Flexible and Integrative Psychiatric Care Based on a Global Treatment Budget: Comparing the Implementation in Germany and Poland

Background: The past decade has witnessed the establishment of flexible and integrative treatment (FIT) models in 55 German and Polish psychiatric catchment areas. FIT is based on a global treatment budget (GTB), which integrates funding of all acute psychiatric hospital services for a regional population. Prior research has identified 11 specific program components of FIT in Germany. In this paper we aim at assessing the applicability of these components to the Polish context and at comparatively analysing FIT implementation in Poland and Germany.Methods: Qualitative interviews about the applicability of the 11 FIT-specific components were conducted with the program managers of the Polish FIT models (n = 19). Semi-quantitative data on the FIT-specific components were then collected in 19 Polish and 10 German FIT models. We assessed the grading of each component, their overall degree of implementation and compared them between the two countries. In all study hospitals, structural and statistical parameters of service delivery were collected and compared.Results: The qualitative results showed that the German FIT-specific components are in principle applicable to the polish context. This allowed the comparative assessment of components grading and degree of implementation, which showed only subtle discrepancies between German and Polish FIT models. The little discrepancies point to specific aspects of care such as home treatment, peer support, and cooperation with non-clinical and social welfare institutions that should be further integrated in the components' definition.Conclusions: The specific program components of FIT as first defined from the German experience, serves as a powerful tool to measure, and evaluate implementation of integrated psychiatric care both within and between health systems.

Challenging Deficit Thinking in Our Schools

Deficit thinking by educators is a barrier to student success. To effectively meet the needs of all students, future teachers need to be able to identify and challenge deficit thinking when they encounter it. Educator preparation programs are well positioned to assist with the rejection of deficit thinking in favor of strengths-based approaches in the classroom through intentionally designed courses and required field experiences. This chapter explores deficit thinking in special education, highlights components of teacher training that have been demonstrated to address issues of equity and combat deficit thinking, and shares one education department's efforts to ensure deficit thinking is adequately addressed in their coursework and fieldwork. Other educator preparation programs may benefit from the exploration of inclusive and equity-focused program components, as well as the auditing process conducted by this education department.

Evaluating Gifted Programs

Program evaluation is one of the few areas in gifted education that considers the coherence among gifted education program components across the K-12 spectrum. It increases the visibility of the gifted program while acknowledging the fluidity of change in a given context and engages individuals in influencing the nature and degree of changes that can occur within their system. Two key questions in the gifted field are: To what degree do these programs make a difference in the lives of gifted children? How do we know they are working? Program evaluation is a solid and necessary step in answering these questions. Program evaluation is necessary to drive gifted program improvement. This chapter provides the rationale and literature review on gifted program evaluation as well as research-based protocols for facilitating gifted program evaluations and the commensurate processes for ensuring quality, transparency, and comprehensiveness.

Virtual Sprint Outpatient Electronic Health Record Training and Optimization Effect on Provider Burnout

Objectives This study aimed to develop a virtual electronic health record (EHR) training and optimization program and evaluate the impact of the virtual model on provider and staff burnout and electronic health record (EHR) experience. Methods UCHealth created and supported a multidisciplinary EHR optimization and training program, known as the Epic Sprint Program. The Sprint Team conducted dozens of onsite Sprint events over the course of several years prior to the pandemic but transitioned to a fully virtual program and successfully “sprinted” 21 outpatient clinics from May to December 2020. Core program components of group and 1:1 training, workflow analysis, and new or adjusted EHR build were unchanged from the onsite model. Pre- and post-Sprint surveys provided detailed, objective data about EHR usability, EHR proficiency, job satisfaction, and burnout. Results The EHR Net Promoter Score (NPS), a likelihood to recommend metric, increased by 39 points (−3 pre and 36 post; p < 0.001) for providers and 29 points (8 pre and 37 post; p = 0.001) for staff post-Sprint. Positive provider (NPS = +53) and staff (NPS = +47) NPS scores indicated a high likelihood to recommend the Sprint Program. Post-Sprint surveys also reflect an increase in providers (10%; p = 0.04) and staff (9%; 0.13) who indicated “no burnout” or “did not feel burned out.” Discussion The UCHealth Sprint Team transitioned this comprehensive, enterprise level initiative from an onsite model to a fully virtual EHR training and optimization program during the first few months of the novel coronavirus disease (COVID-19) pandemic. Despite this change in program delivery, survey data clearly demonstrated improved EHR satisfaction, a high likelihood to recommend a sprint to a friend or colleague, and a trend toward burnout reduction in providers and staff. Conclusion Changing an existing on-site EHR optimization program to a purely virtual format can be successful, and this study showed improved provider and staff EHR satisfaction with reduced burnout.

