Strategic priorities in Patient Safety. Philip Hassen. IV International Conference on Patient Safety. (Madrid, Ministry of Health and Consumer Affairs, 2008)
Purpose of the call:
•Review current data and state of the SSCL
•Discuss the role of communications and team work in patient safety
•Discuss and define how we can measure the effectiveness of the SSCL.
Read more and watch the webinar recording: http://bit.ly/1sXDqaZ
Patient safety is the absence of preventable harm to a patient during the process of health care and reduction of risk of unnecessary harm associated with health.
Patient safety is the cornerstone of high-quality healthcare services. In the presentation, A summary of the frameworks & practical approaches to improve safety of patient care.
Most frameworks involving a “culture of safety” place patients at the center of the care delivery model (Sammer & James, 2011). In view of health policy, Ostrom (2007) stated that frameworks are meant to organize inquiry through identification of elements and potential relationship, but not intended to specifically test, explain, or predict behavioral outcomes or strengths of association as theory would test. In the healthcare setting patients occupy the center prominence of our safety efforts; however, we offer that care providers play an equally important role in optimizing patient safety and caregivers hold a position of equivalent actors in such frameworks. Furthermore, extrinsic factors such as government agencies are at times excluded in these discussions and some frameworks are structurally complex making it difficult for end users to retain, remember, and apply concepts consistently in practice.
Although a culture of safety is serious business (Denham, 2007a), it does not have to be implemented with a grim face. Joy and spirit of caregiving is also linked to patient safety. Joy comes from witnessing successful patient outcomes, and seeing the patient and family experiences of their healing journey (Hinz, 2011). Leape (2013) offers that joy and meaning will be created when the care providers feel valued, safe from harm, and being part of the solutions for change.
How then do we approach a complex system framework, such as patient safety, with a program that is meaningful, sustainable, and consistently recognizable, if not marketable, to the bedside caregivers? We have found that correlation of thoughts plays a significant role in retention and recognition of information for our multicultural staff. Gigerenzer (2007) posited that the strength of recognition surpasses that of simple recall in humans. When recall memory is impaired, recognition memory often remains (Gigerenzer, 2007, p. 111).
One way to strengthen recognition and information recall is through the use of mnemonics (Bakken & Simpson, 2011). Mnemonics encode complex information in which unfamiliar information to be learned is linked with known information, pictures, or symbols (Bakken & Simpson, 2011). Visual cues and auditory reminders enhance meaningfulness of new information and promote overall strength of association between novel learning and known or familiar patterns (Mastropieri, 1988).
Strategic priorities in Patient Safety. Philip Hassen. IV International Conference on Patient Safety. (Madrid, Ministry of Health and Consumer Affairs, 2008)
Purpose of the call:
•Review current data and state of the SSCL
•Discuss the role of communications and team work in patient safety
•Discuss and define how we can measure the effectiveness of the SSCL.
Read more and watch the webinar recording: http://bit.ly/1sXDqaZ
Patient safety is the absence of preventable harm to a patient during the process of health care and reduction of risk of unnecessary harm associated with health.
Patient safety is the cornerstone of high-quality healthcare services. In the presentation, A summary of the frameworks & practical approaches to improve safety of patient care.
Most frameworks involving a “culture of safety” place patients at the center of the care delivery model (Sammer & James, 2011). In view of health policy, Ostrom (2007) stated that frameworks are meant to organize inquiry through identification of elements and potential relationship, but not intended to specifically test, explain, or predict behavioral outcomes or strengths of association as theory would test. In the healthcare setting patients occupy the center prominence of our safety efforts; however, we offer that care providers play an equally important role in optimizing patient safety and caregivers hold a position of equivalent actors in such frameworks. Furthermore, extrinsic factors such as government agencies are at times excluded in these discussions and some frameworks are structurally complex making it difficult for end users to retain, remember, and apply concepts consistently in practice.
Although a culture of safety is serious business (Denham, 2007a), it does not have to be implemented with a grim face. Joy and spirit of caregiving is also linked to patient safety. Joy comes from witnessing successful patient outcomes, and seeing the patient and family experiences of their healing journey (Hinz, 2011). Leape (2013) offers that joy and meaning will be created when the care providers feel valued, safe from harm, and being part of the solutions for change.
