This document summarizes the evaluation of innovation units at a hospital. It describes the evaluation process, data collected, and key findings. An evaluation steering committee oversees the evaluation in 90-day cycles. Data is collected through surveys, interviews, and observations. Findings show positive feedback from patients and staff regarding relationship-based care practices. Opportunities are identified in areas like documenting discharge dates and care team members. Next steps include continuing the evaluation, expanding to more units, and deepening analysis of specific measures to further optimize the innovation units.
Automated, Standardized Reporting of Patient Safety and Quality Measures to E...Edgewater
Edgewater and UPenn presented on "Moving from Volume to Value Based Care" at The World Congress 10th Annual Healthcare Quality Congress, August 2-3, 2012.
Purpose of the Call:
•Recap of aggregated MedRec audit month data that identifies potential opportunities for improvement
•Review quality improvement concepts as it relates to measuring for quality improvement
•Hear how Horizon Health team (NB) is using their data to improve MedRec processes
•Receive a tutorial on how to access your MedRec Quality Score run charts in Patient Safety Metrics.
WATCH: http://bit.ly/1EVcREL
Purpose of the Call:
•Review the results of the Canadian MedRec Audit Month 2015
•Discuss lessons learned from the audit month – strengths and areas for improvement
•Gather ideas about how to improve the quality of MedRec at admission
Purpose of the Call:
Call attendees will learn:
•About the importance of participating in MedRec Quality Audit Month
•How to participate in MedRec Quality Audit Month
•About the use of the MedRec Quality Audit tool (i.e. who should use it and how)
•Tips on the proper use of the tool and the Patient Safety Metrics System
•Where they can access MedRec Quality Audit Month tools and resources
Access the webinar: http://bit.ly/1xVtmDn
How to Eliminate the Burden of Provider Quality Measurement: Able HealthHealth Catalyst
Quality measurement is complicated by incomplete data, calculations, visualizations, and workflows. As a result, quality measurement is a significant burden for medical groups. In fact, research that Health Affairs published in 2016 quantified the burden as 785 hours per provider per year.
That's why Health Catalyst is excited to introduce Able Health, the only quality measures solution that’s truly complete.
In this webinar, you’ll learn how Able Health combines all data, measures, visualizations, and workflows (monitor, improve, and submit) into one complete solution. Eliminating the complexity, and therefore the burden, of provider quality measurement means you spend more time improving performance and less time managing data.
You’ll also learn how each of the three core components of the Able Health solution makes more efficient quality measurement possible:
-Measures engine—calculates performance for all provider quality measures for all payer programs using every available data element.
-Performance dashboard—visualizes all performance metrics for daily tracking, prioritization, and internal reporting for all stakeholders, especially physicians.
-Submission engine—submits compliant data to payers.
Automated, Standardized Reporting of Patient Safety and Quality Measures to E...Edgewater
Edgewater and UPenn presented on "Moving from Volume to Value Based Care" at The World Congress 10th Annual Healthcare Quality Congress, August 2-3, 2012.
Purpose of the Call:
•Recap of aggregated MedRec audit month data that identifies potential opportunities for improvement
•Review quality improvement concepts as it relates to measuring for quality improvement
•Hear how Horizon Health team (NB) is using their data to improve MedRec processes
•Receive a tutorial on how to access your MedRec Quality Score run charts in Patient Safety Metrics.
WATCH: http://bit.ly/1EVcREL
Purpose of the Call:
•Review the results of the Canadian MedRec Audit Month 2015
•Discuss lessons learned from the audit month – strengths and areas for improvement
•Gather ideas about how to improve the quality of MedRec at admission
Purpose of the Call:
Call attendees will learn:
•About the importance of participating in MedRec Quality Audit Month
•How to participate in MedRec Quality Audit Month
•About the use of the MedRec Quality Audit tool (i.e. who should use it and how)
•Tips on the proper use of the tool and the Patient Safety Metrics System
•Where they can access MedRec Quality Audit Month tools and resources
Access the webinar: http://bit.ly/1xVtmDn
How to Eliminate the Burden of Provider Quality Measurement: Able HealthHealth Catalyst
Quality measurement is complicated by incomplete data, calculations, visualizations, and workflows. As a result, quality measurement is a significant burden for medical groups. In fact, research that Health Affairs published in 2016 quantified the burden as 785 hours per provider per year.
