EmCare was hired to optimize operations at the emergency department of Community Hospital South in Indianapolis. They implemented a top-down approach, focusing on strong physician leadership, instituting a culture of excellence, and data-driven decision making. Key changes included bedside registration, team nursing, and optimized staffing models. Metrics improved significantly within 6 months, with left without being seen rates dropping from 3.8% to 0.24% and average length of stay decreasing from 351 to 281 minutes. Continued focus on recruitment, staff satisfaction, documentation, and aligning with hospital goals helped sustain these operational improvements.
This Genesis Cup 2012 runner-up presentation by Medical Director, Harry "Tripp" Wingate, MD and Shayne Middleton, RN, RDCS describes the process used at EMH ED to “flip” the complaint to compliment ratio – a crude measure of customer service performance in a rural ED. The presentation details steps from training on AIDET to the key issues in providing effective feedback to ED staff. Special emphasis is given to the tricky issue of email communication and compliance with HIPAA. New web-based tools (WinZip.com and MyFax.com) for safe email communication are introduced to the audience with comments on benefits and usage.
In 2011, we took it upon ourselves to break down our patient care and examine it from the time the patient arrived (regardless of method) to the time they departed (again, regardless of method). Over the next year, we developed and implemented an end-to-end strategy of patient care and flow, where all decisions were under the scrutiny of what was deemed to be ‘patient-centric’. This process of self-improvement led us to develop a scalable, replicable template for hospitals of all shapes and sizes. Too often, patient flow hurdles and patient care problems are addressed solely through the vantage of individual departments at the expense of efficiency. Our presentation is the result of a personal, real-time experience.
Much has been written in the business literature about managing the waiting experience. Federal Express has noted that “waiting is frustrating, demoralizing, agonizing, aggravating, annoying, time consuming, and incredibly expensive.” We intuitively know this from our own experience as well as from our patients. In this #ACEP13 presentation, Dr. Jensen gives practical tips to improve your patients' ED experience.
From Burnout to Engagement: Strategies to Promote Physician Wellness and Work...Modern Healthcare
Slides from a Modern Healthcare presentation.
http://www.modernhealthcare.com/article/20150225/INFO/302259999/webinar-from-burnout-to-engagement-strategies-to-promote-physician
Faced with long hours, unrelenting administrative burdens and the pressure to treat patients quickly, a growing number of physicians are experiencing burnout, a condition characterized by loss of empathy, exhaustion, and a low sense of accomplishment. According to a Mayo Clinic survey from 2012, nearly one in two U.S physicians reported at least one symptom of burnout, up from 22% in 2001. For hospitals with stressed caregivers, the stakes are high. Burned out, dissatisfied physicians are far more likely to make medical errors and are less able to communicate effectively with patients and co-workers. They're also at a higher risk for substance abuse and are more likely to leave clinical practice altogether.
This Genesis Cup 2012 runner-up presentation by Medical Director, Harry "Tripp" Wingate, MD and Shayne Middleton, RN, RDCS describes the process used at EMH ED to “flip” the complaint to compliment ratio – a crude measure of customer service performance in a rural ED. The presentation details steps from training on AIDET to the key issues in providing effective feedback to ED staff. Special emphasis is given to the tricky issue of email communication and compliance with HIPAA. New web-based tools (WinZip.com and MyFax.com) for safe email communication are introduced to the audience with comments on benefits and usage.
In 2011, we took it upon ourselves to break down our patient care and examine it from the time the patient arrived (regardless of method) to the time they departed (again, regardless of method). Over the next year, we developed and implemented an end-to-end strategy of patient care and flow, where all decisions were under the scrutiny of what was deemed to be ‘patient-centric’. This process of self-improvement led us to develop a scalable, replicable template for hospitals of all shapes and sizes. Too often, patient flow hurdles and patient care problems are addressed solely through the vantage of individual departments at the expense of efficiency. Our presentation is the result of a personal, real-time experience.
Much has been written in the business literature about managing the waiting experience. Federal Express has noted that “waiting is frustrating, demoralizing, agonizing, aggravating, annoying, time consuming, and incredibly expensive.” We intuitively know this from our own experience as well as from our patients. In this #ACEP13 presentation, Dr. Jensen gives practical tips to improve your patients' ED experience.