How then do we approach a complex system framework, such as patient safety, with a program that is meaningful, sustainable, and consistently recognizable, if not marketable, to the bedside caregivers? We have found that correlation of thoughts plays a significant role in retention and recognition of information for our multicultural staff. Gigerenzer (2007) posited that the strength of recognition surpasses that of simple recall in humans. When recall memory is impaired, recognition memory often remains (Gigerenzer, 2007, p. 111).
One way to strengthen recognition and information recall is through the use of mnemonics (Bakken & Simpson, 2011). Mnemonics encode complex information in which unfamiliar information to be learned is linked with known information, pictures, or symbols (Bakken & Simpson, 2011). Visual cues and auditory reminders enhance meaningfulness of new information and promote overall strength of association between novel learning and known or familiar patterns (Mastropieri, 1988).
Hello Everyone :)
I hope this presentation will help us to:
Understand the system-based causes of medication errors.
Describe a model for a systems approach to error analysis.
Identify weaknesses or failures in key elements of the medication-use system.
Select effective risk-reduction strategies to prevent medication errors.
These are the slides from a presentation by Dr. David Fairchild, CMO of Tufts Medical Center, and Dan Dunlop, president of Jennings, a healthcare marketing agency. To visit Dan's blog go to http://thehealthcaremarketer.wordpress.com.
Accident Investigations - Blame and Shame or Listen and Learn? SAMTRAC International
Are all accidents preventable? Steve Woodward walks NOSHCON 2015 attendees through the seven delusions under which safety officials function, and challenges outdated, unsafe habits.
Simple and Safe Approaches Towards Patient SafetyEhi Iden
A conference presentation on simple approaches and steps in achieving and managing patient safety in health. It talks about team approach, mutual support, just system, leadership commitment, complications of blame game and case study of the popular Kimberly Hiatt story.
Training slides of Environmental Risk Management addressing issues on the importance of preserving the nature while doing business. Some important highlights:
- Environmental Risk Assessment
- Environmental Degradation
- Disaster Risk Management
- Environment & Sustainability
- Environmental Management Plan
Contact us for further information regarding the training course: info@asia-masters.com
Free book on patient safety by Dr Aniruddha Malpani
Medical errors can be a nightmare – both for patients, and for doctors. However, this is one of those topics which we prefer to sweep under the carpet, because it can be so emotionally charged.
This book provides a holistic overview of medical errors from multiple perspectives. Doctors, nurses, pharmacists, other healthcare providers, pharmaceutical companies, insurers and patients themselves all need to work together to promote patient safety.
Starting with the basics as to why medical errors are still so common, this book highlights what needs to be done to keep patients safe. Reading this book may help to save your life, or that of a loved one. If you are a patient, please read it before you go to the doctor . If you are a doctor, please read it before you see your next patient !
Safety Event Analysis Teams (SEAT) comprised of believers & opinion builders. The team identified defects from the event reports. Implemented systems changes to reduce the probability of recurring. At least one defect was investigated each month.
The implications of SEAT were, staff came open and reported the incidents. It helped institute a Fair and Just Culture. Investigation examined the processes and not just people. Staff share their experiences with other CUSP units. SEAT helped turn these staff in to champions
In the presentation, a summary of initiatives to be taken by hospitals in different areas for patient safety have been described for the knowledge, practices and implementation of patient safety initiative by hospital managers/Administrators.
Professional Association MembershipExamine the importance ofdavieec5f
Professional Association Membership
Examine the importance of professional associations in nursing. Choose a professional nursing organization that relates to your specialty area, or a specialty area in which you are interested. In a 750-1,000 word paper, provide a detailed overview the organization and its advantages for members. Include the following:
Describe the organization and its significance to nurses in the specialty area. Include its purpose, mission, and vision. Describe the overall benefits, or "perks," of being a member.
Explain why it is important for a nurse in this specialty field to network. Discuss how this organization creates networking opportunities for nurses.
