Society News

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.

Here are some recent clinical discussions in the forum regarding the coronavirus and your patients:

1. Biologic treatment for IBD in the COVID-19 era (http://ow.ly/9akD50yKW8E)

A GI colleague from Italy asks how others are managing IBD patients on ongoing biologic treatment during the coronavirus pandemic.

2. COVID-19 and colonoscopy (http://ow.ly/uYUD50yKWfS)

AGA members discuss recommendations for infection control in endoscopy centers.

3. IBD patients concerned about visiting infusion centers (http://ow.ly/gKED50yKWVZ)

How would you address patient concerns about picking up coronavirus from asymptomatic carriers at bustling infusion centers?



Join these discussions and more at https://community.gastro.org/discussions.

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.

Here are some recent clinical discussions in the forum regarding the coronavirus and your patients:

1. Biologic treatment for IBD in the COVID-19 era (http://ow.ly/9akD50yKW8E)

A GI colleague from Italy asks how others are managing IBD patients on ongoing biologic treatment during the coronavirus pandemic.

2. COVID-19 and colonoscopy (http://ow.ly/uYUD50yKWfS)

AGA members discuss recommendations for infection control in endoscopy centers.

3. IBD patients concerned about visiting infusion centers (http://ow.ly/gKED50yKWVZ)

How would you address patient concerns about picking up coronavirus from asymptomatic carriers at bustling infusion centers?



Join these discussions and more at https://community.gastro.org/discussions.

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.

Here are some recent clinical discussions in the forum regarding the coronavirus and your patients:

1. Biologic treatment for IBD in the COVID-19 era (http://ow.ly/9akD50yKW8E)

A GI colleague from Italy asks how others are managing IBD patients on ongoing biologic treatment during the coronavirus pandemic.

2. COVID-19 and colonoscopy (http://ow.ly/uYUD50yKWfS)

AGA members discuss recommendations for infection control in endoscopy centers.

3. IBD patients concerned about visiting infusion centers (http://ow.ly/gKED50yKWVZ)

How would you address patient concerns about picking up coronavirus from asymptomatic carriers at bustling infusion centers?



Join these discussions and more at https://community.gastro.org/discussions.

AGA has partnered with Rx.Health, a digital health company, to create a colorectal cancer (CRC) preparatory app.

You want to find ways to improve your patient outcomes and reduce your practice costs? Now, there is an app for that. The CRC preparatory app can reduce expenses you lose from aborted or incomplete colonoscopies.

Launched in 2019, the CRC app is already generating remarkable results. The Arizona Center for Digestive Health used the CRC app and recorded a 24% improvement in bowel preparation by colonoscopy patients, a 50% reduction in aborted procedures and a 93% patient satisfaction rate. Research conducted by Rx.Health also determined patients were using the CRC app two to four times longer than competing apps, and the CRC app was saving gastroenterologists between $20,000 and $40,000 annually.

Plans are underway between AGA and Rx.Health to expand the partnership to build apps for colorectal cancer surveillance, an inflammatory bowel disease (IBD) registry, fecal microbiota transplantation (FMT), and other GI disorders.

Interested in learning more? Visit rx.health/gi.

[email protected]

AGA has partnered with Rx.Health, a digital health company, to create a colorectal cancer (CRC) preparatory app.

You want to find ways to improve your patient outcomes and reduce your practice costs? Now, there is an app for that. The CRC preparatory app can reduce expenses you lose from aborted or incomplete colonoscopies.

Launched in 2019, the CRC app is already generating remarkable results. The Arizona Center for Digestive Health used the CRC app and recorded a 24% improvement in bowel preparation by colonoscopy patients, a 50% reduction in aborted procedures and a 93% patient satisfaction rate. Research conducted by Rx.Health also determined patients were using the CRC app two to four times longer than competing apps, and the CRC app was saving gastroenterologists between $20,000 and $40,000 annually.

Plans are underway between AGA and Rx.Health to expand the partnership to build apps for colorectal cancer surveillance, an inflammatory bowel disease (IBD) registry, fecal microbiota transplantation (FMT), and other GI disorders.

Interested in learning more? Visit rx.health/gi.

[email protected]

AGA has partnered with Rx.Health, a digital health company, to create a colorectal cancer (CRC) preparatory app.

You want to find ways to improve your patient outcomes and reduce your practice costs? Now, there is an app for that. The CRC preparatory app can reduce expenses you lose from aborted or incomplete colonoscopies.

Launched in 2019, the CRC app is already generating remarkable results. The Arizona Center for Digestive Health used the CRC app and recorded a 24% improvement in bowel preparation by colonoscopy patients, a 50% reduction in aborted procedures and a 93% patient satisfaction rate. Research conducted by Rx.Health also determined patients were using the CRC app two to four times longer than competing apps, and the CRC app was saving gastroenterologists between $20,000 and $40,000 annually.

Plans are underway between AGA and Rx.Health to expand the partnership to build apps for colorectal cancer surveillance, an inflammatory bowel disease (IBD) registry, fecal microbiota transplantation (FMT), and other GI disorders.

Interested in learning more? Visit rx.health/gi.

[email protected]

The recent explosion of innovations for the diagnosis and treatment of GI diseases makes it difficult to identify what will affect you today and what has implications for tomorrow.

Techniques and Innovations in Gastrointestinal Endoscopy (TIGE) cuts through the noise with quarterly updates featuring groundbreaking advances in GI endoscopy. Previously known as Techniques in Gastrointestinal Endoscopy, TIGE is the newest member of the AGA journal family and illuminates the next generation of technologies in an easily accessible, online-only format. TIGE will continue to be led by Co-Editors-in-Chief Vinay Chandrasekhara, MD, Mayo Clinic, Rochester, Minn., and Michael Kochman, MD, AGAF, University of Pennsylvania School of Medicine, Philadelphia, and a hand-selected editorial board of leaders in GI endoscopy.

Check out the current issue of TIGE focused on how lumen apposing metal stents (LAMS) are changing GI endoscopy. The issue provides a comprehensive review on the current state of LAMS and best practices for using LAMS to optimize patient outcomes.

Discover TIGE at tigejournal.org.
 

[email protected]

The recent explosion of innovations for the diagnosis and treatment of GI diseases makes it difficult to identify what will affect you today and what has implications for tomorrow.

Techniques and Innovations in Gastrointestinal Endoscopy (TIGE) cuts through the noise with quarterly updates featuring groundbreaking advances in GI endoscopy. Previously known as Techniques in Gastrointestinal Endoscopy, TIGE is the newest member of the AGA journal family and illuminates the next generation of technologies in an easily accessible, online-only format. TIGE will continue to be led by Co-Editors-in-Chief Vinay Chandrasekhara, MD, Mayo Clinic, Rochester, Minn., and Michael Kochman, MD, AGAF, University of Pennsylvania School of Medicine, Philadelphia, and a hand-selected editorial board of leaders in GI endoscopy.

Check out the current issue of TIGE focused on how lumen apposing metal stents (LAMS) are changing GI endoscopy. The issue provides a comprehensive review on the current state of LAMS and best practices for using LAMS to optimize patient outcomes.

Discover TIGE at tigejournal.org.
 

[email protected]

The recent explosion of innovations for the diagnosis and treatment of GI diseases makes it difficult to identify what will affect you today and what has implications for tomorrow.

