Overcoming Obstacles to Breast-Feeding in a Large Municipal Hospital: Applications of Lessons Learned

PEDIATRICS ◽  
1987 ◽  
Vol 80 (3) ◽  
pp. 423-433
Author(s):  
Beverly Winikoff ◽  
Deborah Myers ◽  
Virginia Hight Laukaran ◽  
Richard Stone
Keyword(s):  
Breast Feeding ◽  
Professional Education ◽  
Routine Care ◽  
Control Site ◽  
Lessons Learned ◽  
Pediatric Care ◽  
Institutional Constraints ◽  
Municipal Hospital ◽  
Intervention Site ◽  
Intensive Training

A project to overcome institutional constraints to breast-feeding was implemented in a large municipal hospital. Interventions included staff education, intensive training of a team of physicians and nurses, development of user-tested educational materials, and day and evening staffing by a breast-feeding counselor. A nearby hospital served as a control. Project evaluation entailed chart reviews at the intervention site and a control hospital (n = 812); interviews with mothers during their postpartum hospital stay and at return clinic visits (n = 180); and field observations in all areas of the hospital that provided prenatal, intrapartum, postpartum, and pediatric care. Comparisons of the incidence and pattern of breast-feeding were made before, midway through, and after the project. At the intervention site, the incidence of breast-feeding increased from 15% to 56%, and exclusive breast-feeding for more than 3/4 of feedings increased from 0% to 15%. At the control site, the respective changes were from 28% to 41% and from 5% to 7%. Formula use by breast-feeding women decreased but was nonetheless extensive, and the usual reason given by breast-feeding women for supplementation was a perceived insufficiency of breast milk. This may be due, in part, to the fact that bedside assistance to breast-feeding mothers was not integrated into the routine care provided by staff nurses but was relegated to the lactation nurse/counselors who were not available at all times. It is concluded that the process to overcome institutional constraints to breast-feeding is difficult but feasible. Repeated and extensive professional education helps create the context whereby clinical and administrative staff can reassess routines and policies.

scholarly journals Mobile pediatric neurosurgery: rapid response neurosurgery for remote or urgent pediatric patients

2015 ◽  
Vol 16 (3) ◽  
pp. 340-345 ◽  
Author(s):  
Brian K. Owler ◽  
Kathryn A. Browning Carmo ◽  
Wendy Bladwell ◽  
T. Arieta Fa’asalele ◽  
Jane Roxburgh ◽  
...  
Keyword(s):  
Head Injuries ◽  
Pediatric Neurosurgery ◽  
Lessons Learned ◽  
Neurological Deficits ◽  
Pediatric Care ◽  
Start Time ◽  
Tertiary Center ◽  
Metropolitan Hospital ◽  
Time Critical ◽  
Median Interval

OBJECT Time-critical neurosurgical conditions require urgent operative treatment to prevent death or neurological deficits. In New South Wales/Australian Capital Territory patients’ distance from neurosurgical care is often great, presenting a challenge in achieving timely care for patients with acute neurosurgical conditions. METHODS A protocol was developed to facilitate consultant neurosurgery locally. Children with acute, time-critical neurosurgical emergencies underwent operations in hospitals that do not normally offer neurosurgery. The authors describe the developed protocol, the outcome of its use, and the lessons learned in the 9 initial cases where the protocol has been used. Three cases are discussed in detail. RESULTS Nine children were treated by a neurosurgeon at 5 rural hospitals, and 2 children were treated at a smaller metropolitan hospital. Road ambulance, fixed wing aircraft, and medical helicopters were used to transport the Newborn and Paediatric Emergency Transport Service (NETS) team, neurosurgeon, and patients. In each case, the time to definitive neurosurgical intervention was significantly reduced. The median interval from triage at the initial hospital to surgical start time was 3:55 hours, (interquartile range [IQR] 03:29–05:20 hours). The median distance traveled to reach a patient was 232 km (range 23–637 km). The median interval from the initial NETS call requesting patient retrieval to surgical start time was 3:15 hours (IQR 00:47–03:37 hours). The estimated median “time saved” was approximately 3:00 hours (IQR 1:44–3:15 hours) compared with the travel time to retrieve the child to the tertiary center: 8:31 hours (IQR 6:56–10:08 hours). CONCLUSIONS Remote urgent neurosurgical interventions can be performed safely and effectively. This practice is relevant to countries where distance limits urgent access for patients to tertiary pediatric care. This practice is lifesaving for some children with head injuries and other acute neurosurgical conditions.

