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Reflections on ACP's Abstract Competition

2015 Medical Student Abstract Competition winner Jules Vieaux, MD

Each year at Internal Medicine Meeting, ACP announces and honors the winners for its annual National Abstract Competition.

Jules Vieaux, MD, a winner in 2015, offered his thoughts on the competition and how it's positively impacted his career in internal medicine. Vieaux's winning abstract entry's topic was “Quality Improvement for Advance Care Planning Completion Rates in a Community Clinic.”

Can you describe your background in medicine?

Medicine is a second career for me. I worked in marketing and advertising for 15 years, but during the course of my career saw family members who were cared for by skilled and compassionate internists and subspecialists. When the opportunity presented itself, I took pre-requisites at local community colleges and eventually completed my medical school training at UC Davis and residency at Kaiser Oakland.

What drove you to switch from 15 years of marketing and advertising to medicine? How did you find the transition?

Pursuing a career in medicine after working in marketing for 15 years was not a decision I made lightly or arrived at easily. As with many physicians, seeing family members require medical care for serious illnesses gave me experience across a spectrum of disease and healthcare. Throughout the experience, I interacted with professionals within medicine and soon decided it was a career for me.

My prior career enabled me to have real-world experience working with teams across organizations to achieve success. Leadership involves seeing situations in their entirety and being able to formulate plans and stimulate motivation that can be implemented by others on the team to bring about desired outcomes. In this way, medicine has many things in common with many other professions, and my skills and experience translated well.

How did you get involved with ACP?

Early in medical school I joined to learn more about the pathways toward internal medicine residencies and further training in subspecialty fellowship. I was also active in our student interest group and found many terrific ACP mentors willing to share advice and perspective about their experience. I have been a member for five years.

What about being a member of ACP do you find most valuable?

ACP events and resources provide opportunities to learn from and share with other physicians evidenced-based approaches to caring for patients.

Your entry in the Abstract Competition was “Quality Improvement for Advance Care Planning Completion Rates in a Community Clinic.” Can you describe the case and your observations?

Audits indicated the completion rate for advance directives were between 3-7%. A two-phase quality improvement pilot program was developed to determine the ideal workflow for increasing the rates advance care planning and advance directives were offered to and completed by patients.

The second phase investigated quality improvement strategies to increase advance care planning completion rates. We evaluated multiple referral strategies while developing and refining a discussion script to introduce advance directives to patients. We deployed provider and patient surveys to understand motivations and barriers to advance care planning. Finally, we developed an electronic medical record documentation strategy to facilitate accurate tracking of results.

Over nine weeks, 99 patients were introduced to advance care planning services and given a copy of an advance directive during a 3-5 minute discussion while in clinic for other appointments. Each patient was offered the option of a future follow-up discussion either in-person, over the phone, or in a group meeting. Of the patients offered follow-up discussions, 32 requested additional information, with 20 completing in-person discussions reviewing an advance directive, 10 completing a discussion over the phone, and 7 completing advance directives. Electronic medical record documentation noted a 1.8% increase in the offering of advance care planning services across the clinic.

What was your reaction upon winning?

I was thrilled and humbled, as there were so many impactful posters and research projects at the California Northern Chapter competition.

What effect has winning had on your medical career?

Simply participating was a valuable asset on my CV. Having my early work recognized gave me the confidence to explore research into broader aspects of advance care planning. I am now working with the critical care and palliative care teams at my hospital to improve the delivery of palliative care services within an ICU setting.

Did the Abstract Competition and your results play a role in how you educate?

Absolutely, in that it helped me learn how our individual efforts at research can be communicated in a succinct and meaningful way along with the collected efforts of our colleagues to help foster both our learning and the delivery of optimized care for our patients.

ACP holds a National Abstracts Competition as part of the ACP Internal Medicine Meeting every year. The student abstract submissions deadline for this year's competition is Wednesday, November 15, 2017 at 11:59 PM EST. Find out more at ACP Online.

Back to the November 2017 issue of ACP IMpact