The document describes efforts to improve outcomes for sick children at NHS Tayside. Approximately 7,000 children are referred annually, with 30% admitted. ICU admissions are about 7 per 1,000 admissions. The team aimed to reduce preventable readmissions, crash calls, and ICU/HDU admissions through improving early recognition of deterioration, appropriate escalation, and reliable management of sick children. Process measures such as PEWS, SBAR, and safety briefings showed over 98% compliance. Outcome measures like crash call rates and ICU admissions declined. The team now believes in providing high quality care and improving through a safety culture of transparency, data measurement, and continuous learning.
The document discusses out-of-hospital cardiac arrest (OHCA) management. It notes that aggregation of marginal gains through improving many small aspects can lead to significant overall increases. It then discusses OHCA recognition by dispatchers in Western Australia, finding that 83% of cases were recognized, with a median time to recognition of 1.3 minutes. Delayed recognition was associated with poorer outcomes. Training dispatchers to better recognize agonal breathing reduced delayed recognition rates. Overall, focusing on consistently implementing basic interventions like early recognition was emphasized as critical to improving OHCA survival.
BioNIR/EluNIR eDES: 1 Year Outcomes of BIONICS and NIREUS studiesMedinol Ltd
Dr. David Kandzari's overview of the 1 year outcomes of the BIONICS and NIREUS pivotal & randomized studies of the EluNIR elastomer DES by Medinol (formerly BioNIR). Presented during TCT 2016
The document discusses the establishment of an integrated regional dialysis service and clinical networks in Northland, New Zealand using telehealth. It outlines the rural geography which results in long travel times and costs for patients receiving dialysis in the region. Telehealth equipment was installed in three dialysis units to facilitate multidisciplinary meetings, patient assessments, education sessions and clinical discussions with tertiary centers. Initial resistance from tertiary centers was overcome and telehealth is now used for collaborative planning of vascular and transplant care for Northland patients.
This document outlines a value stream analysis conducted at the Salisbury VA Medical Center from July 21-23, 2015 to improve surgical flow and efficiency. It identifies current metrics, issues, and proposed solutions. The aim is to increase surgeries per month from 290 to meet demand, increase Lag Time to 80% and FTS to 75%, and decrease wait times for select specialties. A series of projects and tests of change are proposed and assigned with target completion dates to address issues like scheduling, pre-op processes, surgeon coordination, and OR flow. Progress will be tracked through monthly meetings and metric updates.
This document is about cruising in Russia and exploring sites related to the country's history as the land of the Czars. It mentions several important locations visited on the cruise, including St. Petersburg, Kizhi Island, Goritzy, the Catherine Palace, Peterhof, and the Cathedral of SS Peter and Paul containing the tombs of the Czars. The document provides an overview of touring opportunities in Russia focused on the legacy of its royal Czars.
Making the Books Balance – Understanding the Financial Context and Efficiency...NHSScotlandEvent
NHSScotland has an excellent track record in delivering and exceeding efficiency savings targets. In 2011‐12 we will continue to eliminate waste and drive modernisation programmes to achieve productivity and efficiency gains without compromising quality. This session will provide an overview of the challenges that lie ahead for NHSScotland but also the opportunity to ensure we make the best use of the resources that we have.
The document describes a love triangle between three characters: Ichabod Crane, Brom Bones, and Katrina Van Tassel. Ichabod Crane is a teacher and outsider to the town who is superstitious with questionable musical abilities. Brom Bones is the local bully who uses his physical prowess and aggression to cause trouble. Katrina Van Tassel is a wealthy and beautiful heiress who enjoys the attention of men and plays with their emotions. Both Ichabod and Brom are interested in pursuing Katrina, leading to conflict between the two suitors.
Abhinav Pareek is a Quality Assurance Engineer with over 2.8 years of experience in manual testing, QA engineering, and quality control. He has expertise in software development lifecycles, Agile methodologies, and bug tracking tools like JIRA and Mantis. Some of his project experience includes testing web and mobile applications for clients in various industries like social networking, vacation rentals, and engineering.
The document discusses out-of-hospital cardiac arrest (OHCA) management. It notes that aggregation of marginal gains through improving many small aspects can lead to significant overall increases. It then discusses OHCA recognition by dispatchers in Western Australia, finding that 83% of cases were recognized, with a median time to recognition of 1.3 minutes. Delayed recognition was associated with poorer outcomes. Training dispatchers to better recognize agonal breathing reduced delayed recognition rates. Overall, focusing on consistently implementing basic interventions like early recognition was emphasized as critical to improving OHCA survival.
BioNIR/EluNIR eDES: 1 Year Outcomes of BIONICS and NIREUS studiesMedinol Ltd
Dr. David Kandzari's overview of the 1 year outcomes of the BIONICS and NIREUS pivotal & randomized studies of the EluNIR elastomer DES by Medinol (formerly BioNIR). Presented during TCT 2016
The document discusses the establishment of an integrated regional dialysis service and clinical networks in Northland, New Zealand using telehealth. It outlines the rural geography which results in long travel times and costs for patients receiving dialysis in the region. Telehealth equipment was installed in three dialysis units to facilitate multidisciplinary meetings, patient assessments, education sessions and clinical discussions with tertiary centers. Initial resistance from tertiary centers was overcome and telehealth is now used for collaborative planning of vascular and transplant care for Northland patients.
This document outlines a value stream analysis conducted at the Salisbury VA Medical Center from July 21-23, 2015 to improve surgical flow and efficiency. It identifies current metrics, issues, and proposed solutions. The aim is to increase surgeries per month from 290 to meet demand, increase Lag Time to 80% and FTS to 75%, and decrease wait times for select specialties. A series of projects and tests of change are proposed and assigned with target completion dates to address issues like scheduling, pre-op processes, surgeon coordination, and OR flow. Progress will be tracked through monthly meetings and metric updates.
