The development of a Patient Safety Programme for Primary Care is being informed by the learning from two ongoing primary care safety projects. This session highlights the approaches used, the early findings and describes how to sustain and spread the success of this work.
Objectives:
By the end of this call, you will be able to:
•Describe the processes of Root-Cause Analysis (RCA) and Multi-Incident Analysis (MIA) and their role in quality improvement
•Compare and contrast the different approaches to collecting hospital-acquired VTE data
•Identify an approach suitable for improving patient safety at your institution
On November 17, 2015 the ICU Collaborative Faculty held a National Call to determine the 2016 National Improvement Initiative. Two topics were presented: Dr. Yoanna Skrobik advocated on the side of Pain, Agitation and Delirium. Dr. Claudio Martin and Cathy Mawdsley advocated for working on End of Life Care. Callers voted at the end of the call and chose the new topic led by Dr. Skrobik: Managing “PAD” in your ICU patient: assessment, treatment and prevention.
This resource summarizes the eight recommendations outlined in the Institute of Medicine's a new consensus study entitled, Improving Diagnosis in Health Care. The recommendations are aimed at making diagnoses more accurate, reliable, efficient, and safe. This work is a continuation of the IOM’s Quality Chasm series.
Patient & Family Advisory Councils: the Business Case for Starting a PFAC & P...EngagingPatients
This webinar was presented on March 12, 2015 by Barbara Lewis. It looks at the prevalence and roles that Patient & Family Advisory Councils (PFACs) are playing in U.S. hospitals today, and builds a business case for their implementation:
Clinical practice guidelines and quality metrics often emphasize effectiveness over patient-centered care. In this article, the authors offer three approaches to personalizing quality measurement to ensure patient preferences and values guide all clinical decisions.
Changing practice through knowledge translation and implementation science.
Have you asked, told, taught and begged, but your hand hygiene results aren’t changing as quickly as you want? Changing practice is hard! Join CPSI on May 4th for an interactive webinar exploring the fundamentals of knowledge translation and the efforts of Public Health Ontario to change practice through this innovative science. We will also look at how you can impact patient and family hand hygiene efforts through the successful use of campaigns.
Learn about the new MedRec rebranding strategy and what it means for patients/consumers, and healthcare professionals
2.What’s new with ‘5 Questions to Ask About Your Medications’
3.Hear how organizations are using ‘5 Questions to Ask About Your Medications’ to engage patients and consumers
Objectives:
By the end of this call, you will be able to:
•Describe the processes of Root-Cause Analysis (RCA) and Multi-Incident Analysis (MIA) and their role in quality improvement
•Compare and contrast the different approaches to collecting hospital-acquired VTE data
•Identify an approach suitable for improving patient safety at your institution
On November 17, 2015 the ICU Collaborative Faculty held a National Call to determine the 2016 National Improvement Initiative. Two topics were presented: Dr. Yoanna Skrobik advocated on the side of Pain, Agitation and Delirium. Dr. Claudio Martin and Cathy Mawdsley advocated for working on End of Life Care. Callers voted at the end of the call and chose the new topic led by Dr. Skrobik: Managing “PAD” in your ICU patient: assessment, treatment and prevention.
This resource summarizes the eight recommendations outlined in the Institute of Medicine's a new consensus study entitled, Improving Diagnosis in Health Care. The recommendations are aimed at making diagnoses more accurate, reliable, efficient, and safe. This work is a continuation of the IOM’s Quality Chasm series.
Patient & Family Advisory Councils: the Business Case for Starting a PFAC & P...EngagingPatients
This webinar was presented on March 12, 2015 by Barbara Lewis. It looks at the prevalence and roles that Patient & Family Advisory Councils (PFACs) are playing in U.S. hospitals today, and builds a business case for their implementation:
Clinical practice guidelines and quality metrics often emphasize effectiveness over patient-centered care. In this article, the authors offer three approaches to personalizing quality measurement to ensure patient preferences and values guide all clinical decisions.
