The document discusses clinical transformation at Maine Medical Center through reducing variability in care for patients requiring mechanical ventilation and tracheostomies. A team was formed to standardize processes and reduce length of stay and costs for these patients. The team identified over 70 action items and set goals around reducing length of stay, increasing standardization and palliative care screening, improving patient satisfaction, and generating savings. Metrics were established and showed progress towards the goals over 12 months, including reduced length of stay, increased compliance with best practices, and over $1 million in savings.
Achieving Asset Optimization: A Strategic Approach To Aligning Assets With Mi...Huron Consulting Group
Huron Healthcare managing director Curt Whelan and Advisory Council member Jamie Orlikoff present new tools, processes, frameworks, and data points to enable healthcare executives to strategically align their assets to their mission and market needs. This resource, from the 2014 ACHE Congress on Healthcare Leadership, utilizes recent statistics and the presenters’ years of experience to advise on how to implement a strategic framework shift, leverage board support, and avoid asset rationalization in favor of asset optimization.
WEBINAR: Performance Improvement for Children’s Hospitals – Key Steps in Deve...Huron Consulting Group
In a recent webinar hosted by the Children’s Hospital Association, Huron leaders describe strategies that enable children's hospitals to thrive in the new healthcare environment.
Healthcare leaders share insights at the fifth annual CEO Forum with a focus in three crucial areas: balancing risk and reward, building the foundation for population health and responding to the rise of consumerism.
Webinar: Transforming Operational Throughput – The Journey Toward Value-Based...Huron Consulting Group
At the 2014 Children’s Hospital Association Annual Leadership Conference, Huron Healthcare and Texas Children’s Hospital (TCH) presented an educational session on the journey toward value-based care.
In the presentation, Huron Healthcare managing director, Larry Burnett, TCH Senior Vice President, Tabitha Rice, and TCH Assistant Vice President of nursing, Jackie Ward, shared valuable insights from their work together at TCH. Focusing on insights and results from TCH’s engagement with Huron Healthcare, the presentation includes:
• Opportunities and results at TCH in areas including care management, care progression, patient placement, and care variation.
• Keys to driving results, successful change, and integrated care delivery
• Steps for a sustainable approach
Delivering on the Vision: Keys to Achieving Breakthrough Operational Performa...Huron Consulting Group
In this presentation, Daniel May, Huron Healthcare managing director, and Mark Mullarkey, Texas Children’s Hospital Senior Vice President, share: insights into tracking the initiative’s progress, strategies for engaging physicians, and real-world lessons learned from the initiative.
Achieving Asset Optimization: A Strategic Approach To Aligning Assets With Mi...Huron Consulting Group
Huron Healthcare managing director Curt Whelan and Advisory Council member Jamie Orlikoff present new tools, processes, frameworks, and data points to enable healthcare executives to strategically align their assets to their mission and market needs. This resource, from the 2014 ACHE Congress on Healthcare Leadership, utilizes recent statistics and the presenters’ years of experience to advise on how to implement a strategic framework shift, leverage board support, and avoid asset rationalization in favor of asset optimization.
WEBINAR: Performance Improvement for Children’s Hospitals – Key Steps in Deve...Huron Consulting Group
In a recent webinar hosted by the Children’s Hospital Association, Huron leaders describe strategies that enable children's hospitals to thrive in the new healthcare environment.
Healthcare leaders share insights at the fifth annual CEO Forum with a focus in three crucial areas: balancing risk and reward, building the foundation for population health and responding to the rise of consumerism.
Webinar: Transforming Operational Throughput – The Journey Toward Value-Based...Huron Consulting Group
At the 2014 Children’s Hospital Association Annual Leadership Conference, Huron Healthcare and Texas Children’s Hospital (TCH) presented an educational session on the journey toward value-based care.
In the presentation, Huron Healthcare managing director, Larry Burnett, TCH Senior Vice President, Tabitha Rice, and TCH Assistant Vice President of nursing, Jackie Ward, shared valuable insights from their work together at TCH. Focusing on insights and results from TCH’s engagement with Huron Healthcare, the presentation includes:
• Opportunities and results at TCH in areas including care management, care progression, patient placement, and care variation.
• Keys to driving results, successful change, and integrated care delivery
• Steps for a sustainable approach
Delivering on the Vision: Keys to Achieving Breakthrough Operational Performa...Huron Consulting Group
In this presentation, Daniel May, Huron Healthcare managing director, and Mark Mullarkey, Texas Children’s Hospital Senior Vice President, share: insights into tracking the initiative’s progress, strategies for engaging physicians, and real-world lessons learned from the initiative.