Discuss how the organization keeps its members informed of health care changes and changes to practice that affect the specialty area.
Discuss opportunities for continuing education and professional development.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
References:
Explore the Advocacy page of the American Nurses Association (ANA) website.
URL:
https://www.nursingworld.org/practice-policy/advocacy/
Read Chapter 5 in
Dynamics in Nursing: Art and Science of Professional Practice.
URL:
https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/dynamics-in-nursing_art-and-science-of-professional-practice_1e.php
this is the chapter 5
By June Helbig
“… nurses provide services that maintain respect for human dignity and embrace the uniqueness of each patient and the nature of his or her health problems, without restriction with regard to social or economic status.” (American Nurses Association, n.d.a, para 1)
Essential Questions
What significance does joining a professional organization have on nursing practice?
How can nurses contribute to legislative changes that impact nursing practice and patient outcomes?
Why is evidence-based practice (EBP) the gold standard in patient care protocol improvements?
Introduction
According to the American Nurses Association (ANA) there are currently 3.6 million registered nurses in the United States (American Nurses Association [ANA], n.d.b, para 12). The ANA is a professional nursing organization, which began when fewer than 20 nurses attended a convention in 1896. Nurses at the time were concerned with nursing practice standards and nurse competency. The ANA has since grown into an organization with interests in improving health care and setting standards for nursing practice. All nurses are represented regardless of status within the organization. The goal of professional organizations is to support nurses and improve the profession (ANA, n.d.c).
This chapter will explore the significance of joining professional organizati ...
This session on safety was presented to the International Council of Nurses audience in Durban, South Africa. This is just a sample of the entire session; for more information on safety in the workplace, contact sharonw@corelimited.com
Unsafe medication is a leading cause of harm, most of it preventable, in health care systems across the world. Medication incidents occur when weak medication systems and/or human factors such as fatigue, poor environmental conditions or staff shortages affect prescribing, transcribing, dispensing, administration and monitoring practices, which can then result in severe harm, disability and even death.
Full Details: https://goo.gl/gCQ64V
2 8 5L e a r n I n g o b j e c t I v e sC H A P T E R.docxlorainedeserre
2 8 5
L e a r n I n g o b j e c t I v e s
C H A P T E R 1 0
Q U A L I T Y M A N A G E M E N T I N
T H E P H Y S I C I A N P R A C T I C E
Quality and reliability are system properties.
—W. Edwards Deming
➤ Articulate the nature of performance management.
➤ Describe the approaches to performance improvement.
➤ Appreciate the impact of variation on performance.
➤ Discuss the components of the Triple Aim.
➤ Describe process improvement.
In t r o d u c t I o n
One of the most important issues to address in the medical practice is the quality and
safety of the care provided to patients. The Institute of Medicine (IOM 2001), a presti-
gious branch of the National Institutes of Health, stated in its landmark report Crossing the
Quality Chasm: A New Health System for the 21st Century, “In its current form, habits, and
environment, American health care is incapable of providing the public with the quality
health care it expects and deserves.”
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EBSCO Publishing : eBook Academic Collection (EBSCOhost) - printed on 4/16/2020 7:48 PM via SUNY CANTON
AN: 1839064 ; Wagner, Stephen L..; Fundamentals of Medical Practice Management
Account: s8846236.main.ehost
F u n d a m e n t a l s o f M e d i c a l P r a c t i c e M a n a g e m e n t2 8 6
Another historic IOM (2000) report, To Err Is Human: Building a Safer Health
System, indicated that a shocking number of people—an estimated 44,000 to 98,000 per
year—are harmed by the healthcare system. A more recent study found that this number
has increased since publication of the 2000 IOM report despite substantial efforts to
improve. Medical errors have now become the third leading cause of death in the United
States (Makary and Daniel 2016).
The complexity of medical service and the inconsistency with which these services
are delivered, not to mention the fragmented nature of the system, have led to a number
of quality concerns (Mosadeghrad 2014), including a lack of systematic approaches to care
delivery and quality improvement. Efforts to improve quality in the medical profession
have a long tradition of focusing on individual performance versus system performance.