This document is about cruising in Russia and exploring sites related to the country's history as the land of the Czars. It mentions several important locations visited on the cruise, including St. Petersburg, Kizhi Island, Goritzy, the Catherine Palace, Peterhof, and the Cathedral of SS Peter and Paul containing the tombs of the Czars. The document provides an overview of touring opportunities in Russia focused on the legacy of its royal Czars.
Making the Books Balance – Understanding the Financial Context and Efficiency...NHSScotlandEvent
NHSScotland has an excellent track record in delivering and exceeding efficiency savings targets. In 2011‐12 we will continue to eliminate waste and drive modernisation programmes to achieve productivity and efficiency gains without compromising quality. This session will provide an overview of the challenges that lie ahead for NHSScotland but also the opportunity to ensure we make the best use of the resources that we have.
The document describes a love triangle between three characters: Ichabod Crane, Brom Bones, and Katrina Van Tassel. Ichabod Crane is a teacher and outsider to the town who is superstitious with questionable musical abilities. Brom Bones is the local bully who uses his physical prowess and aggression to cause trouble. Katrina Van Tassel is a wealthy and beautiful heiress who enjoys the attention of men and plays with their emotions. Both Ichabod and Brom are interested in pursuing Katrina, leading to conflict between the two suitors.
Abhinav Pareek is a Quality Assurance Engineer with over 2.8 years of experience in manual testing, QA engineering, and quality control. He has expertise in software development lifecycles, Agile methodologies, and bug tracking tools like JIRA and Mantis. Some of his project experience includes testing web and mobile applications for clients in various industries like social networking, vacation rentals, and engineering.
Getting Knowledge into Action for Best Quality HealthcareNHSScotlandEvent
NHS Education for Scotland and Healthcare Improvement Scotland are working with NHS Boards to define new approaches to implementing and sharing knowledge which support practitioners to get knowledge into action at the frontline. This shift in focus from accessing to applying knowledge will integrate knowledge management more closely with quality improvement. This interactive workshop will use creative knowledge management techniques to challenge the way we apply knowledge in practice.
Ronald Schiller and Penelope Burk are cited as resources on donor-centered leadership. A 2013 study by Compass Point and the Haas Fund is mentioned as being underdeveloped. A CEO survey by Bacon Lee & Associates is also referenced. The document discusses the importance of cultivation in making donors comfortable and setting the stage for larger gifts, as well as having cultivation strategies in place ahead of asks to increase giving amounts.
The document summarizes the Little Ice Age, a period from the 14th to 19th centuries when global temperatures dropped by 2-4 degrees Fahrenheit. This cooling was likely caused by increased volcanic activity, changes in ocean currents and melting glaciers, and reduced solar radiation due to fewer sunspots. The Little Ice Age led to failed crops in Europe and disease, contributing to the death of one-third of the European population. It also encouraged reasons for wars and destroyed a large part of the Spanish Armada. Napoleon's 1812 invasion of Russia was unsuccessful as the Russians destroyed food and water supplies, and only 40,000 of Napoleon's 500,000 man army returned due to illness, hunger and cold.
Parallel Session 2.3.2 What's Your Problem? Lessons on How to Solve National ...NHSScotlandEvent
The document summarizes the Scottish Patient Safety Paediatric Programme (SPSPP), which aims to reduce adverse events in pediatric hospital care in Scotland by 30% by June 2013. The SPSPP uses a pediatric trigger tool to measure adverse events and identify areas for improvement. It takes a multidisciplinary approach including subject matter experts to conduct reviews of cases involving potential adverse events or avoidable harm. The goal is to test changes and improvements that address common causes of harm or system failures, and track metrics to know if the changes are leading to lower rates of avoidable harm.
This document provides instruction on solving proportions and examples of proportion word problems. It explains that a proportion is an equality of two ratios, and that if two proportions are equal the terms can be cross multiplied. It then works through examples of solving single-variable proportions by cross multiplying and evaluating. It concludes with assigning homework problems from the textbook involving solving proportions and proportion word problems.
Transforming Quality Through the Third Sector: Challenging and Influencing Pr...NHSScotlandEvent
The third sector is a vital partner in delivering high quality healthcare in Scotland. Hear case studies from the Long Term Conditions Alliance Scotland which demonstrate effective partnership working between the third sector, NHSScotland and local authorities.
Parallel Session 3.5 Crossing Boundaries to Improve OutcomesNHSScotlandEvent
This document discusses human factors in healthcare. It provides definitions of human factors and outlines some key aspects including work environment, teamwork, safety culture and individual factors. It notes that errors are inevitable due to human fallibility and that around 80% of critical incidents relate to human factors issues. The need for defenses in depth is discussed including integrating human factors into education and having a just culture of reporting and learning from incidents. Examples from other industries like aviation are provided that demonstrate how human factors can be successfully incorporated. The document advocates for a systems approach and taking human factors as a core skill in healthcare.
The document discusses network packet capture in the Linux kernel. It provides an overview of the Linux network stack and packet ingress flow. It describes important data structures like net devices and sk buffers. It also explains methods for capturing packets, including capturing packets during the packet ingress flow through the network stack layers and protocols.
The student conducted an experiment to see how different environmental conditions affected the growth of two potato plants. Plant 1 was placed in the kitchen near electronics and received indirect light and average temperature. Plant 2 was placed outside and received direct sunlight and changing temperatures and humidity based on the weather. After a period of time, Plant 1 had a long pale stem with small leaves, while Plant 2 had a short dark stem with large leaves, showing that the different environmental conditions impacted the growth and development of each plant. The student concluded that a plant's growth can be altered by its surrounding environment.