From Burnout to Engagement: Strategies to Promote Physician Wellness and Work...Modern Healthcare
Slides from a Modern Healthcare presentation.
http://www.modernhealthcare.com/article/20150225/INFO/302259999/webinar-from-burnout-to-engagement-strategies-to-promote-physician
Faced with long hours, unrelenting administrative burdens and the pressure to treat patients quickly, a growing number of physicians are experiencing burnout, a condition characterized by loss of empathy, exhaustion, and a low sense of accomplishment. According to a Mayo Clinic survey from 2012, nearly one in two U.S physicians reported at least one symptom of burnout, up from 22% in 2001. For hospitals with stressed caregivers, the stakes are high. Burned out, dissatisfied physicians are far more likely to make medical errors and are less able to communicate effectively with patients and co-workers. They're also at a higher risk for substance abuse and are more likely to leave clinical practice altogether.
Dr Ian Sturgess: Optimising patient journeysNuffield Trust
In this slideshow Dr Ian Sturgess, Director at IMP Healthcare consultancy, explores how we can better understand admitted flow streams and optimise patient journeys.
Dr Sturgess spoke at the Nuffield Trust ‘Reducing the length of stay’ event in September2014.
Presentation to the North Queensland Return to Work Conference in late April 2016. Summarises ISCRR's research on medical certification for return to work and the role of General Practitioners in return to work.
Integrated Care Guidance MUSE Presentation by Dr. WespJacobus Consulting
This presentation addresses evidence-based care and the EHR. It covers designing and delivering education and training programs aimed at accomplishing best practice clinical informatics models throughout healthcare organizations.
Learner Outcome #1: The learner will obtain an understanding of the importance of the relationship between EHR functionality and guiding evidence-based care at the bedside.
Learner Outcome #2: The learner will walk away with governance and processes of engaging clinicians in the evidence-based content customization process
Learner Outcome #3: The learner will be familiar with the advantages of built in evidence-based care guidance within the EHR
Joint Commission defines Disruptive Behavior as “conduct by a health care professional that intimidates others working in the organization to the extent that quality and safety are compromised”.
Research has found that disruptive behavior not only impacts the morale and staffing of an organization but can lead to medical errors and breakdowns in the quality of care, treatment, and services delivered.
Francesca Rubulotta talks about disproportionate care in ICU. Disproportionate care is disproportionate in relation to the expected prognosis.
Moreover, this can lead to moral distress among clinicians who think they are offering inappropriate care. There is mounting research and evidence pointing to the existence of disproportionate care.
Furthermore, stress and burnout cause increased miscommunication and lead to low performance and concentration. Stress leads to absenteeism or in many cases, presenteeism.
Presenteeism is when someone just shows up for work but does the bare minimum. Francesca shows the financial burden caused by absenteeism across various countries.
Francesca points out that only 14% of employees feel engaged in their jobs. Moreover, data shows that companies which keep their employees engaged have higher rates of performance. Such companies have managers who are more engaged and approachable.
Francesca discusses various studies that look at the appropriateness of care in ICU.
She talks about the CONFLICUS, APPROPRICUS and DISPROPICUS studies, all of which point to the moral stress experienced when clinicians are forced to give inappropriate care.
We must ask whether inappropriate care occurred and why. The three major factors influencing the perception of inappropriate care are client related situations, work characteristics and personal characteristics. 27% of healthcare providers (HCP) report at least one of their patients are mismanaged per day. Furthermore, 63% say that inappropriate care happens all the time.
There are multiple reasons for disproportionate care taking place. Studies show that nurses associated inappropriate care to interpersonal factors while physicians ascribed it to prognostic uncertainty.
Francesca discusses the methods used and results obtained in the DISPROPICUS study and self-awareness and individual development in ICU.
According to her, these future studies will help to find solutions to the problems regarding disproportionate care. Evidently, authentic leaders, who can inspire others, are the need of the hour.