Changing practice through knowledge translation and implementation science.
Have you asked, told, taught and begged, but your hand hygiene results aren’t changing as quickly as you want? Changing practice is hard! Join CPSI on May 4th for an interactive webinar exploring the fundamentals of knowledge translation and the efforts of Public Health Ontario to change practice through this innovative science. We will also look at how you can impact patient and family hand hygiene efforts through the successful use of campaigns.
Learn about the new MedRec rebranding strategy and what it means for patients/consumers, and healthcare professionals
2.What’s new with ‘5 Questions to Ask About Your Medications’
3.Hear how organizations are using ‘5 Questions to Ask About Your Medications’ to engage patients and consumers
This webinar will shift the focus from WHAT you are doing with your improvement efforts, instead shedding light on the importance of HOW you are doing it!
As patient engagement (aka consumer engagement) earns attention, the question increasingly arises: “Where do we start? What can we do?” More specifically, “What do we mean when we say ‘patient engagement’?” The Patient Activation Measure is a powerful tool for understanding where someone's at and how to interact with them differently.
How the CIHI – CPSI collaborative on hospital harm can support patient safety initiatives in your organization
Most patients in Canadian hospitals experience safe care, but when harm happens there is a significant impact on patients, families, the healthcare team, and the health system in general. Until now, there hasn't been a standard approach to measuring and monitoring harm experienced by patients in hospital.
Purpose of the Call:
•Provide an overview of the MARQUIS toolkit components, informed by medication reconciliation best practices, designed to help hospitals improve the quality of their medication reconciliation processes
•Preview the preliminary results of the MARQUIS study in order to understand the effects of a mentored quality improvement intervention on medication reconciliation errors
•Discuss lessons learned from study sites that have implemented the MARQUIS program and how they might be applied to Canadian hospitals, including an exploration of barriers to implementation and how to overcome them
•Make the case for provinces, health systems, and hospitals to invest in medication reconciliation quality improvement efforts, and why physicians need to play a major role in these efforts.
Watch the webinar: http://bit.ly/1ji1voq
Purpose of the Call:
Women's College Hospital is an academic ambulatory hospital. The speaker will share their hospital’s journey as they sought to implement best practices for medication reconciliation from other settings customized for the ambulatory environment.
Read more and watch the webinar recording: http://bit.ly/1sxHIUP
Purpose of the Call:
By the end of this webinar you will: •Hear about the changes to the MedRec in Home Care GSK
•Hear about the broader home care concepts as it relates to MedRec
•Receive practical tips and insights from the field
Gamification as a means to manage chronic diseaseEngagingPatients
UPMC is exploring ways to better engage patients through shared decision making and new approaches to encourage patients and their families to take control of their health. This presentation describes a pilot program UPMC has initiated to leverage gamification as a means to manage chronic heart failure.
Person-centred care and patient activationNuffield Trust
Richard Owen, NHS England, and Dr Natalie Armstrong of the University of Leicester present on evaluating Person Centred Care through Patient Activation Measure (PAM).
Hear firsthand from Healthcare Improvement Scotland and one of their teams that participated in the U.K. Health Foundation collaborative about their experience in applying the Vincent Framework at the frontline. The related challenges and benefits and how it has impacted their work.
Creating value through patient support programsSKIM
How do we become more patient-centered as an organization? How do we ensure the patient/caregiver experience is as optimal as possible?
These are the questions that are being poised to healthcare market researchers in today’s healthcare landscape. And typically healthcare market researchers are turning to methods like “patient journeys” and “patient personas” to help bring that patient-centered understanding to the organization. Problem is … in order to be truly patient-centered, you need to take this charge on from the inside out.
Experience, Design and Innovation departments are springing up in all kinds of healthcare organizations intent on facilitating the organizational shift towards patient-centricity. And, unfortunately, market researchers are intentionally not being invited to the table. If history repeats itself, that will soon change though. These Experience, Design and Innovation departments will need the rigor and breadth of method knowledge that market researchers have in order to succeed in the strategic agendas of their work.
