A presentation by Melissa Fox at the CHA Conference 2012, The Journey, in the 'Innovations in Supporting Acutely Unwell Children, Young People & Their Families' stream.
Maureen Corry, executive director of Childbirth Connection, provides an overview of the state of shared decision making and maternity care.
This presentation was part of a Shared Decision Making Month webinar -- Maternity Care and Shared Decision Making: Improving Care for Mothers and Babies.
Kate Chenok, a director at Pacific Business Group on Health, provides the purchaser perspective on shared decision making and maternity care.
This presentation was part of a Shared Decision Making Month webinar -- Maternity Care and Shared Decision Making: Improving Care for Mothers and Babies.
Using the IAP2 framework is a great place to start when thinking about partnering with consumers. This slide-deck touches on consumer participation, accreditation standards and case studies in participation.
The goal of this virtual discussion is to explore practical solutions for keeping seniors safe. The ideas are drawn from real life experiences noting how COVID-19 impacted seniors, their loved ones as well as healthcare workers and leaders.
The focus of the discussion is on identifying safety risks together with practical solutions for seniors who live at home, in residences and long-term care facilities.
Deirdre Shanagher, IHF: Patient Involvement demonstrates the value and unique voice of people and values patients as the real experts in understanding their unique journey. It also helps empower patients.
Maureen Corry, executive director of Childbirth Connection, provides an overview of the state of shared decision making and maternity care.
This presentation was part of a Shared Decision Making Month webinar -- Maternity Care and Shared Decision Making: Improving Care for Mothers and Babies.
Kate Chenok, a director at Pacific Business Group on Health, provides the purchaser perspective on shared decision making and maternity care.
This presentation was part of a Shared Decision Making Month webinar -- Maternity Care and Shared Decision Making: Improving Care for Mothers and Babies.
Using the IAP2 framework is a great place to start when thinking about partnering with consumers. This slide-deck touches on consumer participation, accreditation standards and case studies in participation.
The goal of this virtual discussion is to explore practical solutions for keeping seniors safe. The ideas are drawn from real life experiences noting how COVID-19 impacted seniors, their loved ones as well as healthcare workers and leaders.
The focus of the discussion is on identifying safety risks together with practical solutions for seniors who live at home, in residences and long-term care facilities.
Deirdre Shanagher, IHF: Patient Involvement demonstrates the value and unique voice of people and values patients as the real experts in understanding their unique journey. It also helps empower patients.
This interactive webinar is part of the world tour series designed by the World Health Organization's Patients for Patient Safety (PFPS) Global Network and hosted by Patients for Patient Safety Canada, the patient-led program of the Canadian Patient Safety Institute, a WHO Collaborating Centre on Patient Safety and Patient Engagement.
Presentation by Caroline Walshe on Memory Assessment and Support Clinic - presented at the Nursing Showcase in 2016 at St Mary's Campus, Phoenix Park, Dublin
Krames Patient Education is the only choice for enterprise-wide patient education. In this presentation, practices will learn who Krames Patient Education is and What we can do for you.
We will review Patient-Centered Care and Patient Education; The Case for a Patient Education Investment, The Krames Differencet; Return on Investment; and Krames Solutions.
This infographic from The Beryl Institute presents key findings from its study, the "State of Patient Experience 2015: A Global Perspective on the Patient Experience Movement," which engaged over 1,500 respondents in 50 countries, sharing challenges and opportunities in addressing the patient experience across all healthcare settings.
A presentation given by Gabrielle Murphy at The Journey, CHA Conference 2012, in the 'Innovations in Mental Health Care for Children and Young People' stream.
This interactive webinar is part of the world tour series designed by the World Health Organization's Patients for Patient Safety (PFPS) Global Network and hosted by Patients for Patient Safety Canada, the patient-led program of the Canadian Patient Safety Institute, a WHO Collaborating Centre on Patient Safety and Patient Engagement.
