SP4.2.10 COVID-19 and General Surgery in a District General; Safety and Quality data

Aim The Covid-19 pandemic forced departments to change standard modes of delivery of care. Within our unit, reductions in junior workforce and changed operating protocols resulted in greater consultant presence on in-patient wards and the ambulatory unit. This study aimed to determine the effect on patient outcomes by interrogation of data collected from weekly Safety and Quality Clinical Governance meetings. Methods Patients admitted between December 2019 and February 2020 were compared to those admitted between April 2020 and June 2020. The weekly meeting mandates consultant discussion of all readmissions, all patients who had a length of stay (LoS) of > 7 days and all admissions to critical care. Outcomes between the two time periods were compared. Results There was a marked reduction in admissions during the second study period. However, the proportion of patients discharged from ambulatory care increased as did the proportion of readmissions; in the pre-Covid period, there were 429 readmissions of which 188 (44%) were unplanned but in the post-Covid period, there were 311 readmissions. There were no serious adverse events from discharged patients or readmissions. There were markedly fewer patients who had a LoS > 7days (179 patients versus 87) and a greater number of unplanned admissions to critical care (44% versus 64%). Conclusions Increased consultant presence may explain the reduced LoS and increased readmissions due to the greater ‘risk’ that senior clinicians are prepared to take. Enhanced consultant presence should be a permanent change, even after the pandemic is over.

Evolution of a mass casualty drill design team: A program evaluation

Introduction: The number of mass casualty incidents (MCIs) is increasing. While many healthcare systems have not experienced an MCI, the need for preparedness is ever present. The unique challenges of MCI preparedness require the use of simulation, which has been found to be an effective model for training in medical environments.Objective: To determine common discussion points when a multidisciplinary team designed and implemented in situ MCI simulation drills to enhance our emergency preparedness plan.Design: This was a retrospective qualitative evaluation of the multidisciplinary mass casualty drill design team’s weekly meeting minutes documents. These documents provided insight into the evolution of a mass casualty drill design team and the advancement of our emergency response plan. Results: Continuous discussions surrounding resource restraints helped to inform the emergenceof the three themes, which were “Staff,” “Space,” and “Stuff.” These three themes were further broken down into different subthemes, but there was a continued focus on resource scarcity.Conclusions: Our results indicate the use of an MCI drill design team and in situ simulations assisted in better understanding of how hospital departments struggled with resource scarcity and provided opportunities to strengthen the emergency preparedness response plan. Incorporating a multidisciplinary mass casualty drill design team helped to ensure different perspectives and department needs were acknowledged and addressed through the in situ simulation trainings.

Transitioning a cardiovascular health and rehabilitation programme to a virtual platform during covid 19

Funding Acknowledgements Type of funding sources: None. OnBehalf Our Hearts Our Minds Purpose Can a virtual cardiovascular prevention and rehabilitation programme be as effective as face-to-face programme. Background The Our Hearts Our Minds (OHOM) prevention and rehabilitation programme rapidly transitioned to a virtual platform in the covid era. Here we compare if a virtual programme potentially could offer the same standard of the nursing intervention (education, smoking cessation, medical risk factor management and psychosocial health) as the previous face to face programme Methods Both the initial assessment (IA) and end of programme (EOP) assessments were conducted via telephone/video as per patient preference. The following measures were recorded at both time points (home blood pressure (BP) monitors were provided) Smoking (self report) BP/Heart rate, Lipids/HbA1c (facilitated by phlebotomy hub), cardio protective drugs (doses, adherence), Hospital Anxiety and Depression score, EuroQoL Nursing Intervention Smoking cessation counselling and pharmacotherapy where appropriate Weekly meeting with cardiologist to optimise BP and lipid management and up titration cardio protective drugs Bimonthly virtual coaching consultation for monitoring/goal resetting Bimonthly group video education sessions Results From April to November 2020, of the 432 referrals received 400 were eligible with 377 accepting the offer of an IA (94% response rate). 262 have had an IA with the remaining 115 awaiting an assessment date. Of the completed IA’s 257 were willing to attend the programme (98% uptake). 120 had been offered an end of programme assessment with 114 attending (96% of those offered). The results for the virtual programme were then compared to the same period one year previously when the programme was fully face to face and are outlined in the table below. The comparison of results delivered via remote delivery are remarkably similar to those achieved in the previous year delivered via face to face. Conclusion Initial data has shown that virtual delivery of the nursing component of the OHOM prevention/rehabilitation programme was highly acceptable to patients and was as effective as that of the traditional face to face service. Table 1 below exhibits the clinical and patient-reported outcomes.

Designing of Web-Based Learning Media for Senior High School During The Covid-19 Pandemic

The learning process of Senior High School level is done by various methods. In the current pandemic condition, a learning process is needed that is implemented with strict health protocols. One alternative method of the effective and online learning processes is by learning to use web-based learning media. The creation of learning media in this study uses a prototype model, which consists of listening to needs, building mock-ups and evaluating mock-ups. As a sample of research is SMAS Wiyata Mandala Balai Batang Tarang, with data collection techniques used consisting of interviews, observations and library studies. The media designed in this study provides facilities to three (3) level users, namely administration, teachers and students. Administration can manage administrative data, majors, subjects, classes, students, teachers, teaching teachers, announcements and access student achievement reports. Teachers can manage to manage teaching materials, problem banks, meeting schedules and access student achievement reports. Students can access modules, work on weekly meeting questions and access the grades in the meeting results. This designed learning media is expected to help SMAS Wiyata Mandala Balai Batang Tarang in carrying out the learning process and can improve student achievement even in the midst of the pandemic.