Exhibit 10.1 illustrates the potential flaw in this thinking. The bell-shaped curve, P-1,
represents the overall performance of any given system. Curve P-2 illustrates an improved
system of performance where the median performance is moved from M-1 to M-2. If an
organization seeks to improve by only focusing on the low performers, it experiences only
a small improvement, shown as I-1. By improving th ...
Defining medical errors, types of medical errors, statistics of medical errors in USA and Europian Union WHO 2017, and their effects, the 10 medical errors that have changed medical practice, the 10 medical errors that kill the patient in the hospital
The ethics of performance monitoring-private sector perspectiveDavid Quek
Increasingly medical practice is coming under intense scrutiny as to what is appropriate and affordable care, including serious considerations of patient safety issues and protection. Medical professionalism must be consciously adhered to as we try and find the best health care for our patients at the best value and outcomes for our patients themselves, and also for society at large. In view of escalating health care costs, physician autonomy to practice as he or she likes or deems fit has now come under siege with more and more performance monitoring, not just for appropriateness, but also for outcomes, necessity and cost-effectiveness. Physician' vested interests must be tempered with evidence-based benefits or at least be associated with no increase in harm or incur affordability issues. Fraudulent physician malfeasance are now being uncovered via whistle-blowers, or through greater more meticulous audit of various validated performance measures, and those physicians found to have flouted these due to pecuniary self-interests, overuse of tests or procedures have been found guilty and sanctioned with heavy fines, return of reimbursements as well as imprisonment, and erasure from medical registries and the removal of license to practice.
Similar to Evolution and transformation of patient safety in to the modern health care system tools & techniques (20)
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.
Back ground
Tawam hospital faced many of the same barriers to patient safety present in hospitals elsewhere. The Leadership realized that the best way to enhance patient safety is to build a Culture of Safety at the hospital and hence has been implementing the Johns Hopkins Comprehensive Unit based Safety Program (CUSP). CUSP started as a pilot project in 2008 and now being implemented in ten units. Prior to implementation the leadership decided to measure staff perception of safety using evidence based tool.
Method
The Safety Attitudes Questionnaire (SAQ) was administered to all Tawam Hospital staff in three phases understand staff perception of safety. SAQ measures culture along 7 dimensions. The survey results are graded against percentage positive responses.
Results
A comparison of the SAQ’s pre & post CUSP implementation. ICU and Pediatric Oncology had six domains in the danger zone. NNU had four domains in the danger zone.
2010 & 2011 SAQ survey, the overall hospital score on all the domain scores were in the danger zone. 20 clinical locations in 2010 and 7 clinical locations in 2011 had less than 60% scores in the primary dependent variables.
Conclusion
SAQ results were disseminated department wise in the presence of a hospital Senior Executive. The unit staff selected one or two areas of concern and developed action plans for improvement.
CUSP was rolled out in Six more units. Safety Analysis Teams have been established in the CUSP pilot units to analyze and learn from defects.
Although the culture of safety is a serious business, it does not have to be implemented with a grim face. Joy and spirit of care giving are also linked to patient safety. Joy comes from witnessing successful patient outcomes and seeing a patient and family experience their healing journey.The use of emoticons to convey information saturates our wired world. One of the more popular emoticons is the smile. The smile is ubiquitous throughout computer generated communication such as emails, texts and social networking applications. Could we parlay its popularity in our patient safety efforts? We surmised that a healthcare provider, who is trained in the SMILE culture of safety model, would more easily recognize our culture of safety framework when this emoticon was used as a part of their daily communicating life.
Healthcare Associated Infections (HAIs) are the fourth leading cause of death in the USA. About 1.8 million patients suffer annually from care-related infections. HAIs cause 99,000 deaths every year in the US alone, at a cost of $3.1 billion dollars in excess healthcare costs in acute care hospitals. Besides HAIs kill more people than AIDS, breast cancer and auto accidents combined.
It is estimated that 271 people died each day from healthcare-associated infections (HAIs) such as Methicillin-resistant Staphylococcus aureus (MRSA) infections. Which is equivalent to one airline crash per day.