Techniques and Innovations in Gastrointestinal Endoscopy (TIGE) cuts through the noise with quarterly updates featuring groundbreaking advances in GI endoscopy. Previously known as Techniques in Gastrointestinal Endoscopy, TIGE is the newest member of the AGA journal family and illuminates the next generation of technologies in an easily accessible, online-only format. TIGE will continue to be led by Co-Editors-in-Chief Vinay Chandrasekhara, MD, Mayo Clinic, Rochester, Minn., and Michael Kochman, MD, AGAF, University of Pennsylvania School of Medicine, Philadelphia, and a hand-selected editorial board of leaders in GI endoscopy.

Check out the current issue of TIGE focused on how lumen apposing metal stents (LAMS) are changing GI endoscopy. The issue provides a comprehensive review on the current state of LAMS and best practices for using LAMS to optimize patient outcomes.

Discover TIGE at tigejournal.org.
 

[email protected]

The AGA Governing Board recognizes and shares the extreme uncertainty faced by the GI community regarding the rapidly evolving coronavirus situation. Priority #1 is, as always, keeping our patients and families safe, but we also would like to ensure the safety of our GI health care providers.

COVID-19 is an emerging disease and there is more to learn about its transmission, severity, and how it will take shape in the U.S. We have asked our clinical guidance experts to determine what, if any, GI-specific scientifically valid recommendations can be made. In fact, Gastroenterology has just published papers on GI symptoms and potential fecal transmission in coronavirus patients. You can see this work at www.gastrojournal.org/inpress.

Stay tuned to www.gastro.org and your email for continued updates on coronavirus, as well as information on AGA live events and DDW given the current circumstances.
 

[email protected]

The AGA Governing Board recognizes and shares the extreme uncertainty faced by the GI community regarding the rapidly evolving coronavirus situation. Priority #1 is, as always, keeping our patients and families safe, but we also would like to ensure the safety of our GI health care providers.

COVID-19 is an emerging disease and there is more to learn about its transmission, severity, and how it will take shape in the U.S. We have asked our clinical guidance experts to determine what, if any, GI-specific scientifically valid recommendations can be made. In fact, Gastroenterology has just published papers on GI symptoms and potential fecal transmission in coronavirus patients. You can see this work at www.gastrojournal.org/inpress.

Stay tuned to www.gastro.org and your email for continued updates on coronavirus, as well as information on AGA live events and DDW given the current circumstances.
 

[email protected]

The AGA Governing Board recognizes and shares the extreme uncertainty faced by the GI community regarding the rapidly evolving coronavirus situation. Priority #1 is, as always, keeping our patients and families safe, but we also would like to ensure the safety of our GI health care providers.

COVID-19 is an emerging disease and there is more to learn about its transmission, severity, and how it will take shape in the U.S. We have asked our clinical guidance experts to determine what, if any, GI-specific scientifically valid recommendations can be made. In fact, Gastroenterology has just published papers on GI symptoms and potential fecal transmission in coronavirus patients. You can see this work at www.gastrojournal.org/inpress.

Stay tuned to www.gastro.org and your email for continued updates on coronavirus, as well as information on AGA live events and DDW given the current circumstances.
 

[email protected]

The AGA Research Foundation is dedicated to supporting future leaders in GI while highlighting today’s luminaries.

Our new program, AGA Honors: Celebrating Difference Makers in Our Field, recognizes individuals who have played a pivotal role in shaping the fields of gastroenterology and hepatology and raises funds for the next generation of investigators working to advance digestive disease research and patient care.

Learn more about our honorees by visiting our website at http://foundation.gastro.org/aga-honors-celebrating/. Help us celebrate their achievements by donating to the AGA Research Foundation. Contributions are tax-deductible and will go directly to the Foundation research award endowment.
 

[email protected]

The AGA Research Foundation is dedicated to supporting future leaders in GI while highlighting today’s luminaries.

Our new program, AGA Honors: Celebrating Difference Makers in Our Field, recognizes individuals who have played a pivotal role in shaping the fields of gastroenterology and hepatology and raises funds for the next generation of investigators working to advance digestive disease research and patient care.

Learn more about our honorees by visiting our website at http://foundation.gastro.org/aga-honors-celebrating/. Help us celebrate their achievements by donating to the AGA Research Foundation. Contributions are tax-deductible and will go directly to the Foundation research award endowment.
 

[email protected]

The AGA Research Foundation is dedicated to supporting future leaders in GI while highlighting today’s luminaries.

Our new program, AGA Honors: Celebrating Difference Makers in Our Field, recognizes individuals who have played a pivotal role in shaping the fields of gastroenterology and hepatology and raises funds for the next generation of investigators working to advance digestive disease research and patient care.

Learn more about our honorees by visiting our website at http://foundation.gastro.org/aga-honors-celebrating/. Help us celebrate their achievements by donating to the AGA Research Foundation. Contributions are tax-deductible and will go directly to the Foundation research award endowment.
 

[email protected]

As gastroenterologists and gastrointestinal researchers, we work with an increasingly diverse patient population amid known disparities in health care delivery and health outcomes. The American Gastroenterological Association values diversity and inclusion, and part of its strategic plan is to increase and diversify its membership and leaders. The AGA Diversity Committee supports this strategic goal by fostering and promoting involvement, advancement, and recognition of underrepresented diverse constituencies. This is accomplished through policy recommendations and programs, providing resources to AGA members for addressing barriers to access and utilization of health care services among diverse patient populations with attention to linguistic, racial, cultural, religious, sexual orientation, gender identity, disability, age, and economic diversity.

There are eight clinician and investigator members, including the chair as well as one trainee member on the AGA Diversity Committee. Four members are appointed at-large and three members are appointed from the AGA Institute Committees and the AGA Institute Council. The committee has set out to achieve mission-driven goals with several initiatives that align with its intention to cultivate a diverse, inclusive, and engaged membership, armed with the necessary tools to provide the highest quality care and perform the most effective research that will benefit our patient population.

The communications task force highlights programs and topics that support the committee’s missions. Members of the committee coauthored a paper on colorectal disparities published in GI & Hepatology News in May 2018.¹ In addition to presenting the disparities in colorectal screening, it provided ways to close this gap. A more recent publication in AGA Perspectives focused on unconscious bias as a prelude to the committee’s workshop at Digestive Disease Week^® (DDW) 2019.² An important initiative has been promoting Black History Month in February and Pride Month in June by posting cases or displaying prominent trailblazers on the AGA Community. In the upcoming months, profiles of several committee members will be featured in eDigest, GI & Hepatology News, and on AGA’s social media platforms.

DDW programming sponsored by the Diversity Committee is an important way to engage our members. At DDW 2019, the committee sponsored a clinical symposium title “Beyond Starbucks: Mitigating Bias Through Awareness.” This session was inspired by the 2018 incidence hallmarked by the inappropriate arrest of two African American men at a Philadelphia Starbucks. This event led to a nationwide educational breakout for all employees aimed at providing unconscious bias training. The Diversity Committee drew inspiration from these events, holding a symposium with set goals of defining unconscious bias and identifying areas within health care where unconscious bias can influence patient care. The committee invited Allyson Dylan Robinson, a portfolio lead from the Association of American Medical Colleges–endorsed Cook Ross Firm, who is nationally recognized as a leader in unconscious bias training. The assembly began with an introductory lecture followed by breakout sessions where small groups reviewed selected patient cases to determine the influence of unconscious bias in clinical scenarios. It was a well-attended symposium and was complementary to the wide array of didactic lectures offered at DDW. Bringing to light significant issues and barriers to health care is one key aspect of the mission set forth by the Diversity Committee.

