(P1-29) Catastrophe Management Plan, Simulations and Results – An Experience of a Private Hospital in Brazil

2011 ◽  
Vol 26 (S1) ◽  
pp. s108-s108
Author(s):  
M. Tucherman ◽  
M. Vaidotas ◽  
Y.K. Sako ◽  
N. Akamine ◽  
D. Smaletz ◽  
...  
Keyword(s):  
State Government ◽  
Private Hospital ◽  
Albert Einstein ◽  
Healthcare Facility ◽  
Management Plan ◽  
Lessons Learned ◽  
Risk Environment ◽  
Disaster Plan ◽  
Care And Support ◽  
Risk Simulation

IntroductionThe terms catastrophe and disaster have been frequently heard worldwide due to situations like earthquakes, floods and events provoked by man as the September 11th and Anthrax attack. Catastrophe means all situations where material and human resources available in a healthcare facility are not enough to assist a large number of victims admitted at the same time. Accreditation requires having a plan to manage effectively those situations, assessing safely as much victims as possible.ObjectiveTo describe the catastrophe plan and its management in a private hospital.MethodologyHospital Albert Einstein is located close to a huge soccer game stadium and near to the State Government Hall. This was the reason to have a plan focusing on casualties with a large number of victims. The literature was revised to choose the triage methodology. Triage to identify the priority of patients' assessment based on their condition, possibility of treatment and determining discharge for those without visible risk. Simulation was implemented, followed by debriefing to register lessons learned.ResultsAn algorithm was developed with a crisis center and defining care and support areas in the organizations to manage the victims at Emergency Room and triage field. The plan was effectively deflagrated twice: 47 victims from a bus accident and 25 from a policeman strike. Debriefing was done in all opportunities and communication is the main issue; 15 simulations have been done for training purpose, with specific goals.ConclusionHospital is a high risk environment itself for an internal or external incident depending on its localization. A disaster plan is necessary to improve everyone safety, to organize resources, to respond effectively to such situations and take the organization back to regular operation as soon as possible. Simulations are essential to guarantee staff competency and organization support and response to adverse situations.

scholarly journals Development of a Positive Psychology Program (LAVENDER) for Preserving Medical Student Well-being: A Single-Arm Pilot Study

2021 ◽  
Vol 10 ◽  
pp. 216495612098848
Author(s):  
Elaine O Cheung ◽  
Ian Kwok ◽  
Allison B Ludwig ◽  
William Burton ◽  
Xinzi Wang ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Positive Psychology ◽  
Positive Emotion ◽  
Albert Einstein College ◽  
Albert Einstein ◽  
Well Being ◽  
Preliminary Evidence ◽  
Lessons Learned ◽  
Psychology Program

Background Mental health tends to worsen over the course of medical school, with steep declines in well-being in students’ clerkship year (M3). Positive emotion promotes adaptive coping to stress and may help preserve medical student well-being. Objective This study describes the development of LAVENDER (Leveraging Affect and Valuing Empathy for Nurturing Doctors’ Emotional Resilience), a program aimed at increasing positive emotion to preserve well-being in medical students. Methods We conducted a single-arm pilot of LAVENDER, a positive psychology intervention developed for medical students delivered in an interactive classroom format to a cohort of 157 third-year medical students at the Albert Einstein College of Medicine. Our primary outcome was the acceptability of LAVENDER. We also examined preliminary efficacy using measures of emotion, stress and burnout collected at each intervention session. Results LAVENDER showed good acceptability: 76% of participants agreed that the LAVENDER skills were useful and 72% agreed that they would recommend the LAVENDER program to others. Qualitative feedback suggested that medical students enjoyed the program and found the skills to be useful for coping with stress, but also reported the following barriers to engagement: lack of time to practice the skills, resistance to the mandatory nature of the wellness sessions, and difficulty integrating the skills in daily life. We did not find support for the preliminary efficacy of LAVENDER for improving medical student well-being in students’ clerkship year. Participants showed decreases in positive emotion and increases in symptoms of burnout over the intervention period ( ps < .01). Conclusion The current paper describes the development and a single-arm pilot test of LAVENDER, a positive psychology program tailored for medical students. Although we found preliminary evidence for the acceptability of LAVENDER, we did not find support for the preliminary efficacy. Lessons learned and next steps for the program are discussed.

