Discussion Board

I, along Michael Bruno and others, am on a panel established by the American College of Emergency Physicians to develop quality measures for the diagnosis of ruptured abdominal aortic aneurysm (rAAA). The effort is funded by a generous grant from the Gordon and Betty Moore Foundation. We held our first organizational meeting this week and discussed how we will proceed. One of our top priorities is to engage with patients or family members who have had experience with rAAA and have them on our work group. 

In addition, ACEP is working on another such effort, funded by the John Ritter Foundation, to develop quality measures for  aortic dissection (AD). The Ritter Foundation came about after John Ritter, a well known and loved TV star, died of AD nearly 20 years ago. Patient involvement in that panel is also desired.

Anyone with interest or experience with these diseases who would be interested in participating in ACEP's efforts is invited to contact me for more details. Thanks in advance for your interest in this matter. 


------------------------------
David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."
------------------------------

The first thing an Emergency Physician should think when he/she sees a complaint of "chest pain" is AAA. Why? Because if it isn't top of mind, that doc will join the long list of those who miss it. By the time a doc sees the patient, the nurse will have done the ECG and sent troponin, etc. to the lab. It's pretty hard to miss an MI these days, but AAA and PE are still missed. Same goes for back pain: Think spinal epidural abscess in every case and you won't miss it.

------------------------------
Charles Pilcher MD FACEP
Editor, Medical Malpractice Insights - Learning from Lawsuits
https://madmimi.com/p/5f4487
------------------------------

Original Message:
Sent: 02-24-2022 17:55
From: David Meyers
Subject: Seeking patient voices

I, along Michael Bruno and others, am on a panel established by the American College of Emergency Physicians to develop quality measures for the diagnosis of ruptured abdominal aortic aneurysm (rAAA). The effort is funded by a generous grant from the Gordon and Betty Moore Foundation. We held our first organizational meeting this week and discussed how we will proceed. One of our top priorities is to engage with patients or family members who have had experience with rAAA and have them on our work group. 

In addition, ACEP is working on another such effort, funded by the John Ritter Foundation, to develop quality measures for  aortic dissection (AD). The Ritter Foundation came about after John Ritter, a well known and loved TV star, died of AD nearly 20 years ago. Patient involvement in that panel is also desired.

Anyone with interest or experience with these diseases who would be interested in participating in ACEP's efforts is invited to contact me for more details. Thanks in advance for your interest in this matter. 


------------------------------
David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."
------------------------------

Original Message:
Sent: 2/24/2022 7:46:00 PM
From: Charles Pilcher
Subject: RE: Seeking patient voices

The first thing an Emergency Physician should think when he/she sees a complaint of "chest pain" is AAA. Why? Because if it isn't top of mind, that doc will join the long list of those who miss it. By the time a doc sees the patient, the nurse will have done the ECG and sent troponin, etc. to the lab. It's pretty hard to miss an MI these days, but AAA and PE are still missed. Same goes for back pain: Think spinal epidural abscess in every case and you won't miss it.

------------------------------
Charles Pilcher MD FACEP
Editor, Medical Malpractice Insights - Learning from Lawsuits
https://madmimi.com/p/5f4487
------------------------------

Original Message:
Sent: 02-24-2022 17:55
From: David Meyers
Subject: Seeking patient voices

I, along Michael Bruno and others, am on a panel established by the American College of Emergency Physicians to develop quality measures for the diagnosis of ruptured abdominal aortic aneurysm (rAAA). The effort is funded by a generous grant from the Gordon and Betty Moore Foundation. We held our first organizational meeting this week and discussed how we will proceed. One of our top priorities is to engage with patients or family members who have had experience with rAAA and have them on our work group. 

In addition, ACEP is working on another such effort, funded by the John Ritter Foundation, to develop quality measures for  aortic dissection (AD). The Ritter Foundation came about after John Ritter, a well known and loved TV star, died of AD nearly 20 years ago. Patient involvement in that panel is also desired.

Anyone with interest or experience with these diseases who would be interested in participating in ACEP's efforts is invited to contact me for more details. Thanks in advance for your interest in this matter. 


------------------------------
David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."
------------------------------

Ha! The old problem of getting from "ought" to "is"! 

------------------------------
David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."
------------------------------

Original Message:
Sent: 02-25-2022 07:41
From: Pat Croskerry
Subject: Seeking patient voices

Agreed. The cognitive forcing strategy ROWs (rule out worst case scenario) at least gets it onto the differential.