That's why Health Catalyst is excited to introduce Able Health, the only quality measures solution that’s truly complete.
In this webinar, you’ll learn how Able Health combines all data, measures, visualizations, and workflows (monitor, improve, and submit) into one complete solution. Eliminating the complexity, and therefore the burden, of provider quality measurement means you spend more time improving performance and less time managing data.
You’ll also learn how each of the three core components of the Able Health solution makes more efficient quality measurement possible:
-Measures engine—calculates performance for all provider quality measures for all payer programs using every available data element.
-Performance dashboard—visualizes all performance metrics for daily tracking, prioritization, and internal reporting for all stakeholders, especially physicians.
-Submission engine—submits compliant data to payers.
Purpose of the Webinar
1.Describe the process of developing an undergraduate MedRec IPE Event involving > 480 senior Medicine, Pharmacy and Nursing students;
2.Explain the logistics of conducting the event in multiple venues and urban/remote locations;
3.Discuss the successes and challenges of communicating MedRec patient safety concepts through this process; and
4.Describe future opportunities for enhancing undergraduate MedRec training in an interprofessional environment.
Watch the webinar recording: http://bit.ly/1fSqsqv
Objectives
1.Understand the importance of measurement in driving improvement
2.Introduce Patient Safety Metrics: a cloud-based tool for data collection and performance monitoring.
3.Demonstrate new auditing tools designed to reduce the burden of measurement
4.Outline the application of Patient Safety Metrics beyond Safer Healthcare Now!
Purpose of the Call:
•Review the results of the Canadian MedRec Audit Month
•Discuss lessons learned from the audit month – strengths and areas for improvement
•Suggest future value of audits and audit tools for your organization
•Gather ideas about how to improve the quality of MedRec at admission
Watch the recorded webinar: http://bit.ly/19aUYbU
Reviewing the Healthcare Analytics Adoption Model: A Roadmap and Recipe for A...Health Catalyst
Dale Sanders provides an update on the Healthcare Analytics Adoption Model. Dale published the first version of this model in 2002, calling it the Analytics Capability Maturity Model. The three intentions at that time are the same as they are today: 1) Provide healthcare leaders with a clear roadmap for the progression of analytic maturity in their organization. 2) Provide vendors with a roadmap to meet the analytic needs of clients. 3) Create a common framework to benchmark the progressive adoption of analytics at the industry level.
In 2012, Dale co-published a new version of the Model with Dr. Denis Protti, rebranding it the Healthcare Analytics Adoption Model and purposely borrowing from the widespread adoption of the EMR Adoption Model (EMRAM) published and supported by HIMSS. In 2015, Dale transferred the model under a creative commons copyright to HIMSS to create a vendor-independent industry standard that is now widely applied to support the original three intentions. He continues to collaborate with HIMSS to progress the Model.
During this webinar, Dale:
-Reviews the current state of the Health Catalyst Model, including recent changes that advocate a ninth level—direct-to-patient analytics and AI.
-Shares his observations of maturity in the market.
-Provides an update on the current state of the HIMSS Adoption Model for Analytic Maturity.
Purpose of the Call:
Change is challenging and getting staff clinicians and physicians to participate in quality improvement initiatives is often a struggle. Understanding the clinical perspective and developing effective change strategies can help.
By the end of this session participants will:
•understand why it is often difficult to engage with clinicians and physicians
•learn how to assess their change strategies for adoptability
•gain experience with the Highly Adoptable Improvement Model and Toolkit
Watch the webinar http://bit.ly/1A0mxOR
Healthcare Delivery Reimagined: Patient Flow and Care Coordination AnalyticsAdrish Sannyasi
Come to learn how Splunk’s data analytics platform could be utilized to solve many high impact business problems in healthcare delivery systems to reduce cost, improve patient outcome and safety, and enhance care coordination experience. Analyze observed behavior from healthcare event data and metadata to discover patterns, monitor compliance, and optimize the workflow. Furthermore 80% of healthcare data is unstructured (clinical free text and documentation), or semi-structured and many new data sources are such as tele health, mobile health, sensors, and devices are getting integrated in many healthcare systems specifically in the area of chronic disease management. So, one need analytics software that can harvest, interpret, enrich, normalize, and model diverse structured and unstructured data and analytics approaches that embrace the “data turmoil” by relying less on standardized data items and more on the capability to process data in any format.