scholarly journals Pediatric Integrative Medicine: Vision for the Future

Children ◽  
2018 ◽  
Vol 5 (8) ◽  
pp. 111 ◽  
Author(s):  
Anna Esparham ◽  
Sanghamitra Misra ◽  
Erica Sibinga ◽  
Timothy Culbert ◽  
Kathi Kemper ◽  
...  
Keyword(s):  
Integrative Medicine ◽  
Professional Education ◽  
Chronic Conditions ◽  
Pediatric Population ◽  
Family Education ◽  
Pediatric Care ◽  
The Past ◽  
Significant Interest ◽  
Important Time ◽  
Ecologically Sustainable

Pediatric integrative medicine (PIM) is of significant interest to patients, with 12% of the general pediatric population and up to 80% of children with chronic conditions using PIM approaches. The field of PIM has evolved over the past 25 years, approaching child health with a number of guiding principles: preventive, context-centered, relationship-based, personalized, participatory, and ecologically sustainable. This manuscript reviews important time points for the field of PIM and reports on a series of meetings of PIM leaders, aimed at assessing the state of the field and planning for its future. Efforts in the first decade of the 2000s led to increased visibility in academic and professional pediatric organizations and through international listservs, designed to link those interested in and practicing PIM, all of which continue to flourish. The PIM leadership summits in recent years resulted in specific goals to advance PIM further in the following key areas: research, clinical practice, professional education, patient and family education, and advocacy and partnerships. Additionally, goals were developed for greater expansion of PIM professional education, broader support for pediatric PIM research, and an expanded role for PIM approaches in the provision of pediatric care.

scholarly journals From Research to Practice: Ten Lessons in Delivering Digital Mental Health Services

2019 ◽  
Vol 8 (8) ◽  
pp. 1239 ◽  
Author(s):  
Nickolai Titov ◽  
Heather D. Hadjistavropoulos ◽  
Olav Nielssen ◽  
David C. Mohr ◽  
Gerhard Andersson ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Psychological Treatment ◽  
Large Body ◽  
Routine Care ◽  
Outcome Data ◽  
Lessons Learned ◽  
Funding Policy ◽  
Four Levels

There is a large body of research showing that psychological treatment can be effectively delivered via the internet, and Digital Mental Health Services (DMHS) are now delivering those interventions in routine care. However, not all attempts to translate these research outcomes into routine care have been successful. This paper draws on the experience of successful DMHS in Australia and Canada to describe ten lessons learned while establishing and delivering internet-delivered cognitive behavioural therapy (ICBT) and other mental health services as part of routine care. These lessons include learnings at four levels of analysis, including lessons learned working with (1) consumers, (2) therapists, (3) when operating DMHS, and (4) working within healthcare systems. Key themes include recognising that DMHS should provide not only treatment but also information and assessment services, that DMHS require robust systems for training and supervising therapists, that specialist skills are required to operate DMHS, and that the outcome data from DMHS can inform future mental health policy. We also confirm that operating such clinics is particularly challenging in the evolving funding, policy, and regulatory context, as well as increasing expectations from consumers about DMHS. Notwithstanding the difficulties of delivering DMHS, we conclude that the benefits of such services for the broader community significantly outweigh the challenges.

Innovation in Higher Education: Lessons Learned from Creating a Faculty Fellowship Program

2016 ◽  
Vol 44 (S1) ◽  
pp. 97-106 ◽  
Author(s):  
Nancy J. Kaufman ◽  
Charity Scott
Keyword(s):  
Higher Education ◽  
Graduate School ◽  
Subject Matter ◽  
Professional Education ◽  
Lessons Learned ◽  
Faculty Members ◽  
Fellowship Program ◽  
School Programs ◽  
Core Components ◽  
Innovation In Higher Education

This concluding essay offers reflections on core components of the faculty fellowship program, its outcomes and results, and program design and administration. Amid the current calls for reform in legal and other professional education, the lessons we learned and perspectives we gained during this fellowship program may be relevant to any faculty members and university administrations that are seeking to create more effective and engaged professional and graduate school programs, whatever may be their subject-matter discipline.

ePortfolio and Educational Change in Higher Education in the Netherlands

2011 ◽  
pp. 2061-2068
Author(s):  
M. W. ("Wijnand") Aalderink ◽  
M. H.C.H. ("Marij") Veugelers
Keyword(s):  
Higher Education ◽  
The Netherlands ◽  
Professional Education ◽  
Large Scale ◽  
Lessons Learned ◽  
Low Countries ◽  
Student Centered ◽  
Future Developments ◽  
Change In Higher Education ◽  
The University

This chapter describes the important role that the concept of ePortfolio plays in new pedagogical paradigms in The Netherlands. ePortfolio can be seen both as a consequence of and a stimulus for the movement towards student-centered, competence-based learning in Dutch higher education. The authors present lessons learned in ePortfolio implementation, derived from experience from the past five years in the Low Countries, both in local institutional projects and in large-scale national projects. They then describe the cases of their own universities, being Windesheim University for Professional Education and the University of Amsterdam. The chapter ends with conclusions and future developments in the field of ePortfolio in The Netherlands.