This presentation will give market researcher pointers on which skills, methods and mindsets they’ll likely need to adopt if they are hoping to be perceived as a valued contributor to an Experience, Design or Innovation team. In essence, give attendees a blueprint for how to open up a whole new professional opportunity for themselves, with a simple reframe on whom they are and what they do.
•Understand the Accreditation Canada requirements for medication reconciliation at discharge
•Learn from the experience of patients and receiving healthcare providers
•Gain insight into practical strategies for communicating accurate medication information at discharge
READ MORE: http://bit.ly/1ja1gxY
At the end of the session patient/family champions as well as health authorities will understand different approaches to patient engagement in patient safety and quality committees (e.g. dealing with incident reporting, root cause analysis, developing policies and procedures) and how patient engagement impacted patient safety and quality outcomes. The participants and presenters are invited to present examples, tools, and leading practices so the participants will leave with at least one practical idea to implement.
Closing the Loop: Strategies to Extend Care in the EDEngagingPatients
This HIMSS15 presentation discusses the challenges faced in hospital emergency departments and offers insights for implementing a process to follow up with discharged ED patients to enhance outcomes and satisfaction,while optimizing utilization and reducing risk.
5 Reasons the Practice of Evidence-Based Medicine Is a Hot TopicHealth Catalyst
Evidence-based medicine is an important model of care because it offers health systems a way to achieve the goals of the Triple Aim. It also offers health systems an opportunity to thrive in this era of value-based care. In specific, there are five reasons the industry is interested in the practice of evidence-based medicine: (1) With the explosion of scientific knowledge being published, it’s difficult for clinicians to stay current on the latest best practices. (2) Improved technology enables healthcare workers to have better access to data and knowledge. (3) Payers, employers, and patients are driving the need for the industry to show transparency, accountability, and value. (4) There is broad evidence that Americans often do not get the care they need. (5) Evidence-based medicine works. While the practice of evidence-based medicine is growing in popularity, moving an entire organization to a new model of care presents challenges. First, clinicians need to change how they were taught to practice. Second, providers are already busy with increasingly larger and larger workloads. Using a five-step framework, though, enables clinicians to begin to incorporate evidence-based medicine into their practices. The five steps include (1) Asking a clinical question to identify a key problem. (2) Acquiring the best evidence possible. (3) Appraising the evidence and making sure it’s applicable to the population and the question being asked. (4) Applying the evidence to daily clinical practice. (5) Assessing performance.
Access the webinar here:
http://bit.ly/1eio3ka
Purpose of the Call:
1.Discuss the results of the pan-Canadian survey of existing practices with respect to the use of technology to support Medication Reconciliation (MedRec)
2.Describe the steps and considerations for transitioning to electronic MedRec (eMedRec)
3.Identify factors that support and impede successful migration of paper MedRec to eMedRec.
4.Discuss the lessons learned from research and other organizations.
5.Introduce the toolkit to support healthcare providers in making a safe and effective transition from paper MedRec to eMedRec.
Improvement training - Presentation from the Winterbourne Medicines Programme Launch held in London on 10 September 2014
Ensuring safe, appropriate and optimised use of medication for people with learning disabilities who demonstrate behaviour that can challenge
This webinar will shift the focus from WHAT you are doing with your improvement efforts, instead shedding light on the importance of HOW you are doing it!
As patient engagement (aka consumer engagement) earns attention, the question increasingly arises: “Where do we start? What can we do?” More specifically, “What do we mean when we say ‘patient engagement’?” The Patient Activation Measure is a powerful tool for understanding where someone's at and how to interact with them differently.
How the CIHI – CPSI collaborative on hospital harm can support patient safety initiatives in your organization
Most patients in Canadian hospitals experience safe care, but when harm happens there is a significant impact on patients, families, the healthcare team, and the health system in general. Until now, there hasn't been a standard approach to measuring and monitoring harm experienced by patients in hospital.
