Hospital Medicine CME

Hospital Medicine: Management of the Hospitalized Adult Patient
February 14-18, 2011 (8:00am-12:15pm) Location: Hyatt Regency Sarasota, Florida 20 AMA PRA Category 1 Credits™ 20 CME Credits - AAFP ACEP ACOG Mainpro-M1 (Canadian Physicians)	Course #SEMLA-2520110214 Price: $645.00 - $795.00

by Robert Hasty, D.O., F.A.C.O.I. - Nova Southeastern University College of Osteopathic Medicine (NSU-COM); Assistant Professor of Internal Medicine; Director, Internal Medicine Residency Program, Palmetto General Hospital, Hialeah, FL; Joshua D. Lenchus, D.O., R.Ph., F.A.C.P., F.H.M. - University of Miami Miller School of Medicine; Assistant Professor of Clinical Medicine, Division of Hospital Medicine; Associate Program Director, Internal Medicine Residency Training Program and Associate Director, UM-JMH Center for Patient Safety, Department of Anesthesiology, Jackson Memorial Hospital, Miami, FL; Ganesan Murali, M.D. - Jefferson Medical College, Thomas Jefferson University; Assistant Professor of Medicine; Director, Albert Einstein Sleep Center and Attending Physician, Division of Pulmonary, Critical Care and Sleep Medicine, Albert Einstein Medical Center, Philadelphia, PA and Arshad A. Wani, M.D. - Jefferson Medical College, Thomas Jefferson University; Assistant Professor of Medicine; Associate Director, Medical Intensive Care Unit and Attending Physician, Division of Pulmonary, Critical Care and Sleep Medicine, Albert Einstein Medical Center, Philadelphia, PA.

Learning Objectives
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NARRATIVE DESCRIPTION: Following this course, the participant should be able to formulate a practical approach to common disorders found in the hospitalized adult patient; determine the diagnostic tests that can be used to determine the severity of the patient's problem and make an accurate diagnosis; apply the various treatment options available and recognize when to treat and when to call for a specialist. This activity is expected to result in improved competence in making an appropriate diagnosis and providing effective treatment and consultation with the overall goal of improving patient outcomes.

The emphasis will be on aligning physician behavior with current guidelines and evidence-based medicine, as indicated within each topic’s specific objectives. As recent advances in diagnostic modalities and treatments make it necessary to improve competence in an inpatient setting, this course was designed as an update for all practitioners at the level of a practicing physician in the hospital setting.

Day 1 Stroke. Anticoagulation Update. COPD – Overview of Patient Management. Pneumonia.

Day 2 Respiratory Failure. Mechanical Ventilation. Prevention of Medical Errors. Sign-Out/Transfer of Care.

Day 3 Septic Shock. Critical Care Cases for Review. Pulmonary Function Testing. Asthma Update.

Day 4 Acid Base Disorders. Case-Based Approach to Disorders of Sugar, Salt and Water. Prophylaxis and Treatment of Venous Thromboembolism. Dyslipidemia in High-Risk Patient Populations.

Day 5 Preoperative Medical Evaluation. Patient Safety. Pleural Diseases: Effusions and Pneumothorax. Pulmonary Cases for Review.

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Hospital Medicine: Management of the Hospitalized Adult Patient
February 14-18, 2011
Location: Hyatt Regency Sarasota, Florida

SPECIFIC OBJECTIVES

Day 1

Stroke - Upon completion of this session, the participant should be able to:

1.	Employ antithrombotics for secondary prevention of stroke.
2.	Manage hypertension in the setting of acute ischemic stroke.
3.	Debate the use of anticoagulants in the setting of acute ischemic stroke.
Anticoagulation Update - Upon completion of this session, the participant should be able to:
1.	Use the recommendations of the eighth American College of Chest Physicians (ACCP 8) Conference on Antithrombotic and Thrombolytic Therapy.
2.	Utilize the updated recommendations by ACCP 8 regarding the management of vitamin K antagonists.
3.	Employ the updated recommendations by ACCP 8 regarding the management and prevention of venous thromboembolic disease.
COPD – Overview of Patient Management - Upon completion of this session, the participant should be able to:
1.	Apply the definition and pathophysiology of COPD to improve their assessment of the disease.
2.	Appraise the natural history and relate the clinical features of COPD.
3.	Formulate the management of acute exacerbations and outpatient management including long term oxygen and pharmacologic treatment.
4.	Assess the need for surgical and newer treatments of emphysema.
Pneumonia - Upon completion of this session, the participant should be able to:
1.	Determine the presentation of community acquired and atypical pneumonia.
2.	Distinguish the different pathogens that cause pneumonia.
3.	Assess patients with respect to severity of pneumonia.
4.	Develop an effective approach to health care associated pneumonia.

