleural fluid viscosity and fluid analytes commonly measured in clinical laboratories.
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Clinician Comfort, Attitudes, and Practices with Provision of Harm Reduction Supplies to Patients Who Use Drugs
Amanda Cahn, Melissa Calica, Erin Mooz, Malia Haddock, Wendy Craig, Tania Strout, and Kinna Thakarar
Over 100,000 individuals in the United States died from drug overdose in 2022, over 80,000 of which involved opioids. Overdose deaths from psychostimulants (cocaine, methamphetamine) have also been on the rise.
There has also been an increase in substance-related emergency department visits and hospitalizations. People who use drugs (PWUD) often have longer hospital stays, higher self-discharge, and readmission rates.
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Community Health Workers: Putting "Community" in the MaineHealth Vision
Tim Cowan, Barbara Ginley, LeeAnna Lavoie, Jennifer Maillet, Jemma Penberthy, and Lori Travis
Community Health Workers (CHW) play an increasingly key role across the MaineHealth system. The integration of CHWs and growth of the workforce enhances care and improve patient engagement and outcomes. Utilizing data from FY24, modelling from the MH CHW Work Group as well as patient feedback, this poster illustrates the impact CHWs are having on the lives of patients, the care teams they support and the communities in which they live, work and play.
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Electrodermal activity (EDA) confirms that PGY-1s experience more stress and distress during simulation than residents of other PGY levels
Michael Ferguson, Anya K. Cutler, Micheline Chipman, Leah Mallory, Erika Mayer, Leah M. Seften, Michael Zubrow, and Mary Ottolini
Introduction:
• Simulation is known to induce stress in participants
• Instructors aim to achieve the optimal level on the Yerkes-Dodson curve
• Simulation sessions may overshoot this target with no knowledge until after the event
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Electrodermal activity (EDA) correlates with reported stress levels in residents during simulation
Michael Ferguson, Anya K. Cutler, Micheline Chipman, Leah Mallory, Erika Mayer, Leah M. Seften, Michael Zubrow, and Mary Ottolini
Introduction:
• Simulation is known to induce stress in participants
• Instructors aim to achieve the optimal level on the Yerkes-Dodson curve
• Simulation sessions may overshoot this target with no knowledge until after the event
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Evaluation of Engagement and Collaboration Among Hospitals in the Maine Rural Maternity & Obstetrics Management Strategies (RMOMS) Network
Molly Volt, Lori Travis, Caroline Zimmerman, Erica Swan, Katherine Crothers, Anna Gilbert, and Kate Allerding
Introduction
• Maine RMOMS Network: Grant awarded to Maine in 2022, 16 rural birthing hospitals & 5 state partners
• Network Goal: Improve access to maternity and obstetrics care for rural communities
• A qualitative Network Health Evaluation was conducted to diagnose strengths and areas of growth regarding engagement and collaboration
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Experiences with Mental Health Screening in Primary Care
Elizabeth Bernier, Merelise Ametti, Elizabeth Mutina, Saras Yerlig, Elias Peirce, Sameena Flinner, Yaerin Wallenberger, and Kristen Woodberry
Patients with psychosis may answer mental health questions less honestly in primary care settings due to experiences with and fear of disclosure of mental health symptoms to legal guardians, involuntary hospitalization, stigma, and dismissal of physical health symptoms.
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Factors Influencing No Show Rates in Adult Urology Patients
Bruce T. Ndebanje, Ethan Griffin, Evelyn James, and Lily C. Wang
Our study highlights a strong association between insurance status and no-show rates. Patients with Medicaid or no insurance were significantly more likely to miss appointments (OR 3.25 and 5.99).
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Impact of Individual Team Members on Team Performance in a Longitudinal Neonatal Resuscitation Telesimulation Program
Allison Zanno, Anya K. Cutler, Micheline Chipman, Leah Mallory, Leah M. Seften, Tara Palnitkar, Mary Ottolini, and Misty Melendi
Physician participation in interprofessional simulation program improves team adherence to neonatal resuscitation guidelines.
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Implementation and Evaluation of a Resident Pediatric Complex Care Education Series
Calivin Schaffer, Danielle Doctor, Amy Buczkowski, Bonnie Lynne Boomsma, and Logan Murray
Children with medical complexity have significant chronic health problems that affect multiple organ systems and result in functional limitations, high health care need or utilization, and often dependence on medical technology. Addressing their needs requires optimizing care within the medical home and medical neighborhood.