Motor Skills Development: Peculiarities of Programmed Teaching of Acrobatic Exercises to Girls Aged 15

The purpose of the study was to determine the peculiarities of programmed teaching of a cartwheel to girls aged 15. Material and methods. The study participants were 20 girls aged 15. The children and their parents were fully informed about all the features of the study and gave their consent to participate in the experiment. To solve the tasks set, the following research methods were used: study and analysis of scientific and methodological literature; pedagogical observation, timing of training tasks; pedagogical experiment, methods of mathematical statistics, factor analysis, nearest neighbor analysis. Results. The analysis of similarities revealed that the program components are interrelated. Series of training tasks ІV, V and VI have the highest correlation. Series of training tasks І, ІІІ and IV are combined into one group and provide conditions for teaching girls aged 15 the cartwheel. Conclusions. The study obtained factor models of the teaching program, which explain 70.645% and 68.468% of the variation of results. The models characterize the two-factor structure of the teaching program where training tasks are closely connected with one another, which indicates their effective selection. It was found that the tasks of series I, II and III, and the tasks of series III, IV and V are most connected with one another, which confirms the combined nature of the method of algorithmic instructions. Optimization of the number of repetitions of the entire exercise (series of tasks VI) depends on the amount of exercises of the second and fifth series of training tasks.

Addressing Systemic Racism by Creating a Diversity, Equity, and Inclusion Department Initiative

Background Catalyzed by social injustice and worsening racial inequities highlighted by the COVID-19 pandemic, a diverse academic geriatrics and palliative medicine department in NYC launched a DEI initiative. This report presents key program components and lessons learned in launching this initiative in the interprofessional academic medicine setting. Methods First, DEI core and departmental administration met 2-4 times/month to plan and review program activities, vision, and mission. The team conducted confidential roundtable discussions about DEI issues and 1:1 interviews to assess needs. A monthly Humanities, Arts, and Books (HAB) Initiative provided a safe space for discussion and learning. The HAB platform supported a longitudinal curriculum emphasizing (1) group discussion and self-reflection on DEI concerns, (2) knowledge dissemination including a “Learning Pathway” series, and (3) skill-based workshops. With each event, we collected anonymous feedback. Comments were systematically recorded and an engagement evaluation was conducted to iteratively shape future sessions. Departmental administration was engaged to track DEI-focused measures of recruitment, career advancement, and retention. Finally, we centralized DEI activities on a departmental website, including an anonymous online feedback box. Results Quantitative and qualitative assessment of DEI initiatives are forthcoming. Metrics include DEI and professional development surveys, departmental demographic and diversity measures, increase in DEI-related projects and grants, and individual participation in DEI programs. Conclusions Creating a strong and sustainable DEI initiative within an academic medical setting requires a passionate and diverse core team, deliberate backing by administration, and thoughtful dissemination of sensitive content in the midst of a highly charged social justice landscape.

Co-Designing a Social Connections Program With Older Adults

Loneliness presents a higher risk for mortality than smoking 15 cigarettes per day. COVID-19 has exacerbated loneliness for many older adults, without access to family, friends, and community. Friendly caller programs utilizing volunteers to talk with older adults who are lonely can be helpful, providing much-needed contact. However, few lasting connections have formed in these programs. To enhance our social connections program, we systematically engaged a group of older adults who struggle with social isolation to co-design a program to meet their needs. This group met virtually twice for two hours to (1) identify contributors to their isolation, generate ideas for ideal program components, and how best to connect older adults to each other; and (2) to refine the multi-component program created by staff based on the first discussion. Group process and themes will be presented, along with a discussion of key issues in program co-design with older adults.

Unpacking the Theory Behind One Health Food Safety Programs: A Vietnam Case Study

Many One Health programs are inherently complex, characterized by multiple perspectives from multiple sectors, delivery across various scales, and a focus on complex problems at the convergence of people, animals, and the environment. This complexity makes them difficult to conceptualize, requiring frameworks to organize the different program components. Evaluation frameworks that unpack the sequence of events linking program activities to outcomes (e.g., Theory of Change) and track outcomes (e.g., Outcome Mapping) show promise in supporting the development of One Health programs. While widely used in international development and health contexts, there has been little reflection on the use of Theory of Change and Outcome Mapping within One Health efforts. This paper reflects on the process of applying these frameworks to conceptualize a One Health food safety program in Vietnam. We find Theory of Change fostered the characterization of a change pathway toward safer pork, while Outcome Mapping kept us informed of where along the change pathway we were. One Health programs considering evaluation frameworks should adopt elements that make sense to them, be intentional about co-designing the evaluation, and view evaluation as a process, not a product.

FIRST: Enhancing Agency Dementia Capability through Dementia-Specific Interventions and Supportive Services

Through the First Identify and Refer then Serve and Track (FIRST) Project, individuals and caregivers have critical connections to community organizations and resources to learn ways to handle living with memory problems. The FIRST project integrated new practices into existing programs to address gaps in service and piloted a new dementia-specific case management program. The initial intervention is a system-level change within the County of San Diego’s Aging & Independence Services (AIS) department to identify, pilot, and implement a brief Alzheimer’s Disease and Related Dementias (ADRD) screening tool. The tool was used by non-clinical personnel to identify potential ADRD cases. Individuals who screened positive for possible ADRD were referred to their physicians for an accurate diagnosis. The second intervention consisted of two components: a behavioral symptom management intervention for social workers to use in the home with caregivers and a dementia-specific case management program (including respite care) to improve quality of life and future planning for those with ADRD living alone or with a family caregiver. As of January 2021, 536 clients across several AIS programs have been screened for ADRD, of which, 60% screened positive. FIRST case management has served 196 clients, 70 who lived alone and 126 who lived with their caregiver. Respite was provided to 98 clients totaling to 3,666 hours. This poster evaluates the effectiveness of the program components in increasing dementia capability of an agency, and where applicable, its effect on caregiver burden and self-efficacy.