Jacquie White, Deputy Director of NHS England Long Term Conditions, Older People & End of Life Care and Claire Cordeaux SIMUL8 Executive Director for Health & Social Care were invited by Centers for Medicare & Medicaid Services to discuss how NHS England work in chronic disease.
This paper presents analysis of a Kent ‘whole population’ dataset, linking wholepopulation demographics with activity and cost data for the population from acute, community, mental health and social care providers. The data helps commissioners to understand the impact of different selections methods for people with ‘very complex’ health and social care needs, particularly in relation to the development of a LTC year of care currency.
This document should be seen alongside the ‘Recovery, Rehabilitation and Reablement – step-by-step guide’ which describes how providers can carry out the audit in their own organisation. Other documents and learning materials This document is part of a suite of learning materials being produced by the LTC Year of Care Commissioning Programme to support the spread and adoption of capitated budgets for people with complex care needs.
John Hennessy, Primary Care National Director, HSEInvestnet
John Hennessy outlines future plans for primary care in Ireland. Key priorities include addressing demographic pressures and growth in medical cards, introducing free GP care for children under 6, improving chronic disease management, reducing costs through generic prescriptions and reference pricing, upgrading primary care centers and ICT, and shifting care to the community to avoid hospitalizations and delayed discharges. The overall goals are moving to a health and wellbeing model, balancing the healthcare system, and creating the right environment through optimized models and governance.
Chronic diseases account for $93 billion annually in Canada to manage. Despite this spending, 12% of Canadians report being unsatisfied with healthcare quality, posing a challenge for policymakers. The document proposes several projects to identify effective interventions for improving primary care practices and outcomes for patients with chronic conditions. It will analyze policies across Canadian provinces to better integrate health, social, and community services and identify best practices. It will also evaluate tools to screen for social determinants of health and characterize high healthcare users.
The document discusses population health management and achieving healthy communities. It outlines major issues with the US healthcare system like uneven access to care. Real reform requires a focus on prevention, continuous care relationships, and evidence-based decisions. Population health management programs aim to maintain and improve people's health across different risk levels. Barriers to population health include fragmented care and misaligned incentives. Patient-centered medical homes and accountable care organizations show promise by emphasizing coordinated, team-based care. Automation and health information technology can help strengthen these models and drive effective population health management.
Judith Smith and Chris Ham: Commissioning integrated care - what role for cli...The King's Fund
Dr Judith Smith, Head of Policy at the Nuffield Trust, and Professor Chris Ham, Chief Executive of The King’s Fund, share the findings of their recent research into how NHS commissioners have been commissioning better integrated services and care for people in local areas.
Population Health Management PresentationCANorfolk
The document discusses population health management (PHM) and its role in supporting integrated care systems (ICS) in the UK. Key points:
- ICSs will be established everywhere by 2021 to integrate primary/specialist care, physical/mental health, and health/social care.
- PHM solutions will help ICSs understand health needs and match NHS services accordingly through data analysis.
- PHM aims to improve population health through proactive, data-driven care that prevents illness and reduces health inequalities.
The National Disability Insurance Scheme (NDIS) is Australia's national disability insurance scheme that aims to provide insurance coverage for the costs of disability support. Key points of the NDIS include:
1) It pools the financial risks of disability so that no individual or family bears the full cost alone through contributions from all taxpayers.
2) It provides choice and control for participants over their disability supports and services.
3) While the NDIS funds disability supports, mainstream systems remain responsible for other services like healthcare, and the NDIS aims to coordinate with these other systems.
This document outlines research priorities related to improving health systems and community care. It identifies priorities such as exploring how other jurisdictions have organized health systems to improve outcomes and reduce costs, ensuring the needs of vulnerable populations are met, and redesigning mental health and addiction services to improve access and outcomes. Other priorities include exploring models of integrated health and social services, enhancing care transitions between settings and sectors, developing housing support options, expanding self-management support, and redesigning community care and payment systems to improve care coordination and reduce system utilization.
This document discusses managed care and group medical practices. It describes how group practices can provide benefits to both physicians and patients by sharing resources and responsibilities. However, it also notes potential disadvantages like less choice for patients. The document also examines the development of health maintenance organizations (HMOs) and how they aim to contain costs while providing comprehensive care. However, HMOs have been criticized for potentially limiting access and quality of care in some cases. The appropriate level of control managers should have over clinical decisions compared to physician autonomy is also debated.
Delivered by Prof Frances Ruane, Chairperson of the Expert Group on Resource Allocation in the Health Sector, Executive Director of the ESRI at the IPHA Annual Meeting 2010.
The document discusses key aspects of evaluating healthcare system performance based on three criteria: quality, equity, and efficiency. Quality is assessed by examining structure, process, and outcomes at both the clinical and population levels. Equity looks at fair access and treatment across groups. Efficiency aims to deliver services at minimum cost. Data and health information technology are critical to comprehensively measure performance over time on a national scale.