The AGA Diversity Committee e-poster tour at DDW 2019 promoted the research led by scientist and physician members of underrepresented groups in medicine and/or research focused on gastrointestinal diseases in underrepresented populations. Several high-quality abstracts were reviewed and four were selected for the e-poster tour. Each scientist presented their research in front of an enthusiastic audience of DDW attendees, followed by a question and answer session. Gonzalo Parodi, BS (Cedars-Sinai Medical Center, Los Angeles), presented an elegant study showing that the antibiotic changes to intestinal microbiome were sex specific in mice. Alexis Rivera, MD (University of Puerto Rico, San Juan), found no association between inflammatory bowel disease (IBD) serologic markers and risk of surgery in patients with IBD in Puerto Rico. Maria Gonzalez-Pons, PhD (University of Puerto Rico Comprehensive Cancer Center, San Juan), presented the first study looking at the mutational landscape of early-onset colorectal cancer tumors in Puerto Rican Hispanics, as a first step toward personalizing early screening in this population. Finally, Sushrut Jangi, MD (Brigham and Women’s Hospital, Boston), presented the first longitudinal study describing the unique demographic and phenotypic characteristics of IBD in South Asians living in the United States, showing that smoking was less relevant as a risk factor, and that Crohn’s presented with a more aggressive penetrating phenotype in this population. At the conclusion of the e-poster tour, attendees and presenters had the opportunity to exchange future research ideas or follow-up and network.

The upcoming DDW 2020 AGA Diversity Committee–sponsored symposium entitled “GI Health Disparities and Creating Affirming Environments for the LGBT+ Community: The Gastroenterologist, Patient, Researcher and Educator Perspectives” will provide attendees with the opportunity to learn not only about challenges faced by the LGBTQ+ community as patients, learners, and scientists, but how we as educators, researchers, clinicians, and leaders can strategically address these challenges and intentionally create inclusive spaces in an effort to reduce health care disparities and inequities in both clinical and academic environments.

A current initiative is the creation of an archive of notable underrepresented gastroenterologists and GI scientists. The database will serve as a resource for conference organizers and committee members to identify junior speakers and mentors from diverse minority, ethnic, and racial backgrounds. This will be a platform for divisional chairs, program directors, and mentors to recommend and promote upcoming stars in their designated fields. Once the website and cloud database have been built, the diversity committee will reach out to divisional chairs, program directors, committee members, and leaders in the field to recommend physicians and scientists to include in this database. We will then reach out to nominees with an invitation and link to complete their profile in the database. We believe that this will be an opportunity for young physicians and scientists and a resource to promote diversity in medicine and science.

While we share many common experiences as ethnic minorities, the gastroenterologists comprising the AGA Diversity Committee come from various cultural backgrounds, ethnicities, and clinical practice settings. Yet rather than creating contention, our differences are the strength of this committee. Our diverse backgrounds lead to a plethora of innovative ideas and perspectives in group discussions, resulting in very robust and productive meetings. In recognizing that a diverse group can render novel solutions to many topics and issues, one of our goals is to increase membership of underrepresented groups in the AGA, as well as participation in AGA committees. This entails direct outreach to gastroenterologists in these groups and acquainting them with the ways active participation in the numerous AGA committees will support the issues affecting their profession and patients.

The process of serving on an AGA committee is simple. Interested members can nominate themselves or be nominated by another AGA member and fill out a short application. The list of AGA committees, responsibilities, open positions, and application can be found at https://www.gastro.org/aga-leadership/committees. We believe committee participation is personally and professionally rewarding, and serving on the Diversity Committee is particularly gratifying, as we can address pertinent issues that may otherwise be neglected.

Dr. Badurdeen is assistant professor at Johns Hopkins Medicine, Columbia, Md; Dr. Charabaty Pishvaian is associate professor, clinical director of the GI division, and director of the IBD Center at Sibley Memorial Hospital, Washington; Dr. Malespin is assistant professor at the University of South Florida, Tampa, and transplant hepatologist, Tampa General Hospital; Dr. Oduyebo is a gastroenterologist for Mid-Atlantic Permanente Medical Group, Shady Grove, Md; Dr. Quezada is associate professor and assistant dean for academic and multicultural affairs, University of Maryland, Baltimore County; and Dr. Stephen is a gastroenterologist at Annadel Medical Group, Santa Rosa, Calif.
 

References

1. Oduyebo I et al. Underserved populations and colorectal cancer screening: Patient perceptions of barriers to care and effective interventions. GI & Hepatology News. May 2018.

2. Munroe CA et al. The AGA Diversity Committee: Opening up a conversation about unconscious bias in GI practice. AGA Perspectives. July 2019.

As gastroenterologists and gastrointestinal researchers, we work with an increasingly diverse patient population amid known disparities in health care delivery and health outcomes. The American Gastroenterological Association values diversity and inclusion, and part of its strategic plan is to increase and diversify its membership and leaders. The AGA Diversity Committee supports this strategic goal by fostering and promoting involvement, advancement, and recognition of underrepresented diverse constituencies. This is accomplished through policy recommendations and programs, providing resources to AGA members for addressing barriers to access and utilization of health care services among diverse patient populations with attention to linguistic, racial, cultural, religious, sexual orientation, gender identity, disability, age, and economic diversity.

There are eight clinician and investigator members, including the chair as well as one trainee member on the AGA Diversity Committee. Four members are appointed at-large and three members are appointed from the AGA Institute Committees and the AGA Institute Council. The committee has set out to achieve mission-driven goals with several initiatives that align with its intention to cultivate a diverse, inclusive, and engaged membership, armed with the necessary tools to provide the highest quality care and perform the most effective research that will benefit our patient population.

The communications task force highlights programs and topics that support the committee’s missions. Members of the committee coauthored a paper on colorectal disparities published in GI & Hepatology News in May 2018.¹ In addition to presenting the disparities in colorectal screening, it provided ways to close this gap. A more recent publication in AGA Perspectives focused on unconscious bias as a prelude to the committee’s workshop at Digestive Disease Week^® (DDW) 2019.² An important initiative has been promoting Black History Month in February and Pride Month in June by posting cases or displaying prominent trailblazers on the AGA Community. In the upcoming months, profiles of several committee members will be featured in eDigest, GI & Hepatology News, and on AGA’s social media platforms.

