scholarly journals Enhanced DM program in British Columbia's healthcare sector

2014 ◽  
Vol 9 ◽  
Author(s):  
Theresa Morrison ◽  
Lani deHek
Keyword(s):  
British Columbia ◽  
Case Management ◽  
Best Practice ◽  
Management Plan ◽  
Healthcare Sector ◽  
List Type ◽  
Occupational Illness ◽  
Training Support ◽  
Work Related ◽  
Collective Agreements

Background: The Healthcare Sector in British Columbia, Canada is comprised of over 110,000 employees covered by four union collective agreements. The overall disability burden for this industry is close to $300M annually. The EDMP was negotiated and developed through employer-union partnership. It is a province-wide program that is a component of the four healthcare collective agreements. Implemented in 2012, EDMP supports employees that are absent from work/struggling at work due to occupational or non-occupational illness/injury.Objectives: To showcase a leading DM best practice, highlighting effective joint union/employer stewardship of a comprehensive DM program for a major industry in British Columbia, Canada.Methods: Participation in EDMP is required for regular employees who meet one of the following criteria: •shift due to illness or injury resulting from a work-related event•consecutive shifts due to a non work-related illness or injury.Comprehensive policy and process documents developed collaboratively guide the program, with provincial steering joint committee over-site. Union representatives with DM-specific training support the program, working in collaboration with employer's DM professionals to administer a pro-active, comprehensive case management plan with an overarching principle of early intervention and recovery at work. DM-related issues are removed from the labor-relations realm, with a separate dispute resolution process to address disagreements with case management plans.Findings: The collaborative partnership between EDMP union reps and employer DM professionals facilitates engagement of injured/ill employee and improves the ability to identify and address return to work barriers: medical, workplace, vocational, personal. The mandatory component of the CA language improves engagement from both union and employer, with reductions in both WCB and LTD claim durations as a positive result. Fewer conflicts regarding DM related issues are an additional benefit.Conclusion: The EDMP should be used a model of effective union-employer partnership in the management of employee illness/injury and should be replicated in other industries/jurisdictions.

21 Identification and management of delirium in the palliative inpatient unit

2018 ◽  
Vol 8 (3) ◽  
pp. 367.3-367
Author(s):  
Andrew Gill ◽  
Clare Rayment ◽  
Chris Kane
Keyword(s):  
Palliative Care ◽  
Best Practice ◽  
Management Plan ◽  
List Type ◽  
Acute Confusional State ◽  
Pharmacological Management ◽  
Assessment And Treatment ◽  
Inpatient Settings ◽  
Palliative Care Units ◽  
A Prospective Study

IntroductionDelirium is an acute confusional state. The incidence of delirium in palliative care units is estimated between 13% and 42% (Hosie 2014). Delirium is associated with an increase in mortality and length of hospice stay yet it is poorly identified. Up to 50% of cases of delirium are reversible (Lawlor 2000) as such early identification and impeccable assessment and treatment could relieve the suffering.AimTo assess identification and management of delirium in two hospices.MethodsRetrospective notes analysis to identify patients with delirium whether they were coded with a delirium diagnosis and whether the management of delirium followed best practice.Results77 inpatients across two hospices were assessed in one month in 2018. There were 37 episodes of possible delirium only five were coded as delirium none had assessment with a recognised delirium tool. Reversibility was considered for 48 episodes; it was not clear from the documentation that this was all possible reversible causes. Family were kept informed 94% of the time. A management plan was documented for five patients.ConclusionDelirium was being considered but not documented a common problem in medical notes. Documentation of a management plan was poor but when there was a plan best practice was followed with non-pharmacological management then low dose antipsychotic with stronger sedation reserved for terminal agitation. An education feedback loop formal training on delirium and design of an electronic medical record template to prompt the management of delirium is ongoing. Practice will be reassessed three months after this intervention.References. Hosie A, Davidson P, Agar M, et al. Delirium prevalence incidence and implications for screening in specialist palliative care inpatient settings: A systematic review. Palliative Medicine2013;27(6):486–498.. Lawlor P, Gagnon B, Mancini I, et al. Occurrence causes and outcome of delirium in patients with advanced cancer: A prospective study. Archives of Internal Medicine2000;160(6):786–794.