Purpose of the Call:
•Provide an overview of the MARQUIS toolkit components, informed by medication reconciliation best practices, designed to help hospitals improve the quality of their medication reconciliation processes
•Preview the preliminary results of the MARQUIS study in order to understand the effects of a mentored quality improvement intervention on medication reconciliation errors
•Discuss lessons learned from study sites that have implemented the MARQUIS program and how they might be applied to Canadian hospitals, including an exploration of barriers to implementation and how to overcome them
•Make the case for provinces, health systems, and hospitals to invest in medication reconciliation quality improvement efforts, and why physicians need to play a major role in these efforts.
Watch the webinar: http://bit.ly/1ji1voq
Purpose of the Call:
Women's College Hospital is an academic ambulatory hospital. The speaker will share their hospital’s journey as they sought to implement best practices for medication reconciliation from other settings customized for the ambulatory environment.
Read more and watch the webinar recording: http://bit.ly/1sxHIUP
Purpose of the Call:
By the end of this webinar you will: •Hear about the changes to the MedRec in Home Care GSK
•Hear about the broader home care concepts as it relates to MedRec
•Receive practical tips and insights from the field
Gamification as a means to manage chronic diseaseEngagingPatients
UPMC is exploring ways to better engage patients through shared decision making and new approaches to encourage patients and their families to take control of their health. This presentation describes a pilot program UPMC has initiated to leverage gamification as a means to manage chronic heart failure.
Person-centred care and patient activationNuffield Trust
Richard Owen, NHS England, and Dr Natalie Armstrong of the University of Leicester present on evaluating Person Centred Care through Patient Activation Measure (PAM).
Hear firsthand from Healthcare Improvement Scotland and one of their teams that participated in the U.K. Health Foundation collaborative about their experience in applying the Vincent Framework at the frontline. The related challenges and benefits and how it has impacted their work.
Creating value through patient support programsSKIM
How do we become more patient-centered as an organization? How do we ensure the patient/caregiver experience is as optimal as possible?
These are the questions that are being poised to healthcare market researchers in today’s healthcare landscape. And typically healthcare market researchers are turning to methods like “patient journeys” and “patient personas” to help bring that patient-centered understanding to the organization. Problem is … in order to be truly patient-centered, you need to take this charge on from the inside out.
Experience, Design and Innovation departments are springing up in all kinds of healthcare organizations intent on facilitating the organizational shift towards patient-centricity. And, unfortunately, market researchers are intentionally not being invited to the table. If history repeats itself, that will soon change though. These Experience, Design and Innovation departments will need the rigor and breadth of method knowledge that market researchers have in order to succeed in the strategic agendas of their work.
This presentation will give market researcher pointers on which skills, methods and mindsets they’ll likely need to adopt if they are hoping to be perceived as a valued contributor to an Experience, Design or Innovation team. In essence, give attendees a blueprint for how to open up a whole new professional opportunity for themselves, with a simple reframe on whom they are and what they do.
•Understand the Accreditation Canada requirements for medication reconciliation at discharge
•Learn from the experience of patients and receiving healthcare providers
•Gain insight into practical strategies for communicating accurate medication information at discharge
READ MORE: http://bit.ly/1ja1gxY
At the end of the session patient/family champions as well as health authorities will understand different approaches to patient engagement in patient safety and quality committees (e.g. dealing with incident reporting, root cause analysis, developing policies and procedures) and how patient engagement impacted patient safety and quality outcomes. The participants and presenters are invited to present examples, tools, and leading practices so the participants will leave with at least one practical idea to implement.
Closing the Loop: Strategies to Extend Care in the EDEngagingPatients
This HIMSS15 presentation discusses the challenges faced in hospital emergency departments and offers insights for implementing a process to follow up with discharged ED patients to enhance outcomes and satisfaction,while optimizing utilization and reducing risk.
