Presentasi yang saya bawakan dalam pelatihan "Strategi Penggunaan ICD-10 dan ICD-9 CM dalam Mendukung BPJS" yang diadakan oleh RS Panti Nugroho, Sabtu, 8 Mei 2014. Semoga bermanfaat.
Introduction: Postponement of elective scheduled operations results in inefficient use of operating room (OR) time on the day of surgery. Inconvenience to patients and families also caused by postponements. Moreover, day of surgery (DOS) postponement creates logistic and financial burden associated with extended hospital stay and repetitions of pre-operative preparations to an extend of repetition of investigations in some cases causing escalated costs, wastage of time and reduced income. Methodology: A cross sectional study was done in the operation theaters of a tertiary care hospital in which total ten operation theaters of General Surgery Data of scheduled, performed and postponed surgeries was collected from all the operation theater with effect from march 1st to September 30th 2018. A questionnaire was developed to find out the reasons for the postponement for all hospital’s stakeholders (Surgeons, Anesthetist, Nursing officer) and they were further evaluated Time series analysis of scheduling of Operation Theater for Moving average Technique. Results: total 2,466 surgeries were scheduled and 1,980 surgeries were performed and 486 surgeries were postponed in the general surgery department during the study period. Month wise postponement forecast was in accordance with the performed surgeries and on regression analysis postponed surgeries were in perfect linear relationship with the postponement Rate.
Clinical Science for Medical Devices: A Guide for Entrepreneurs | Jim Gustafs...UCICove
About UCI Applied Innovation:
UCI Applied Innovation is a dynamic, innovative central platform for the UCI campus, entrepreneurs, inventors, the business community and investors to collaborate and move UCI research from lab to market.
About the Cove @ UCI:
To accelerate collaboration by better connecting innovation partners in Orange County, UCI Applied Innovation created the Cove, a physical, state-of-the-art hub for entrepreneurs to gather and navigate the resources available both on and off campus. The Cove is headquarters for UCI Applied Innovation, as well as houses several ecosystem partners including incubators, accelerators, angel investors, venture capitalists, mentors and legal experts.
Follow us on social media:
Facebook: @UCICove
Twitter: @UCICove
Instagram: @UCICove
LinkedIn: @UCIAppliedInnovation
For more information:
cove@uci.edu
http://innovation.uci.edu/
Feasibility Solutions to Clinical Trial Nightmaresjbarag
Slow patient recruitment and poor retention cause recurrent nightmares and perpetual problems often resulting in missing recruitment milestones. The cost of these delays represents hundreds of thousands of dollars for drug and device developers. By recognizing this issue, early detailed feasibility can provide planning and contingency solutions that are focused on reducing the impact of delayed recruitment. Furthermore understanding what motivates investigators and patients to actively participate in clinical studies and how patient recruitment strategies and materials can support all stakeholders to complete studies on time are critical aspects of clinical study delivery planning.
During this presentation, an experienced Premier Research feasibility and patient recruitment specialist, reviewed feasibility approaches to address protocol evaluation as well as addressed influences on country selection, site distribution and patient recruitment strategies to provide for more effective clinical trial planning and conduct.
For more information, go to http://www.premier-research.com.
Introduction: Postponement of elective scheduled operations results in inefficient use of operating room (OR) time on the day of surgery. Inconvenience to patients and families also caused by postponements. Moreover, day of surgery (DOS) postponement creates logistic and financial burden associated with extended hospital stay and repetitions of pre-operative preparations to an extend of repetition of investigations in some cases causing escalated costs, wastage of time and reduced income. Methodology: A cross sectional study was done in the operation theaters of a tertiary care hospital in which total ten operation theaters of General Surgery Data of scheduled, performed and postponed surgeries was collected from all the operation theater with effect from march 1st to September 30th 2018. A questionnaire was developed to find out the reasons for the postponement for all hospital’s stakeholders (Surgeons, Anesthetist, Nursing officer) and they were further evaluated Time series analysis of scheduling of Operation Theater for Moving average Technique. Results: total 2,466 surgeries were scheduled and 1,980 surgeries were performed and 486 surgeries were postponed in the general surgery department during the study period. Month wise postponement forecast was in accordance with the performed surgeries and on regression analysis postponed surgeries were in perfect linear relationship with the postponement Rate.
Clinical Science for Medical Devices: A Guide for Entrepreneurs | Jim Gustafs...UCICove
About UCI Applied Innovation:
UCI Applied Innovation is a dynamic, innovative central platform for the UCI campus, entrepreneurs, inventors, the business community and investors to collaborate and move UCI research from lab to market.
About the Cove @ UCI:
To accelerate collaboration by better connecting innovation partners in Orange County, UCI Applied Innovation created the Cove, a physical, state-of-the-art hub for entrepreneurs to gather and navigate the resources available both on and off campus. The Cove is headquarters for UCI Applied Innovation, as well as houses several ecosystem partners including incubators, accelerators, angel investors, venture capitalists, mentors and legal experts.
