This section of the agenda will feature leaders in innovation, patient experience, and design within a clinical setting. Each panelist will present the current state of experiential innovation at their organization, what successes they have seen, what situations they have learned from, and what their challenges and obstacles are, and where they would like to see things head in the future. Then Amy Cueva will guide the group in a discussion around strategy, measurement, culture change, and other important topics relevant to delivering phenomenal experiences.
HXR 2016: Improving Insurance Member Experiences -Janna Kimel, CambiaHxRefactored
This section of the agenda will feature leaders in innovation, customer experience, and design within the health insurance space. Each panelist will present the current state of experience at their organization, what successes they have seen, what situations they have learned from, and what their challenges and obstacles are, and where they would like to see things head in the future. Then Amy Cueva will guide the group in a discussion around strategy, measurement, culture change, and other important topics relevant to delivering phenomenal experiences.
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons C...HxRefactored
Leveraging technology to prevent adolescent suicide, the document discusses how suicide is a leading cause of death for adolescents and young adults. It presents data on suicide rates and risk factors from national surveys. The author describes the development of a mobile application called Crisis Care designed to help struggling youth communicate their pain to caring adults and access immediate support to prevent suicide.
Health care consumers benefit from understanding some of the issues involved in providing them with the best care, and some things they can do themselves to prepare for and learn about these issues. Doctors, nurses, and other health professionals dedicate their lives to caring for their patients. But providing health care can be complicated.
This document discusses SBARR, a communication tool used to standardize nurse-physician handoffs. It begins by explaining that SBARR stands for Situation, Background, Assessment, Recommendation, and Read-back. It then describes each component of SBARR and provides examples of the information that should be included. The document emphasizes that SBARR improves safety by ensuring all relevant patient information is communicated clearly and concisely between clinicians.
2016 Connected Care and the Patient ExperienceSurescripts
Annual survey of 1,000 Americans reveals increased dissatisfaction with data availability and innovation, even though the technology exists today for a safer, more convenient and connected healthcare experience.
Infographic: Ask if Your EHR Offers Surescripts CompletEPA Electronic Prior A...Surescripts
Surescripts works with EHRs serving nearly half a million physicians. Ask your EHR if they work with us. Tell them you want CompletEPA to save your practice time and money.
HXR 2016: Improving Insurance Member Experiences -Janna Kimel, CambiaHxRefactored
This section of the agenda will feature leaders in innovation, customer experience, and design within the health insurance space. Each panelist will present the current state of experience at their organization, what successes they have seen, what situations they have learned from, and what their challenges and obstacles are, and where they would like to see things head in the future. Then Amy Cueva will guide the group in a discussion around strategy, measurement, culture change, and other important topics relevant to delivering phenomenal experiences.
HXR 2016: Designing to Support Mental Health -Dr. Kimberly O'Brien, Simmons C...HxRefactored
Leveraging technology to prevent adolescent suicide, the document discusses how suicide is a leading cause of death for adolescents and young adults. It presents data on suicide rates and risk factors from national surveys. The author describes the development of a mobile application called Crisis Care designed to help struggling youth communicate their pain to caring adults and access immediate support to prevent suicide.
Health care consumers benefit from understanding some of the issues involved in providing them with the best care, and some things they can do themselves to prepare for and learn about these issues. Doctors, nurses, and other health professionals dedicate their lives to caring for their patients. But providing health care can be complicated.
This document discusses SBARR, a communication tool used to standardize nurse-physician handoffs. It begins by explaining that SBARR stands for Situation, Background, Assessment, Recommendation, and Read-back. It then describes each component of SBARR and provides examples of the information that should be included. The document emphasizes that SBARR improves safety by ensuring all relevant patient information is communicated clearly and concisely between clinicians.
2016 Connected Care and the Patient ExperienceSurescripts
Annual survey of 1,000 Americans reveals increased dissatisfaction with data availability and innovation, even though the technology exists today for a safer, more convenient and connected healthcare experience.
Infographic: Ask if Your EHR Offers Surescripts CompletEPA Electronic Prior A...Surescripts
Surescripts works with EHRs serving nearly half a million physicians. Ask your EHR if they work with us. Tell them you want CompletEPA to save your practice time and money.
Telehealth and Mental Health offers opportunities to expand access to mental healthcare. New technologies now allow for telehealth applications like mobile health apps for symptom tracking, counseling, and treatment progress monitoring. Online video game therapy is also being used to help those with conditions like ADHD, anxiety, and autism by providing engaging activities that can inhibit hyperactivity. Telehealth benefits vulnerable groups as well, such as geriatric patients who have risks of isolation, non-compliance, and limited care access, which can lead to earlier nursing home placement.
How and why you (individually and collectively) should promote your neuraxial labor analgesia service. Talk from Sol Shnider
Conference in San Francisco, 2018. http://anesthesiaill.wpengine.com/portfolio/promoting-your-neuraxial-labor-analgesia-service/
Technion lecture @T2med- Patients and ePatients are not third person wordUri Goren
This document discusses the importance of centering healthcare around patients' needs rather than what physicians do. It notes that patients are an underused resource and that moving to a patient-centered system could achieve better outcomes at lower costs. The document also discusses challenges like information overload for doctors, the rise of online information sources, and the need to engage patients. Examples from England show potential savings of £4.4 billion from more engaged "people powered" healthcare that addresses patients' holistic needs.
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 !
Kaiser Permanente developed a bundled approach to improve care transitions called the Transition Care Journey. The bundle includes risk stratification, a dedicated phone number for post-discharge questions, standardized discharge summaries, medication management, and follow-up appointments and calls. Implementation of the bundle in Northwest Kaiser led to reductions in readmission rates, medication list errors, and time to primary care follow-up. It also improved communication between hospitalists, primary care physicians, and specialists. The bundled approach is being spread to other Kaiser regions nationally.
The document summarizes the author's experience in their first semester of a Master of Science in Health Informatics program. Some key points:
- The author realized their goal of pursuing a masters degree and was interested in learning about health informatics and how it could impact the Philippines.
- They enjoyed learning about new topics each week and reflecting on their learning through blog posts. This helped enrich their knowledge on the field.
- Through discussions with professors and classmates, the author gained valuable insights that helped them better understand topics they initially struggled with, like enterprise architecture and standards.
- They found the program gave them a strong foundation of knowledge to start their career in health informatics.
1) The document discusses establishing community awareness and fundraising for the Health Information Technology Solutions for Kids (HITS for kids) program. This program has developed apps and software to help doctors better diagnose and treat concussions in children without unnecessary CT scans.