DDW programming sponsored by the Diversity Committee is an important way to engage our members. At DDW 2019, the committee sponsored a clinical symposium title “Beyond Starbucks: Mitigating Bias Through Awareness.” This session was inspired by the 2018 incidence hallmarked by the inappropriate arrest of two African American men at a Philadelphia Starbucks. This event led to a nationwide educational breakout for all employees aimed at providing unconscious bias training. The Diversity Committee drew inspiration from these events, holding a symposium with set goals of defining unconscious bias and identifying areas within health care where unconscious bias can influence patient care. The committee invited Allyson Dylan Robinson, a portfolio lead from the Association of American Medical Colleges–endorsed Cook Ross Firm, who is nationally recognized as a leader in unconscious bias training. The assembly began with an introductory lecture followed by breakout sessions where small groups reviewed selected patient cases to determine the influence of unconscious bias in clinical scenarios. It was a well-attended symposium and was complementary to the wide array of didactic lectures offered at DDW. Bringing to light significant issues and barriers to health care is one key aspect of the mission set forth by the Diversity Committee.

The AGA Diversity Committee e-poster tour at DDW 2019 promoted the research led by scientist and physician members of underrepresented groups in medicine and/or research focused on gastrointestinal diseases in underrepresented populations. Several high-quality abstracts were reviewed and four were selected for the e-poster tour. Each scientist presented their research in front of an enthusiastic audience of DDW attendees, followed by a question and answer session. Gonzalo Parodi, BS (Cedars-Sinai Medical Center, Los Angeles), presented an elegant study showing that the antibiotic changes to intestinal microbiome were sex specific in mice. Alexis Rivera, MD (University of Puerto Rico, San Juan), found no association between inflammatory bowel disease (IBD) serologic markers and risk of surgery in patients with IBD in Puerto Rico. Maria Gonzalez-Pons, PhD (University of Puerto Rico Comprehensive Cancer Center, San Juan), presented the first study looking at the mutational landscape of early-onset colorectal cancer tumors in Puerto Rican Hispanics, as a first step toward personalizing early screening in this population. Finally, Sushrut Jangi, MD (Brigham and Women’s Hospital, Boston), presented the first longitudinal study describing the unique demographic and phenotypic characteristics of IBD in South Asians living in the United States, showing that smoking was less relevant as a risk factor, and that Crohn’s presented with a more aggressive penetrating phenotype in this population. At the conclusion of the e-poster tour, attendees and presenters had the opportunity to exchange future research ideas or follow-up and network.

The upcoming DDW 2020 AGA Diversity Committee–sponsored symposium entitled “GI Health Disparities and Creating Affirming Environments for the LGBT+ Community: The Gastroenterologist, Patient, Researcher and Educator Perspectives” will provide attendees with the opportunity to learn not only about challenges faced by the LGBTQ+ community as patients, learners, and scientists, but how we as educators, researchers, clinicians, and leaders can strategically address these challenges and intentionally create inclusive spaces in an effort to reduce health care disparities and inequities in both clinical and academic environments.

A current initiative is the creation of an archive of notable underrepresented gastroenterologists and GI scientists. The database will serve as a resource for conference organizers and committee members to identify junior speakers and mentors from diverse minority, ethnic, and racial backgrounds. This will be a platform for divisional chairs, program directors, and mentors to recommend and promote upcoming stars in their designated fields. Once the website and cloud database have been built, the diversity committee will reach out to divisional chairs, program directors, committee members, and leaders in the field to recommend physicians and scientists to include in this database. We will then reach out to nominees with an invitation and link to complete their profile in the database. We believe that this will be an opportunity for young physicians and scientists and a resource to promote diversity in medicine and science.

While we share many common experiences as ethnic minorities, the gastroenterologists comprising the AGA Diversity Committee come from various cultural backgrounds, ethnicities, and clinical practice settings. Yet rather than creating contention, our differences are the strength of this committee. Our diverse backgrounds lead to a plethora of innovative ideas and perspectives in group discussions, resulting in very robust and productive meetings. In recognizing that a diverse group can render novel solutions to many topics and issues, one of our goals is to increase membership of underrepresented groups in the AGA, as well as participation in AGA committees. This entails direct outreach to gastroenterologists in these groups and acquainting them with the ways active participation in the numerous AGA committees will support the issues affecting their profession and patients.

The process of serving on an AGA committee is simple. Interested members can nominate themselves or be nominated by another AGA member and fill out a short application. The list of AGA committees, responsibilities, open positions, and application can be found at https://www.gastro.org/aga-leadership/committees. We believe committee participation is personally and professionally rewarding, and serving on the Diversity Committee is particularly gratifying, as we can address pertinent issues that may otherwise be neglected.

Dr. Badurdeen is assistant professor at Johns Hopkins Medicine, Columbia, Md; Dr. Charabaty Pishvaian is associate professor, clinical director of the GI division, and director of the IBD Center at Sibley Memorial Hospital, Washington; Dr. Malespin is assistant professor at the University of South Florida, Tampa, and transplant hepatologist, Tampa General Hospital; Dr. Oduyebo is a gastroenterologist for Mid-Atlantic Permanente Medical Group, Shady Grove, Md; Dr. Quezada is associate professor and assistant dean for academic and multicultural affairs, University of Maryland, Baltimore County; and Dr. Stephen is a gastroenterologist at Annadel Medical Group, Santa Rosa, Calif.
 

References

1. Oduyebo I et al. Underserved populations and colorectal cancer screening: Patient perceptions of barriers to care and effective interventions. GI & Hepatology News. May 2018.

2. Munroe CA et al. The AGA Diversity Committee: Opening up a conversation about unconscious bias in GI practice. AGA Perspectives. July 2019.

As gastroenterologists and gastrointestinal researchers, we work with an increasingly diverse patient population amid known disparities in health care delivery and health outcomes. The American Gastroenterological Association values diversity and inclusion, and part of its strategic plan is to increase and diversify its membership and leaders. The AGA Diversity Committee supports this strategic goal by fostering and promoting involvement, advancement, and recognition of underrepresented diverse constituencies. This is accomplished through policy recommendations and programs, providing resources to AGA members for addressing barriers to access and utilization of health care services among diverse patient populations with attention to linguistic, racial, cultural, religious, sexual orientation, gender identity, disability, age, and economic diversity.

There are eight clinician and investigator members, including the chair as well as one trainee member on the AGA Diversity Committee. Four members are appointed at-large and three members are appointed from the AGA Institute Committees and the AGA Institute Council. The committee has set out to achieve mission-driven goals with several initiatives that align with its intention to cultivate a diverse, inclusive, and engaged membership, armed with the necessary tools to provide the highest quality care and perform the most effective research that will benefit our patient population.

The communications task force highlights programs and topics that support the committee’s missions. Members of the committee coauthored a paper on colorectal disparities published in GI & Hepatology News in May 2018.¹ In addition to presenting the disparities in colorectal screening, it provided ways to close this gap. A more recent publication in AGA Perspectives focused on unconscious bias as a prelude to the committee’s workshop at Digestive Disease Week^® (DDW) 2019.² An important initiative has been promoting Black History Month in February and Pride Month in June by posting cases or displaying prominent trailblazers on the AGA Community. In the upcoming months, profiles of several committee members will be featured in eDigest, GI & Hepatology News, and on AGA’s social media platforms.