The best way to enhance patient safety is to build a culture of safety at the hospital. The Johns Hopkins Hospital Comprehensive Unit-based Safety Program (CUSP)
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
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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.
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.
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
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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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.
- 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
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Evolution and transformation of patient safety in to the modern health care system tools & techniques
1. Evolution and transformation of Patient Safety in
to the Modern Health Care System-
Tools & Techniques
Presented by Krish Sankaranarayanan MS, MBA, CPHQ
Senior Safety Officer
Tawam Hospital. UAE
2. Introduction-About me
• Been in healthcare domain for over 24 years.
• Triple Masters degree.
• MS in Patient Safety Leadership from UOI- Chicago.
• Certified Professional in Healthcare Quality (CPHQ)
• Educational consultant- Canadian Healthcare
Association- CQI progarm
• Membership
– Member American College of Healthcare Executives
– Member National Association of Healthcare Quality
– Member American Society for Healthcare Risk Management
– Member American Society of Professionals in Patient Safety
– Vice President of the ACHE Middle East and North Africa Group
3. Disclosure
The presenter has nothing to disclose, nor has
any commercial interest with any of those
information's displayed in this presentation.
2013-8-23 3
4. About Tawam Hospital
• Tawam is a 466-bed tertiary care facility located in the garden city Al
Ain in the middle of the desert, and one among the largest healthcare
facilities in the United Arab Emirates.
• In 2006 the General Authority of Heath Services now called as the Abu
Dhabi Health Services Company PJSC (SEHA) entered in to a ten
year affiliation contract with Johns Hopkins Medicine.
• Tawam Hospital has current status with
• Joint Commission International Accreditation (2006; 2009; 2012),
• College of American Pathology (CAP; 2011) and
• American College of Graduate Medical Education- International (ACGME;
Program Accreditation)
2013-8-23 4
9. Hippocratic Oath
5th century BC -Physicians and other healthcare professionals swearing
to practice medicine honestly
10. Florence Nightingale
The founder of modern nursing
1863-―the very first requirement in a Hospital is that it should do the sick no
harm
11. Dr. Ernest Codman
1905 started "end result idea.― Hospital standardization.
Doctors should follow up with all patients to assess the results of their treatment
and that the outcomes actively be made public.
12. How is it that aviation became safer than
healthcare ???
15. The Annual Toll of Medical Injury
IOM ―To Err is Human‖ (1999)
• 44,000 – 98,000 deaths/year in US due to
medical errors.
• $ 50 billion in total costs.
• 7% of patients suffer a medication error.
• Every patient admitted to ICU suffers an
adverse event.
1 in 3 people say that they or a family member has experienced a medical error at
some point in their lives
180,000 people die each year due to iatrogenic injury in US.
This is equivalent to three fully loaded jumbo- jet crashing every two days.
Most of it where preventable !!!!
16. 1
10
100
1,000
10,000
100,000
1 10 100 1,000 10,000 100,000 1,000,000 10,000,000
Number of encounters for each fatality
Totalliveslostperyear
REGULATEDDANGEROUS
(>1/1000)
ULTRA-SAFE
(<1/100K)
Health
Care
Mountain
Climbing
Driving
Chemical
Manufacturing
Chartered
Flights
Scheduled
Airlines
European
Railroads
Nuclear
Power
25. National Quality Forum
List of Never Events-28
• Unintended retention of a foreign body in
a patient after surgery or other procedure
• Surgery performed on the wrong body part
• Surgery performed on the wrong patient
• Wrong surgical procedure performed on a
patient
• Infant discharged to the wrong person
• Stage 3 or 4 pressure ulcers acquired
after admission to a healthcare facility
26.