2) The team launched a social media campaign including a Facebook page and created materials to promote their annual Race for Every Child 5k to raise awareness about the program.
3) Moving forward, HITS for kids plans to expand their social media presence and participate in more advocacy and community outreach to spread awareness of their diagnostic tools for concussions to more hospitals nationwide.
Strategies and Tactics to Leverage Social and Digital Media in Clinical Rese...Inspire
A pharmaceutical company partnered with Inspire, a social network for health, to better understand idiopathic pulmonary fibrosis (IPF) patients. Through surveys of IPF patients on Inspire, the company found that around 70% said their biggest issue was the "lack of therapies which make me feel better." When asked about clinical trial participation, 80% saw the comprehensive evaluation as a benefit, while around 20% saw the chance of a placebo as a drawback. The presentation argues that social networks provide a way for patients, particularly those with rare diseases, to be engaged, informed and have their voices heard by industry to accelerate research.
Speaker Presentation from U.S. News Healthcare of Tomorrow leadership summit, November 2-4, 2016 in Washington, DC. Find out more about this forum at www.usnewshot.com.
Health Informatics Mobile Health, Telemedicine, and the Consumerjetweedy
Health informatics involves the use of information technology and systems to deliver healthcare. Mobile health or mHealth uses mobile devices to improve health outcomes through platforms like mobile apps and sensors. Telemedicine uses technology to provide remote healthcare services and overcome geographical barriers. Consumers are increasingly using mobile apps, fitness trackers, and online resources for health information. However, challenges include issues with costs, privacy, user-friendliness, and low health literacy.
Clinical informatics will see more molecular data collected from patients, increased democratization of biomedical data and knowledge, and the integration of data and digital tools to empower patients and support wellness. In the next 10 years, biomedical informatics will focus on predicting and preventing disease before symptoms occur, explaining rare conditions, keeping people healthy longer through personalized care, and ensuring safe, effective, cost-efficient care is delivered to patients.
Grace Ku is a hospitalist at Sound Physicians in Seattle, WA. She received her D.O. from Western University of Health Sciences and completed her internal medicine residency at Camden Clark Medical Center. Her experience includes medical volunteering in Zimbabwe and Haiti. She is proficient in EMR systems and has held leadership roles on various medical committees. In her free time, she enjoys cooking, singing, live music, dancing, and outdoor activities.
Closing perception gaps between patients and their caregiversInspire
This session at the Stanford University School of Medicine "Medicine X 2013" conference examined the perception gap between patients and their spouses about severity of disease and suffering, with insights from a cancer patient, Maggie Heim, and her husband, Paul Hoffman, and from Aanand Naik, MD. Healthcare professionals need to be more attuned to the potential for a communications disconnect between a patient and his/her caregiver, which could lead to inadequate treatment. We discussed several studies, including a survey that Inspire conducted in 2012 in collaboration with Novartis, illustrating this gap: "Perceptions of stage IV NSCLC patients and caregivers regarding severity of symptoms and willingness to participate in supportive care trials."
5 Ways Predictive Analytics Can Improve HealthcareTyrone Systems
Medical analytics have the potential to radically change health care worldwide. As the sector shifts to a valuation-based delivery system, the use of analytics in health care is gaining attention. Hospitals and medical systems are seeking the ability to recognize patient activity, improve efficiency, and reduce the physician and the client's level of commitment. That's where the equation enters analytics. Predictive analytics enables hospitals and medical structures to use technology and methodologies to obtain insights from large amounts of data to help inform patient, prospect & population relationships.
The document discusses various types of medical errors, including failure to provide care leading to self-harm and errors leading to harm not caused by the patient. It emphasizes the importance of accurate assessment over time, noting that diagnoses can change in response to life events. The document recommends differential diagnosis, awareness of issues like medical complexity, pregnancy, and domestic violence, and implementing intervention and prevention strategies to provide ethical care.
The document discusses challenges for rural physicians in adopting electronic medical records (EMRs) and improving healthcare through technology. It presents results from case studies and surveys of rural physicians that suggest physicians' perceptions of technology directly impact their willingness to adopt EMRs and perceptions of patients' needs. While rural medicine lags in EMR implementation compared to urban areas, the technologies are the same and continued research can help address challenges of the transition to digital healthcare in rural communities.
Home Healthcare + Data Science: A Prescription For Our Nation's Readmissions ...Wes Little
A result of over a year's worth of data science research and home healthcare's largest data-set, Kinnser RiskPoint was built to help solve the huge challenge of preventable patient readmissions. If this metric is a top priority for your organization- read here to learn more about the research and early results
Design Trials to Better Satisfy Patient Centric Outcomes Prior to Product LaunchInspire
Incorporate Patient Participation – Design Trials to Better Satisfy Patient Centric Outcomes Prior to Product Launch
Presentation by Inspire Research Director Dave Taylor at Evidence for Value-Based Programs conference
August 12, 2015
Care Coordination: Provider and Patient Impact | West Corporationwestcorphealth
The National Quality Forum defines care coordination as “a function that helps ensure that the patient’s needs and preferences for health services and information sharing across people, functions, and sites are met over time.” This infographic shows the impact of poor care coordination on both providers and patients.
This document provides a study protocol for a randomized controlled trial evaluating the effectiveness of advance care planning (ACP) for patients with incurable cancer. The trial aims to determine if a formal ACP intervention improves compliance with patients' end-of-life wishes and satisfaction with care compared to standard care alone. 210 patient-family dyads will be randomly assigned to receive either standard care or standard care plus a nurse-led ACP intervention. Primary outcomes are family-reported discussion of end-of-life wishes and perception that wishes were met. Secondary outcomes include documentation of preferences, quality of end-of-life care, family mental health, communication, satisfaction, and costs.
Screening for heart defects in the first trimesterTony Terrones
This document discusses two studies on screening for heart defects in the first trimester of pregnancy. The first study measured cardiac axis in 100 pregnancies between 11-14 weeks and found an abnormal axis in 4 cases that were later diagnosed with congenital heart disease. However, the study excluded women with high BMI and nearly 20% required additional imaging, calling into question its applicability for widespread screening. The second study found measuring ductus venosus pulsatility index could help predict heart defects, but obtaining a clear measurement may be difficult and half of postnatally diagnosed cases were missed prenatally. The document concludes that while identifying high-risk cases early is important, screening also needs to allow for timely diagnostic imaging and accurate diagnosis
Telehealth and Mental Health offers opportunities to expand access to mental healthcare. New technologies now allow for telehealth applications like mobile health apps for symptom tracking, counseling, and treatment progress monitoring. Online video game therapy is also being used to help those with conditions like ADHD, anxiety, and autism by providing engaging activities that can inhibit hyperactivity. Telehealth benefits vulnerable groups as well, such as geriatric patients who have risks of isolation, non-compliance, and limited care access, which can lead to earlier nursing home placement.
