Including patients in treatment planning improves their experience, and patient reported outcomes (PROs) offer new ways to do just that — talking with patients about how treatment impacts their daily life. Clinical nurse coordinator Lisa McMurtrey shares the Burn Clinic team’s award-winning work implementing PROs during patient visits without disrupting flow.
Hourly rounding was initiated at Deer Lodge Centre to further reduce falls among older adult patients. Previous efforts had reduced falls but not achieved the anticipated results. A working group examined restarting hourly rounding by identifying barriers and facilitators. They changed the rounding method with a new policy and documentation. An action plan for long-term sustainability was created, outlining steps, timelines, responsibilities and monitoring. Lessons showed that change takes time, staff buy-in requires involvement, and ongoing audits and feedback are needed to address issues and engage staff in the new approach. The initiative aims to establish consistent understanding of hourly rounding benefits for quality care, safety and satisfaction.
Hourly rounding was implemented in a long term care facility to reduce falls among residents. The pilot program involved education of staff on hourly rounding and use of a checklist to document rounds. Initial results showed a 43% reduction in falls during the 30 day pilot period compared to the previous year. However, compliance with hourly rounding decreased due to staffing shortages. Continuous education and supervision are recommended to sustain fall reductions through consistent hourly rounding. Direct observation of staff also improved adherence to the rounding protocol.
Everything You Wanted to Know About the Quality Measurement FrameworkNHSScotlandEvent
The Quality Measurement Framework provides a structure for us to think about how everything aligns to the Quality Ambitions. This session will help
delegates understand the three levels of the framework and help them understand how their work fits into this.
This document summarizes a presentation on why change management fails. It discusses three main points. First, resistance is no longer the biggest enemy of change but rather too much commitment can be bad. Second, when commitment levels were examined separately, each type of commitment positively predicted support for change. Third, a nonlinear model more accurately showed how factors like affective, continuance and normative commitment interacted and simultaneously contributed to behavior, whereas a linear model only showed additive effects. The presentation concluded practitioners should focus less on resistance and more on compliance, and researchers should use nonlinear regression and tools to better analyze variance.
Workplace, Work and Well-being: Joining the Dots by Bridget JuniperWorkplace Trends
This document summarizes the results of an employee well-being assessment conducted at a call center company with 600 agents. The assessment measured well-being across 8 domains and found that facilities, physical health, and psychological health were most closely linked to sickness absence. Employees in the lowest quartile for facilities well-being were over twice as likely to take more than 4 days of sickness absence and 11.5 times more likely to leave the company compared to those in the highest quartile. The assessment identifies priorities such as improving canteen provision, parking, rest areas, shift patterns, and manager awareness training to help boost employee well-being.
Veterinary nurse consult clinics provide basic examinations, procedures, treatments, and advice to clients under a nurse's supervision. They aim to improve patient care and generate income while better utilizing staff skills. Nurse consult clinics offer individual consults on topics like weight management, nutrition, dental care, and disease management. They perform basic procedures like annual checks, vaccines, and lab tests using spare exam rooms and basic equipment. Benefits include reducing vet workload, improving the clinic image and bond with clients, and promoting preventative healthcare for happy, healthy pets.
Hourly rounding was initiated at Deer Lodge Centre to further reduce falls among older adult patients. Previous efforts had reduced falls but not achieved the anticipated results. A working group examined restarting hourly rounding by identifying barriers and facilitators. They changed the rounding method with a new policy and documentation. An action plan for long-term sustainability was created, outlining steps, timelines, responsibilities and monitoring. Lessons showed that change takes time, staff buy-in requires involvement, and ongoing audits and feedback are needed to address issues and engage staff in the new approach. The initiative aims to establish consistent understanding of hourly rounding benefits for quality care, safety and satisfaction.
Hourly rounding was implemented in a long term care facility to reduce falls among residents. The pilot program involved education of staff on hourly rounding and use of a checklist to document rounds. Initial results showed a 43% reduction in falls during the 30 day pilot period compared to the previous year. However, compliance with hourly rounding decreased due to staffing shortages. Continuous education and supervision are recommended to sustain fall reductions through consistent hourly rounding. Direct observation of staff also improved adherence to the rounding protocol.
Everything You Wanted to Know About the Quality Measurement FrameworkNHSScotlandEvent
The Quality Measurement Framework provides a structure for us to think about how everything aligns to the Quality Ambitions. This session will help
delegates understand the three levels of the framework and help them understand how their work fits into this.