Dr. Salma Burton's presentation outlines the six key building blocks of an effective health system: 1) service delivery, 2) health workforce, 3) health information systems, 4) medical products/vaccines/technologies, 5) health financing, and 6) governance. Each building block plays an important role in ensuring people have access to safe, effective, and quality health services. Strong leadership and coordination across these areas through a systems thinking approach can help improve overall population health outcomes.
The purpose of this briefing is to help you to identify the immediate priority actions to commission effective end of life care.
Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013
1115 aine carroll clinical leaders forum nhc integrated care turning healthca...investnethealthcare
This document summarizes a presentation on integrated care given at the National Healthcare Conference in 2015. It discusses different types of integrated care including horizontal, vertical, and within sectors. Integrated care aims to provide coordinated services across providers and settings to support patients. Barriers to integrated care include fragmentation, distrust, and lack of coordination between strategy and operations. National clinical programs in Ireland have led to improved outcomes for conditions like heart attacks, surgery, and stroke through more integrated models of care. However, challenges remain around resources, hierarchies, and fully implementing integrated approaches across the healthcare system.
Question of Quality Conference 2016 - Patient Experience - Innovation in pati...HCA Healthcare UK
The South Somerset Symphony Programme is one of nine Primary and Acute Care systems (PACs) Vanguards born out of Simon Stevens’ Five Year Forward View. To address the problems of an ageing population and an increased burden of long-term conditions, it is essential to have a coordinated response across sectors, putting the patient at the centre of care. The session will look at a joint venture that will hold a single budget for the population and how this enables them to target resources to parts of the system where they can make the most difference to patients.
The document discusses primary health care (PHC) and its importance in the Canadian health system. It outlines the key principles of PHC, including accessibility, public participation, health promotion, appropriate technology, and intersectoral cooperation. While primary care focuses on clinical services and treatment, PHC takes a more holistic approach to consider various social and environmental factors that influence health. The Canadian Nurses Association has advocated for a health system based on PHC and involved nurses in various initiatives to better integrate PHC in practice.
Guidance for commissioners of services for people with medically unexplained ...JCP MH
This guide is about the commissioning of comprehensive MUS services across the healthcare system. In developing this guide, we recognise that ‘medically unexplained symptoms’ is an unsatisfactory term for a complex range of conditions.
MUS refers to persistent bodily complaints for which adequate examination does not reveal suf ciently explanatory structural or other specified pathology. The term MUS is commonly used to describe people presenting with pain, discomfort, fatigue and a variety of other symptoms in general practice and specialist care. Whilst recognising that the phrase ‘medically unexplained symptoms’ can be problematic, it is nonetheless widely used, and an appropriate term to use in this guide.
This guide aims to: describe MUS and the associated outcomes: outline current service provision for MUS and detail the components of a high quality comprehensive MUS service, and highlight the importance of commissioning comprehensive MUS services.
The impact of New Models of Care on a Health Economy’s Digital StrategyHIMSS UK
This document discusses the key digital implications of new models of care on a health economy's digital strategy. It presents a case study of the Croydon Accountable Provider Alliance (APA) in the UK. The three key digital implications discussed are:
1) Organizational form and governance - The new model of care requires a shared governance structure and independent project management to achieve digital ambitions.
2) Interoperability - The model requires a fully interoperable electronic health record that can be shared across providers and with patients. Options for integration platforms are considered.
3) Analytics - A culture of data-driven decision making is needed. Joint business intelligence services and a focus on population health analytics can improve
Jacquie White, Deputy Director of NHS England Long Term Conditions, Older People & End of Life Care and Dr Eileen Pepler, Academic, Researcher and Consultant in the Canadian Healthcare will discuss how NHS England work in chronic disease is being translated into a Canadian context.
The document discusses the current high demand for urgent and emergency care services in the UK healthcare system. It notes there are over 100 million calls or visits to urgent and emergency services annually, placing strain on the system. It proposes developing community-based integrated care as an alternative to reducing pressure on hospitals. This would involve coordinating various services like general practice, nursing, social care, and hospitals to provide more coordinated care outside of the hospital setting. It also discusses challenges in implementing such a system, like payment reforms, information sharing across organizations, establishing measures of an integrated system, and shifting some workforce skills to this new model of care.
This document discusses Elder Medical, a division of IPC Healthcare that provides elder care services across the continuum of care. It outlines Elder Medical's focus on personalized medicine through risk assessment, prevention, early detection, accurate diagnosis, targeted treatment, disease management, and seamless information sharing. The document discusses the growing elder population and increasing prevalence of chronic diseases as attractive markets. It also discusses integrated delivery networks and partnerships that can improve coordination of care, reduce costs, and increase quality. The role of Elder Medical in providing medical management and care coordination for post-acute care facilities is highlighted.