The webcast focuses on what Executives need to know as the Open Payments Program is fully implemented focusing on the broader implications of how to prepare for healthcare professional transparency.
How to commission for improving health outcomes: an introduction to choosing ...The King's Fund
This slide set is the first of two looking at how commissioners can make the best use of measurement to support commissioning for improved outcomes.
The slides introduce general concepts about approaches to measurement in health care, the uses of structure, process and outcome indicators, and how to achieve a good mix of indicators for commissioning.
Quality improvement is integral to the practice of medicine. Sometimes, QI strays over into clinical research. This presentation provides an overview of the intersection between QI and research
We specialize in the successful placement of all physician specialties and sub-specialties in small rural facilities, large medical centers, healthcare systems, and academics. We ensure that your new physician will integrate well into your community as both a true leader and a valuable asset for your facility.
Webinar: Thriving in the New Healthcare Environment: 3 Key StrategiesModern Healthcare
www.modernhealthcare.com/article/20140512/SPONSORED/305129926/webinar-thriving-in-the-new-healthcare-environment-3-key-strategies
Many CEOs are looking to make cost and revenue improvements between 20 and 40 percent. Attend this webinar to hear success strategies from two leading CEOs.
University of Utah Health Exceptional Value Annual Report 2014University of Utah
Every year the Exceptional Value Annual Report documents the performance of University of Utah Health on all 45 of the key initiatives identified in the organization's Operational Plan. Focused on value-driven outcomes (quality, service and cost), our successes are celebrated and failures are reviewed for learning opportunities.
Acute Care Hospital Strategic Plan PowerPoint PresentationAndrea Ratz
This project was done for my class “Strategic Planning for Healthcare Organizations”. After creating the five-year strategic plan, my group created a PowerPoint presentation in order to present our final strategic plan to the class and several other instructors. This presentation was meant to summarize our strategic plan and present the main points of our paper. My role was to communicate with the class what part I researched, which was critical strategic issues and response strategies.
The project was to be representative of how real professionals would present a strategic plan to the board of directors of a hospital. This presentation required use of verbal communication skills, planning and developing skills, organizational skills, and persuasion. When our instructors ranked all the projects, my group came in second place out of twelve other groups.
This presentation by the Bureau of Health Information to the Royal Australasian College of Physicians looks at using clinical outcome data to improve patient care.
It examines:
Why measure and report on performance?
- Accountability and quality improvement
What is performance really?
- It is not a measure of what the system is, it is a measure of how well the system does
Whose performance is it anyway?
- Attributing results to providers, units or sectors requires a careful assessment
The LACE index identifies patients that are at risk for re-admission or death within thirty days of discharge. It incorporates four parameters. "L" stands for the length of stay of the index admission. "A" stands for the acuity of the admission. Specifically, if the patient is admitted through the Emergency Department vs. an elective admission. "C" stands for co-morbidities, incorporating the Charlson Co-Morbidity Index. "E" stands for the number of Emergency Department visits within the last 6 months.
LACE sores range from 1-19 and as mentioned above predict the rate of re-admission or death within thirty days of discharge. Below is an example of how to calculate the LACE index. A score of 0 - 4 = Low; 5 - 9 = Moderate; and a score of ≥ 10 = High risk of re-admission.
Personal Data Tracking and the Digital Transformation of HealthcareLarry Smarr
12.12.05
Invited Talk
University of Illinois Silicon Valley Round Table
Title:Personal Data Tracking and the Digital Transformation of Healthcare
Palo Alto, CA
The webcast focuses on what Executives need to know as the Open Payments Program is fully implemented focusing on the broader implications of how to prepare for healthcare professional transparency.
How to commission for improving health outcomes: an introduction to choosing ...The King's Fund
This slide set is the first of two looking at how commissioners can make the best use of measurement to support commissioning for improved outcomes.
The slides introduce general concepts about approaches to measurement in health care, the uses of structure, process and outcome indicators, and how to achieve a good mix of indicators for commissioning.
Quality improvement is integral to the practice of medicine. Sometimes, QI strays over into clinical research. This presentation provides an overview of the intersection between QI and research
We specialize in the successful placement of all physician specialties and sub-specialties in small rural facilities, large medical centers, healthcare systems, and academics. We ensure that your new physician will integrate well into your community as both a true leader and a valuable asset for your facility.
Webinar: Thriving in the New Healthcare Environment: 3 Key StrategiesModern Healthcare
www.modernhealthcare.com/article/20140512/SPONSORED/305129926/webinar-thriving-in-the-new-healthcare-environment-3-key-strategies
Many CEOs are looking to make cost and revenue improvements between 20 and 40 percent. Attend this webinar to hear success strategies from two leading CEOs.