For more like this, head to our podcast page. #CodaPodcast
Evelyn Sparks, Acting VP of Professional Practice at The Royal shared her tips for returning to work after taking a leave to recover from a mental illness.
University of Utah Health Improving Wellness: 40 Champions, 20 Projects, 12 M...University of Utah
On December 14, 2017, the Wellness & Integrative Health’s Resiliency Center, Accelerate, and the Spencer S. Eccles Health Sciences Library will presented a Faculty Wellness Poster Session. Each department in the School of Medicine highlighted the past year’s Wellness Champion projects, which were focused on personal resilience, burden reduction, and team work. The poster session demonstrated the work completed so far as the Wellness Champion program is expanded to faculty and staff across U of U Health.
Keeping People Housed
Presentation by Richard Kruszynski, Director of Consultation and Training/Center for Evidence-Based Practices at Case Western Reserve University
An Evidenced Based Practice (EBP) is an intervention for which there is strong research (randomized clinical trials) demonstrating effectiveness in achieving positive consumer outcomes.
Studies have demonstrated positive outcomes in programs where the most common diagnoses were schizophrenia, schizoaffective disorder, and bipolar disorder and consumers showed substantial functional impairment.
Other studies have documented benefits for consumers with co-occurring substance abuse disorders.
Center for Evidence-Based Practices (CEBP)
Case Western Reserve University
10900 Euclid Avenue
Cleveland, Ohio 44106-7169
216-368-0808
This presentation, based on a University of Florida course on Fixing Patient Responsibility explains the importance of teamwork in healthcare, esp. with respect to saving patients' lives.
Dr Ian Sturgess: Optimising patient journeysNuffield Trust
In this slideshow Dr Ian Sturgess, Director at IMP Healthcare consultancy, explores how we can better understand admitted flow streams and optimise patient journeys.
Dr Sturgess spoke at the Nuffield Trust ‘Reducing the length of stay’ event in September2014.
Presentation to the North Queensland Return to Work Conference in late April 2016. Summarises ISCRR's research on medical certification for return to work and the role of General Practitioners in return to work.
Integrated Care Guidance MUSE Presentation by Dr. WespJacobus Consulting
This presentation addresses evidence-based care and the EHR. It covers designing and delivering education and training programs aimed at accomplishing best practice clinical informatics models throughout healthcare organizations.
Learner Outcome #1: The learner will obtain an understanding of the importance of the relationship between EHR functionality and guiding evidence-based care at the bedside.
Learner Outcome #2: The learner will walk away with governance and processes of engaging clinicians in the evidence-based content customization process
Learner Outcome #3: The learner will be familiar with the advantages of built in evidence-based care guidance within the EHR
Joint Commission defines Disruptive Behavior as “conduct by a health care professional that intimidates others working in the organization to the extent that quality and safety are compromised”.
Research has found that disruptive behavior not only impacts the morale and staffing of an organization but can lead to medical errors and breakdowns in the quality of care, treatment, and services delivered.
Francesca Rubulotta talks about disproportionate care in ICU. Disproportionate care is disproportionate in relation to the expected prognosis.
Moreover, this can lead to moral distress among clinicians who think they are offering inappropriate care. There is mounting research and evidence pointing to the existence of disproportionate care.
Furthermore, stress and burnout cause increased miscommunication and lead to low performance and concentration. Stress leads to absenteeism or in many cases, presenteeism.
Presenteeism is when someone just shows up for work but does the bare minimum. Francesca shows the financial burden caused by absenteeism across various countries.
Francesca points out that only 14% of employees feel engaged in their jobs. Moreover, data shows that companies which keep their employees engaged have higher rates of performance. Such companies have managers who are more engaged and approachable.
Francesca discusses various studies that look at the appropriateness of care in ICU.
She talks about the CONFLICUS, APPROPRICUS and DISPROPICUS studies, all of which point to the moral stress experienced when clinicians are forced to give inappropriate care.
We must ask whether inappropriate care occurred and why. The three major factors influencing the perception of inappropriate care are client related situations, work characteristics and personal characteristics. 27% of healthcare providers (HCP) report at least one of their patients are mismanaged per day. Furthermore, 63% say that inappropriate care happens all the time.