Evidence Based Clinical Decision Support – An Enabler for Clinicians in 21st Century by Dr. Lalit Singh, Director for Content & Product Strategy, Elsevier, India
Katherine Howell, MBA, BSN, RN, NEA-BC, Senior Vice President and Chief Nurse Executive, Saint Luke's Health System - Presentation delivered at the marcus evans National Healthcare CNO Summit 2016 held in Las Vegas, NV
How to Prepare to For the HIMSS Value ScoreAdam Bazer
This presentation provides information on the features and benefits of the HIMSS Value Score, how to prepare your organization for completing a HIMSS Value Score, and who to contact for more information on how to leverage your HIMSS Value Score in your strategic planning processes
Purpose of the Call:
•Introduce the quality audit month
•Describe front line experience with using audit tool and key learning
•Respond to questions about the tool and the audit month
Information Management for Health Care Group E Presentation
Building Consensus for Electronic Health Records
Jacksonville University Online School Nursing NUR353
Early benefits and impacts of Electronic Patient Record implementation: Findings from the UK. Presented by Steven Shaha, Center for Policy & Public Administration, UK, at HINZ 2014, 11 November 2014, 12pm, Marlborough Room 3
Purpose of the Call:
•Speakers from AHS will share:
•AHS’ approach to measurement for improvement (MedRec)
•Lessons learned throughout our measurement journey
•Their approach to using data to drive change at the frontline
Industry Perspectives and Future Trends in Population HealthRohan DSouza
Presentation on industry perspectives on the future of population health management. This is a talk I gave at the eClinicalWorks National Users Conference in Nashville, TN (2015). With a lot of buzz surrounding pop health programs, I wanted to provide a roadmap on making the switch and succeeding.
Purpose of the Webinar
1.Describe the process of developing an undergraduate MedRec IPE Event involving > 480 senior Medicine, Pharmacy and Nursing students;
2.Explain the logistics of conducting the event in multiple venues and urban/remote locations;
3.Discuss the successes and challenges of communicating MedRec patient safety concepts through this process; and
4.Describe future opportunities for enhancing undergraduate MedRec training in an interprofessional environment.
Watch the webinar recording: http://bit.ly/1fSqsqv
Objectives
1.Understand the importance of measurement in driving improvement
2.Introduce Patient Safety Metrics: a cloud-based tool for data collection and performance monitoring.
3.Demonstrate new auditing tools designed to reduce the burden of measurement
4.Outline the application of Patient Safety Metrics beyond Safer Healthcare Now!
Purpose of the Call:
•Review the results of the Canadian MedRec Audit Month
•Discuss lessons learned from the audit month – strengths and areas for improvement
•Suggest future value of audits and audit tools for your organization
•Gather ideas about how to improve the quality of MedRec at admission
Watch the recorded webinar: http://bit.ly/19aUYbU
Reviewing the Healthcare Analytics Adoption Model: A Roadmap and Recipe for A...Health Catalyst
Dale Sanders provides an update on the Healthcare Analytics Adoption Model. Dale published the first version of this model in 2002, calling it the Analytics Capability Maturity Model. The three intentions at that time are the same as they are today: 1) Provide healthcare leaders with a clear roadmap for the progression of analytic maturity in their organization. 2) Provide vendors with a roadmap to meet the analytic needs of clients. 3) Create a common framework to benchmark the progressive adoption of analytics at the industry level.
In 2012, Dale co-published a new version of the Model with Dr. Denis Protti, rebranding it the Healthcare Analytics Adoption Model and purposely borrowing from the widespread adoption of the EMR Adoption Model (EMRAM) published and supported by HIMSS. In 2015, Dale transferred the model under a creative commons copyright to HIMSS to create a vendor-independent industry standard that is now widely applied to support the original three intentions. He continues to collaborate with HIMSS to progress the Model.
During this webinar, Dale:
-Reviews the current state of the Health Catalyst Model, including recent changes that advocate a ninth level—direct-to-patient analytics and AI.
-Shares his observations of maturity in the market.
-Provides an update on the current state of the HIMSS Adoption Model for Analytic Maturity.