University of Utah Health Exceptional Value Annual Report 2014University of Utah
Every year the Exceptional Value Annual Report documents the performance of University of Utah Health on all 45 of the key initiatives identified in the organization's Operational Plan. Focused on value-driven outcomes (quality, service and cost), our successes are celebrated and failures are reviewed for learning opportunities.
Acute Care Hospital Strategic Plan PowerPoint PresentationAndrea Ratz
This project was done for my class “Strategic Planning for Healthcare Organizations”. After creating the five-year strategic plan, my group created a PowerPoint presentation in order to present our final strategic plan to the class and several other instructors. This presentation was meant to summarize our strategic plan and present the main points of our paper. My role was to communicate with the class what part I researched, which was critical strategic issues and response strategies.
The project was to be representative of how real professionals would present a strategic plan to the board of directors of a hospital. This presentation required use of verbal communication skills, planning and developing skills, organizational skills, and persuasion. When our instructors ranked all the projects, my group came in second place out of twelve other groups.
This presentation by the Bureau of Health Information to the Royal Australasian College of Physicians looks at using clinical outcome data to improve patient care.
It examines:
Why measure and report on performance?
- Accountability and quality improvement
What is performance really?
- It is not a measure of what the system is, it is a measure of how well the system does
Whose performance is it anyway?
- Attributing results to providers, units or sectors requires a careful assessment
The LACE index identifies patients that are at risk for re-admission or death within thirty days of discharge. It incorporates four parameters. "L" stands for the length of stay of the index admission. "A" stands for the acuity of the admission. Specifically, if the patient is admitted through the Emergency Department vs. an elective admission. "C" stands for co-morbidities, incorporating the Charlson Co-Morbidity Index. "E" stands for the number of Emergency Department visits within the last 6 months.
LACE sores range from 1-19 and as mentioned above predict the rate of re-admission or death within thirty days of discharge. Below is an example of how to calculate the LACE index. A score of 0 - 4 = Low; 5 - 9 = Moderate; and a score of ≥ 10 = High risk of re-admission.
Personal Data Tracking and the Digital Transformation of HealthcareLarry Smarr
12.12.05
Invited Talk
University of Illinois Silicon Valley Round Table
Title:Personal Data Tracking and the Digital Transformation of Healthcare
Palo Alto, CA
Healthcare and Digital Transformation - Lessons from the ResearchStefan Tornquist
A 30 minute talk based on survey research conducted in Q4 of 2015 w/Ogilvy CommonHealth on how digital trends are affecting healthcare and healthcare marketing.
Christina Wanscher presents an introduction to the Danish Healthcare system, healthcare transformation initiatives, National Healthcare IT and Integrated Care.
Details on the presentation found in link:
http://www-01.ibm.com/software/city-operations/curam-research-institute/curam-roundtable/index.html
Healthcare Transformation: The Journey of High-Value HealthcareHealth Catalyst
To manage population health, one needs to intimately understand the anatomy of healthcare and model how healthcare is delivered, in order to systematically improve healthcare outcomes. In this webinar, Dr. Burton draws on his 26-year executive career at Intermountain, Select Health, and Health Catalyst. He emphasizes the importance of linking administrative data (e.g., billing codes) to processes of clinical care to use the 80/20 principle to prioritize care processes within each venue to focus improvement initiatives on the things that matter most. He will also discuss a Clinical Integration framework to use in driving out waste by reducing variation in the ordering of care, the efficiency with which the care that is ordered is delivered and reducing defects in care delivery to make it safer.
Conferencia de Manuel Serrano Ortega, Gerente de Transformación Digital de Accenture, en El Instituto de la Economia Digital de ESIC, hablando sobre la Transformación Digital en la Industria de Healthcare y Pharma, descubriendo las últimas tendencias a través de la metodología del Coolhunting.
HXR 2016: The Health IoT: Remote Care and Mobile Solutions -Manu Varma, PhilipsHxRefactored
Through new telehealth technologies and increased data analysis physicians are gaining insights into patients like never before, allowing them to facilitate early interventions, improve adherence, and reduce readmission rates -- not to mention at a price more affordable than ever. The companies you’ll hear from in this session are using a healthy and innovative mix of data, educational tools, sensors, and more to improve patient outcomes.
A look at benefits realisation during every phase of transformation activities to operationalise portable digital health records
Day Two, Pop-up University 2, 09.00
Developing a Strategic Analytics Framework that Drives Healthcare TransformationTrevor Strome
About the presentation.