Follow us on social media:
Facebook: @UCICove
Twitter: @UCICove
Instagram: @UCICove
LinkedIn: @UCIAppliedInnovation
For more information:
cove@uci.edu
http://innovation.uci.edu/
Feasibility Solutions to Clinical Trial Nightmaresjbarag
Slow patient recruitment and poor retention cause recurrent nightmares and perpetual problems often resulting in missing recruitment milestones. The cost of these delays represents hundreds of thousands of dollars for drug and device developers. By recognizing this issue, early detailed feasibility can provide planning and contingency solutions that are focused on reducing the impact of delayed recruitment. Furthermore understanding what motivates investigators and patients to actively participate in clinical studies and how patient recruitment strategies and materials can support all stakeholders to complete studies on time are critical aspects of clinical study delivery planning.
During this presentation, an experienced Premier Research feasibility and patient recruitment specialist, reviewed feasibility approaches to address protocol evaluation as well as addressed influences on country selection, site distribution and patient recruitment strategies to provide for more effective clinical trial planning and conduct.
For more information, go to http://www.premier-research.com.
Role responsibilities of_a_clinical_research_coordsushant deshmukh
Clinical Research Coordinator (CRC) is a specialized research person working with and under the direction of the Principal Investigator .While the Principal Investigator(PI) is primarily responsible for the overall designing, conducting, and management of the clinical trial, the CRC supports, and coordinates the regular clinical trial activities and plays a crucial role in the conduct of the study. By doing these duties, the CRC works with the PI, sponsor ,department, and institution to support and provide guidance on every related aspects of the study.
Every clinical research project may have one or more study coordinators depending on the workload at the trial site. Clinical trials at site level can be roughly divided into 3 stages. The three stages and the role of the coordinators at these stages are:
1) Before starting the clinical trial
2) During the conduct of the clinical trial
3) After finishing the clinical trial
1) Before starting the clinical trial:
Data Safety Monitoring Boards in Pediatric Clinical TrialsCarlo Carandang
“Data Safety Monitoring Boards and Safety in High Risk Trials in Youths,”
Halifax, Nova Scotia, Canada; June 6, 2007
Dalhousie University, Department of Psychiatry, Clinical Conference
*Safety in high risk randomized controlled trials (RCTs) in young persons
*Data Safety Monitoring Boards (DSMBs)
*Defining the concept of “high risk”
*Capturing Adverse Events
*Recommendations for improvement of safety in pediatric psychiatry trials
*Case Study: Evaluating safety in a clinical trial
Physician age and outcomes in elderly patients in hospial in the US: observat...Akshay Mehta
It is an observational study Physicians age and outcomes of their treatment on elderly patients.
Datas are really very shocking and it tells more about the experience and technology.
The patient journey in the palestinian governmental health system in hebronmarwan abo fara
a reaserch results about the patient journey in the palestenian health system done bu heborn university students : ayah al sharawnah and marwan abo fara
A guide to become clinical research associatepptxRidhimaPatel2
An integral part of modules in clinical research courses focus on the ethical standards that have to be implemented without compromising the quality of trial results.
How Clinical Decision Support Systems (CDSS) is the right tool for physicians?Eurostars Programme EUREKA
We believe that CDSS delivered using information systems, ideally with the electronic medical record as the platform, will finally provide decision makers with tools making it possible to achieve large gains in performance, narrow gaps between knowledge and practice, and improve safety.
Role responsibilities of_a_clinical_research_coordsushant deshmukh
Clinical Research Coordinator (CRC) is a specialized research person working with and under the direction of the Principal Investigator .While the Principal Investigator(PI) is primarily responsible for the overall designing, conducting, and management of the clinical trial, the CRC supports, and coordinates the regular clinical trial activities and plays a crucial role in the conduct of the study. By doing these duties, the CRC works with the PI, sponsor ,department, and institution to support and provide guidance on every related aspects of the study.
Every clinical research project may have one or more study coordinators depending on the workload at the trial site. Clinical trials at site level can be roughly divided into 3 stages. The three stages and the role of the coordinators at these stages are:
1) Before starting the clinical trial
2) During the conduct of the clinical trial
3) After finishing the clinical trial
1) Before starting the clinical trial:
Data Safety Monitoring Boards in Pediatric Clinical TrialsCarlo Carandang
“Data Safety Monitoring Boards and Safety in High Risk Trials in Youths,”
Halifax, Nova Scotia, Canada; June 6, 2007
Dalhousie University, Department of Psychiatry, Clinical Conference
*Safety in high risk randomized controlled trials (RCTs) in young persons
*Data Safety Monitoring Boards (DSMBs)
*Defining the concept of “high risk”
*Capturing Adverse Events
*Recommendations for improvement of safety in pediatric psychiatry trials
*Case Study: Evaluating safety in a clinical trial
Physician age and outcomes in elderly patients in hospial in the US: observat...Akshay Mehta
It is an observational study Physicians age and outcomes of their treatment on elderly patients.
