Lisa R Stoneking

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Scholarly Contributions

Journals/Publications

• Chuffe, E., Grall, K. H., Stoneking, L. R., & Panchal, A. R. (2016). Feasibility of Spanish-language acquisition for acute medical care providers: novel curriculum for emergency medicine residencies.. Advanced Medical Educucation Practices. 2016 Feb 18;7:81-6. doi: 10.2147/AMEP.S96928. eCollection 2016., 7, 81-66.
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  Language and cultural barriers are detriments to quality health care. In acute medical settings, these barriers are more pronounced, which can lead to poor patient outcomes.
• Pritchard, G., Stoneking, L. R., Koch, B. D., McAtee, R., Grall, K., Min, A., Waterbrook, A. L., Lane, A. D., Prior, J., Farrell, I. J., Mcnulty, H. G., & Stolz, U. (2016). Development of a novel sports medicine rotation for emergency medicine residents.. Advances in Medical Education and Practice.
• Stoneking, L. R., Stoneking, L. R., Waterbrook, A. L., Waterbrook, A. L., Garst Orozco, J., Garst Orozco, J., Johnston, D., Johnston, D., Bellafiore, A., Bellafiore, A., Davies, C., Davies, C., Nuno, T., Nuno, T., Fatas, J. M., Fatas, J. M., Beita, O., Beita, O., Ng, V., , Ng, V., et al. (2016). Does Spanish instruction for emergency medicine resident physicians improve patient satisfaction in the emergency department and adherence to medical recommendations?. Advances in Medical Education and Practice, 7, 467-473.
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  Approximately 1 hours spent on project for 2015Approximately 6 hours spent on project for 2016
• Stoneking, L. R., Waterbrook, A. L., Garst Orozco, J., Johnston, D., Bellafiore, A., Davies, C., Nuno, T., Fatas, J. M., Beita, O., Ng, V., Grall, K., & Adamas-Rappaport, W. (2016). Does Spanish instruction for emergency medicine resident physicians improve patient satisfaction in the emergency department and adherence to medical recommendations?. Advances in Medical Education and Practice, 7, 467-473.
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  Approximately 1 hours spent on project for 2015
• Stoneking, L., Denninghoff, K., Deluca, L., Keim, S. M., & Munger, B. (2016). Sepsis bundles and compliance with clinical guidelines. Journal of intensive care medicine, 26(3), 172-82.
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  Realizing the vast medical benefits of validated protocols, recommendations and practice guidelines requires acceptance and implementation by frontline care providers. Knowledge translation is the science of accelerating the transfer of knowledge to practice by understanding and creatively addressing the barriers that prevent adoption of new professional standards. In an attempt to improve patient care and reduce mortality, the Surviving Sepsis Campaign and The Institute for Healthcare Improvement created the resuscitation and management bundles for patients with severe sepsis and septic shock. These bundles have been accepted as best practice by many clinicians since multiple clinical trials have produced similar positive results when they were implemented. However, transferring these research outcomes-based guidelines to the clinical practice arena has been associated with poor compliance due to important barriers to implementation. Delays in the adoption of sepsis bundles are not surprising since the time from validation to implementation of a new clinical practice is typically 17 years. Using sepsis bundles as a model, this article explores why guidelines are important, examines physician adherence to protocols, and reviews the literature on strategies to improve clinical compliance and enhance knowledge translation.
• Waterbrook, A. L., Pritchard, T. G., Lane, A. D., Stoneking, L. R., Koch, B. D., McAtee, R., Grall, K. H., Min, A. A., Prior, J., Farrell, I. J., McNulty, H. G., & Stolz, U. (2016). Development of a novel sports medicine rotation for emergency medicine residents. Advances in medical education and practice, 7, 249-55. doi:https://doi.org/10.2147/AMEP.S92428
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  Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational experience when compared to the traditional orthopedics rotation. All SC residents successfully completed their sports medicine rotation, had completed postrotation evaluations by attending physicians, and had no duty hour violations while on sports medicine. In our experience, a sports medicine rotation is an effective alternative to the traditional orthopedics rotation for EM residents.
• Stoneking, L. R., Stoneking, L. R., Stoneking, L. R., Waterbrook, A. L., Waterbrook, A. L., Waterbrook, A. L., Garst Orozco, J., Garst Orozco, J., Garst Orozco, J., Johnston, D., Johnston, D., Johnston, D., Bellafiore, A., Bellafiore, A., Bellafiore, A., Davies, C., Davies, C., Davies, C., Nuno, T., , Nuno, T., et al. (2016). Does Spanish instruction for emergency medicine resident physicians improve patient satisfaction in the emergency department and adherence to medical recommendations?. Advances in Medical Education and Practice, 7, 467-473.
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  Approximately 1 hours spent on project for 2015
• Stoneking, L. R., Winkler, J. P., DeLuca, L. A., Stolz, U., Stutz, A., Luman, J. C., Gaub, M., Wolk, D. M., Fiorello, A. B., & Denninghoff, K. R. (2015). Physician documentation of sepsis syndrome is associated with more aggressive treatment. The western journal of emergency medicine, 16(3), 401-7.
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  Timely recognition and treatment of sepsis improves survival. The objective is to examine the association between recognition of sepsis and timeliness of treatments.
• Stoneking, L., Denninghoff, K., Deluca, L., Keim, S. M., & Munger, B. (2015). Sepsis bundles and compliance with clinical guidelines. Journal of intensive care medicine, 26(3), 172-82.
  More info