Based on Chapter 3 of my book "Healthcare Analytics for Quality and Performance Improvement", this presentation describes the key components of a strategic analytics framework that can enable your healthcare organization to leverage data from source-systems to achieve its quality, safety, and performance improvement goals.
What is an analytics strategy?
Analytics is currently a very “trendy” topic. The internet is scattered with many buzzwords, marketing angles, white papers, and opinions on the topic of healthcare analytics. With all this “noise”, it is easy to get distracted from what is actually required, from an analytics perspective, by your organization. An analytics strategy helps cut through the noise and keep focus on what is important for the organization. Regardless of what the latest “buzz” is, your analytics strategy will enable your organization to Invest now for what is required now, and invest later for what is required in the future.
An analytics strategy helps ensure that analytics development and capabilities are in alignment with enterprise quality and performance goals and helps avoids the “all dashboard, no improvement” syndrome. Furthermore, a well formed strategy document helps to achieve optimal use of analytics within a healthcare organization and can mean the difference between a “collection of reports” versus a high-value information resource.
An analytics strategy can rarely stand on its own. In general, the analytics strategy should use as input an organization’s Quality Improvement (QI) strategy and should be used to inform an organization’s Business Intelligence (BI) or Information Technology (IT) strategy. The analytics strategy is an important input to technical strategies because analytics, after all, can involve a sophisticated use of data and technology. Requirements for analytics may trigger a cascade of enhancements throughout other components of IT and BI (i.e., reporting, data storage, ETL, etc)
The document is intended to accompany Chapter 3, “Developing an Analytics Strategy to Drive Change”, so please refer to the chapter for further information about developing an analytics strategy.
Michigan Hospital Association Governance meetingMary Beth Bolton
Patient centered medical home activities in MI and Nationally and the opportunity to improve quality outcomes by increased access to primary care doctors who outreach members who are missing preventive and chronic care services.
This presentation focuses on key elements, graphs, and charts from a CMR Institute white paper written by Anthony D. Slonim, MD, DrPH, Executive Vice President and Chief Medical Officer, Barnabas Health. Executive Director, Barnabas Health ACO-North.
Health IT Summit Houston 2014 - Case Study "EHR Optimization for Organizational Value in a Changing Healthcare Environment"
Luis Saldana, MD, MBA, FACEP
CMIO
Texas Health Resources
iHT2 case studies and presentations illustrate challenges, successes and various factors in the outcomes of numerous types of health IT implementations. They are interactive and dynamic sessions providing opportunity for dialogue, debate and exchanging ideas and best practices. This session will be presented by a thought leader in the provider, payer or government space.
NYU Langone Medical Center’s TJA BPCI Experience: Lessons in How to Maximize ...Wellbe
The Bundled Payments for Care Improvement (BPCI) Initiative began generating data in January of 2013. Dr. Iorio will outline the challenges and benefits of implementing BPCI for Total Joint Arthroplasty at an urban, tertiary, academic medical center with a hybrid compensation model. Early results from the implementation of a Medicare BPCI Model 2 primary TJA program demonstrate cost-savings with an improvement in quality of care metrics and continued cost savings through year 3 of our experience. Changes in patient optimization, care coordination, clinical care pathways, and evidence-based protocols are the key to improving the quality metrics and cost effectiveness within the implementation of the Bundled Payment for Care Initiative, thus bringing increased value to our TJA patients.
Maximizing Value in a Bundled Environment – Keys to Success:
• Evidence based, cost effectiveness analysis
• Standardized protocol adoption
• Transparent data
• Perioperative Patient Optimization
• Care management
• Physician-hospital alignment with Gain sharing
• Enhanced pain relief and rehabilitation protocols
• Blood management and rational VTED prophylaxis
About the Speaker:
Richard Iorio, MD, is the William and Susan Jaffe Professor of Orthopaedic Surgery at New York University Langone Medical Center Hospital for Joint Diseases and Chief of Adult Reconstruction at NYU Langone HJD. He co-founded Labrador Healthcare Consulting Services, Responsive Risk Solutions, and the Value Based Healthcare Consortium in 2015. He is a member of the Board of Directors for LIMA, the Lifetime Initiative for the Management of Arthritis. Dr. Iorio is a national expert in physician and hospital quality and safety and a leader in the implementation of alternate payment paradigms in orthopaedic surgery.
Rob Reid: Redesigning primary care: the Group Health journeyThe King's Fund
Rob Reid, Senior Investigator at Group Health Research Institute, explains the journey taken by Group Health in support of integrated primary care. A case study in how primary care can be delivered effectively and efficiently to a population, Rob laid out the challenges facing general practice in the States, and how Group Health worked to improve the situation for both patients and the workforce.