The document outlines various offers and promotions from The Chemists India Trusts including:
1. Buy 1 Get 1 free offers on select Guardian products and 50% discounts on Guardian baby care products.
2. Special discounts for customers who use Citibank, ICICI, Amity Synergy, SBI, American Express, and Freecharge cards.
3. A focus on promoting Guardian products in the categories of vigor and vitality, Ayurveda, and personal hygiene.
4. The launch of several new Guardian branded products spanning various categories.
Curso Livre de Python - Aula 03/11 - Módulo IPeslPinguim
La Unión Europea ha acordado un embargo petrolero contra Rusia en respuesta a la invasión de Ucrania. El embargo prohibirá las importaciones marítimas de petróleo ruso a la UE y pondrá fin a las entregas a través de oleoductos dentro de seis meses. Esta medida forma parte de un sexto paquete de sanciones de la UE destinadas a aumentar la presión económica sobre Moscú y privar al Kremlin de fondos para financiar su guerra.
The curriculum at Lawrence Middle School's Technology & Robotics Classroom is broken into two units: Web 2.0 (Media Literacy) and Robotics, Engineering, & Problem Solving. In the first unit, students create digital portfolios, timelines of technology, and research projects. They also learn about internet safety. In the second unit, students identify and propose solutions to global issues, construct and program robots, and analyze robotic sensors and movements through collaborative tasks. The goal is for students to expand their technological knowledge and problem solving skills.
O documento resume a formação e experiência profissional de Luciana França Cescon na área da saúde mental, com foco na prevenção do suicídio. Ela atua na prefeitura de Santos e realizou pesquisas sobre o atendimento a pessoas com risco de suicídio em um CAPS. O texto também fornece estatísticas sobre suicídio no Brasil e no mundo e discute mitos e fatores de risco associados ao comportamento suicida.
Clinical quality assurance in RadiotherapyBharti Devnani
This document discusses quality assurance requirements and resources for clinical radiotherapy. It outlines the philosophy of radiotherapy quality assurance as improving clinical practice quality, promoting consistency, ensuring accuracy, and validating clinical trial results. It then describes the integrated planning and delivery process and sources of errors. The document provides detailed guidelines for quality assurance procedures during pre-planning, immobilization, simulation/CT, volume determination, treatment planning evaluation, treatment verification and delivery, follow-up, and the importance of audits for quality assurance.
Keynote address by Brent James at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.
Dr. Brent James describes how Intermountain Healthcare is systematically, and successfully, bringing together clinicians, patients and leaders to: establish best practices; drive out waste in their system; and ultimately deliver better, safer care. Dr. James will share insights about the structures, strategies and relationships that have been pivotal in transforming their health system.
Getting Knowledge into Action for Best Quality HealthcareNHSScotlandEvent
NHS Education for Scotland and Healthcare Improvement Scotland are working with NHS Boards to define new approaches to implementing and sharing knowledge which support practitioners to get knowledge into action at the frontline. This shift in focus from accessing to applying knowledge will integrate knowledge management more closely with quality improvement. This interactive workshop will use creative knowledge management techniques to challenge the way we apply knowledge in practice.
Ronald Schiller and Penelope Burk are cited as resources on donor-centered leadership. A 2013 study by Compass Point and the Haas Fund is mentioned as being underdeveloped. A CEO survey by Bacon Lee & Associates is also referenced. The document discusses the importance of cultivation in making donors comfortable and setting the stage for larger gifts, as well as having cultivation strategies in place ahead of asks to increase giving amounts.
The document summarizes the Little Ice Age, a period from the 14th to 19th centuries when global temperatures dropped by 2-4 degrees Fahrenheit. This cooling was likely caused by increased volcanic activity, changes in ocean currents and melting glaciers, and reduced solar radiation due to fewer sunspots. The Little Ice Age led to failed crops in Europe and disease, contributing to the death of one-third of the European population. It also encouraged reasons for wars and destroyed a large part of the Spanish Armada. Napoleon's 1812 invasion of Russia was unsuccessful as the Russians destroyed food and water supplies, and only 40,000 of Napoleon's 500,000 man army returned due to illness, hunger and cold.
Parallel Session 2.3.2 What's Your Problem? Lessons on How to Solve National ...NHSScotlandEvent
The document summarizes the Scottish Patient Safety Paediatric Programme (SPSPP), which aims to reduce adverse events in pediatric hospital care in Scotland by 30% by June 2013. The SPSPP uses a pediatric trigger tool to measure adverse events and identify areas for improvement. It takes a multidisciplinary approach including subject matter experts to conduct reviews of cases involving potential adverse events or avoidable harm. The goal is to test changes and improvements that address common causes of harm or system failures, and track metrics to know if the changes are leading to lower rates of avoidable harm.
This document provides instruction on solving proportions and examples of proportion word problems. It explains that a proportion is an equality of two ratios, and that if two proportions are equal the terms can be cross multiplied. It then works through examples of solving single-variable proportions by cross multiplying and evaluating. It concludes with assigning homework problems from the textbook involving solving proportions and proportion word problems.
Transforming Quality Through the Third Sector: Challenging and Influencing Pr...NHSScotlandEvent
The third sector is a vital partner in delivering high quality healthcare in Scotland. Hear case studies from the Long Term Conditions Alliance Scotland which demonstrate effective partnership working between the third sector, NHSScotland and local authorities.
Parallel Session 3.5 Crossing Boundaries to Improve OutcomesNHSScotlandEvent
This document discusses human factors in healthcare. It provides definitions of human factors and outlines some key aspects including work environment, teamwork, safety culture and individual factors. It notes that errors are inevitable due to human fallibility and that around 80% of critical incidents relate to human factors issues. The need for defenses in depth is discussed including integrating human factors into education and having a just culture of reporting and learning from incidents. Examples from other industries like aviation are provided that demonstrate how human factors can be successfully incorporated. The document advocates for a systems approach and taking human factors as a core skill in healthcare.