5 Reasons the Practice of Evidence-Based Medicine Is a Hot TopicHealth Catalyst
Evidence-based medicine is an important model of care because it offers health systems a way to achieve the goals of the Triple Aim. It also offers health systems an opportunity to thrive in this era of value-based care. In specific, there are five reasons the industry is interested in the practice of evidence-based medicine: (1) With the explosion of scientific knowledge being published, it’s difficult for clinicians to stay current on the latest best practices. (2) Improved technology enables healthcare workers to have better access to data and knowledge. (3) Payers, employers, and patients are driving the need for the industry to show transparency, accountability, and value. (4) There is broad evidence that Americans often do not get the care they need. (5) Evidence-based medicine works. While the practice of evidence-based medicine is growing in popularity, moving an entire organization to a new model of care presents challenges. First, clinicians need to change how they were taught to practice. Second, providers are already busy with increasingly larger and larger workloads. Using a five-step framework, though, enables clinicians to begin to incorporate evidence-based medicine into their practices. The five steps include (1) Asking a clinical question to identify a key problem. (2) Acquiring the best evidence possible. (3) Appraising the evidence and making sure it’s applicable to the population and the question being asked. (4) Applying the evidence to daily clinical practice. (5) Assessing performance.
Access the webinar here:
http://bit.ly/1eio3ka
Purpose of the Call:
1.Discuss the results of the pan-Canadian survey of existing practices with respect to the use of technology to support Medication Reconciliation (MedRec)
2.Describe the steps and considerations for transitioning to electronic MedRec (eMedRec)
3.Identify factors that support and impede successful migration of paper MedRec to eMedRec.
4.Discuss the lessons learned from research and other organizations.
5.Introduce the toolkit to support healthcare providers in making a safe and effective transition from paper MedRec to eMedRec.
Improvement training - Presentation from the Winterbourne Medicines Programme Launch held in London on 10 September 2014
Ensuring safe, appropriate and optimised use of medication for people with learning disabilities who demonstrate behaviour that can challenge
Presentation given by Dr Thomas Christie, Director, Aga Khan University Examination Board on July 15,2011 at WORLD EDUCATION SUMMIT (www.worldeducationsummit.net) in the School Education Track: LOCALISED LEARNING IN A GLOBALISED CONTExT: CAPACITy BUILDING, CONTENT AND TRAINING OF TRAINERS
Older and Better: Living Well at Home or in the CommunityNHSScotlandEvent
Every healthcare contact is a health improvement opportunity but how well do we embed lifestyle advice in our day‐to‐day encounters? Gain a greater awareness and understanding of the Health Promoting Health Service and how we can implement this activity in your workplace.
Presentation given by Navdeep Surii, IFS. Joint Secretary and Head. Public Diplomacy Division. Ministry of External Affairs on August 3rd, 2011 at eWorld Forum (www.eworldforum.net) in the session Citizen Centric Service Delivery
Acute hospitals end of life care best practiceNHSRobBenson
Delivering reliable best practice in an acute hospital setting for patients whose recovery is uncertain. Including details of the AMBER care bundle. Presentation from Anita Hayes and colleagues from England's National End of Life Care Programme as part of the Department of Health's QIPP end of life care workstream seminar series at Healthcare Innovation Expo 2011
The Surgical Initiative concluded on March 31, 2014; the first system Hoshin to “graduate” to everyday work. Join us for an interactive discussion of the lessons learned over four years of transformational change.
The organization provides care and services that achieve effective outcomes and ensures that the correct consumer /patient receives the correct procedure
Becoming Better Advocates for Your HealthBest Doctors
A leader and innovator in research on patient-centered care, Dr. Leana Wen will share her perspectives on what patients and providers can do to work more effectively together to achieve their shared goal – better health and outcomes. She will be joined by Sonia Millsom, VP of Best Doctors, who will discuss how optimizing care and controlling costs are within reach for today’s patient. The presenters will finish with live questions from the audience.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
4. Patient Safety in Primary Care - Why Bother? High Volume Increasingly complex Adverse Events cause: 1 in 8 Admissions to hospital 1 in 20 Deaths Largely preventable
5.
