Urgent and emergency care remains a high priority across the NHS as demand, length of stay and variation in practice continues to increase. NHS Improvement has worked with a number of acute hospital sites to understand the complexity of urgent and emergency care attendances, and admissions. “Making connections with the challenges of unscheduled care” shares the issues, the outcomes and identifies some tried and tested solutions that can ease the burden of unscheduled care
An overview of cerebral palsy = الشلل الدماغيRahma ShahBahai
Cerebral palsy (CP) is a group of permanent movement disorders caused by damage to the developing brain. The damage can occur before, during, or after birth from injury or illness. CP affects muscle tone, movement, and motor skills. There are several types of CP defined by the parts of the body affected and the brain areas damaged. Common signs include poor muscle control, feeding difficulties, and developmental delays. Diagnosis involves ruling out other causes through exams and tests. Treatment is multidisciplinary and focuses on rehabilitation, physical therapy, medications, and surgery to improve function and independence over time. The earlier treatment begins, the more improvement can be made.
This document is a project report on recruitment and selection practices at Durgapur Steel Plant, which is one of the integrated steel plants owned by Steel Authority of India Limited (SAIL). It includes an acknowledgement, index, executive summary, company profiles of SAIL and Durgapur Steel Plant, objectives of the study, and sections on recruitment policies and procedures for different job roles at the plant. The report also covers findings, conclusions, and a bibliography. It provides details on the history, facilities, modernization efforts, and future expansion plans of Durgapur Steel Plant.
The document provides definitions for 13 disability categories under the IDEA. It explains that the federal definitions guide how states define eligibility for special education services. It then lists and defines each disability category, including autism, deaf-blindness, deafness, emotional disturbance, hearing impairment, intellectual disability, multiple disabilities, orthopedic impairment, other health impairment, speech or language impairment, traumatic brain injury, visual impairment, and learning disabilities.
This document discusses rehabilitation, including definitions, models, approaches, and services. It defines rehabilitation as using medical, social, educational, and vocational measures to train individuals to their highest functional ability level. The main models discussed are biomedical, social, biopsychosocial, ICIDH, CBR, and HRQOL. Approaches include institution-based rehabilitation, community-based rehabilitation, homes, day care centers, outpatient clinics, and camp approaches. Current rehabilitation services in India are also outlined.
the Private healthcare sector regulation in Bangladeshredwanrahman
The private health care sector in Bangladesh has grown significantly since 1978 while growth of the public sector has stagnated. There are problems with both the private and public sectors including high costs, lack of quality standards, and exploitation of patients in the private sector as well as shortages in resources and capacity in the public sector. The state regulates the private sector through licensing and inspections but regulatory capacity is limited by inadequate laws, shortages in resources and manpower, and conflicts between organizations. Poor regulatory practices have negatively impacted quality, cost, access, equity and distribution in the healthcare system. Recommendations include strengthening the legal framework, improving state involvement, reorganizing oversight structures, and empowering consumers.
This document discusses cerebral palsy (CP), including its causes, presentation, diagnosis, and treatment. It notes that the brain differentiates in the first trimester and neurons develop in the second trimester. CP is a non-progressive motor disorder that can range from mild impairment to complete dependence. Treatment is multidisciplinary and includes physical, occupational, speech and recreational therapies, orthopedic surgery, medications and assistive devices to improve function and prevent complications.
Vocational rehabilitation of person with intellectual disabilitiesTejal Patil
Vocational Rehabilitation is series of services that are designed to facilitate the entrance into or return to work by people with disabilities or by people who have recently acquired an injury.
This ppt focuses on intellectual disabilities, their challenges and opportunities.
The document discusses team minimums, which are basic activities that team leaders are expected to follow to ensure high quality team experiences. It lists the elements of team minimums, which include having a team purpose, job descriptions, individual contributions, training, tools, direction, tracking, coaching, performance reviews, reflection, and evaluation. It explains that implementing these minimums can contribute to member productivity, development, and satisfaction. It then provides steps for implementing team minimums over a 90 day period, dividing it into start, middle, and end experiences and outlining the expected activities and milestones for each phase.
An overview of cerebral palsy = الشلل الدماغيRahma ShahBahai
Cerebral palsy (CP) is a group of permanent movement disorders caused by damage to the developing brain. The damage can occur before, during, or after birth from injury or illness. CP affects muscle tone, movement, and motor skills. There are several types of CP defined by the parts of the body affected and the brain areas damaged. Common signs include poor muscle control, feeding difficulties, and developmental delays. Diagnosis involves ruling out other causes through exams and tests. Treatment is multidisciplinary and focuses on rehabilitation, physical therapy, medications, and surgery to improve function and independence over time. The earlier treatment begins, the more improvement can be made.
This document is a project report on recruitment and selection practices at Durgapur Steel Plant, which is one of the integrated steel plants owned by Steel Authority of India Limited (SAIL). It includes an acknowledgement, index, executive summary, company profiles of SAIL and Durgapur Steel Plant, objectives of the study, and sections on recruitment policies and procedures for different job roles at the plant. The report also covers findings, conclusions, and a bibliography. It provides details on the history, facilities, modernization efforts, and future expansion plans of Durgapur Steel Plant.
The document provides definitions for 13 disability categories under the IDEA. It explains that the federal definitions guide how states define eligibility for special education services. It then lists and defines each disability category, including autism, deaf-blindness, deafness, emotional disturbance, hearing impairment, intellectual disability, multiple disabilities, orthopedic impairment, other health impairment, speech or language impairment, traumatic brain injury, visual impairment, and learning disabilities.