Datas are really very shocking and it tells more about the experience and technology.
The patient journey in the palestinian governmental health system in hebronmarwan abo fara
a reaserch results about the patient journey in the palestenian health system done bu heborn university students : ayah al sharawnah and marwan abo fara
A guide to become clinical research associatepptxRidhimaPatel2
An integral part of modules in clinical research courses focus on the ethical standards that have to be implemented without compromising the quality of trial results.
How Clinical Decision Support Systems (CDSS) is the right tool for physicians?Eurostars Programme EUREKA
We believe that CDSS delivered using information systems, ideally with the electronic medical record as the platform, will finally provide decision makers with tools making it possible to achieve large gains in performance, narrow gaps between knowledge and practice, and improve safety.
Do you want bad patient relations? Do you want to lose patients? Do you want to fail your patient satisfaction surveys? Do you want a non professional image? Do you want to reduce the number of new patient referrals? Do you want to demonstrate poor quality care? Do you want to jeopardize participation in healthcare plans?
We can Help you :)
Railhealth EMR encompasses the information and capabilities required to support healthcare service delivery, where the information is captured in a computer-readable form that supports interoperability and clinical decision support.
In this presentation, you will know regarding the features, objectives and benefits by using our Railhealth EMR
A basic introduction to POMR's Problem oriented medical records.
This is one approach to collect as much data as possible from a patient in order to provide accurate care to a patient. Initally proposed by Dr Lawrence (Larry) Weed this now has become one of the ways information has been collected
Master the HCAHPS by moving your hospital from the patient customer service to the customer experience. This grand rounds was provided to doctors and nurses, but is suitable for all hospital personnel.
This is an overview on the organization andd function of the medical records department in a hospital. It would be of help to administrators and planners, as well as for teachers.
Medical Records is a foremost important in the healthcare accreditation bodies like JCI,NABH are very adherent about its documentation,retention and confidentiality.
Auditing Medication errors in hospitalised patients at Chiradzulu and QECH Ho...Samson Rangford Chilambe
A proposal for Pharmacy year undergraduate research study for Samson Chilambe and Frank Chadewa. The proposal was approved by the COMREC hence the study was conducted at a small scale level in . Should funding be there, it shall be conducted at larger scale.
Data Science Deep Roots in Healthcare IndustryDinesh V
Data Science transforms the healthcare industry with impeccable solutions that can improve patient care through EHRs, medical imaging, drug discovery, predictive medicines and genetics and genomics.
Improving Discharge Procedures to Reduce Unnecessary Emergency DMalikPinckney86
Improving Discharge Procedures to Reduce Unnecessary Emergency Department Return Visits
Name:
DNP Project Proposal
Purdue University Global
1
Unnecessary return visits to the emergency department are a problem for most healthcare facilities face across Florida and other states.
Unnecessary return visits are indicators of poor care quality.
Numerous studies have demonstrated emergency departments discharge procedures are a significant contributor to unnecessary return visits (Taylor, 2000).
This issue creates gabs in continuity of care for patients resulting in an inadequate or incomplete emergency department discharge.
The healthcare providers must realize that inadequate discharge negatively impacts patient compliance with care, treatments and follow-ups.
Purdue University Global | This is Where the Title of the Presentation Will Go
2
Introduction
Unnecessary return visits to the emergency department are a problem for most healthcare facilities face across Florida and other states. Unnecessary return visits are indicators of poor care quality. Numerous studies have demonstrated emergency departments discharge procedures are a significant contributor to unnecessary return visits (Taylor, 2000). This issue creates gabs in continuity of care for patients resulting in an inadequate or incomplete emergency department discharge. The healthcare providers must realize that inadequate discharge negatively impacts patient compliance with care, treatments and follow-ups. Providing verbal and pre-formatted written discharge instructions to the patient does not guarantee that the patient understands information provided. The patient must understand the medical information given and participates in their care. The best way to achieve patient understanding is communicating, and reinforcing while acknowledging culture, belief and language barriers.
2
Project Purpose
The purpose of this project is to implement a discharge tool that will help healthcare providers to better communicate with patients and better achieve patient understanding.
The proposed intervention is to implement a discharge checklist tool that enables patients to document their understanding of discharge instructions by marking and answering questions about the discharge instructions packet.
The patient and the provider will document the exchange by both signing the discharge tool. The tool will remain in the patient’s medical records.
Cite your slides here
3
Introduction
The purpose of this project is to implement a discharge tool that will help healthcare providers to better communicate with patients and better achieve patient understanding. The proposed intervention is to implement a discharge checklist tool that enables patients to document their understanding of discharge instructions by marking and answering questions about the discharge instructions packet. The patient and the provider will document the exchange by both signing the discharge tool. The ...