Day 2

Respiratory Failure - Upon completion of this session, the participant should be able to:

1.	Specify the various etiologies of acute respiratory failure.
2.	Integrate the pathophysiology of gas exchange in various disorders.
3.	Develop a plan for the management of acute respiratory failure.
4.	Differentiate the indications for non-invasive vs. invasive ventilation for respiratory failure.
Mechanical Ventilation - Upon completion of this session, the participant should be able to:
1.	Determine the indications for mechanical ventilation.
2.	Differentiate the various modes of ventilation.
3.	Assess and recommend the different ventilator settings in response to disease states.
4.	Detect the complications of ventilation and develop a weaning strategy.
Prevention of Medical Errors - Upon completion of this session, the participant should be able to:
1.	Employ the 2010 Ambulatory Care/Office-Based Surgery National Patient Safety Goals of the Joint Commission on Accreditation of Healthcare Organizations.
2.	Appraise the “Swiss Cheese” Model of Majors Accidents and Errors.
3.	Evaluate selected key points of the Institute of Medicine report, “To Err is Human”.
4.	Construct a culture of safety in a healthcare organization.
5.	Debate the role of technology in prevention of medical errors.
6.	Employ selected strategies for error reduction and prevention.
7.	Utilize selected strategies for improving patient safety.
8.	Integrate a systematic approach for reducing medication errors, surgical errors, diagnostic inaccuracies, and system failures.
Sign-Out/Transfer of Care - Upon completion of this session, the participant should be able to:
1.	Employ selected transition of care strategies.
2.	Debate risk management principles related to transitions of care.
3.	Design safe practice systems for transitioning care of a patient.

Day 3

Septic Shock - At the completion of this session the participant should be able to:

1.	Define shock and differentiate the various types of shock.
2.	Outline the concept of sepsis management bundles.
3.	Formulate and manage the early resuscitation of septic shock, vasopressor use and monitoring.
4.	Specify the current controversies in steroid use in shock and glycemic control in the ICU.
Critical Care Cases for Review - A wide variety of Critical Care Cases will be presented with audience participation. At the completion of this session the participant should be able to:
1.	Determine the various causes of hemoptysis and plan their management.
2.	Appraise treatment modalities of pulmonary embolism including thrombolysis and vena caval filters.
3.	Determine and differentiate pulmonary conditions associated with pregnancy and plan the investigations for the pregnant patient with pulmonary problems.
4.	Detect common overdose/poisonings and formulate a plan for management.
Pulmonary Function Testing - At the completion of this session the participant should be able to:
1.	Assess the components of Pulmonary Function Testings (PFTs) including spirometry, lung volumes and diffusion.
2.	Determine the indications of PFTs.
3.	Develop a stepwise approach to PFT interpretation and recognize patterns.
4.	Determine of the role of PFTs and appropriately order them in select disease states.
Asthma Update - We will review the current status of outpatient asthma, diagnosis and treatment, emphasizing recent NIH guidelines. Upon completion of this session, the participant should be able to:
1.	Appraise the pathophysiology of this inflammatory disease.
2.	Distinguish the typical and atypical clinical presentations with cases serving as examples.
3.	Determine the clinical value and appropriate use of the available diagnostic modalities.
4.	Develop a stepwise approach to treatment of asthma and management of status asthmaticus.
5.	Detect the patient who is not responding and define indications for subspecialty referral.

Day 4

Acid Base Disorders - At the completion of this session the participant should be able to:

1.	Distinguish the type of acid base disturbance – Acidosis and Alkalosis.
2.	Determine the anion gap and its role in defining acid base disorders.
3.	Utilize osmolal gap and urine anion gap.
4.	Plan the management of acid base disorders by case-based examples.
Case-Based Approach to Disorders of Sugar, Salt and Water - At the completion of this session the participant should be able to:
1.	Determine the presentation of diabetic emergencies - ketoacidosis, non-ketotic hyperglycemia and hypoglycemia.
2.	Formulate treatment strategies for the diabetic emergencies.
3.	Develop an approach to hyponatremia and hypernatremia.
4.	Detect common electrolyte imbalances and plan their management.
Prophylaxis and Treatment of Venous Thromboembolism - Upon completion of this session, the participant should be able to:
1.	Identify common risk factors in the development of venous thromboembolic events (VTE).
2.	Appropriately assess an individual patient's risk of experiencing a VTE.
3.	Apply evidence-based consensus guidelines in determining the correct prophylaxis and treatment in patients who suffer a VTE.
Dyslipidemia in High-Risk Patient Populations - Upon completion of this session, the participant should be able to:
1.	Identify a few of the higher risk patient populations with dyslipidemia.
2.	Interpret some of the landmark lipid studies supporting various treatment options.
3.	Apply evidence-based recommendations in the treatment of dyslipidemia.

Day 5

Preoperative Medical Evaluation - Upon completion of this session, the participant should be able to

1.	Recognize the necessary components of the history and physical in conducting a thorough preoperative medical evaluation.
2.	Integrate some of the recent published information supporting or refuting traditional practice into a preoperative evaluation.
3.	Apply evidence-based guidelines in conducting a preoperative medical evaluation.
Patient Safety - Upon completion of this session, the participant should be able to
1.	Identify reasons why errors occur in medicine.
2.	Describe different systems utilized to advance patient safety.
3.	Employ evidence-based measures in preventing errors and how to address them.
Pleural Diseases: Effusions and Pneumothorax - Upon completion of this session, the participant should be able to:
1.	Determine the etiology of pleural effusions by means of cases.
2.	Formulate the investigation and management of pleural effusions.
3.	Detect and assess the clinical presentation of pneumothorax.
4.	Develop an approach to effective management of pneumothorax.
Pulmonary Cases for Review - A wide variety of Pulmonary Cases will be presented with audience participation. At the completion of this session, the participant should be able to:
1.	Identify and properly evaluate sleep apnea and excessive daytime sleepiness.
2.	Develop a differential diagnosis and approach to a patient with a non-resolving infiltrate.
3.	Assess the causes and formulate an evaluation of a solitary lung nodule.
4.	Assess and evaluate interstitial lung diseases.

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