An Urban School District-University-Industry Partnership to Increase Diversity in the Health Professions: Lesson Learned from the University of Kansas Health Science Academy.

School-industry partnerships bring invaluable cognitive and material resources to K-12 but might inadvertently contribute to widening the achievement gap. Lack of social capital and industry connections make urban schools less likely to partner. This paper describes the University of Kansas (KU) Medical Center Health Science Academy, a university-industry-K-12 partnership designed to increase the number of underrepresented students in health science careers. Using data gathered from 1) meetings with stakeholders, 2) semi-structured interviews with key informants, and 3) focus groups with students, we present the features that made the process and outcomes of this partnership a success. Preliminary results from our pilot year show that students experienced a positive change in their knowledge and intention to pursue a health career.

Splenic Embolization After Trauma: An Opportunity to Improve Best Immunization Practices.

BACKGROUND: The spleen is the second most commonly injured solid organ during blunt abdominal trauma. Although total splenectomy is frequently performed for injury, splenic rupture can also be managed by splenic embolization. For these patients, current Advisory Committee on Immunization Practices (ACIP) recommendations indicate that if 50% or more of the splenic mass is lost, patients should be treated as though they are asplenic. We have previously demonstrated that compliance with ACIP guidelines regarding immunization after splenectomy is poor. Compliance with vaccination in the setting of splenic embolization for trauma is unknown and we hypothesized patients would not receive the recommended immunizations. MATERIALS AND METHODS: All admissions at our level 1 trauma center requiring splenic embolization secondary to traumatic injury between January 1, 2010, and November 1, 2015, were reviewed. Demographic and injury data, dates and imaging of splenic embolizations, immunization documentation, subsequent vaccination boosters received, and outcomes were collected from the medical record. The proportion of spleen embolized was estimated by review of angiographic imaging using an established method. RESULTS: Nine thousand nine hundred sixty-five trauma patients were admitted during the period studied. Nineteen patients met inclusion and exclusion criteria. Median age of the patient population was 35 y, 85% were male, and median injury severity score was 28. Of these, 15 patients underwent a splenic embolization, in which 50% or more of their splenic mass was lost through embolization. Eight patients received at least one immunization before discharge. Six received initial immunizations against Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae, while three received only the initial immunization against S pneumoniae. None of the 15 patients received any ACIP-recommended booster. Of the four patients having less than 50% of their spleen embolized, three wrongly received immunization against encapsulated organisms before hospital discharge. CONCLUSIONS: Trauma patients undergoing splenic embolization at our institution receive postsplenectomy immunizations incorrectly and had no recorded booster vaccines. We speculate that this is common among the U.S. trauma centers. Review of immunization practices in our trauma and nontrauma patient populations is underway in our health system to improve the care of these patients, and our experience may serve as a guide for other centers to reduce complications associated with asplenia.

An opportunity for improvement in trauma care: 8-week booster vaccination adherence among patients after trauma splenectomy.

BACKGROUND: Splenectomies are common after abdominal trauma, and measures must be taken to prevent infection, namely, the administration of available conjugate vaccinations against encapsulated organisms. While initial immunization is frequently completed prior to discharge, the Advisory Council on Immunization Practices recommends administration of an 8-week vaccination booster against S. pneumoniae, and compliance with this practice is unknown. We hypothesized that patients undergoing splenectomy for trauma would not routinely receive the recommended immunization and subsequent booster. METHODS: All trauma admissions at our center who required splenectomy secondary to trauma between 2010 and 2015 were included. Demographic and injury data, splenectomy dates, immunization documentation, subsequent boosters received, and outcomes were collected from the medical record. RESULTS: Of the 9,965 patients observed, 44 patients underwent splenectomy, with 31 patients meeting inclusion/exclusion criteria. Two patients received subsequent boosters during office or hospital visits; however, no patient received any booster within Advisory Council on Immunization Practices' recommended timeframe with median time to subsequent boosters of 22 months. Seven patients have had a subsequent admission for infection or sepsis, with one presenting with S. pneumoniae meningitis. None of the patients subsequently admitted for infection or sepsis had received boosters. CONCLUSION: While trauma patients at our institution receive recommended immunizations after splenectomy prior to discharge, they receive boosters at a suboptimal rate and beyond the advised timeframe. We speculate that this phenomenon is widespread in the American trauma population. These data suggest a need for improved patient and provider education and coordination with primary care practitioners to ensure ideal defense against infectious complications.