The document discusses network packet capture in the Linux kernel. It provides an overview of the Linux network stack and packet ingress flow. It describes important data structures like net devices and sk buffers. It also explains methods for capturing packets, including capturing packets during the packet ingress flow through the network stack layers and protocols.
The student conducted an experiment to see how different environmental conditions affected the growth of two potato plants. Plant 1 was placed in the kitchen near electronics and received indirect light and average temperature. Plant 2 was placed outside and received direct sunlight and changing temperatures and humidity based on the weather. After a period of time, Plant 1 had a long pale stem with small leaves, while Plant 2 had a short dark stem with large leaves, showing that the different environmental conditions impacted the growth and development of each plant. The student concluded that a plant's growth can be altered by its surrounding environment.
The document outlines various offers and promotions from The Chemists India Trusts including:
1. Buy 1 Get 1 free offers on select Guardian products and 50% discounts on Guardian baby care products.
2. Special discounts for customers who use Citibank, ICICI, Amity Synergy, SBI, American Express, and Freecharge cards.
3. A focus on promoting Guardian products in the categories of vigor and vitality, Ayurveda, and personal hygiene.
4. The launch of several new Guardian branded products spanning various categories.
Curso Livre de Python - Aula 03/11 - Módulo IPeslPinguim
La Unión Europea ha acordado un embargo petrolero contra Rusia en respuesta a la invasión de Ucrania. El embargo prohibirá las importaciones marítimas de petróleo ruso a la UE y pondrá fin a las entregas a través de oleoductos dentro de seis meses. Esta medida forma parte de un sexto paquete de sanciones de la UE destinadas a aumentar la presión económica sobre Moscú y privar al Kremlin de fondos para financiar su guerra.
The curriculum at Lawrence Middle School's Technology & Robotics Classroom is broken into two units: Web 2.0 (Media Literacy) and Robotics, Engineering, & Problem Solving. In the first unit, students create digital portfolios, timelines of technology, and research projects. They also learn about internet safety. In the second unit, students identify and propose solutions to global issues, construct and program robots, and analyze robotic sensors and movements through collaborative tasks. The goal is for students to expand their technological knowledge and problem solving skills.
O documento resume a formação e experiência profissional de Luciana França Cescon na área da saúde mental, com foco na prevenção do suicídio. Ela atua na prefeitura de Santos e realizou pesquisas sobre o atendimento a pessoas com risco de suicídio em um CAPS. O texto também fornece estatísticas sobre suicídio no Brasil e no mundo e discute mitos e fatores de risco associados ao comportamento suicida.
Clinical quality assurance in RadiotherapyBharti Devnani
This document discusses quality assurance requirements and resources for clinical radiotherapy. It outlines the philosophy of radiotherapy quality assurance as improving clinical practice quality, promoting consistency, ensuring accuracy, and validating clinical trial results. It then describes the integrated planning and delivery process and sources of errors. The document provides detailed guidelines for quality assurance procedures during pre-planning, immobilization, simulation/CT, volume determination, treatment planning evaluation, treatment verification and delivery, follow-up, and the importance of audits for quality assurance.
Keynote address by Brent James at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.
Dr. Brent James describes how Intermountain Healthcare is systematically, and successfully, bringing together clinicians, patients and leaders to: establish best practices; drive out waste in their system; and ultimately deliver better, safer care. Dr. James will share insights about the structures, strategies and relationships that have been pivotal in transforming their health system.
A presentation given by international keynote speaker Dr. Stephen Muething from Cincinnati Children's Hospital, USA at the CHA conference The Journey, in October 2012.
eHealth Summit: "How a mathematical patient flow modelling study can eliminat...3GDR
Slides from National eHealth Summit, 30 Sept 2015 at Carton House, Kildare: Professor Gary Courtney, Lead, National Acute Medicine Programme (NAMP).
#eHealthSummit15
http://www.ehealthsummit.ie
http://mhealthinsight.com/2015/09/25/mhealth-insights-from-the-ehealth-summit/
This document provides a weekly schedule and contact information for pediatric residents and clerks rotating at McMaster University and St. Joseph's Healthcare in Hamilton, Ontario. It outlines the daily schedules and responsibilities at each site, including grand rounds, teaching sessions, patient care duties, and administrative details. Resources and guidelines are also included for common pediatric topics, exams, procedures, and conditions to assist residents during their rotation.
The document describes the Safer Patient Flow Bundle implemented at Ipswich Hospital NHS Trust to improve patient flow and prevent unnecessary waiting. The bundle consists of 5 core components: Senior Review, All Patients, Flow of patients, Early discharges, and Review (SAFER). If all components are followed, it will improve the patient experience and support safe, timely discharges. The bundle led to an 11% increase in daily discharges, reduced length of stay, and allowed closure of an escalation ward over peak winter months.
Drs. Jeff Zimmerman & Rodger Main - Evolution of BiosurveillanceJohn Blue
The document discusses the evolution of biosurveillance through a federal-state-industry partnership. It proposes leveraging existing veterinary diagnostic laboratories (VDLs) and veterinarians by establishing a centralized database to share sample testing results. Standardizing sample types like oral fluids and tests can provide high-throughput and accurate surveillance. Challenges include ensuring comprehensive diagnostic records that can be electronically transferred and establishing data standards. The system was tested during a high pathogenic avian influenza outbreak in 2015 where over 1,000 tests were run per week at one VDL. Overall, the document argues that collaborating networks between producers, veterinarians, and VDLs can create an effective biosurveillance system by building on existing resources and
Incorporating Peripherally Inserted Central Catheters (PICC) into hospital cl...HTAi Bilbao 2012
This document summarizes the evidence-based incorporation of peripherally inserted central catheters (PICC) for cancer patients at Araba University Hospital. A literature review and training program was conducted before developing a protocol for PICC insertion, maintenance, and patient education. Over 200 PICCs were successfully inserted with few complications. PICCs provided a safe, effective long-term venous access alternative to implanted ports or central venous catheters at a lower cost. The process demonstrated how new technologies can be incorporated into clinical practice using an evidence-based approach.