Transforming Primary Care through the development of Primary Care Networks – ...NHS England
The document discusses transforming primary care in the UK through the establishment of primary care networks (PCNs). It notes that the changing health needs of the population are putting pressure on the health system, with an aging population and rise in chronic conditions. While services are fragmented, the NHS Long Term Plan aims to develop integrated care systems with PCNs as the foundation. PCNs will comprise groupings of clinicians serving populations of 30,000 to 50,000 people, in order to provide proactive, accessible, and coordinated primary and community care at scale. The plan provides funding for PCNs to expand multidisciplinary teams.
Integrated health & social care: service transformation supported by technolo...flanderscare
The document provides an overview of integrated health and social care in North Kent, including:
1) It discusses the complexities of the current health and social care system in Kent and past pilots using telehealth and telecare that demonstrated benefits like reduced admissions and costs.
2) It outlines the current agenda around the Pioneer Programme and Better Care Fund aimed at integrating services.
3) North Kent's approach focuses on transforming services to promote independence, provide the right care in the right place, and deliver seamless integrated care for those with complex needs through measures like shared care plans and integrated primary care teams.
Nick Goodwin: making a success of care co-ordinationThe King's Fund
Nick Goodwin, Chief Executive at the International Foundation for Integrated Care, looks at how care could be better co-ordinated around people with complex needs, and the challenges around delivering joined-up care.
Practical considerations in enabling new models of care, pop up uni, 10am, 3 ...NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Using models-of-care-to-understand-the-impact-of-networks-of-care-for-lt csNHS Improving Quality
The document discusses using models of care to understand the impact of networks of care for long term conditions. It describes a patient-centered "House of Care" framework for delivering coordinated care to people with long term conditions. The House of Care aims to provide person-centered care that addresses all of a patient's needs at both the local level, through integrated systems involving health, social care and other services, and at the personal level through care planning and self-management support. Implementing the House of Care framework could save the NHS money by reducing unplanned hospital admissions and empowering patients.
Long term conditions like diabetes place a large burden on healthcare systems. A study in Yorkshire examined experiences providing care for long term conditions. It found that telehealth interventions can reduce hospital admissions, bed days, and costs while improving patients' quality of life. The Whole System Demonstrator Programme trial of telehealth and telecare in various UK regions showed a 45% reduction in mortality rates and 20% fewer emergency admissions among other benefits. Telehealth represents an opportunity to deliver more specialized care while reducing strain on hospitals and caregivers.
The document discusses increasing patient participation in their treatment and care through personal health budgets. It provides evidence that activating patients through shared decision making, self-management support, and personal health budgets can lead to better health outcomes and lower costs. The presentation outlines plans to expand personal health budgets for those with long-term conditions in accordance with NHS objectives. It highlights early positive results from personal health budget trials showing improved quality of life and independence.
Using simulation to drive changes in health and care - long term conditions Year of Care model
Bev Matthews and Claire Cordeaux
Presentation from Day 1 of the Health and Care Innovation Expo 2014, Manchester Central
The document summarizes a social prescribing program in Rotherham that aims to reduce hospital admissions and support patients' non-medical needs through community services. Key points:
- The program refers patients identified as at high risk of hospitalization to voluntary community services through case management.
- An evaluation found the program achieved a 7-17% reduction in hospital admissions and emergency department visits among participants. Greater reductions were seen for those who engaged more and were under age 80.
- Participants also experienced improved mental health and well-being. The program provides an estimated return on investment of 43 pence to £1.98 for every £1 invested through reduced healthcare costs.
- Stakeholders see the program as
Newbury Call to Action slides - 5 March 2015BerksWestCCGs
The document discusses plans to transform primary care in Berkshire West CCGs to meet the challenges outlined in the NHS Five Year Forward View. Key points include: developing new models of coordinated care across primary, community, and social care; transforming primary care through increased access and a focus on admissions avoidance; and greater emphasis on public health and improving mental health services. The refresh will focus on hospital services, urgent care systems, and integrated out-of-hospital care.
The document discusses integrated care and the transition from a non-system to a system of care. It emphasizes several key points:
1) Currently, care is fragmented, uncoordinated, and episodic with providers working in isolation and multiple points of entry. Integrated care involves coordination, collaboration, continuity of care and a long-term relationship with patients.
2) Barriers to integration include a lack of referral systems, communication between providers, and continuity of personal care. Integrated systems involve multidisciplinary teams working together towards shared goals of improving patient health.
3) The core components of successful integrated care strategies include defined patient populations, aligned financial incentives, use of data and guidelines, effective leadership,
The document discusses issues facing the UK NHS healthcare system including rising costs, an aging population creating greater demands, antibiotic-resistant superbugs, and a need for improved long-term management of health problems. It notes the NHS spends over 80% of GDP but will need £65 billion more by 2030. Current issues include overloaded A&Es, a disconnect between health and social care, and a failure to implement past reforms to transform the delivery model. Proposed changes center on prevention, personalized services, reducing inequalities, and integrating health and social care.
