This booklet is published as a resource for MPS members in the UK. It is intended as general guidance only. MPS members are always welcome to telephone our medicolegal advice line – 0845 605 4000 – for more specific practical advice and support with medicolegal issues that may arise.
This document discusses providing outstanding patient service. It begins by defining good, poor, and outstanding patient service. Good service meets expectations, while outstanding service exceeds expectations and is memorable. The document then provides tips for offering outstanding patient service, such as treating each patient as an individual, identifying their needs, and looking for opportunities to exceed their expectations. It emphasizes building rapport with patients through active listening, making a personal connection, and following up after providing a service. The document also discusses dealing with patients' emotional needs through empathy and validation. Overall, it provides guidance for staff on understanding patients' perspectives and consistently delivering service that exceeds their expectations.
This document discusses abuse, neglect, trauma and exploitation. It defines different types of abuse and provides signs and symptoms to look for. It emphasizes the responsibility of all staff to know how to identify and report any suspected cases. Staff are trained on proper investigation and documentation procedures. The document outlines how to report cases internally and according to different state guidelines. It also provides tips for dealing with patient stressors and aggressive behaviors, including assessing triggers and using distraction techniques. Staff are reminded not to take patient behavior personally and to maintain dignity and respect at all times.
This document outlines precautions doctors should take against negligence. Things not to do include examining female patients without a third person present, abandoning patients, guaranteeing cures, admitting fault, criticizing other doctors to patients, and performing procedures without proper skill or consent. Things to do include obtaining informed consent, maintaining accurate records, confirming diagnoses, seeking consultations when needed, informing patients, keeping up with advances, selecting competent assistants, and identifying drugs before use. Practicing with care, competence, communication and documentation can help prevent negligence claims.
This document provides an overview of East Zone Medico Legal Services Pvt. Ltd., a private company that provides medico-legal consulting services. It was established in 2013 in Patna, Bihar, India and assists hospitals, doctors, and medical professionals with legal issues related to their work, including defending clients in litigation, conducting audits, and providing training. The document outlines some common types of medical negligence claims and legal issues that doctors and hospitals face.
This newsletter provides a summary of activities from the SRTD-II project in Jordan between June 2015. It discusses several key events:
1) An orientation, networking and brokerage workshop was held for SRTD-II grant beneficiaries, investors, entrepreneurs and researchers from Jordan and EU to connect and plan joint research proposals.
2) SRTD-II participated in the 15th International Congress of the International Society for Ethnopharmacology in Jordan to raise awareness of HCST projects and establish international links in health and food research.
3) A meeting was held with 11 Technology Transfer Units established by SRTD-I to evaluate achievements and select 5 officers for additional training to enhance commercialization
This document contains a summary of Adesanya Afolabi Ibukun's personal and professional details. It includes his address, contact information, date of birth, education history, skills, work experience including current role as a structural design engineer, interests and references. He holds a Postgraduate Diploma in Civil Engineering from the Federal University of Agriculture and has over 5 years of work experience in structural design and construction site supervision.
This document discusses providing outstanding patient service. It begins by defining good, poor, and outstanding patient service. Good service meets expectations, while outstanding service exceeds expectations and is memorable. The document then provides tips for offering outstanding patient service, such as treating each patient as an individual, identifying their needs, and looking for opportunities to exceed their expectations. It emphasizes building rapport with patients through active listening, making a personal connection, and following up after providing a service. The document also discusses dealing with patients' emotional needs through empathy and validation. Overall, it provides guidance for staff on understanding patients' perspectives and consistently delivering service that exceeds their expectations.
This document discusses abuse, neglect, trauma and exploitation. It defines different types of abuse and provides signs and symptoms to look for. It emphasizes the responsibility of all staff to know how to identify and report any suspected cases. Staff are trained on proper investigation and documentation procedures. The document outlines how to report cases internally and according to different state guidelines. It also provides tips for dealing with patient stressors and aggressive behaviors, including assessing triggers and using distraction techniques. Staff are reminded not to take patient behavior personally and to maintain dignity and respect at all times.
This document outlines precautions doctors should take against negligence. Things not to do include examining female patients without a third person present, abandoning patients, guaranteeing cures, admitting fault, criticizing other doctors to patients, and performing procedures without proper skill or consent. Things to do include obtaining informed consent, maintaining accurate records, confirming diagnoses, seeking consultations when needed, informing patients, keeping up with advances, selecting competent assistants, and identifying drugs before use. Practicing with care, competence, communication and documentation can help prevent negligence claims.