DDW programming sponsored by the Diversity Committee is an important way to engage our members. At DDW 2019, the committee sponsored a clinical symposium title “Beyond Starbucks: Mitigating Bias Through Awareness.” This session was inspired by the 2018 incidence hallmarked by the inappropriate arrest of two African American men at a Philadelphia Starbucks. This event led to a nationwide educational breakout for all employees aimed at providing unconscious bias training. The Diversity Committee drew inspiration from these events, holding a symposium with set goals of defining unconscious bias and identifying areas within health care where unconscious bias can influence patient care. The committee invited Allyson Dylan Robinson, a portfolio lead from the Association of American Medical Colleges–endorsed Cook Ross Firm, who is nationally recognized as a leader in unconscious bias training. The assembly began with an introductory lecture followed by breakout sessions where small groups reviewed selected patient cases to determine the influence of unconscious bias in clinical scenarios. It was a well-attended symposium and was complementary to the wide array of didactic lectures offered at DDW. Bringing to light significant issues and barriers to health care is one key aspect of the mission set forth by the Diversity Committee.

The AGA Diversity Committee e-poster tour at DDW 2019 promoted the research led by scientist and physician members of underrepresented groups in medicine and/or research focused on gastrointestinal diseases in underrepresented populations. Several high-quality abstracts were reviewed and four were selected for the e-poster tour. Each scientist presented their research in front of an enthusiastic audience of DDW attendees, followed by a question and answer session. Gonzalo Parodi, BS (Cedars-Sinai Medical Center, Los Angeles), presented an elegant study showing that the antibiotic changes to intestinal microbiome were sex specific in mice. Alexis Rivera, MD (University of Puerto Rico, San Juan), found no association between inflammatory bowel disease (IBD) serologic markers and risk of surgery in patients with IBD in Puerto Rico. Maria Gonzalez-Pons, PhD (University of Puerto Rico Comprehensive Cancer Center, San Juan), presented the first study looking at the mutational landscape of early-onset colorectal cancer tumors in Puerto Rican Hispanics, as a first step toward personalizing early screening in this population. Finally, Sushrut Jangi, MD (Brigham and Women’s Hospital, Boston), presented the first longitudinal study describing the unique demographic and phenotypic characteristics of IBD in South Asians living in the United States, showing that smoking was less relevant as a risk factor, and that Crohn’s presented with a more aggressive penetrating phenotype in this population. At the conclusion of the e-poster tour, attendees and presenters had the opportunity to exchange future research ideas or follow-up and network.

The upcoming DDW 2020 AGA Diversity Committee–sponsored symposium entitled “GI Health Disparities and Creating Affirming Environments for the LGBT+ Community: The Gastroenterologist, Patient, Researcher and Educator Perspectives” will provide attendees with the opportunity to learn not only about challenges faced by the LGBTQ+ community as patients, learners, and scientists, but how we as educators, researchers, clinicians, and leaders can strategically address these challenges and intentionally create inclusive spaces in an effort to reduce health care disparities and inequities in both clinical and academic environments.

A current initiative is the creation of an archive of notable underrepresented gastroenterologists and GI scientists. The database will serve as a resource for conference organizers and committee members to identify junior speakers and mentors from diverse minority, ethnic, and racial backgrounds. This will be a platform for divisional chairs, program directors, and mentors to recommend and promote upcoming stars in their designated fields. Once the website and cloud database have been built, the diversity committee will reach out to divisional chairs, program directors, committee members, and leaders in the field to recommend physicians and scientists to include in this database. We will then reach out to nominees with an invitation and link to complete their profile in the database. We believe that this will be an opportunity for young physicians and scientists and a resource to promote diversity in medicine and science.

While we share many common experiences as ethnic minorities, the gastroenterologists comprising the AGA Diversity Committee come from various cultural backgrounds, ethnicities, and clinical practice settings. Yet rather than creating contention, our differences are the strength of this committee. Our diverse backgrounds lead to a plethora of innovative ideas and perspectives in group discussions, resulting in very robust and productive meetings. In recognizing that a diverse group can render novel solutions to many topics and issues, one of our goals is to increase membership of underrepresented groups in the AGA, as well as participation in AGA committees. This entails direct outreach to gastroenterologists in these groups and acquainting them with the ways active participation in the numerous AGA committees will support the issues affecting their profession and patients.

The process of serving on an AGA committee is simple. Interested members can nominate themselves or be nominated by another AGA member and fill out a short application. The list of AGA committees, responsibilities, open positions, and application can be found at https://www.gastro.org/aga-leadership/committees. We believe committee participation is personally and professionally rewarding, and serving on the Diversity Committee is particularly gratifying, as we can address pertinent issues that may otherwise be neglected.

Dr. Badurdeen is assistant professor at Johns Hopkins Medicine, Columbia, Md; Dr. Charabaty Pishvaian is associate professor, clinical director of the GI division, and director of the IBD Center at Sibley Memorial Hospital, Washington; Dr. Malespin is assistant professor at the University of South Florida, Tampa, and transplant hepatologist, Tampa General Hospital; Dr. Oduyebo is a gastroenterologist for Mid-Atlantic Permanente Medical Group, Shady Grove, Md; Dr. Quezada is associate professor and assistant dean for academic and multicultural affairs, University of Maryland, Baltimore County; and Dr. Stephen is a gastroenterologist at Annadel Medical Group, Santa Rosa, Calif.
 

References

1. Oduyebo I et al. Underserved populations and colorectal cancer screening: Patient perceptions of barriers to care and effective interventions. GI & Hepatology News. May 2018.

2. Munroe CA et al. The AGA Diversity Committee: Opening up a conversation about unconscious bias in GI practice. AGA Perspectives. July 2019.

CHEST has been notified of the following deaths.

We extend our sincere condolences.


Nana Sunarya, MD (2019)

Michael Grant Ehrie Jr., MD (2019)

Robert F. Dunton, MD, FCCP (2020)

CHEST has been notified of the following deaths.

We extend our sincere condolences.


Nana Sunarya, MD (2019)

Michael Grant Ehrie Jr., MD (2019)

Robert F. Dunton, MD, FCCP (2020)

CHEST has been notified of the following deaths.

We extend our sincere condolences.


Nana Sunarya, MD (2019)

Michael Grant Ehrie Jr., MD (2019)

Robert F. Dunton, MD, FCCP (2020)

Disaster response and global health

Corona virus and disaster preparedness campaign

On January 28, 2020, the US Centers for Disease Control and Prevention (CDC) issued a travel advisory recommending against all nonessential travel to China, in light of the 2019 novel coronavirus (2019-nCoV) outbreak.

Shortly thereafter, a plane that flew out of China was directed to land on a US air force base in California on Friday, January 31. Since then, other US government flights have evacuated patients to military bases throughout the country. The CDC issued a federal quarantine order lasting the 14-day incubation period to these repatriated US citizens. Nearby hospitals were debriefed and command centers set up in anticipation of any required intervention.

Practice operations

New Medicare billing rules bring welcome documentation relief

At the end of 2019, the Centers for Medicare and Medicaid Services (CMS) released several changes to the Medicare Physician Fee Schedule, which will go into effect starting January 1, 2021. Though the adjustments are substantial (the document outlining the revisions is nearly 2,500 pages!), there are a few that deserve highlighting.

The most significant modification contained within the policy involves revisions to E/M codes for office visits. While the changes eliminate 99201, they preserve other graded levels for visits, with increases to the relative value units (RVUs) for most levels.

The most welcome changes for clinicians are twofold. First, billing no longer needs to be based on the maddening practice of trying to meet a minimum number of points from the history and exam. Clinicians can instead now bill based on time spent. The second refreshing modification is that time-based billing need no longer be solely face-to-face but can now be based on the realities of clinical practice today, ie, reviewing information and coordinating care with others.