Redeployment of dental teams during the covid-19 pandemic: A review of experiences and lessons learned

Dental Update ◽  
2021 ◽  
Vol 48 (2) ◽  
pp. 152-155
Author(s):  
Christopher Platais ◽  
Francesca Siodlak ◽  
Ishpinder Toor ◽  
Louise Ormondroyd
Keyword(s):  
Dental Care ◽  
Service Provision ◽  
Clinical Relevance ◽  
Healthcare Systems ◽  
Routine Care ◽  
Lessons Learned ◽  
Early Career ◽  
Healthcare Staff ◽  
Health Crisis ◽  
Medical Wards

The COVID-19 pandemic has spread across the globe, causing millions of cases and disrupting the lives of people worldwide. The increase in the number of critically unwell patients has put healthcare systems under immense strain, requiring them to adapt their service provision to cope with increased demand. At Guy's and St Thomas' NHS Foundation Trust (GSTFT) in London, redeployment of healthcare staff has been used to relieve pressure on the most overburdened hospital sectors, and this saw clinical dental teams involved in auxiliary medical roles throughout much of 2020. On the cusp of the New Year, COVID-19 cases continued to soar and GSTFT opted to cancel routine care and re-implement a second round of clinical redeployment. Here, we discuss our experiences and present positive feedback of early-career dentists being redeployed to medical wards during the UK's greatest health crisis of recent years. CPD/Clinical Relevance: Clinical dental teams can positively contribute to the national COVID-19 response through the provision of urgent dental care, inpatient mouthcare services and auxiliary medical roles.

Mechanisms of Gatekeeping in the Social Work Profession: Lessons Learned from Canada, Hong Kong and South Korea

2020 ◽  
Author(s):  
Miu Chung Yan ◽  
Jinah Lee ◽  
Edward Ko Ling Chan
Keyword(s):  
Hong Kong ◽  
Social Work ◽  
South Korea ◽  
Professional Education ◽  
Self Regulation ◽  
Lessons Learned ◽  
Professional Status ◽  
Registration System ◽  
The Social ◽  
The Usa

Abstract Striving to be a full-fledged profession with statutorily delegated self-regulatory authority has been a goal of the social work profession in many countries since Abraham Flexner’s (1915 ‘Is social work a profession?’, Paper presented at the Forty-Second Annual Session of The National Conference of Charities and Correction, Baltimore, MD, pp. 581, 584–8, 590. denial of its professional status in the USA. A full self-regulation requires two gatekeeping mechanisms: professional education and registration. Whereas professional social work education has been in place in many parts of the world, the establishment of a mandatory registration system is still limited to a few countries. Although two mechanisms share the same mandate and function as self-regulation, they tend to be discussed separately in the literature. How they connect and work with each other is seldom explored. In this article, by examining the development of these two mechanisms in Canada, Hong Kong and South Korea, we present three different ways of how these mechanisms are connected and discuss observations of those connections.

Lessons Learned From Hospital Ebola Preparation

2015 ◽  
Vol 36 (6) ◽  
pp. 627-631 ◽  
Author(s):  
Daniel J. Morgan ◽  
Barbara Braun ◽  
Aaron M. Milstone ◽  
Deverick Anderson ◽  
Ebbing Lautenbach ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Ebola Virus ◽  
Virus Disease ◽  
The United States ◽  
Routine Care ◽  
Lessons Learned ◽  
Convenience Sample ◽  
Control And Prevention ◽  
Prevention Activities ◽  
Healthcare Epidemiology

BACKGROUNDHospital Ebola preparation is underway in the United States and other countries; however, the best approach and resources involved are unknown.OBJECTIVETo examine costs and challenges associated with hospital Ebola preparation by means of a survey of Society for Healthcare Epidemiology of America (SHEA) members.DESIGNElectronic survey of infection prevention experts.RESULTSA total of 257 members completed the survey (221 US, 36 international) representing institutions in 41 US states, the District of Columbia, and 18 countries. The 221 US respondents represented 158 (43.1%) of 367 major medical centers that have SHEA members and included 21 (60%) of 35 institutions recently defined by the US Centers for Disease Control and Prevention as Ebola virus disease treatment centers. From October 13 through October 19, 2014, Ebola consumed 80% of hospital epidemiology time and only 30% of routine infection prevention activities were completed. Routine care was delayed in 27% of hospitals evaluating patients for Ebola.LIMITATIONSConvenience sample of SHEA members with a moderate response rate.CONCLUSIONSHospital Ebola preparations required extraordinary resources, which were diverted from routine infection prevention activities. Patients being evaluated for Ebola faced delays and potential limitations in management of other diseases that are more common in travelers returning from West Africa.Infect Control Hosp Epidemiol 2015;00(0): 1–5

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