This document provides an overview of East Zone Medico Legal Services Pvt. Ltd., a private company that provides medico-legal consulting services. It was established in 2013 in Patna, Bihar, India and assists hospitals, doctors, and medical professionals with legal issues related to their work, including defending clients in litigation, conducting audits, and providing training. The document outlines some common types of medical negligence claims and legal issues that doctors and hospitals face.
This newsletter provides a summary of activities from the SRTD-II project in Jordan between June 2015. It discusses several key events:
1) An orientation, networking and brokerage workshop was held for SRTD-II grant beneficiaries, investors, entrepreneurs and researchers from Jordan and EU to connect and plan joint research proposals.
2) SRTD-II participated in the 15th International Congress of the International Society for Ethnopharmacology in Jordan to raise awareness of HCST projects and establish international links in health and food research.
3) A meeting was held with 11 Technology Transfer Units established by SRTD-I to evaluate achievements and select 5 officers for additional training to enhance commercialization
This document contains a summary of Adesanya Afolabi Ibukun's personal and professional details. It includes his address, contact information, date of birth, education history, skills, work experience including current role as a structural design engineer, interests and references. He holds a Postgraduate Diploma in Civil Engineering from the Federal University of Agriculture and has over 5 years of work experience in structural design and construction site supervision.
This website helps businesses grow by allowing them to take online orders through a website and mobile apps built by the company, and manage their menu, customer information, and promotions through a self-serve dashboard. The goal is to provide customers with a new experience ordering online or through mobile apps.
This document provides Marion Pound's contact information and summarizes her experience working in long-term care facilities as both a caregiver and medication aide over the past 17 years. It details her experience caring for her friend Irene Pullen after injuries and declining health conditions, as well as various roles she has held at several long-term care facilities, independent living communities, and through an in-home care agency. Her experience includes assisting with activities of daily living, medication administration, meal preparation, housekeeping, appointment scheduling, and end-of-life care.
Este documento fornece informações sobre direitos autorais de uma obra literária disponibilizada gratuitamente online pela equipe Le Livros e seus parceiros com o objetivo de oferecer conteúdo para pesquisa e estudo acadêmico. É proibida a venda ou uso comercial do conteúdo. A equipe disponibiliza obras de domínio público e propriedade intelectual gratuitamente acreditando que conhecimento e educação devem ser acessíveis.
unfolding - Nan Tien Institute art exhibition
2 - 22 November 2012
12 IAVA artists explored the idea of unfolding in the context of Australian Artists in the Asian Century.
Artists: Kendal Heyes, Jennifer Jackson, Garry Jones, Alena Kennedy, Flossie Peitsch, Jennifer Portman, Deborah Redwood, Robert Reid, Sue Smalkowski, Arja Välimäki, Vyvian Wilson, Mary Wingrave.
Ice boxes are available for purchase from Bayou Ice Boxes. They can be ordered online at bayouiceboxes.com or by calling 251.654.9736. The website and phone number provided are resources for learning more about and purchasing ice boxes.
Este documento presenta el plan de estudios para un curso de Introducción a la Teoría Administrativa impartido en la Universidad Autónoma de Santo Domingo. El objetivo general del curso es proporcionar conceptos generales sobre la administración y su impacto en las organizaciones. Los objetivos específicos incluyen definir conceptos clave de la administración, conocer la evolución del pensamiento administrativo y los roles de los administradores. El curso cubrirá temas como las escuelas del pensamiento administrativo, los enfoques de sistemas,
Perché aderire a CambioMerci.com - RivenditoriCAMBIOMERCI.COM
Perché aderire in un circuito che utilizza la moneta complementare? Scopri tutti i vantaggi per la tua azienda! Visita il sito www.cambiomerci.com e inizia a fare acquisti per la tua azienda senza utilizzare l'Euro.
Mrs. Wilkes' Dining Room in Savannah, Georgia has offered family-style Southern meals since 1943. It began as a boardinghouse restaurant run by L.H. and Sema Wilkes. For nearly seven decades, Sema rang a bell and said grace before meals. Currently, Ryon Thompson, a great-grandson of the original owners, manages the restaurant to preserve the family atmosphere and tradition of sharing meals with strangers who become friends. The food is classic Southern cooking prepared by long-time staff using time-honored recipes.