Two of the New York metro area’s largest provider organizations will share their experiences leveraging HIE as one of many tools to decrease fragmentation of care and improve patients’ experiences across acute and post-acute care settings for patients undergoing elective surgeries. Representatives from NYULMC and VNSNY will summarize their efforts to redesign more personalized specific care pathways and the central role played by the implementation of real-time data exchange to provide a seamless transfer of clinical data between providers caring for the patient at the time of discharge and throughout the post-acute period.
• Kathleen Mullaly - Senior Director for Clinical Operations, Department of Network Integration, NYU Langone Medical Center
• Amy Weiss - Director for Strategic Account Development, Integrated Delivery Systems, Visiting Nurse Service of New York (VNSNY)
New York eHealth Collaborative Digital Health Conference
November 18, 2014
Patient’s experience, improve the quality health3zsaddique
Putting patients first requires more than world-class clinical care – it requires care that addresses every aspect of a patient’s encounter with Hospital, including the patient’s physical comfort, as well as their educational, emotional, and spiritual needs. A team of professionals should serves as an advisory resource for critical initiatives across the Hospital health system. In addition, it should provide resources and data analytics; identify, support, and publish sustainable best practices; and collaborate with a variety of departments to ensure the consistent delivery of patient-centered care.
Pharmacy's Emerging Role in Accountable Care Organizations (ACO)Parata Systems
Your pharmacy is an excellent partner for accountable care organizations. ACOs are formed by doctors, hospitals and other healthcare providers to improve health outcomes and lower overall medical expenses for a targeted patient population. Reimbursements are tied to patient outcomes.
ACOs’ highest-risk and highest-cost patients are those managing chronic illnesses and taking multiple medications a day. When your pharmacy can improve and track adherence – a key driver of readmission prevention and overall health – you are a valuable partner to help ACOs prevent unnecessary medical care.
Jamie Hale serves as the Chief Pharmacy Officer for Cornerstone Health Care where he is responsible for the development and integration of pharmaceutical care services in the Accountable Care Organization. He transitioned to Cornerstone in December 2012 after a 15 year career at Wake Forest Baptist Health, where he last served as Director of Pharmacy.
Download the full audio webinar at http://bit.ly/pharmacyACO.
The University of Kansas, in an effort to find efficiencies and free up money to invest in academic programs, is undertaking 11 different change initiatives simultaneously. See a summary.
Students applying for an MBA are expecting the degree to lead to significant bumps in their incomes. The applicants valued the help of consultants in preparing their applications, but many had mixed feelings about the video interviews that many business schools have begun to use. The applicants also suggest that business schools adopt common processes for recommendations.
These were some of the findings from a survey by Huron Education’s Constituent Research Group for the Association of International Graduate Admissions Consultants.
Our presentation shares the best-in-class perspective that success is equal parts transformation and technology. We’ll also review our lessons learned during the upgrade and how we leveraged new features and functionality to eliminate 25+ customizations & simplified the procure-to-pay process
The Fully Funded PeopleSoft Project : Funding your ERP Project with Non-Labo...Huron Consulting Group
Funding your ERP Project with Supply Chain Transformation: Large systems projects are an opportunity to dramatically improve business processes, increase efficiency, and improve the end user experience. In today’s economic reality of tighter budgets and rising costs, some organizations are forced to put off systems projects. However, by simultaneously undertaking a supply chain transformation savings initiative that will reduce procurement and services costs and streamline processes throughout the organization, organizations can achieve the Fully Funded PeopleSoft Project.
Current Practice Alignment Strategies to Ensure Long Term SurvivalHuron Consulting Group
In this MGMA presentation, John Lutz explores the merits and drawbacks of various physician alignment models and provides insights into competencies needed in the new market.
Huron Education Survey Documents Increasing Use of Social Media in Higher Edu...Huron Consulting Group
Social media is where students are, and increasingly where alumni and other important constituencies can be reached. Colleges and universities are increasingly incorporating social media into their communication and fundraising campaigns, according to a new survey from Huron Education and marketing and communications firm mStoner.
Over the last 18 months, leaders of the Huron Education Innovation solution have talked with some of the leading scholars and thinkers who are reinventing higher education. Among the guests have been Jason Lane, William Massy, Patti Peterson, and Philip Altbach. This piece ties together and summarizes the topics and emergent themes, including: an elite online-only university now in development, a virtual foreign-exchange program, and how globalization and technology challenge higher education business models while creating new opportunities.