Materi "Luka Akut" ini diberikan untuk mahasiswa tingkat sarjana di Program Studi Pendidikan Dokter, Fakultas Kedokteran dan Kedokteran Hewan Universitas Nusa Cendana. Materi ini diperbarui untuk kuliah bulan Maret tahun 2024.
Luka bakar bukan luka biasa. Luka bakar adalah cedera berat yang menimbulkan morbiditas dan mortalitas luar biasa. Dokter muda diharapkan mampu mengenali luka bakar, mengetahui resusitasi dan kapan harus merujuk, merawat luka bakar minor, dan tahu bagaimana mengedukasi masyarakat untuk mencegah luka bakar. Bahan ini dibuat untuk kepentingan pendidikan klinis bedah dokter muda di lingkungan RSUD Prof. Dr. W. Z. Johannes - FKKH Universitas Nusa Cendana. Presentasi ini diperbarui 2024.
"Manus mani, homo hominis" atau "hakikat tangan, hakikat manusia". Tangan adalah salah satu pembeda manusia dari primata yang lain. Dapat dikatakan, peradaban manusia ditentukan oleh tangan. Trauma tangan, dengan demikian merupakan hendaya yang serius dalam kesejahteraan manusia. Asesmen yang menyeluruh dan teliti diperlukan agar trauma tangan dapat ditata laksana dengan paripurna. Presentasi ini ditujukan bagi pengantar pendidikan klinis bedah dokter muda FKKH Universitas Nusa Cendana di RSUD Prof. Dr. W. Z Johannes Kupang, dan telah diperbarui ke versi tahun 2024.
Regio maksilofasial didefinisikan sebagai regio yang dibatasi mentale dan sutura coronaria. Trauma pada regio ini sering terjadi di Indonesia, mayoritas karena kecelakaan lalu lintas dan kecelakaan kerja. Trauma wajah penting karena trauma pada regio ini mempengaruhi tidak hanya wajah sebagai identitas seseorang namun juga panca indera dan saluran nafas. Bahan ini dibuat untuk kepentingan pendidikan klinis bedah dokter muda di lingkungan RSUD Prof. Dr. W. Z. Johannes - FKKH Universitas Nusa Cendana. Presentasi ini diperbarui tahun 2024.
Presentasi ini mengenalkan sumbing bibir dan langit-langit atau biasa disebut cleft lip and/or palate atau labiognatopalatoschizis atau orofacial cleft. Cacat ini merupakan kelainan kraniofasial kongenital tersering. Bahan ini dibuat untuk kepentingan pembelajaran dokter muda di lingkungan RSUD Prof. Dr. W. Z. Johannes - FKKH Universitas Nusa Cendana. Presentasi ini diperbarui tahun 2024
Presentasi singkat ini memperkenalkan kepada dokter muda di RSUD Prof. Dr. W. Z. Johannes - FK Universitas Nusa Cendana mengenai bedah plastik sebagai sebuah spesialisasi dan apa saja kajian utamanya. Bahan presentasi ini diperbarui tahun 2024.
Saya jarang sekali mendapatkan kesempatan membagikan bagaimana kegiatan pembelajaran di Magister Manajemen Rumah Sakit prodi Pasca Sarjana IKM FKKMK UGM menunjang praktek klinis saya. Kali ini kesempatan itu datang. Materi ini dibuat untuk pada dokter muda FKKMK UGM yang sedang menjalani rotasi klinik di Ilmu Kesehatan Masyarakat FKKMK UGM. Presentasi ini dibawakan 25 September 2023. Dalam presentasi ini saya membahas empat dari sekian banyak hal yang saya pelajari di MMR UGM dan sangat mendukung kegiatan praktek klinik sebagai dokter spesialis. Semoga bermanfaat!
Trauma wajah atau trauma maksilofasial (maxillofacial trauma) tidak banyak dibicarakan di pendidikan dokter. Trauma di atas clavicula lebih sering berfokus pada trauma atau cedera otak sementara sebagian besar trauma otak datang bersamaan dengan trauma maksilofasial. Trauma maksilofasial penting untuk dikuasai selain karena insidensinya cukup tinggi juga karena wajah merupakan ujung panca indera sekaligus merupakan identitas pribadi. Kegagalan mendiagnosis dan menatalaksana trauma wajah membawa konsekuensi yang berat bagi kualitas hidup penderitanya. Presentasi ini disusun untuk acara seminar yang diadakan Alumni Universitas Nusa Cendana di Kabupaten Sabu Raijua, 16 Agustus 2023.
Bahan pembelajaran ini disusun untuk presentasi kuliah Blok Trauma mahasiswa Pendidikan Dokter Fakultas Kedokteran dan Kedokteran Hewan (FKKH) Universitas Nusa Cendana (Undana). Materi ini diperbarui dengan beberapa poin penting tambahan pada bulan Maret 2023.