Pat

Original Message:
Sent: 2/24/2022 7:46:00 PM
From: Charles Pilcher
Subject: RE: Seeking patient voices

The first thing an Emergency Physician should think when he/she sees a complaint of "chest pain" is AAA. Why? Because if it isn't top of mind, that doc will join the long list of those who miss it. By the time a doc sees the patient, the nurse will have done the ECG and sent troponin, etc. to the lab. It's pretty hard to miss an MI these days, but AAA and PE are still missed. Same goes for back pain: Think spinal epidural abscess in every case and you won't miss it.

------------------------------
Charles Pilcher MD FACEP
Editor, Medical Malpractice Insights - Learning from Lawsuits
https://madmimi.com/p/5f4487

Original Message:
Sent: 02-24-2022 17:55
From: David Meyers
Subject: Seeking patient voices

I, along Michael Bruno and others, am on a panel established by the American College of Emergency Physicians to develop quality measures for the diagnosis of ruptured abdominal aortic aneurysm (rAAA). The effort is funded by a generous grant from the Gordon and Betty Moore Foundation. We held our first organizational meeting this week and discussed how we will proceed. One of our top priorities is to engage with patients or family members who have had experience with rAAA and have them on our work group. 

In addition, ACEP is working on another such effort, funded by the John Ritter Foundation, to develop quality measures for  aortic dissection (AD). The Ritter Foundation came about after John Ritter, a well known and loved TV star, died of AD nearly 20 years ago. Patient involvement in that panel is also desired.

Anyone with interest or experience with these diseases who would be interested in participating in ACEP's efforts is invited to contact me for more details. Thanks in advance for your interest in this matter. 


------------------------------
David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."
------------------------------

Original Message:
Sent: 2/26/2022 11:00:00 PM
From: David Meyers
Subject: RE: Seeking patient voices

Ha! The old problem of getting from "ought" to "is"! 

But 15 years of SIDM history, let alone mountains of experience, research and efforts, make the case that saying it should happen does not cause it to happen. The IOM/NAM made the point that fixing the human is not usually a long-term winning strategy absent other efforts. Fixing systems is likely to be more impactful, at least partly by removing impediments and making it easier to do the right thing than the wrong. 

And even if ROWS is an effective strategy, it probably must be inculcated very early in training (along with "when you hear hoofbeats, think of horses not zebras"?) so that in the real world of production pressures, distractions, faulty memory, cognitive biases, etc etc, etc, it will still float to the surface and have an influence before the patient is discharged.

------------------------------
David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."
------------------------------

Original Message:
Sent: 02-25-2022 07:41
From: Pat Croskerry
Subject: Seeking patient voices

Agreed. The cognitive forcing strategy ROWs (rule out worst case scenario) at least gets it onto the differential.

Pat

Original Message:
Sent: 2/24/2022 7:46:00 PM
From: Charles Pilcher
Subject: RE: Seeking patient voices

The first thing an Emergency Physician should think when he/she sees a complaint of "chest pain" is AAA. Why? Because if it isn't top of mind, that doc will join the long list of those who miss it. By the time a doc sees the patient, the nurse will have done the ECG and sent troponin, etc. to the lab. It's pretty hard to miss an MI these days, but AAA and PE are still missed. Same goes for back pain: Think spinal epidural abscess in every case and you won't miss it.

------------------------------
Charles Pilcher MD FACEP
Editor, Medical Malpractice Insights - Learning from Lawsuits
https://madmimi.com/p/5f4487

Original Message:
Sent: 02-24-2022 17:55
From: David Meyers
Subject: Seeking patient voices

I, along Michael Bruno and others, am on a panel established by the American College of Emergency Physicians to develop quality measures for the diagnosis of ruptured abdominal aortic aneurysm (rAAA). The effort is funded by a generous grant from the Gordon and Betty Moore Foundation. We held our first organizational meeting this week and discussed how we will proceed. One of our top priorities is to engage with patients or family members who have had experience with rAAA and have them on our work group. 

In addition, ACEP is working on another such effort, funded by the John Ritter Foundation, to develop quality measures for  aortic dissection (AD). The Ritter Foundation came about after John Ritter, a well known and loved TV star, died of AD nearly 20 years ago. Patient involvement in that panel is also desired.

Anyone with interest or experience with these diseases who would be interested in participating in ACEP's efforts is invited to contact me for more details. Thanks in advance for your interest in this matter. 