  Realizing the vast medical benefits of validated protocols, recommendations and practice guidelines requires acceptance and implementation by frontline care providers. Knowledge translation is the science of accelerating the transfer of knowledge to practice by understanding and creatively addressing the barriers that prevent adoption of new professional standards. In an attempt to improve patient care and reduce mortality, the Surviving Sepsis Campaign and The Institute for Healthcare Improvement created the resuscitation and management bundles for patients with severe sepsis and septic shock. These bundles have been accepted as best practice by many clinicians since multiple clinical trials have produced similar positive results when they were implemented. However, transferring these research outcomes-based guidelines to the clinical practice arena has been associated with poor compliance due to important barriers to implementation. Delays in the adoption of sepsis bundles are not surprising since the time from validation to implementation of a new clinical practice is typically 17 years. Using sepsis bundles as a model, this article explores why guidelines are important, examines physician adherence to protocols, and reviews the literature on strategies to improve clinical compliance and enhance knowledge translation.
• Beskind, D. L., Hiller, K. M., Stolz, U., Bradshaw, H., Berkman, M., Stoneking, L. R., Fiorello, A., Min, A., Viscusi, C., & Grall, K. J. (2014). Does the experience of the writer affect the evaluative components on the standardized letter of recommendation in emergency medicine?. The Journal of emergency medicine, 46(4), 544-50.
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  The Standardized Letter of Recommendation (SLOR) was developed in an attempt to standardize the evaluation of applicants to an emergency medicine (EM) residency.
• DeLuca, L. A., Simpson, A., Beskind, D., Grail, K., Stoneking, L., Stolz, U., Spaite, D. W., Panchal, A. R., & Denninghoff, K. R. (2009). Analysis of Automated External Defibrillator Device Failures Reported to the Food and Drug Administration. ANNALS OF EMERGENCY MEDICINE, 59(2), 103-111.
• Grall, K. H., Hiller, K. M., & Stoneking, L. R. (2014). Analysis of the evaluative components on the Standard Letter of Recommendation (SLOR) in Emergency Medicine. The western journal of emergency medicine, 15(4), 419-23.
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  The standard letter of recommendation in emergency medicine (SLOR) was developed to standardize the evaluation of applicants, improve inter-rater reliability, and discourage grade inflation. The primary objective of this study was to describe the distribution of categorical variables on the SLOR in order to characterize scoring tendencies of writers.
• Grall, K. H., Stoneking, L. R., DeLuca, L. A., Waterbrook, A. L., Pritchard, T. G., & Denninghoff, K. R. (2014). An innovative longitudinal curriculum to increase emergency medicine residents' exposure to rarely encountered and technically challenging procedures. Advances in medical education and practice, 5, 229-36.
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  Procedural skills have historically been taught at the bedside. In this study, we aimed to increase resident knowledge of uncommon emergency medical procedures to increase residents' procedural skills in common and uncommon emergency medical procedures and to integrate cognitive training with hands-on procedural instruction using high- and low-fidelity simulation.
• Grall, K. H., Stoneking, L. R., Deluca, L. A., Waterbrook, A. L., Pritchard, T. G., & Denninghoff, K. R. (2014). An innovative longitudinal curriculum to increase emergency medicine residents' exposure to rarely encountered and technically challenging procedures. Advances in medical education and practice, 5, 229-36. doi:https://doi.org/10.2147/AMEP.S58073
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  Procedural skills have historically been taught at the bedside. In this study, we aimed to increase resident knowledge of uncommon emergency medical procedures to increase residents' procedural skills in common and uncommon emergency medical procedures and to integrate cognitive training with hands-on procedural instruction using high- and low-fidelity simulation.
• Min, A. A., Stoneking, L. R., Grall, K. H., & Spear-Ellinwood, K. (2014). Implementation of the Introductory Clinician Development Series: an optional boot camp for Emergency Medicine interns. Advances in medical education and practice, 5, 275-9.
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  The transition from medical student to first-year intern can be challenging. The stress of increased responsibilities, the gap between performance expectations and varying levels of clinical skills, and the need to adapt to a new institutional space and culture can make this transition overwhelming. Orientation programs intend to help new residents prepare for their new training environment.
• Stoneking, L. R., Grall, K. H., Min, A., Dreifuss, B., & Spear Ellinwood, K. C. (2014). Role of an audience response system in didactic attendance and assessment. Journal of graduate medical education, 6(2), 335-7.