This document discusses rehabilitation, including definitions, models, approaches, and services. It defines rehabilitation as using medical, social, educational, and vocational measures to train individuals to their highest functional ability level. The main models discussed are biomedical, social, biopsychosocial, ICIDH, CBR, and HRQOL. Approaches include institution-based rehabilitation, community-based rehabilitation, homes, day care centers, outpatient clinics, and camp approaches. Current rehabilitation services in India are also outlined.
the Private healthcare sector regulation in Bangladeshredwanrahman
The private health care sector in Bangladesh has grown significantly since 1978 while growth of the public sector has stagnated. There are problems with both the private and public sectors including high costs, lack of quality standards, and exploitation of patients in the private sector as well as shortages in resources and capacity in the public sector. The state regulates the private sector through licensing and inspections but regulatory capacity is limited by inadequate laws, shortages in resources and manpower, and conflicts between organizations. Poor regulatory practices have negatively impacted quality, cost, access, equity and distribution in the healthcare system. Recommendations include strengthening the legal framework, improving state involvement, reorganizing oversight structures, and empowering consumers.
This document discusses cerebral palsy (CP), including its causes, presentation, diagnosis, and treatment. It notes that the brain differentiates in the first trimester and neurons develop in the second trimester. CP is a non-progressive motor disorder that can range from mild impairment to complete dependence. Treatment is multidisciplinary and includes physical, occupational, speech and recreational therapies, orthopedic surgery, medications and assistive devices to improve function and prevent complications.
Vocational rehabilitation of person with intellectual disabilitiesTejal Patil
Vocational Rehabilitation is series of services that are designed to facilitate the entrance into or return to work by people with disabilities or by people who have recently acquired an injury.
This ppt focuses on intellectual disabilities, their challenges and opportunities.
The document discusses team minimums, which are basic activities that team leaders are expected to follow to ensure high quality team experiences. It lists the elements of team minimums, which include having a team purpose, job descriptions, individual contributions, training, tools, direction, tracking, coaching, performance reviews, reflection, and evaluation. It explains that implementing these minimums can contribute to member productivity, development, and satisfaction. It then provides steps for implementing team minimums over a 90 day period, dividing it into start, middle, and end experiences and outlining the expected activities and milestones for each phase.
This document discusses vocational rehabilitation, independent living, and consumerism for people with disabilities. It covers several topics:
Vocational rehabilitation programs help prepare and employ people with various disabilities. The government has set up 20 vocational rehabilitation centers with objectives like assessment, rehabilitation planning, and job placement assistance.
The vocational rehabilitation process involves evaluation, job skills training, job analysis, job placement and accommodations, and follow up.
Independent living centers are consumer-controlled and aim to maximize self-sufficiency through services like housing assistance, transportation, peer counseling and advocacy. They differ from vocational rehabilitation in focusing on independence rather than employment.
The document also outlines various livelihood opportunities, government schemes
Cerebral palsy is a permanent neurological disorder caused by non-progressive brain damage early in life. It affects movement and posture. The incidence is about 2 per 1000 live births in developed countries and 7 per 1000 in developing countries. Causes include complications during pregnancy, birth injuries, infections, and genetic factors. Treatment is non-curative and aims to improve function through a multidisciplinary approach including physiotherapy, orthopedic management, medications, assistive devices, and early intervention. Prognosis depends on the type and severity of symptoms present.
The document discusses key concepts in community occupational therapy including health, community, occupation, and community-based rehabilitation. It describes occupational therapists' focus on the interactions between a person, their occupations, and their environment. The overall goal of occupational therapy in a community setting is to help people develop skills for independent living and decrease hospitalization.
This document discusses the history and current state of physiotherapy regulation in Nepal. It outlines the regulatory bodies overseeing physiotherapy, including the Nepal Health Professional Council and Nepal Physiotherapy Association. The document also examines challenges such as the lack of a license exam and proliferation of unaccredited physiotherapy programs. However, it notes recent positive developments like revisions to the code of ethics and plans to improve education standards through a license exam and master's program. Overall, the document presents an overview of physiotherapy regulation in Nepal and both current issues and planned reforms to strengthen the profession.
This course is designed to provide the student with the practical knowledge in the concepts of community, societal structure and the importance of meaningful occupation. Emphasis is laid on WHO model of Community Based Rehabilitation (CBR) and how the therapist could work with other Medical and Dental Team (MDT) members to sustain this community rehabilitation model.
The aim of this course is to make therapy services accessible, acceptable, and affordable in the community setting.
The document discusses early intervention for children with disabilities or developmental delays. It provides definitions of early intervention, outlines its history and legislation. Key points include:
- Early intervention aims to support children's growth and development and assist families of children from birth to age 3 with delays or disabilities.
- Milestones from birth to 3 years show progression in physical, cognitive, communication and other skills.
- The process involves referral, evaluation, developing an Individualized Family Services Plan (IFSP) and providing ongoing services like speech therapy in natural environments.
- Benefits include improved IQ, behaviors, and relationships, as well as decreased need for future special education services. Challenges include access to care and ensuring inclusion of children
models of rehabilitation - community based rehabilitationAkshayBadore2
This document discusses community-based rehabilitation (CBR), its key principles and components. CBR is defined as a strategy that promotes the rehabilitation, equal opportunities and social integration of people with disabilities through community efforts. It focuses on enhancing quality of life, meeting basic needs, and ensuring inclusion. CBR is seen as necessary because institutional rehabilitation is often too expensive, ignores cultural contexts and community reintegration. The principles of CBR include inclusion, participation, sustainability, empowerment and advocacy. Effective CBR programs cover all disability types, have multi-sectoral approaches and referral systems, and aim for full community integration.
This document discusses the biomechanics of various knee ligaments including the medial collateral ligament (MCL), lateral collateral ligament (LCL), anterior cruciate ligament (ACL), and posterior cruciate ligament (PCL). It describes the anatomy and function of each ligament, noting that they resist different motions like valgus, varus, anterior/posterior tibial translation, and rotation. The roles and tensions of the ligaments change with knee position. Muscle forces can also impact ligament strains.