Presentation by Caroline Walshe on Memory Assessment and Support Clinic - presented at the Nursing Showcase in 2016 at St Mary's Campus, Phoenix Park, Dublin
Krames Patient Education is the only choice for enterprise-wide patient education. In this presentation, practices will learn who Krames Patient Education is and What we can do for you.
We will review Patient-Centered Care and Patient Education; The Case for a Patient Education Investment, The Krames Differencet; Return on Investment; and Krames Solutions.
This infographic from The Beryl Institute presents key findings from its study, the "State of Patient Experience 2015: A Global Perspective on the Patient Experience Movement," which engaged over 1,500 respondents in 50 countries, sharing challenges and opportunities in addressing the patient experience across all healthcare settings.
A presentation given by Gabrielle Murphy at The Journey, CHA Conference 2012, in the 'Innovations in Mental Health Care for Children and Young People' stream.
A presentation given by Elizabeth Harnett at the CHA Conference 2012, The Journey, in the 'Delivering Safety & Quality: Innovations in Clinical Governance' stream.
A presentation given by margaret Allwood at teh 2012 CHA Conference, The journey, in the 'Innovations in Supporting Acutely Unwell Children, Young People & Their Families' stream.
A presentation given by David Fitzsimons in the 'Delivering Safety & Quality: The Health Reform Agenda stream at the CHA Conference 2012, The Journey, in October.
A presentation given by Rachael Worthington at the 2012 CHA Conference, The Journey, in the 'Innovations in Supporting Acutely Unwell Children, Young People & Their Families' stream.
A presentation given by Sharon Payne at the 2012 CHA Conference, The Journey, in the 'Innovation in Supporting Acutely Unwell Children, Young People and Their Fmailies' stream.
Presented by Mr David Fitzsimons, Clinical Specialist Speech Pathologist from the Children's Hospital at Westmead, at the CHA Conference on 24 October 2012
A presentation given by Nick Kowalenko at The Journey, CHA Conference 2012, in the 'Innovations in Mental Health Care for Children and Young People' stream.
A presentation given by Sonya Preston at The Journey, CHA Conference 2012, in the 'Delivering Safety & Quality: Innovations in Clinical Governance' stream.
A presentation given by Sue Peter at the 2012 CHA Conference, The Journey, in the 'Delivering Safety & Quality: Innovations in Clinical Governance' stream
It’s no secret the U.S. health care system needs to change. The Affordable Care Act (ACA) introduced
a focus on new health care payment models, which placed clear economic incentives on providers
while also striving for better outcomes. Today, we see an emphasis on preventing hospital
readmissions, reducing emergency room visits and avoiding unnecessary health care utilization
while enhancing quality and the patient experience.
As a result, health care stakeholders are rethinking the way care is delivered, how data is used and
how people collaborate and communicate in more preventive, proactive ways. This means moving
from episodic, fee-for-service, disease treatment models toward value-based care delivery to
improve outcomes, better utilize resources and expand access to care. Improved population health
has become the Holy Grail of U.S. health care, with many early experiments and some promising
successes. We take a look at Banner Health, a pioneer in transforming their health delivery systems with Robert Groves, MD, Vice President, Health Management, Banner Health.
Collaborative Leadership Insights - creating a digital health eco-systemAndrew M Saunders
Digital health is an essential enabler in achieving person centred health and wellbeing, A collaborative digital health strategy is required to manage the complexities of the complex hybrid health model in Australia, This presentation explores the approaches to leadership, transformation and culture that can be effective when working in a complex stakeholder environment.
Patient Centered Medical home talk at WVUPaul Grundy
To employers the cost of healthcare is now a business issue and this talk is about what one large buyer IBM did to drive transformation via broad coalition with other large employers to form the Patient Centered Medical Home movement and the covenant between buyer and provider away from the garbage we now buy episodic uncoordinated disintegrated care. In the change of convenient conversation we have worked with the Primary care providers to give us coordinated, integrated, accessible and compressive care with a set of principles know as the Patient centered medical home.