Developing Networks of Care through Long Term Conditions Year of Care Commissioning & Long Term Conditions Improvement Programmes
Bev Matthews
Programme Lead for Long Term Conditions @Bev_J_Matthews
Presentation from the Tackling Long Term Conditions conference on 29 October 2014
John Gillies: Health and Social Care Integration in Scotland 2018STN IMPRO
The document discusses health and social care integration in Scotland. It provides background on the Scottish population and healthcare system. The key goals of integration are to support people living independently at home, provide positive experiences of care, and design services around individual needs rather than organizational structure. Integration partnerships aim to improve outcomes such as quality of life, reducing inequalities, and supporting carers through coordinated primary, community and social care services.
Right Care Overview and National Roll Outian.mckinnell
1. Right Care is an approach developed by NHS England to maximize value in healthcare by helping health systems identify wasteful spending and redirect resources to more effective interventions.
2. It does this through a methodology involving clinical leadership, data analysis, engagement, and processes to design optimal care pathways focused on patient populations rather than just individual patients.
3. The goal is to deliver more efficient and sustainable healthcare through reducing unwarranted variation in spending and outcomes across different regions and conditions.
Similar to CMS Measures Forum - Chronic Disease (20)
Testing the impact of policy decisions using simulationSIMUL8 Corporation
With many factors and risks to consider, identifying the impact of policy change can be a challenge.
Learn why simulation is used to make evidence-based policy decisions, improve program outcomes and deliver services more efficiently to the public.
Using real-life examples from healthcare to smart cities, Tom Stephenson shows the benefits of using simulation for evaluating policy changes.
In this webinar session, Dr Tracey England, Mathematical Modeller and Research Fellow at ABCi, shared three case studies of how simulation software has supported healthcare improvements at Aneurin Bevan University Health Board.
Learn how Memorial Health System have utilized simulation to answer facility planning questions – saving unnecessary costs, avoiding delays in construction, and improving patient safety and satisfaction.
Graham Prellwitz and Lance Millburg discuss the benefits of using SIMUL8 for validating healthcare facilities ahead of finalizing building plans and construction.
In this on-demand webinar session, you'll learn 4 recommendations for successful simulation projects and see how these have been applied across a range of planning projects.
Tom Stephenson from SIMUL8 Corporation gives a presentation on improving laboratory flow with simulation. He discusses how simulation can be used to test improvements, assess the impact of new machinery, optimize layouts, and understand how systems will cope with demand changes. Common uses of simulation for laboratories include evaluating new equipment purchases, assessing total laboratory automation, and testing different layouts and demand scenarios. Case studies are presented on comparing tissue processors and simulating an automated laboratory and its impact on patient flow.
Merging Cath Labs: Using simulation to design a solution and understand the i...SIMUL8 Corporation
Learn how Boston Scientific used simulation to test the impact of merging Cath Labs from two different sites in a Canadian hospital.
In this live webinar session, Boston Scientific's Yixin Wang will discuss how simulation formed a key part of the change process, engaged clinicians and administrators in the redesign, and ensured consensus on the best solution.
You'll learn how the teams worked together to understand the complexities of future demand from the local population, procedure types and timings, staffing, scheduling, as well as determining the optimum design for the combined unit.
In highly congested hospitals it may be common for patients to overstay at Intensive Care Units (ICU) due to blockages and imbalances in capacity.
Watch the webinar in full at: https://www.simul8healthcare.com/case-studies/releasing-icu-bed-capacity
Reece Holbrook, Technical Fellow at <b>Medtronic</b>, discusses how simulation is being used to turn available data from clinical trials into actionable insights for hospital electrophysiology lab managers. Watch the webinar in full: https://www.simul8healthcare.com/case-studies/medtronic-bringing-data-to-life
Simulation modeling of pre/post bed needs for an Interventional PlatformSIMUL8 Corporation
Architect Frank Zilm discusses how simulation software was used to explore the implementation of an interventional platform concept, integrating surgery, cardiac procedures, interventional radiology and endoscopy services, at Saint Louis University Hospital.
Redefining the care team to meet Population Health objectivesSIMUL8 Corporation
Dr. Phil Smeltzer from The Medical University of South Carolina demonstrates an interactive simulation that helps physicians adopt a population health mindset.
In the third webinar of the series, Max builds on the example simulation in Sessions 1 & 2 and shows how you can control the simulation using spreadsheets, and how to link Excel to the simulation. Find out more at: http://www.SIMUL8.com/the-complete-guide-to-simul8-success
This document summarizes Webinar 2 from a series on using SIMUL8 simulation software. The webinar focuses on adding complexity to simulations by covering labels to identify mixed products, using probability profiles to control product mixes, and modeling changeover times between different products. The agenda also previews upcoming webinars on custom reports and controlling simulations from spreadsheets.