There are multiple reasons for disproportionate care taking place. Studies show that nurses associated inappropriate care to interpersonal factors while physicians ascribed it to prognostic uncertainty.
Francesca discusses the methods used and results obtained in the DISPROPICUS study and self-awareness and individual development in ICU.
According to her, these future studies will help to find solutions to the problems regarding disproportionate care. Evidently, authentic leaders, who can inspire others, are the need of the hour.
For more like this, head to our podcast page. #CodaPodcast
Evelyn Sparks, Acting VP of Professional Practice at The Royal shared her tips for returning to work after taking a leave to recover from a mental illness.
University of Utah Health Improving Wellness: 40 Champions, 20 Projects, 12 M...University of Utah
On December 14, 2017, the Wellness & Integrative Health’s Resiliency Center, Accelerate, and the Spencer S. Eccles Health Sciences Library will presented a Faculty Wellness Poster Session. Each department in the School of Medicine highlighted the past year’s Wellness Champion projects, which were focused on personal resilience, burden reduction, and team work. The poster session demonstrated the work completed so far as the Wellness Champion program is expanded to faculty and staff across U of U Health.
Keeping People Housed
Presentation by Richard Kruszynski, Director of Consultation and Training/Center for Evidence-Based Practices at Case Western Reserve University
An Evidenced Based Practice (EBP) is an intervention for which there is strong research (randomized clinical trials) demonstrating effectiveness in achieving positive consumer outcomes.
Studies have demonstrated positive outcomes in programs where the most common diagnoses were schizophrenia, schizoaffective disorder, and bipolar disorder and consumers showed substantial functional impairment.
Other studies have documented benefits for consumers with co-occurring substance abuse disorders.
Center for Evidence-Based Practices (CEBP)
Case Western Reserve University
10900 Euclid Avenue
Cleveland, Ohio 44106-7169
216-368-0808
This presentation, based on a University of Florida course on Fixing Patient Responsibility explains the importance of teamwork in healthcare, esp. with respect to saving patients' lives.
Australia has one of the most affordable, accessible and comprehensive healthcare systems in the world. The Commonwealth Department of Health and Ageing promotes good health and ensure all Australians have access to key health and family services
L'AOU di Udine partecipa a Dr Foster's Global Comparator Initiative, un benchmarking internazionale tra ospedali universitari. Conferenza di Boston 2011
The Myles Bradbury case - what do we learn and how do we change?Verita
The independent choice for regulated organisations.
Verita is the leading independent consultancy for regulated organisations in the UK. Our work ranges from specialist support and advice on challenging operational and strategic matters to reviews and investigations of complex, sensitive issues.
We are renowned for our thoroughness and commitment to producing evidence-based reports that can withstand rigorous challenge. Our approach is always measured, appropriate and focused on improvement. And by getting it right first time, we save our clients time and money.
The Future of OB Hospitalist Programs: The Unexpected DeliverablesEmCare
You might expect that with an OB hospitalist onsite 24/7, hospitals are better equipped to manage obstetric and gynecologic care and emergencies, providing the ultimate in patient safety while reducing liability and risk. That’s true. But there are unexpected benefits as well.
Wayne L. Farley, Jr., D.O., FACOG, presents “The Future of OB Hospitalist Programs: The Unexpected Deliverables.” This webinar was September 21, 2016, hosted by Becker’s Hospital Review.
Alexander Strachan, Jr., MD, MBA, and Asim Usman, MD, of EmCare Hospital Medicine, discuss bundled payments for care improvement (BPCI) and how hospitalists are leading the charge.
Originally presented May 4, 2016, as a webinar in partnership with Becker's Hospital Review.
PowerPoint: Practical Approaches to Improving Patient Pre-Op PreparationEmCare
Michael Hicks, MD, MBA, FACHE, CEO of EmCare Anesthesia, and Lisa Kerich, PA-C, VP of Operations for EmCare Anesthesia, provide expert advice for improving the performance of your O.R. through an integrated, collaborative approach. Learn how Pre-Anesthesia Testing (PAT) clinics are being used successfully to improve patient readiness, surgeon satisfaction and financial performance.