This document summarizes a presentation on why change management fails. It discusses three main points. First, resistance is no longer the biggest enemy of change but rather too much commitment can be bad. Second, when commitment levels were examined separately, each type of commitment positively predicted support for change. Third, a nonlinear model more accurately showed how factors like affective, continuance and normative commitment interacted and simultaneously contributed to behavior, whereas a linear model only showed additive effects. The presentation concluded practitioners should focus less on resistance and more on compliance, and researchers should use nonlinear regression and tools to better analyze variance.
Workplace, Work and Well-being: Joining the Dots by Bridget JuniperWorkplace Trends
This document summarizes the results of an employee well-being assessment conducted at a call center company with 600 agents. The assessment measured well-being across 8 domains and found that facilities, physical health, and psychological health were most closely linked to sickness absence. Employees in the lowest quartile for facilities well-being were over twice as likely to take more than 4 days of sickness absence and 11.5 times more likely to leave the company compared to those in the highest quartile. The assessment identifies priorities such as improving canteen provision, parking, rest areas, shift patterns, and manager awareness training to help boost employee well-being.
Veterinary nurse consult clinics provide basic examinations, procedures, treatments, and advice to clients under a nurse's supervision. They aim to improve patient care and generate income while better utilizing staff skills. Nurse consult clinics offer individual consults on topics like weight management, nutrition, dental care, and disease management. They perform basic procedures like annual checks, vaccines, and lab tests using spare exam rooms and basic equipment. Benefits include reducing vet workload, improving the clinic image and bond with clients, and promoting preventative healthcare for happy, healthy pets.
This document discusses big data in healthcare and physical therapy. It provides an overview of ATI's use of big data through its large patient outcomes registry, which includes over 800 variables and has been accepted into federal registries. ATI leverages data on patient demographics, referrals, outcomes, satisfaction surveys, and costs to enhance care and outcomes. The challenges of evidence-based medicine in an era of big data are also examined, highlighting the need to reconcile evidence-based and precision approaches through standardized sharing of data.
This document discusses patient-reported outcomes (PROs) and their importance in clinical research. It covers:
1) Why PROs that measure how patients feel and function are increasingly important primary outcomes, as they better reflect the impacts of chronic diseases than physiological tests alone.
2) The different types of PRO instruments and their properties, such as discriminating between patient groups or measuring changes over time.
3) Key concepts in interpreting PRO results, including the minimal important difference (MID) - the smallest difference perceived as important by patients - and using it to determine meaningful treatment benefits.
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While the acceptance of technology by seniors has been the biggest concern of those who want to do telehealth with them, the truth is many elderly love their iPhones and are comfortable with doing FaceTime with their grandchildren. So what are the real barriers?
For more information of the webinar such as recording and transcript, please visit:
https://goo.gl/IIAyNw
For other webinars:
https://vsee.com/webinars/
Or join our Linkedin Group: https://www.linkedin.com/groups/Telehealth-Failures-Secrets-Success-13500037/about
Or Join our Facebook Group:
https://www.facebook.com/groups/tfssgroup/?ref=group_cover
Enzalutamide showed significant benefits over placebo in preserving health-related quality of life in patients with metastatic castration-resistant prostate cancer based on EQ-5D data from the PREVAIL trial. Specifically, enzalutamide slowed the decline in EQ-5D index and visual analogue scale scores compared to placebo. Analysis of individual EQ-5D dimensions found that enzalutamide was associated with significantly less deterioration in pain/discomfort and anxiety/depression. Enzalutamide also showed benefits over placebo for time to worsening health status according to the EQ-5D.
Thriving, not just surviving after critical illnessCoda Change
1. Many ICU survivors experience long-term physical and mental disability after discharge, impacting their quality of life.
2. A study of 262 Australian ICU survivors found 57% experienced disability 6 months after discharge, with highest impairment in physical activity. Predictors included a history of anxiety/depression, separated/divorced marital status, and more days on mechanical ventilation.
3. Clinicians believe strategies like early mobilization, improved sedation practices, nutrition protocols, and enhancing family support could help ICU survivors recover and thrive after discharge.
The document summarizes a presentation on neurocognitive complications of HIV disease. The presentation was given at the UC San Diego AntiViral Research Center, which sponsors weekly presentations on infectious diseases research. The goal is to provide current research, clinical practices, and trends in diseases like HIV, HBV, HCV, and TB. The slides from this particular presentation on neurocognitive complications of HIV are intended for educational purposes of the audience and may not be used for other purposes without permission.