A Patient Centered Medical Home (PCMH) happens when primary care healers keeping that core healing relationship with their patients step up to become specialists in Family and Community Medicine. The move is to the discipline of leading a team that delivers population health management, patent centered prevention, care that is coordination, comprehensive accessible 24/7 and integrated across a deliver system. PCMH happens when the specialists in Family and Community Medicine wake up every morning and ask the question how will my team improve the health of my community today?
All over the world three huge factors are in play that is driving the concept of Patient Centered Medical Home. They are:
1) Cost and demography
2) Information technology and data (information that is actionable will equal a demand for accountability by the payer or buyer of the care)
3) Consumer demand to engage healthcare differently (at least as well as they can their bank- on line) have a question about lab results why not e-mail?
But at its core it is a move toward integration of a healing relationship in primary care and population management all at the point of care with the tools to do just that.
Accountable and Collaborative Care: Lessons Learned from Across the Globe.
Alan spoke about how important it is to have Collaborative Care; especially in chronic conditions, such as diabetes and COPD. Collaborative Care is facilitated by multi-specialty facilities which makes it more convenient for the patients to get tests results; for example, to make less visits to the doctors office. This can give patient care continuity, since everyone is working for the same cause: You, the patient.
Also bundled payments give physicians the incentive to be more efficient with how they treat their patients.
Reproductive Health Lecture Note !
The Nairobi Summit on ICPD25 provides an opportunity to complete the unfinished business
of the ICPD programme of action and also a chance to commit to a forward-looking sexual
and reproductive health and rights (SRHR) agenda to meet the Sustainable Development
Goals (SDGs) and its targets. It is an opportunity for the global community to build on the
ICPD framework and fully commit to realizing a visionary agenda for SRHR and to reaching
those who have been left behind. This agenda must pay attention to population dynamics and
migration patterns, recognize the diverse challenges faced by different countries at various
stages of development, and ground policies and programmes in respect for, and fulfilment of,
human rights and the dignity of the individual (United Nations Population Fund, 2019).
Since 1994, the world has developed through responding to the Millennium Development
Goals (MDGs), which focused on the achievement of a few, specific health targets, to commit
to the comprehensive 2030 Agenda for Sustainable Development. The aspirational targets
of the health SDG (SDG 3 – Good Health and Well-being) are not merely ambitious in
themselves, but cover nearly every important aspect of human well-being, both physical and
relational. Unlike the MDGs, the SDGs explicitly recognize sexual and reproductive health as
essential to health, development and women’s empowerment. Sexual and reproductive health
is referenced under both SDG 3, including met family planning needs, maternal health-care
access and fertility rates in adolescence, and SDG 5 (gender equality), which additionally refers
to sexual health and reproductive rights.
With the SDGs, the world has also committed to achieving UHC, including financial risk
protection, access to high-quality essential health-care services and access to safe, effective,
high-quality and affordable essential medicines and vaccines for all. In connection with the
74th session of the United Nations General Assembly (2019), world leaders made a political
declaration1
recommitting to achieving UHC by 2030. The declaration further re-emphasizes
the right to health for all and a commitment to achieving universal access to sexual and
reproductive health services and reproductive rights as stated in the SDGs. As such, UHC
and SRHR are intimately linked. Without taking into account a population’s SRHR needs,
UHC is impossible to achieve, as many of the basic health needs are linked to people’s sexual
and reproductive health. Similarly, universal access to SRHR cannot be achieved without
countries defining a pathway towards UHC, which includes prioritizing resources according to health needs.
The purpose of this paper is to define and describe the key components of a comprehensive,
life course approach to SRHR. Furthermore, the ambition is to describe how countries can move towards universal access to SRHR as an essential part of UHC.
RH 4 GMPH Students
Aligning Incentives for Patient Engagement: Enabling Widespread Implementation of Shared Decision Making
May 24, 2013
Jeff Thompson, Washington State Health Care Authority
David Downs, Engaged Public
David Swieskowski, Mercy ACO Mercy Clinics, Inc.