27. The patients saw an average of 17.8 health
professionals during their hospitalization
28. National Patient Safety Goals
Established in 2003
Established in 2001
Anesthesia Patient Safety Foundation
launched in late 1985
APSF was incorporated as
an association in July 1989
World Alliance for Patient Safety
was launched in 2004
Canadian Patient Safety Institute
Established in 2003
National Patient Safety Foundation
Established in 1997
29. What is Patient Safety?- Definition
• The freedom from accidental injury due to medical
care or from medical error.(Institute Of Medicine)
• The prevention of healthcare errors, and the
elimination or mitigation of patient injury caused by
healthcare errors. (National Patient Safety Foundation)
• The absence of the potential for or occurrence of
health care associated injury to patients. Created by
avoiding medical errors as well as taking action to
prevent errors from causing injury. (Agency for
Healthcare Research and Quality)
32. “The single greatest impediment to error
prevention in the medical industry is that
we punish people for making mistakes.”
(Leape 2009)
Dr. Lucian Leape is a professor at Harvard School of
Public Health, he is a health policy analyst whose
research has focused on patient safety and quality of
care
35. Common Response After a Medical
Error
The types of suffering are
• Increased anxiety about the future possibility of
errors.
• Loss of confidence in the work they do.
• Some face difficulty sleeping.
• Concern about their reputation as a care giver
• Reduction in their sense of job satisfaction.
• Excellent clinicians may leave the profession
prematurely when involved in a preventable
error.
36. Medical error: the second victim..
• The term second victim was initially coined by Wu in
his description of the impact of errors on
professionals. The doctor who makes the mistake
needs help too.
• In the aftermath of a mistake, it's important the
doctor seek support to deal with the consequences.
Albert W Wu associate professor
School of Hygiene and Public Health and School of Medicine, Johns
Hopkins University, Baltimore, MD
2013-8-23 36
38. ―Insanity: doing the same
thing over and over again and
expecting different results‖
Albert Einstein
2013-8-23 38
39. Avedis Donabedian
1966 –Structure leading to Process and process leading to Outcome
Whether a procedure or intervention has made a favorable difference.
Structure Process Outcome Paradigm
40. ―Every system is perfectly designed to
achieve the results it gets.‖
Donald Berwick, M.D.
President & CEO of Institute for Healthcare Improvement
2013-8-23 40
42. Medical Errors related Behavioral
Choices
Reckless
Behavior
Intentional Risk-Taking
Manage through:
• Remedial action
• Disciplinary action
At-Risk
Behavior
Unintentional Risk-Taking
Human
Error
Product of our current
system design
Manage through changes in:
• Processes
• Procedures
• Training
• Design
• Environment
Console Coach Punish
Manage through:
• Removing incentives for
at-risk behaviors
• Creating incentives for
healthy behaviors
• Increasing situational
awareness
43. How do we prevent errors?
Errors can be prevented by
designing systems that make it
hard for people to do the wrong
thing, and easy for people to do
the right thing.
2013-8-23 43
48. Steps to Minimize Medical Error
Forcing functions & constraints
Automation & computerization
Standardization & protocol
Checklist & double check system
Rules & policies
Education/ Information
Be more careful, be vigilant
Most
effective
Least
effective
50. Accreditation programs
Seeking gold standards
National Accreditation Board for Hospitals
& Healthcare Providers (NABH) is a
constituent board of Quality Council of
India
51. JCIA- Standards
1. International Patient Safety Goals (IPSG)
2. Access to care and continuity of Care (ACC)
3. Patient and Family Rights (PFR)
4. Assessment of patients (AOP)
5. Care of patients (COP)
6. Anesthesia and Surgical care (ASC)
7. Medication management and use (MMU)
8. Patient and Family Education (PFR)
9. Quality Improvements and patient Safety(QPS)
10.Prevention and Control of Infections (PCI)
11.Governance Leadership and Direction (GLD)
12.Facility Management and Safety (FMS)
13.Staff Qualification and Education (SQE)
14.Management of communication and Information (MCI)
52. Patient Safety Goals
1. Identify Patients Correctly
2. Improve Effective Communication
3. Improve the Safe Use of Medications
4. Ensure correct-site, correct-
procedure, correct- patient Surgery
5. Reduce the Risk of Health Care –Associated
Infections
6. Reduce the Risk of Patient Harm Resulting
from Falls
53. Goal 1
Identify Patients Correctly
Use two identifiers
Patient full name, DOB, Medical Record # etc
• Before giving medication
• Before administering blood or blood products
• Before taking blood samples & specimens
• Before doing clinical testing
• Before providing any treatment or procedures
57. Goal 2
Improve Effective Communication
• Effective communication, which is
timely, accurate, complete, unambiguo
us, and understood by the
recipient, reduces errors and results in
improved patient safety.