How and why you (individually and collectively) should promote your neuraxial labor analgesia service. Talk from Sol Shnider
Conference in San Francisco, 2018. http://anesthesiaill.wpengine.com/portfolio/promoting-your-neuraxial-labor-analgesia-service/
Technion lecture @T2med- Patients and ePatients are not third person wordUri Goren
This document discusses the importance of centering healthcare around patients' needs rather than what physicians do. It notes that patients are an underused resource and that moving to a patient-centered system could achieve better outcomes at lower costs. The document also discusses challenges like information overload for doctors, the rise of online information sources, and the need to engage patients. Examples from England show potential savings of £4.4 billion from more engaged "people powered" healthcare that addresses patients' holistic needs.
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 !
Kaiser Permanente developed a bundled approach to improve care transitions called the Transition Care Journey. The bundle includes risk stratification, a dedicated phone number for post-discharge questions, standardized discharge summaries, medication management, and follow-up appointments and calls. Implementation of the bundle in Northwest Kaiser led to reductions in readmission rates, medication list errors, and time to primary care follow-up. It also improved communication between hospitalists, primary care physicians, and specialists. The bundled approach is being spread to other Kaiser regions nationally.
The document summarizes the author's experience in their first semester of a Master of Science in Health Informatics program. Some key points:
- The author realized their goal of pursuing a masters degree and was interested in learning about health informatics and how it could impact the Philippines.
- They enjoyed learning about new topics each week and reflecting on their learning through blog posts. This helped enrich their knowledge on the field.
- Through discussions with professors and classmates, the author gained valuable insights that helped them better understand topics they initially struggled with, like enterprise architecture and standards.
- They found the program gave them a strong foundation of knowledge to start their career in health informatics.
1) The document discusses establishing community awareness and fundraising for the Health Information Technology Solutions for Kids (HITS for kids) program. This program has developed apps and software to help doctors better diagnose and treat concussions in children without unnecessary CT scans.
2) The team launched a social media campaign including a Facebook page and created materials to promote their annual Race for Every Child 5k to raise awareness about the program.
3) Moving forward, HITS for kids plans to expand their social media presence and participate in more advocacy and community outreach to spread awareness of their diagnostic tools for concussions to more hospitals nationwide.
Strategies and Tactics to Leverage Social and Digital Media in Clinical Rese...Inspire
A pharmaceutical company partnered with Inspire, a social network for health, to better understand idiopathic pulmonary fibrosis (IPF) patients. Through surveys of IPF patients on Inspire, the company found that around 70% said their biggest issue was the "lack of therapies which make me feel better." When asked about clinical trial participation, 80% saw the comprehensive evaluation as a benefit, while around 20% saw the chance of a placebo as a drawback. The presentation argues that social networks provide a way for patients, particularly those with rare diseases, to be engaged, informed and have their voices heard by industry to accelerate research.
Speaker Presentation from U.S. News Healthcare of Tomorrow leadership summit, November 2-4, 2016 in Washington, DC. Find out more about this forum at www.usnewshot.com.
Health Informatics Mobile Health, Telemedicine, and the Consumerjetweedy
Health informatics involves the use of information technology and systems to deliver healthcare. Mobile health or mHealth uses mobile devices to improve health outcomes through platforms like mobile apps and sensors. Telemedicine uses technology to provide remote healthcare services and overcome geographical barriers. Consumers are increasingly using mobile apps, fitness trackers, and online resources for health information. However, challenges include issues with costs, privacy, user-friendliness, and low health literacy.
Clinical informatics will see more molecular data collected from patients, increased democratization of biomedical data and knowledge, and the integration of data and digital tools to empower patients and support wellness. In the next 10 years, biomedical informatics will focus on predicting and preventing disease before symptoms occur, explaining rare conditions, keeping people healthy longer through personalized care, and ensuring safe, effective, cost-efficient care is delivered to patients.
Grace Ku is a hospitalist at Sound Physicians in Seattle, WA. She received her D.O. from Western University of Health Sciences and completed her internal medicine residency at Camden Clark Medical Center. Her experience includes medical volunteering in Zimbabwe and Haiti. She is proficient in EMR systems and has held leadership roles on various medical committees. In her free time, she enjoys cooking, singing, live music, dancing, and outdoor activities.
Closing perception gaps between patients and their caregiversInspire
This session at the Stanford University School of Medicine "Medicine X 2013" conference examined the perception gap between patients and their spouses about severity of disease and suffering, with insights from a cancer patient, Maggie Heim, and her husband, Paul Hoffman, and from Aanand Naik, MD. Healthcare professionals need to be more attuned to the potential for a communications disconnect between a patient and his/her caregiver, which could lead to inadequate treatment. We discussed several studies, including a survey that Inspire conducted in 2012 in collaboration with Novartis, illustrating this gap: "Perceptions of stage IV NSCLC patients and caregivers regarding severity of symptoms and willingness to participate in supportive care trials."
5 Ways Predictive Analytics Can Improve HealthcareTyrone Systems
Medical analytics have the potential to radically change health care worldwide. As the sector shifts to a valuation-based delivery system, the use of analytics in health care is gaining attention. Hospitals and medical systems are seeking the ability to recognize patient activity, improve efficiency, and reduce the physician and the client's level of commitment. That's where the equation enters analytics. Predictive analytics enables hospitals and medical structures to use technology and methodologies to obtain insights from large amounts of data to help inform patient, prospect & population relationships.
The document discusses various types of medical errors, including failure to provide care leading to self-harm and errors leading to harm not caused by the patient. It emphasizes the importance of accurate assessment over time, noting that diagnoses can change in response to life events. The document recommends differential diagnosis, awareness of issues like medical complexity, pregnancy, and domestic violence, and implementing intervention and prevention strategies to provide ethical care.
The document discusses challenges for rural physicians in adopting electronic medical records (EMRs) and improving healthcare through technology. It presents results from case studies and surveys of rural physicians that suggest physicians' perceptions of technology directly impact their willingness to adopt EMRs and perceptions of patients' needs. While rural medicine lags in EMR implementation compared to urban areas, the technologies are the same and continued research can help address challenges of the transition to digital healthcare in rural communities.