scholarly journals Implementing out of hours MDT safety huddles at the Ladywell Unit, Lewisham, South London and the Maudsley (SLAM) NHS Foundation Trust

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S229-S230
Author(s):  
Su Yeoh ◽  
Natavan Babayeva ◽  
Hugh Williams ◽  
Emma Jones
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Best Practice ◽  
Management Plan ◽  
Slight Reduction ◽  
List Type ◽  
Physical And Mental Health ◽  
Out Of Hours ◽  
Team Cohesiveness ◽  
Mental And Physical Health

Aims•For 100% of patients admitted OOH (Friday 5pm – Sunday 9am) to have a multi-disciplinary review of their treatment•For 100% of patients with deteriorating physical and mental health to be discussed•To improve multi-disciplinary team (MDT) morale, working relationships and team cohesiveness OOHBackgroundIn most specialties, the standard of best practice is that patients admitted to the ward out of hours (OOH) receive a senior review over the weekend. However this does not usually take place in Psychiatry, and patients routinely wait until Monday to be seen by the ward team. This has been highlighted as problematic in cases where patients are agitated and not receiving any treatment for > 24 hours.We trialled a weekend teleconference safety huddle in Lewisham involving the on call consultant, registrar (SpR), core trainee (CT) and duty senior nurse (DSN).MethodThe weekend huddles were through a teleconference line, with participants dialling in at 9.45am.Issues discussed: 1)Management plan for newly admitted patients OOH.2)Plan for patients with deteriorating mental health or escalating level of aggression.3)Plan for patients with deteriorating physical health.Feedback was collected from CTs, SpRs and consultants focusing on whether the huddle made any difference to the speed of care, cohesiveness of the OOH team, and whether it was generally helpful or not.Result54% of CTs (n = 11) felt that patients admitted OOH had an MDT review, and 90% felt that patients with deteriorating mental and physical health were discussed and a plan put in place. 80% of CTs, 63% of SpRs (n = 8) and 67% of consultants (n = 6) agreed it improved team cohesiveness. 90% of DSNs felt safer and more supported in decision-making OOH.80% of CTs, 63% of SpRs and 83% of consultants found weekend huddles helpful.Data were also collected on violent incidents OOH, and there was a slight reduction in the number of violent incidents in the weeks following introduction of the huddle.ConclusionIntroducing safety huddles in Lewisham has facilitated the prompt discussion of the management of patients admitted OOH, and of those with deteriorating mental and physical health. It has also fostered a greater sense of cohesiveness in the MDT team.In light of this feedback, safety huddles have now been established as part of the weekend schedule in Lewisham, and are being rolled out to other boroughs within SLaM.

Evaluation of best practice interventions for work-related violence and work-related stress

2008 ◽  
Author(s):  
K. Lindstrom ◽  
M. Vartia ◽  
S. Leka ◽  
K. Pahkin ◽  
S. Sutela ◽  
...  
Keyword(s):  
Best Practice ◽  
Work Related Stress ◽  
Work Related ◽  
Related Stress

scholarly journals Cooperation & Liaison between Universities & Editors (CLUE): recommendations on best practice

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Elizabeth Wager ◽  
◽  
Sabine Kleinert
Keyword(s):  
Peer Review ◽  
Best Practice ◽  
Research Integrity ◽  
Decision Makers ◽  
Publication Ethics ◽  
List Type ◽  
Research Institutions ◽  
Academic Journals ◽  
Before And After ◽  
Published Research

Abstract Background Inaccurate, false or incomplete research publications may mislead readers including researchers and decision-makers. It is therefore important that such problems are identified and rectified promptly. This usually involves collaboration between the research institutions and academic journals involved, but these interactions can be problematic. Methods These recommendations were developed following discussions at World Conferences on Research Integrity in 2013 and 2017, and at a specially convened 3-day workshop in 2016 involving participants from 7 countries with expertise in publication ethics and research integrity. The recommendations aim to address issues surrounding cooperation and liaison between institutions (e.g. universities) and journals about possible and actual problems with the integrity of reported research arising before and after publication. Results The main recommendations are that research institutions should: develop mechanisms for assessing the integrity of reported research (if concerns are raised) that are distinct from processes to determine whether individual researchers have committed misconduct; release relevant sections of reports of research integrity or misconduct investigations to all journals that have published research that was investigated; take responsibility for research performed under their auspices regardless of whether the researcher still works at that institution or how long ago the work was done; work with funders to ensure essential research data is retained for at least 10 years. Journals should: respond to institutions about research integrity cases in a timely manner; have criteria for determining whether, and what type of, information and evidence relating to the integrity of research reports should be passed on to institutions; pass on research integrity concerns to institutions, regardless of whether they intend to accept the work for publication; retain peer review records for at least 10 years to enable the investigation of peer review manipulation or other inappropriate behaviour by authors or reviewers. Conclusions Various difficulties can prevent effective cooperation between academic journals and research institutions about research integrity concerns and hinder the correction of the research record if problems are discovered. While the issues and their solutions may vary across different settings, we encourage research institutions, journals and funders to consider how they might improve future collaboration and cooperation on research integrity cases.