Angela Cheng offers tutoring services for a variety of subjects including English, Chinese, math, art, swimming, piano, vocal lessons, and acting. She can be reached by phone at (201) 844-3506 for tutoring help.
Este documento fornece instruções sobre o preenchimento do Registo Biográfico online para docentes. Inclui informações sobre login, navegação no sistema, e detalhes sobre como preencher seções de informação pessoal, qualificações, e submeter o registo para validação.
A system to match the route of access to being the most appropriate for patients - using the most appropriate mode of consultation to resolve the patient's problem.
This 3 sentence summary provides the high level information about the document:
The document outlines the process for drafting a policy on the prevention of sexual harassment (POSH) in the workplace. It defines key terms, establishes an internal complaints committee and complaint resolution process, including conducting inquiries and providing interim relief. The process aims to effectively deal with complaints in a fair and unbiased manner in accordance with the Sexual Harassment of Women at Workplace Act.
This document summarizes discussions from a Primary Care Collaborative meeting in Swindon, England on September 7, 2016. It provides information on the West of England Academic Health Science Network and their Patient Safety Collaborative initiative. The collaborative is a one year project working with 14 GP practices to develop a safe and open culture through incident reporting and quality improvement methodology. Data on reported patient safety incidents from general practices in England is also presented, showing the most common types of incidents and numbers reported between October 2014 and June 2015.
This website helps businesses grow by allowing them to take online orders through a website and mobile apps built by the company, and manage their menu, customer information, and promotions through a self-serve dashboard. The goal is to provide customers with a new experience ordering online or through mobile apps.
This document provides Marion Pound's contact information and summarizes her experience working in long-term care facilities as both a caregiver and medication aide over the past 17 years. It details her experience caring for her friend Irene Pullen after injuries and declining health conditions, as well as various roles she has held at several long-term care facilities, independent living communities, and through an in-home care agency. Her experience includes assisting with activities of daily living, medication administration, meal preparation, housekeeping, appointment scheduling, and end-of-life care.
Este documento fornece informações sobre direitos autorais de uma obra literária disponibilizada gratuitamente online pela equipe Le Livros e seus parceiros com o objetivo de oferecer conteúdo para pesquisa e estudo acadêmico. É proibida a venda ou uso comercial do conteúdo. A equipe disponibiliza obras de domínio público e propriedade intelectual gratuitamente acreditando que conhecimento e educação devem ser acessíveis.
unfolding - Nan Tien Institute art exhibition
2 - 22 November 2012
12 IAVA artists explored the idea of unfolding in the context of Australian Artists in the Asian Century.
Artists: Kendal Heyes, Jennifer Jackson, Garry Jones, Alena Kennedy, Flossie Peitsch, Jennifer Portman, Deborah Redwood, Robert Reid, Sue Smalkowski, Arja Välimäki, Vyvian Wilson, Mary Wingrave.
Ice boxes are available for purchase from Bayou Ice Boxes. They can be ordered online at bayouiceboxes.com or by calling 251.654.9736. The website and phone number provided are resources for learning more about and purchasing ice boxes.
Este documento presenta el plan de estudios para un curso de Introducción a la Teoría Administrativa impartido en la Universidad Autónoma de Santo Domingo. El objetivo general del curso es proporcionar conceptos generales sobre la administración y su impacto en las organizaciones. Los objetivos específicos incluyen definir conceptos clave de la administración, conocer la evolución del pensamiento administrativo y los roles de los administradores. El curso cubrirá temas como las escuelas del pensamiento administrativo, los enfoques de sistemas,
Perché aderire a CambioMerci.com - RivenditoriCAMBIOMERCI.COM
Perché aderire in un circuito che utilizza la moneta complementare? Scopri tutti i vantaggi per la tua azienda! Visita il sito www.cambiomerci.com e inizia a fare acquisti per la tua azienda senza utilizzare l'Euro.
Mrs. Wilkes' Dining Room in Savannah, Georgia has offered family-style Southern meals since 1943. It began as a boardinghouse restaurant run by L.H. and Sema Wilkes. For nearly seven decades, Sema rang a bell and said grace before meals. Currently, Ryon Thompson, a great-grandson of the original owners, manages the restaurant to preserve the family atmosphere and tradition of sharing meals with strangers who become friends. The food is classic Southern cooking prepared by long-time staff using time-honored recipes.