This document discusses strategies to prevent and manage delirium in critically ill patients. It outlines the ABCDEF bundle which includes assessing, preventing, and managing pain, both spontaneous awakening and breathing trials, minimizing sedation, assessing and preventing delirium, early mobility and exercise, and engaging family members. Screening for delirium using the CAM-ICU tool and implementing non-pharmacological interventions can reduce length of hospital stay, duration of mechanical ventilation, and mortality. Widespread use of protocols and bundles that incorporate these strategies may help address the high cost and poor outcomes associated with delirium.
I was asked to present something on Fibromyalgia during a Pain Summit. I ended up describing what we know so far about clinical features, evolution of diagnostic criteria and synthesized some recent guidelines.
“8th National Biennial Conference on Medical Informatics 2012”Ashu Ash
“8th National Biennial Conference on Medical Informatics 2012” at Jawaharlal Nehru Auditorium, AIIMS New Delhi on 5th Feb 2012,
The organizing committee consisting of Mr. S.K. Meher (Organizing Secretary), Major (Dr.) Anil Kuthiala (Jt. Organizing Secretary) and Ashu (Assistant to the Organizing Secretariat) worked hard and toiled to make the conference a grand success.
The scientific committee comprising of Dr. S.B Gogia, Prof. Khalid Moidu, Prof Arindam Basu, Dr. S Bhatia, Dr. Thanga Prabhu, Dr. Karanvir Singh, Tina Malaviya, Dr. Kamal Kishore, Dr. Vivek Sahi, Spriha Gogia, Dr. Supten Sarbhadhikari, Dr.Sanjay Bedi, Mr. Sushil Kumar Meher actively reviewed all papers for the various scientific sessions.
Psychosocial aspect of bariatric surgeryAndri Andri
1) This study examined changes in employment impairment and productivity in 164 patients one year after bariatric surgery.
2) It found significant reductions in work impairment and improvements in work productivity, as well as improved quality of life and reduced depression and anxiety symptoms.
3) Pre-surgery depression, anxiety, and quality of life scores were significant predictors of changes in work outcomes after surgery, but a history of psychiatric illness was not a predictor. Patients with greater pre-surgery work impairment and psychopathology experienced the greatest employment improvements.
This document summarizes a presentation about implementing a real-time patient experience survey system called "My Experience Matters" at Western Sydney Local Health District. The system captures feedback from patients and families using tablets, online forms, and paper to get real-time data. Survey questions and reporting are customized for each ward and clinic. Free-text comments provide insights into root causes and allow staff to address issues. An integrated 6E framework supports improving patient experience outcomes through staff engagement. Initial results show over 1500 responses identified focus areas and led to actions that improved communication, noise levels, cleanliness and food variety. Key lessons included the importance of leadership, a holistic culture change approach, and resources to handle the increased workload.
A tele-rehabilitation program for stroke survivors called CLEAR was evaluated. The program provided task-oriented rehabilitation in hospitals, homes, and community kiosks. 253 patients received either usual care or the CLEAR program. The CLEAR program was found to be safe and more effective than usual care based on improvements in arm function, disability, and quality of life. Adherence to the kiosk sessions was predicted by distance from home to kiosk and need for assistance. Patients were highly satisfied with the program and found it useful. The tele-rehabilitation approach reduced travel costs and time compared to usual care.
Actigraphy as a Metric in PAH Research and Clinical CareDuke Heart
Actigraphy devices can provide objective measures of physical activity and are being used more in PAH research and clinical care. Limitations of the 6-minute walk test include only providing a snapshot of function and not capturing daily fluctuations. Activity monitors continuously measure real-world activity levels and have been used in clinical trials to assess changes from baseline as primary or secondary endpoints. Emerging data suggest PAH patients have significantly reduced activity levels compared to controls and activity levels correlate with functional class and quality of life. Activity monitors may help evaluate therapeutic responses more sensitively than the 6-minute walk test alone.
This document describes ThedaCare, a community-owned healthcare system focused on achieving better value for customers. It provides an overview of ThedaCare's facilities and services. Key accomplishments highlighted include creating an internship program to develop leaders in continuous improvement, achieving significant reductions in defects and wait times through rapid improvement events, and establishing standard work practices. Challenges noted include managing change with professional staff by addressing fears of lost autonomy and building trust with data showing standard work improves outcomes.
This document summarizes the results of an analysis of the 2007-08 UK GP Patient Survey, which assessed patient satisfaction with access to primary care. The analysis found that while overall satisfaction was high, it varied based on patient, practice, and location characteristics. Patient age, ethnicity, and employment status most impacted satisfaction levels. Having the ability to take time off work greatly improved satisfaction for employed patients. Practice size also had a strong influence, with smaller practices receiving higher satisfaction ratings. Geographic location made a difference, as patients in northeast England reported the best experiences.