Music Therapy Pre-internship Education and Training: Support for a Methods-Based Approach

2021 ◽  
Author(s):  
Susan C Gardstrom ◽  
James Hiller ◽  
Annie Heiderscheit ◽  
Nancy L Jackson
Keyword(s):  
Music Therapy ◽  
Best Practice ◽  
Clinical Decision Making ◽  
Well Being ◽  
Clinical Decision ◽  
Education And Training ◽  
Population Based ◽  
Music Therapists ◽  
Training Support ◽  
And Training

Abstract As music therapists, music is our primary realm of understanding and action and our distinctive way of joining with a client to help them attain optimal health and well-being. As such, we have adopted and advocate for a music-focused, methods-based (M-B) approach to music therapy pre-internship education and training. In an M-B approach, students’ learning is centered on the 4 music therapy methods of composing, improvising, re-creating, and listening to music and how these music experiences can be designed and implemented to address the health needs of the diverse clientele whom they will eventually encounter as practicing clinicians. Learning is highly experiential, with students authentically participating in each of the methods and reflecting on these self-experiences as a basis for their own clinical decision-making. This is differentiated from a population based (P-B) approach, wherein students’ attention is directed at acquiring knowledge about the non-musical problems of specific “clinical populations” and the “best practice” music interventions that are presumed to address these problems. Herein, we discuss both approaches, identifying the limitations of a P-B perspective and outlining the benefits of an M-B curriculum and its relevance to 21st-century music therapy practice.

FC08-05 - Work-related threats and violence and incident use of psychotropics

2011 ◽  
Vol 26 (S2) ◽  
pp. 1856-1856
Author(s):  
I.E.H. Madsen ◽  
H. Burr ◽  
R. Rugulies
Keyword(s):  
Statistical Power ◽  
Mental Health Problems ◽  
List Type ◽  
Questionnaire Response ◽  
Large Sample ◽  
Adjusted Risk ◽  
Work Related ◽  
Increased Risk ◽  
Violence In The Workplace ◽  
Reported Data

IntroductionThe consequences of work-related violence and threats for clinically significant mental health problems are unclear: One study showed associations with hospitalisation for depressive and stress-related disorders, but a different study found no association with use of antidepressants. This null-finding, however, could be due to lack of statistical power.ObjectivesRe-examining the relation between exposure to work-related threats and violence in a large sample of Danish employees (n = 15527).AimsAssessing whether employees reporting exposure to work-related threats or violence are more likely to start treatment with psychotropics.MethodsWe synthesized three Danish studies with self-reported data on exposure to work-related threats or violence within the past 12 months and linked it with purchases of psychotropic medications through registry-data. After excluding 1750 respondents who had used psychotropic medication previous to 12 months before questionnaire-response, the final study population was 15527 employees. We examined four mutually exclusive outcomes:1)antidepressants (N06a),2)anxiolytics (N05b),3)antidepressants and anxiolytics,4)hypnotics only (N05c).Using four separate logistic regressions we adjusted risk estimates for confounding by gender, age, cohabitation, education, and income.ResultsPreliminary analyses show increased risk for treatment with antidepressants (OR = 1.46; 95%CI: 1.15–1.86) and antidepressants combined with anxiolytics (OR = 1.79; 95%CI:1.16–2.76), but not anxiolytics (OR = 1.04; 95%CI: 0.74-1.45) or hypnotics only (OR = 1.08; 95%CI: 0.77–1.50). Final results will be available for the conference.ConclusionsIn this large sample of Danish employees, exposure to threats or violence in the workplace is associated with treatment with antidepressants, and antidepressants combined with anxiolytics, but not anxiolytics or hypnotics only.

