Redesigning the Process for Scheduling Elective Orthopaedic Surgery: A Combined Lean Six Sigma and Person-Centred Approach

The Health Service Executive Ireland model of care for elective surgery supports the delivery of elective surgical care in achieving both process and clinical outcomes. This project was conducted in the Orthopaedic Department. Following an outpatient consultation with an orthopaedic surgeon, patients who required surgical intervention were scheduled for their intervention by the administrative team. Prior to commencing this project, the average time from patient consultation to being scheduled for surgery on the hospital system was 62 h/2.58 days. A pre- and post-team-based intervention design employing Lean Six Sigma methodology was applied to redesign the process for scheduling elective orthopaedic surgery. The project was informed by collaborative, inclusive, and participatory stakeholder engagement. The goal was to streamline the scheduling process for elective orthopaedic surgery, with a target that 90% of surgeries are scheduled “right first time” within 48 h/two working days of the outpatient consultant appointment. The main outcome measures showed that 100% of orthopaedic surgeries were scheduled successfully within 2 days of outpatient appointment. Duplication in work between patient services and scheduling teams was eliminated and facilitated a reduction in unnecessary staff workload. This project highlights the importance of collaborative interdisciplinary stakeholder engagement in the redesigning of processes to achieve sustainable outcomes, and the findings have informed further improvements across the hospital’s surgical scheduling system.

Application of Sport and Physical Education in the Period of Pandemic Covid-19 From the Point of View of Teachers

Summary The study aimed to identify the physical education and sports classes implementation in the light of the Corona pandemic, as seen by the teachers. To this end, the researchers used the descriptive approach based on the survey method. The sample included (60) teachers from high schools in the Wilaya of El Bayadh, chosen at random. The results of the study showed that the teachers experienced to a more than average degree, difficulties with the administrative organization, and moderate difficulties during the practice of the lesson of physical education and sports, and therefore the researchers recommended in this regard, the provision of national educational establishments with the material necessary for comprehensive prevention, as well as the need for mutual assistance between the administrative team and teachers.

Attitudes of professionals from Psychosocial Care Centers towards alcohol, alcoholism, and alcoholics

Objective: to assess the attitudes of professionals from Psychosocial Care Centers towards alcohol, alcoholism, and alcoholics. Methods: a cross-sectional evaluation study with 288 professionals from 12 healthcare services. Sociodemographic data, Patient Satisfaction Scale with Mental Health Services and Attitude Scale for alcohol, alcoholism, and alcoholics were collected. Results: the professionals who showed a more critical attitude towards their work routine and those who worked in the healthcare services for longer had positive attitudes towards alcohol, alcoholism, and alcoholics. Professionals from the administrative team and health technicians had more negative attitudes. Conclusion: the attitudes of professionals towards alcohol, alcoholism, and alcoholics, in general, are positive and were associated with longer working time in the field and the manifestation of disapproving situations with work.

Changing relationships: how does patient involvement transform professional identity? An ethnographic study

ObjectivesTo understand identity tensions experienced by health professionals when patient partners join a quality improvement committee.DesignQualitative ethnographic study based on participatory observation.SettingAn interdisciplinary quality improvement committee of a Canadian urban academic family medicine clinic with little previous experience in patient partnership.ParticipantsTwo patient partners, seven health professionals (two family physicians, two residents, one pharmacist, one nurse clinician and one nurse practitioner) and three members of the administrative team.Data collectionData collection included compiled participatory observations, logbook notes and semi-structured interviews, collected between the summer of 2017 to the summer of 2019.Data analysisGhadiri’s identity threats theoretical framework was used to analyse qualitative material and to develop conceptualising categories, using QDA Miner software (V.5.0).ResultsAll professionals with a clinical care role and patient partners (n=9) accepted to participate in the ethnographic study and semi-structured interviews (RR=100%). Transforming the ‘caregiver–patient’ relationship into a ‘colleague–colleague’ relationship generated identity upheavals among professionals. Identity tensions included competing ideals of the ‘good professional’, challenges to the impermeability of the patient and professional categories, the interweaving of symbols associated with one or the other of these identities, and the inner balance between the roles of caregiver and colleague.ConclusionThis research provides a new perspective on understanding how working in partnership with patients transform health professionals’ identity. When they are called to work with patients outside of a simple therapeutic relationship, health professionals may feel tensions between their identity as caregivers and their identity as colleague. This allows us to better understand some underlying tensions elicited by the arrival of different patient engagement initiatives (eg, professionals’ resistance to working with patients, patients’ status and remuneration, professionals’ concerns toward patient ‘representativeness’). Partnership with patients imply the construction of a new relational framework, flexible and dynamic, that takes into account this coexistence of identities.