Parallel Session 3.2 Innovations in Acute Flow and Capacity ManagementNHSScotlandEvent
Patient flow refers to the movement of patients through the healthcare system. Slow patient flow can negatively impact quality of care and increase costs. When patient flow slows down, more patients are at risk of dying from delays in treatment or medical errors. It also increases costs due to longer lengths of stay, increased use of expensive hospital resources, and less efficient use of staff time. Improving patient flow requires considering the entire patient journey, separating elective and emergency care streams, eliminating unnecessary variability, and ensuring capacity matches demand.
This document discusses quality assurance indicators for radiation oncology facilities and treatment. It outlines general, medical physics, treatment accuracy and complexity, and patient satisfaction indicators. It provides details on staffing records, recommendations, treatment planning, equipment quality assurance, treatment delivery, acute and late effects for different treatment sites, and results of patient satisfaction surveys. Overall it evaluates the performance and quality of a radiation oncology facility based on various quality indicators.
This document provides an overview of a presentation on the science of safety training. Some key points:
- The presenter has over 24 years of experience in healthcare and various safety-related certifications and memberships.
- The presentation covers topics like historical context of patient safety, learning from defects, and celebrating safety. It also discusses tools to measure safety culture like the Safety Attitudes Questionnaire.
- The presentation describes how the Comprehensive Unit-based Safety Program (CUSP) was implemented at Tawam Hospital. Initial assessments found issues like hierarchies and a tendency to blame individuals for errors. CUSP helped establish a culture focused on systems and teamwork.
Increasing Access or Improving Mortality in EndoscopyNHS Improvement
Debate: Increasing Access or Improving
Mortality in Endoscopy
Elective v Acute
Dr Sanchoy Sarkar FRCP. PhD
Endoscopy Services Lead
Consultant Gastroenterologist
Senior Lecturer
Presentation from seven day services in diagnostics event, 4 March 2013 #7dayDiagnostics
SCIE Investor Presentation January 2017Mike Oliver
This document discusses SpectraScience's optical biopsy technology platform and commercialization plans. The technology uses light to provide faster, non-invasive cancer detection compared to physical biopsies. Clinical studies show the technology exceeds accuracy criteria for detecting colon cancer. The company plans to commercialize the technology first in Europe, where distribution agreements are in place, to take advantage of single-payer healthcare systems and proven cost savings. Future indications for bladder, esophageal, and other cancers are also discussed.
The correct answer is C. The new H1N1 codes require specifying if the manifestation is pneumonia, other respiratory manifestations, or other manifestations.
Fecal Impaction Has New Options
Answer 2: False.
Talking point: 787.6 is deleted and replaced with more specific codes for fecal incontinence symptoms like full incontinence, incomplete defecation, smearing, and urgency.
Pain Gets 1 More Symptom
Answer 3: C.
Talking point: A new code (784.92) has been added for jaw pain.
Innovative IT Solutions for 7 Day Services – 8 November 2016NHS England
Safe Hands using real-time locating to improvement patient safety and support 7DS services
Guest Speakers: Clare Nash RGN, Senior Nurse Procurement and SafeHands & Jane McKiernan – The Royal Wolverhampton NHS Trust
Using Nervecentre to support 7DS services
Guest Speakers: John Jameson, Deputy Medical Director and Julia Ball, Assistant Chief Nurse – University Hospitals Leicester NHS Trust
Reducing harm at a national level the scottish storyProqualis
This document summarizes Scotland's national efforts to reduce patient harm and mortality rates in acute care hospitals between 2008-2015. Key points:
1. Scotland set ambitious aims in 2008 to reduce mortality by 15% and adverse events by 30% by 2012 through a system-wide strategy focused on reliability and implementation of safety bundles/checklists.
2. By 2015, Scotland achieved a 20% reduction in mortality, a 30% reduction in adverse events, and reliability of over 95% for safety processes through developing leadership, measurement systems, and testing improvements at local hospitals before spreading changes nationally.
3. Improvements included a 90% reduction in C. difficile infections, a 25% reduction in ICU
This document discusses quality improvement in healthcare. It begins by posing questions about defining quality, what quality improvement is, and how quality can be improved. It then discusses the safety paradox in healthcare - that despite highly trained staff and technology, errors are common and patients are frequently harmed. Several studies on adverse event rates in hospitals are summarized. The document discusses concepts for safety and quality improvement like reliability, variation, measurement, and change management. It provides examples of quality improvement tools and approaches like process mapping, care bundles, measurement, and the PDSA (Plan-Do-Study-Act) cycle. Overall, the document provides an overview of key issues and approaches related to quality and safety in healthcare.
Dr. Clayton Johnson - Why Are We Not Making More Progress to Decrease PRRS In...John Blue
Why Are We Not Making More Progress to Decrease PRRS Incidence? - Dr. Clayton Johnson, Director of Health at Carthage Veterinary Service, from the 2017 Allen D. Leman Swine Conference, September 16-19, 2017, St. Paul, Minnesota, USA.
More presentations at http://www.swinecast.com/2017-leman-swine-conference-material
The student completed various clinical experiences in long-term care, labor and delivery, pediatrics, and medical-surgical units totaling approximately 450 hours. During these experiences, the student assisted with assessments, vital signs, feeding, hygiene, wound care, medication administration through various routes, procedures like catheterization and NG tube insertion, as well as documentation. The experiences provided opportunities to care for patients across the lifespan and in different healthcare settings.