Angela Cheng offers tutoring services for a variety of subjects including English, Chinese, math, art, swimming, piano, vocal lessons, and acting. She can be reached by phone at (201) 844-3506 for tutoring help.
Este documento fornece instruções sobre o preenchimento do Registo Biográfico online para docentes. Inclui informações sobre login, navegação no sistema, e detalhes sobre como preencher seções de informação pessoal, qualificações, e submeter o registo para validação.
A system to match the route of access to being the most appropriate for patients - using the most appropriate mode of consultation to resolve the patient's problem.
This 3 sentence summary provides the high level information about the document:
The document outlines the process for drafting a policy on the prevention of sexual harassment (POSH) in the workplace. It defines key terms, establishes an internal complaints committee and complaint resolution process, including conducting inquiries and providing interim relief. The process aims to effectively deal with complaints in a fair and unbiased manner in accordance with the Sexual Harassment of Women at Workplace Act.
This document summarizes discussions from a Primary Care Collaborative meeting in Swindon, England on September 7, 2016. It provides information on the West of England Academic Health Science Network and their Patient Safety Collaborative initiative. The collaborative is a one year project working with 14 GP practices to develop a safe and open culture through incident reporting and quality improvement methodology. Data on reported patient safety incidents from general practices in England is also presented, showing the most common types of incidents and numbers reported between October 2014 and June 2015.
Handling complaints in social care servicesRami Okasha
The Care Inspectorate is changing how it investigates complaints about care services in Scotland. This presentation describes these changes and reinforces why an apology is so important when things go wrong.
Here are the key pros and cons of assault weapons bans discussed in the article:
Pros:
- Most Americans (55%) support banning assault weapons according to recent polls. This suggests a ban could have broad public support.
Cons:
- Younger generations like Millennials are less supportive of bans, potentially due to the popularity of military-style guns in video games and the gun market. Greater exposure to these guns is shifting views away from support for bans.
The article provides a brief overview of the debate around assault weapons bans by noting majority public support but also discussing factors contributing to weaker support among younger demographics. It presents both sides of the issue without making a clear argument for either position.
A Practical Roadmap For Navigating Medical Staff Legal Nightmares In Current ...Quarles & Brady
This document provides a summary of key legal and process considerations for medical staff when navigating investigations into a medical staff member's conduct or competence. It outlines when the medical staff process versus administrative process should be used, timelines around summary suspensions of privileges, requirements for fair investigative committees and hearings, and ensuring physician access to relevant documents. The overall goal is to follow medical staff bylaws and legal standards to maintain immunity while addressing quality or conduct issues in a fair manner.
ODANO (Oncology Drug Access Navigators of Ontario) is a provincial organization that provides support and advocacy to help cancer patients access the medications they need. It has over 50 members across various regions of Ontario who help navigate public and private drug coverage plans and work with patients' treatment teams. The organization faces challenges with wait times for public drug plans and lack of direct communication with private insurers, and works on case studies to help patients receive adequate funding for their cancer treatments.
The document discusses disclosure and apology practices for medical errors and adverse events. It recommends a three step process: 1) Initial empathy and addressing patient needs, apologizing but not admitting fault; 2) A swift investigation involving outside experts; 3) Resolution by sharing results, admitting error if found and compensating, or proving no error if found. It emphasizes quick response, transparency, communication and resolving issues to reduce future injuries.
The document provides guidance on developing an effective complaints resolution system with six key principles:
1. A positive complaints culture where complaints are seen as opportunities for improvement rather than criticism.
2. Accountability where the organization follows its complaints policy and procedure, keeps accurate records, and informs users of improvements from complaints.
3. A fair system where all parties' views are represented impartially and decisions are based on facts.
4. Confidentiality where complaint information and records are kept private and only discussed with those directly involved.
5. Accessibility where the process is responsive to all users and interpreters are available to help those who need assistance.
6. Responsiveness where complaints are acknowledged
Patient complaints are inevitable. And when a patient complaint is not effectively managed, unfavorable or harmful consequences can result—noncompliance, dissolving of the patient-physician relationship, litigation, or reduced compensation. Therefore, strong complaint management is a core component for success worth cultivating and honing.