This document discusses disability and impairment in India. It begins with background on defining and understanding disability, noting it is complex with both medical and social aspects. Disability results from interactions between health conditions and environmental/personal factors. The document then discusses prevalence of disability in India, citing 2011 Census data that found over 26 million persons or 2.21% of the population identified as disabled. It increased from 2001. Most disabled persons live in rural areas and males have a higher proportion than females. The document provides definitions of disability types and risk factors like malnutrition, conflict, and traffic accidents. It also outlines government policies and schemes in India related to disability.
Principles and methods of vocational and social rehabilitationDr. Jasjyot
This document discusses principles and methods of vocational and social rehabilitation. It defines vocational rehabilitation as services to help individuals with impairments overcome handicaps and reintegrate into society through employment. Methods of vocational rehabilitation include vocational guidance, training, and placement services. Social rehabilitation aims to help individuals develop skills to participate in everyday life and pursue education. It involves assessing needs and providing rehabilitation services like home help, attendant care, and housing modifications. The document outlines principles, legislation, agencies, and assessment processes involved in vocational and social rehabilitation services.
Modification of curriculum for visually impared studentsNusrat Zerin
The document discusses modifying curriculum for visually impaired students. A curriculum is designed to prepare students for adult life by teaching necessary skills and knowledge as determined by society. For visually impaired students, a "plus curriculum" is recommended in addition to the standard curriculum to help develop compensatory skills like Braille, orientation and mobility, daily living skills, and social skills. The expanded core curriculum for visually impaired students also includes independent living, recreation, self-determination, sensory efficiency, career education, assistive technology skills, and visual efficiency skills. Co-curricular activities that can be included are sports, cultural activities, physical education, and participation in student groups.
Using ICF to understand problems faced in the bathrooms by elders with knee painAlakananda Banerjee
The document discusses a pilot study that used the International Classification of Functioning (ICF) framework to understand elderly problems in the bathroom due to lower leg pain. Only 15% of surveyed elderly homes had grab rails in the bathroom, indicating an environmental barrier. The ICF was useful for considering the dynamic interaction between health conditions, activities, and environmental factors on participation and identifying appropriate home modifications. More research is needed on applying the ICF to understand disability in the elderly and inform policies to ensure safe, accessible homes.
Abby Jones is a 5-year-old girl diagnosed with severe quadriplegic spastic cerebral palsy with athetosis. She was born prematurely at 28 weeks and spent 5 months in the NICU. Her treatment plan focuses on range of motion, strength, balance, and standing exercises both in the pool and on land. In the pool, activities help challenge her respiratory system and facilitate movement. On land, exercises include stretching, joint mobilization, and adaptive cycling. Her progress is slow given her involvement, but maintaining flexibility and preventing worsening of impairments is considered progress for her condition.
Meaning of Cerebral Palsy , Definition of Cerebral Palsy , Areas affected by Cerebral Palsy , Causes of Cerebral Palsy , Types of Cerebral Palsy ( many basis ) , Signs and Symptoms of Cerebral Palsy , Developmental Milestones of Cerebral Palsy child , Associated problems of Cerebral Palsy , Treatment of Cerebral Palsy ,
An Introduction to Cerebral Palsy and Hypoxic Ischaemic Encephalopathymeducationdotnet
Cerebral Palsy is a non-progressive brain lesion that occurs during development and causes motor impairment. The document discusses CP, including defining it as a motor disorder resulting from a brain lesion before maturity. It also outlines the main causes of CP as being prenatal, perinatal, or postnatal events. The classifications of CP are described as spastic, ataxic, or dyskinetic. Hypoxic-ischemic encephalopathy (HIE) is presented as a major cause of CP, with hypothermia therapy emerging as an effective intervention for reducing brain injury in newborns with HIE.
From testing to spread: Sharing the knowledge and learning from organisations...NHS Improvement
From testing to spread:Sharing the knowledge and learning from organisations spreading the Winning Principles - case studies
The spread case studies illustrate many of these factors and provide an opportunity for sharing ‘working’ knowledge and learning experiences with the intention to promote further spread, adoption and action of good practice across the country and benefit more patients (Published July 2010).
The winning principles - transforming inpatient care programme for cancer pat...NHS Improvement
The Winning Principles- Transforming Inpatient Care Programme for Cancer Patients. (July 2008) By bringing together all the test sites experience and learning, FOUR WINNING PRINCIPLES have been identified that if applied can make a significant difference to the management and experience of the inpatient pathway.
For more information contact: Slideshare@marcusevans.com
Presentation delivered by Donna Medina, Regional Director,OSF Hospice and Homecare Foundation at the marcus evans Home Care Leadership Summit held on July 13 & 14 2015 in Palm Beach FL.
User Acceptance Scheermesser Kosow Tampereguestd6b375
This document summarizes the key findings from two case studies on user acceptance of pervasive computing in healthcare. [1] The studies examined factors like perceived usefulness, ease of use, and subjective norms that can facilitate or inhibit acceptance. [2] Across both studies, perceived usefulness and medical benefit were found to be decisive for user acceptance, but usability needed improvement to account for healthcare environments and abilities. [3] Subjective norms around changing roles could also inhibit implementation if social roles or job images felt threatened.
The document summarizes the Special Care Center, a service created by AtlantiCare to provide coordinated care for patients with chronic conditions. The Special Care Center aims to (1) manage chronic conditions effectively through a patient-centered medical home model, (2) reduce healthcare costs by focusing on preventative care and avoiding unnecessary emergency visits and hospitalizations, and (3) improve patient outcomes by providing integrated care, health coaching, open access to providers and services, and an emphasis on the patient experience. Since opening in 2007, the Special Care Center has expanded its services and grown to over 2,600 enrolled patients.