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  The Residency Review Committee for Emergency Medicine mandates conference participation, but tracking attendance is difficult and fraught with errors. Feedback on didactic sessions, if not collected in real time, is challenging to obtain.
• Stoneking, L., Deluca, L. A., Fiorello, A. B., Munzer, B., Baker, N., & Denninghoff, K. R. (2014). Alternative methods to central venous pressure for assessing volume status in critically ill patients. Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association, 40(2), 115-23.
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  Early goal-directed therapy increases survival in persons with sepsis but requires placement of a central line. We evaluate alternative methods to measuring central venous pressure (CVP) to assess volume status, including peripheral venous pressure (PVP) and stroke volume variation (SVV), which may facilitate nurse-driven resuscitation protocols.
• Hiller, K. M., Stoneking, L., Min, A., & Rhodes, S. M. (2013). Syndromic surveillance for influenza in the emergency department-A systematic review. PloS one, 8(9), e73832.
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  The science of surveillance is rapidly evolving due to changes in public health information and preparedness as national security issues, new information technologies and health reform. As the Emergency Department has become a much more utilized venue for acute care, it has also become a more attractive data source for disease surveillance. In recent years, influenza surveillance from the Emergency Department has increased in scope and breadth and has resulted in innovative and increasingly accepted methods of surveillance for influenza and influenza-like-illness (ILI). We undertook a systematic review of published Emergency Department-based influenza and ILI syndromic surveillance systems. A PubMed search using the keywords "syndromic", "surveillance", "influenza" and "emergency" was performed. Manuscripts were included in the analysis if they described (1) data from an Emergency Department (2) surveillance of influenza or ILI and (3) syndromic or clinical data. Meeting abstracts were excluded. The references of included manuscripts were examined for additional studies. A total of 38 manuscripts met the inclusion criteria, describing 24 discrete syndromic surveillance systems. Emergency Department-based influenza syndromic surveillance has been described worldwide. A wide variety of clinical data was used for surveillance, including chief complaint/presentation, preliminary or discharge diagnosis, free text analysis of the entire medical record, Google flu trends, calls to teletriage and help lines, ambulance dispatch calls, case reports of H1N1 in the media, markers of ED crowding, admission and Left Without Being Seen rates. Syndromes used to capture influenza rates were nearly always related to ILI (i.e. fever +/- a respiratory or constitutional complaint), however, other syndromes used for surveillance included fever alone, "respiratory complaint" and seizure. Two very large surveillance networks, the North American DiSTRIBuTE network and the European Triple S system have collected large-scale Emergency Department-based influenza and ILI syndromic surveillance data. Syndromic surveillance for influenza and ILI from the Emergency Department is becoming more prevalent as a measure of yearly influenza outbreaks.
• Stoneking, L. R., Grall, K. H., Min, A. A., & Panchal, A. R. (2013). Online research article discussion board to increase knowledge translation during emergency medicine residency. Advances in medical education and practice, 4, 17-21.
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  Many clinicians have difficulties reading current best practice journal articles on a regular basis. Discussion boards are one method of online asynchronous learning that facilitates active learning and participation. We hypothesized that an online repository of best practice articles with a discussion board would increase journal article reading by emergency medicine residents.
• Stoneking, L. R., Patanwala, A. E., Winkler, J. P., Fiorello, A. B., Lee, E. S., Olson, D. P., & Wolk, D. M. (2013). Would earlier microbe identification alter antibiotic therapy in bacteremic emergency department patients?. The Journal of emergency medicine, 44(1), 1-8.
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  Although debate exists about the treatment of sepsis, few disagree about the benefits of early, appropriately targeted antibiotic administration.
• Stoneking, L., DeLuca, L. A., Fiorello, A. B., Munzer, B., Baker, N., & Denninghoff, K. R. (2013). ALTERNATIVE METHODS TO CENTRAL VENOUS PRESSURE FOR ASSESSING VOLUME STATUS IN CRITICALLY ILL PATIENTS. JOURNAL OF EMERGENCY NURSING, 40(2), 115-123.
• Svirsky, I., Stoneking, L. R., Grall, K., Berkman, M., Stolz, U., & Shirazi, F. (2013). Resident-initiated advanced triage effect on emergency department patient flow. The Journal of emergency medicine, 45(5), 746-51.
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  Emergency Department (ED) overcrowding is a national problem. Initiating orders in triage has been shown to decrease length of stay (LOS), however, nurse, physician assistant, and attending physician advanced triage have all been criticized.