Fair Market Value Impact of Sunshine Act for R&D and Clinical OperationsHuron Consulting Group
This session was presented at the 5th Annual Summit on Dislcosure, Transparency and Aggregate Spend for Drug, Device and Biotech Companies, February 20, 2013.
FDA’s Draft Guidance – Exploring the impact on compliance and operationsHuron Consulting Group
This session, "FDA's Draft Guidance - Exploring the impact on compliance and operations" was presented at the 10th Annual Pharmaceutical Compliance Congress, hosted by CBI.
In a recent presentation before a national higher-education conference, Jeffrey S. Vitter, provost and executive vice chancellor of the University of Kansas, and John Curry, a managing director at Huron Education, demonstrated how recommendations for efficiency and maximizing existing operations will result in almost $100 million in savings and new revenue for the university over three years.
In this webinar, we briefly discussed the regulatory considerations for biorepositories including the following: When HHS, FDA and HIPAA regulations apply, When informed consent is not required , Pros and cons of different informed consent approaches
OHRP Regulatory Interpretations That You Need To Know But Have Never Been ToldHuron Consulting Group
The Health and Human Services (HHS) human subjects regulations aren't always clear-cut and often times Institutional Review Boards (IRBs) and researchers struggle with how to interpret them. During this webinar, the presenters will share the knowledge Huron has gained through communications with the Office for Human Research Protections (OHRP) about topics such as: How to handle "protocol exceptions for a single subject", When an unanticipated problem involving risks to subjects or others does not have to be reported to OHRP, Whether the IRB has to require the submission of the names of all study staff on a research study, and When Subpart C does not apply to a subject who becomes incarcerated.
Leaders from two Huron Education clients – Georgia Tech and Northern Kentucky University – described to large audiences at the annual meeting of the National Association of College and University Business Officers (NACUBO) initiatives they have undertaken that are resulting in greater efficiency and administrative cost reductions.
Leaders from two Huron Education clients – Georgia Tech and Northern Kentucky University – described to large audiences at the annual meeting of the National Association of College and University Business Officers (NACUBO) initiatives they have undertaken that are resulting in greater efficiency and administrative cost reductions.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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
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.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Clinical Transformation: Fundamentally Changing Clinical Processes to Achieve a Sustainable Advantage
1. Clinical Transformation:
Fundamentally Changing
Clinical Processes to Achieve
a Sustainable Advantage
4th Annual Becker’s Hospital Review
May 10, 2013
Andrew Ziskind, MD
Managing Director, Huron Healthcare
Stephen Mette, MD
Chief, Department of Critical Care
Maine Medical Center
16. Clinical Transformation at
Maine Medical Center
• A systematic approach to reduce indefensible clinical
variation and costs (improved value) in the care of patients
defined by specific DRGs.
• DGRs where MMC had costs (charges) significantly above
benchmark hospitals (12 similar medical centers in
New England).
17. Facility Name City State
Albany Medical Center Albany NY
Baystate Medical Center Springfield MA
Berkshire Medical Center Pittsfield MA
Dartmouth-Hitchcock Medical Center Lebanon NH
Faulkner Hospital Boston MA
Fletcher Allen Health Care Burlington VT
Hartford Hospital Hartford CT
Lahey Clinic Hospital Burlington MA
Long Island Jewish Medical Center New Hyde Park NY
Mount Auburn Hospital Cambridge MA
Tufts Medical Center Boston MA
Upstate Medical University Syracuse NY
Northeast Teaching Hospitals
Custom Benchmark
18. ―Streamline and reduce variability in the care of patients with
mechanical ventilation and tracheostomy including palliative care,
falling into DRGs 4 & 5.
Design and implement an efficient, safe effective and timely
process based on best practices for patient safety and satisfaction,
meeting regulatory requirements.‖
— Tracheostomy/Mechanical Ventilation/ Palliative Care Team Charter
Focus
DRG 4
• Tracheostomy with long-term mechanical ventilation
with an extensive procedure.
DRG 5
• Tracheostomy with long-term mechanical ventilation
without an extensive procedure.
19. Background
• Sickest patient population
• Utilize multiple resources
• Variation in care
• These patients have huge
impact on patient flow
• In 2010, cost for 104
patients > $17M more than
our 12 comparison
hospitals at the 75%ile
(TBS).