Lisa Weiss, High Value Healthcare Collaborative
Kate Chenok, Pacific Business Group on Health
Eysenbach: eHealth: Transforming the dynamics of a complex health systemGunther Eysenbach
Keynote for the Australian 10th Annual Health Care Congress ( http://www.webcitation.org/5Vlz9j0HO ) in Sydney, 27th - 29th February 2008. Keynote contains a run-down of what ehealth is all about, and then focusses a fair bit on Personal Health Records (PHR 2.0) and Personal Health Applications. This is partly because the new Australian government under its new prime minister Kevin Rudd has set a couple of priorities for reforming health care, among them is "focussing on preventative health care and health promotion to help keep Australians healthy and out of hospital", which is a goal that can - in my opinion - be attained or at least greatly supported with Personal Health Records, or more specifically with what I call second generation PHRs or PHR 2.0. Contains screenshots of our Healthbook (TM) project, which was subsequently mentioned mentioned in the preliminary report of the 2020 Summit to the Prime Minister in Australia, see http://gunther-eysenbach.blogspot.com/search/label/healthbook
March 2001I N S T I T U T E O F M E D I C I N E Shap.docxwkyra78
March 2001
I N S T I T U T E O F M E D I C I N E
Shaping the Future for Health
CROSSING THE QUALITY CHASM:
A NEW HEALTH SYSTEM FOR THE 21ST CENTURY
The U.S. health care delivery system does not provide consistent, high-quality medical care to all people. Americans should be able to count on receiving care that meets their needs and is based on the best scien
tific knowledge--yet there is strong evidence that this frequently is not the
case. Health care harms patients too frequently and routinely fails to deliver
its potential benefits. Indeed, between the health care that we now have and
the health care that we could have lies not just a gap, but a chasm.
A number of factors have combined to create this chasm. Medical sci
ence and technology have advanced at an unprecedented rate during the past
half-century. In tandem has come growing complexity of health care, which
today is characterized by more to know, more to do, more to manage, more to
watch, and more people involved than ever before. Faced with such rapid
changes, the nation’s health care delivery system has fallen far short in its
ability to translate knowledge into practice and to apply new technology
safely and appropriately. And if the system cannot consistently deliver to-
day’s science and technology, it is even less prepared to respond to the ex
traordinary advances that surely will emerge during the coming decades.
The public’s health care needs have changed as well. Americans are
living longer, due at least in part to advances in medical science and techno l
ogy, and with this aging population comes an increase in the incidence and
prevalence of chronic conditions. Such conditions, including heart disease,
diabetes, and asthma, are now the leading cause of illness, disability, and
death. But today’s health system remains overly devoted to dealing with
acute, episodic care needs. There is a dearth of clinical programs with the
multidisciplinary infrastructure required to provide the full complement of
services needed by people with common chronic conditions.
The health care delivery system also is poorly organized to meet the
challenges at hand. The delivery of care often is overly complex and uncoor
dinated, requiring steps and patient “handoffs” that slow down care and de-
crease rather than improve safety. These cumbersome processes waste re-
sources; leave unaccountable voids in coverage; lead to loss of information;
Faced with such
rapid changes, the
nation’s health care
delivery system has
fallen far short in its
ability to translate
knowledge into
practice and to ap
ply new technology
safely and appro
priately.
CARE SYSTEM
Supportive
payment and
regulatory en
vironment
Organizations
that facilitate
the work of
patient-
centered teams
High perform
ing patient-
centered teams
Outcomes:
• Safe
• Effective
• Efficient
• Personalized
• Timely
• Equitable
REDESIGN IMPERATIVES: SIX CHALLENGES
• Reeng.
Similar to Melissa Fox - Informed Decision Making & Patient Centred Care for Children From a Parent's Perspective (20)
A presentation given by Prof. Phil Robinson at The Journey, CHA Conference 2012, in the 'Innovations in Mental Health Care for Children and Young People' stream.