This document discusses vocational rehabilitation, independent living, and consumerism for people with disabilities. It covers several topics:
Vocational rehabilitation programs help prepare and employ people with various disabilities. The government has set up 20 vocational rehabilitation centers with objectives like assessment, rehabilitation planning, and job placement assistance.
The vocational rehabilitation process involves evaluation, job skills training, job analysis, job placement and accommodations, and follow up.
Independent living centers are consumer-controlled and aim to maximize self-sufficiency through services like housing assistance, transportation, peer counseling and advocacy. They differ from vocational rehabilitation in focusing on independence rather than employment.
The document also outlines various livelihood opportunities, government schemes
Cerebral palsy is a permanent neurological disorder caused by non-progressive brain damage early in life. It affects movement and posture. The incidence is about 2 per 1000 live births in developed countries and 7 per 1000 in developing countries. Causes include complications during pregnancy, birth injuries, infections, and genetic factors. Treatment is non-curative and aims to improve function through a multidisciplinary approach including physiotherapy, orthopedic management, medications, assistive devices, and early intervention. Prognosis depends on the type and severity of symptoms present.
The document discusses key concepts in community occupational therapy including health, community, occupation, and community-based rehabilitation. It describes occupational therapists' focus on the interactions between a person, their occupations, and their environment. The overall goal of occupational therapy in a community setting is to help people develop skills for independent living and decrease hospitalization.
This document discusses the history and current state of physiotherapy regulation in Nepal. It outlines the regulatory bodies overseeing physiotherapy, including the Nepal Health Professional Council and Nepal Physiotherapy Association. The document also examines challenges such as the lack of a license exam and proliferation of unaccredited physiotherapy programs. However, it notes recent positive developments like revisions to the code of ethics and plans to improve education standards through a license exam and master's program. Overall, the document presents an overview of physiotherapy regulation in Nepal and both current issues and planned reforms to strengthen the profession.
This course is designed to provide the student with the practical knowledge in the concepts of community, societal structure and the importance of meaningful occupation. Emphasis is laid on WHO model of Community Based Rehabilitation (CBR) and how the therapist could work with other Medical and Dental Team (MDT) members to sustain this community rehabilitation model.
The aim of this course is to make therapy services accessible, acceptable, and affordable in the community setting.
The document discusses early intervention for children with disabilities or developmental delays. It provides definitions of early intervention, outlines its history and legislation. Key points include:
- Early intervention aims to support children's growth and development and assist families of children from birth to age 3 with delays or disabilities.
- Milestones from birth to 3 years show progression in physical, cognitive, communication and other skills.
- The process involves referral, evaluation, developing an Individualized Family Services Plan (IFSP) and providing ongoing services like speech therapy in natural environments.
- Benefits include improved IQ, behaviors, and relationships, as well as decreased need for future special education services. Challenges include access to care and ensuring inclusion of children
models of rehabilitation - community based rehabilitationAkshayBadore2
This document discusses community-based rehabilitation (CBR), its key principles and components. CBR is defined as a strategy that promotes the rehabilitation, equal opportunities and social integration of people with disabilities through community efforts. It focuses on enhancing quality of life, meeting basic needs, and ensuring inclusion. CBR is seen as necessary because institutional rehabilitation is often too expensive, ignores cultural contexts and community reintegration. The principles of CBR include inclusion, participation, sustainability, empowerment and advocacy. Effective CBR programs cover all disability types, have multi-sectoral approaches and referral systems, and aim for full community integration.
This document discusses the biomechanics of various knee ligaments including the medial collateral ligament (MCL), lateral collateral ligament (LCL), anterior cruciate ligament (ACL), and posterior cruciate ligament (PCL). It describes the anatomy and function of each ligament, noting that they resist different motions like valgus, varus, anterior/posterior tibial translation, and rotation. The roles and tensions of the ligaments change with knee position. Muscle forces can also impact ligament strains.
This document discusses disability and impairment in India. It begins with background on defining and understanding disability, noting it is complex with both medical and social aspects. Disability results from interactions between health conditions and environmental/personal factors. The document then discusses prevalence of disability in India, citing 2011 Census data that found over 26 million persons or 2.21% of the population identified as disabled. It increased from 2001. Most disabled persons live in rural areas and males have a higher proportion than females. The document provides definitions of disability types and risk factors like malnutrition, conflict, and traffic accidents. It also outlines government policies and schemes in India related to disability.
Principles and methods of vocational and social rehabilitationDr. Jasjyot
This document discusses principles and methods of vocational and social rehabilitation. It defines vocational rehabilitation as services to help individuals with impairments overcome handicaps and reintegrate into society through employment. Methods of vocational rehabilitation include vocational guidance, training, and placement services. Social rehabilitation aims to help individuals develop skills to participate in everyday life and pursue education. It involves assessing needs and providing rehabilitation services like home help, attendant care, and housing modifications. The document outlines principles, legislation, agencies, and assessment processes involved in vocational and social rehabilitation services.
Modification of curriculum for visually impared studentsNusrat Zerin
The document discusses modifying curriculum for visually impaired students. A curriculum is designed to prepare students for adult life by teaching necessary skills and knowledge as determined by society. For visually impaired students, a "plus curriculum" is recommended in addition to the standard curriculum to help develop compensatory skills like Braille, orientation and mobility, daily living skills, and social skills. The expanded core curriculum for visually impaired students also includes independent living, recreation, self-determination, sensory efficiency, career education, assistive technology skills, and visual efficiency skills. Co-curricular activities that can be included are sports, cultural activities, physical education, and participation in student groups.