Presentasi ini mengenalkan sumbing bibir dan langit-langit atau biasa disebut cleft lip and/or palate atau labiognatopalatoschizis atau orofacial cleft. Cacat ini merupakan kelainan kraniofasial kongenital tersering. Bahan ini dibuat untuk kepentingan pembelajaran dokter muda di lingkungan RSUD Prof. Dr. W. Z. Johannes - FKKH Universitas Nusa Cendana. Presentasi ini diperbarui tahun 2023.
Luka bakar bukan luka biasa. Luka bakar adalah cedera berat yang menimbulkan morbiditas dan mortalitas luar biasa. Dokter muda diharapkan mampu mengenali luka bakar, mengetahui resusitasi dan kapan harus merujuk, merawat luka bakar minor, dan tahu bagaimana mengedukasi masyarakat untuk mencegah luka bakar. Bahan ini dibuat untuk kepentingan pendidikan klinis bedah dokter muda di lingkungan RSUD Prof. Dr. W. Z. Johannes - FKKH Universitas Nusa Cendana. Presentasi ini diperbarui 2023).
Dalam bahan pembelajaran ini akan dibahas mengenai beberapa ide pokok mengenai luka akut dan kronis beserta tata laksananya yang perlu diketahui dokter muda selama menjalani kepaniteraan klinik di bagian bedah. Bahan ini dipersiapkan untuk pembelajaran dokter muda FKKH Universitas Nusa Cendana (Undana) selama kepaniteraan klinik di SMF Bedah RSUD Prof. Dr. W. Z. Johannes, Kupang. Presentasi ini diperbarui secara menyeluruh di tahun 2023.
Regio maksilofasial didefinisikan sebagai regio yang dibatasi mentale dan sutura coronaria. Trauma pada regio ini sering terjadi di Indonesia, mayoritas karena kecelakaan lalu lintas dan kecelakaan kerja. Trauma wajah penting karena trauma pada regio ini mempengaruhi tidak hanya wajah sebagai identitas seseorang namun juga panca indera dan saluran nafas. Bahan ini dibuat untuk kepentingan pendidikan klinis bedah dokter muda di lingkungan RSUD Prof. Dr. W. Z. Johannes - FKKH Universitas Nusa Cendana. Presentasi ini diperbarui tahun 2023.
"Hakikat tangan, hakikat manusia". Tangan adalah salah satu pembeda manusia dari primata yang lain. Dapat dikatakan, peradaban manusia ditentukan oleh tangan. Trauma tangan, dengan demikian merupakan hendaya yang serius dalam kesejahteraan manusia. Asesmen yang menyeluruh dan teliti diperlukan agar trauma tangan dapat ditata laksana dengan paripurna. Presentasi ini ditujukan bagi pengantar pendidikan klinis bedah dokter muda FKKH Universitas Nusa Cendana di RSUD Prof. Dr. W. Z Johannes Kupang,
Presentasi singkat ini memperkenalkan kepada dokter muda di RSUD Prof. Dr. W. Z. Johannes - FK Universitas Nusa Cendana mengenai bedah plastik sebagai sebuah spesialisasi dan apa saja kajian utamanya. Bahan presentasi ini diperbarui tahun 2023.
Regio maksilofasial didefinisikan sebagai regio yang dibatasi mentale dan sutura coronaria. Trauma pada regio ini sering terjadi di Indonesia, mayoritas karena kecelakaan lalu lintas dan kecelakaan kerja. Bahan ini dibuat untuk kepentingan pembelajaran dokter muda di lingkungan RSUD Prof. Dr. W. Z. Johannes - FK Universitas Nusa Cendana. Materi ini adalah pembaruan terakhir dengan tambahan foto pemeriksaan fisik pada sukarelawan sehat (telah memberikan izin untuk digunakan fotonya sebatas untuk pendidikan dan pendidikan berkelanjutan tenaga kesehatan dan calon tenaga kesehatan).
Anamnesis dan pemeriksaan fisik pada trauma wajah (trauma maksilofasial) tetap merupakan strategi utama untuk menegakkan diagnosis dan menentukan rencana tata laksana. Kurang lebih seperempat kasus cedera kepala datang dengan trauma maksilofasial, baik pada jaringan lunak maupun tulang. Keterampilan anamnesis, pemeriksaan fisik, dan pemilihan pemeriksaan penunjang menjadi penting bagi dokter yang melayani di pelayanan gawat darurat.
Bedah plastik rekonstruksi & estetik adalah salah satu cabang ilmu bedah. Kata plastik berasal dari bahasa Yunani "plasticos" yang berarti membentuk. Bedah plastik memiliki perhatian yang mendalam pada jaringan lunak dan tulang wajah (maksilofasial) sehingga baik rekonstruksi pasca trauma maupun estetika wajah merupakan kajian utama bedah plastik.