20. Team Selected
Identify Need for
Change
Identify Waste
Lead-Time
Analysis
Standardized
Operations
Brainstorm
Solutions/
Action Items
Plan and
Implement
Workgroup Efforts
Subcommittees
Convened
Weekly Team Meetings
Team Orientation
3-Day Workshop
Direct Observation Event
Team Process
21. Patient Stay at Maine Medical Center
Admission Discharge
Order for
Mechanical
Ventilation
Tracheostomy/
PEG Performed
Tracheostomy
Recommended
Patient Transferred
from ICU to AVU
Mechanical
Ventilation
Weaning
Patient Weaned
from Mechanical
Ventilation
Team Scope
23. MMC tracheostomy/Vent/Palliative Care Vision:
Improve goal-directed care and outcomes for patients
needing tracheostomy and ventilator support.
Pilot LTAC
|
APCU
-Long-term weanable
-Unweanable
-Long-term
tracheostomy
-Terminal illness
ICU AVU
Patient & Family
|
Clinical Navigator
Standardize
|
Admission
- ED/ICU
- JIV
- Palliative care
screening
Standardize
|
Place tracheostomy
- Assess AVP
candidacy
Standardize
|
Admit to AVP
- Only if needed
Standardize
|
Goal assessment /
palliative care
- Only if needed
Standardize
|
Discharge
Build bridge for pt transfersPre-admission
community care
- PCP to Medical
Home integration
- Early goal triggers
- ED
- Pre-Op
- D/C planning
- PC screening tool
- 8P Assessment
- Apache
- Care according to
patient’s goals
- Service Line
collaboration
- Dedicated Critical
Care Team 24/7
- Geographic NP/PA
- IDCR
- Q Shift – formalize
- Family meeting
- Documentation on
Day 1, 3, 5
- Care process
standardization
- Decrease
variability
- Weaning
- tracheostomy
- Practice care
- Dedicated AVU Team
24/7
- Appropriate NP/PA
- IDCR
- Q Shift – formalize
- Family meeting
- Documentation
weekly
State
MaineHealth
PCP
MMC
Leadership
Support
Buy-In
CC Screening
Communicate
- Patient & Family-
Centered Care
- Systems
- Culture
24. 73 Action Items
Immediate Short Term Long Term Total Items
Care Plan Design 4 5 3 12
Care Transition 4 2 4 10
Enhancing
Professionalism
4 0 3 7
Environment of Care 6 2 5 13
Standardization of Care
Processes
3 3 4 10
Structural
Reorganization
9 3 9 21
55% of solutions were started prior to the workshop’s conclusion.
26. Goals: Where team saw the biggest
opportunities
• Early assessment of palliative care needs (days lost awaiting
decision making)
• Standardization of tracheotomy placement (why, when, where,
how, who)
• Standardization of mechanical ventilation weaning process (lost
days through lost progress)
• Standardization of post mechanical ventilation care (lost days
through no standardization of tracheotomy care and removal)
27. Goals (continued)
• Improve patient flow: The right patient, at the right time, in the right
bed (blocked ICU beds)
• Finding long term care solutions: Few options in Maine (patient
satisfaction, staff satisfaction)
• Supporting employees: Helping employees feel
confident, competent, and take pride in their work (full understanding
of plan, improved hand-off, competencies)
• Assessing the patient perspective: ―Experiencing consistent
messaging, every day, all day, for the length of a shortened stay, in
which my family is communicated with, and I am confident in my
safety.‖
28. How to measure our success?
• LOS
• Processes
• Patient/family satisfaction
• Financials
29. Measurement Statements
Measurement
Statement Measurement Goal Baseline
3 Month
Results
6 Month
Results
9 Month
Results 12 Month Results
Average Length of Stay (ALOS) for APR-DRG 4
(Trach Pts w/ Extensive Procedure)
Reduce by 10% 48.8 days 47.8 46.4 44.9 43.9
Average Length of Stay (ALOS)
for APR-DRG 5 (Trach Pts w/o
Extensive Procedure)
Reduce by 10% 41.7 days 40.9 39.6 38.4 37.5
ALOS on SCU Reduce by 10% 34.3 days 33.3 32.5 32.0 31.3
VAP Bundle Compliance 90% at 12 mos 75.7% 80% > 90% > 90% > 90%
Palliative Care Screening 90% at 12 mos 0% Complete
Development of
Screening Tool
30% 60% 90%
Frequency of Bounce Back to SCU none TBD TBD TBD TBD TBD
ALOS Between Order and Treatment
(AVP Referral)
Reduce by 1 day 3.4 days 3.2 2.9 2.5 2.4
SCU Patient Satisfaction Survey Create No survey exists Complete Survey
Development
Measure Baseline Increase Baseline
by 5%