Presentations

• Deluca, L. A., Walsh, P., Davidson, D. D., Stoneking, L. R., Yang, L. M., Grall, K., Gonzaga, M. J., Larson, W. J., Durns, T., Miller, R., Pickering, A., Yeaton, J., Stolz, U., Sabb, D. M., & Denninghoff, K. R. (2016, March). VAP Rates are Significantly Reduced by an ED-Based VAP Prevention. SAEM Western Regional Meeting. Los Angeles, CA: Society for Academic Emergency Medicine.
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  ED-Based VAP prevention lowers VAP rates.

Poster Presentations

• Stoneking, L. (2015, May/2015). Retrospective educational analysis of emergency medicine resident experience on orthopedic and sports medicine rotations. BUMCS Scholarly Day. Tucson, AZ.
• Svirsky, I., Stoneking, L. R., Stolz, U., Berkman, M. R., Grall, K., Shirazi, F., & DeBeche, J. (2013, June). Resident-initiated advanced triage effect on emergency department efficiency. Western Regional Society for Academic Emergency Medicine Annual Conference.
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  Long Beach, CA

Others

• Deluca, L. A., Deluca, L. A., Stoneking, L. R., Stoneking, L. R., Grall, K., Grall, K., Tran, A., Tran, A., Rosell, J., Rosell, J., Vira, A., Vira, A., Davidson, D., Davidson, D., Cox, L., Cox, L., Gerlach, E., Gerlach, E., Gonzaga, J., , Gonzaga, J., et al. (2015, June). Ventilator-Associated Pneumonia (VAP) Rates are Significantly Reduced by Deploying the VAP Bundle in an Academic Emergency Department. Academic Emergency Medicine.
• Yang, L., Sabb, D., Munzer, B., Gonzaga, J., Grall, K., Denninghoff, K., Stoneking, L., & DeLuca, L. (2014, DEC). Incidence of Ventilator-Associated Pneumonia compared to Ventilator-Associated Events in the ED. CRITICAL CARE MEDICINE.
• Hiller, K. M., Beskind, D. L., Bradshaw, H. R., Berkman, M. R., Viscusi, C. D., Min, A. A., Grall, K., & Stoneking, L. R. (2013, June). How Much do Students Cost? Clinical Productivity in the Academic Emergency Department. Western Regional Society for Academic Emergency Medicine Annual Conference.
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  Long Beach, CA
• Svirsky, I., Stoneking, L. R., Stolz, U., Berkman, M. R., Grall, K., Shirazi, F., & DeBeche, J. (2013, June). Resident-initiated advanced triage effect on emergency department efficiency. Western Regional Society for Academic Emergency Medicine Annual Conference.
  More info

  Long Beach, CA