Manus Mani, Homo Homini.
Hakikat tangan, hakikat manusia.
Selain fungsi luhur, tangan adalah pembeda manusia dari primata yang lain. Lewat tangan manusia purba membentuk peradaban.
Oleh karena itu, kesehatan tangan memainkan peran yang krusial dalam hidup dan karya manusia. Trauma di tangan, secara signifikan akan mengurangi kualitas hidup manusia. Dengan demikian, trauma tangan perlu ditata laksana dengan paripurna.
Di sisi lain, penatalaksanaan yang paripurna hanya dapat dicapai apabila dilakukan pemeriksaan dan pembuatan diagnosis yang akurat.
Presentasi ini akan mengupas dasar-dasar anatomi - fisiologi dan asesmen klinis dasar pada trauma tangan.
Bahan ini dipresentasikan pada hari Sabtu, 1 Oktober 2022 secara online untuk para dokter di RS St. Carolus Borromeus Kupang.
Dalam bahan pembelajaran ini akan dibahas mengenai beberapa ide pokok mengenai asesmen luka, merawat luka, dan menjahit luka yang perlu diketahui dokter muda selama menjalani kepaniteraan klinik di bagian bedah. Bahan ini dipersiapkan untuk pembelajaran dokter muda Universitas Nusa Cendana (Undana) selama kepaniteraan klinik di SMF Bedah RSUD Prof. Dr. W. Z. Johannes, Kupang.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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1. Medical Record for DRG/
CBG Coding Purpose
dr.
Robertus
Arian
D.
Head
of
Emergency
Dept.
Panti
Rapih
Hospital
http://www.jacksongeneral.com
2. Topics
• Literature
Review
• Medical
Record
Files
• Problems
• Fraud
• Conclusion
http://i.livescience.com
3. Learning from Thailand (1) - Results
• Hospital
providers
should
not
be
assumed
capable
of
producing
high
quality
DRG
codes,
especially
in
resource-‐
limited
settings.
• …
variation
in
hospital
coding
practices
in
an
under-‐
resourced
health
system
is
another
major
determinant
of
DRG
coding
quality.
• It
was
not
fair
for
a
hospital
to
be
assumed
‘capable’
of
producing
good
codes
without
qualified
physicians
and/or
coders.
• …
the
use
of
software,
number
of
medical
statisticians,
and
experience
of
physicians
seemed
to
be
the
most
important.
Pongpirul
K,
Walker
DG,
Rahman
H,
Robinson
C;
DRG
coding
practice:
a
nationwide
hospital
survey
in
Thailand;
BMC
Health
Services
Research
2011,
11:290
4. Learning from Thailand (2) –Hosp. Intention
• FACTOR
1
–
Data
Quality
• Audit
• Improvement
http://images.amari.com
• FACTOR
2
–
Coding
Practice
• Physician
responsible
• Incentive
/
punishment
• Career
pathway
for
medical
statistician
• FACTOR
3
–
Reimbursement
• DRG
seeker
software
• Various
combinations
of
codes
entered
• Swap
principal
and
secondary
diagnoses
Pongpirul
K,
Walker
DG,
Rahman
H,
Robinson
C;
DRG
coding
practice:
a
nationwide
hospital
survey
in
Thailand;
BMC
Health
Services
Research
2011,
11:290
5. Pongpirul
K,
Walker
DG,
Winch
PJ,
Robinson
C;
A
qualitative
study
of
DRG
coding
practice
in
hospitals
under
the
Thai
Universal
Coverage
Scheme
;
BMC
Health
Services
Research
2011,
11:71
6. Thailand vs Indonesia
• Discharge
Summarization.
Clinical
data
in
medical
records
are
used
to
fill
out
the
discharge
summary.
The
physician
responsible
for
the
patient
is
considered
the
best
person
for
this
task.
• Completeness
Checking.
This
step
is
to
check
the
completeness
of
the
medical
record
and
discharge
summary.
Charts
with
incomplete
clinical
data
will
be
returned
to
the
responsible
physician
for
correction.
• Diagnosis
and
Procedure
Coding.
The
hospital
coder
assigns
the
ICD-‐10
code
and
ICD-‐9-‐CM.
Should
there
be
any
missing
or
questionable
information
in
the
discharge
summary
or
medical
record,
the
coder
will
inform
the
responsible
physician,
who
may
or
may
not
agree
to
revise.
• Relative
Weight
Challenging.
• Coding
Report.
Pongpirul
K,
Walker
DG,
Winch
PJ,
Robinson
C;
A
qualitative
study
of
DRG
coding
practice
in
hospitals
under
the
Thai
Universal
Coverage
Scheme
;
BMC
Health
Services
Research
2011,
11:71
7. About Discharge Summary (1)
• “…
the
Medical
Records
are
not
documented
properly
in
the
university
hospital
where
the
Medical
Records
are
also
used
for
educational
purposes.”