Home Healthcare + Data Science: A Prescription For Our Nation's Readmissions ...Wes Little
A result of over a year's worth of data science research and home healthcare's largest data-set, Kinnser RiskPoint was built to help solve the huge challenge of preventable patient readmissions. If this metric is a top priority for your organization- read here to learn more about the research and early results
Design Trials to Better Satisfy Patient Centric Outcomes Prior to Product LaunchInspire
Incorporate Patient Participation – Design Trials to Better Satisfy Patient Centric Outcomes Prior to Product Launch
Presentation by Inspire Research Director Dave Taylor at Evidence for Value-Based Programs conference
August 12, 2015
Care Coordination: Provider and Patient Impact | West Corporationwestcorphealth
The National Quality Forum defines care coordination as “a function that helps ensure that the patient’s needs and preferences for health services and information sharing across people, functions, and sites are met over time.” This infographic shows the impact of poor care coordination on both providers and patients.
This document provides a study protocol for a randomized controlled trial evaluating the effectiveness of advance care planning (ACP) for patients with incurable cancer. The trial aims to determine if a formal ACP intervention improves compliance with patients' end-of-life wishes and satisfaction with care compared to standard care alone. 210 patient-family dyads will be randomly assigned to receive either standard care or standard care plus a nurse-led ACP intervention. Primary outcomes are family-reported discussion of end-of-life wishes and perception that wishes were met. Secondary outcomes include documentation of preferences, quality of end-of-life care, family mental health, communication, satisfaction, and costs.
Screening for heart defects in the first trimesterTony Terrones
This document discusses two studies on screening for heart defects in the first trimester of pregnancy. The first study measured cardiac axis in 100 pregnancies between 11-14 weeks and found an abnormal axis in 4 cases that were later diagnosed with congenital heart disease. However, the study excluded women with high BMI and nearly 20% required additional imaging, calling into question its applicability for widespread screening. The second study found measuring ductus venosus pulsatility index could help predict heart defects, but obtaining a clear measurement may be difficult and half of postnatally diagnosed cases were missed prenatally. The document concludes that while identifying high-risk cases early is important, screening also needs to allow for timely diagnostic imaging and accurate diagnosis
This Volume of Progress in Clinical Neurosciences brings to you a synthesized overview of clinically relevant topics in an easy-to-read format. It would enable both the practicing Clinician and the student in training to update their knowledge and apply it in day-to-day practice. The most significant advances in traumatic brain injury, pituitary adenomas, myasthenia gravis, epilepsy source localization, and poststroke rehabilitation have been addressed. The controversies regarding the management of low grade gliomas, solitary brain metastasis and optimal surgical approach to colloid cysts are discussed cogently. A systematic diagnostic approach to myelopathy and encephalopathy is illustrated. The future of neurosurgical education is simulation and there is a detailed explanation of this strategy. The importance and relevance of clinical examination in today's era of highly advanced diagnostic imaging cannot be understated and this has been put forth emphatically.
This document summarizes key findings from a study on returning genomic sequencing results to patients with idiopathic diseases and their physicians. The study found that [1] physicians may need help interpreting and communicating genomic results to patients, as post-sequencing patients graded their physician's communication skills lower than pre-sequencing, and [2] both patients and physicians preferred that secondary or incidental findings from sequencing be returned. The study highlights the challenges of integrating genomic medicine into clinical practice and the need for improved physician education in genetics and result disclosure.
This study analyzed 1,474 cases of congenital heart disease (CHD) identified between 1997-2007 in Utah to evaluate prenatal detection rates and barriers. The main findings were:
1) CHD was only detected prenatally in 39% of cases, and the detection rate did not improve over the 10-year study period.
2) While 97% of mothers received at least one prenatal ultrasound, the ultrasound failed to detect CHD in 61% of cases.
3) Factors associated with increased odds of prenatal detection included a family history of CHD, presence of extracardiac defects, and ultrasound performed at a high-risk clinic rather than a general clinic. Defect
Medical ethics and ceilings of care in hepatologyphilaberry
Presented at Royal Free Hepatology course May 2017, this lecture examines the evolving evidence and ethical challenges relating to treatment escalation in cirrhosis patients.
Roundtable Expert Discussions on CML Clinical Debates: A Collaborative Video Viewpoint Series With Medscape
This video viewpoint in its original and unaltered format is for educational purposes and is current as of May 31, 2012. All materials contained herein reflect the views of the faculty, and not those of IMER, the CME provider, or the commercial supporter. These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. Readers should not rely on this information as a substitute for professional medical advice, diagnosis, or treatment. The use of any information provided is solely at the user’s own risk, and all users should verify the prescribing information and all data before treating patients or employing any therapeutic products described in this educational activity.
Pancreatic Cancer Advances in Treatment Assignment.pdfbkbk37
This document provides information on pancreatic cancer, including a description of the disease, risk factors, signs and symptoms, assessment, staging, and treatment options. It summarizes that pancreatic cancer is difficult to diagnose early and has a poor prognosis. Treatment may include surgery, chemotherapy, and radiation therapy depending on the type and stage of cancer. Pain management and palliative care are also important to improve quality of life.
The document discusses the importance of taking a thorough medical history. It outlines that a history is the first step in diagnosis and is often the least expensive way to determine the correct diagnosis. It also emphasizes that history taking requires establishing rapport with the patient and developing one's own systematic technique through practice and experience. A table provides a suggested sequence for obtaining a patient's history.
The ed as gatekeeper in transitions of care james hoekstra md 1jgillmd
This document discusses the role of the emergency department (ED) as a gatekeeper in transitions of care. It covers several key points:
1) The ED plays an important role in determining whether patients are observed, admitted, or discharged. Risk stratification tools help guide these decisions for conditions like chest pain.
2) The ED communicates patient acuity levels and makes recommendations about observation, medical-surgical floors, intensive care, etc. Information on condition, interventions, and risk scores are important to transmit.
3) Protocol-driven care that begins in the ED can continue on hospital floors, improving outcomes. Guidelines help with conditions like heart attacks and pneumonia.
4) The ED can help
Palliative care is about providing well-being and the highest quality of life to patients with serious, progressive, chronic life-limiting illness, including during the dying process.
User Acceptance Scheermesser Kosow Tampereguestd6b375
This document summarizes the key findings from two case studies on user acceptance of pervasive computing in healthcare. [1] The studies examined factors like perceived usefulness, ease of use, and subjective norms that can facilitate or inhibit acceptance. [2] Across both studies, perceived usefulness and medical benefit were found to be decisive for user acceptance, but usability needed improvement to account for healthcare environments and abilities. [3] Subjective norms around changing roles could also inhibit implementation if social roles or job images felt threatened.
