Jo Anna Leuck

Bio

I am the Vice Chair of Academics and the Director of Simulation at John Peter Smith Health System in Fort Worth, Texas. I work and teach as an Emergency Medicine Attending at a busy, level 1 trauma center. I am proud of the fact that I climbed Mount Kilimanjaro last fall and lived to tell the tale. Lately, I have been into teaching the Difficult Airway Course at Emergency Medicine residency programs in a variety of countries. Other than travel, I enjoy working out and mainly use it to balance my other loves, great food and great cocktails.


Does the Early Bird Catch the Worm?: How to be truly "awake" during a shift

This lecture will review the available literature surrounding mental fatigue and shift work and focus on techniques both before and during shifts to potentially mitigate any clinical sluggishness and improve patient care.
Is there a specific time during our shift when we are too fatigued to safety practice? That was the question that led to a research project comparing the clinical performance of providers during the first hour of a day shift and the final hour of a string of night shifts. These providers were pulled out of their real-time clinical duties and video-taped while performing simulated critical care cases. The hypothesis was that the day shift providers would out-perform the night shift, but the opposite proved true. Blinded reviewers assigned the day shift providers lower performance scores and noticed some surprising medical errors committed during these simulated cases. So are we “awake” when we come to work? Should some type of case-based warm up exercise be encouraged just prior to a shift? Also, upon reviewing the data, it was found that the majority of the providers studied had been off the day prior to their morning shift. Jan Paderewski, a famous pianist said, “If I miss one day of practice, I notice it. If I miss two days, the critics notice it. If I miss three days, the audience notices it.” Perhaps clinicians, similar to others who are elite in their field, truly need daily practice or some type of deliberate exercise prior to a shift to perform at the highest levels of care. How can we determine when we are not at our maximum level of mental sharpness during a shift? Can anything be done to improve our abilities in real time? This lecture will review the available literature surrounding mental fatigue and critical care based shift work and focus on techniques both before and during shifts to recognize and potentially mitigate any clinical sluggishness and improve patient care.

Remembering Rory: Sepsis and Learning from Error

We will walk together through the events surrounding the tragic death of Rory Staunton, caused by sepsis. The focus will be on the medical errors that were found during a review of this case and strategies to prevent similar errors in the future.

Rory Staunton was a healthy 12-year old boy, known for his smile and his work standing up for others. A simple fall during basketball practice caused an abrasion on his arm, which is the suspected beginning of a cascade of events that led to his death from sepsis. Rory was seen by both his pediatrician and a local emergency department, and was sent home with a diagnosis of a viral illness. He returned the next day in septic shock and died shortly thereafter.
A review of the medical records revealed that there were errors that occurred during his emergency department visit. These errors were the focus of a controversial article in the New York Times, that included both details of the case, as well as the name of the physician that provided care. A backlash from the medical community occurred leading to multiple physician-written op-ed pieces, as well as over 1600 comments on the online version of the article.
This talk will attempt to move away from the controversy of the actual article and instead focus on how these common errors could have occurred during any busy shift and what we can do to prevent them in the future.
My intention in giving this talk is to continue to use this case to raise awareness of both pediatric sepsis and common medical error and hopefully lead to fewer outcomes like Rory’s.


Rory Staunton was a healthy 12-year old boy, known for his smile and his work standing up for others. A simple fall during basketball practice caused an abrasion on his arm, which is the suspected beginning of a cascade of events that led to his death from sepsis. Rory was seen by both his pediatrician and a local emergency department, and was sent home with a diagnosis of a viral illness. He returned the next day in septic shock and died shortly thereafter.
A review of the medical records revealed that there were errors that occurred during his emergency department visit. These errors were the focus of a controversial article in the New York Times, that included both details of the case, as well as the name of the physician that provided care. A backlash from the medical community occurred leading to multiple physician-written op-ed pieces, as well as over 1600 comments on the online version of the article.
This talk will attempt to move away from the controversy of the actual article and instead focus on how these common errors could have occurred during any busy shift and what we can do to prevent them in the future.
My intention in giving this talk is to continue to use this case to raise awareness of both pediatric sepsis and common medical error and hopefully lead to fewer outcomes like Rory’s.



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