Does measurement lead to better health outcomes 20161202Tienie Stander
Health outcomes research, real world evidence, registries, comparative effectiveness trials: all are current buzzwords. However, the ultimate question is whether all these measurements lead to better health outcomes? We explore this question from a philosophical and practical perspective
This study evaluated whether measuring copeptin levels could help identify patients undergoing surgery for sellar lesions who would develop diabetes insipidus (DI). The study found that patients who developed postoperative DI had significantly lower median copeptin levels compared to those who did not develop DI. Measuring copeptin may help clinicians identify patients needing closer observation in the hospital and determine when safe discharge is possible by predicting who is more likely to develop DI after this type of surgery. The results could help change clinical management by informing closer monitoring and treatment decisions.
Measuring Improvement: Using metrics and data to evaluate seven day servicesNHS England
A supporting document from a webinar run by Rhuari Pike, Programme Lead (Seven Day Services, London) on behalf of the NHS England Sustainable Improvement Team.
Final Rural Nurse Residency Looping Expereince.dunlop pptArla Dunlop
This document outlines plans for developing a rural graduate nurse residency curriculum at Kittitas Valley Hospital (KVH) in Kittitas County, Washington. The following key points are discussed:
1) KVH currently has no formal nurse residency program, leading to inexperienced nurses, staff frustration, and potential safety risks. The goal is to develop a new residency curriculum from scratch to support new graduate nurses.
2) The curriculum will include 5 components: didactic learning, clinical immersion, looping experiences, mentoring, and supportive debriefing. The looping component provides exposure to other units to improve assessment skills for this generalist environment.
3) Initial plans include gathering resources, conducting research,
CBT skills usage after receiving internet-delivered cognitive behavioral therapy (iCBT) was assessed to understand its role in maintaining treatment effects. 77 participants completed measures of depression, anxiety and functioning before, immediately after, and 3 months after iCBT. Symptoms significantly improved post-treatment and were maintained at follow-up. At follow-up, participants reported frequently using cognitive and behavioral CBT skills. While CBT skills usage predicted immediate outcomes, it did not predict maintenance of effects at 3-month follow-up, suggesting other factors may be involved in long-term outcomes.
Designing a Virtual Clinic Workflow that Actually Works for Your TeamUniversity of Utah
Chronic conditions do not pause during a pandemic. When faced with delaying the care of over 1,000 patients with neurological conditions, University of Utah Health Neurology Vice Chairs Susan Baggaley and Vivek Reddy rapidly developed a new virtual visit workflow.
U of U Health Discharge Prescriptions: Do They Correlate with Patient Needs?University of Utah
General Surgery’s Josh Bleicher spent twelve months tackling opioid prescribing patterns in hospital patients discharged after elective general surgery. What did his team find? We need a more patient-centered approach to opioid prescribing.
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This document discusses big data in healthcare and physical therapy. It provides an overview of ATI's use of big data through its large patient outcomes registry, which includes over 800 variables and has been accepted into federal registries. ATI leverages data on patient demographics, referrals, outcomes, satisfaction surveys, and costs to enhance care and outcomes. The challenges of evidence-based medicine in an era of big data are also examined, highlighting the need to reconcile evidence-based and precision approaches through standardized sharing of data.
This document discusses patient-reported outcomes (PROs) and their importance in clinical research. It covers:
1) Why PROs that measure how patients feel and function are increasingly important primary outcomes, as they better reflect the impacts of chronic diseases than physiological tests alone.
2) The different types of PRO instruments and their properties, such as discriminating between patient groups or measuring changes over time.
3) Key concepts in interpreting PRO results, including the minimal important difference (MID) - the smallest difference perceived as important by patients - and using it to determine meaningful treatment benefits.
10 Unexpected Pitfalls of Telehealth Home Care for SeniorsVSee
While the acceptance of technology by seniors has been the biggest concern of those who want to do telehealth with them, the truth is many elderly love their iPhones and are comfortable with doing FaceTime with their grandchildren. So what are the real barriers?
For more information of the webinar such as recording and transcript, please visit:
https://goo.gl/IIAyNw
For other webinars:
https://vsee.com/webinars/
Or join our Linkedin Group: https://www.linkedin.com/groups/Telehealth-Failures-Secrets-Success-13500037/about
Or Join our Facebook Group:
https://www.facebook.com/groups/tfssgroup/?ref=group_cover
Enzalutamide showed significant benefits over placebo in preserving health-related quality of life in patients with metastatic castration-resistant prostate cancer based on EQ-5D data from the PREVAIL trial. Specifically, enzalutamide slowed the decline in EQ-5D index and visual analogue scale scores compared to placebo. Analysis of individual EQ-5D dimensions found that enzalutamide was associated with significantly less deterioration in pain/discomfort and anxiety/depression. Enzalutamide also showed benefits over placebo for time to worsening health status according to the EQ-5D.