scholarly journals Closing the Equity Gap of Access to Emergency Departments of Private Hospitals in Thailand

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Paibul Suriyawongpaisal ◽  
Pongsakorn Atiksawedparit ◽  
Samrit Srithamrongsawad ◽  
Thanita Thongtan
Keyword(s):  
Emergency Care ◽  
Private Hospital ◽  
Financial Incentive ◽  
Gender Disparity ◽  
Lessons Learned ◽  
Care Seeking ◽  
Health Coverage ◽  
Private Hospitals ◽  
Middle Income ◽  
Strategic Policies

Background. Previous policy implementation in 2012 to incentivize private hospitals in Thailand, a country with universal health coverage, to provide free-of-charge emergency care using DRG-based payment resulted in an equity gap of access and copayment. To bridge the gap, strategic policies involving financial and legal interventions were implemented in 2017. This study aims to assess whether this new approach would be able to fill the gap. Methods. We analyzed an administrative dataset of over 20,206 patients visiting private hospital EDs from April 2017 to October 2017 requested for the preauthorization of access to emergency care in the first 72 hours free of charge. The association between types of insurance and the approval status was explored using logistic regression equation adjusting for age, modes of access, systolic blood pressure, respiratory rate, and Glasgow coma scores. Results and Discussion. The strategic policies implementation resulted in reversing ED payer mix from the most privileged scheme, having the major share of ED visit, to the least privileged scheme. The data showed an increasing trend of ED visits to private hospitals indicates the acceptance of the financial incentive. Obvious differences in degrees of urgency between authorized and unauthorized patients suggested the role of preauthorization as a barrier to the noncritical patient visiting the ED. Furthermore, our study depicted the gender disparity between authorized and unauthorized patients which might indicate a delay in care seeking among critical female patients. Lessons learned for policymakers in low-and-middle income countries attempting to close the equity gap of access to private hospital EDs are discussed.

scholarly journals NM GRADS: Lessons Learned from Implementing a School-Based Program for Young Parents Across New Mexico

2020 ◽  
Vol 24 (S2) ◽  
pp. 163-170 ◽  
Author(s):  
Jessica Harper ◽  
Dean Hopper ◽  
Betsy Keating ◽  
Jessica Harding
Keyword(s):  
High School ◽  
New Mexico ◽  
Large Scale ◽  
Lessons Learned ◽  
District Leaders ◽  
Program Administrators ◽  
School Based ◽  
Young Fathers ◽  
Care And Support ◽  
Parenting Students

Abstract Purpose The New Mexico Graduation Reality and Dual-role Skills (GRADS) program provides services for expectant and parenting students at high schools. The GRADS program has operated since 1989, serving more than 17,000 youth. This study summarizes the GRADS program model and program administrators’ lessons learned from implementing this comprehensive, large-scale program. Description The GRADS program is a multicomponent intervention that can include a classroom intervention, case management, linkages to child care and health care, and support for young fathers. The program aims to support expectant and parenting youth in finishing high school, delaying a repeat pregnancy, promoting health outcomes for their children, and preparing for college and career. This study presents program administrators’ lessons learned to increase understanding of how to implement a statewide program to support expectant and parenting students. Assessment During the 2010–2017 school years, the GRADS program operated in 26–31 sites each year, serving a total of 2691 parenting youth. Program administrators identified lessons learned from implementing the GRADS program during that period of expansion, including allowing variation across sites based on resources and needs, providing centralized implementation support, fostering buy-in from school and district leaders, and collecting consistent data to better understand participant outcomes. Conclusions Although not based on a rigorous impact or implementation study, this article provides lessons learned from a statewide, school-based program that may be a promising way to serve a large number of expectant and parenting youth and help them overcome challenges for completing high school.

scholarly journals Development and Implementation of First Hospital-Based Epidemic Outbreak Management Plan: Lessons Learned from Nepal

2019 ◽  
Vol 34 (s1) ◽  
pp. s56-s56
Author(s):  
Ashis Shrestha ◽  
Michael Khouli ◽  
Sumana Bajracharya ◽  
Rose House ◽  
Joshua Mugele
Keyword(s):  
National Level ◽  
Disaster Medicine ◽  
Lessons Learned ◽  
World Health ◽  
High Fidelity ◽  
Disaster Plan ◽  
Outbreak Management ◽  
Incident Command ◽  
Hospital Systems ◽  
Response Plan