This document outlines the complaints policy and procedures for John Kelly Girls Technology College. It provides the legal framework for handling complaints according to education law. It defines the scope of the policy as not covering individual teachers or the principal. It then details the multi-stage process for handling initial concerns, formal complaints to the principal, and appeals to the governing body complaints committee. It also addresses resolving complaints, record keeping, and vexatious complaints.
The document outlines steps residents and families of nursing homes in Colorado can take to resolve health care issues. It provides contact information for the state ombudsman who can help address complaints, as well as instructions for filing formal complaints with the Colorado Department of Public Health and Environment if initial steps do not resolve the problem. Nursing home inspections are discussed, including how surveyors evaluate care by interviewing residents and families, observing interactions, and reviewing records. Residents are encouraged to share their views with surveyors.
Team-Based Care 101 for Health Professions Students CHC Connecticut
This webinar provided an overview of team-based care for health professions students. Speakers from Community Health Center, Inc. and the National Nurse-Led Care Consortium discussed key components of effective teams, including clear roles and communication. Specific tools for communication, such as SBAR and huddles, were reviewed. The webinar aimed to describe high-performing teams, effective communication strategies, and how to optimize team roles.
This document discusses adult safeguarding procedures and case studies. It outlines the four stages of the safeguarding process: concern/pre-referral, enquiry, safeguarding plan and review, and closing the enquiry. Case studies address issues like elder domestic abuse, pressure ulcers, do not attempt resuscitation (DNAR) orders, and families' role in decision making. It emphasizes obtaining consent, supporting patients' desires and best interests, considering capacity, and consulting families as part of the safeguarding and medical decision process. Future changes include emailing instead of faxing safeguarding forms to adult social care.
· After A review of the current literature regarding the challe.docxLynellBull52
·
After A review of the current literature regarding the challenges faced by many hospital systems as a result of emergency department overcrowding, a qualitative study of by means of a written questionnaire to determine factors or potential factors that influence a health care consumers decision to access care at an emergency room.
As the population ages emergency departments will continue to experience overcrowding from many factors, among them overutilization due patients seeking non-urgent care. Increased use of emergency departments In terms of financial viability it will be essential to understand factors affecting how patients perceive their medical condition, and further the accessibility to the appropriate level of care. The purpose of this study is to determine and evaluate the factors that contribute to the overutilization of emergency departments for non-urgent needs.
The study is targeted to patients in a rural North Carolina county with approximately 26,000 residents. Study participants will be those seen in the local emergency department that averages 1300 visits per month. Each participant will be required to complete a consent form and provide demographic data. Organizational approval for this study will be obtained at the facility level from the Assistant Vice President for the facility. Additionally. The Institutional Review Board (IRB) consent must be obtained.
During the data collection process, the surveyor will approach each participant separately and seek their consent for participation in the survey. During this encounter, the survey will collect the appropriate demographic information. Participant's names will not be disclosed in an attempt to preserve their anonymity
Introduction: My name is Teresa Cochran. I am a Director of Nursing and also a graduate student seeking a Master’s in Business Administration. I am currently completing a survey of factors that contribute to patient’s utilization of Emergency Services and I would like to ask you a few questions.
Questionnaire
I.
1. What is the reason for your visit to the Emergency Department today?
a. Chest pain
b. Accident
c. Respiratory distress
d. Diarrhea/vomiting
e. Other _____________________________________
2. How many times per year do you come to the Emergency Department?
a. 0-2
b. 3-5
c. 6-8
d. >9
3. What, if any of the following factors may influence your decision to come to the Emergency Department:
a. No available appointment at primary care
b. Second opinion
c. Receive better care in ED than at doctor’s office
d. No transportation
e. Convenience
f. Other___________
4. Do you have a doctor you see on a regular basis?
a. Yes
b. No
5. How many times do see your doctor per year?
6. 0-2
7. 3-5
8. 6-8
9. > 9
10. Before you came to the ED did you call your primary care physician? Why or Why not?
11. What prevents you from getting health care at your primary care provider?
12. What is your age? Gender?
13. Employment statu.
Coupling customer journey maps with twitterAli Anani, PhD
The document discusses analyzing customer sentiment about eye hospitals through social media data. It presents a case study of a customer journey map for an eye hospital created by analyzing tweets related to eye surgery and appointments. Negative sentiments were expressed regarding long wait times and poor communication. The importance of a positive patient experience with friendly staff in maintaining clean facilities is emphasized. Analyzing emotional language in tweets can provide insights into improving patient satisfaction and promoting recommendations.