Thriving, not just surviving after critical illnessCoda Change
1. Many ICU survivors experience long-term physical and mental disability after discharge, impacting their quality of life.
2. A study of 262 Australian ICU survivors found 57% experienced disability 6 months after discharge, with highest impairment in physical activity. Predictors included a history of anxiety/depression, separated/divorced marital status, and more days on mechanical ventilation.
3. Clinicians believe strategies like early mobilization, improved sedation practices, nutrition protocols, and enhancing family support could help ICU survivors recover and thrive after discharge.
The document summarizes a presentation on neurocognitive complications of HIV disease. The presentation was given at the UC San Diego AntiViral Research Center, which sponsors weekly presentations on infectious diseases research. The goal is to provide current research, clinical practices, and trends in diseases like HIV, HBV, HCV, and TB. The slides from this particular presentation on neurocognitive complications of HIV are intended for educational purposes of the audience and may not be used for other purposes without permission.
This document discusses strategies to prevent and manage delirium in critically ill patients. It outlines the ABCDEF bundle which includes assessing, preventing, and managing pain, both spontaneous awakening and breathing trials, minimizing sedation, assessing and preventing delirium, early mobility and exercise, and engaging family members. Screening for delirium using the CAM-ICU tool and implementing non-pharmacological interventions can reduce length of hospital stay, duration of mechanical ventilation, and mortality. Widespread use of protocols and bundles that incorporate these strategies may help address the high cost and poor outcomes associated with delirium.
I was asked to present something on Fibromyalgia during a Pain Summit. I ended up describing what we know so far about clinical features, evolution of diagnostic criteria and synthesized some recent guidelines.
“8th National Biennial Conference on Medical Informatics 2012”Ashu Ash
“8th National Biennial Conference on Medical Informatics 2012” at Jawaharlal Nehru Auditorium, AIIMS New Delhi on 5th Feb 2012,
The organizing committee consisting of Mr. S.K. Meher (Organizing Secretary), Major (Dr.) Anil Kuthiala (Jt. Organizing Secretary) and Ashu (Assistant to the Organizing Secretariat) worked hard and toiled to make the conference a grand success.
The scientific committee comprising of Dr. S.B Gogia, Prof. Khalid Moidu, Prof Arindam Basu, Dr. S Bhatia, Dr. Thanga Prabhu, Dr. Karanvir Singh, Tina Malaviya, Dr. Kamal Kishore, Dr. Vivek Sahi, Spriha Gogia, Dr. Supten Sarbhadhikari, Dr.Sanjay Bedi, Mr. Sushil Kumar Meher actively reviewed all papers for the various scientific sessions.
Psychosocial aspect of bariatric surgeryAndri Andri
1) This study examined changes in employment impairment and productivity in 164 patients one year after bariatric surgery.
2) It found significant reductions in work impairment and improvements in work productivity, as well as improved quality of life and reduced depression and anxiety symptoms.
3) Pre-surgery depression, anxiety, and quality of life scores were significant predictors of changes in work outcomes after surgery, but a history of psychiatric illness was not a predictor. Patients with greater pre-surgery work impairment and psychopathology experienced the greatest employment improvements.
This document summarizes a presentation about implementing a real-time patient experience survey system called "My Experience Matters" at Western Sydney Local Health District. The system captures feedback from patients and families using tablets, online forms, and paper to get real-time data. Survey questions and reporting are customized for each ward and clinic. Free-text comments provide insights into root causes and allow staff to address issues. An integrated 6E framework supports improving patient experience outcomes through staff engagement. Initial results show over 1500 responses identified focus areas and led to actions that improved communication, noise levels, cleanliness and food variety. Key lessons included the importance of leadership, a holistic culture change approach, and resources to handle the increased workload.
A tele-rehabilitation program for stroke survivors called CLEAR was evaluated. The program provided task-oriented rehabilitation in hospitals, homes, and community kiosks. 253 patients received either usual care or the CLEAR program. The CLEAR program was found to be safe and more effective than usual care based on improvements in arm function, disability, and quality of life. Adherence to the kiosk sessions was predicted by distance from home to kiosk and need for assistance. Patients were highly satisfied with the program and found it useful. The tele-rehabilitation approach reduced travel costs and time compared to usual care.
