Carvour capstone project presentation headed for national stage

Martha Carvour, MD, PhD, assistant professor in Infectious Diseases, will present her capstone project, “Optimizing Communication in Outpatient Parenteral Antimicrobial Therapy Amid the COVID-19 Pandemic,” at the 2021 American College of Physicians (ACP) Internal Medicine Meeting. The project was the final phase Carvour had to complete the ACP and the American Association of Physician Leadership’s joint Certificate in Physician Leadership program. Carvour’s project was one of only two selected for this honor.

Carvour’s project examined the Complex Care Coordination for Outpatient Parenteral Antimicrobial Therapy (OPAT) in the setting of COVID-19. Mentored by Division Director Dan Diekema, MD, MS, Carvour worked with an interdisciplinary team of ID clinic providers and staff, including UI Health Care Information Systems and departmental and divisional adminstrators. ACP has made Carvour’s presentation available. (Scroll to the bottom of the page to find both the video link and a PDF of her slides.)

“I found it really fruitful to be thinking about the concepts I was learning in the certificate program while watching how leadership was being modeled at my institution and elsewhere (in response to COVID-19),” Carvour said. “Thinking about these themes was actually very helpful for not only informing the project but thinking about where my career may lead down the road and thinking about the very core principles emphasized in the curriculum.”

The OPAT process includes two steps: inpatient-to-outpatient transition and post-discharge monitoring. Carvour’s study hoped to identify barriers and facilitators of the inpatient-to-outpatient transition through an interdisciplinary lens. Furthermore, Carvour aimed to identify gaps in the post-discharge monitoring system that would impact patient safety or provider efficiency.

Focused, interdisciplinary discussions were employed after clinical and during faculty meetings to develop the telemedicine and OPAT monitoring system. The main focus was scheduling. Carvour wanted to ensure that patients were able to schedule a virtual meeting to replace their regularly scheduled in-person meeting.  

There were two areas of the OPAT process that required attention from the core team. In terms of workflow, there was an absence of secondary workflow administration, so the team resolved this issue by adding tertiary providers who could step in if needed. Data review was delayed or incomplete, so the team created an OPAT-integrated dashboard. During the session’s Q&A, Diekema, who also attended Carvour’s presentation, emphasized her point that the program has provided significant benefit to the patient population and that the dashboard and the project’s structure have flexibility for other process improvements in the future.

The 18-month joint Certificate in Physician Leadership program, which Carvour just completed, offers physicians formal leadership training for hospital medicine or primary care internal medicine through a virtual, three-tiered curriculum which includes core courses, elective course, and the capstone project. 

Members of the ACP Capstone Review Board submitted written feedback in support of their decision to award Carvour one of the two slots in the Early Career Physicians Virtual Presentations segment of the virtual conference, which will be held from April 29 to May 1, 2021. “Dr. Carvour came up with a very good project which involves not only a good design but also a timely and intense execution,” one member wrote. “Despite several changes happening in the recent health care structure due to COVID-19, she had shown strong leadership in executing the project via utilizing tele visit feature.” 

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