Administrators and healthcare professionals can take measures to prevent lawsuits in hospitals. This includes establishing legal cells and alternative dispute resolution policies, maintaining malpractice insurance, ensuring patient safety, and developing good communication with patients and their families. When complications do occur, administrators should promptly discuss what happened with patients and their families, acknowledge their feelings, focus on recovery, and have a plan to compensate for errors. Maintaining legal knowledge, complying with standards, and reducing medical errors can also help minimize liability.
This project was chosen following several cases where individuals had moved from other regions into the Thames Valley area, with little or no planning resulting in near misses. Likewise, when individuals from the Thames Valley moved to other regions e.g. for University, some regions did not accept the referrals in a timely coordinated manner, thus increasing the risk for the individual and their family. It was therefore agreed that the Thames Valley EIP Best Practice group would review its standard practices for patient transfers to firstly understand the issues and agree on a new standard procedure.
The patient is a 69-year-old male admitted to the hospital with respiratory failure due to chronic obstructive pulmonary disease (COPD) from long-term smoking. His medical history and current symptoms will be assessed using the nursing process framework. This will include evaluating lab results and medications to understand the pathophysiology of his COPD and related conditions. Developing a comprehensive care plan is important to address his acute needs and support his long-term health management.
Similar to Six steps to successful complaint resolution for medicolegal consultant (20)
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdfrightmanforbloodline
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Know the difference between Endodontics and Orthodontics.
Six steps to successful complaint resolution for medicolegal consultant
1. MEDICAL PROTECTION SOCIETY
PROFESSIONAL SUPPORT AND EXPERT ADVICE
MPS COMPLAINTS SERIES – BOOK 3
Six Steps to Successful
Complaint Resolution For
Medicolegal Consultant
An MPS case study
2. www.mps
Contents
Case study page 2
Step 1 – Initial action on receipt of complaint page 3
Step 2 – Action to be taken within three working days
of receipt of the complaint page 4
Step 3 – Finalise a plan of action for investigating the complaint page 5
Step 4 – The Investigation page 6
Step 5 – Response page 7
Step 6 – Monitoring and Review page 8
.org.u
4. SIX STEPS TO SUCCESSFUL COMPLAINT RESOLUTION 3
Case Study
This case study is not intended as a prescriptive approach, but provides a
guide based on the principles of good complaints handling.
Dear Dr Busy
I am writing to you because I am very angry about what happened at
my consultation with you Tuesday.
I rang for an appointment the previous week and your receptionist was
very rude and unhelpful. She said I couldn’t have one and had to ring
back at 8.30 am the next day. When I did ring at 8.30 I was told there
were no more appointments. This is ridiculous, I pay my taxes like
anyone else. I did my bit for my country and this is how I am treated!!
Old people are always “discriminated” against and you should be
ashamed with the way your staff run the practice.
I eventually got an appointment on Tuesday and was seen by you.
I told you about the pain in my chest and how terrible I felt but you
weren’t interested. You didn’t examine me properly and fobbed me off
Iwith some tablets saying it was just indigestion. You made me feel like
was making a fuss about nothing and I left feeling that it was a waste of
time making the appointment.
I felt unwell again overnight but because of how you made me feel I
decided to go to hospital and a very nice man there said I had angina
not indigestion as you said.
I could have died because of your negligence and total disregard for
my symptoms.
This is not the first time I have had problems with your practice. Two
years ago I saw a locum who gave me penicillin even though my
records say that I am allergic to it. Luckily the pharmacist picked this
up before giving me the tablets. I never received an apology for this.
I have since spoken to lots of my friends and they have said they have
had similar problems with you and your staff.
Mr Cross
5. 4 COMPLAINTS
Step 1 – Initial action on receipt of complaint
■■ Log in complaint.
■■ Pass to complaints lead.
■■ Check whether there is any immediate action that needs to be taken in
relation to the patient’s care.
■■ Check whether there are any consent issues.
■■ Consider whether it would be helpful to seek advice from MPS.
■■ Do initial risk assessment.