Using ICF to understand problems faced in the bathrooms by elders with knee painAlakananda Banerjee
The document discusses a pilot study that used the International Classification of Functioning (ICF) framework to understand elderly problems in the bathroom due to lower leg pain. Only 15% of surveyed elderly homes had grab rails in the bathroom, indicating an environmental barrier. The ICF was useful for considering the dynamic interaction between health conditions, activities, and environmental factors on participation and identifying appropriate home modifications. More research is needed on applying the ICF to understand disability in the elderly and inform policies to ensure safe, accessible homes.
Abby Jones is a 5-year-old girl diagnosed with severe quadriplegic spastic cerebral palsy with athetosis. She was born prematurely at 28 weeks and spent 5 months in the NICU. Her treatment plan focuses on range of motion, strength, balance, and standing exercises both in the pool and on land. In the pool, activities help challenge her respiratory system and facilitate movement. On land, exercises include stretching, joint mobilization, and adaptive cycling. Her progress is slow given her involvement, but maintaining flexibility and preventing worsening of impairments is considered progress for her condition.
Meaning of Cerebral Palsy , Definition of Cerebral Palsy , Areas affected by Cerebral Palsy , Causes of Cerebral Palsy , Types of Cerebral Palsy ( many basis ) , Signs and Symptoms of Cerebral Palsy , Developmental Milestones of Cerebral Palsy child , Associated problems of Cerebral Palsy , Treatment of Cerebral Palsy ,
An Introduction to Cerebral Palsy and Hypoxic Ischaemic Encephalopathymeducationdotnet
Cerebral Palsy is a non-progressive brain lesion that occurs during development and causes motor impairment. The document discusses CP, including defining it as a motor disorder resulting from a brain lesion before maturity. It also outlines the main causes of CP as being prenatal, perinatal, or postnatal events. The classifications of CP are described as spastic, ataxic, or dyskinetic. Hypoxic-ischemic encephalopathy (HIE) is presented as a major cause of CP, with hypothermia therapy emerging as an effective intervention for reducing brain injury in newborns with HIE.
From testing to spread: Sharing the knowledge and learning from organisations...NHS Improvement
From testing to spread:Sharing the knowledge and learning from organisations spreading the Winning Principles - case studies
The spread case studies illustrate many of these factors and provide an opportunity for sharing ‘working’ knowledge and learning experiences with the intention to promote further spread, adoption and action of good practice across the country and benefit more patients (Published July 2010).
The winning principles - transforming inpatient care programme for cancer pat...NHS Improvement
The Winning Principles- Transforming Inpatient Care Programme for Cancer Patients. (July 2008) By bringing together all the test sites experience and learning, FOUR WINNING PRINCIPLES have been identified that if applied can make a significant difference to the management and experience of the inpatient pathway.
For more information contact: Slideshare@marcusevans.com
Presentation delivered by Donna Medina, Regional Director,OSF Hospice and Homecare Foundation at the marcus evans Home Care Leadership Summit held on July 13 & 14 2015 in Palm Beach FL.
User Acceptance Scheermesser Kosow Tampereguestd6b375
This document summarizes the key findings from two case studies on user acceptance of pervasive computing in healthcare. [1] The studies examined factors like perceived usefulness, ease of use, and subjective norms that can facilitate or inhibit acceptance. [2] Across both studies, perceived usefulness and medical benefit were found to be decisive for user acceptance, but usability needed improvement to account for healthcare environments and abilities. [3] Subjective norms around changing roles could also inhibit implementation if social roles or job images felt threatened.
The document summarizes the Special Care Center, a service created by AtlantiCare to provide coordinated care for patients with chronic conditions. The Special Care Center aims to (1) manage chronic conditions effectively through a patient-centered medical home model, (2) reduce healthcare costs by focusing on preventative care and avoiding unnecessary emergency visits and hospitalizations, and (3) improve patient outcomes by providing integrated care, health coaching, open access to providers and services, and an emphasis on the patient experience. Since opening in 2007, the Special Care Center has expanded its services and grown to over 2,600 enrolled patients.
The document provides an overview of critical care nursing. It discusses the history of critical care units emerging in the 1950s to provide one-to-one nursing care to very ill patients. It defines critical care nursing as dealing with human responses to life-threatening problems. Critical care nurses work in intensive care units and other areas where critically ill patients require complex care and monitoring. The document outlines the roles, skills, and responsibilities of critical care nurses in advocating for and providing specialized care to critically ill patients.
This document discusses interprofessional rounding teams and strategies to improve teamwork and communication. It provides background on how interprofessional healthcare teams can improve patient outcomes. Checklists, care pathways, and interprofessional education are presented as potential solutions. Checklists have been shown to reduce medical errors and mortality. Care pathways, while challenging to implement, can standardize care and reduce prescribing errors. Brief interprofessional education sessions have been found to improve collaboration attitudes and skills among professionals. Overall, the document advocates for interprofessional rounding teams and strategies to enhance communication and teamwork across disciplines.
Rapid review of current service provision following cancer treatmentNHS Improvement
NHS Improvement carried out a rapid review of current provision of services for breast, prostate and colorectal cancer patients following treatment during the summer of 2009 at the request of the National Cancer Survivorship Initiative (NCSI). This publication shares the findings from this review.
(Published September 2010)
The document discusses design responses to changing clinical practices and outlines several models for hospital space allocation. It summarizes considerations for inpatient units, emergency departments, interventional suites, and workplaces. Key points include utilizing decentralized staff stations and single rooms in inpatient units, rethinking emergency department processes to minimize wait times, and anticipating future technologies like real-time imaging in operating rooms.
BrightStar offers private duty home care programs like HANDS and Clinical Pathways to reduce hospital readmissions and improve quality of life. HANDS provides home care after discharge to address issues that arise. Clinical Pathways is a condition-specific, transitional care program focused on reducing negative outcomes and optimizing quality of life through RN visits, education, and monitoring. These programs aim to address the top reasons for readmissions like medication management and lack of home support. They utilize technology, evidence-based practices, and specially trained staff to benefit patients, healthcare systems, and providers through better outcomes and efficiencies.
