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The Annual Kaiser Permanente (KP) Los Angeles Research Week is culminated by the highly anticipated oral abstract competition. This research competition is often described by the house staff as the highlight of the academic year with its competitive intensity, celebratory aura, and even drama. The work is often a product of effort spanning the entire duration of training. The judges for this prestigious competition are a diverse group representing research, operations, clinical medicine, and medical education.
Several days before the competition, the Medical Center hosted the annual research abstract poster session of original research, quality and patient outcomes, operational research, and case reports. The set of 40 papers in the linked-bibliography came from different medical subspecialties and from different health fields, including pharmacy and nursing.
Throughout the years, KP research has provided insights and helped shape medicine in many ways. In 1969, Irving Rasgon, MD, published a study on colon cancer screening in the journal CA: A Cancer Journal for Clinicians,1 and in 1977, Harry Ziel, MD, with Gordon et al, published a study on estrogens causing endometrial cancer in the New England Journal of Medicine.2 In 1981, Peter Mahrer, MD, with Eshoo, published his study of the safety of same-day cardiac catheterization in Catheterization and Cardiovascular Diagnosis.3 More recent examples include identifying major adverse risk with common drugs such as cox 2 inhibitors,4 questioning the overall benefit vs risk of routine colonoscopy in the elderly population,5 and informing people of the risks associated with beta blockers in pregnancy.6 In addition, we have dispelled myths about porcelain gallbladder,7 described unlikely benefits of cannabis, and helped establish guidelines for care such as with hematuria.8 We have helped provide insights on comparative outcomes for management strategies for many different diseases including cancer, and continue to describe and share our success rates for chronic disease management programs and innovations in care delivery for such conditions as hypertension, diabetes, and heart failure, to name a few.911 KP has become a source for health information not just on its members, but on its medical residents as well. A recent qualitative study gathered the perspectives of both residents and faculty across multiple disciplines on the causal and protective factors for burnout in residency. The results have been presented locally, as well as nationally, and are being used to develop prevention and intervention strategies across the region.9
Research is a standard for the KP community and now part of its DNA. The history of the Los Angeles Medical Center Research Week (see Sidebar: History Highlights: Los Angeles Medical Center Research Week) has reflected a changing culture where recognition, emphasis, and support of research continues to increase in the organization and training programs. If physicians are asked to change and improve on the ways they practice medicine, the evidence must be there. This has led to the fostering and growth of researchers as well as the recruitment and attraction of talented research-minded physicians to KP. This year’s work, like others in the past, will affect future care within KP and elsewhere.
History Highlights: Los Angeles Medical Center Research Week
June 7, 2018, was another warm sunny day in Southern California and a period of transition at the Kaiser Permanente (KP) Los Angeles Medical Center. Spring at KP marks the end of the academic year for our residency and fellowship programs, and those in their last year of training were eagerly looking forward to the next step in their careers and lives. Faculty physicians greeted the end of another academic year with mixed emotions: A sadness and fondness for the departing trainees coupled with excitement and anticipation for the incoming eager but inexperienced new batch of trainees. This first Thursday in June also marked the end of the annual KP Los Angeles Research Week. The 19th event of its kind.
The exact dates are vague, but many people refer to J Fenimore Cooper, MD, (a urologist) as the very first Los Angeles Medical Center research lead, dating to the 1960s. We often refer to the 1960s as the days of giants because these individuals stood tall from the norm, and they represented people who went against the grain and did not follow the path of least resistance. For the KP physicians of this era, research was truly a labor of love. “People doing research at KP at the time were often chastised by others, and their work was deemed inappropriate conduct for a KP physician,” said Sheldon Wolfe, MD, a neurologist. Wolfe assumed the first official research chair position in the 1970s. Nevertheless, this small army of scholars and trendsetters persisted and continued to grow.
It was not until the fall of 2001 that there was enough interest and support to hold the first research week. According to Michael Glowalla, MD, Research Chair at the time, it took the form of an informal luncheon to acknowledge the few researchers and house staff doing research on campus. As miniscule as it may have seemed at the time, it represented another meaningful step in the growth and acceptance of research at KP Los Angeles. Since then, the event has grown tremendously in the number of researchers, the magnitude and number of projects presented, and the number of people interested, attending, and supporting research. People like Dennis Kim, MD; Bruce Goldberg, MD; Albert Shen, MD; and Nilesh Patel, DM; come to mind, helping to lead and oversee the surging culture of research. Overall, the transformation of the annual event has paralleled the growth of the research infrastructure including the clinician researchers, dedicated research scientists, research funding, and the findings that affect our organization. The following pages include the abstracts from the 19th annual KP Los Angeles Research Week. We feel that some of this year’s work, like others in the past, will affect future care within KP and elsewhere. This annual event is just a small sample of the number, quality, and vastness of the research conducted in Los Angeles, Southern California, and KP nationally. The year 2018 also marked the first year that KP Fontana (nearly 30 research posters presented this year) had such an event, and KP San Diego will follow suit in 2019. Although 2018’s panel of judges included Edward Ellison, MD (Executive Medical Director of KP Southern California); Steven Jacobsen, MD (Director of Research and Evaluation); and Adam Sharp, MD (Research Scientist and Emergency Physician); previous judges have included Michael Kanter, MD (Chief Quality Officer of the KP Federation); and Marc Klau, MD (Vice Dean KP School of Medicine). Chairman and CEO of Kaiser Foundation Health Plan and Hospitals, Bernard J Tyson, made this comment: “Kaiser Permanente has one of the nation’s most-respected research institutions, and the research we develop improves the quality of care and health outcomes we deliver for our members and the communities we serve. The Los Angeles Medical Center Research Week is an exciting example of how we are working together—through research—to find new ways to impact and transform the future of health.”
KP medicine strives to continually transform and improve upon itself because of its introspective approach and willingness to study what we do from all perspectives. Thus, research is embedded in so much of how we operate. With research as a priority, we hope to continue to challenge and advance the field of medicine. Finally, the basis for why we deliver high-quality and efficient care largely lies within the information that we obtain from our own clinical practice and experience, which is based entirely on our members. For this we are infinitely grateful to the members of KP. They are truly the reason we do research and the reason we can do research.