The document discusses elder psychiatry in nursing homes. It provides background on the author's clinical experience in liaison psychiatry and common issues seen in nursing homes. It then summarizes key points regarding altered mental states in elderly patients, including the many potential organic and psychiatric causes of confusion. It reviews tools for assessing delirium like the RASS scale. It discusses predisposing and precipitating factors for delirium and lists medications that commonly cause adverse drug reactions or are potentially inappropriate. Treatment options for delirium and weaning psychotropic medications are briefly covered. The need for early discussion of end of life care and capacity assessment is also mentioned.
Cancer genetic counseling services provide important benefits for those with and without cancer. Genetic counselors educate patients about their cancer risks, help patients understand genetic testing results, and empower informed decision making. While genetic testing identifies only a small percentage of cancer cases, it allows for targeted treatment and screening that can prevent cancer in families. Expanding access to genetic risk assessment and counseling could help identify more high-risk individuals and families earlier to reduce cancer burden through prevention and early detection strategies.
This systematic review and meta-analysis examined the prevalence of abnormalities associated with persistent left superior vena cava (PLSVC) detected on prenatal ultrasound. The main findings were:
1) Associated intra-cardiac and extra-cardiac anomalies were detected at the initial scan in 56.6% and 37.8% of cases, respectively.
2) Chromosomal abnormalities occurred in 12.5% of all PLSVC cases and 7% of isolated PLSVC cases.
3) Additional intra-cardiac and extra-cardiac anomalies missed on initial ultrasound but detected after birth occurred in 2.4% and 6.7% of isolated PLSVC cases, respectively.
4) Co
Caring Conversations: Talking about goals of care with patients and familiesAndi Chatburn, DO, MA
The document discusses goals of care and advance directives, providing evidence-based guidance on discussing end-of-life wishes and preferences with patients. It outlines tools and resources for starting conversations about advance care planning, including living wills, durable powers of attorney, and forms tailored for pediatric patients. The presentation also addresses barriers to discussing code status and provides suggestions for conducting effective family meetings on goals of care.
This document contains two summaries of research studies:
1) A study of 80 patients under 1 year old presenting to an urban optometry clinic. 43 patients had eye or vision problems including strabismus, ocular pathology, and vision problems. The study highlights the importance of eye exams before age 1.
2) A literature review on the effects of long-chain polyunsaturated fatty acids (LCPs) in infant formulas on visual development. Studies found LCP supplementation improved visual acuity test results. Optometrists should educate parents on the importance of LCPs for visual health in breastfed or formula-fed infants.
Similar to HXR 2016: Human Focused Innovation in a Clinical Setting -Jennie Kung, UCLA Health (20)
HXR 2017: Denise Gosnell, Pokitdok: Blockchain: The Now and The Future: HxRefactored
Hear from experts on what’s the future of blockchain and how it will transform the health industry.
The topic of “Blockchain,” first debuted in 2008, is the revolutionary technological advance that will impact health care in a positive direction.
HXR 2017: Susan Hunt Stevens, WeSpire: Holistic WellbeingHxRefactored
This document discusses holistic wellbeing and how the WeSpire platform can be used to design positive impact programs to improve employee wellbeing. It outlines how wellbeing impacts businesses by reducing costs and improving productivity. The WeSpire platform uses behavioral science and gamification to create customized wellbeing campaigns across multiple areas like physical, social, financial, and community wellbeing. Campaigns aim to change behaviors long-term through social networks and targeting different skill levels. The platform offers 150 pre-made campaigns that can be customized or users can build their own. It provides reporting on engagement and impact. An example is shared of a beauty brand client that ran meditation campaigns on the platform which over 800 employees participated in.
HXR 2017: John Weiss, Human Design: Building a Culture of HealthHxRefactored
We heard a lot about building a better culture of health, but what does that mean?
Experts will speak on how employers, educational institutions, government, and corporations can contribute to a culture of health and well-being in our workplaces, schools, communities, and the public consciousness.
This document discusses the benefits of using robots and AI assistants to manage healthcare and free up humans to focus on more meaningful tasks. It argues that machines are well-suited for collecting and analyzing health data over time without burdening people. With a standardized health record accessible to both humans and machines, baseline health metrics can be established and personalized care plans can dynamically evolve based on changing health status. Ultimately, this approach aims to help people better understand and own their health so they can focus on their goals and dreams rather than worrying over mundane healthcare tasks.
HXR 2017: Heather Patrick, Carrot Sense: Motivation and Health Behavior ChangeHxRefactored
Learn how to facilitate motivation for positive health behaviors in a variety of context.
Motivation - the psychological process that gives behavior its energy and direction - plays a central role in the adoption and sustained execution of health-promoting behaviors critical to prolonging length and quality of life.
In this session, you'll learn from experts in the field about theory-backed and evidence-based approaches to facilitating motivation for positive health behaviors in a variety of contexts from interpersonal (coaching and clinical encounters) to commercial applications (digital services, websites & apps) to large-scale multi-modal public health campaigns.
HXR 2017: Casey Quinlan: the Price is RightHxRefactored
This document introduces several people involved in health care including a precision medicine research advocate who is a lung cancer survivor, a health and health tech consultant nicknamed Wonder Woman, a writer and policy expert nicknamed Mighty Mouth, and a writer and analyst who is a marathon addict. It also lists several common medical procedures and experiences in the U.S. healthcare system such as mammograms, emergency room stitches, childbirth, and multiple sclerosis treatment, followed by a call to discuss healthcare delivery and patients.
HXR 2017: Bakul Patel: How the FDA Is Promoting Innovation and Protecting the...HxRefactored
Health care entrepreneurs have described the FDA as a barrier to the market. Most of the time companies do not know when the FDA is regulating their app, device, or software. With new hands-off policies instituted to promote innovations to the market, Bakul will provide insights on the FDA's plans to regulating health technology as well as protecting the patients who are using the products.
HXR 2017: Jay Gupta, RxRelax: RxRelax to Reverse Polypharmacy TrendsHxRefactored
Bring a person-centered approach into the way we think about, prescribe and take medications.
The magic pills to cure our ills seem to multiply on our kitchen tables as we age or if we get sick. This creates significant, and sometimes dangerous consequences, that continue to emerge. Jay Gupta wondered why no one seems to be talking about polypharmacy, so he decided to do something about that. He will share his perspective about the problem and offer solutions that can change the way we all think about medication. This includes the emerging role of a powerful blockbuster drug that is safe if used as prescribed, easy to take and can be highly effective.
