Program Book - Keck School of Medicine of USC - University of ...

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POLICY ON CULTURAL AND LINGUISTIC COMPETENCE 2011‐12Keck School of Medicine of USCOffice of Continuing Medical EducationPOLICY ON CULTURAL AND LINGUISTIC COMPETENCYIN CONTINUING MEDICAL EDUCATIONThe Accreditation Council of Continuing Medical Education (ACCME) expects accredited providersto operate business and management policies and procedures of their CME program so that theirobligations and commitments are met. As part of this accreditation requirement, the ACCMEexpects that accredited providers located in California will be in compliance with all applicableCalifornia state laws regarding continuing medical education delivered in California, including CAA.B. 1195, enacted in 2005.In accordance with A.B. 1195, the Keck School of Medicine of the University of Southern CaliforniaOffice of Continuing Medical Education has adopted a policy of incorporating cultural and linguisticcompetency in the formulation and planning of Continuing Medical Education (CME) courses inorder to maintain, develop, or increase the knowledge, skills, and professional performance that aphysician uses to provide care, or improve the quality of care provided for patients.These educational activities should include, but are not limited to, any of the following criteria:1. Have a scientific or clinical content with a direct bearing on the quality or cost-effectiveprovision of patient care, community or public health, or preventive medicine;2. Concern quality assurance or improvement, risk management, health facility standards, or thelegal aspects of clinical medicine;3. Concern bioethics or professional ethics;4. Are designed to improve the physician-patient relationship.A.B. 1195 has provided three ways to comply with the law:1. Cultural competency is defined as a set of integrated attitudes, knowledge, and skills thatenables a health care professional to care effectively for patients from diverse cultures,groups, and communities. Items to be addressed include linguistic skills, cultural informationto establish therapeutic relationships, cultural data in diagnosis and treatment, and culturaland ethnic data applying to the process of clinical care. To comply with the culturalcompetency requirement, an activity should include the following:a. applying linguistic skills to communicate effectively with the target population;b. utilizing cultural information to establish therapeutic relationships;c. eliciting and incorporating pertinent cultural data in diagnosis and treatment;d. understanding and applying cultural and ethnic data to the process of clinical care.2. Linguistic competency is defined as the ability of a physician to provide patients who do notspeak English or who have limited ability to speak English with direct communication in thepatient’s primary language. To comply with the linguistic competency requirement, an1149
POLICY ON CULTURAL AND LINGUISTIC COMPETENCE 2011‐12activity may incorporate translation/interpretation resources and/or strategies into activitymaterials.3. A review and explanation of relevant federal and state laws and regulations regardinglinguistic access. At the activity site, KSOM OCME will provide supporting documents andresources to the physicians, including, but not limited to, handouts, websites, patienteducation, and local resources.Continuing medical education activities that are exempt from these requirements include thoseactivities solely dedicated to research and other activities that do not contain patient care components(such as leadership).Documentation of compliance will be presented on the application and/or planning form for theCME activity. This policy will be included in the planning packet for activity directors and facultyso that the program and presentations will comply with the law.June, 20062150
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Program Book
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Needs AssessmentOver 370,000 patien
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ACKNOWLEDGEMENTSWe would like to th
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No relevant financial relationships
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2:25 pm Vascular Access Infections,
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ESRD in 2012: Socio-economicImpactJ
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Geographic variations in adjustedin
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Adjusted all-cause & cause specific
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ESRD-International ComparisonsPreva
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Outcomes for first-time wait-listed
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NOTES______________________________
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Vascular Access Planning andPreoper
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• Veins not circular but ovoid, m
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VENOGRAM+ -CFDI+ 17(true positive)-
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• Thorough preoperative assessmen
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NOTES______________________________
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Options and Strategies forUpper Ext
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Cimino (radiocephalic) AVFPotential
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Two Stage BBAVFStage 1 anastomosis
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Brachial Artery-Brachial Vein AVFSu
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Forearm AV GraftsLarge surface area
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Comparison of brachial-basilic AVfi
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Racial differences in AVfistula rat
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THANK YOU!46
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Lower ExtremityDialysis AccessAhmed
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Lower Extremity Dialysis AccessWhat
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Lower Extremity Dialysis AccessData
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Lower Extremity Dialysis AccessData
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Thank You!LLUMC56
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NOTES______________________________
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NOTES______________________________
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When to Break the Guidelines in Vas
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efore initiation of dialysis. It fu
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NOTES______________________________
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Vascular AccessSurveillanceIs it wo
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Monitoring Vs. SurveillanceClinical
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Vascular Access Surveillance• Obs
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Vascular Access SurveillanceRandomi
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Vascular Access SurveillanceRandomi
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So why does preemptiveangioplasty n
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• ConclusionAccess Surveillance
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Management of the Non-MaturingArter
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Specific Definition• “…use of
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AVF Maturation in Clinical Practice
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Hemodialysis Fistula MaturationCons
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Physical Exam of AVF• Has an accu
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Significant Accessory VeinsSurgical
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Venous Stenosis in AVF Body/Outflow
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Deep or Excessively Tortuous AVF•
Page 99 and 100: Robert Hye, MD September 27, 2012Ka
Page 101 and 102: Influence of Access Type onInfectio
Page 103 and 104: Prevention of HemodialysisAccess In
Page 105 and 106: Summary of CatheterManagement in CR
Page 107 and 108: Partial versus Total GraftExcision
Page 109 and 110: Infected Autogenous DialysisFistula
Page 111 and 112: Ischemic Steal Syndrome due to Hemo
Page 113 and 114: Figure 2: (From JACS 2000: Wixon et
Page 115 and 116: Theoretically the presence of a lar
Page 117 and 118: Treatment of Ischemic Steal Syndrom
Page 119 and 120: performing a femoral-femoral bypass
Page 121 and 122: Ligation may still be an option for
Page 123 and 124: arterio-venous fistula. Acta Chir S
Page 125 and 126: David Shavelle, MD September 27, 20
Page 127 and 128: Definitions• Early (Primary) Fail
Page 129 and 130: Dual-Sheath TechniqueStep 1: Thromb
Page 131 and 132: Role of Stent Placement• Stenting
Page 133 and 134: ComplicationsPulmonary Embolism~10%
Page 135 and 136: PrePostMedical Therapy• Clopidogr
Page 137 and 138: Karen Woo, MD September 27, 2012Ass
Page 139 and 140: Dilation occurs over several years
Page 141 and 142: Replace with interposition graft◦
Page 143 and 144: Heparin Proximal and distal control
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Page 147 and 148: Perioperative variableOperative tim
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