Introduction:Patan Hospital, located in Kathmandu Valley, Nepal is a 400-bed hospital that has a long history of responding to natural disasters. Hospital personnel have worked with the Ministry of Health (MOH) and the World Health Organization (WHO) to develop standardized disaster response plans that were implemented in multiple hospital systems after the earthquake of 2015. These plans focused primarily on traumatic events but did not account for epidemics despite the prevalence of infectious diseases in Nepal.Aim:To develop and test a robust epidemic/pandemic response plan at Patan Hospital in Kathmandu that would be generalizable to other hospitals nationwide.Methods:Using the existing disaster plan in conjunction with public health and disaster medicine experts,we developed an epidemic response plan focusing on communication and coordination (between the hospital and MOH, among hospital administration and staff), logistics and supplies including personal protective equipment (PPE), and personnel and hospital incident command (IC) training. After development, we tested the plan using a high-fidelity, real-time simulation across the entire hospital and the hospital IC using actors and in conjunction with the MOH and WHO. We adjusted the plan based on lessons learned from this exercise.Results:Lessons learned from the high-fidelity simulation included the following: uncovering patient flow issues to avoid contamination/infection; layout issues with the isolation area, specifically accounting for donning/doffing of PPE; more sustained duration of response compared to a natural disaster with implications for staffing and supplies; communication difficulties unique to epidemics; need for national and regional surveillance and inter-facility planning and communication. We adjusted our plan accordingly and created a generalizable plan that can be deployed at an inter-facility and national level.Discussion:We learned that this process is feasible in resource-poor hospital systems. Challenges discovered in this process can lead to better national and system-wide preparedness.

Postcard from Pennsylvania: lessons learned during successful fight over Marcellus Shale operations that may have applicability to Australian discussion

2017 ◽  
Vol 57 (2) ◽  
pp. 567 ◽  
Author(s):  
Chris Tucker
Keyword(s):  
New York ◽  
State Government ◽  
Marcellus Shale ◽  
Lessons Learned ◽  
Historical Background ◽  
Environmental Groups ◽  
Hydrocarbon Production ◽  
Media Campaigns ◽  
Well Stimulation ◽  
Natural Gas Development

This article explores the recent history and significance of unconventional natural gas development in the Marcellus region of Pennsylvania, including a look at the state’s historical background on hydrocarbon production, the effect of political and social media campaigns against development activities and the outlook for the future. In consultation with industry and environmental groups, Pennsylvania’s state government has crafted rules and regulations allowing responsible development to proceed, helping industry secure and retain its licence to operate in the process. This success was further made possible by an early and robust public engagement strategy that refuted misinformation and provided proper context for both the benefits and challenges inherent in resource development. However, in neighbouring states like New York and Maryland, similar public strategies and campaigns in support of development were not as quickly assembled and mobilised. The contrasting histories (and final results) help provide a template of lessons learned for other areas considering shale development, including an opportunity to avoid the kinds of mistakes that have led to moratoria, bans or other restrictions on specific well stimulation technologies, such as hydraulic fracturing.

A Successful Remediation Project

2009 ◽  
Author(s):  
L. Max Scott
Keyword(s):  
Public Relations ◽  
Manufacturing Industry ◽  
Nuclear Regulatory Commission ◽  
Management Plan ◽  
Lessons Learned ◽  
Radioactive Material ◽  
Aircraft Manufacturing ◽  
Molten Magnesium ◽  
Regulatory Commission ◽  
A Site