Improving Eye Care Outpatient Services with SimulationSIMUL8 Corporation
David Southern and Dr. Eren Demir of Pathway Communications demonstrate how simulation used to forecast demand and improve the clinical management of retinal diseases.
The first webinar in the series, "The Complete Guide to SIMUL8 Success." Max Guild talks us through how to get results fast using SIMUL8. Full webinar recording: http://simul8.com/the-complete-guide-to-SIMUL8-success-webinars
The document describes a simulation project called SIMTEGR8 that was conducted to evaluate the impact of interventions from the Better Care Fund on emergency admissions in Leicestershire, UK. The project used simulation modeling to assess four integrated care pathways and provide recommendations. Workshops were held with stakeholders and patients to discuss the pathways and identify issues. The findings from the project informed local commissioning of integrated care under the Better Care Fund.
Lance Millburg, Senior Lean Six Sigma Project Manager talks us through how Memorial Health System built their simulation team from the ground up into a nationally recognized program in 2 years.
This document summarizes a guest lecture on simulation modeling. The lecture covered:
1. An introduction of the speaker and their background in healthcare, Lean Six Sigma, and simulation.
2. Examples of how variability in arrival and service times can impact waiting times, even when average arrival and service rates remain the same.
3. An overview of what simulation is and when it is useful to use, such as when averages are not sufficient, processes are complex, and testing changes without implementing them for real.
4. Examples of how simulation has been used for call center optimization and airport terminal modeling projects to reduce costs and improve customer experience.
From Cars to Calls - Expanding the Limits of SimulationSIMUL8 Corporation
Sander Vermeulen presented a session with Ford Motor Company’s Capacity Manager Supervisor Tom Woods at MSUG 2015 about using simulation in other areas in your manufacturing organization. They discussed the use of simulation within contact center projects and looking at the specific examples of improving your support desk.
BED MAKINGIt is the techniques of preparing different types of bed in making assuser3155141
DEFINITION
It is the techniques of preparing different types of bed in making a patients\clients comfortable or his\her position suitable for a particular condition.
Database Creation in Clinical Trials: The AI AdvantageClinosolIndia
The use of AI in creating and managing databases for clinical trials offers significant advantages, transforming how data is collected, managed, and analyzed. Here are the key benefits and approaches of leveraging AI in this context
Left Atrial Appendage Closure Devices Market by Product Type, Distribution Ch...IMARC Group
The global left atrial appendage closure devices market size reached US$ 1.5 Billion in 2023. Looking forward, IMARC Group expects the market to reach US$ 6.3 Billion by 2032, exhibiting a growth rate (CAGR) of 16.85% during 2024-2032.
More Info:- https://www.imarcgroup.com/left-atrial-appendage-closure-devices-market
August 2024. Smart hospitals use advanced technologies like the Internet of Medical Things (IoMT), AI, ML, NLP, and blockchain to improve efficiency, sustainability, and patient experience. Smart hospital applications include electronic health records (EHR), telemedicine, and MHealth. Smart and sustainable hospitals offer many benefits, like enhanced care, cost savings, and pollution reduction. However, challenges like high electricity consumption and cyberattack vulnerability exist. To overcome these, smart hospitals must adopt energy-efficient technologies, use renewable energy, and enhance cybersecurity. In this slideshow, you will learn about the definition, benefits, challenges, sustainability strategies, UN policy, and global statistics of smart hospitals and smart healthcare.
TEST BANK For Carolyn Jarvis, Physical Examination and Health Assessment 4th ...rightmanforbloodline
TEST BANK For Carolyn Jarvis, Physical Examination and Health Assessment 4th Canadian Edition 2024 Verified Chapters 1 - 31.pdf
TEST BANK For Carolyn Jarvis, Physical Examination and Health Assessment 4th Canadian Edition 2024 Verified Chapters 1 - 31.pdf
TEST BANK For Carolyn Jarvis, Physical Examination and Health Assessment 4th Canadian Edition 2024 Verified Chapters 1 - 31.pdf
Management of materials and finance hospital pharmacysibirajpharmdoff
Definition:
It is concerned with the planning, organizing & controlling the flow of materials from their initial purchase through internal operations to the service point through distribution
Aims of material management:
The right quality
Right quality of supplies
At the right time
At the right place
For the right cost
CYLIC MEDITATION - STRESS MANAGEMENT CORPORATE YOGA
Step-I: Starting Prayer
• Lie on your back. Relax and collapse the whole body on the ground legs apart, hands apart, palms facing the roof, smiling face, let go all parts of the body. As you repeat the prayer feel the resonance throughout the body.
Prayer
Laye sombhodayeth chittam
vikshiptham shamayeth punaha
sakaashaayam vijaneeyat
Samapraptam na chalayet
Om shaanti shaanti shaantihi
Meaning: In the state of oblivion awaken the mind, when agitated pacify it, in between the mind is full of desires. If the mind has reached the state of perfect equilibrium, then do not disturb it again.