A presentation given by Jacques Esterhuizen at The Journey, CHA Conference 2012, in the 'Innovations in mental Health Care for Children & Young People'
A presentation given by Susan Jury & Andrew Kornberg at The Journey, CHA Conference 2012, in the 'Enhancing Outcomes Through Innovations in Technologies' stream.
A presentation given by Cheryl McCullough at The Journey, CHA conference for 2012, in the 'Enhancing Outcomes Through Innovations in Technologies' stream.
A presentation given by Leanne Crittenden & Cathy Hastings at the October 2012 CHA Conference, The Journey, in the 'Service Redesign & Innovation' stream.
A presentation given by Joyce Murphy and consumers at the October 2012 CHA Conference, The Journey, in the 'Innovations in Supporting Chronically Unwell Children, Young People and Their Families' stream.
A presentation given by Prof. David Croaker & Eunice Gribben at the CHA Cofnerence in October 2012, The Journey, in the 'innovations in supporting chronically unwell children, young people and their families' stream.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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.
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.
21. HCQ’s definition of consumer-
centred care
accessible, safe and
responsive
informed, active decision
making
coordinated care
inclusive of the patient’s
support network
mutually respectful
partnerships
22. What were the enablers?
Parental advocacy
Openness
Informed decision making
Individualised care
Mater culture
Health Consumers Queensland Health Advocacy Toolkit
www.health.qld.gov.au/hcq/publications/hcq_toolkit_may11.
pdf
23. Why patient- centred care?
Research increasingly suggests that, not only is
patient-centred care the right thing to do, it is
associated with better health outcomes. Health
services with high patient centricity are
associated with reduced mortality and infection
rates, reduced cost of care, decreased length of
stay, and fewer readmissions, adverse incidents
and complaints leading to litigation. The case for
patient-centred care is compelling.
QH Centre for Healthcare Improvement’s report “Patient safety: from learning
to action 2012. Fifth Queensland Health report on clinical incidents and
sentinel events in the Queensland public health system 2009–10 and 2010–
24. The Australian Charter of
Healthcare Rights
http://www.safetyandquality.gov.au
acsqhc_program/australian-
charter-of-healthcare-rights/
25. Australian Commission on Safety &
Quality in Healthcare (ACSQHC)
National Safety and Quality Health Service
Standards
http://www.safetyandquality.gov.au
26. Standard 2:
Partnering with Consumers
Consumer partnership in service
planning
Consumer partnership in designing care
Consumer partnership in service
measurement and evaluation
27. Safety and Quality Improvement Guides
http://www.safetyandquality.gov.au/our-
work/accreditation/nsqhss/safety-and-quality-
improvement-guides-and-accreditation-
workbooks/
28. Health Consumers Queensland
publications
Consumer and Community Engagement Framework
www.health.qld.gov.au/hcq/publications/consumer-engagement.pdf
Developing a consumer and community engagement
strategy: a toolkit for Hospital and Health Services
http://www.health.qld.gov.au/hcq/
Consumer Representatives Program Agency Handbook
www.health.qld.gov.au/hcq/network_reps/agen_handbook.pdf
Health Consumers Queensland Health Advocacy Toolkit
www.health.qld.gov.au/hcq/publications/hcq_toolkit_may11.pdf
Editor's Notes
Unique perspective – Experienced Brisbane based consumer representative and advocate in the area of maternity, blessed two healthy children, no chronic disease in family, routine interactions with the health care system. Suddenly navigating through the acute healthcare system, very quickly advocating, seeking patient & family centred care. Two years on, learnings and reflections from our daughter’s journey. place patient-centred care within a context of national and state reform including the new Standards. Provide links to resources which support service providers to provide patient-centred care and empower parents to advocate for patient-centred care for their children.