6.
7.
8.
9.
10. Harm thro Omission Lack of reliable care Methotrexate – 12% not monitored Mix of strengths 30% Not prescribed weekly
11. ( un)Reliable Heart Failure Care ACE inhibitor 88% B Blocker 70% B blocker at target dose 28% Pneumococcal 71% NYHA 71% All 5 - 23 %
17. Reliable Care - Care Bundles 4 or 5 elements of care Evidence based Across Patients Journey Creates teamwork Done reliably All or nothing Small frequent samples
18.
19. DMARDS Full blood count in the past 6 weeks? Abnormal results acted on? Review of blood tests prior to issue of last prescription? Had pneumococcal vaccine? Asked re side effects last time blood was taken?
20. Bundles - Successes “ The care bundle was useful because it identified gaps” “ Not as reliable as we thought we were” Focus for improvement
22. Seeing Improvement “ You can see week by week, month by month, whether or not you are showing any improvement, we seem to be improving and that’s good”
27. Safety Improvement in Primary Care PATIENT INVOLVEMENT IN LOTHIAN Isobel Miller, Public Partner
28. Patient Involvement Scottish Health Council SIGN Public Partnership Forum Personal involvement in own healthcare with own healthcare workers Scottish Medicines Consortium Healthcare Environment Inspectorate
34. Feedback You Said Our Response Only half of the patients attending the meeting had a ‘yellow pack’ (warfarin information) Some patients had heard about a new drug which might be taking over from warfarin When you attend for a blood test you will be asked if you have a yellow pack and this will be recorded in your notes so that we know that everyone has one who wants one There is no information on when this will be available but any news will be given out in the education session.
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41. “ The main learning was that they appreciate being involved in their own care”
42. “ Barriers have just been ourselves” Need Resources Facilitators Expertise
43. The Trigger Tool and GP-SafeQuest Measuring – Learning – Improving Carl de Wet MBChB DRCOG MRCGP MMed (Fam) GP / Patient Safety Advisor
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46. SUB HEADING The trigger tool: Review of medical records Rapid, focused, structured, active Screen for undetected harm / error
50. 1. Plan and prepare 2. Review records 3. Reflection, further action Can triggers be detected? Did harm occur? Severity? Preventability? Origin? No. Continue to next trigger or record No Yes. Summarize the harm incident and judge three characteristics: Yes. For each detected trigger, consider: Review the next record Aim? Data ? Sampling: size and method? Individual and Team responsibilities? Triggers: number and type? Practitioner level Patient and medical records Practice team Primary-secondary care interface
56. Seemed a bit intimidating when we first had it presented to a large group … much easier to use in practice … it’s a remarkably effective tool for reflective analysis on patient safety and other clinical issues …has created a lot of interest from other doctors in the practice as a tool for professional development and for appraisals Doctor Gordon Cameron GP Edinburgh
72. Insights “ Many of us in the practice staff hadn’t really made the link that us failing to communicate in was a threat to patient safety ….we had a lot of really good stuff came out of it, a lot of very open discussion”
87. Themes Reliable care for Chronic diseases Healthcare Acquired Infection Antibiotic prescribing Hand washing Culture and Leadership Safety Climate Trigger Tool
88. Based on SIPC 1 and 2 Medication Reconciliation Co-prescribing Other work….
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92. Developing Patient Safety in Primary Care in NHS Scotland Questions? How do we sustain and spread this work? Volunteers? [email_address]
Editor's Notes
Scotland - Tayside / Forth Valley 32 Volunteer Practices –structured selection over 2 years Clinical Effectiveness/Governance Services Medical Protection Society HS QIS: support & funded
Like most people here, I am a patient and, in my case, make good use of the NHS facilities. For this project, I am a Public Partner, not a patient representative because at present I don’t use Warfarin or DMARDS nor am I suffering from heart failure …yet. Because I don’t have a healthcare background, the work I am doing with Lothian Health Board is related to patient involvement. What is Patient Involvement?