Originally presented Sept. 17, 2015, as a webinar in partnership with Becker's Hospital Review.
Hardwiring Hospital-Wide Flow To Drive Competitive PerformanceEmCare
Thom Mayer, MD, FACEP, FAAP and Kirk Jensen, MD, MBA, FACEP, authors of “Hardwiring Flow” and “The Patient Flow Advantage, " share their secrets for streamlining processes, changing behaviors, and achieving sustainable advances in hardwiring flow throughout your hospital system.
This presentation is an abridged version of the webinar that Drs. Jensen and Mayer delivered July 9, 2015, in partnership with Becker's Hospital Review.
How one Hospital Shaved Off 88 Minutes from their ALOSEmCare
With goals of getting the right processes and staffing in place, the administration and staff at LewisGale Medical Center in Salem, Virginia put a priority on patient-centered process improvements that would shorten wait times and length of stay in the emergency department (E.D.). Here’s how they improved metrics including decreasing the ED ALOS by 45 percent.
Efficiency in the emergency department is always at the forefront of the minds of hospital leaders -- and for good reason. The infographic below reveals the true cost of inefficiency in the emergency department when it comes to patients who leave without treatment (LWOT) and why hospitals can't afford to leave this issue unaddressed.
OPERATIONAL INTEGRATION: CREATING A HIGH-PERFORMING HEALTHCARE ORGANIZATIONEmCare
What strategies are in your arsenal to combat and conquer the thorny challenges
of healthcare reform? Reducing costs? Improving quality, productivity and efficiency? Redesigning processes? Improving the patient experience? Transforming your organization from one that delivers episodic sick care to one that nurtures wellness and personal responsibility is daunting, but absolutely necessary. While consultants
have prospered by touting the “solution-of-the-day,” a handful of approaches have gained traction. One of those is clinical integration.
Learn how Methodist Richardson Achieved Fastest Total Patient Treatment Time ...EmCare
Methodist Richardson Medical Center (MRMC) and the Richardson Fire Department (RFD) were recognized by the American Heart Association for having the fastest total combined patient treatment time for cardiac events for the first quarter of 2011 for the state of Texas.
Learn how a shift in processes, leadership and culture to an integrated solution can put your hospital on track to achieve improved clinical outcomes, metrics and patient experiences, each of which can have a potentially dramatic financial impact.
[HOW TO] Create High Performance Emergency DepartmentsEmCare
EmCare’s latest White Paper on implementing a system-wide approach to providing emergency care. At Baylor Health Care System, the initiative has fostered the development of numerous approaches to managing the challenges faced by its emergency departments, including an innovative protocol to manage overcrowding at the system’s flagship facility.
Proven Techniques to Boost Lean Implementation in Your Emergency DepartmentEmCare
Six facilities of a national hospital chain located in the Southeast United States teamed up with EmCare® to review recent best practice publications, incorporate individual ideas, implement changes, modify processes and develop a standard best practice recommendation for efficient, quality ED care. The main goal was to satisfy the patient’s primary need in presenting to an ED – the desire to see a physician as soon as possible.
The concepts herein have been proven to work in various size and volume EDs. The following chart outlines the descriptions of the six facilities involved in this effort.
We are all engaged in a hospital-wide a system of
patient flow or patient care. We are each part of the
whole. The emergency department is connected
to the ICU. The ICU is connected to the OR. The
discharge and discharge processes are connected
to our admission capabilities and capacity. It’s
like the “Dry Bones” song you learned as a child,
“The foot bone’s connected to the leg bone, the
leg bone’s connected to the knee bone, the knee
bone’s connected to the thigh bone” and so forth.
Overall flow, or “the system,” can only be improved
by applying several key strategic concepts to these
disparate but equal parts.
Fast and Efficient Practice: The Emergency Department Clinician on the Emerge...EmCare
Patient safety and satisfaction are the focus
within any emergency department. To streamline
navigation on the ED autobahn, i.e., flow, and
thus accomplish these goals most efficiently
can be accomplished by the consideration of
several factors and the application of several
key techniques.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
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Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
- 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
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.