Some of my back story – In 2003 we were planning to conceive our first child. I knew I wanted care with a known midwife in a home-like environment in a nearby hospital. Frustrated that this was either non-existent or access limited, I became involved with consumer groups Friends of the Birth Centre and Maternity Coalition. I was very lucky to be able to have our first daughter Lily in 2004 with care from birth centre midwives and a private obstetrician.
Second time round we chose homebirth with the care of a midwife in private practice.
Driven by my passion that how women and babies are looked after before, during and after birth MATTERS, over the last nine yearsI’ve sat on many hospital-based, government, national and professional committees, helping to make services and policies more family-friendly and evidence based, and increasing women’s access to differentoptions including care with a known midwife. I’ve presented at conferences, met with politicians, organised media events, developed relationships with hospital managers and health care workers, advocated for individual women for care that meets their needs and much more. I’m currently a committee member of Qld’s peak consumer body Health Consumers Queensland and have been a Maternity Coalition consumer representative at the Mater Mothers Hospitals since 2005.However two years ago my family’s world was turned upside down.Husband and five year old daughter went on a camping trip in Northern NSW to celebrate him getting a new job. Received call no parent wants. Had lost control of his 4WD on a dirt track and it hit two trees head on. Couldn’t breathe and wanted me. This is our family’s story, I’ll reflect on key things that stood out for us as exemplar consumer-centred care during our journey.
-My mother and I arrived at Lismore Hospital having driven from Brisbane. My husband (pictured here with our daughter Lily and my Mum) was miraculously uninjured however Lily had a severely ruptured liver and internal bleeding. The call was made to airlift her to a tertiary childrens hospital and that she would need an NG tube and a urinary catheter for the journey. I knew these procedures could be very traumatic and the whole journey ahead set her up with a fear of hospitals for life. Or opportunity for her to learn how to navigate health care system to ensure her needs were met. - Birthtalk is a Brisbane-based support organisation who help women heal from disappointing or traumatic births and prepare for empowered, informed births. They talk about that it doesn’t necessarily matter what unfolds during a birth, it’s how the woman feels during the experience and how she is treated by staff and her support people that’s matters – does she feel safe, respected, listened to, like she is being given information to make decisions, like she is at the centre of care? If a woman doesn’t feel this, even if she has had from the outside what might have been an uncomplicated vaginal birth, then there is the danger that she will be traumatised by her experience, and even go on to develop post traumatic stress disorder. Conversely…. So with this in my mind, I asked the nurse to explain to Lily why the ng tube & catheter were being recommended and what the procedures would entail. We said that Lily could be the one to say when it started.
seamless process, nurse was amazed at how calm she was.
Lily was airlifted to the Mater Childrens’ Hospital in South Brisbane and spent her first 5 days in PICU for pain relief and monitoring. The recommendation was to treat with conservative management, and having been given the reasons and evidence behind this, we agreed. This is my mother standing by the bed, who ironically until a few years prior, had been a social worker for 7 years in this very unit.
Transferred onto the surgical ward, Lily was reluctant to sit up and stand, and unable to keep food down. It was recommended that we strongly encourage her to move, in order to help absorb the fluid that was gathering in her belly. I regret forcing her, as you will discover she had very good reasons for not wanting to move though no one knew why.
This is Lily’s then 2 year old sister Mia, who brought many much needed light-hearted moments to our journey, in this photo doing a floor show for us all!It would be no surprise to any of you, but I think it was to us, that it quickly became apparent that it was necessary to always have either myself, my husband or my Mum with Lily all the time. Of course we wanted to and there simply wasn’t the staff ratio to be otherwise. I was grateful my family had the capacity to do so (I saw some families for whom circumstances meant this wasn’t possible) – we lived locally and we were blessed with support from our family and friends for meals as well as playdates for Mia. I was also grateful that, as I was still breastfeeding Mia, she and I were both allowed to sleep on the day bed each night.