Similar to Parallel Session 2.3.3 What's Your Problem? Lessons on How to Solve National and Local Challenges (20)
Plenary 3.2 From Idea to Delivery - A Journey of DiscoveryNHSScotlandEvent
This document discusses the history of hearing healthcare in Denmark and a plan to redesign community services. It begins by describing pioneering Danish legislation from the 1950s that made hearing examinations and aids free for all citizens and established regional hearing centers. The document then outlines themes from community engagement including giving back, caring for others, and recognizing resilience. It proposes a new service model delivered locally but also at scale through collaboration between community organizations, healthcare services, and technology.
The document outlines an experiential challenge where teams must create an innovative solution to safely launch a fresh egg without breaking it. Teams are given materials and brief instructions. The goal is to design, build, cost and brand a product to launch an egg into the target zone. Teams have 25 minutes to build their solution and the first intact egg to land in the target zone wins a prize. The document also includes an overview of the innovation process and how it relates to the challenge.
Parallel Session 3.9 The Quality Improvement Hub: Supporting You to Develop S...NHSScotlandEvent
This document summarizes resources from the Quality Improvement Hub in Scotland. It describes the hub's website as a one-stop shop for free quality improvement resources. It outlines support available for implementation, education, networks, and measurement. It also summarizes programs for a Quality Improvement Education Program, Knowledge into Action initiative, SPSP Fellowship, and building a network of networks to spread best practices in healthcare quality improvement across Scotland.
The document discusses NHS Lanarkshire's plans to develop a clinical portal that will pull together a patient's clinical information from various systems into a single view, addressing issues around fragmented records and information sharing between services. It aims to provide clinicians with a complete patient record regardless of where data was created or stored. The portal is intended to improve care coordination and reduce risks around late intervention or lack of awareness of a patient's full clinical history.
The document discusses options and opportunities for health science innovation in Scotland. It outlines current challenges posed by chronic diseases and emphasizes the need for quality healthcare and research. It presents information science as a catalyst for change and the role of academic health science networks. Case studies are provided on initiatives like the Scottish Diabetes System that have improved clinical outcomes through coordinated efforts and data sharing.
Plenary 2 Leaders and Leadership - The Good, The Bad and The UglyNHSScotlandEvent
Leaders and leadership - the Good, the Bad and the Ugly by Irwin Turbitt discusses different types of leadership. It notes that leadership requires change, which leads to loss and distress, but that distress can be productive. Adaptive leadership maintains people within their productive zone of distress and focuses on relationships rather than authority alone. Creating public value through both goods/services and obligations is important for public sector leadership. Overall it emphasizes that leadership is about facing complex problems through trial and error while keeping people focused.
This document discusses values and culture within the NHS in Scotland. It outlines "The Lothian Way", a set of values developed within NHS Lothian including being person-centered, having partnerships, integrity, accountability, and innovation. It also discusses some underlying cultural assumptions like suppressing bad news. The document advocates for continuing to improve safety and quality of care, making the right choices, learning together, and renewing a commitment to ethics and values. It aims to deliver the highest quality healthcare and for Scotland to be a world leader in healthcare quality.
Parallel Session 4.9 Talking and Really Listening - Taking an Innovative Appr...NHSScotlandEvent
This document discusses using dialogue techniques to achieve large-scale change in complex situations. It outlines three fundamental dialogue concepts: monologue vs generative conversation, dialogue actions and intentions, and fields of conversation. Examples of using dialogue in NHS Fife are provided. The document recommends dialogue methodologies when issues are complex with no obvious solution, multiple interconnected roles must be aligned, and authority is unclear. Dialogue allows all voices and perspectives to be heard to increase understanding before commitment.
Parallel Session 4.8 Creative and Innovative Approaches to Empower and Suppor...NHSScotlandEvent
The document discusses creative and innovative approaches to empowering people through self-management and greater control over their health outcomes and risks. It focuses on person-centered care, identifying assets and building support networks to facilitate self-management of long-term conditions. The importance of risk enablement is emphasized to promote choice and control for individuals through self-directed support options.
Parallel Session 4.7 Understanding Potential and Evaluating Actual Impacts of...NHSScotlandEvent
The document discusses initiatives by three health care providers - Perth and Kinross CHP, North Lanarkshire CHP, and Midlothian CHP - to improve outcomes for people with dementia while reducing costs. It provides an overview of the Dementia Demonstrators program, which aims to demonstrate better outcomes for more people using the same or fewer resources. The sites hope to achieve this by addressing unnecessary resource use through interventions people don't need or want, or providing interventions too late.
Parallel Session 4.6 Developing Your Team’s Safety Culture and Safety Practic...NHSScotlandEvent
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My slides at Nordic Testing Days 6.6.2024
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Paper presented at SYNERGY workshop at AVI 2024, Genoa, Italy. 3rd June 2024
https://alandix.com/academic/papers/synergy2024-epistemic/
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What will you get from this session?
1. Insights into integrating generative AI.
2. Understanding how this integration enhances test automation within the UiPath platform
3. Practical demonstrations
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What is generative AI
Test Automation with generative AI and Open AI.
UiPath integration with generative AI
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2. Sick Children – Our Journey in Tayside
• 7000 acutely unwell children referred annually
– ~30% admitted
• ICU admissions ~ 7 per 1000 admissions
– Tayside accounts for 10% of all inpatient paediatric admissions
per annum in Scotland, only 5% of PICU admissions
• How many patients deteriorate in our care?
• How many ICU admissions/deaths are preventable?
• Can we improve?