------------------------------
David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."
------------------------------

Original Message:
Sent: 2/27/2022 2:06:00 PM
From: David Meyers
Subject: RE: Seeking patient voices

Regarding patient voices, take a look at this important paper by SIDM's own Suze Schrandt and Michael Kanter.

https://www.bmj.com/content/bmj/376/bmj.o451.full.pdf

David

David L Meyers, MD, MBE, FACEP

Original Message:
Sent: 2/26/2022 11:00:00 PM
From: David Meyers
Subject: RE: Seeking patient voices

Ha! The old problem of getting from "ought" to "is"! 

But 15 years of SIDM history, let alone mountains of experience, research and efforts, make the case that saying it should happen does not cause it to happen. The IOM/NAM made the point that fixing the human is not usually a long-term winning strategy absent other efforts. Fixing systems is likely to be more impactful, at least partly by removing impediments and making it easier to do the right thing than the wrong. 

And even if ROWS is an effective strategy, it probably must be inculcated very early in training (along with "when you hear hoofbeats, think of horses not zebras"?) so that in the real world of production pressures, distractions, faulty memory, cognitive biases, etc etc, etc, it will still float to the surface and have an influence before the patient is discharged.

------------------------------
David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."
------------------------------

Original Message:
Sent: 02-25-2022 07:41
From: Pat Croskerry
Subject: Seeking patient voices

Agreed. The cognitive forcing strategy ROWs (rule out worst case scenario) at least gets it onto the differential.

Pat

Original Message:
Sent: 2/24/2022 7:46:00 PM
From: Charles Pilcher
Subject: RE: Seeking patient voices

The first thing an Emergency Physician should think when he/she sees a complaint of "chest pain" is AAA. Why? Because if it isn't top of mind, that doc will join the long list of those who miss it. By the time a doc sees the patient, the nurse will have done the ECG and sent troponin, etc. to the lab. It's pretty hard to miss an MI these days, but AAA and PE are still missed. Same goes for back pain: Think spinal epidural abscess in every case and you won't miss it.

------------------------------
Charles Pilcher MD FACEP
Editor, Medical Malpractice Insights - Learning from Lawsuits
https://madmimi.com/p/5f4487

Original Message:
Sent: 02-24-2022 17:55
From: David Meyers
Subject: Seeking patient voices

I, along Michael Bruno and others, am on a panel established by the American College of Emergency Physicians to develop quality measures for the diagnosis of ruptured abdominal aortic aneurysm (rAAA). The effort is funded by a generous grant from the Gordon and Betty Moore Foundation. We held our first organizational meeting this week and discussed how we will proceed. One of our top priorities is to engage with patients or family members who have had experience with rAAA and have them on our work group. 

In addition, ACEP is working on another such effort, funded by the John Ritter Foundation, to develop quality measures for  aortic dissection (AD). The Ritter Foundation came about after John Ritter, a well known and loved TV star, died of AD nearly 20 years ago. Patient involvement in that panel is also desired.

Anyone with interest or experience with these diseases who would be interested in participating in ACEP's efforts is invited to contact me for more details. Thanks in advance for your interest in this matter. 


------------------------------
David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."
------------------------------

Original Message:
Sent: 3/10/2022 12:46:00 PM
From: Pat Croskerry
Subject: RE: Seeking patient voices

FYI
https://www.bmj.com/content/376/bmj-2021-068044/rr-1

Pat Croskerry

Original Message:
Sent: 2/27/2022 2:06:00 PM
From: David Meyers
Subject: RE: Seeking patient voices

Regarding patient voices, take a look at this important paper by SIDM's own Suze Schrandt and Michael Kanter.

https://www.bmj.com/content/bmj/376/bmj.o451.full.pdf

David

David L Meyers, MD, MBE, FACEP

Original Message:
Sent: 2/26/2022 11:00:00 PM
From: David Meyers
Subject: RE: Seeking patient voices

Ha! The old problem of getting from "ought" to "is"! 

But 15 years of SIDM history, let alone mountains of experience, research and efforts, make the case that saying it should happen does not cause it to happen. The IOM/NAM made the point that fixing the human is not usually a long-term winning strategy absent other efforts. Fixing systems is likely to be more impactful, at least partly by removing impediments and making it easier to do the right thing than the wrong. 