This was Lily almost two weeks since the accident, her first time out of bed in a wheelchair, with her Christmas tree of pumps. Still unable to eat, she had had to go on TPN.She was still in a lot of pain, under the care of the pain management team who were very attentive and eased my concerns about her being on the opiate medications for such a prolonged period.
Notice her belly here above again just under 2 weeks after the accident, her first time up and walking (again, to try to move the fluid). Her belly was so swollen she looked pregnant. She had had numerous different types of scans (u/s, CT, MRI). None explained where the large amount of fluid was coming from.
As I mentioned, I had had continuity of care with a known midwife for both my pregnancies, and then the one-to-one care in PICU. I did find it a bit of a shock being on the surgical ward and having so many different carers (all needed of course) from all the different disciplines. Although everything was in her chart, sometimes they would ask me what had been happening and I have to try to remember. AT this point particularly there were lots of procedures and medications that needed to happen at certain times. Her pain was very bad at this point so I really wanted to make sure she had as good pain relief coverage as possible. Also an antibiotic dose was missed. So I decided to take in a whiteboard to track her day, write down who she had seen, etc. It helped me keep across what needed to happen and I’ve since heard of these being used as parent communication boards in the NICU at the Mater, where parents can write down when they are coming back, when they would like to bath the baby, etc. But you can also see how busy and “interrupted” the days were, and sometimes hard for her to rest (close the door).
Decision was made for keyhole surgery at 2 weeks post accident – laparoscopic washout drained 3.5L of fluid.Did feel better, even ate for a day or two, but the fluid started to reaccumulate. Didn’t know why. Frustrating, devastating, terrifying, rollercoaster. Why not yelling at us – because open communication. The consultant & the registrars were honest about lack of evidence for what was going on, honest about risks of surgery and balancing with waiting.Major surgery was scheduled at 3 weeks post accident. Adult liver surgeon brought over to work alongside the paediatric surgeon. After removing gall bladder, they discovered her bile duct was completely severed, leaking bile into abdominal cavity. Explained severe pain and inability to eat. It hadn’t showed up on any of the scans, and I believe a review afterwards of the scans showed this to still be true.Did a roux en y bypass, to connect the bile duct directly into her bowel. Epidural. Someone said this must be hard for you – knowing that I . Right care, right time, right place. Ultrasound guided drainage of another two abdominal collections a week after the major surgery. More of the rollercoaster.
During her stay, the vast majority of Mater staff supported the consumer-centred informed decision making we had started at Lismore Hospital and continued to advocate for. Eg. daily blood collections. Unfortunately there were a few instances when this didn’t happen, sometimes when another family member was with her – once they described her experiencing a traumatic cannula insertion, with the vein being missed several times and Lily becoming hysterical. Another time a nurse said that changing the dressing on her PICC line wouldn’t hurt and it did very much. She was used to being told realistic facts about procedures. She did develop an infection from the major surgery which further prolonged her stay. Overnight one night the very caustic antibiotics she required gave her an extravasation burn on her ankle, despite her saying through the night that the cannula site hurt. I believe these instances of not being listened to, as well as the sheer number of daily blood tests, drain removals, dressing changes and cannula insertions contributed to Lily still developing heightened anxiety around procedures. We made a request for the OT department and the Child and Youth Mental Health service to work with Lily and the nursing staff. The fabulous OT on the screen helped a nurse demonstrate a procedure on the doll and then Lily would do it to the doll.
The OT helped Lily negotiate for different kinds of pain relief for cannula changes and drain removals.
They did some great work together. Lily was inspired by a book written by 10 year old Jordan Fothergill called “Be Brave” about how to be courageous when having blood tests. The OT helped Lily start to write her own book called “Research on how to make things stop hurting in hospital”.
If things are going to hurt and happen to you, it sometimes helps to ask questions. One day when I got a needle I was feeling scared. Then it helped to ask the doctors what they could do to stop it hurting.