Purpose of the Call:
Change is challenging and getting staff clinicians and physicians to participate in quality improvement initiatives is often a struggle. Understanding the clinical perspective and developing effective change strategies can help.
By the end of this session participants will:
•understand why it is often difficult to engage with clinicians and physicians
•learn how to assess their change strategies for adoptability
•gain experience with the Highly Adoptable Improvement Model and Toolkit
Watch the webinar http://bit.ly/1A0mxOR
Healthcare Delivery Reimagined: Patient Flow and Care Coordination AnalyticsAdrish Sannyasi
Come to learn how Splunk’s data analytics platform could be utilized to solve many high impact business problems in healthcare delivery systems to reduce cost, improve patient outcome and safety, and enhance care coordination experience. Analyze observed behavior from healthcare event data and metadata to discover patterns, monitor compliance, and optimize the workflow. Furthermore 80% of healthcare data is unstructured (clinical free text and documentation), or semi-structured and many new data sources are such as tele health, mobile health, sensors, and devices are getting integrated in many healthcare systems specifically in the area of chronic disease management. So, one need analytics software that can harvest, interpret, enrich, normalize, and model diverse structured and unstructured data and analytics approaches that embrace the “data turmoil” by relying less on standardized data items and more on the capability to process data in any format.
Evidence Based Clinical Decision Support – An Enabler for Clinicians in 21st Century by Dr. Lalit Singh, Director for Content & Product Strategy, Elsevier, India
Katherine Howell, MBA, BSN, RN, NEA-BC, Senior Vice President and Chief Nurse Executive, Saint Luke's Health System - Presentation delivered at the marcus evans National Healthcare CNO Summit 2016 held in Las Vegas, NV
How to Prepare to For the HIMSS Value ScoreAdam Bazer
This presentation provides information on the features and benefits of the HIMSS Value Score, how to prepare your organization for completing a HIMSS Value Score, and who to contact for more information on how to leverage your HIMSS Value Score in your strategic planning processes
Purpose of the Call:
•Introduce the quality audit month
•Describe front line experience with using audit tool and key learning
•Respond to questions about the tool and the audit month
Information Management for Health Care Group E Presentation
Building Consensus for Electronic Health Records
Jacksonville University Online School Nursing NUR353
Early benefits and impacts of Electronic Patient Record implementation: Findings from the UK. Presented by Steven Shaha, Center for Policy & Public Administration, UK, at HINZ 2014, 11 November 2014, 12pm, Marlborough Room 3
Purpose of the Call:
•Speakers from AHS will share:
•AHS’ approach to measurement for improvement (MedRec)
•Lessons learned throughout our measurement journey
•Their approach to using data to drive change at the frontline
Industry Perspectives and Future Trends in Population HealthRohan DSouza
Presentation on industry perspectives on the future of population health management. This is a talk I gave at the eClinicalWorks National Users Conference in Nashville, TN (2015). With a lot of buzz surrounding pop health programs, I wanted to provide a roadmap on making the switch and succeeding.
To increase the effectiveness of the incident analysis in improving care, analysis can’t be addressed in isolation from incident management (the multitude of activities that take place before and after an incident). Three main topics will be covered in this module: the main steps in the incident management continuum; differentiating between incident analysis (focused on system improvement) and accountability reviews (focused on individual performance), and selecting an incident analysis method.
TEST BANK For Critical Thinking, Clinical Reasoning, and Clinical Judgment A ...rightmanforbloodline
TEST BANK For Critical Thinking, Clinical Reasoning, and Clinical Judgment A Practical Approach 7th Edition by Rosalinda Alfaro-LeFevre, Verified Chapters 1 - 7, Complete Newest Version.
TEST BANK For Critical Thinking, Clinical Reasoning, and Clinical Judgment A Practical Approach 7th Edition by Rosalinda Alfaro-LeFevre, Verified Chapters 1 - 7, Complete Newest Version.
TEST BANK For Critical Thinking, Clinical Reasoning, and Clinical Judgment A Practical Approach 7th Edition by Rosalinda Alfaro-LeFevre, Verified Chapters 1 - 7, Complete Newest Version.