Actigraphy as a Metric in PAH Research and Clinical CareDuke Heart
Actigraphy devices can provide objective measures of physical activity and are being used more in PAH research and clinical care. Limitations of the 6-minute walk test include only providing a snapshot of function and not capturing daily fluctuations. Activity monitors continuously measure real-world activity levels and have been used in clinical trials to assess changes from baseline as primary or secondary endpoints. Emerging data suggest PAH patients have significantly reduced activity levels compared to controls and activity levels correlate with functional class and quality of life. Activity monitors may help evaluate therapeutic responses more sensitively than the 6-minute walk test alone.
This document describes ThedaCare, a community-owned healthcare system focused on achieving better value for customers. It provides an overview of ThedaCare's facilities and services. Key accomplishments highlighted include creating an internship program to develop leaders in continuous improvement, achieving significant reductions in defects and wait times through rapid improvement events, and establishing standard work practices. Challenges noted include managing change with professional staff by addressing fears of lost autonomy and building trust with data showing standard work improves outcomes.
This document summarizes the results of an analysis of the 2007-08 UK GP Patient Survey, which assessed patient satisfaction with access to primary care. The analysis found that while overall satisfaction was high, it varied based on patient, practice, and location characteristics. Patient age, ethnicity, and employment status most impacted satisfaction levels. Having the ability to take time off work greatly improved satisfaction for employed patients. Practice size also had a strong influence, with smaller practices receiving higher satisfaction ratings. Geographic location made a difference, as patients in northeast England reported the best experiences.
Does measurement lead to better health outcomes 20161202Tienie Stander
Health outcomes research, real world evidence, registries, comparative effectiveness trials: all are current buzzwords. However, the ultimate question is whether all these measurements lead to better health outcomes? We explore this question from a philosophical and practical perspective
This study evaluated whether measuring copeptin levels could help identify patients undergoing surgery for sellar lesions who would develop diabetes insipidus (DI). The study found that patients who developed postoperative DI had significantly lower median copeptin levels compared to those who did not develop DI. Measuring copeptin may help clinicians identify patients needing closer observation in the hospital and determine when safe discharge is possible by predicting who is more likely to develop DI after this type of surgery. The results could help change clinical management by informing closer monitoring and treatment decisions.
Measuring Improvement: Using metrics and data to evaluate seven day servicesNHS England
A supporting document from a webinar run by Rhuari Pike, Programme Lead (Seven Day Services, London) on behalf of the NHS England Sustainable Improvement Team.
Final Rural Nurse Residency Looping Expereince.dunlop pptArla Dunlop
This document outlines plans for developing a rural graduate nurse residency curriculum at Kittitas Valley Hospital (KVH) in Kittitas County, Washington. The following key points are discussed:
1) KVH currently has no formal nurse residency program, leading to inexperienced nurses, staff frustration, and potential safety risks. The goal is to develop a new residency curriculum from scratch to support new graduate nurses.
2) The curriculum will include 5 components: didactic learning, clinical immersion, looping experiences, mentoring, and supportive debriefing. The looping component provides exposure to other units to improve assessment skills for this generalist environment.
3) Initial plans include gathering resources, conducting research,
CBT skills usage after receiving internet-delivered cognitive behavioral therapy (iCBT) was assessed to understand its role in maintaining treatment effects. 77 participants completed measures of depression, anxiety and functioning before, immediately after, and 3 months after iCBT. Symptoms significantly improved post-treatment and were maintained at follow-up. At follow-up, participants reported frequently using cognitive and behavioral CBT skills. While CBT skills usage predicted immediate outcomes, it did not predict maintenance of effects at 3-month follow-up, suggesting other factors may be involved in long-term outcomes.
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University of Utah Health Leader Development Institute (LDI) afternoon session: Dan Lundergan, Allison Flynn Gaffney, Brigitte Smith, MD, Carissa Christensen, Sue Childress, Jessica Rivera, Tracy Farley and Bob Pendleton.
University of Utah Health's Leadership Development Institute (LDI) morning session: Linda Tyler and Gordon Crabtree welcome, Greg McKeown "Essentialism," and A. Lorris Betz, MD, PhD, Sr. VP of Health Sciences. Grand America Hotel, Salt Lake City, Utah.
University of Utah Health: Wellness Champion Poster Session 2017University of Utah
Improving Wellness: 40 Champions, 20 Projects and 12-months of Progress: The Wellness and Integrative Health’s Resiliency Center, Accelerate, and the Spencer S. Eccles Health Sciences Library presented a Faculty Wellness Poster Session. Each department in the School of Medicine highlighted the past year’s Wellness Champion projects, which are focused on personal resilience, burden reduction, and team work. The poster session demonstrates work completed so far as the Wellness Champion program is expanded to faculty and staff across U of U Health.