The Scottish government have been keen to develop the concept of “mutual NHS” where patients are partners rather than merely recipients of care and have both rights and responsibilities towards the health service that they “own”. Most of the work on this public involvement has been including patients in many, many committees and organisations where healthcare workers may have to accommodate the outpourings of some ill-informed patient. In SIPC we are operating at a different level of Patient Involvement. We are working to help individual patients to become involved. The aim is to improve their health and to improve the service they receive. The Patient Rights (Scotland) Act 2011 an NHS based on mutually beneficial partnerships between patients, their families and those delivering healthcare services.
Involving patients doesn’t have to be difficult. Here is one example One practice frequently writes information leaflets. This time they did it differently. The nurse, in consultation with the rest of the team, wrote a leaflet with information about Warfarin. Once her colleagues had pulled it to pieces, it was handed over to several patients for their comments. One of these patients had been a proof reader so was ideally suited for this task. An example of how many patients have many experiences from life and work which you can use. Once the patients made their comments, the leaflet was edited and used for patient education. Other practices loved it and have made use of it too. Not difficult – and have produced good product that helps all patients and gives the involved patients a special stake in the leaflet, in the practice and in their health.
One of the aims was to improve resources for practices and patients but we had to find out what improvements were required. There fore we needed to find out how patients using Warfarin felt . No point gathering Information if nothing is done about it You said – we did One rather academic exercise was seeing how the patients’ views of the process of having their Warfarin monitored, varied with the practices’ views
Just to explain what is meant by process map. Haven’t a chance of reading it but it is a flow chart showing the process from the patient attending practice for a blood test to check INR. Seen like this it is interesting to see how many tasks (12) must be carried out by practice and lab compared with the 6 communications with the patient. The reason for showing this is that the patients identified situations where their actual experience did not meet the mapped process. Action was taken by the practice to remedy these problems.
The first thing was to find out what patients thought. Our assumption was that not many folk would be interested. Seven practices sent letters to all of their Warfarin users – 425 in all Of these, 136 patients wanted to be involved (32%) 80 turned up (19%) 2 sessions – tables of 8-12, facilitator/recorder. Facilitators not from practices but health board office staff. “feedback shows that having an independent facilitator puts both patients and practices at ease.” Tayside report at Steering Group 05.05.11 Answers to 3 questions at different stages in life with warfarin Themes raised were fed back to practices No action resulted other than a request to have local focus groups Repeated the exercise with individual practices The themes raised were similar but practices felt responsibility for these and were willing to consider alterations if necessary Happy Patients Key topics were – Main difficulties with lack of information or muddly information. Scary drug need reassurance. Like more GP contact. “ witchcraft” Little understanding of the side effects.
Just two comments that were made and the type of response that the practice offered. One covering the lack of information.
Answer our own questions . Realised that patients, particularly those who had been using Warfarin for many years didn’t have uptodate information about using Warfarin. The creation of the new leaflet was clear and easy for patients to understand. There is evidence that well informed patients have better outcomes. The themes raised in practice focus groups had a validity and relevance for each practice and staff worked to solve problems The “You said, We did” sheets made patients feel that their comments were listened to. Although the focus group was a meeting between patients and non-practice facilitators, twice practice staff joined the meeting later. One GP and nurse took the opportunity to have a group education session. This was so successful that there is enthusiasm to use the same technique with other patient groups eg those with diabetes. The surprise resulted in an improvement too – staff were dismayed when one patient revealed that she had been using a wide range herbal medicines for many years so she never responded to the question “Any changes to your medications?”. Now the question asked is “what medications are you using?”