Research

Research, untrammeled by near reference to practical ends, will go on in every properly organized medical school; its critical method will dominate all teaching whatsoever.
— Abraham Flexner, 1866–1959, American educator, reformer of medical and higher education in the US and Canada

Poster Awards—Surgery

Aortic Dissection Causing Malperfusion from Stent Graft Collapse in a Patient with Previous Hybrid Repair of a Paravisceral Aortic Aneurysm: A Case Report
Marie S Tran-McCaslin, MD; Wesley K Lew, MD; Kaushal (Kevin) Patel, MD; Linda J Chun, MD
A National Review of ACGME General Surgery Resident Case Logs: Assessing the Impact of Minimally Invasive Surgery
Janice Verham, MD; Borna Mohabbatizadeh, MD; Kaushal (Kevin) Patel, MD

Poster Awards—Urology

Safety and Feasibility of Outpatient Robotic-Assisted Radical Prostatectomy
Peter Elliott, MD; Pooya Banapour, MD; Ashish Parekh, MD; Apurba Pathak, MD; Madhur Merchant, MD; Kirk Tamaddon, MD
Adoption of Robotic Partial Nephrectomy: Its Effect on Renal Cancer Surgery and Kaiser Permanente Southern California Practice Patterns
Ramzi Jabaji, MD; Heidi Fischer, PhD; Gary W Chien, MD
Prevalence of Urethral Stricture in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
Tyler Kern, MD; Daniel Artenstein, MD; Gil Weintraub MD; Polina Reyblat, MD; Christopher Tenggardjaja, MD

Reference

1.
Rasgon IM. The importance of routine sigmoidoscopic examination in asymptomatic patients. CA Cancer J Clin. 1969 Nov-Dec; 19(6):339-43.
2.
Gordon J, Reagan JW, Finkle WD, Ziel HK. Estrogen and endometrial carcinoma. An independent pathology review supporting original risk estimate. N Engl J Med. 1977 9 15 297(11):570-1.
3.
Mahrer PR, Eshoo N. Outpatient cardiac catheterization and coronary angiography. Cathet Cardiovasc Diagn. 1981 7(4):355-60.
4.
Cheetham TC, Graham DJ, Campen Det al. Myocardial Infarction and its association with the use of nonselective NSAIDs: A nested case-control and time-to-event analysis. Perm J. 2008 Winter; 12(1):16-22.
5.
Tran AH, Man Ngor EW, Wu BU. Surveillance colonoscopy in elderly patients: A retrospective cohort study. JAMA Intern Med. 2014 10 174(10):1675-82.
6.
Duan L, Ng A, Chen Wet al. β-Blocker exposure in pregnancy and risk of fetal cardiac anomalies. JAMA Intern Med. 2017 6 1 177(6):885-7.
7.
Chen GL, Akmal Y, DiFronzo AL, Vuong B, O’Connor V. Porcelain gallbladder: No longer an indication for prophylactic cholecystectomy. Am Surg. 2015 10 8 81(10):936-40.
8.
Loo RK, Lieberman SF, Slezak JMet al. Stratifying risk of urinary tract malignant tumors in patients with asymptomatic microscopic hematuria. Mayo Clin Proc. 2013 2 88(2):129-38.
9.
Kanter MH, Lindsay G, Bellows J, Chase A. Complete care at Kaiser Permanente: Transforming chronic and preventive care. Jt Comm J Qual Patient Saf. 2013 11 39(11):484-94.
10.
Sim JJ, Handler J, Jacobsen SJ, Kanter MH. Systemic implementation strategies to improve hypertension: The Kaiser Permanente Southern California experience. Can J Cardiol. 2014 5 30(5):544-52.
11.
Sim JJ, Rutkowski MP, Selevan DCet al. Kaiser Permanente Creatinine Safety Program: A mechanism to ensure widespread detection and care for chronic kidney disease. Am J Med. 2015 11 128(11):1204-1211.e1201.

Information & Authors

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Published In

cover image The Permanente Journal
The Permanente Journal
Volume 23Number 3September 1, 2019

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Keywords

  1. chronic conditions
  2. community health
  3. cultural
  4. education
  5. epidemiology
  6. health research
  7. medical research

Authors

Affiliations

John J Sim, MD
Division of Nephrology and Hypertension, Los Angeles Medical Center, CA
Kristen Ironside, MA
Center for Medical Education, Los Angeles, CA
Gary W Chien, MD
Department of Urology, Los Angeles Medical Center, CA

Notes

Corresponding Author: John J Sim, MD ([email protected])

Competing Interests

Disclosure Statement
The author(s) have no conflicts of interest to disclose.

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Citing Literature

  • Kaiser Permanente Los Angeles Annual Research Week 2023: Research as a Pillar for Well-Being in Graduate Medical Education and Beyond, The Permanente Journal, 10.7812/TPP/23.144, 28, 4, (3-6), (2024).

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