After almost seven weeks as an in-patient (including several days on day passes towards the end), having had such a complex journey, Lily was finally able to come home. The vast majority of staff, in particular the paediatric surgeon, the registrars pictured above and many wonderful nurses, can be proud that they truly provided consumer- and family- centred care.
Lily today – a happy 8 year old, I hope with the lifelong skills to advocate for herself to get what we all deserve - consumer centred care.
HCQ proposes consumer-centred care is: accessible, safe and responsive to individual consumer needs, preferences, values and beliefs. It ensures the consumer (including children) are well-informed and fully involved throughout the process and that their personal choices and circumstances guide the continuity of clinical options and transition arrangements, with coordinated physical care and emotional support respectfully delivered. It should be inclusive of the child’s support network of carers and family members. It involves mutually respectful partnerships with clear communication and meaningful conversations between children and their support networks, and health professionals and providers across public and private healthcare settings.My family feel like we received all of this.
- Strong parental advocacy – toolkit. - Open, regular, respectful, transparent communication. - Respect for & facilitation of informed decision making by answering questions, explaining options and sharing decision making.- Individualised care - true caring and support from across the disciplines including social work, child & youth mental health, OT department, pain management team, pastoral care, Starlight Room. As a parent I haven’t experienced emergency care for either of my children in a non-Mater hospital, but I have often said that I think that the Mater culture, Catholic institution & Mercy Mission influenced the wholistic, compassionate care we received. But what if enablers not there? Well connected, informed, high level of health literacy, advocacy skills. Sobering to remember that even with these things in place, it this doesn’t always happen. And when it comes to parents declining care on their children’s behalf, things get murkier and rights can disappear, even to the point of involving the authorities. I was highly distressed to read several disturbing examples of this in Mark Whittaker’s recent article “Bitter pills” published in the SMH on 13 October.
Know benefits.If need further evidence – this from QH’s Centre for Healthcare Improvement’s recent report “Patient safety: from learning to action 2012”:Research increasingly suggests that, not only is patient-centred care the right thing to do, it is associated with better health outcomes. Health services with high patient centricity are associated with reduced mortality and infection rates, reduced cost of care, decreased length of stay, and fewer readmissions, adverse incidents and complaints leading to litigation. The case for patient-centred care is compelling.
Consumer-centred care sits in a context supported at every level from consumers, service providers, professional associations and governments. It is embedded inthe national and state reform agendas.It is supported by the Australian Charter of Healthcare Rights.
Deb Picone from theComission spoke this morning about the implications of the new National Healthcare Standards for children’s healthcare. As you would be aware from 1 January next year all health services undergoing accreditation will be measured against the new National Standards.
Standard 2 requires effective and meaningful engagement of patients (& parents & carers) in the review, design and implementation of services.Lifts bar even higher – particularly it’s requirements to have consumers actively involved in decision making about safety and quality and increasing the supports which the Standard says should be provided to consumers and carers partnering with the organisation. Can use it as a lever to increase engagement. So what resources can support health services to meet Standard 2?
The Commission have recently published final versions of their Safety and Quality Improvement Guides to support service providersto meet each of the 10 Standards, including Standard 2. will be sent to all health service organisations in the coming weeks.
I also recommend you looking at these publications by Health Consumers Qld:- Consumer and Community Engagement Framework. (The Framework is being adapted by other States including SA).Developing a consumer and community engagement strategy: a toolkit for Hospital and Health Services (HCQ has developed this as a how to companion guide to inform public and private health services' application of HCQ's Consumer and Community Engagement Framework in the development of engagement strategies and approaches. You will be able to access the toolkit on the HCQ site in the near future- Consumer Representatives Program Agency Handbook Health Advocacy Toolkit (mentioned ealier) to support patient advocacy and informed decision making
I hope that by:- sharing my family’s story of exemplar patient-centred care;- providing you with supports for services to do this, at a service delivery level and across a service; and-Giving you links to some resources….…that you are stimulated to think about your role in ensuring that consumer-centred care is in place at all levels, from service delivery through to policy and planning and quality improvement.