偏鄉學校變革之挑戰教育優先區─成功專案推動歷程研究

<p>本研究以參與「教育優先區─成功專案」之四個區19所國中小為研究對象，透過文件分析及質性訪談，分析成功專案籌備及實施第一年期間（2014至2015年）在四個區的運作情況。研究旨在探討專案學校如何推動成功專案、剖析成功專案在多大程度上促進改變，及阻礙改變產生的因素。研究發現區計畫書的經費配置取決於規劃者對基本學力的重視程度，區計畫書規劃策略深受學校行政教學分工及教育優先區計畫執行經驗之影響。成功專案在區層級所產生的改變為促進區內學校的交流與對話，在學校層級觀察到的改變則是調整補救教學實施和促進弱勢家長參與策略。缺乏行政權、共同討論時間和整合經驗，及人員流動是啟動與維持區變革之挑戰。本研究提出四項建議：（1）以提升學生基本學力為國中小整合主軸，發展行政人員課程領導能力；（2）引進結構化的補救教學模式，搭配與現場教學工作銜接的培訓課程，提升教師分析學生學習成效及差異化教學知能；（3）建立區內及校內行政人員與教師對話討論機制；（4）提供討論的鷹架與專業伴隨，以提升專案的綜效。</p> <p>&nbsp;</p><p>Since 1996, Taiwan has been implementing the Educational Priority Areas (EPA) Program to reduce the achievement gaps between students in different regions. However, according to the results from PISA, TIMSS, PILRS and the Basic Competence Test, the achievement gap has widened between urban and rural students over time. The Taiwanese Ministry of Education piloted the &quot;&quot;Success Program&quot;&quot; from 2014 to 2017, an experimental program in order to reform the EPA Program. This study sought to investigate the implementation of the Success Program. The researcher conducted semi-structured interviews with 26 school principals, division heads and teachers recruited from participating schools and utilized content analysis to analyze challenges, difficulties and compromises during the first two years of implementation. The purpose was to explore the extent to which the Success Program promoted educational change, the advantages and limitations of zone-based intervention, as well as the factors hindering educational change. Suggestions are provided for improving area-based intervention. Results: The results indicate that the Success Program facilitated inter-school cooperation among elementary teachers at the zone level. Besides, the adjustment of remedial teaching and parental involvement strategies were observed at the school level. However, no change was found at the classroom level. In addition, there was a goal displacement at the school level. In terms of zone integration, lacking of administrative power, short of discussion time, insufficient collaboration skills as well as high teacher turnover rate were main challenges of initiating and sustaining educational change. Policy recommendations: (1) Cultivating instructional leaders and concentrating the focus of zone integration on basic competences. (2) Providing instructional guidance and introducing school-based workshops to strengthen instructional practices. (3) Establishing the discussion mechanism between the administrative team and teachers. (4) Providing scaffolding and expert consultations to support collaborative discussions.</p> <p>&nbsp;</p>

Editorial

The COVID-19 pandemic caused by the SARS-CoV-2 virus has resulted in more than 2.9 million deaths and more than 134 million cases around the world, with an estimated lethality of 2.16% since it was first reported in Wuhan, China, in December 2019; based on the reports from John’s Hopkins University (April 9, 2021). The impact of the pandemic has been different in each country, as a result of the different prevention and relief measures being implemented. To date, the vaccination program represents the best hopeful opportunity to fight the pandemic and also emphasizes the importance of research as a tool to solve adverse circumstances for society. This health crisis has demonstrated that the virus can impact patients with comorbidities in a distinct manner resulting in an increased awareness of the importance of healthy habits as well as of programs of preventive health measures. This health crisis has also turned into a social, economic, and education crisis. The projections are not encouraging as it is estimated that it may take several years to recover. To better understand these crises and their effects, it is critical to understand the effect of the pandemic in different areas that may lead to making appropriate decisions that can facilitate a prompt recovery. It is in this context that this special edition of NOVA SCIENTIA becomes a discussion forum to understand the impact of the COVID19 pandemic in different aspects of daily life such as health, economy, education, and social or mental health aspects. Of particular importance is to understand the negative impact of comorbidities in the progression of a COVID-19 patient. In this special edition, we include scientific papers that evaluate different perspectives of the pandemic. In addition, we provide important information that may aid decision-making to mitigate the effects of the pandemic. This number is focused on the Mexican population; however, some of the learning points can be extended to other countries. The invited editors would like to thank the contributions of the authors, the support of the reviewers, and all the administrative team efforts that have made possible the publication of this special edition of NOVA SCIENTIA.