Transplant

Investigating clinical practice of lung transplantation in systemic sclerosis

Interstitial lung disease (ILD) as a sequela of systemic sclerosis (SSc) poses a significant health concern. Patients with SSc-ILD experience symptoms of shortness of breath, reduced exercise capacity, and limited activities of daily living. Inducing fibrotic parenchymal change and pulmonary hypertension, SSc-ILD presents as both the most common extra-cutaneous manifestation and cause for mortality in this cohort (Mathai et al. Springer. 2014;139). Although rare, the prognosis of SSc-ILD is both difficult to understand and complex to manage.

With lung transplant being a treatment for end stage pulmonary disease, the role for lung transplantation in SSc-ILD is considered; however, remains controversial. Published literature exist without consensus. According to the recommendations of ISHLT, SSc is to be “carefully selected,” however, for some institutions, SSc remains a relative contraindication for lung transplant as definitive therapy (Weill et al. J Heart Lung Transplant. 2014;34[1]:1). Disease-specific concerns for SSc patients following lung transplant are esophageal dysmotility, dysphagia, gastroparesis, aspiration, and reflux disease. These comorbidities are associated with worsening prognosis in transplant survival (De Cruz, et al. Curr Opin Rheumatol. 2013;25[6]:714).

As clinical practices vary significantly in the management of SSc-ILD, we will survey transplant pulmonologist and surgeons from programs listed in Scientific Registry of Transplant Recipients (SRTR). We will evaluate transplant candidacy, preoperative transplant testing, postoperative transplant care, and outcomes. With this survey, we plan to determine the key practices of lung transplant programs regarding candidacy of patients with SSc-ILD perioperative management.

Clauden Louis, MD

Fellow-in-Training Member
 

Women’s lung health

Asthma and sex hormones

Overall asthma prevalence, severity, exacerbation rate, hospitalizations, and mortality are higher among women than men. Population studies show that asthma becomes more prevalent and severe in women following puberty, particularly in women with early menarche or multiple gestations. These findings suggest that sex hormones are important to the development and severity of asthma. Additional confounding variables include obesity, exposures, atopy, and age (Zien, et al. Curr Allergy Asthma Rep. 2015;15[6]:28).

In summary, testosterone is suggested to provide a protective, anti-inflammatory effect in women with asthma (Sathish, et al. Pharmacol Ther. 2015;150:94). Obesity interaction with sex hormones highlights its role as an important risk factor and disease modifier (Peters, et al. J Allergy Clin Immunol. 2018;141:1169). Future studies should continue to expand upon the role of sex hormones in relationship to multiple confounders. These insights will continue to define mechanisms that can be manipulated leading to novel pathway targeted therapies.

Candace Huebert, MD, FCCP

Margaret Pisani, MD, MPH, FCCP

Jill Poole, MD

Steering Committee Members
 

Disaster response and global health

Corona virus and disaster preparedness campaign

On January 28, 2020, the US Centers for Disease Control and Prevention (CDC) issued a travel advisory recommending against all nonessential travel to China, in light of the 2019 novel coronavirus (2019-nCoV) outbreak.

Shortly thereafter, a plane that flew out of China was directed to land on a US air force base in California on Friday, January 31. Since then, other US government flights have evacuated patients to military bases throughout the country. The CDC issued a federal quarantine order lasting the 14-day incubation period to these repatriated US citizens. Nearby hospitals were debriefed and command centers set up in anticipation of any required intervention.

Practice operations

New Medicare billing rules bring welcome documentation relief

At the end of 2019, the Centers for Medicare and Medicaid Services (CMS) released several changes to the Medicare Physician Fee Schedule, which will go into effect starting January 1, 2021. Though the adjustments are substantial (the document outlining the revisions is nearly 2,500 pages!), there are a few that deserve highlighting.

The most significant modification contained within the policy involves revisions to E/M codes for office visits. While the changes eliminate 99201, they preserve other graded levels for visits, with increases to the relative value units (RVUs) for most levels.

The most welcome changes for clinicians are twofold. First, billing no longer needs to be based on the maddening practice of trying to meet a minimum number of points from the history and exam. Clinicians can instead now bill based on time spent. The second refreshing modification is that time-based billing need no longer be solely face-to-face but can now be based on the realities of clinical practice today, ie, reviewing information and coordinating care with others.

Transplant

Investigating clinical practice of lung transplantation in systemic sclerosis

Interstitial lung disease (ILD) as a sequela of systemic sclerosis (SSc) poses a significant health concern. Patients with SSc-ILD experience symptoms of shortness of breath, reduced exercise capacity, and limited activities of daily living. Inducing fibrotic parenchymal change and pulmonary hypertension, SSc-ILD presents as both the most common extra-cutaneous manifestation and cause for mortality in this cohort (Mathai et al. Springer. 2014;139). Although rare, the prognosis of SSc-ILD is both difficult to understand and complex to manage.

With lung transplant being a treatment for end stage pulmonary disease, the role for lung transplantation in SSc-ILD is considered; however, remains controversial. Published literature exist without consensus. According to the recommendations of ISHLT, SSc is to be “carefully selected,” however, for some institutions, SSc remains a relative contraindication for lung transplant as definitive therapy (Weill et al. J Heart Lung Transplant. 2014;34[1]:1). Disease-specific concerns for SSc patients following lung transplant are esophageal dysmotility, dysphagia, gastroparesis, aspiration, and reflux disease. These comorbidities are associated with worsening prognosis in transplant survival (De Cruz, et al. Curr Opin Rheumatol. 2013;25[6]:714).

As clinical practices vary significantly in the management of SSc-ILD, we will survey transplant pulmonologist and surgeons from programs listed in Scientific Registry of Transplant Recipients (SRTR). We will evaluate transplant candidacy, preoperative transplant testing, postoperative transplant care, and outcomes. With this survey, we plan to determine the key practices of lung transplant programs regarding candidacy of patients with SSc-ILD perioperative management.

Clauden Louis, MD

Fellow-in-Training Member
 

Women’s lung health

Asthma and sex hormones

Overall asthma prevalence, severity, exacerbation rate, hospitalizations, and mortality are higher among women than men. Population studies show that asthma becomes more prevalent and severe in women following puberty, particularly in women with early menarche or multiple gestations. These findings suggest that sex hormones are important to the development and severity of asthma. Additional confounding variables include obesity, exposures, atopy, and age (Zien, et al. Curr Allergy Asthma Rep. 2015;15[6]:28).

In summary, testosterone is suggested to provide a protective, anti-inflammatory effect in women with asthma (Sathish, et al. Pharmacol Ther. 2015;150:94). Obesity interaction with sex hormones highlights its role as an important risk factor and disease modifier (Peters, et al. J Allergy Clin Immunol. 2018;141:1169). Future studies should continue to expand upon the role of sex hormones in relationship to multiple confounders. These insights will continue to define mechanisms that can be manipulated leading to novel pathway targeted therapies.