(Pourasghar
et
al,
2008)
• “Inadequacies
were
found
in
clinical
documentation,
especially
gross
underutilization
of
discharge
summary
forms.
Some
forms
were
properly
documented,
suggesting
that
hospital
healthcare
providers
possess
the
necessary
skills
for
quality
clinical
documentation
but
lack
the
will.”
(Adeleke
et
al,
2012)
• “…medication
details
were
frequently
omitted
or
inaccurate
…
lack
of
clarity
about
follow-‐up
plans
regarding
further
investigations
and
visits
to
other
consultants
as
the
areas
requiring
the
most
improvement.”
(Legault
et
al,
2012)
8. About Discharge Summary
• “…accurate
identification
of
clinical
abbreviations
is
a
challenging
task
and
advanced
abbreviation
recognition
modules
are
needed…”
(Wu
et
al,
2012)
• “…audit
and
feedback
sessions
significantly
improved
the
completeness
of
discharge
summaries
dictated
by
geriatric
medicine
fellows
at
one
academic
medical
center.”
(Dinescu
et
al,
2011)
• “An
Electronic
Discharge
Summary
program
can
be
used
by
housestaff
to
more
easily
create
hospital
discharge
summaries…”
(Maslove
et
al,
2009)
9. Unreliable Discharge Summary, then?
• Admission
form
• Integrated
medical
record
• Medical
• Nursing
• Other
health
profession
• Surgery
report
• Supporting
results
• Laboratory
• Radiology
/
Imaging
• Electromedics
• Others
• Transfusion
“flag”
http://a57.foxnews.com/
19. Case
Mrs
S.W.,
female,
53
y.o.
was
referred
by
a
medical
oncologist
to
our
internal
medicine
ward.
She
was
diagnosed
with
a
Non-‐
Hodgkin
Lymphoma
and
an
advanced
grade
of
Haemorrhoid.
She
had
a
surgery
during
her
13-‐day
hospitalization
and
received
supportive
treatment
for
her
NHL,
tranfusion
of
packed
red
cells,
and
antibiotics
for
amebic
gastroenteritis.
Her
discharge
summary
was
completed
by
the
medical
oncologist
without
stating
anything
about
surgery
and
surgeon
consultation.
The
swap
between
primary
and
secondary
diagnoses
was
performed
by
the
coder
and
she
found
an
interesting
fact.
A
modification
of
DS
is
therefore
necessary.
20. Common Problems
• Unrecognizable
handwriting
• Different:
admision
and
discharge
diagnosis
• Common
diagnosis
confusion:
• Post
laparatomy
• Abbreviation
• Medical
procedure
confusion:
• Incomplete
• Abbreviation
• Unrecorded
consultation
• Primary
and
secondary
diagnoses
vs
attending
phycisians’
role
• Tariff
consideration
(?)
Source:
Interview
with
Coders
http://www.pharmacyerrorinjurylawyer.com/
• Post
partum
22. Fraud and Abuse. Corruption?
• Fraud:
Intentional
deception
or
misrepresentation
that
the
individual
or
entity
makes
knowing
that
the
misrepresentation
could
result
in
some
unauthorized
benefit
to
the
individual,
or
the
entity
or
to
some
other
party.
(NHCAA,
2012)
• Abuse:
Unintentional
practice
that
directly
or
indirectly
results
in
an
overpayment
to
the
healthcare
provider.
(Rudman
et
al,
2009)
• Corruption
(Riyanto,
2009)
• Desire
to
act,
• Ability
to
act,
• Opportunity
to
do
corruption,
• Suitable
target.
https://www.unodc.org
23. Intervention in Fraud
• “…a
lack
of
evidence
of
effect
of
the
interventions
to
combat
health
care
fraud.”
(Rashidian,
2012)
• “Do
EHRs
and
other
healthcare
IT
lead
to
increased
fraud
compared
to
paper
medical
records?
Again,
we
do
not
know
the
answer
definitively.
It
has
not
been
properly
studied.
Such
studies
are
difficult
to
perform,
and
true
controlled
studies
are
impossible.”
(Simborg,
2011)
• "Yang
kami
tangkap,
ada
lima
titik.
Investasi
dana
badan
itu,
investasi
dana
jaminan
sosial,
potensi
korupsi
saat
pengalihan
aset,
potensi
korupsi
penggunaan
dana
operasional,
potensi
korupsi
saat
pembayaran
di
fasilitas
kesehatan.
Kami
berterima
kasih
kepada
KPK
yang
mengingatkan
kami
karena
mencegah
itu
lebih
baik
daripada
mengobati,”
(Idris,
2014)
24. Conclusion
• Medical
records
are
the
only
source
of
information
available
for
DRG/CBG
coding
è
Quality
variation.
• Indonesian
hospitals
are
interested
only
in
“reimbursement
factor”.
• Completeness
checking
before
DS
goes
to
coder.
