2017 Right Care Vignette Competition

2017 Right Care Vignette Competition

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In collaboration with JAMA Internal Medicine, the Lown Institute is proud to announce the third national Right Care Vignette Competition. We are seeking clinical vignettes written by trainees describing harm or near-harm from medical overuse. In particular, we want to hear about medical interventions that are commonly performed and seem acceptable, rather than errors or obvious malpractice. 

Applications should include a clinical vignette that provides an engaging story with pertinent clinical and historical findings. Vignettes must also include a succinct summary of the clinical issues that describes the evidence for medical overuse and suggests an alternative approach going forward. The deadline to submit a vignette is February 28, 2017.

Don’t miss your chance – Apply Now

 

Background

Medical overuse – the provision of unnecessary or unwanted medical tests and procedures to patients – is common in our healthcare system, but often goes unnoticed. One third of healthcare interventions are considered unnecessary, but such instances can be hard to recognize in real time. The purpose of the Right Care Vignette Competition is to shine a light on everyday overuse – commonly performed tests and procedures that seem acceptable, but are actually harmful. Sharing stories of the downstream consequences of overuse can be a powerful counterbalance to the ‘more is better’ culture and can help clinicians recognize and avoid overuse.

The goal of this competition is to improve clinicians’ awareness of the harms patients may face as a result of overuse and to share ideas about how the delivery of care may be improved in the future. In an era of increasingly depersonalized health care, we hope to promote the importance of thoughtful, individualized care tailored to the patient. We want to hear your stories!

Why Participate?

The authors of the top two vignettes will be eligible for a scholarship to participate in the 5th Annual Lown Institute Conference, May 5-7, 2017 in Boston, MA, (up to $1200 in reimbursements in accordance with the Scholarship Policy) AND will be asked to give an oral presentation during a Right Care workshop session on the Saturday of the conference. Many of the top vignettes will be published on Lown Institute’s website. Authors of these top two vignettes will also receive a consulting session with Brandon Combs, MD (co-founder, Do No Harm Project) on implementing Right Care Tools in their community.

JAMA Internal Medicine’s Teachable Moment series publishes clinical vignettes by trainees describing harm or near harm from medical overuse as well as underuse. Competition participants will have the opportunity to submit their vignettes to the Teachable Moment series for review and potential publication.

Examples

Past vignettes are available for review here. Last year’s winning vignettes illustrated the consequences of off-label drug treatment for insomnia and patient dissatisfaction with unhelpful bed alarms. Other example topics for vignettes include:

  • CT pulmonary angiogram study in a low-risk patient with negative d-dimer results in unnecessary radiation and workup of incidental finding
  • Tight glycemic control in elderly patient (HbA1C < 7) results in hypoglycemia, fall and hospitalization
  • Pre-operative testing in an asymptomatic patient leads to benign incidental findings and cancellation of needed surgery

Other examples where harm can result from overuse can be read here.

Key Proposal Elements

First-round applications are due on Tuesday, February 28, 2017. All finalists will be contacted by the end of March. The Lown Institute will convene a panel of judges to evaluate submissions, and select finalists for further review.

A complete application should be submitted here. A complete application includes:

  1. Authors: Contact information for up to three authors. The first author must be a trainee who is a professional student, intern, resident, fellow, masters or doctoral student, or post-doctoral student.
  2. Vignette: Maximum word count is 800 words (excluding references). Submissions should include a clinical vignette headed “Story From the Front Lines” which provides an engaging story with pertinent clinical and historical findings. Vignettes must also include a succinct summary of the clinical issues with the heading, “Teachable Moment” describing the evidence for medical overuse and suggesting an alternative approach going forward. The manuscript should be given a title that reflects the specific focus.
  3. References: Up to five references are permitted.
  4. Patient Consent: Completion of a patient consent form.

 

The Right Care Vignette Competition is part of the broader suite of Right Care tools, which include Right Care Rounds the Do No Harm Project and, and programs, which include the Young Innovator Grant Program, and the Right Care Educator Program.

Eligibility and Selection Criteria

Vignettes will be judged on the following criteria:

  • Is the vignette engaging and well written? To what extent are the ideas presented in a logical and interesting manner?
  • Does the vignette address a meaningful aspect of medical overuse? Does the vignette describe harm or near harm caused by medical overuse? Does the vignette focus on activities that are commonly performed and seem acceptable rather than errors or obvious malpractice?
  • To what extent does the vignette advance right care? What is the potential for the alternative approach included in the clinical summary to improve quality of care and patient experience?

Judges Include:

    • Tanner Caverly, MD, MPH, Clinical Lecturer, Department of Internal Medicine, University of Michigan Health System; Co-founder, Do No Harm Project; Section Editor, Teachable Moments, JAMA Internal Medicine
    • Harry Cho, MD, Assistant Professor, Hospital Medicine, Mount Sinai School of Medicine; Senior Fellow, Lown Institute
    • Brandon Combs, MD, Associate Professor of Medicine, University of Colorado School of Medicine; Co-founder, Do No Harm Project; Senior Fellow at the Lown Institute; Section Editor, Teachable Moments, JAMA Internal Medicine
    • Stephanie Cull, MD, MSc, Internal Medicine Resident, Saint Louis University School of Medicine; 2016 Right Care Vignette Competition Winner
    • Deborah Grady, MD, MPH, Associate Dean of Clinical and Translational Research, Interim Director, Clinical and Translational Science Institute, University of California San Francisco School of Medicine; Deputy Editor, JAMA Internal Medicine
    • Chris Moriates, MD, Associate Professor of Internal Medicine; Assistant Dean for Healthcare Value, Dell Medical School, The University of Texas at Austin; Section Editor, Teachable Moments, JAMA Internal Medicine
    • Vikas Saini, MD, President, Lown Institute

 

***

2016 Right Care Vignette Competition

Congratulations to our two winners of the 2016 Right Care Vignette Competition:

Stephanie Cull, MD, MSc
Resident, Saint Louis University School of Medicine

and

Ploa Desforges, MD
Resident, Internal Medicine, McGill University Health Center

Honorable mention goes to the following individuals who placed in the top 10:

  • David Furfaro, MD
  • Josh Glick, MD
  • Brittne Halford, MD
  • Masha Jones, MD
  • Steven Lai, MD
  • Justin Laracy, MD
  • Elizabeth Nguyen, MD
  • Florence-Damilola Odufalu, MD
  • Danielle Thurtle, MD

 

 

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