Step-II(A): Immediate Relaxation
• Bring your legs together, join the heels, toes together, palms by the side of the thighs. Keep your face smiling till the end. Gently bring your awareness to the tip of the toes. Stretch the toes, tighten the ankle joints, tighten the calf muscles. Pull up the kneecaps. Tighten the thigh muscles. Compress and squeeze the buttocks. Exhale and suck in the abdomen. Make the fists of the palms and tighten the arms. Inhale and expand the chest.
Positive Parenting: Raising Happy, Confident Children | UCSinfo513572
This presentation explores Positive Parenting: strategies, benefits, and how United Community Solution (UCS) classes empower parents with expert guidance, interactive learning, and support to raise happy, confident children. Read more: https://unitedcommunitysolution.com/service/parenting-classes/
Dawn of new Era: Digital Human, Agentic AI, and Auto sapiensJAI NAHAR, MD MBA
This interactive talk focuses on Intelligent Digital
agents, Digital human, and Embodied agents, which
are important emerging applications of Generative AI
in 2024 and beyond.
Cost-Effective Hospital Marketing Strategies Maximize your reach without Brea...HMS Advisors Pvt Ltd
In today's competitive healthcare landscape, effective marketing is essential for attracting and retaining patients, but budget constraints can make extensive campaigns challenging. This article explores affordable marketing solutions to help healthcare providers maximize their reach without breaking the bank.
Concerned About HIV or STDs? Get Tested in Dubaigettestedqwik
Worried about your health? It’s important to get tested for HIV and STDs to ensure your well-being and peace of mind. In Dubai, you have access to confidential and reliable testing services. Here's why you should get tested:
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https://www.biomedscidirect.com/journalfiles/IJBMRF2024345/prevalence-and-drug-susceptibility-of-e-coli-campylobacter-and-citrobacter-from-the-eggshell-surface-of-table-and-hatchable-eggs-in-lahore-pakistan.pdf
Authors: Muhammad Danish Mehmood, Shan E Fatima, Huma Anwar Ul-Haq, Rabia Habib, Muhammad Usman Ghani
Int J Biol Med Res. 2024; 15(3): 7825-7832
Abstract
Eggs, a staple food consumed globally, are at risk of contamination, posing a severe threat to their safety and quality. The bacterial load on the eggshell surface is crucial in predicting bacterial penetration and egg interior contamination. Exposure to nesting material and faecal matter can introduce egg-borne pathogens, some of which can lead to food-borne illnesses. The global scale of epidemics caused by egg-borne pathogens underscores the criticality of egg safety. A comprehensive study was conducted in Punjab, Pakistan, to assess the potential risk of contamination. A total of 360 eggs from various breeds of hens were tested and categorized as unclean, soiled and clean. The bacteria Salmonella, Proteus and Staphylococcus were isolated from the eggs. The highest percentage of isolates were found in unclean eggs: Salmonella (26.7%), Proteus (24.5%) and Staphylococcus (33%). In soiled eggs, the highest percentage of isolates were Salmonella (22.6%), Proteus (17.6%) and Staphylococcus (10.9%). In cleaned eggs, Proteus showed the highest prevalence (15.5%), followed by Salmonella (10.3%) and Staphylococcus (9.4%). The antibiotic susceptibility test (AST) results showed that all bacterial isolates were sensitive to the drugs Ofloxacin (5 µg/ml) and Cefotaxime (30 µg/ml). However, Staphylococcus and Proteus also showed sensitivity to Trimethoprim + Sulphamethoxazole (2.25/23.75 µg/ml). The study aimed not only to raise awareness about the importance of egg safety and identify the most common pathogens found on eggshells but also to develop effective strategies to reduce the risk of contamination of eggs and egg products. Once implemented, these strategies will ensure the safety and quality of this essential food source, offering a promising solution to the current challenges.
BURNS, CALCULATION OF BURNS, CALCULATION OF FLUID REQUIREMENT AND MANAGEMENT.pdfDolisha Warbi
Nursing assessment of burns, Rule of nine,calculation of fluid by Parkland formula, Brooke formula and Evan's formula, Definition of Burns, causes of burns, classification of burns, pathophysiology of burns, clinical manifestation, Diagnostic evaluation, medical management, surgical management, nursing diagnosis, nursing management, phase of burn care, first aid, complication of burns.
A price that is appropriate for massage therapy enables cost-effective healthcare access. If such treatments cost is low, it would provide more individuals with an opportunity to enjoy frequent massages which are crucial in relieving anxiety and pain. Because it is cheap, individuals may incorporate such treatments in their healthcare lifestyles without having to be concerned about how much they spend on themselves. At Malayali Kerala Spa Ajman, we are providing all types of massage services @ 99 AED. Visit us today.