• Internal
audit:
medical
record,
DS,
coding.
• DRG/CBGs
improves
coding
practice?
• Willingness
to
prevent
fraud
and
abuse:
upcoding,
unbundling.
http://networkingstar.com
25. Thank You!
@robertus_arian
|
arian9677@gmail.com
The
content
of
this
presentation
is
author’s
responsibility
and
not
necessarily
reflects
organization’s
view
of
this
topic.
The
author
declares
no
competing
interest.
All
references
used
are
stated
below.
All
picture
sources
are
stated
below
each
picture.
26. References (1)
• Pongpirul
K,
Walker
DG,
Rahman
H,
Robinson
C;
DRG
coding
practice:
a
nationwide
hospital
survey
in
Thailand;
BMC
Health
Services
Research
2011,
11:290
• Pongpirul
K,
Walker
DG,
Winch
PJ,
Robinson
C;
A
qualitative
study
of
DRG
coding
practice
in
hospitals
under
the
Thai
Universal
Coverage
Scheme
;
BMC
Health
Services
Research
2011,
11:71
• Pourasghar
F,
Hossein
M,
Kazemi
A,
Ellenius
J,
Fors
U;
What
they
fill
in
today,
may
not
be
useful
tomorrow:
Lessons
learned
from
studying
Medical
Records
at
the
Women
hospital
in
Tabriz,
Iran;
BMC
Public
Health
2008,
8:139
• Adeleke
IT,
Adekanye
AO,
Onawola
KA,
Okuku
AD,
Adefemi
SA,
Erinle
SA,
Shehu
AA,
Yahaya
OE,
Aebisi
AA,
James
JA,
AbdulGhaney
OO,
Ogundiran
LM,
Jibril
AD,
Atakere
ME,
Achinbee
M,
Abodunrin
OA,
Hassan
MW;
Data
quality
assessment
in
healthcare:
a
365-‐day
chart
review
of
inpatients’
health
records
at
a
Nigerian
tertiary
hospital;
J
Am
Med
Inform
Assoc
2012;19:1039–1042
27. References (2)
• Legault
K,
Ostro
J,
Khalid
Z,
Wasi
P,
You
JJ;
Quality
of
discharge
summaries
prepared
by
first
year
internal
medicine
residents;
BMC
Medical
Education
2012,
12:77
• Wu
Y,
Denny
JC,
Rosenbloom
ST,
Miller
RA,
Giuse
DA,
Xu
H;
A
comparative
study
of
current
clinical
natural
language
processing
systems
on
handling
abbreviations
in
discharge
summaries;
AMIA
Annu
Symp
Proc.
2012:
997-‐1003
• Dinescu
A,
Fernandez
H,
Ross
JS,
Karani
R;
Audit
and
feedback:
an
intervention
to
improve
discharge
summary
completion;
J
Hosp
Med.
2011
January
;
6(1):
28–32
• Maslove
DM,
Leiter
RE,
Griesman
J,
Arnott
C,
Mourad
O,
Chow
C,
Bell
CM;
Electronic
Versus
Dictated
Hospital
Discharge
Summaries:
a
Randomized
Controlled
Trial;
J
Gen
Intern
Med
24(9):995–1001
28. References (3)
• NHCAA
(US);
A
Private-‐Public
Partnership
Against
Health
Care
Fraud
[Internet];
US:
National
Health
Cara
Anti-‐Fraud
Association;
Consumer
Info
&
Action;
Available
at
http://www.nhcaa.org/resources/health-‐care-‐anti-‐fraud-‐resources/consumer-‐
info-‐action.aspx;
Accessed
March
4th,
2013
• Rudman
WJ,
Eberhardt
III
JS,
Pierce
W,
Hart-‐Hester
S;
Healthcare
Fraud
and
Abuse;
Perspectives
in
Health
Information
Management
6,
Fall
2009
• Pernyataan
Bibit
S.
Riyanto
(2009)
dikutip
oleh
Niken
Ariati
dalam
seminar
Strategi
untuk
mencegah
Fraud
dan
Korupsi
di
Jaminan
Kesehatan
Nasional;
Jakarta;
November
2013;
Available
at
http://kebijakankesehatanindonesia.net/component/content/article/
2232.html
• Rashidian
A,
Joudaki
H,
Vian
T;
Health
Care
Fraud
and
Abuse:
A
Systematic
Review
of
Literature;
PLoS
ONE
7(8):
e41988.
29. References (4)
• Simborg
DW;
There
is
no
neutral
position
on
fraud!;
J
Am
Med
Inform
Assoc
2011;18:675e677.
• Pernyataan
Fahmi
Idris
(2014)
dikutip
oleh
Kompas
Online;
Available
at
http://nasional.kompas.com/read/2014/02/11/1501433/
KPK.Temukan.Lima.Titik.Rawan.Korupsi.Pengelolaan.JKN.oleh.BPJS