HXR 2017: Kathleen Howland, Berklee College of Music: Music Therapy in Health...HxRefactored
For the past 35 years, she has worked with a variety of clinical populations using music to enhance speech, language, cognition, and movement in habilitation and rehabilitation settings. Today she will talk about the need and possibility that music-based interventions can support the long term disabilities of millions of Americans and beyond.
HXR 2017: Center for Health Experience Design Announcement HxRefactored
The Center for Health Experience Design serves as a conduit to create health experiences that help people heal and flourish.
Healthcare organizations are facing complex problems that cannot be solved by any one organization in isolation. There are promising opportunities in front of us to amplify our impact by extending beyond the boundaries of our organization to create new solutions that support patients, families and the care team.
HXR 2017: Paul Kahn, Mad*Pow: Lessons Learned from a Bill you can understandHxRefactored
The document summarizes lessons learned from efforts to create more understandable medical bills. It describes patients' common experiences with surprise, confusion and delay regarding medical bills. It then outlines three approaches that could help reduce complexity: 1) provider networks managing all charges, 2) insurers managing all payments, or 3) a new third-party platform managing claims and payments between all parties. The key is establishing a single financial relationship for patients to alleviate fragmentation and create a coherent experience.
HXR 2017: Aneesh Chopra, NavHealth: Call to Action: All Hands on Deck to Brin...HxRefactored
As the debate in Washington rages on the future of the Affordable Care Act, one set of reforms continues unabated - the movement to redesign the care delivery system around a patient’s needs. In this session, Aneesh will share his perspective on why we are entering the golden era of IT-fueled care delivery innovation, and issue a call to action for developers and designers to put the emerging open API standards to work in helping consumers taking a more active role in navigating the health care delivery system. He will offer a pragmatic path to build the necessary foundation for organizing, enriching and (securely) sharing patient health data, including taking full advantage of the emerging “health internet,” efforts worth advancing even amidst this period of policy uncertainty.
The health care industry is in the midst of a great deal of disruption and change. We are trying to heal pain and improve care but we know that technology isn't always the answer. How can we channel our empathy to better understand the health ecosystem and re-orient it to deliver meaningful change? Hear from Amy as she speaks on how purpose-driven design can provide us with a solution
HXR 2016: Sustainable Design -Jen Briselli, James Christie, Mad*PowHxRefactored
Discover the carbon impact of the internet (hint: it's bigger than that of entire countries and due to hit 9 billion tons of CO2 by 2020)
How to design, build, and host low-carbon websites
Learn behavior change techniques that can help consumers make greener choices online
Attitudes and beliefs: design for audiences with diverse world-views (including those who disagree about climate change)
HXR 2016: Designing for Addiction and Recovery -Mary Beth Schoening, Behavior...HxRefactored
This panel is comprised of parents who’ve lost their children to addiction, a parent whose son is in recovery, and individuals themselves in long-term recovery. We will hear directly from them about their struggles, the impact on individuals and families dealing with addiction, as well as their opinions on where the system could benefit from solutions. The addiction issue is complex and would benefit from solutions in many areas. We invite you to join us to hear first hand.
HXR 2016: Addressing the Opioid CrisisHxRefactored
David W Casavant and Stephen Carson present on the Online Pediatric Pain and Opioid Education Program. The presentation discusses treating non-cancer pain with minimal risk of addiction or abuse, focusing on physician compensation and patient satisfaction. Resources are provided from the Substance Abuse and Mental Health Services Administration on the 2013 National Survey on Drug Use and Health.
HXR 2016: New Models for Care Delivery -Andrew Schutzbank, Iora HealthHxRefactored
Andrew’s passion for revolutionizing health care began as a medical student at Tulane in pre- and post-Katrina New Orleans, continuing during his Internal Medicine & Primary Care residency at the Beth Israel Deaconess Medical Center. Andrew has worked across Iora Health since its founding: building the collaborative care platform, advancing a dynamic model of primary care.
HXR 2016: New Models for Care Delivery -Ethan Berke, Dartmouth-HitchcockHxRefactored
ImagineCare is a digital health platform developed by Dartmouth-Hitchcock Health System to help people better manage chronic diseases. The platform was designed using principles of behavior change and focuses on making services easy to use, continuously valuable, and aimed at behavior modification. It incorporates consumer health wearables, evidence-based care pathways, and secure cloud technologies. The goal of ImagineCare is to empower individuals to live healthier lives and better self-manage chronic conditions through a mobile app that enables 24/7 access to personalized care plans, remote patient monitoring, and proactive support.
HXR 2016: Human Focused Innovation in a Clinical Setting -Lesley Solomon, Bri...HxRefactored
The Brigham and Women's Hospital Innovation Hub (iHub) was created to foster innovation among clinicians and staff and help move ideas from concept to implementation. The iHub provides programs like innovation accelerators and advisory services to help innovators overcome common barriers to innovation such as lack of funding, time, and clarity on next steps. Notable innovations supported include reducing MRI analysis time from 3 days to 3 seconds. Innovators report that the iHub helped connect them to resources and partners to further develop their ideas.
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/
Stem Cell Solutions: Dr. David Greene's Path to Non-Surgical Cardiac CareDr. David Greene Arizona
Explore the groundbreaking work of Dr. David Greene, a pioneer in regenerative medicine, who is revolutionizing the field of cardiology through stem cell therapy in Arizona. This ppt delves into how Dr. Greene's innovative approach is providing non-surgical, effective treatments for heart disease, using the body's own cells to repair heart damage and improve patient outcomes. Learn about the science behind stem cell therapy, its benefits over traditional cardiac surgeries, and the promising future it holds for modern medicine. Join us as we uncover how Dr. Greene's commitment to stem cell research and therapy is setting new standards in healthcare and offering new hope to cardiac patients.
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.
We are one of the top Massage Spa Ajman Our highly skilled, experienced, and certified massage therapists from different corners of the world are committed to serving you with a soothing and relaxing experience. Luxuriate yourself at our spas in Sharjah and Ajman, which are indeed enriched with an ambiance of relaxation and tranquility. We could confidently claim that we are one of the most affordable Spa Ajman and Sharjah as well, where you can book the massage session of your choice for just 99 AED at any time as we are open 24 hours a day, 7 days a week.
Visit : https://massagespaajman.com/
Call : 052 987 1315
Healthy Eating Habits:
Understanding Nutrition Labels: Teaches how to read and interpret food labels, focusing on serving sizes, calorie intake, and nutrients to limit or include.