Candace Huebert, MD, FCCP

Margaret Pisani, MD, MPH, FCCP

Jill Poole, MD

Steering Committee Members
 

Disaster response and global health

Corona virus and disaster preparedness campaign

On January 28, 2020, the US Centers for Disease Control and Prevention (CDC) issued a travel advisory recommending against all nonessential travel to China, in light of the 2019 novel coronavirus (2019-nCoV) outbreak.

Shortly thereafter, a plane that flew out of China was directed to land on a US air force base in California on Friday, January 31. Since then, other US government flights have evacuated patients to military bases throughout the country. The CDC issued a federal quarantine order lasting the 14-day incubation period to these repatriated US citizens. Nearby hospitals were debriefed and command centers set up in anticipation of any required intervention.

Practice operations

New Medicare billing rules bring welcome documentation relief

At the end of 2019, the Centers for Medicare and Medicaid Services (CMS) released several changes to the Medicare Physician Fee Schedule, which will go into effect starting January 1, 2021. Though the adjustments are substantial (the document outlining the revisions is nearly 2,500 pages!), there are a few that deserve highlighting.

The most significant modification contained within the policy involves revisions to E/M codes for office visits. While the changes eliminate 99201, they preserve other graded levels for visits, with increases to the relative value units (RVUs) for most levels.

The most welcome changes for clinicians are twofold. First, billing no longer needs to be based on the maddening practice of trying to meet a minimum number of points from the history and exam. Clinicians can instead now bill based on time spent. The second refreshing modification is that time-based billing need no longer be solely face-to-face but can now be based on the realities of clinical practice today, ie, reviewing information and coordinating care with others.

Transplant

Investigating clinical practice of lung transplantation in systemic sclerosis

Interstitial lung disease (ILD) as a sequela of systemic sclerosis (SSc) poses a significant health concern. Patients with SSc-ILD experience symptoms of shortness of breath, reduced exercise capacity, and limited activities of daily living. Inducing fibrotic parenchymal change and pulmonary hypertension, SSc-ILD presents as both the most common extra-cutaneous manifestation and cause for mortality in this cohort (Mathai et al. Springer. 2014;139). Although rare, the prognosis of SSc-ILD is both difficult to understand and complex to manage.

With lung transplant being a treatment for end stage pulmonary disease, the role for lung transplantation in SSc-ILD is considered; however, remains controversial. Published literature exist without consensus. According to the recommendations of ISHLT, SSc is to be “carefully selected,” however, for some institutions, SSc remains a relative contraindication for lung transplant as definitive therapy (Weill et al. J Heart Lung Transplant. 2014;34[1]:1). Disease-specific concerns for SSc patients following lung transplant are esophageal dysmotility, dysphagia, gastroparesis, aspiration, and reflux disease. These comorbidities are associated with worsening prognosis in transplant survival (De Cruz, et al. Curr Opin Rheumatol. 2013;25[6]:714).

As clinical practices vary significantly in the management of SSc-ILD, we will survey transplant pulmonologist and surgeons from programs listed in Scientific Registry of Transplant Recipients (SRTR). We will evaluate transplant candidacy, preoperative transplant testing, postoperative transplant care, and outcomes. With this survey, we plan to determine the key practices of lung transplant programs regarding candidacy of patients with SSc-ILD perioperative management.

Clauden Louis, MD

Fellow-in-Training Member
 

Women’s lung health

Asthma and sex hormones

Overall asthma prevalence, severity, exacerbation rate, hospitalizations, and mortality are higher among women than men. Population studies show that asthma becomes more prevalent and severe in women following puberty, particularly in women with early menarche or multiple gestations. These findings suggest that sex hormones are important to the development and severity of asthma. Additional confounding variables include obesity, exposures, atopy, and age (Zien, et al. Curr Allergy Asthma Rep. 2015;15[6]:28).

In summary, testosterone is suggested to provide a protective, anti-inflammatory effect in women with asthma (Sathish, et al. Pharmacol Ther. 2015;150:94). Obesity interaction with sex hormones highlights its role as an important risk factor and disease modifier (Peters, et al. J Allergy Clin Immunol. 2018;141:1169). Future studies should continue to expand upon the role of sex hormones in relationship to multiple confounders. These insights will continue to define mechanisms that can be manipulated leading to novel pathway targeted therapies.

Candace Huebert, MD, FCCP

Margaret Pisani, MD, MPH, FCCP

Jill Poole, MD

Steering Committee Members
 

CHEST 2019 marked the inaugural FISH Bowl competition for attendees. Inspired by Shark Tank, our kinder, gentler, yet still competitive and cutting-edge FISH Bowl (Furthering Innovation and Science for Health) featured CHEST members disrupting our beliefs about how clinical care and education are performed. As health-care providers, they presented innovative ideas pertaining to education and clinical disease for pulmonary, critical care, and sleep medicine. Six finalists were chosen from dozens of submissions, and three emerged winners. In this new Meet the FISH Bowl Finalists series, CHEST introduces you to many of them – including Clinical Disease Category Winner Dr. Gao.

Name: Catherine Gao, MD

Institutional Affiliation: Northwestern University

Position: Pulmonary & Critical Care Fellow


Title: Time to Vent: A Blended Learning Experience

Brief Summary: It is difficult for ventilated patients to communicate, and this is cited by patients as one of the most stressful parts of their ICU stays. Brain-computer interface technology allows for communication to happen directly from brain wave activity and represents a potential tool to fix this problem.


1. What inspired your innovation? Every clinician has had the frustrating experience of difficulty communicating with their ventilated patients, and it is even more challenging for patients and their families. I read about recent advances in communication methods from the neurology literature and thought about expanding this technology to the ICU.

2. What do you see as challenges to your innovation gaining widespread acceptance? How can they be overcome? This is still an early idea with technology still being developed – there have been investments by the military and large tech companies, as well as universities – it will take time for the technology to be ready for clinical use, and there will be troubleshooting needed as with all new technologies.

3. What impact has winning FISH Bowl 2019 had on your vision for the innovation? The judges gave great feedback and had wonderful suggestions and questions. This is just the beginning.

4. How do you think your success at FISH Bowl 2019 will continue to impact your career overall in the months and years to come? This was a great experience to talk about interesting ideas, and I had the opportunity to talk to many people with similar interests after the presentation. I thank CHEST for this amazing opportunity and look forward to the years to come!

CHEST 2019 marked the inaugural FISH Bowl competition for attendees. Inspired by Shark Tank, our kinder, gentler, yet still competitive and cutting-edge FISH Bowl (Furthering Innovation and Science for Health) featured CHEST members disrupting our beliefs about how clinical care and education are performed. As health-care providers, they presented innovative ideas pertaining to education and clinical disease for pulmonary, critical care, and sleep medicine. Six finalists were chosen from dozens of submissions, and three emerged winners. In this new Meet the FISH Bowl Finalists series, CHEST introduces you to many of them – including Clinical Disease Category Winner Dr. Gao.

Name: Catherine Gao, MD

Institutional Affiliation: Northwestern University

Position: Pulmonary & Critical Care Fellow


Title: Time to Vent: A Blended Learning Experience

Brief Summary: It is difficult for ventilated patients to communicate, and this is cited by patients as one of the most stressful parts of their ICU stays. Brain-computer interface technology allows for communication to happen directly from brain wave activity and represents a potential tool to fix this problem.