The practice manager, as the complaints manager for the practice, has logged
in the complaint from Mr Cross. There are no consent issues as the complaint
has been received from the patient. She has been in touch with the hospital to
ask for their report on Mr Cross’s attendance to see if there is any immediate
action that needs to be taken on follow up. With the help of the senior partner
in the practice (who is not Dr Busy), she has risk assessed the administrative
issues (appointments) and the clinical issues (consultation and diagnosis). She
has taken the higher risk level rating of the two as the guide to the approach to
be taken. It is considered that an in-house investigation would be appropriate
and proportionate to the level of risk.
Step 2 – Action to be taken within three working days of receipt of the
complaint
■■ Acknowledge the complaint
■■ The acknowledgement can be oral or written, but should include:
■■ an apology for the difficulties the patient has experienced.
■■ an invitation to discuss the way forward.
■■ details of an advocacy service.
■■ a copy of the practice’s complaints procedure.
If you cannot contact the complainant by phone within the three working days
required, you should acknowledge the complaint in writing. One way forward,
under such circumstances, would be to enclose a draft plan of action for the
complainant’s consideration, asking for confirmation within a set timescale.
The practice manager manages to contact Mr Cross by phone and provides an
oral acknowledgement. She discusses with him the way forward for the
investigation, using a template planning document (see 3 below) and this
enables her to draw up an agreed plan of action. She makes a note of the
conversation in the complaints log.
6. SIX STEPS TO SUCCESSFUL COMPLAINT RESOLUTION 5
Step 3 – Finalise a plan of action for investigating the complaint
The plan should include:
■■ Complaint reference number.
■■ Complainant’s name and contact details.
■■ Complainant’s preferred means of contact (if it is email make it clear that
this may not be a secure means of corresponding).
■■ Patient’s name and details if different from complainant.
■■ Has consent been sought/obtained, if appropriate?
■■ Name of person who contacted the complainant.
■■ Date of contact.
■■ Summary of complaint with dates of incidents.
■■ List of issues to be investigated.
■■ Outcome the complainant is seeking.
■■ Agreed investigation plan (eg, use of conciliator, internal investigation by
whom, external investigation by whom).
■■ Consent to share information with those involved in the investigation.
■■ Agreed timescale for a response.
■■ How the practice will provide the response.
■■ Details of source of advocacy suggested.
■■ Any further information which may be helpful (eg, language or disability issues).
Send a copy of the plan to the complainant.
During her telephone conversation with Mr Cross the practice manager
has confirmed that the issues for investigation are:
■■ Difficulty in getting an appointment and attitude of receptionist on 26
and 27 March.
■■ Failure to diagnose angina at the consultation and the doctor’s attitude
on 31 March.
■■ Failure to identify his allergy to penicillin in the past.
■■ Third party feedback about problems experienced by other patients.
Mr Cross has agreed that:
■■ The practice manager will investigate the issues relating to the appointment
system, attitude of the receptionist and third party feedback.
■■ The senior partner will investigate the clinical issues relating to the
alleged missed diagnosis and the patient’s allergy.
7. 6 COMPLAINTS
The practice manager explains that she cannot comment on the third
party feedback Mr Cross has provided in his letter but she is willing to
let him have information on the general feedback the practice have
received via its patient surveys.
When asked what he would like to see achieved at the end of the
investigation, Mr Cross stated that he wanted to see an improvement
in the appointment system and wanted an apology from Dr Busy for
what he considered to be a misdiagnosis. He also wanted an apology
from the practice, with reassurances, about his penicillin allergy.
A timescale for the investigation is negotiated. The senior partner is on
leave for a week and the practice manager allows for this in estimating
how long the investigation will take. She indicates that Mr Cross should
receive a full response within four weeks. She gives a specific date.
The practice manager agrees that she will ring Mr Cross to let him know when
the response is being posted to him. It is also agreed that once Mr Cross
receives the letter setting out the findings of the investigation, the practice
manager will ring him to see whether he would like to come into the surgery to
discuss the matter further, before Local Resolution is signed off.
She includes in the plan confirmation of the advocacy services available. In
Mr Cross’s case, the practice manager provides both ICAS and also Age
Concern as possible sources of help.
A copy of the plan is sent to Mr Cross with an invitation to get in touch if
he is unhappy with any aspect of it.
Step 4 – The Investigation
An investigation could include:
■■ Obtaining statements from staff/staff interviews.