TEST BANK For Critical Thinking, Clinical Reasoning, and Clinical Judgment A ...robinsonayot
TEST BANK For Critical Thinking, Clinical Reasoning, and Clinical Judgment A Practical Approach 7th Edition by Rosalinda Alfaro-LeFevre, Verified Chapters 1 - 7, Complete Newest Version.pdf
TEST BANK For Critical Thinking, Clinical Reasoning, and Clinical Judgment A Practical Approach 7th Edition by Rosalinda Alfaro-LeFevre, Verified Chapters 1 - 7, Complete Newest Version.pdf
Making Healthcare Waste Reduction and Patient Safety Actionable - HAS Session 6Health Catalyst
Multiple studies have estimated that at least 30% of US healthcare expenditures are wasteful. But how do you identify and reduce that waste? In this session, we will share with you a three-part framework for understanding, measuring and addressing waste reduction. In particular, we will highlight the importance patient safety and injury prevention, framing the importance of shifting from a system of incident reporting (which creates a culture of blame and guilt) to a system in which patient injury is regarded as a process failure rather than a person failure. To make that transition, health systems will need to 1) define process flows and metrics for each major type of patient injury; and 2) create a learning environment in which team members are engaged in process redesign to prevent process failure and injury. A leading health system in patient safety and quality will also share their best practices in how they have created a culture of patient safety and quality.
Clinician Satisfaction Before and After Transition from a Basic to a Comprehe...Allison McCoy
Healthcare organizations are transitioning from basic to comprehensive electronic health records (EHRs) to meet Meaningful Use requirements and improve patient safety. Yet, full adoption of EHRs is lagging and may be linked to clinician dissatisfaction. In depth assessment of satisfaction before, during, and after EHR transition is rarely done. Using an adapted published tool to assess adoption and satisfaction with EHRs, we surveyed clinicians at a large, non-profit academic medical center before (baseline) and 6-12 months (short-term follow-up) and 12-24 months (long-term follow-up) after transition from a basic, locally-developed to a comprehensive, commercial EHR. Satisfaction with the EHR (overall and by component) was captured at each interval. Overall satisfaction was highest at baseline (85%), lowest at short-term follow-up (66%), and increasing at long-term follow-up (79%). This trend was similar for satisfaction with EHR components designed to improve patient safety including clinical decision support, patient communication, health information exchange, and system reliability. Conversely, at baseline, short-term and long-term follow-up, perceptions of productivity, ability to provide better care with the EHR, and satisfaction with available resources, were lower at both short- and long-term follow-up compared to baseline. Persistent dissatisfaction with productivity and resources was identified. Addressing determinants of dissatisfaction may increase full adoption of EHRs. Further investigation in larger populations is warranted.
The mission statement sets the direction and priority for developing and implementing the quality plan. It clearly states the nature of the organization’s commitment to quality and should then be tied to the organizational operations through programs, projects, actions and rewards/recognition.
Measuring “Culture of Safety” Tawam’s Experience
Discovery:
Tawam Hospital’s Executive leadership realized the need to establish a “Culture of Safety” within the organization and implemented the Johns Hopkins Medicine “Comprehensive Unit based Safety Program” (CUSP). CUSP was introduced as a pilot project in the Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NNU) and Paediatric Oncology Unit (Peds Onc).
Prior to implementation the leadership decided to measure staff perception of safety using evidence based tool.
Solution:
Tawam partnered with Pascal Metrics to implement the Safety Attitude Questionnaire survey. The SAQ was administered to all Tawam Hospital staff in three phases (2008, 2010 and 2011). In 2010 the pilot CUSP units were also resurveyed to determine the status of safety culture since its introduction in 2008.
An email from the CEO was sent to the participants encouraging them to participate in the SAQ survey.
Physicians, nurses, ward-clerks; respiratory therapist, physiotherapist, dieticians etc were included in the survey.
Those who spent at least 50% of their time in the identified units were only included to participate in the survey.
Survey was administered during departmental meetings to increase response rate.
Conducted separate sessions of physicians.
Staff dropped the completed surveys in an envelope.
82% of staff in the patient care areas of the whole hospital participated in the overall 3 phases of SAQ Survey.
The three CUSP pilot units were re-surveyed in 2010.
Anonymity, privacy and confidentiality were maintained from the beginning till the end.