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Implementation and Sustainability of a Neonatal Resuscitation Telesimulation Program in Rural Delivery Hospitals: A Qualitive Study
Leah M. Seften, Tara Palnitkar, Leah Mallory, Micheline Chipman, Mary Ottolini, Allison Zanno, Misty Melendi, and Gloria Sclar
Background:
• Rural teams have limited exposure to neonatal resuscitation due to low birth volumes making it challenging to maintain skills
• Developed Maine Ongoing Outreach Simulation Education (MOOSE), offering interprofessional NRP® telesimulation (TS)
• Facilitated scheduling and provided remote debriefing support from neonatologists & simulation educators • Implemented in rural delivery hospitals in a longitudinal phased approach: Phase 1, monthly TS; Phase 2, quarterly TS
• Our objective was to explore the MOOSE implementation across a rural health system, including program impacts, challenges, and strategies for sustainability (with rural hospitals facilitating ongoing implementation more with less support from the remote team)
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Implementation of MOMSim 2.0
Beth Gray, Micheline Chipman, Lauren Weller, Emily Watson, Sarah Austin, Tara Palniker, and Leah Mallory
Rural birth units are facing BIG challenges. SIMULATION can help.
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Improving Clinician Competence to Screen for Suicide Risk: An Organizational Change
Melissa Gattine and Kendall Dapprich
MHBH is on a journey to implement Zero Suicide across the organization. Zero Suicide is a quality improvement model that transforms system-wide 0% 10% 20% 30% 40% 50% 60% Outpatient Staff Inpatient Staff September 2021 May 2024 Project Life Worth Living is supported by a grant from Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (CMHS), under Grant No. 1H79SM088556 % who strongly agree: “I have the knowledge and skills to screen for suicide risk” prevention and care with an aspirational goal of zero suicide deaths among the people we serve.
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Infective Endocarditis in the Overdose Crisis: Addiction Care and Healthcare Utilization
Eva J. Farkas, Victoria Molina, Brittany Mohoney, Wendy Craig, Amy McAuliffe, and Kinna Thakarar
What is the impact of the IMAT program on healthcare utilization and addiction care outcomes following admissions for IDU-IE?
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Iterative Simulation and Healthcare Failure Modes and Effects Analysis Improves Child Abduction Response Systems Over Four Years of Testing in a Children's Hospital
Dani Bruno, Marissa Perry, Madison (Max) Doane, Jamie Fey, Micheline Chipman, Brian Richardson, and Leah Mallory
Iterative Simulations Improve Child Abduction Unit Readiness.
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Laying the Groundwork: Implementing the 2021 AAP Well Appearing Febrile Infant Clinical Practice Guideline Across a Rural Health System
E Freeman, L Mallory, LM Seften, T Palnitkar, A Cutler, J Gregory, and M Jackson
The American Academy of Pediatrics (AAP) published their first-ever Clinical Practice Guideline (CPG) on the management of well-appearing febrile infants aged 8-60 days in 2021. A system specific CPG and order set for the management of well-appearing febrile infants has been published across MaineHealth (MH) to align with the AAP.
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Mental Health Conditions Among Patients with a Disorder of the Gut-Brain Interaction
Ambia Ahmed, Nicole Smith, Anya Cutler, MariaElena Terzis, Laura J. Faherty, and Julia Fritz
Two thirds of pediatric patients with disorders of the gut-brain interaction have mental health comorbidity.
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MOMSim-A Simulation-Based Outreach Program to Maintain Team Readiness for Obstetrical Emergencies Across a Rural Health System
Lauren Weller, Micheline Chipman, Beth Gray, Becky Hunt, Emily Watson, Sarah Austin, Anya Cutler, Jeff Holmes, and Leah Mallory
An in situ Obstetric Emergency Simulation Training Program increased interprofessional Labor and Delivery team member confidence across our rural health system.
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Overcoming Specialty Care Connection Barriers: The eConsult Effect
Genevieve Whiting, Noah Hoffman, Anya K. Cutler, Leah M. Seften, and Laura J. Faherty
Pediatric patients are 2.6x more likely to attend a new specialist visit after Specialist affirms referral need via eConsult.
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Parent Perspectives on Primary/Specialty Co-management of Pediatric Asthma
James Bohnhoff, Mike Kohut, Dana Schwartz, Darby Glenn, Anya Cutler, and Elizabeth A. Jacobs
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Pediatric Asthma Subspecialty Referral Practices in Rural Maine
Paras Patnaik, John DiPalazzo, and James Bohnhoff
Over 7.2 million children in the United States have asthma.