Implementing a national case-management training program in Portugal

2011 ◽  
Vol 26 (S2) ◽  
pp. 555-555
Author(s):  
P. Mateus ◽  
M. Xavier ◽  
J. Caldas-Almeida
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Case Management ◽  
Training Program ◽  
National Level ◽  
Management Training ◽  
Role Playing ◽  
List Type ◽  
Program Content

IntroductionIn Portugal, a new National Mental Health Plan has been launched with the following objectives: equal access to care, decentralisation of mental health services and integration of mental health services in the general health services. In order to change the operational model for mental health teams, a case-management training program has been launched by the Ministry of Health.ObjectivesThis study aims to evaluate: a)the feasibility of implementing the program on a national level,b)the quality of the training program andc)the satisfaction of the trainees.MethodsThe study was carried out at 36 public mental health services in mainland Portugal. The professionals attended a case management course (SAMHSA procedures), in which they were trained by means of guidelines, demonstrative audios, scenarios and role-playing. The assessment was conducted with a questionnaire addressing logistics, program content, acquisition of skills, usefulness and overall satisfaction.Results135 professionals from the whole country have been involved. The trainees’ acquisition of competences was found rather satisfactory. Results of the training were impressive regarding satisfaction and motivation of the trainees (69% were highly satisfied). Dimensions such as organization (35% highly satisfied, 52% satisfied), program content (41% highly satisfied, 43% satisfied), practical skills gaining (35% highly satisfied, 58% satisfied) and usefulness (58% highly satisfied, 31% satisfied) were also very well rated.ConclusionsOf upmost relevance, it was possible to implement a case management training program at a national level, with no particular difficulties. The impact of courses on trainees was overall impressive.

scholarly journals WED 131 Evaluating the clinical utility of the parkinson’s kinetigraph (PKG)

2018 ◽  
Vol 89 (10) ◽  
pp. A15.1-A15 ◽  
Author(s):  
Lewis Hutchinson ◽  
Thea Dominey ◽  
Emma Pearson ◽  
Fiona Murphy ◽  
Lucy Bell ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Treatment Recommendations ◽  
Healthcare Sector ◽  
Patient Questionnaire ◽  
List Type ◽  
Patient Acceptability ◽  
P4 Medicine ◽  
Remote Management ◽  
Centered Care

ObjectiveTo evaluate the utility of the Parkinson’s Kinetigraph (PKG™) in the remote management of Parkinson’s disease (PD).BackgroundThere is a movement in Parkinson’s care from a clinic-based model1 to P4 medicine, meaning medicine that is predictive, preventive, personalised and participatory.2 The development of wearable technology provides an opportunity to monitor patients remotely, and deliver targeted care. The PKG™ is a wrist-worn device that objectively measures Parkinson’s symptoms.AimTo evaluate the utility of the PKG™ in managing PD patients remotely, and the perception of service users.MethodPKG™ data were collated in real time. Patient acceptability data were collated via a patient questionnaire (n=61).ResultsBetween July 2015 and January 2018, 216 PKGs were performed. A variety of symptoms were identified, including different types of ‘OFF’ times (wearing off (25%), delayed on (6%) no drug response (8%)) and non-motor complications (fragmented sleep (33%) and daytime somnolence (21%)), with subsequent treatment recommendations being made. Patient acceptability of the PKG™ was high, 81% of patients being satisfied not having to travel for clinic appointments.ConclusionsThe PKG™ facilitated remote treatment recommendations. Remote management was acceptable to patients. Future evaluations will evaluate patient outcome.References. van der Eijk M, Nijhuis FAP, Faber MJ, Bloem BR. Moving from physician-centered care towards patient-centered care for Parkinson’s disease patients. Parkinsonism Relat Disord [Internet]. Elsevier; 1 November 2013;19(11):923–7. Available from: https://www.sciencedirect.com/science/article/pii/S1353802013001697?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb [cited 2018 February 6]. P4 medicine: how systems medicine will transform the healthcare sector and society. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4204402/pdf/nihms532619.pdf [cited 2018 April 6]

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