And even if ROWS is an effective strategy, it probably must be inculcated very early in training (along with "when you hear hoofbeats, think of horses not zebras"?) so that in the real world of production pressures, distractions, faulty memory, cognitive biases, etc etc, etc, it will still float to the surface and have an influence before the patient is discharged.

------------------------------
David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."
------------------------------

Original Message:
Sent: 02-25-2022 07:41
From: Pat Croskerry
Subject: Seeking patient voices

Agreed. The cognitive forcing strategy ROWs (rule out worst case scenario) at least gets it onto the differential.

Pat

Original Message:
Sent: 2/24/2022 7:46:00 PM
From: Charles Pilcher
Subject: RE: Seeking patient voices

The first thing an Emergency Physician should think when he/she sees a complaint of "chest pain" is AAA. Why? Because if it isn't top of mind, that doc will join the long list of those who miss it. By the time a doc sees the patient, the nurse will have done the ECG and sent troponin, etc. to the lab. It's pretty hard to miss an MI these days, but AAA and PE are still missed. Same goes for back pain: Think spinal epidural abscess in every case and you won't miss it.

------------------------------
Charles Pilcher MD FACEP
Editor, Medical Malpractice Insights - Learning from Lawsuits
https://madmimi.com/p/5f4487

Original Message:
Sent: 02-24-2022 17:55
From: David Meyers
Subject: Seeking patient voices

I, along Michael Bruno and others, am on a panel established by the American College of Emergency Physicians to develop quality measures for the diagnosis of ruptured abdominal aortic aneurysm (rAAA). The effort is funded by a generous grant from the Gordon and Betty Moore Foundation. We held our first organizational meeting this week and discussed how we will proceed. One of our top priorities is to engage with patients or family members who have had experience with rAAA and have them on our work group. 

In addition, ACEP is working on another such effort, funded by the John Ritter Foundation, to develop quality measures for  aortic dissection (AD). The Ritter Foundation came about after John Ritter, a well known and loved TV star, died of AD nearly 20 years ago. Patient involvement in that panel is also desired.

Anyone with interest or experience with these diseases who would be interested in participating in ACEP's efforts is invited to contact me for more details. Thanks in advance for your interest in this matter. 


------------------------------
David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."
------------------------------

Original Message:
Sent: 3/10/2022 1:05:00 PM
From: William Follansbee
Subject: RE: Seeking patient voices

Hear, Hear!

 

William P. Follansbee, MD, FACC, FACP, FASNC

The Master Clinician Professor of Cardiovascular Medicine

Director, The UPMC Clinical Center For Medical Decision Making

Suite A429, UPMC Presbyterian

200 Lothrop Street

Pittsburgh, PA 15213

Office: 412-647-3437

Fax: 412-647-3873

 

Original Message:
Sent: 3/10/2022 12:46:00 PM
From: Pat Croskerry
Subject: RE: Seeking patient voices

FYI
https://www.bmj.com/content/376/bmj-2021-068044/rr-1

Pat Croskerry

Original Message:
Sent: 2/27/2022 2:06:00 PM
From: David Meyers
Subject: RE: Seeking patient voices

Regarding patient voices, take a look at this important paper by SIDM's own Suze Schrandt and Michael Kanter.

https://www.bmj.com/content/bmj/376/bmj.o451.full.pdf

David

David L Meyers, MD, MBE, FACEP

Original Message:
Sent: 2/26/2022 11:00:00 PM
From: David Meyers
Subject: RE: Seeking patient voices

Ha! The old problem of getting from "ought" to "is"! 

But 15 years of SIDM history, let alone mountains of experience, research and efforts, make the case that saying it should happen does not cause it to happen. The IOM/NAM made the point that fixing the human is not usually a long-term winning strategy absent other efforts. Fixing systems is likely to be more impactful, at least partly by removing impediments and making it easier to do the right thing than the wrong. 

And even if ROWS is an effective strategy, it probably must be inculcated very early in training (along with "when you hear hoofbeats, think of horses not zebras"?) so that in the real world of production pressures, distractions, faulty memory, cognitive biases, etc etc, etc, it will still float to the surface and have an influence before the patient is discharged.

------------------------------
David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."
------------------------------

Original Message:
Sent: 02-25-2022 07:41
From: Pat Croskerry
Subject: Seeking patient voices

Agreed. The cognitive forcing strategy ROWs (rule out worst case scenario) at least gets it onto the differential.