Tips for Healthy Eating: Offers practical advice such as incorporating a variety of foods, practicing moderation, staying hydrated, and eating mindfully.
Benefits of Regular Exercise:
Physical Benefits: Discusses how exercise aids in weight management, muscle and bone health, cardiovascular health, and flexibility.
Mental Benefits: Explains the psychological advantages, including stress reduction, improved mood, and better sleep.
Tips for Staying Active:
Encourages consistency, variety in exercises, setting realistic goals, and finding enjoyable activities to maintain motivation.
Maintaining a Balanced Lifestyle:
Integrating Nutrition and Exercise: Suggests meal planning and incorporating physical activity into daily routines.
Monitoring Progress: Recommends tracking food intake and exercise, regular health check-ups, and provides tips for achieving balance, such as getting sufficient sleep, managing stress, and staying socially active.
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.
Visit : https://massagespaajman.com/
Call : 052 987 1315
Letter to MREC - application to conduct studyAzreen Aj
Application to conduct study on research title 'Awareness and knowledge of oral cancer and precancer among dental outpatient in Klinik Pergigian Merlimau, Melaka'
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
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.
This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardso...rightmanforbloodline
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
Let's Talk About It: Breast Cancer (What is Mindset and Does it Really Matter?)bkling
Your mindset is the way you make sense of the world around you. This lens influences the way you think, the way you feel, and how you might behave in certain situations. Let's talk about mindset myths that can get us into trouble and ways to cultivate a mindset to support your cancer survivorship in authentic ways. Let’s Talk About It!
INFECTION OF THE BRAIN -ENCEPHALITIS ( PPT)blessyjannu21
Neurological system includes brain and spinal cord. It plays an important role in functioning of our body. Encephalitis is the inflammation of the brain. Causes include viral infections, infections from insect bites or an autoimmune reaction that affects the brain. It can be life-threatening or cause long-term complications. Treatment varies, but most people require hospitalization so they can receive intensive treatment, including life support.
Champions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdf
HXR 2016: Human Focused Innovation in a Clinical Setting -Jennie Kung, UCLA Health
1.
2.
3.
4. FOCUS AREA CLUSTERSPATIENT AND EXPERT TAKEAWAYSTRANSCRIBED DATA
Patient 01 Patient 02
SME 01 SME 02
Focus Area 3
Focus Area 2
Focus Area 1
Opportunity 3
Opportunity 2
Opportunity 1
OPPORTUNITY RECOGNITIONRAW DATA OUTCOMES
Interview Notes
Workgroup Minutes
Observations
Opportunities
Ideas
Patient Journey
Patient Journey
QDM/HCAHPS/Grievance
s
21. Cardiac Observation Unit (COU) General Internal Medicine & Health
Services Research
Cardiac Care Unit (CCU) Bilingual Cultural Initiative Medical
Psychology Assessment Center at Semel
Institute for Neuroscience and Human
Behavior
Cardiology UCLA Innovation in Health
Interpreter Services ValU/Quality
Nursing Department Leadership Performance Excellence
24. I have to tell my parents that
I’m not getting any better…
I don’t want to be reminded
of my disease…
16 year old
patient
25. Mother of a
hospitalized infant,
who is a nurse
herself, stated that
she “loves bedside
rounds” but the nurse
was present on
rounds only about
half of the time.
Mother of 6 year old child hospitalized
for leukemia had concerns that her
child kept getting woken up in the night
for trash being removed from the room.
Mother of 6 year old
admitted multiple times
with leukemia, who is
unclear of the roles of the
medical students/doctors
on the team.
32. “The Patient Voice
project changed how I
view the care I deliver
on a routine basis…
Our Department discovered a spectrum of actions we could take to
enhance the value of care we deliver to our patients…
It all started with asking them
about their care.”
Christopher Saigal MD, MPH
Editor's Notes
UCLA Health aims to rank among the best‐performing programs for care nationally and internationally.
Value projects help to achieve this aim by analyzing program performance from all perspectives – cost, quality, and patient experience – to gain a deep understanding of the value embedded in the care pathway, and by using this understanding to make improvements that yield greater value on all fronts.
The Patient Voice Toolkit is part of this broader Value initiative that seeks to match financial and outcome measures to what UCLA patients are really seeking in their care.
It facilitates deep learning of the current state of care through heavy patient engagement and input, thus providing insights from the patient perspective.
The Patient Voice focuses on the patient journey, both from the patient perspective and the care team perspective.
Initially, the process relies heavily on interviews with patients and providers to provide helpful data that is used to uncover themes and, finally, possible interventions to improve the care pathway.
UCLA Health aims to rank among the best‐performing programs for care nationally and internationally.
Value projects help to achieve this aim by analyzing program performance from all perspectives – cost, quality, and patient experience – to gain a deep understanding of the value embedded in the care pathway, and by using this understanding to make improvements that yield greater value on all fronts.
The Patient Voice Toolkit is part of this broader Value initiative that seeks to match financial and outcome measures to what UCLA patients are really seeking in their care.
It facilitates deep learning of the current state of care through heavy patient engagement and input, thus providing insights from the patient perspective.
The Patient Voice focuses on the patient journey, both from the patient perspective and the care team perspective.
Initially, the process relies heavily on interviews with patients and providers to provide helpful data that is used to uncover themes and, finally, possible interventions to improve the care pathway.
UCLA Health aims to rank among the best‐performing programs for care nationally and internationally.
Value projects help to achieve this aim by analyzing program performance from all perspectives – cost, quality, and patient experience – to gain a deep understanding of the value embedded in the care pathway, and by using this understanding to make improvements that yield greater value on all fronts.
The Patient Voice Toolkit is part of this broader Value initiative that seeks to match financial and outcome measures to what UCLA patients are really seeking in their care.
It facilitates deep learning of the current state of care through heavy patient engagement and input, thus providing insights from the patient perspective.
The Patient Voice focuses on the patient journey, both from the patient perspective and the care team perspective.
Initially, the process relies heavily on interviews with patients and providers to provide helpful data that is used to uncover themes and, finally, possible interventions to improve the care pathway.
Idea Generation
Idea Prioritization
The “Yo Entiendo” Patient Voice project was designed to help us better understand health literacy and cultural barriers faced by the Spanish-speaking heart failure patients in 7N/7CCU.