Shrouk form zewail academy17 زويل د حاتم البيطار تغذذية علاجية.pdf
CMS Measures Forum - Chronic Disease
1. Population Health Planning in
Chronic Disease:
Measuring the impact of applying a capitated budget for
people living with multi morbidity in NHS England
CMS Measures Forum
May 19, 2016
Jacquie White
Deputy Director for LTC, Older People
& End of Life Care
NHS England
Claire Cordeaux
Executive Director
SIMUL8 Corporation
2. Objectives
The webinar will focus on how the National Health
Service (NHS) in England, UK have been implementing
person-centered care for people with Long Term
Conditions (LTCs) and in particular multi-morbidity.
It will cover:
• The concept and the change programme
• Whole population analysis and identification of target
populations
• Financial instruments to facilitate change
• Models of delivery to support person centred outcomes
• How simulation models have supported decision-making,
and will include a demonstration of simulation models
3. Who are we? NHS England
• Established 1948 to provide good healthcare to all regardless of wealth.
• Free at the point of delivery
• NHS England serves a population of 53.9 million, seeing 1 million patients
every 36 hours and employs more than 1.3 million people including the
following clinical groups:
• 40,236 primary care physicians
• 351,446 nurses
• 18576 ambulance staff
• 111,963 hospital and community health service, medical and dental staff.
• Funding for the NHS comes directly from taxation. For 2015/16, the
overall NHS budget was around £116.4 billion. NHS England is managing
£101.3 billion
• Reformed in 2013 and underpinned by the Health and Social Care Act
2012, the “Five Year Forward View” is the national strategy for healthcare
in England and sets out the system transformation required to meet the
changing needs of current and future patients. Person-centered care is a
key part of the strategy.
4. Who are we? SIMUL8 Corporation
• Established 1994
• Business simulation software
worldwide
• Specialists in health and social care
• Combine healthcare knowledge and software development
to create sector-wide tools
• Close working with NHS since 2008
5. Setting the Scene: Global Changes
Increasing demand for healthcare
• Rise of long term conditions and multi-morbidity: physical
and mental
• Ageing population
• Increasing expectations: access, treatment, cure not care
Supply pressures
• Dependence on system
• Hospital and medic-centric care models
• Workforce – recruitment & retention, ageing, diversity and
culture
• Fragmentation of care in health and to social care
• Crisis curve – late identification of people needing support
6. The Patient at the Center?
A man being treated for heart
failure in UK primary care
rejected the offer to attend a
specialist heart failure clinic to
optimise management of his
condition. He stated that in the
previous two years he had made
54 visits to specialist clinics for
consultant appointments,
diagnostic tests, and treatment.
The equivalent of one full day
every two weeks was devoted to
this work.
BMJ 2009;339:b2803
7. The NHSProgram: the priorities
• Empowering patients and informal caretakers to be full
partners in care
• Whole person focus
• Life course approach to care needs
• Strengthening Primary and Community Care
• Older people with increasingly complex needs including
frailty
• New care models moving away from purely medical,
hospital-centric focus
• Strengthen key enablers – IT, Workforce, Technology
• Need for a new purchaser/provider/funding model
8. The Person at the Center: Changing the
Language Changes Culture
Patient > Person
Chronic Disease > Long Term Conditions
List of Needs > Whole Person
Integrated Care > Coordinated Care
Changing the language helped to reinforce the different behaviours
needed to implement change
9. Long Term Conditions (LTC):
House of Care
NHS Commissioning:
Planning and Paying for
Services for a Population
10. Person-centered Outcomes
Better Health for the
Population
• Access
• Clinical outcomes
• Co-ordination
• Transitions of care
• Urgent care response
Better Care for
Individuals
• Experience of care
• Quality of life and
death
• “Activation” levels
• Goal achievement
Lower Cost Through
Improvement
• Acute care
• Residential care
• Shifts in spend
11. Outcomes and Benefits
• More activated patients have 8% lower costs in the base year and 21%
lower costs in the following year than less activated patients
• Health coaching can yield a 63% cost saving from reduced clinical time,
giving a potential annual saving of £12,438 per FTE from a training cost
of £400
• Coaching and care co-ordination has shown to reduce emergency
admissions by 24%
• Improved medication adherence improves outcomes and yields
efficiencies, for instance in 6000 adults in the UK with Cystic Fibrosis,
could save more than £100 million over 5-years
• Between 20% and 30% of hospital admissions in over 85’s could be
prevented by proactive case finding, frailty assessment, care planning
and use of services outside of hospital
14. Research on People with
Multi-Morbidity
• Research shows that of people with chronic disease, a
third have more than one
• On this basis we should be planning for the needs of
the person, rather than focussing on the single disease
• The following slide shows a graph illustrating this
18. Risk Stratification:
Selecting the cohort
• There are many techniques that
can be used to segment a
population.