Outcome:
The survey results were graded against percentage positive responses. Responses that were less than 60% mark were graded in the danger zone and anything above the 80% mark were graded in the goal zone. Teamwork climate and Safety climate scale scores are considered to be primary dependent variables, because they are important in preventing patient harm.
The overall hospital score on all the domain scores were in the danger zone, less than 60%. 20 clinical locations in 2010 and 7 clinical locations in 2011 had less than 60% scores in the primary dependent variables.
The SAQ results were disseminated department wise in the presence of a hospital Senior Executive. Every department did an action plan using the SAQ de-briefer tool. The hospital administrators to bring about the change played a facilitators role and helped the departments to come up with their actionable plans.
The hospital leadership in their pursuit to continuing the culture of safety journey, identified six more units for CUSP implementation based on the Phase 2 SAQ scores of 2010. Accordingly the Medical 1, Medical 2, Surgical 1, Surgical 2, Day Case and OBGYN Units were identified for the CUSP roll out. Senior Executive leaders were assigned to each of these new CUSP units to ensure leadership commi
Fully meeting the needs of those who need the service most, at the lowest cost to the organization, within limits and directives set by higher authority
How can you extend current uses of Lean Six Sigma beyond process but to incorporate empathy building? Join Jill Secord, RN, MBA, who will explore effective integration of proven approaches to accelerate quality and efficient health care services.
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
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.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Evaluating Change and Tracking Improvement
1. Evaluating Innovation:
Moving Toward the New Paradigm
of Care Delivery
Jeffrey M. Adams, PhD, RN
Director, Center for Innovations in Care Delivery
Connell Nursing Research Scholar
October 2013
1
2. EVALUATION STEERING COMMITTEE
Gaurdia Banister
Annie Kingsley
Marianne Ditomassi
Linda Lacke
Rick Evans
Bret O’Flaherty
Brian French
Robin Lipkis-Orlando
Amy Giuliano
Colleen Snydeman
Dorothy Jones
Jeff Adams
2
3. Innovation is…?????
Haircuts
Soda
Airlines
Garden Utensils
Hardwood Flooring
Automobiles
Laundry Detergent
Source: Adams JM. (in press) Guest Editorial: How do we know if we’re innovating? A strategy for
innovation evaluation in a practice setting. Journal of Nursing Administration.
3
6. “Patient Journey” Framework
Before
Preadmission
Care
During
Admission
Process: ED,
Direct Admits,
Transfers
Patient Stay;
Direct Patient Care, Tests,
Treatments, Procedures,
Clinical Support,
Operational Support
Post
Discharge
Process
Support Functions: Finance, Information Systems, HR
Goal: High-performing interdisciplinary teams that deliver safe, effective, timely,
efficient and equitable care that is patient and family centered.
Where Are There Opportunities to Reduce Costs Across These Processes of Care?
6
Post
Discharge
Care
7. INNOVATION UNIT EXPERIENCES SURVEY
“The MGH Innovation Units Program was developed as a frontline
initiative to address the gaps in the continuum of care and utilize the
expertise of all clinical disciplines to improve the patient experience,
quality of care, staff satisfaction and empowerment while decreasing
redundancy, costs, length of stay and readmission rates.”
Source: Ives Erickson J, Ditomassi M, Adams JM. (2012) Innovations in Care Delivery: A Blueprint for
the Future. Nursing Economic$ 30(5): 282-287.
7
8. MGH PCS’s Approach
Innovation Cluster
Focus Areas *
Interventions **
Evaluation
(Pre, During, Post)
Throughout Admission
Relationship-Based Care
Attending Nurse
Handover Rounding Checklist
Patient Engagement
Quantitative
•HCAHPS
Pre-Admission
•Leadership Influence
over Professional
Practice Environments
(LIPPES)
Pre-Admit Data Collection
Welcome Packet
During Admission
Roles & Structures
Education
Communication
Domains of Practice
Interdisciplinary Rounds
Business Cards
Quiet Hours
Hourly Rounding
Electronic White Boards
In Room White Boards
Smart Phones
Hand Held/ Tablets
Post-Discharge
Discharge Follow-up Phone Calls
Others as identified
•Quality Indicators
•Patients Perceptions
of Feeling Known
(PPFKN)
•Readmissions
•Focus Groups
(Staff, Patients,
Families, etc)
•Observations
•Survey of the
Innovation Unit
Expectations
(SIUE-pre)
•Survey of the
Innovation Unit
Experiences
(SIUE-post)
•Revised Perceptions
of Practice
Environment Scale
(RPPE)
•Cost per Case Mix
* The clusters are a lens
with which we gain
perspective on any
particular intervention.