61. Improve Effective Communication
• Verbal & Telephonic order
– Write down and ―Read- Back‖
• Communicate critical test results
– Write down and ―Read- Back‖
• Use of SBAR, I PASS BATON- structured form of
communication
• Daily Goals Checklist
67. Goal 3
Improve the Safe Use Of Medications
• Following the Seven Rights
• Storage, labeling and segregation of
High Alert Medication
• Do Not Use dangerous abbreviation
List
• Medication Reconciliation
68. Seven rights to prevent medication
errors
• RIGHT drug
• RIGHT patient (Two Identifiers)
• RIGHT dose
• RIGHT time
• RIGHT route
• RIGHT reason
• RIGHT documentation
69. Improve the Safety of High-Alert
Medications
HIGH ALERT MEDICATIONS :-
Drugs that bear a heightened risk of
causing significant patient harm when
they are used in error. Although mistakes
may or may not be more common with
these drugs, the consequences of an
error with these medications are clearly
more devastating to patients.
(Institute for Safe Medication Practice)
70. Storage, labeling and segregation
• Concentrated Electrolytes are removed
from patient care areas unless clinically
necessary
• Segregated from other medications and
Labeled as "High Alert
Concentrated electrolytes are:
Magnesium sulfate injection
Potassium Acetate injection
Potassium chloride for injection concentrate
Potassium phosphates injection
Sodium Acetate injection
Sodium bicarbonate 8.4% injection
Sodium Chloride for injection, hypertonic (greater
than 0.9% concentration)
Sodium Phosphate injection
75. Medication Reconciliation
• Obtain information on the medications
the patient is currently taking
• Medication orders are compared to the
list of medications taken prior to
admission
76. The Medication Use System
Selection
&
Procuring
Establish
formulary
Monitoring
Assess patient
response to
drug; report
reactions &
errors
Administering
Review
dispensed drug
order; assess
patient &
administer
Preparing &
Dispensing
Purchase &
store drug;
review &
confirm order;
distribute to
patient location
Prescribing
Assess
patient;
determine
need for drug
therapy; select
& order drug
Clinician &
administrators
Physician/
prescriber
Pharmacist Nurse/other health
professionals
All
practitioners, plus
patient &/or
family
Joint Commission. 1998
77. Major Areas for Medication Error
Prescribing
Transcribing
Dispensing
Administering
38% 39%
12% 11%
Medication Errors Reporting Program US
78.
79. Prescribing Errors
Contributing factors:
• Illegible handwriting
• Inaccurate medication history taking
• Confusion with the drug name
• Inappropriate use of decimal points
• Use of abbreviations
• Use of verbal order
Williams DJ. 2007
87. Administration Errors
Contributing factors:
• Failure to check the patient’s identity
prior to administration
• Storage of similar preparations in
similar areas
• Noise, interruptions, & poor lighting
Williams DJ. 2007
93. Goal 4
Ensure correct-site, correct-procedure, correct- patient
Surgery.
• Use a checklist.
• Verify all documents.
• Check equipment needed for surgery.
• Mark the precise site ( involve the
patient ).
• Use "time-out" just before starting a
surgical / invasive procedure.
97. Goal 4
Reduce the Risk of Health Care –Associated Infections
• Strict hand hygiene before and after contact with
each patient or their environment
• Adequate hand hygiene facilities for staff and
patients
• A clean hospital environment and good hygiene
practice
• Isolation of patients in single rooms, when
necessary, to reduce the risk of infection
• Careful prescription of antimicrobial drugs
• Training on infection prevention and control for all
staff
102. Antimicrobial Stewardship
• Antibiotic stewardship refers to a set of
coordinated strategies to improve the
use of antimicrobial medications with
the goal of enhancing patient health
outcomes, reducing resistance to
antibiotics, and decreasing
unnecessary costs.