Practices did not identify with the issues raised by the large focus group involving patients from all practices. All comments could be countered by “It isnae me”. The practice groups raised topics that could not be ignored and staff were quick to react. The large group was good as a learning exercise for facilitators but was not essential Only 3 of the 7 practices requested a focus group. These, together with the practice that created the leaflet, are tuned into patients’ concerns. We hope that the remaining practices will see the benefits arising from this exercise Patient reps are never representative patients.
Action occurs when experiences directly relate to practices Gathering a group of people that share similar health situations results in a sharing of experience and learning. Good opportunity to ensure that correct information is given, not rumour. Hard to reach groups are a challenge which our resources have not allowed us to meet. Tell more folk about it – so I hope you’ll tell others of our work What I wouldn’t change is seeing how practices now involve patients in a new way and are more open to their comments. Make use of your patients please!
Three main tasks Search for triggers, Search for harm Describe the characteristics of detected harm Five questions Are triggers present Did harm occur? How serious was the harm incident? Where did the incident of harm originate? Was the harm incident preventable? The focus is harm, not error . Ask yourself: ‘Would I have wanted this to happen to me or my family?’ Only review the specific period in the record (three months). Choose full calendar months to facilitate the review. The maximum spend on reviewing any record should be twenty minutes . The objective is to detect ‘obvious’ problems, rather than every single episode. If there is reasonable doubt whether harm occurred, the incident should not be recorded.
Systematic – start in one section and work way through. Selective / focused May have to ‘read up’ a specific time in another section Hospital admission – any that is overnight, including elective Clinical read codes vary according to the type of software that you use – GPASS, VISION, EMIS
Various Complementary Different indications Specific strengths and weaknesses Varying degrees of evidence Select according to context, cost, aims, criteria Varying degrees of evidence of each method’s reliability, validity, acceptability (usability), feasibility, transferability
Specific changes made in response to things picked up during reviews: New protocol for recording adverse drug reactions Minimum annual FBC checks for all Warfarin patients Minimum annual Digoxin levels check Better systems for highlighting possible drug interactions when deciding the next dose of Warfarin Much better at coding relevant read codes Checking that locums are familiar with practice systems for Warfarin patients
The survey measures perceptions – not reality. A ‘positive’ score does not necessarily mean that things are safe – only that staff thinks it is safe!
It is the shared perceptions of safety policies, procedures and practices held by a group. (Flin et al, 2006) ‘ Culture’ and ‘climate’ are often used interchangeably. ‘… The measurable features of safety culture…’ Factors (domains) are specific characteristics of climate Leadership Communication Workload Safety Systems Team work
Various instruments: Qualitative (dimensional) or Quantitative (typological) USA, industry, secondary care BUT … few for Scottish primary care Specifically developed for intended users, geography and organisation Undergo psychometric testing Relevant factors: communication, team work Written feedback (78) and interviews (46) with various staff groups. Endorsed by UK patient safety ‘expert’ group. Content validity index (CVI) 0.94. Psychometrically tested to a gold standard - 49 practices, 563 team members High validity and reliability of 30 items and 5 factors
What factor is most positive? Which factor is least positive? What is the difference between most and least positive and the overall safety climate? (relativeness) What proof is there for these perceptions?
Are there any differences between the two groups? (The size of variation is more important than what group is right!) Are there any similarities? What does that mean? (Increases the reliability of the finding) Does any of the findings change when you now consider clinical vs non-clinical? Is there additional variation? How does this fit with the first section? Practice x = about 12-14% variation vs. Practice Y = about 3-4%
Scores may not be numerical
Remember the cautions The results are yours - only you and your team can make sense of it. Statistical significance vs. practical significance Consider what evidence (if any) there are for the reported perceptions Involve as many team members as possible Keep an open mind !! High Reliability organisations (oil / aviation industries) Improved safety outcomes Improved safety behaviour Health care Emerging evidence of an association between safety climate and clinical outcomes in secondary care (but not yet primary care): shorter hospital stays, fewer medication errors, reduced rates of ventilator associated pneumonia, fewer patient falls, reduced bloodstream infection rates, increased adoption of safe work practices.