The document summarizes criteria for admission to intensive care units. It outlines that intensive care is appropriate for patients requiring advanced organ system support, such as mechanical ventilation or multiple organ support. The key factors in determining admission are the diagnosis, severity of illness, physiological reserve, prognosis, availability of treatment, and the patient's wishes. Patients should be admitted early before their condition deteriorates irreversibly. Clear referral criteria can help identify at-risk patients and trigger calls for intensive care team assistance.
This document discusses ambulatory care services provided by pharmacists. It defines ambulatory care as health services for patients who do not require overnight hospital stays. The value of ambulatory pharmacy services includes increasing physician availability, decreasing hospitalization rates, and improving quality of care. Pharmacists play roles in health screening, medication management, and patient education in areas such as diabetes and falls prevention. Studies show pharmacist telephone follow-ups with seniors reduce drug-related problems. Future opportunities for ambulatory care include expanding reimbursement models and measuring quality and patient outcomes.
The document discusses guidelines for day surgery. It notes that day surgery has expanded significantly due to advances in surgical and anesthetic techniques. National and international guidelines on patient care, admission/discharge processes, and running day surgery units have helped the growth of day surgery. The latest joint guidelines from 2019 provide recommendations such as thorough pre-assessment, determining fitness based on function rather than physical status, undertaking most surgeries as day cases, and trained multidisciplinary teams. Day surgery provides benefits to both patients, such as early mobility, and hospitals by freeing beds and reducing costs. A wide range of procedures are now suitable as day cases.
The document outlines the key responsibilities and duties of an emergency medical technician (EMT) which include responding to medical emergency calls, assessing patients' conditions, providing treatment, and transporting patients to healthcare facilities while maintaining safety and composure in stressful situations. It also discusses the training and certification required to become an EMT as well as typical career paths, salaries, employment outlook, and professional organizations in the field.
This document discusses implementing a national telephone triage service for cancer patients in Scotland. It aims to provide consistent triage using the UKONS tool and refer patients to secondary care if needed. The service would involve NHS 24 call handlers triaging patients who call a dedicated number with concerns after cancer treatment. Patients referred for further assessment would be seen by an acute oncology team within each region. The benefits cited include safe and reliable triage, timely access to care, and audit capabilities to support quality. Next steps include developing training programs and further planning electronic health integration between NHS 24 and secondary care services.
Delivering major breast surgery safely as a day case or one night stay (exclu...NHS Improvement
Delivering major breast surgery safely as a day case or one night stay (excluding reconstruction)
"Streamlining of the breast surgical pathway could reduce length of stay by 50% and release 25% of unnecessary bed days for 80% of major breast surgery (excl reconstruction)"
The document discusses the International Patient Safety Goals (IPSG) which were developed by the Joint Commission International to help improve patient safety. It provides background on how the IPSG were adapted from the National Patient Safety Goals established by the Joint Commission. The document then outlines several of the IPSG, including proper patient identification, improving staff communication, reducing risks associated with medications, and preventing wrong site/procedure surgery. The goals are aimed at reducing common safety issues and medical errors in healthcare facilities.
Implementing best practice in acute care: case studies from the Stroke Improv...NHS Improvement
The document describes initiatives at several NHS trusts to improve acute stroke care, including direct admission protocols to stroke units. Examples include dedicating a bed for fast-track stroke admissions, improving communication between ambulance services and hospitals, and extending thrombolysis services and staff training. These changes aimed to reduce delays in patient transfers and assessments, and increase the percentage of time patients spend on stroke units. The results included reduced door-to-treatment times, more patients receiving timely brain scans and medications, and more direct admissions to stroke units.
Integrated Cancer Solutions - Cancer Care PathwaysKirby Ryan, Jr.
This document describes an integrated cancer solutions program from Innovent Oncology that addresses the primary cost drivers of cancer care. It consists of three main components: Level I Pathways to standardize treatment selection and reduce variability, Patient Support Services to improve health status between treatments through disease management, and Advance Care Planning to improve end of life care and reduce unnecessary interventions. The goal is more consistent, predictable care that improves outcomes and the experience for patients, payers, and providers.
Improving Outcome for the Elderly Surgical Patients in a Singapore Teaching H...Crimsonpublisherssmoaj
Improving Outcome for the Elderly Surgical Patients in a Singapore Teaching Hospital by Si Ching Lim*, Peter Chow, Peter CL Chow, Fuyin Li, Swee Sim Hiew, Lau Soy Soy and Zhang Di in Crimson Publishers: Surgical Medicine Open Access Journal
The elderly patients admitted under surgery have longer lengths of stay and develop multiple complications during their hospital stay particularly with delirium, medical complications and functional decline. A Geriatrician’s input was helpful to identify incident and postop delirium early and put in measures to improve outcome, together with better nursing care and pharmacist’s input to reduce harm from medications.
https://crimsonpublishers.com/smoaj/fulltext/SMOAJ.000537.php
For more open access journals in Crimson Publishers
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This document outlines a webinar series from the Patient Experience Network (PEN) discussing initiatives that have improved patient experience. The webinars will feature presentations on a homeless hospital discharge program in the UK that improved outcomes for homeless patients, and a digital platform called Patient Connect and Staff Connect that provides personalized health information and engagement tools. The webinar series runs from September to November 2015 and invites attendees to learn about successful approaches to enhancing patient experience.
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This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
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Diagnosis and Staging
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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.