Accelerate: What the Elephant and the Rider Teaches Us About Change in Health...University of Utah
University of Utah Health's Chief Medical Quality Officer Dr. Bob Pendleton explains why emotions are critical to motivating change using two principles borrowed from behavioral economics. He argues that in health care, we over-intellectualize everything. We say that research and data changes practice. We tell ourselves, “If I just show them data, people will understand they need to change direction.” Not the case. What really motivates change is emotion.
Gemma Wean- Nutritional solution for Artemiasmuskaan0008
GEMMA Wean is a high end larval co-feeding and weaning diet aimed at Artemia optimisation and is fortified with a high level of proteins and phospholipids. GEMMA Wean provides the early weaned juveniles with dedicated fish nutrition and is an ideal follow on from GEMMA Micro or Artemia.
GEMMA Wean has an optimised nutritional balance and physical quality so that it flows more freely and spreads readily on the water surface. The balance of phospholipid classes to- gether with the production technology based on a low temperature extrusion process improve the physical aspect of the pellets while still retaining the high phospholipid content.
GEMMA Wean is available in 0.1mm, 0.2mm and 0.3mm. There is also a 0.5mm micro-pellet, GEMMA Wean Diamond, which covers the early nursery stage from post-weaning to pre-growing.
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareVITASAuthor
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
Chandrima Spa Ajman is one of the leading Massage Center in Ajman, which is open 24 hours exclusively for men. Being one of the most affordable Spa in Ajman, we offer Body to Body massage, Kerala Massage, Malayali Massage, Indian Massage, Pakistani Massage Russian massage, Thai massage, Swedish massage, Hot Stone Massage, Deep Tissue Massage, and many more. Indulge in the ultimate massage experience and book your appointment today. We are confident that you will leave our Massage spa feeling refreshed, rejuvenated, and ready to take on the world.
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Exploring the Benefits of Binaural Hearing: Why Two Hearing Aids Are Better T...Ear Solutions (ESPL)
Binaural hearing using two hearing aids instead of one offers numerous advantages, including improved sound localization, enhanced sound quality, better speech understanding in noise, reduced listening effort, and greater overall satisfaction. By leveraging the brain’s natural ability to process sound from both ears, binaural hearing aids provide a more balanced, clear, and comfortable hearing experience. If you or a loved one is considering hearing aids, consult with a hearing care professional at Ear Solutions hearing aid clinic in Mumbai to explore the benefits of binaural hearing and determine the best solution for your hearing needs. Embracing binaural hearing can lead to a richer, more engaging auditory experience and significantly improve your quality of life.
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
This lecture briefly covers some of the underrepresented topics in Molecular imaging with cases , such as:
- Primary pleural tumors and pleural metastases.
- Distinguishing between MPM and Talc Pleurodesis.
- Urological tumors.
- The role of FDG PET in NET.
Unlocking the Secrets to Safe Patient Handling.pdfLift Ability
Furthermore, the time constraints and workload in healthcare settings can make it challenging for caregivers to prioritise safe patient handling Australia practices, leading to shortcuts and increased risks.
MBC Support Group for Black Women – Insights in Genetic Testing.pdfbkling
Christina Spears, breast cancer genetic counselor at the Ohio State University Comprehensive Cancer Center, joined us for the MBC Support Group for Black Women to discuss the importance of genetic testing in communities of color and answer pressing questions.
Can Allopathy and Homeopathy Be Used Together in India.pdfDharma Homoeopathy
This article explores the potential for combining allopathy and homeopathy in India, examining the benefits, challenges, and the emerging field of integrative medicine.
I appreciate the opportunity to present the information from this poster to you today. I would also like to express appreciation to the co-authors and the staff of the Burn Outpatient Clinic for their support of this project.
Our Burn Outpatient Clinic completed nearly 4,400 patient visits during fiscal year 2017. We are open Monday through Friday, 8 AM to 5 PM. We have four exam rooms. We care for pediatrics as well as adult patients. We primarily care for patients with burn related wounds, however we also care for patients who have wounds from skin infections, chronic or non-healing wounds as well as wounds sustained from frostbite, Necrotizing Soft Tissue Infection (NSTI) and Toxic Epidermal Necrolysis (TEN). Our patients are primarily seen by a Nurse Practitioner or Physician Assistant. Physicians are available for surgical consultation and other patient needs. Our interdisciplinary team also includes a Child Life Specialist, Social Worker, nursing staff, and Therapy staff.