59 Impact of A Mature Burn Telemedicine Program On Inpatient, Outpatient, and Aftercare Programs During COVID19.

Introduction In 2014, a multidisciplinary burn telemedicine program was developed in order to increase access of burn specialists and improve care. This proved to be beneficial in the face of the pandemic through utilization of existing programs and development of new processes. Methods The basis of this burn telemedicine program utilizes a partnership approach. Visit types include inpatient and outpatient consultation, with visits occurring in in-patient settings, emergency departments, out-patient clinics, and in patient’s homes. During the COVID 19 pandemic, a weekly meeting was held with telemedicine program and clinic leadership, program coordinators, and our burn surgeon to triage patients to telemedicine or inpatient visit types. This often required the nursing staff to contact the patients to obtain more information about the injury and help them to securely upload photographs. The telemedicine visits were primarily video visits occurring either in clinic settings or the patient’s home. The burn psychotherapist and occupational therapists also utilized telemedicine for patient care. In addition, aftercare support groups, which originally were held twice each month onsite, transitioned to video and increased to three times. Telemedicine is also being utilized for school re-entry programming and the annual burn camps. The program is also tracking reimbursement for telemedicine activities. Results The pandemic resulted in a significant increase of telemedicine visits as compared to in person clinic visits often occurring directly into the patient’s homes. A greater number of burn patients were seen overall than previous to this process. Attached graphs show the comparison of in person visits compared to telemedicine visits during this time frame. Additional data will be presented showing the breakdown of visit location, provider (psychotherapist versus surgeon for example), and usage with aftercare programming. Conclusions This telemedicine program with established processes and partnerships, allowed transitioning alternative care due to the pandemic to be less stressful event. Benefits to patient care included the ability of the multidisciplinary burn team to see more patients safely via video especially in their own homes and allowed continuation and expansion of aftercare support. Challenges experienced included needing additional staff to ensure patients were triaged appropriately, scheduling of visits, and technology training for patients and families, and to ensure that patients were receiving medications and dressings as needed. The increased volume of patients seen could be attributed to more frequent visits and an increased volume of burn injuries.

Towards a More Efficient Training Process in High-Level Female Volleyball From a Match Analysis Intervention Program Based on the Constraint-Led Approach: The Voice of the Players

The aim of the research was to know the perception of high-level volleyball players of the changes produced (in relation to the previous season) in the efficiency of the training process, after a match analysis intervention program based on the Constraint-led Approach (CLA). The sample consisted of 11 players from a women's volleyball team. The protocol of the intervention program consisted of providing objective, contextualised and systematic information to the coach (adapted to his needs) that would allow understanding the different real game contexts. We used semi-structured interviews to assess players' perceptions. The athletes perceived changes in training, both in their preparation and development, specifically in greater involvement and organisation in preparing the training; in an increase in the specificity and suitability of training tasks according to individual needs; in the representativeness of the restrictions of the game; in a more tactical approach; in the variability of task and in the accountability to achieve the objective proposed. In addition, in the preparation and development for competition, the players detected more game planning; a deeper analysis of the opponents; an objective selection of the most relevant data, an increase in the depth of match analysis and the inclusion of the weekly meeting with the use of video compared to the previous season. These results expose the benefits of coaches incorporate programmes to obtain objective information about the game in their training process.

Policy Analysis of Teacher Professional Improvement in YPPSB Elementary School

The purpose of the research was to identify policy formulation, policy implementation, policy environment, and performance professional improvement of teachers in the elementary school of YPPSB. This policy research used a qualitative approach. The data of this research was collected by in-depth interviews, observation, documentation study. Analysis of data using a technique of organizing data, coding, verification, and conclusions). This research's findings are as follows: (1) policy of the teacher professional improvement of SD YPPSB - PT. Kaltim Prima Coal follows a Top-down approach and bottom-up approach model of formulation policy, (2) the implementation of teacher professional improvement policy successfully conducted to its vision, mission, and goal; (a) recruitment of qualification teachers, (b) Conducting and includes teachers in the education and training, (c) professionalization of teachers through KKG and MGMP, (d) facilitating teachers to continue their studies S2, (e) educational supervision, ( f) course intensification, (g) weekly meeting, (h) reward, and (i) allowance. Policy recommendations that can be given are as follows, (1) Principal of SD YPPSB needs to increase teachers' professional development, primarily through forms of training, (2) the Education Department to develop comprehensive education, especially for private schools, and (3) The Government continually strive to find alternatives to increase the professionalism of teachers.

The Contribution of Obeya for Business Intelligence

The main objective of the study is to minimize interdepartmental communication, potentiation of fast and efficient decision making, and computerization of data. Using software such as MS Excel® and MS Power BI®, a Power BI® tool was conceived to be capable of incorporating, for the entire company, the dashboards that collect the main KPIs of each department. After the tool was implemented, the company's paradigm shift was noticeable. Quickly, the weekly meeting of the planning team began to take place using the MS Power BI® dashboard. In this way, processes were automated and the important data for the normal functioning of the company became accessible to all departments, thus minimizing interdepartmental communication. The chapter shows an Obeya Digital that was implemented in a company in which all the performance indicators of each department are incorporated. In this way, information becomes accessible to all employees and manual data update processes are minimized.