1. What inspired your innovation? Every clinician has had the frustrating experience of difficulty communicating with their ventilated patients, and it is even more challenging for patients and their families. I read about recent advances in communication methods from the neurology literature and thought about expanding this technology to the ICU.

2. What do you see as challenges to your innovation gaining widespread acceptance? How can they be overcome? This is still an early idea with technology still being developed – there have been investments by the military and large tech companies, as well as universities – it will take time for the technology to be ready for clinical use, and there will be troubleshooting needed as with all new technologies.

3. What impact has winning FISH Bowl 2019 had on your vision for the innovation? The judges gave great feedback and had wonderful suggestions and questions. This is just the beginning.

4. How do you think your success at FISH Bowl 2019 will continue to impact your career overall in the months and years to come? This was a great experience to talk about interesting ideas, and I had the opportunity to talk to many people with similar interests after the presentation. I thank CHEST for this amazing opportunity and look forward to the years to come!

CHEST 2019 marked the inaugural FISH Bowl competition for attendees. Inspired by Shark Tank, our kinder, gentler, yet still competitive and cutting-edge FISH Bowl (Furthering Innovation and Science for Health) featured CHEST members disrupting our beliefs about how clinical care and education are performed. As health-care providers, they presented innovative ideas pertaining to education and clinical disease for pulmonary, critical care, and sleep medicine. Six finalists were chosen from dozens of submissions, and three emerged winners. In this new Meet the FISH Bowl Finalists series, CHEST introduces you to many of them – including Clinical Disease Category Winner Dr. Gao.

Name: Catherine Gao, MD

Institutional Affiliation: Northwestern University

Position: Pulmonary & Critical Care Fellow


Title: Time to Vent: A Blended Learning Experience

Brief Summary: It is difficult for ventilated patients to communicate, and this is cited by patients as one of the most stressful parts of their ICU stays. Brain-computer interface technology allows for communication to happen directly from brain wave activity and represents a potential tool to fix this problem.


1. What inspired your innovation? Every clinician has had the frustrating experience of difficulty communicating with their ventilated patients, and it is even more challenging for patients and their families. I read about recent advances in communication methods from the neurology literature and thought about expanding this technology to the ICU.

2. What do you see as challenges to your innovation gaining widespread acceptance? How can they be overcome? This is still an early idea with technology still being developed – there have been investments by the military and large tech companies, as well as universities – it will take time for the technology to be ready for clinical use, and there will be troubleshooting needed as with all new technologies.

3. What impact has winning FISH Bowl 2019 had on your vision for the innovation? The judges gave great feedback and had wonderful suggestions and questions. This is just the beginning.

4. How do you think your success at FISH Bowl 2019 will continue to impact your career overall in the months and years to come? This was a great experience to talk about interesting ideas, and I had the opportunity to talk to many people with similar interests after the presentation. I thank CHEST for this amazing opportunity and look forward to the years to come!

Developing resilient nurses and work environments can help organizations prevent burnout.

The Joint Commission released an advisory urging health-care organizations to promote resilience as a way to combat and prevent nurse burnout.

“Developing resilience to combat nurse burnout,” in The Joint Commission’s Quick Safety newsletter, notes that 15.6% of all nurses in a survey of more than 2,000 healthcare partners reported experiencing burnout “with emergency room nurses being at a higher risk,” which can affect the physical and emotional health of staff, as well as patient safety, mortality, and satisfaction.

According to data presented in the article, omitting nurses from the decision-making process, security risks, a need for more autonomy, and staffing challenges are the most common factors associated with nurse burnout.

To promote resilience in nurses and in the work environment, which can help prevent and reduce burnout among nurses and other front-line staff, health-care organizations should consider a number of strategies, including the following:

• Teach nurses and nurse leaders the elements of resilience, such as empowerment and colleague support, and how to identify symptoms of burnout.

• Provide positive role models and mentors.

• “Engage nursing input in staff meetings by posting an agenda and asking for additional items the nurses would like to discuss or present.”

• Measure the well-being of health-care providers; try interventions and then assess their effectiveness.

The article also notes that “mindfulness and resilience training alone cannot effectively address burnout unless the leadership is simultaneously reducing and eliminating barriers and impediments to nursing workflow, such as staffing and workplace environment concerns.”
 

Reference

The Joint Commission. Developing resilience to combat nurse burnout. Quick Safety. 2019;(50):1-4.

Developing resilient nurses and work environments can help organizations prevent burnout.

The Joint Commission released an advisory urging health-care organizations to promote resilience as a way to combat and prevent nurse burnout.

“Developing resilience to combat nurse burnout,” in The Joint Commission’s Quick Safety newsletter, notes that 15.6% of all nurses in a survey of more than 2,000 healthcare partners reported experiencing burnout “with emergency room nurses being at a higher risk,” which can affect the physical and emotional health of staff, as well as patient safety, mortality, and satisfaction.

According to data presented in the article, omitting nurses from the decision-making process, security risks, a need for more autonomy, and staffing challenges are the most common factors associated with nurse burnout.

To promote resilience in nurses and in the work environment, which can help prevent and reduce burnout among nurses and other front-line staff, health-care organizations should consider a number of strategies, including the following:

• Teach nurses and nurse leaders the elements of resilience, such as empowerment and colleague support, and how to identify symptoms of burnout.

• Provide positive role models and mentors.

• “Engage nursing input in staff meetings by posting an agenda and asking for additional items the nurses would like to discuss or present.”

• Measure the well-being of health-care providers; try interventions and then assess their effectiveness.

The article also notes that “mindfulness and resilience training alone cannot effectively address burnout unless the leadership is simultaneously reducing and eliminating barriers and impediments to nursing workflow, such as staffing and workplace environment concerns.”
 

Reference

The Joint Commission. Developing resilience to combat nurse burnout. Quick Safety. 2019;(50):1-4.

Developing resilient nurses and work environments can help organizations prevent burnout.

The Joint Commission released an advisory urging health-care organizations to promote resilience as a way to combat and prevent nurse burnout.

“Developing resilience to combat nurse burnout,” in The Joint Commission’s Quick Safety newsletter, notes that 15.6% of all nurses in a survey of more than 2,000 healthcare partners reported experiencing burnout “with emergency room nurses being at a higher risk,” which can affect the physical and emotional health of staff, as well as patient safety, mortality, and satisfaction.

According to data presented in the article, omitting nurses from the decision-making process, security risks, a need for more autonomy, and staffing challenges are the most common factors associated with nurse burnout.

To promote resilience in nurses and in the work environment, which can help prevent and reduce burnout among nurses and other front-line staff, health-care organizations should consider a number of strategies, including the following:

• Teach nurses and nurse leaders the elements of resilience, such as empowerment and colleague support, and how to identify symptoms of burnout.

• Provide positive role models and mentors.

• “Engage nursing input in staff meetings by posting an agenda and asking for additional items the nurses would like to discuss or present.”

• Measure the well-being of health-care providers; try interventions and then assess their effectiveness.

The article also notes that “mindfulness and resilience training alone cannot effectively address burnout unless the leadership is simultaneously reducing and eliminating barriers and impediments to nursing workflow, such as staffing and workplace environment concerns.”
 

Reference

The Joint Commission. Developing resilience to combat nurse burnout. Quick Safety. 2019;(50):1-4.