• The Infectious Diseases Society of
America (IDSA)
103. Healthcare Associated Infection-
HAI
• Central line Associated Blood Stream
Infection- CLABSI
• Surgical Site Infection-SSI
• Cather Associated Urinary Tract
Infection-CAUTI
• Ventilator Associated Pneumonia -VAP
104. HAI
• CLABSI
– Attributable mortality: 9-25%
– Attributable cost: $25,000-$45,000
– Of patients who get a bloodstream infection from
having a central line, up to 1 in 4 die.
• CMS Medicare and Medicaid no longer pays
hospital for CLABSI
• CLABSI
– Remove Unnecessary Lines
– Wash Hands Prior to Procedure
– Use Maximal Barrier Precautions
– Clean Skin with Chlorhexidine
– Avoid Femoral Lines
115. Goal 6
Reducing the risk of patient resulting from fall
• Falls account for a significant portion of
injuries in hospitalized patients.
• Establish fall-risk reduction program
– Initial assessment of patients for fall risk
during admission
– Reassessment of patients when indicated
by a change in condition or medications
– Implemented fall reduction strategies
– Monitor intended and unintended
consequences of fall risk measures
116. Epidemiology of inpatient falls
• 1235 falls by 1082 pts (3.10 falls/1000 pt
days)
• 89% single fall, 11% more than once
• 40% related to toileting
• Serious injury (laceration requiring
sutures, loss of
consciousness, fracture, SDH) – 6%
• Death – 0.2% (both in patient with more than
1 fall)
Source: Inf Control Hosp Epidem 2005;26:822
122. Fall Prevention Strategies
Place fall precautions sign in patient’s room.
Communicate fall risk during hand-off of care
Maintain bed in low position, and put bed rails up.
Assess hourly patient’s need for toileting.
Actively engage patient and family
Lock all moveable equipment before transferring patients.
Do not leave patient unattended for transfers/toileting.
Place patient care articles within reach (call bell, urinal, phone,
water).
Provide physically safe environment (adequate lighting,
eliminate spills, clutter, electrical cords, and unnecessary
equipment).
Evaluate medication profile for fall risk.
Move patient closer to the nursing station for those at High Risk
124. ―If you can’t measure it, you
can’t manage it.‖
Peter Drucker
125. Key Performance Indicators (KPIs)
• Embrace the following :
– People – staff focus
– Service – customer focus
– Quality – excellence in clinical
outcomes and service
– Finance
– Growth – expansion of
services
126. Dashboards
• Powerful graphs
communicating both the
financial and nonfinancial
key performance
indicators
• Designed to translate
vision & strategy into
objectives
• Employees can:
– embrace, achieve,
measure & celebrate.
– focus on annual goals &
long term strategic goals.
135. References
• How many health professionals does a patient see during an average
hospital stay? N Whitt, R Harvey, S Child
• Waterman AD, Garbutt J, Hazel E, et al. The emotional impact of
medical errors on practicing physicians in the United States and
Canada. Jt Comm J Qual Patient Saf 2007;33:467–76.
• Rossheim J. To err is human—even for medical workers. Healthcare
monster. http://healthcare.monster.ca/8099_en-CA_pf.asp (accessed
21 Jan 2009).
• Green, M.J., Farber, N.J., and Ubel, P.A. Lying to each other. Archives
of Internal Medicine, 2000;160:2317-23.
• Mizrahi, T. Managing medical mistakes: ideology, insularity and
accountability among internists-in-training. Social Science & Medicine,
1984;19(2):135-46
• Hickson, G. B., Clayton, E. W., Githens, P. B., et al. Factors that
prompted families to file medical malpractice claims following perinatal
injuries. JAMA, 1992;267:1359-63.
136. References
• Vincent, C., Young, M., and Philips, A. Why do people sue doctors? A
study of patients and relatives taking legal action.
Lancet, 1994;343:1609-13.
• Witman, A. B., Park, D. M., and Hardin, s. B. How do patients want
physicians to handel mistakes? A survey of internal medicince patients
in an academic setting, Archives of Internal
Medicine, 1996;156(22):2565-69.