Join me online: Supporting faculty and staff wellness in the Age of Zoom

At the beginning of March 2020, when everything in our world suddenly ground to a halt, I realized that we were not going to have an ordinary end to the semester. I did not imagine that we would still be in flux nearly a year later. Our faculty and staff were already heading for Spring Break when decisions were made to go online and to work from home. Over Spring Break, the administrative team prioritized creating the public facing messages and planned how we would continue to provide services to faculty and students in this unusual situation. These were the questions that libraries across the country were grappling with at the same time, and we were quickly learning from one another.

Embedding Diverse Children's Literature Throughout a Teacher Preparation Program

This chapter explores the incorporation of diverse children's literature into a teacher preparation program, both in and beyond a required Literature for Children course. With the aim of cultivating positive reading identities for pre-service teachers, the authors focus on the process for implementing changes to build a culture of reading, so that pre-service teachers identify as life-long readers, and specifically readers who understand the importance of diverse texts. Changes to curriculum in writing, social studies, and special education methods courses are described, as is the creation of a college-wide book club. The goal of embedding children's literature in and across teacher preparation programs is for pre-service teachers to feel prepared to bring these texts into their own classrooms and to facilitate discussions on the topics that these texts raise with their students, administrative team, and parents. In order to do this, teacher educators need to provide ample opportunities for students to practice selecting, analyzing, and discussing diverse children's literature.

偏鄉學校變革之挑戰教育優先區─成功專案推動歷程研究

<p>本研究以參與「教育優先區─成功專案」之四個區19所國中小為研究對象，透過文件分析及質性訪談，分析成功專案籌備及實施第一年期間（2014至2015年）在四個區的運作情況。研究旨在探討專案學校如何推動成功專案、剖析成功專案在多大程度上促進改變，及阻礙改變產生的因素。研究發現區計畫書的經費配置取決於規劃者對基本學力的重視程度，區計畫書規劃策略深受學校行政教學分工及教育優先區計畫執行經驗之影響。成功專案在區層級所產生的改變為促進區內學校的交流與對話，在學校層級觀察到的改變則是調整補救教學實施和促進弱勢家長參與策略。缺乏行政權、共同討論時間和整合經驗，及人員流動是啟動與維持區變革之挑戰。本研究提出四項建議：（1）以提升學生基本學力為國中小整合主軸，發展行政人員課程領導能力；（2）引進結構化的補救教學模式，搭配與現場教學工作銜接的培訓課程，提升教師分析學生學習成效及差異化教學知能；（3）建立區內及校內行政人員與教師對話討論機制；（4）提供討論的鷹架與專業伴隨，以提升專案的綜效。</p> <p>&nbsp;</p><p>Since 1996, Taiwan has been implementing the Educational Priority Areas (EPA) Program to reduce the achievement gaps between students in different regions. However, according to the results from PISA, TIMSS, PILRS and the Basic Competence Test, the achievement gap has widened between urban and rural students over time. The Taiwanese Ministry of Education piloted the &quot;&quot;Success Program&quot;&quot; from 2014 to 2017, an experimental program in order to reform the EPA Program. This study sought to investigate the implementation of the Success Program. The researcher conducted semi-structured interviews with 26 school principals, division heads and teachers recruited from participating schools and utilized content analysis to analyze challenges, difficulties and compromises during the first two years of implementation. The purpose was to explore the extent to which the Success Program promoted educational change, the advantages and limitations of zone-based intervention, as well as the factors hindering educational change. Suggestions are provided for improving area-based intervention. Results: The results indicate that the Success Program facilitated inter-school cooperation among elementary teachers at the zone level. Besides, the adjustment of remedial teaching and parental involvement strategies were observed at the school level. However, no change was found at the classroom level. In addition, there was a goal displacement at the school level. In terms of zone integration, lacking of administrative power, short of discussion time, insufficient collaboration skills as well as high teacher turnover rate were main challenges of initiating and sustaining educational change. Policy recommendations: (1) Cultivating instructional leaders and concentrating the focus of zone integration on basic competences. (2) Providing instructional guidance and introducing school-based workshops to strengthen instructional practices. (3) Establishing the discussion mechanism between the administrative team and teachers. (4) Providing scaffolding and expert consultations to support collaborative discussions.</p> <p>&nbsp;</p>