I want to share with you another project…
One that used the Patient Voice to better understand the needs of our Limited English Proficient patients…
An elderly Chinese speaking man having chest pain was transferred from a community based hospital over the weekend to UCLA for an emergent left heart cath. He came with his English speaking daughter who agreed with the outside hospital for her father to have an emergent cath. When they arrived to the cath lab at UCLA, as they were rolling the patient into the procedure room, he yelled and screamed waiving his hands in the air. UCLA staff weren’t sure what was happening. They called the interpreter services number only to find out that the patient did not want to have the procedure.
How did this happen?
1. The daughter spoke/interpreted on behalf of the patient
Inaccurate language preference documentation
In 1984, a 22 y/o Spanish speaking male told his girlfriend he felt ‘intoxicado’ and collapsed. When she repeated the term, hospital personnel took it to mean intoxicated, though the intended meaning was ‘nauseated.’ His brain clot was misdiagnosed as a drug overdose. A jury later awarded a $71 million malpractice settlement against the hospital.
[Shutts, S. (Feb 25 2008) Ohio medical students train with interpreters to improve minority care.]
8 Bedside RNs
3 NPs
2 Care Partners
1 Social Worker
1 Patient Expert
4 Cardiologist
4 Fellows
10 Residents
1 Medical Student
1 Clinical and industrial psychologist
Collaborators
Malka Sierra- Senior Multicultural Director American Heart Association
“Caring for Your Heart: Living Well with Heart Failure” – Developers: San Francisco General Hospital; University of North Carolina; Northwestern University Feinberg School of Medicine
The American Academy of Pediatrics endorses bedside rounds, with the family present, as the standard of care. At Mattel Children’s Hospital UCLA, inpatient teams round on their patients at the bedside. Family centered bedside rounds with the nurse present improves family satisfaction. We have room to improve our family satisfaction data, especially focusing on doctor communication.
We had the honor of listening to the voices of our hospitalized children and their families to find out how we could improve the bedside rounding experience, and improve overall communication at Mattel Children’s Hospital UCLA.
16 year old patient admitted to the pediatric floor. She speaks English and Spanish, and her parents speak Spanish only. She told us that she is “often” used as the translator for medical information during rounds, and throughout her stay. This causes her “stress” because she “doesn’t want to be reminded of her disease.” Every time she has to translate, she is reminded of how sick she is. Her mother added “nobody wants to be reminded of their disease.”
Spanish Speaking Families – Unfortunately, we are using hospitalized children as translators often on rounds due to lack of regularly-available in-person translators. Our family that had been inpatient for months had never seen an in-person interpreter prior to this project. The family also said that the translator phone service “glitches” and “cuts out.”
RN joining bedside rounds on all patients. This is complicated because multiple teams round at the same time and RN’s are often busy in isolation rooms and cannot answer the phone or participate in rounds.
RN will have specific role on rounds – reading vitals, I/O’s, nursing plan of care.
Could we bring in a relief nurse during morning rounds who could free up the bedside nurse if he/she is busy during rounds?
Families not understanding the roles of the medical team.
Doctors to have role on ID badge – similar to flu badge – (resident, fellow, attending)
Distribute a welcome packet which explains the roles of the medical team to all inpatients.
Role of families on bedside rounds
Door hanger – Give families choice of “I do / do not want to join rounds. Please wake /do not wake me for rounds. Please round inside/outside the room. I speak English/Spanish/Other.”
Nearly 4,000 children are admitted to inpatient pediatrics at Mattel Children’s Hospital UCLA and Santa Monica UCLA each year. It is exceedingly difficult for patients and their families to achieve the amount and quality of sleep needed during this period of illness and stress. It has been known that critically ill patients experience poor sleep quality with severe sleep fragmentation and disruption of sleep architecture. Poor sleep while hospitalized is one of the most common complaints of patients who survive severe illness.
Phase 1:
children slept for a longer amount of time
sleep scores improved
Everyone benefits from a good night’s rest, but sleep is especially important in healing and strengthening children in the pediatric intensive care unit (PICU) at Mattel Children’s Hospital UCLA. Unfortunately, catching some Z’s at a hospital that operates 24/7 isn’t always easy.
“We knew from talking to parents that their children’s slumber here wasn’t restful,” says Myke Federman, MD, medical director of the cardiothoracic PICU. “It seemed counterproductive that we were providing a high level of medical care to these children, yet we weren’t addressing something as fundamentally important as sleep. We wanted to see what we could do to improve the patient and family experience by providing a more comforting and quiet place to rest.”
Thanks to a patient-experience award from the UCLA Institute for Innovation in Health, Dr. Federman, along with PICU physician Yonca Bulut, MD, and PICU clinical nurse specialist Theresa Kirkpatrick, CCRN, launched a sleep-hygiene initiative in March 2015 called Supporting Sleep for Health and Healing (SSHH).
“We began by surveying nurses and parents to pinpoint the biggest sleep stealers in the unit and worked with day- and night-time staff to make certain improvements,” says Dr. Bulut. “We had to educate the staff about the unique sleep needs of infants, children and teens because a teen’s sleep needs and patterns are going to be different than a toddler’s, so it’s important to take these into account.”
Since these sleep hygiene steps were imple-mented, PICU patients and their parents are resting easier. “Before this initiative, parents reported that their kids were averaging about six hours of nightly sleep in the hospital,” says Dr. Federman. “Our PICU kids today get an average of 7.5 hours of sleep every night. We hope that the extra rest will translate into better health outcomes for them.”
Thanks to another award from the UCLA Institute for Innovation in Health, the team is expanding the SSHH initiative to all of Mattel Children’s Hospital UCLA, as well as the pediatrics unit at UCLA Medical Center, Santa Monica. “We believe adult patients could benefit from this program as well,” says Dr. Bulut. “One day we hope to see SSHH in place throughout UCLA Health. After all, everyone feels better after a good night’s rest.”
Improvements for a Good Night’s Rest:
Creating and displaying signage that designates the unit as a sleep-friendly zone.
Implementing a 10 pm lights-out policy.
Lubing squeaky wheels on medical carts.
Placing silencers on the doors to the PICU so they don’t bang shut.
Equipping each patient room with a white-noise machine.
Supplying foam earplugs and eye masks to patients and their families.
Installing a noise detector that flashes yellow or red when sound levels in the unit exceed set noise limits.
Creating signs for parents to hang on their children’s doors that let staff know to come back later because a child is resting, or to enter because a child is awake.
Combining nighttime medical procedures when possible.
Silencing the ice makers that nurses use to store bloodwork.
$10K: The team will use new technology to reduce multiple needle sticks often required to obtain IV access due to poor vein visibility.
So we think that in order for our hypothesis to hold true, the thinking needs to change around lean and around innovation.
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