8
•LOS
Qualitative
•Staff Retention
Other measures as identified
** May apply to any or all 3 of the cluster focus areas
June 2013
11. Why is this Innovation Unit Evaluation complex?
•
Aimed at understanding successes & challenges of structures
processes and outcomes of care delivery AND the evaluation process
itself.
•
Telling the story in context of the immediate, while tracking
longitudinally to optimize sustainability.
•
All while the ship is sailing…
•
Different than research
11
12. The Process
Innovation Evaluation (90-Day Cycle)
Day 1-30
Day 31-60
Day 61-90
Source: Institute for Healthcare Improvement (2013)
12
13. So what are we finding?
•
Three examples of how and what we’re finding…
– Idea Books
– Innovation Unit Experiences Survey
– Innovation Unit Interventions Sustainability Checklist
13
16. Analysis of the data yielded five interrelated themes:
1. Feeling prepared: “There was ample support and pre-education.”
2. Innovation: “A complete change of culture.”
3. Managing Challenges and Concerns: “It has been very challenging.”
4. The Attending RN: “The glue for nursing care.”
5. Benefits to patients and families: “The impact on patient care is worth it all.”
16
19. PATIENT/ FAMILY INTERVIEW
Do you have an Attending Nurse?
Phase I Only
Phase II Only
Phase I & II
Yes
59%
57%
58%
No
41%
43%
42%
If YES, was patient/family able to provide a name?
Yes
85%
57%
66%
No
15%
43%
34%
Did you receive an ARN Business Card?
Yes
36%
47%
No
64%
53%
57%
Do the nurses, doctors, and other staff make you feel like you
are part of the team?
Yes
100%
94%
96%
No
0%
6%
4%
Do you have a Discharge Envelope/Checklist?
Yes
47%
49%
48%
No
53%
51%
52%
If YES, is there a discharge date noted in the space provided?
Yes
0%
21%
14%
No
100%
79%
86%
Do you have a copy of the Patient & Family Notebook?
Yes
55%
53%
54%
No
45%
47%
46%
If YES, has it been helpful to you?
Yes
27%
73%
58%
*
No
73%
27%
42%
*
*
43%
*
*
20. Phase I Only
PATIENT/ FAMILY INTERVIEW
Phase II Only
Phase I & II
When someone comes in to check on you: Do they ask
about your pain?
Yes
96%
92%
93%
No
4%
8%
7%
When someone comes in to check on you: Do they ask you
whether you need to go to the bathroom?
Yes
54%
58%
57%
No
46%
42%
43%
When someone comes in to check on you: Do they ask you if
you need to change position and if you are comfortable?
Yes
71%
84%
80%
No
29%
16%
20%
When someone comes in to check on you: Do they ask you if
you need anything else before they leave the room?
Yes
96%
96%
96%
No
4%
4%
4%
Has your call bell been answered promptly?
Yes
92%
86%
88%
No
8%
14%
12%
*
*
*
*
21. Phase I Only
STAFF INTERVIEW OR OBSERVATION
Phase II Only
Phase I & II
Can you tell me the purpose of the Attending Nurse role?
Yes
100%
100%
100%
No
0%
0%
0%
Can you share an example of Relationship-based Care
that has occurred on the unit?
Yes
96%
90%
92%
No
4%
10%
8%
Do Interdisciplinary Rounds occur at a regular scheduled
time on your unit?
Yes
83%
98%
93%
No
17%
2%
7%
The Electronic White Board is utilized on the unit.
(Phase I and Lunder only).
Yes
92%
93%
92%
No
8%
7%
8%
Voaltés are utilized on the unit.
Yes
100%
100%
100%
No
0%
0%
0%
Hourly Rounding (Safety Rounds) occur on the unit.