Pat

Original Message:
Sent: 2/24/2022 7:46:00 PM
From: Charles Pilcher
Subject: RE: Seeking patient voices

The first thing an Emergency Physician should think when he/she sees a complaint of "chest pain" is AAA. Why? Because if it isn't top of mind, that doc will join the long list of those who miss it. By the time a doc sees the patient, the nurse will have done the ECG and sent troponin, etc. to the lab. It's pretty hard to miss an MI these days, but AAA and PE are still missed. Same goes for back pain: Think spinal epidural abscess in every case and you won't miss it.

------------------------------
Charles Pilcher MD FACEP
Editor, Medical Malpractice Insights - Learning from Lawsuits
https://madmimi.com/p/5f4487

Original Message:
Sent: 02-24-2022 17:55
From: David Meyers
Subject: Seeking patient voices

I, along Michael Bruno and others, am on a panel established by the American College of Emergency Physicians to develop quality measures for the diagnosis of ruptured abdominal aortic aneurysm (rAAA). The effort is funded by a generous grant from the Gordon and Betty Moore Foundation. We held our first organizational meeting this week and discussed how we will proceed. One of our top priorities is to engage with patients or family members who have had experience with rAAA and have them on our work group. 

In addition, ACEP is working on another such effort, funded by the John Ritter Foundation, to develop quality measures for  aortic dissection (AD). The Ritter Foundation came about after John Ritter, a well known and loved TV star, died of AD nearly 20 years ago. Patient involvement in that panel is also desired.

Anyone with interest or experience with these diseases who would be interested in participating in ACEP's efforts is invited to contact me for more details. Thanks in advance for your interest in this matter. 


------------------------------
David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."
------------------------------

Original Message:
Sent: 3/10/2022 12:46:00 PM
From: Pat Croskerry
Subject: RE: Seeking patient voices

FYI
https://www.bmj.com/content/376/bmj-2021-068044/rr-1

Pat Croskerry

Original Message:
Sent: 2/27/2022 2:06:00 PM
From: David Meyers
Subject: RE: Seeking patient voices

Regarding patient voices, take a look at this important paper by SIDM's own Suze Schrandt and Michael Kanter.

https://www.bmj.com/content/bmj/376/bmj.o451.full.pdf

David

David L Meyers, MD, MBE, FACEP

Original Message:
Sent: 2/26/2022 11:00:00 PM
From: David Meyers
Subject: RE: Seeking patient voices

Ha! The old problem of getting from "ought" to "is"! 

But 15 years of SIDM history, let alone mountains of experience, research and efforts, make the case that saying it should happen does not cause it to happen. The IOM/NAM made the point that fixing the human is not usually a long-term winning strategy absent other efforts. Fixing systems is likely to be more impactful, at least partly by removing impediments and making it easier to do the right thing than the wrong. 

And even if ROWS is an effective strategy, it probably must be inculcated very early in training (along with "when you hear hoofbeats, think of horses not zebras"?) so that in the real world of production pressures, distractions, faulty memory, cognitive biases, etc etc, etc, it will still float to the surface and have an influence before the patient is discharged.

------------------------------
David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."
------------------------------

Original Message:
Sent: 02-25-2022 07:41
From: Pat Croskerry
Subject: Seeking patient voices

Agreed. The cognitive forcing strategy ROWs (rule out worst case scenario) at least gets it onto the differential.

Pat

Original Message:
Sent: 2/24/2022 7:46:00 PM
From: Charles Pilcher
Subject: RE: Seeking patient voices

The first thing an Emergency Physician should think when he/she sees a complaint of "chest pain" is AAA. Why? Because if it isn't top of mind, that doc will join the long list of those who miss it. By the time a doc sees the patient, the nurse will have done the ECG and sent troponin, etc. to the lab. It's pretty hard to miss an MI these days, but AAA and PE are still missed. Same goes for back pain: Think spinal epidural abscess in every case and you won't miss it.

------------------------------
Charles Pilcher MD FACEP
Editor, Medical Malpractice Insights - Learning from Lawsuits
https://madmimi.com/p/5f4487

Original Message:
Sent: 02-24-2022 17:55
From: David Meyers
Subject: Seeking patient voices

I, along Michael Bruno and others, am on a panel established by the American College of Emergency Physicians to develop quality measures for the diagnosis of ruptured abdominal aortic aneurysm (rAAA). The effort is funded by a generous grant from the Gordon and Betty Moore Foundation. We held our first organizational meeting this week and discussed how we will proceed. One of our top priorities is to engage with patients or family members who have had experience with rAAA and have them on our work group. 