- >300,000 asthma-related ED visits & hospitalizations yearly
- Both PCP’s and pediatric asthma subspecialists (allergist/immunologists and pediatric pulmonologists) provide long-term asthma care
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Pharmacist-Led Statin Initiation in Adults with Diabetes at an Adult Internal Medicine Clinic
Kevin Le, Michael Takach, Linh Gagnon, and Dylan Atchley
Purpose: Implement and evaluate a pharmacist-led program addressing the current underutilization of statins among these high-risk patients with diabetes
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Physical Activity Programming to Improve QoL in Pediatric IBD Patients
Anna Briley, George Russell, Anya K. Cutler, Anna Furr, Julia Fritz, Kevin Sztam, Birgitta Polson, Rebecca Edwards, and Noah Hoffman
Discussion: This work contributes to limited literature supporting the positive impact of PA in a target population and provides novel guidelines to implement an accessible PA program proven to be effective and well-liked by patients & families. Findings support incorporation of PA into the holistic care of pediatric patients with IBD.
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Physical Activity Programming to Improve QoL in Pediatric IBD Patients
George Russell, Anya K. Cutler, Anna Furr, Julia Fritz, Kevin Sztam, Birgitta Polson, Rebecca Edwards, and Noah Hoffman
Discussion: This work contributes to limited literature supporting the positive impact of PA in a target population and provides novel guidelines to implement an accessible PA program proven to be effective and well-liked by patients & families. Findings support incorporation of PA into the holistic care of pediatric patients with IBD.
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Pilot Study of Serial Telemedicine Assessments to Safely Exclude Neonates from Therapeutic Hypothermia Treatment
Alexa Craig and Anya K. Cutler
Two neonatal encephalopathy exams performed by telemedicine, with scores of less than 4, correctly excluded neonates from treatment with therapeutic hypothermia.
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Rigid Sternal Fixation Alone Does Not Result in a Reduction in Postoperative Opiod Administration Following Cardiac Surgery
Jane Branch, Chinedu Okoli, Kyla Wigant, Jaime Rabb, Robert S. Kramer, Anne Hicks, and Ansar Hassan
Background: Persistent postoperative pain, infection, and sternal dehiscence are devastating complications after cardiac surgery that affect patient quality of life and increase healthcare system burden. Chronic sternal pain lasting more than 1 year affects 25 to 33% of cardiac surgery patients, and wound complications such as infection and sternal nonunion represent significant peri-operative risk factors1,2. Wire cerclage (WC) is the most widely accepted sternal closure technique among cardiac surgeons because of its perceived lower rates of sternal dehiscence, wound infection, and cost.
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Shortage as a Catalyst for High-Value Care: Evaluation of a Bloof Culture Stewardship Intervention Driven by Supply Chain Disruption
Lesley B. Gordon, Camille Ezran, Elizabeth Herrle, Christina Yen, Nicholas J. Mercuro, and Daniel J. Diekema
Evaluate the impact of diagnostic stewardship interventions on repeat blood culture ordering in bacteremic patients during the 2024 BD Bactec™ blood culture bottle shortage.
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Testing Paths of Travel for Pediatric Patients Using Healthcare Failure Mode and Effects Analysis (HFMEA)
Micheline Chipman, Dani Bruno, Leah Mallory, Marissa Perry, Sophie Martens, and Lauren Weller
HFMEA using in-situ simulation identified LSTs and mitigation strategies prior to opening a new cardiac tower.
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Test-Retest Agreement and Reliability of Psychosis and Mental Health Screens for Maine Adolescents and Young Adults in Primary Care
Erika Mayer, Eb Bernier, Merelise Ametti, Julia Plumb, Adriana Lovric, Yaerin Wallenberger, and Kristen Woodberry
Psychotic spectrum disorders are among the most severe mental health conditions. Although early intervention can lead to significantly improved outcomes, minimizing delays in the identification of psychotic spectrum symptoms (PSS) remains challenging.
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Work Hard, Play Hard: How Game-Based Learning Impacts Learner's Engagement and Satisfaction in Intern Academic Half-Day
Katelyn Chadwick, Lesley Gordon, Monica Thim, and Nicole Hudak
Background: Gamification and game-based learning (GBL) is being incorporated into graduate medical education (GME) to augment the more traditional lecture-based format, with the goal of promoting an interactive learning environment that strengthens collaboration. Although some GME programs have adopted GBL, there is limited study on its effect on learners.
The 2025 Costas T. Lambrew Research Retreat was a day-long, hybrid event, attended by over 300 MaineHealth care team members from across the health system. This year’s successful retreat included oral presentations by trainees and faculty of award-winning abstracts, a community engagement research panel led by Dr. Kevin Stein, PhD, small interest groups, two poster sessions (covering a total of 130 abstracts), and many opportunities to connect and network with colleagues.
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