3. Team ‘buy in’ - What is your Project 1?
• What really drives the team nuts – what is the biggest
waste, safety, inefficiency issue that annoys all staff
• Start there
• Consult all staff re the process and empower all staff to
test changes
• Don’t dismiss ideas until you have tried them
• Credit the team with team success
4. Tayside “Project 1”
• 5/12 old boy
• Presented at 10 am to SSAA
• Unwell for 3-4 hours with pyrexia and runny nose, still
feeding and babbling and smiling
• Known to unit – complicated neonatal course
• Thought to be well but not discharged due to parental
concern – first febrile illness since discharge
• Sudden collapse in unit and died with meningococcal
sepsis by 6pm
5. Case review
• Non recognition of the sick child
• Then late recognition and failure to act promptly
• Failure to escalate
• Once escalated senior multidisciplinary team involved in
simultaneous resuscitation
• Team invested in this patient as well known to unit
• huge division in team ensued with a blame culture
• How do we turn this around and restore faith in each other
and our team? We do our best to ensure we provide the
appropriate and timely care to all our patients.
6. Improvement Aim – ambitious or naïve
Outcome Primary Drivers Secondary Drivers (change concepts)
Early recognition (PEWS, watcher criteria)
Appropriate escalation (PEWS escalation flow chart)
Appropriate, Appropriately trained staff (life support courses, senior review, up
timely and skilling, regular updates)
reliable Testing theory in real time real place (emergency simulation)
recognition and
management of Guidelines for common emergencies updated and immediately
sick children accessible (review dates and website updating)
Zero preventable Functioning appropriate equipment (bedspace checks, resus trolley)
readmissions,
Appropriate medicines ( in date, algorithms, remove unused)
crash calls,
HDU/ PICU Timely ( teaching re timelines, process change)
admissions. SBAR – handover, escalation
In-ward deaths Effective
Safety Briefing
Multidisciplinary rounding
by June 2013 communication Daily goals
Effective discharge planning
Effective readmission planning /CYADM, anticipatory care plans
Multiagency
Infrastructure
Empower all staff to voice concerns
and culture to Safety walkrounds
promote Learning from adverse events (case note reviews, IR1, PTT)
safety Sharing all data with whole team +/- patients and carers
Capability and capacity
7. Can we predict who will deteriorate?
Can we prevent it?
% acute admissions to HDU Tayside Childrens Hospital Nov
2011 - April 2012
35
30
25
20
%
15
10
5
0
0 1 2 3 4 5 6 7
PEWS score
80% of acute admissions to HDU have a PEWS <3
Why admit to HDU?
9. Watchers
Gut Feelings.......
“Researchers explain that intuition represents one of the ways our brains store,
process and retrieve information........ The researchers .... concluded that intuition
- a feeling that something is right or wrong - is the brain drawing on past
experiences and current external cues to make a decision; a process so
rapid that the reaction is subconscious.”
British Journal of Psychology (April 2008)
10. How do we know a change is an
improvement?
• Outcome measures
– Crash call rate, HDU & ICU admission rates, In ward mortality
rate
– Prediction of Watchers
• Process Measures
– PEWS, SBAR, MDR, DG, safety brief, equipment checks,
guideline checks, simulations, time to first dose of antibiotics,
adherence to specific guidelines
• Balancing measures
– HDU admission rate, staff feedback (simulation), time invested in
measuring v delivering service
11. How to move towards Safety Culture of
recognising deteriorating children?
12. Safety Brief – shared mental model
MULTIDISCIPLINARY SAFETY BRIEFING WARD 29
DATE: TIME:
PLANNED
EMPTY BEDS ANTICIPATED
/ ADMISSION
(bays/SR) DISCHARGES
S
WARD ISSUES PROBLEM DETAILS (including bed
number)
YES NO
PATIENTS WITH SIMILAR NAMES
HIGH PEWS / WATCHERS
PATIENTS WITH INDIVIDUALISED
PROTOCOLS (eg CYPADM)
14. Ap
r
0
10
20
30
40
50
60
70
80
90
100
110
120
130
140
150
160
170
180
190
200
Ma -09
y
Ju -09
n-0
Ju 9
Au l-09
g
Se -09
p-0
Oc 9
t
No -09
v-0
De 9
c-
Ja 09
n
Fe -10
b-1
Ma 0
r
Ap -10
r-1
Ma 0
y
Ju -10
n-1
Ju 0
Au l-10
g
Se -10
p-1
Oc 0
t
No -10
v-1
De 0
c-
Ja 10
n
Fe -11
b-1
Ma 1
r
Ap -11
r-1
Ma 1
y
HDU Admission Rate
Ju -11
n-1
Ward 29, Ninewells Hospital
Ju 1
Au l-11
g
HDU Admission Rate
Se -11
p-1
Oc 1
t
Ward 29, Ninewells Hospital
No -11
v-1
De 1
c-
Ja 11
n
Fe -12
b-1
Ma 2
r
Ap -12
r-1
Ma 2
y
Ju -12
n-1
Ju 2
Au l-12
g
Se -12
p-
Oc 12
t
No -12
v-1
De 2
c-1
2
Balancing measure: HDU admission rate
15. Ap
r
0
5
10
15
20
Ma -09
y-0
Ju 9
n-0
Ju 9
l
Au -09
g-0
Se 9
p-
Oc 09
t
No -09
v
De -09
c-0
Ja 9
n
Fe -10
b-
Ma 10
r
Ap -10
r-1
Ma 0
y
Ju -10
n-1
Ju 0
l
Au -10
g-1
Se 0
p-
Oc 10
t
No -10
v-1
De 0
c-
Ja 10
n
Fe -11
b-
Ma 11
r
Ap -11
r-1
Ma 1
y
Admission
Ju -11