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PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
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
1. NHS
CANCER
NHS Improvement
DIAGNOSTICS Making connections with the
challenges of unscheduled care
HEART
Sharing knowledge - Delivering benefits
LUNG
STROKE
2. How big is the problem?
Definition of Urgent Care: A condition that requires an assessment and planned intervention within
seven days, or which is likely to lead to an emergency within four weeks
Definition of Emergency Care: Not always life threatening, but needs prompt assessment and a
planned intervention within 24 hours
5,135,794 emergency hospital 35% over a 37% increase 40% of rising emergency
admissions in England in third are in emergency admissions can be explained
2009/10 (Hospital Episodes classified as hospital by the ageing population
Statistics (HES) emergency admissions
hospital over the last
admissions 10 years
The majority of accident and Patients admitted as an emergency at
emergency attendances are weekends have a higher mortality than those
for medical conditions admitted on weekdays - Is this a failure to
rescue or failure to access?
For cancer patients - There is significant variation
Haematological, Lung and in emergency admissions,
Urological tumours are the bed days and length of stay
highest users of emergency between NHS Trusts and
cancer bed days between PCT’s
Resouces and references
www.rightcare.nhs.uk/atlas/downloads/nonPBC_AoV_2011.pdf
www.cqc.org.uk/sites/default/files/media/documents/ip11_national_summary_final.pdf
www.kingsfund.org.uk/document.rm?id=9524
www.ncepod.org.uk/2007report1/Downloads/EA_report.pdf
www.rcplondon.ac.uk/sites/default/files/documents/hospitals-on-the-edge-report.pdf
3. Understand the real issues before you put in solutions
14 COMMON ISSUES
1. VARIATION IN CLINICAL PRACTICE 2. NO CLEAR DEFINED PATHWAYS OF
CARE 3. OUT OF HOURS ACCESS, KNOWLEDGE AND INFORMATION
4. VARIATION IN TIMELY SENIOR CLINICAL DECISION MAKING AT THE POINT
OF ENTRY 5. MULTIPLE ENTRY ROUTES OF SINGLE ACCESS 6. LACK OF
INTEGRATION AND COORDINATION ALONG THE CARE PATHWAY, LONG LENGTHS
OF STAY 7. DISEASE SILOS, DISEASE THINKING ‘V’ WHOLE PATIENT, PERSON
APPROACH 8. LACK OF SYMPTOM BASED PATHWAYS 9. REACTIVE CARE –
CRISIS MANAGEMENT, FOUR HOUR WAITS 10. POOR RISK MANAGEMENT/
RISK STRATIFICATION BEFORE AND AFTER ADMISSION 11. THE EMERGENCY
MINDSET CAUSING A NUMBER OF MISCONCEPTIONS 12. FREQUENT
ATTENDERS, READMISSIONS 13. LACK OF OWNERSHIP OF CASE MANAGEMENT
ACROSS BOUNDARIES, PRIMARY, COMMUNITY AND ACUTE CARE
14. PATIENTS KNOWN TO THE SYSTEM BUT THE SYSTEM DOES NOT KNOW
THE PATIENTS
6 COMMON POOR OUTCOMES
DEATH: COMPLAINTS: PATIENT DISSATISFACTION, LOSS OF CONFIDENCE,
WASTED RESOURCES: COMPLICATIONS: STAFF DISSATISFACTION
4. Triage, Treat, Transfer – Developing the right
response to meet the need
Challenge: Do you know if patients are assessed
appropriately prior to the decision to admit?
There are a selection of tried and
tested solutions, e.g. senior clinical Whole Pathway Approach
decision making, defined symptom
TRIAGE
pathways, communication alerts,
seven day services that allow Patient self Test the urgency of your symptoms Single call
management number
patients to be assessed and treated NHS 111
in a timely way; which has an impact
on quality improvement, efficiency TREAT
Senior clinical decision making
Defined symptom pathways
and the patients' experience.
Communication alerts
Ambulance Out of Community General
Seven day services
services hours services e.g. practice
Emergency care Walk in District Nurse,
Unscheduled admissions
practioners Social Care
should be the exception
not the norm TRANSFER
Hospice Day Rapid Straight Assessment Emergency
or care case or access to test unit department
8,000 strokes per year
home inpatient clinic 24 hours 4 hours
ward outpatients
could be prevented by DISCHARGE HOME
using the GRASP-AF tool - Avoid unnecessary admission Proactive clinical decisions improve outcomes Reduce length of stay and readmissions
This could save the
NHS £96m
Resouces and references
www.improvement.nhs.uk/communicationalerts
www.improvement.nhs.uk/definedemergencypathways
5. Test the urgency of the symptoms = Patient
self-management
Challenge: Do you know how you can encourage
your patients and carers to self-manage ?
Patient and carers need to know about their condition Neutropenic sepsis CD
and symptoms to encourage self-management, choice Blackpool, Fylde and Wyre Hospitals NHS
and to know who, where and when to access services.
Foundation Trust
Tested solution – Patient informed of symptoms
WHY
by use of DVD.
• Empowers patient and carers to act
• Increases knowledge to understand symptoms Stratified Pathways of Care
and make choices Survivorship test sites from five acute trusts tested
• Manages patients and carers expectation stratified pathways of follow up care and discovered
• Increases independency an expected 70% of breast cancer patients were
• Increases confidence predicted to be suitable for a supported self-
• Reduces patient/carer anxiety management pathway
• Reduces professional dependency
Pleural effusion symptom alert card: Case study
Peterborough and Stamford Hospitals NHS
Aligning patient expectations with those Foundation Trust
Tested solution – Patients with recurring pleural
who are delivering the service is critical effusions from lung cancer are given an alert card
to success informing them of symptoms.