Patient Reported Outcomes quantify symptoms, function and quality of life from a patient’s perspective. Burn patients have unique needs related to pain, itching, physical function, social activity, depression and PTSD. Our clinic implemented a patient reported outcomes assessment that would provide burn related information for real-time intervention.
Our methods began with collaboration between our organization’s mEval team and our interdisciplinary care team to identify which PROMIS instruments we wanted to use. In addition to the standard assessments of general health, pain, physical function, social activity and depression, we were also interested in assessing itching and PTSD. Initially we included sleep and anxiety instruments. We received patient feedback that the assessment was too long. We realized that questions about sleep and anxiety are included in the PTSD tool and the instruments for sleep and anxiety were removed from the assessment.
We implemented mEval by providing patient education and staff training through the use of “scripts” to help the staff and the patients understand why we were implementing patient reported outcomes and how it would benefit them.
We designed a workflow that would minimize the impact on our day to day clinic workflow. The assessment is emailed to the patient prior to their clinic visit. The assessment can also be given in the clinic at check in (through the use of a tablet). We are able to administer the assessment to patients with next day or same day scheduled visits. The results are available in the EMR with the use of a .dotphrase. The results are available in real-time to be discussed with the patient during their visit and serve to guide the patient’s plan of care.
Each instrument has a reporting threshold. We created a provider tip sheet, which serves as a guide to interpret the results of the assessment. Our interdisciplinary team collaborated to decide what intervals would be used for each instrument. A patient in optimal health will have a high physical function score, high social activity score, and low scores for both depression and PTSD.
Our results: Since implementation in October 2016, 704 assessments have been completed, this is a 36% completion rate. There is a need for us to identify what contributes to a missed opportunity. We want to encourage our patients to complete the assessment. These missed opportunities include issues with the mEval portal not showing our next day and same day appointments. An assessment needs to be generated manually for these patients and check in can be a really busy time to add additional steps. Ongoing conversations with our staff about the importance and value of obtaining the assessment helps them to see that the additional steps are indeed worth the effort. We continue to dialogue and collaborate how to problem solve this situation. We are committed to working to improve our completion rates and look forward to reviewing the results over time.
Total n=1,946
The results of the instruments are listed here. Pain scores—we are close to the reporting threshold and yet given the circumstances of our patients we are pleased that our patients’ pain is being managed as well as it is. We trend the individual 5D itch scores and look for ways to help control this difficult issue. From a social perspective, our patients seem to be doing fairly well. The physical function scores are about where we expect them to be given their physical situation. The mean depression results, are below the reporting threshold for a SW referral. Although PTSD is a concern, the mean PTSD results are also below the reporting threshold for a SW referral.
We have the ability to trend patient scores over time and we are able to adjust the patient’s plan of care based on these results. Our social worker and therapy staff receive daily reports with the scores for depression, PTSD and physical function. Since implementation, we have made 34 SW referrals for depression and 172 SW referrals for PTSD.
We acknowledge that there are limitations. The integration of the results into our EMR is limited, particularly with 5D Itch and the PTSD tool. In order to view the specific results for each instrument, you need to leave the EMR and log in to the mEVAL portal. The mEVAL reporting system can be difficult to navigate. It has been challenging to obtain ongoing results for each instrument. The reports (both completion and refusal) include patients who are not eligible (< 16 yrs age) and accurate results need to be calculated separately from the automated report. Ongoing conversations are occurring with the mEVAL data team to work through these issues. We are beginning to see some signs of improvement.
We continue to provide ongoing education to staff and patients to improve completion rates. While repeated education can seem monotonous, it is necessary to sustain compliance and obtain results. Our hope in the future is to have PRO assessments available to our pediatric patients. We have begun to use PRO’s with our burn telemedicine patients as well. This is a nice addition to the care that we provide these patients remotely.
This poster was presented earlier this month at the American Burn Association Annual Meeting. There is a computer adaptive test being trialed to assess community participation with burn survivors. It is the Life Impact Burn Recovery Evaluation or LIBRE assessment. This is a tool that is specific to people with burn injuries, and focuses on the social impact of the burn injury. One of the future directions I would like to investigate is how to incorporate LIBRE into mEval. Since implementation, PRO have been an effective way to assess and treat the individual needs of burn patients. The results guide interdisciplinary care and promote early intervention. As we continue to improve our completion rates, we will reach additional patients and be able to support them in more effective and efficient ways as they transition from being a patient with an injury to being a true survivor.