In addition, ACEP is working on another such effort, funded by the John Ritter Foundation, to develop quality measures for  aortic dissection (AD). The Ritter Foundation came about after John Ritter, a well known and loved TV star, died of AD nearly 20 years ago. Patient involvement in that panel is also desired.

Anyone with interest or experience with these diseases who would be interested in participating in ACEP's efforts is invited to contact me for more details. Thanks in advance for your interest in this matter. 


------------------------------
David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."
------------------------------

Thank you for sharing, Dr. Meyers! Although I'm a PhD candidate currently working on my dissertation, I've been working on this kind of research the past 6 years. SIDM and its community (and AHRQ) have given me such valuable resources to cite in my work, and I will definitely be using this in my dissertation. I also cite from Traber Giardina's work, and she has been a tremendous mentor to me.

Thank you, Suze and Michael, for this publication! I look forward to citing it.

------------------------------
Allyson Bontempo, MA
PhD Candidate / Instructor
School of Communication & Information
Rutgers, The State University of New Jersey
allyson.bontempo@rutgers.edu
------------------------------

Original Message:
Sent: 02-27-2022 14:06
From: David Meyers
Subject: Seeking patient voices

Regarding patient voices, take a look at this important paper by SIDM's own Suze Schrandt and Michael Kanter.

https://www.bmj.com/content/bmj/376/bmj.o451.full.pdf

David

David L Meyers, MD, MBE, FACEP

Original Message:
Sent: 2/26/2022 11:00:00 PM
From: David Meyers
Subject: RE: Seeking patient voices

Ha! The old problem of getting from "ought" to "is"! 

But 15 years of SIDM history, let alone mountains of experience, research and efforts, make the case that saying it should happen does not cause it to happen. The IOM/NAM made the point that fixing the human is not usually a long-term winning strategy absent other efforts. Fixing systems is likely to be more impactful, at least partly by removing impediments and making it easier to do the right thing than the wrong. 

And even if ROWS is an effective strategy, it probably must be inculcated very early in training (along with "when you hear hoofbeats, think of horses not zebras"?) so that in the real world of production pressures, distractions, faulty memory, cognitive biases, etc etc, etc, it will still float to the surface and have an influence before the patient is discharged.

------------------------------
David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."

Original Message:
Sent: 02-25-2022 07:41
From: Pat Croskerry
Subject: Seeking patient voices

Agreed. The cognitive forcing strategy ROWs (rule out worst case scenario) at least gets it onto the differential.

Pat

Original Message:
Sent: 2/24/2022 7:46:00 PM
From: Charles Pilcher
Subject: RE: Seeking patient voices

The first thing an Emergency Physician should think when he/she sees a complaint of "chest pain" is AAA. Why? Because if it isn't top of mind, that doc will join the long list of those who miss it. By the time a doc sees the patient, the nurse will have done the ECG and sent troponin, etc. to the lab. It's pretty hard to miss an MI these days, but AAA and PE are still missed. Same goes for back pain: Think spinal epidural abscess in every case and you won't miss it.

------------------------------
Charles Pilcher MD FACEP
Editor, Medical Malpractice Insights - Learning from Lawsuits
https://madmimi.com/p/5f4487

Original Message:
Sent: 02-24-2022 17:55
From: David Meyers
Subject: Seeking patient voices

I, along Michael Bruno and others, am on a panel established by the American College of Emergency Physicians to develop quality measures for the diagnosis of ruptured abdominal aortic aneurysm (rAAA). The effort is funded by a generous grant from the Gordon and Betty Moore Foundation. We held our first organizational meeting this week and discussed how we will proceed. One of our top priorities is to engage with patients or family members who have had experience with rAAA and have them on our work group. 

In addition, ACEP is working on another such effort, funded by the John Ritter Foundation, to develop quality measures for  aortic dissection (AD). The Ritter Foundation came about after John Ritter, a well known and loved TV star, died of AD nearly 20 years ago. Patient involvement in that panel is also desired.

Anyone with interest or experience with these diseases who would be interested in participating in ACEP's efforts is invited to contact me for more details. Thanks in advance for your interest in this matter. 


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David L Meyers, MD, MBE, FACEP
Sinai Hospital of Baltimore
Berman Institute of Bioethics
Johns Hopkins University

"Aneurysm of the abdominal aorta is very often diagnosed when not present, and when present the symptoms may be so obscure that the nature of the trouble is overlooked."
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