Impact
• Inpatient length of stay for pleural effusion
Resouces and references ranged from 0 to 4 days - is now managed as an
Eight top tips for patient empowerment attendance.
www.improvement.nhs.uk/documents/eight_top_tips.pdf
NHS Improvement Case Studies
www.improvement.nhs.uk/urgentcare/casestudies Fulfilling the Potential: A better journey for patients and a
better deal for the NHS
Eight Top Tips for Patient Empowerment - www.improvement.nhs.uk/documents/er_better_journey.pdf
www.improvement.nhs.uk/documents/patientempowerment.pdf
Stratified Pathways of Care
My role and my responsiblities in helping to improve my recovery www.improvement.nhs.uk/documents/survivorship/
www.improvement.nhs.uk/documents/er_my_role.pdf Stratified_Pathways_of_Care.pdf
6. NHS 111 – When it’s less urgent than 999
Challenge: Are your services aligned to the local
Directory of Service that informs patients where to
go to access services in your area?
NHS 111, the urgent care number for patients, will be
rolled out across England in 2013. NHS Pathways is one Lung and Urology clinical reference groups
of a number of clinical management systems for assessing The development of symptom pathways for NHS
patients that delivers a single clinical assessment tool Pathways/NHS 111 has drawn on clinical expertise
that provides effective triage over the telephone. from around the country. Cancer Clinical Advisors
NHS 111 will accommodate patients to go to the right place, from Lung and Urology (high cancer emergency bed
first time, it is based on symptom pathways, not disease day users, HES) have been involved in developing
specific pathways, and it also aligns itself to patient specific symptom pathways for pain, shortness of breath,
protocols. pleural effusions, retention of urine/renal failure,
visible haematuria with or without retention and
Clinical Commissioning Groups (CCGs) will lead on the design catheter, cough and coughing up blood.
of urgent care service provision accessible in each area
through NHS 111. The choice of provider and clinical Patients who have been treated by chemotherapy
assessment services available will be aligned to a local can also be identified. Some urgent admissions can
Directory of Service (DOS). be due to the effects of treatment, having a tagged
question: “Have you had treatment for cancer in the
last year?” ensures the patient is directed onto the
right pathway and is seen by the right person.
Ensuring the alignment and positioning
of initiatives (e.g. 24 hour help lines)
are critical; They need to be included in Resouces and references
regional plans, Clinical Commissioning www.nhs.uk/NHSEngland/AboutNHSservices/Emergency
andurgentcareservices/Pages/NHS-111.aspx
Groups and local Directory of Services http://webarchive.nationalarchives.gov.uk/+/www.dh.
(DOS) that link to NHS 111. gov.uk/en/MediaCentre/FAQ/DH_119189
‘Getting to grips with integrated 24/7 emergency and
urgent care’ - NHS Alliance, 2012
7. Contact - Response - Action = Timely senior clinical
decision making
Challenge: Do you have a communication alert
process in place and do you know how timely your
senior clinical decision making is?
The provision of timely senior clinical decision making
can have a significant impact on quality improvement,
efficiency and the patients' experience.
Communication alerts let nominated clinicians know
that patients have arrived, where they are, and where
they may be admitted to.
The key in any alert system is ensuring
the responsibility for placing and taking
of alerts and ensuring they get acted on.
Alerts at Sandwell and Birmingham
Hospitals released 3,500 bed days and
reduced admission rates by 12%
Resouces and references
www.improvement.nhs.uk/documents/
CommunicationsAlerts.pdf
8. Delivering safe care - seven days a week
Challenge: Would extending your services across
seven days improve your outcomes? Do you know
how many deaths happen at weekends? Are you
doing enhanced recovery for your emergency
patients?
Extending services across the whole week, improves Seven day whole care pathway approach to
equality of treatment and outcome regardless of the enhance recovery of emergency and elective
day of the week. patients
South Devon Healthcare NHS Foundation Trust
No ‘one size fits all’. There are different service models Emergency ward rounds carried out twice a day, seven
to ensure flow of patients along care pathways from a days a week in medicine.
whole hospital wide approach to a departmental
Moving from a six to a seven day all day trauma list and
approach.
identifying a surgical consultant of the week improved
patient care, quality and efficiency.
Clinical decision making through consultant presence
Shouldn’t every one of us have provides earlier diagnosis, management and discharge.
the best chance possible, no Impact
• Earlier diagnosis with 24 hour radiology and
matter what time of day or day reporting and timely decision making
• Reduction in emergency fracture neck of femur
of week it is? LOS from 10 to 5 days.
Patient Representative
Consultant led one-stop TIA service
University Hospital of Leicester NHS Trust
Patients are assessed and receive appropriate
investigations, diagnosis and treatment, including
Resouces and references referral for carotid intervention, in a single visit to
www.improvement.nhs.uk/sevendayservices the hospital seven days a week.
Impact
• 70% of patients are now seen within 24 hours
compared to baseline of 33%.
9. Achieving integrated care
Challenge: Is their willingness and determination
to achieve integrated care across whole systems
within your health community?
Integrated care is what the NHS,
social care and the voluntary sector The integration between hospital and community services for Whittington
thrive for, however in reality it Health has made it easier to provide ambulatory care for people that
previously may have needed an emergency admission. District nurses and
stretches many organisations, and
community matrons visit emergency departments and acute medical units
is not easy to achieve. daily to identify patients who can be better managed at home. An example
of this is providing IV antibiotics at home rather than as an inpatient.
Celia Ingham Clark, Associate Medical Director, Whittington Health and NHS London
Recommendations to
achieve integration
Communication:
To ensure Direction: Establish
engagement develop steering groups to drive
robust communication the work
mechanisms
Time: Without Engagement and Evaluate and
investment in time, ownership: Identify measure: Need to
and people integration the common demonstrate outcomes
is unlikely to be denominators across in quality, efficiency
successful all organisations and patient
Leadership: You Assumptions: Test
need executive, them out, solutions
operation and clinical that work in one area
leadership across ALL many not work in
organisations another, adapt
Patients and carer Stability and
Win - Win: Align
involvement: Listen, sustainability:
the integration to
they know what Continue to test the
organisations strategic
happens, it happens strength of the
objectives
to them integration