As part of a program to visit formerly licensed sites to determine if they meet current uncontrolled release conditions, a United States Nuclear Regulatory Commission (USNRC) inspection was conducted in the fall of 1993 at a site that had possessed a radioactive material license from about 1955 to 1970. While the license was in force, the plant processed magnesium scrap containing up to 4 percent thorium. The source of the scrap is believed to be the aircraft manufacturing industry. The scrap was placed in furnaces and heated to the melting point of magnesium, and the molten magnesium was drawn off, leaving the thorium with the residue (dross). Under the regulation in existence at that time, the thorium dross was buried on site in an approximate 14 acre field. In 1993 the inspector found readings up to 900uR/h. Early in 1994 an informal grid survey of most of the 14 acre site was conducted. Based on that survey, it was concluded that the thorium was widespread and extended beyond the property lines. The preliminary findings were reported to the USNRC, and in 1994 the site was designated as a Site Decommissioning Management Plan (SMPD) site. A remediation team was formed which included the following disciplines: remediation health physics, geology, hydrology, engineering, law, public relations, and project management. This remediation team planned, participated in selecting vendors, and provided project over site for all activities from site characterization through the final status survey. In 2006 the site was released for uncontrolled access. A chronology of activities with lessons learned will be presented.

scholarly journals Physical Control of Nonindigenous Aquatic Plants in Emerald Bay, Lake Tahoe, CA

2016 ◽  
Vol 9 (2) ◽  
pp. 138-147 ◽  
Author(s):  
Daniel W. H. Shaw ◽  
Zachary P. Hymanson ◽  
Tamara L. Sasaki
Keyword(s):  
Aquatic Plants ◽  
Weed Management ◽  
Lake Tahoe ◽  
Complete Removal ◽  
Management Plan ◽  
Freshwater Ecosystems ◽  
Lessons Learned ◽  
Integrated Weed Management ◽  
Control Techniques ◽  
Physical Control

Establishment of nonindigenous (NI) aquatic plants in the nearshore regions of freshwater ecosystems has resulted in environmental degradation, recreation concerns, economic impacts, and substantial management challenges. To reduce these undesirable effects, NI aquatic plants are often targeted for removal or control by management agencies, but the efficacy of implementation is often not documented or sustained. In this study, we developed a management plan to completely remove all NI plants from Emerald Bay, Lake Tahoe, CA, using only physical control techniques. Management plan priorities were based on previous research and lessons learned, including the need for (1) integrated weed management using multiple physical control techniques, (2) a large initial treatment investment, (3) ongoing early detection and rapid response, (4) detailed ecological monitoring, and (5) a long-term commitment to annual maintenance removal. Application of this management plan resulted in complete removal of all NI aquatic plants from Emerald Bay and substantial cost savings each year after the initial large investment. Annual maintenance removal and monitoring will need to continue as long as NI aquatic plants continue to enter Emerald Bay on boats and currents from other areas of Lake Tahoe.

Implementation of an antimicrobial stewardship program in an Australian metropolitan private hospital: lessons learned

2015 ◽  
Vol 20 (3-4) ◽  
pp. 134-140 ◽  
Author(s):  
Jeannine A.M. Loh ◽  
Jonathan D. Darby ◽  
John R. Daffy ◽  
Carolyn L. Moore ◽  
Michelle J. Battye ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Private Hospital ◽  
Lessons Learned ◽  
Antimicrobial Stewardship Program ◽  
Stewardship Program

Creating Patient Safety with Organizational Learning: A Case-Based Learning Intervention at a Public and Private Hospital

2002 ◽  
Vol 46 (16) ◽  
pp. 1438-1442
Author(s):  
Amanda Eisenlohr ◽  
Marta L. Render ◽  
Emily S. Patterson
Keyword(s):  
Private Hospital ◽  
Program Effectiveness ◽  
High Reliability ◽  
Organizational Factors ◽  
Lessons Learned ◽  
Public And Private ◽  
Learning Intervention ◽  
Case Based Learning ◽  
The Individual ◽  
Case Based

A critical component of a high reliability organization (HRO) is believed to be a safety culture. Historically, healthcare placed the onus on individuals for perfection in performance of complex work. A six-month, case-based learning intervention at a public and private hospital, Safety Minutes™, attempted to shift the focus from the individual to systems. The intervention is organized in rotating modules of a medical and non-medical incident that exemplify a safety concept, displayed via posters in a staff meeting space, followed by a moderated discussion. Moderators asked how the stories resembled or differed from the nurses' experiences and guided participants away from ingrained “blame” responses in order to look more deeply at systemic and organizational factors. We assessed program effectiveness by ethnographic analysis of written transcripts of the moderated sessions and discuss lessons learned.

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