■■ Reviewing records/policies/procedures.
■■ Obtaining information from other sources if necessary.
■■ Drawing conclusions from the findings.
■■ Discussing the conclusions as a practice and deciding on the actions to be taken.
■■ Drawing up an action plan.
Details of all documentation, notes of interviews and staff statements are kept
on the complaint file.
It is advisable to consider asking a doctor who has not been involved in the
patient’s care to review the clinical management. This injects some objectivity
and independence into the process and reflects the Ombudsman’s Principles
of Good Complaints Handling.
8. SIX STEPS TO SUCCESSFUL COMPLAINT RESOLUTION 7
The practice manager:
■■ Interviews staff who dealt with Mr Cross’s requests for an appointment.
■■ Leads a general discussion on the current appointment system at a
practice meeting. In doing this she also reviews other feedback on
the appointments system.
■■ Reviews feedback from patient surveys, to obtain the opinion of
patients about the service provided by the surgery in general.
The senior partner:
■■ Reviews the clinical notes and discusses these with Dr Busy. He
highlights the need for better record-keeping.
■■ Obtains a report on Mr Cross’s hospital visit.
■■ Checks that penicillin allergy has been marked clearly on records.
The senior partner and the practice manager review the evidence and draw
conclusions. They make a list of improvements they feel need to be made,
as a result of the complaint for discussion at the practice meeting.
Step 5 – Response
You should consider including the following elements in a response letter, but
also be mindful of the plan you agreed with the complainant. Check the draft
response with MPS if you consider this to be appropriate.
■■ An apology and some acknowledgement of distress (condolences
where appropriate).
■■ A summary of the main issues they have raised in their letter (this will also
help you focus your response).
■■ What action you have taken to investigate the complaint (eg, spoken to the
staff concerned, reviewed records/policies).
■■ A clear explanation in response to each of the issues raised. If this relates to a
consultation, refer to the history you took; any examination and findings (including
negative findings); treatment provided; advice given and any follow up.
■■ What action the practice is taking, as a result of the complaint, to reduce
the risk of a similar occurrence.
■■ An invitation to meet or contact you again if they have any further questions.
■■ Details of their redress, through the complaints procedure to the
Ombudsman, and their right to use an independent advocacy service if they
have not already done so.
■■ A reiteration of your apology for what occurred.
9. 8 COMPLAINTS
A letter of response is sent to Mr Cross. The practice manager rings Mr Cross
to tell him it is on its way and invites him to contact her when it is received, or
she will ring him in two days’ time if she has not heard from him.
Two days later they discuss the response in greater detail. Mr Cross is happy
with the issues relating to the appointments system and is pleased to know
that there are to be improvements. However, the hospital report did not
confirm a definite diagnosis of angina and he therefore still remains
concerned. The practice manager arranges for him to come in to discuss this
with the senior partner and also to have a further medical checkup for
reassurance. He is invited to bring someone with him if he wishes. He does
not feel this is necessary and he will come alone. Confirmation of this
conversation and the details of the meeting are sent to Mr Cross by post.
At the end of the meeting with the senior partner, with Mr Cross’s
agreement, Dr Busy is invited to join them, in order that the doctor–patient
relationship can be re-established.
After the meeting Mr Cross feels reassured. The senior partner writes to
him again to confirm the main points that they discussed at the meeting
and confirming that Local Resolution is now completed. Mr Cross’s rights
through the Ombudsman are reiterated in this letter.
Step 6 – Monitoring and Review
There should be follow up on the action arising from a complaint. For example:
■■ Would it be beneficial to share lessons learned more widely?
■■ Check agreed action is taken within set timescale.
■■ Provide feedback to practice team and, if appropriate, complainant.
The practice manager makes the agreed changes to the practice appointment
procedures and ensures all staff are aware of the new process.
She reviews the feedback from patients following the subsequent
patient survey and notes increased satisfaction with the appointment
system. She feeds this back to the practice and to the complainant.
The senior partner audits Dr Busy’s record-keeping to ensure improvement.
A note of the service improvements achieved is made for inclusion in the
annual report.
10. SIX STEPS TO SUCCESSFUL COMPLAINT RESOLUTION 9
Notes
12. SIX STEPS TO SUCCESSFUL COMPLAINT RESOLUTION 11
Notes
13. MEDICAL PROTECTION SOCIETY
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