Yes
100%
90%
93%
No
0%
10%
7%
*
*
*
*
*
*
22. Phase I
Only
OBSERVATION - IN-ROOM WHITE BOARD
Phase II
Only
Phase
I & II
100%
89%
93%
Patient Name
Complete & Accurate
Complete / Not Accurate
0%
0%
0%
Not Complete
0%
11%
7%
Date
Complete & Accurate
92%
79%
83%
Complete / Not Accurate
4%
19%
14%
Not Complete
4%
2%
3%
Nurse Name
Complete & Accurate
92%
82%
85%
Complete / Not Accurate
4%
16%
12%
Not Complete
4%
2%
3%
Physician Name
Complete & Accurate
65%
30%
43%
Complete / Not Accurate
4%
2%
3%
Not Complete
31%
68%
54%
Other Members of the Care Team (s)
Complete & Accurate
50%
76%
68%
Complete / Not Accurate
0%
0%
0%
Not Complete
50%
24%
32%
Estimated Discharge Date
Complete & Accurate
17%
13%
14%
Complete / Not Accurate
0%
2%
2%
Not Complete
83%
85%
84%
Goals for the Day
Complete & Accurate
68%
48%
54%
Complete / Not Accurate
0%
2%
2%
Not Complete
32%
50%
44%
*
*
*
*
*
*
*
23. OBSERVATION - PATIENT FACE SHEET
Phase I Only
Phase II Only
Phase I & II
Pre-Admission Estimated Length of Stay was identified
Yes
20%
26%
24%
No
80%
74%
76%
Estimated Discharge Date was identified
Yes
15%
0%
4% err
No
85%
100%
96%
Discharge Disposition was identified
Yes
9%
0%
3%
No
91%
100%
*
97%
OBSERVATION/STAFF REPORT –
QUIET HOURS
Phase I Only
Phase II Only
*
*
Phase I & II
Do Quiet Hours occur on the unit?
Yes
97%
92%
100%
No
3%
8%
0%
Quiet Hours signage is visible on the unit?
Yes
89%
92%
88%
No
11%
8%
12%
*
*
24. Positive:
Patient
Do nurse, doctors and others make you feel part of the team?
When someone comes in to check on you do they ask about – your pain?
When someone comes in to check on you do they ask if your are
comfortable and want to change position?
When someone comes in to check on you do they ask if you need anything
else before they leave the room?
Has your call bell been answered promptly?
Staff
Can you tell me the purpose of ARN role?
Can you share an example of Relationship Based Care?
Do interdisciplinary rounds occur at a regularly scheduled time?
Observation
Electronic White Boards utilized on unit (Phase 1 and Lunder only)?
Voaltés are utilized on the unit?
In Room White Board – Patient Name Complete?
Quiet Hours signage is visible?
24
Observed or Reported
Quiet Hours occur on the unit?
Hourly Rounding occurs on the unit?
25. Opportunities: Observation
D/C Envelope – if yes is a D/C date noted?
In Room White Board – Physician Name?
In Room White Board – Care Team Members Names?
In Room White Board – Estimated Discharge Date?
In Room White Board – Goals for the Day?
Face Sheet – Pre-admit expected LOS?
Face Sheet – EDD?
Face Sheet – Discharge disposition?
Aggregate data for Phase 1 and Phase 2
25
27. Next Steps for Evaluation
Continued evaluation in the 90-Day Cycle
Inclusion of Phase 3 and Phase 4 Units
Adjustment of measures based on Evaluation Steering Committee
Recommendations (i.e., deep dive: Estimated D/C Date, White Boards, Face Sheet)
Increased evaluation of ARN role
Increased transdisciplinary team input (regular meetings/groups soliciting insights)
Coordinate longitudinal data management (research)
Developing an Innovation Evaluation Manual
Publish, present, publish, present, repeat
27
28. MASSACHUSETTS GENERAL HOSPITAL
PATIENT CARE SERVICES
Including
Mechanisms of Evaluations
Data Elements
Instruments
Questions
Timelines
Dashboard examples
Observation Checklist
Number of Resources Needed
28
29. To identify the new paradigm
• Evaluate trends
• Build for research
• Utilize evidence to make
decisions
• Adopt, Adapt & Abandon
• Disseminate work
29
30. Nursing Director Survey Quote:
“Managing the new [innovation] processes is
time consuming. Communication to other staff
is ongoing. I feel I’ve answered the question,
‘What is this all about?’ too many times.
But…the impact on patient care is worth it all.”
30