Increase Baseline
by 10%
HCAHPS Scores on R4 AIP target Decrease gap by
50%
Meet Meet or Exceed AP
Targets
New Interdisciplinary Rounds Redefine, 100%
attend
25% Attend 100% Attend 100% Attend 100% Attend
Family Meeting Conducted Prior to Trach
Placement (Identify Team and Family Needs for
Comprehensive Discussion of Implications of
Proceeding with Trach)
Unknown 25% 50% 75% 100%
Generate >$1M in Savings Within 1st Year $100,000 $300,000 $500,000 $1,000,000
30. Potential Savings
Decrease 1 SCU Day @ $3,831* $3831* X 104 pts**=$398,424.00
Decrease 1 AVU Day @ $2,300* $2300* X 104 pts**=$239,200.00
Decrease 1 Med/Surg Day @ $2,300* $2300* X 104 pts**=$239,200.00
$876,824.00
(End of Stay)
Decrease LOS Cost With Long-Term Solution TBD
* (Based on FY2010, RCC=.525 per C. Alsdurf)
**( Based on Data for DRG 4 and 5 for 2010)
Cost
104 = number of patients with DRG 4 & 5
31. Results
• LOS
– ICU LOS declined from 34 to 24 days
– Transfer time from 3.4 to < 1 day
– Hospital LOS declined by 3.5 days (9.2%)
• Processes
– > 4 disciplines in attendance at IDCR: 82%
– Palliative Care Screening tool created, implemented
– Electronic Family Meeting tool created, implemented
• Patient/Family satisfaction
– ICU specific survey created and implemented
• Financial
– Cost reduction (savings) — $300K at 9 months ($500K goal)
32. Results
• Palliative care assessment process has become the
model for the health system
• MH/private corp. partnership for creation of a long
term vent facility
• Model for independent and MMC employed
physician partnerships in clinical transformation
– Cultural
– Operational
33. Measurement
Statement
Measurement
Goal Baseline 3 Month Goal
3 Month
Actual 6 Month Goal
6 Month
Actual 9 Month Goal
9 Month
Actual
12 Month
Goal
12 Month
Actual
HCAHPS Scores on R4 Improve •MD gap =
12.04%
•RN Gap =
7.14%
Decrease Gap
by
50%
•MD Gap =
16.57%
(-38%
Change)
•RN Gap =
.25% (+96%
Change)
Meet •Physicians=
75.78%
•Nurses =
71.07%
•Combined=
73.44%
Meet or
Exceed AP
Targets
•Physicians =
65.79%
•Nurses =
72.0%
New Interdisciplinary
Rounds
Improve Non-Existent 25%
Attend
Data Not
Available
100%
Attend
Work in
Progress - 0%
100%
Attend
Go-Live 100%
Attend
82.30%
Family Meeting Conducted
Prior to Trach Placement
(Identify Team and Family
Needs for Comprehensive
Discussion of Implications
of Proceeding with Trach)
Improve Unknown 25% Data Not
Available
50% Work in
Progress - 0%
75% Data Not
Available
100% Data Not
Available
Generate >$1M in Savings
Within 1st Year
Generate Cost
Savings
0$ $100,000 $112,041 $300,000 $80,477 $500,000 $119,933 $1,000,000 Data Not
Available
Total Cost Savings Generate Cost
Savings
0$ $112,041 $192,545 $312,351 Data Not
Available
Measurement Statements
34. Critical Areas of Success
• Building a sustainable Clinical Transformation team
• Hardwired hand-off process – face to face
• Reduction in MMC cultural handicaps
• Implementation of palliative care screening
• Reduction in LOS
• Partnership to create the 1st chronic vent facility in Maine
• Cost reduction
35. Key Lessons Learned
• Managing the time commitment
– Measure, monitor, mentor
• Clinicians rely on timely, accurate and relevant data
– The lack thereof demeans the process
• Senior leadership commitment is essential
– Provide the resources to get the work done, address barriers
• Change comes at different velocities
– Manage change milestones expectations
• Communication is vital
– 8 times, 8 ways, don’t assume receptivity or memory
36. Modeled on: Silversin, DMD, DrPH, Jack. "Plain Talk About Physician." Lecture. 12th Annual International Summit on Improving Patient Care in the Office Practice and the
Community. Dallas, Texas, United States. 21 Mar. 2011. Institute for Healthcare Improvement. Web. 6 Mar. 2012.
<http://www.ihi.org/offerings/Conferences/Summit2011/Documents/International%20Summit%20Brochure.pdf>.
LeadershipTeam
Validation of
Resources
Expended
Accomplishment
of Team
Objectives
Progress
Made on
Work Plan
Support in
Removing
Barriers
Engagement
on Ideas and
Solutions
Ensuring Time is
Protected to
Accomplish Goals
Open Lines of Communication
Reciprocal Accountability