Ward 29, 29, Ninewells Hospital
n-1
Ju 1
l
Au -11
g-1
Se 1
PICUICU Admission Rate Rate
p-
Oc 11
t
No -11
Ward Ninewells Hospital
v-1
De 1
c-
Ja 11
n
Fe -12
b-
Ma 12
r
Ap -12
r-1
Ma 2
y
Ju -12
n-1
Ju 2
l
Au -12
g-1
Se 2
p-
Oc 12
t
No -12
v-1
De 2
c-1
2
Outcome measure – PICU admission rate
16. Ja
n-1
0
10
20
Fe 0
b-
10
Ma
r-1
0
Ap
r-1
Ma 0
y-1
Ju 0
n-1
0
Ju
l-1
Au 0
g-1
Se 0
p-1
0
Oc
t -1
No 0
v-1
De 0
c-1
0
Ja
n-1
Fe 1
b-
11
Ma
r-1
1
Ap
r-1
Ma 1
y-1
Ju 1
n-1
1
Ju
l-1
Au 1
g-1
Se 1
p-1
Ninewells
1
Oc
t -1
Crash Call Rate
No 1
Ward 29,HDU, SSAA Ninewells Hospital
v-1
De 1
c-1
1
Ja
n-1
Ward 29, Crash Call Rate Hospital
Fe 2
b-
12
Ma
r-1
2
Ap
r-1
Ma 2
y-1
Ju 2
n-1
2
Ju
l-1
Au 2
Outcome measure: Crash Calls
g-1
Se 2
p-1
2
Oc
t -1
No 2
v-1
De 2
c-1
2
17. Ap
r-
0
10
Ma 09
y-0
Ju 9
n-0
Ju 9
l-
Au 09
g-0
Se 9
p-0
Oc 9
t-
No 09
v-0
De 9
c-0
Ja 9
n-
Fe 10
b-
1
Ma 0
r-1
Ap 0
r-
Ma 10
y-1
Ju 0
n-1
Ju 0
l-
Au 10
g
Se -10
p-1
Oc 0
t-
No 10
v-1
De 0
c-1
Ja 0
n-
Fe 11
b-
Ma 11
r-
Ap 11
r-
Ma 11
In Ward Mortality Rate
y-1
Ju 1
Ward 29, Ninewells Hospital
n-1
Ju 1
l-
Au 11
g-1
In-Ward Mortality Rate
Se 1
p-1
Oc 1
t-
Ward 29, Ninewells Hospital
No 11
v-1
De 1
c-1
Ja 1
n-
Fe 12
b-
Ma 12
r-
Ap 12
r-
Ma 12
y-1
Ju 2
n-1
Ju 2
l-
Au 12
g-1
Se 2
p-1
Oc 2
Outcome measure: In-Ward Mortality
t-
No 12
v
D e -1 2
c-1
2
18. Outcome measure: combined outcome
Potential for national Serious Harm Index?
Ward 29 Ninewells Hospital total significant events rate
(total mortality + crash calls + ICU admissions)
40
35
30
25
20
15
10
5
0
Apr-10
Aug-10
Apr-11
Aug-11
Apr-12
Feb-10
Sep-10
Jun-10
Oct-10
Nov-10
Dec-10
Feb-11
Sep-11
Jun-11
Oct-11
Nov-11
Dec-11
Feb-12
Jan-10
Mar-10
May-10
Jul-10
Jan-11
Mar-11
May-11
Jul-11
Jan-12
Mar-12
May-12
Simulation New PEWS charts and reliability
started for multiple process measures
across whole unit
19. Who is the sickest patient on the ward?
• 16 different responses
May • Little overlap
• No agreement with attending
2011 Consultant
• Agreement
May • Theory: Early recognition and
shared mental model increases
number of reviews, decreases
2012 time to treatment and prevents
deterioration
20. Tayside “Project 1” outcomes
• Tayside team believe in themselves as individuals and
as a team
• We know we are providing high quality care (and have
the data to show it)
• We may be improving outcomes for children but it is
early days
• We know we have improved staff morale (and have data
to prove it!)
• We now we have a team who “knows how to improve”
• We are now on project 40+
21. Learning / Challenges – developing a
Safety Culture
• Data is everything:
– Baseline
– And accurate, appropriate measurement
• Person dependence & improvement fatigue
• Capability and capacity
• Culture – transparency about “bad data”
• Running before we could walk – especially simulation
• “spread control”
• What do we not know? Should we be worried about it?
Editor's Notes
Does this low PICU usage reflect a high standard of acute care? Or are children being cared for outside PICU ie in adult or neonatal ICU, or do we do a higher level of HDU Care? Not clearCan we improve or is this as good as it gets?
All of these drivers And many more (the original driver diagram rolls to 5 A4 pages) have a part to play. However you cannot ask a whole team to adopt all changes at once. So prioritiseSegment into pilot populations and then spread once reliable.
PEWS is a tool but it isn’t thw whole answerChildren are physiologically robust – physiological changes seen lateAlso need “Gut instinct”, experience, training,
PEWS of 0 but scores for staff concern and concern re airway
Particularly note the parental concerns
Multiple parallel projects – hundreds of PDSAs – and still many more to goA team allocated to each major workstream – multidisciplinary or at minimum 1 nurse and 1 doctor
Ask anyone on the ward – “who is the sickest patient?” or “which patient are you most concerned about today?” and you should get the same answer.
All started coming togethe in Aug/sept 2011Redesigned PEWS form – what was the challenge within the ward – find out the problem and put together a solution design together!
I don’t think so
Trend down but not meeting run chart rules
Is this significant?Is it all down to patient safety work – also significant work going on in palliative care processes (quality and patient centred rather than safety). Is it because it was a quiet winter with fewer sick patients?
May 2011 – 11 respondents
Need to know what you are aiming for and set appropriate measures .Move with what your data tells you.This is work that never finishes – the more you look the more you find.Your unit needs to be ready for that – need to understand that data isn’t bad and as long as you are taking measures to improve is what matters. All other units will have similar data – they just don’t know that because they aren’t looking.