• Different segmentation methods
select different people - the
method used should match the
outcomes required
• IT-based intelligence should be
supplemented with humanistic
intelligence
• People in the cohort still need to
be assessed to determine
suitability for inclusion and before
a care plan is developed and
services delivered.
19. Changes in risk profiling over time
Crisis Curve:
• Selected individuals with the most complex care needs demonstrate a
‘crisis curve’ (cost curve).
• They enter a period where they need more non-elective acute care, and
then their health stabilizes.
Death within 12 months:
• A large proportion of individuals selected with the most complex care
needs die within a year of selection – up to 35% of individuals with risk
scores within the top 0.5%
Both of these factors reduce when using multi-morbidity to select the cohort.
Conclusion:
• Risk scores measure historical needs, rather than future needs
• Multi-morbidity appears to select a more stable patient cohort
20. People with Complex Health and Care
Needs Appear to Demonstrate a ‘Crisis
Curve’
22. And…
People living longer but not always well
The larger the number of co-morbidities a patient
has, the lower their quality of life
Increasing evidence on over-treatment and
harm
Social isolation/loneliness a risk factor for
mortality in people over 75 and should be
supported as a co- morbidity
23. What if we set a Capitated
Budget to Facilitate Spend on
Individual Needs rather than
Healthcare Organizations?
25. Emerging Delivery Models
The service models being developed by our sites are
essentially similar but differ to match local conditions.
Similarities include:
• Single point of access
• Care planning and shared care record
• Supported self management
• Care co-ordination
• Community multi-disciplinary team based around primary care,
• Wider neighborhood support including specialist practitioners, therapists
• Recovery, Rehabilitation and Reablement “services”
• Care navigators and voluntary sector as a key enabler.
Differences include:
• Whole population or selected cohorts
• Formation of new organizations
• New delivery models within and across existing organizations
26. Capitated Budgets
Overall aim is to include all services and total cost of care for
cohort with the purpose of incentivising providers to work
together to deliver person centred co-ordinated care
The main issue for setting credible capitated budgets is the management
of risk. Financial risk results from:
• Poor data quality – some services might not be included within the capitated budget if
data quality results in poor budget estimates
• Changes in the use of care over time by selected patients – selection method
important
• Potential for double payment – IT systems and information flows are needed to
support the capitated budget
Changes in the budget need to be managed because:
• The patient cohort will change as individuals die or leave the area and new patients
join
• The needs of individuals will change as their health and social circumstances change
• The patient cohort may grow as more individuals who may benefit from integrated
care are identified
27. Contracts
Contracts are more about relationships than legality.
Currently NHS organisations are constrained to use the NHS
standard contract, but alternative agreements can be used in
parallel with this contract.
There are many contracts being explored and tested by the teams. The
most common are the:
• Alliance contract – requires exceptional relationships between all stakeholder
because all decisions need to be joint decisions
• Prime provider contract – shifts control and management of relationships to
another organisation (who will then need to set up sub-contracts)
• Development of accountable care organisations – organisationally aligning care
Performance monitoring of the contract is based on outcome metrics,
developed by patients, care practitioners and finance with all organisations
accountable for all outcomes.
28. The Total Health and Social Care Cost is
Strongly Related to Multi-morbidity
35. Results from a Simulation:
What is the Cost of a Patient Each Year?
36. How do Patients Typically use Services,
What is the Cost and what Resource is
Needed:
Emergency Department Example
37. Person-Centered Care Example:
Extensivist Care and Enhanced Primary Care
• 1.6% of the population assessed as in need of extensive
support
• Person-centered model includes:
• All care co-ordinated by a clinician
• Regular contact with a health and wellbeing support worker to
ensure referral to relevant services
• Patient activated
• Reduces hospital emergency and planned visits
• 36% of population receiving Enhanced Primary Care,
managed by Primary Care Physician with lighter touch:
• Health and wellbeing support
• Support for high intensity users
• Care Co-ordination
40. Using Simulation Results to:
• Discuss with stakeholders across organizational
boundaries
• Agree a capitated budget for each patient type
• Test the impact of a new model of person-centered
care to:
• Understand the RoI
• Understand financial and resource impact for each
provider
45. Simulation Benefits
Test before implement (no harm to patients)
Dissemination of practice and sharing of models of
care
Supports decisions where no historical data
Helps to formulate exact models of care and predict
impacts
47. National Support and Dissemination
• Virtual facilitation and improvement expertise
• Networking and learning...
• From each other, the early implementer sites
and national experts in various related fields
Through...
• Email updates
• Our website
• Facilitated Webinars with specialist input
• National workshops
• Coaching, facilitation and
improvement expertise
• Networking and
learning…From each other,
and national experts in
various related fields
• Programme funding to
support specific
developments e.g. data
analysis, testing delivery
models
• Simulation – capturing,
sharing and reusing
48. LTC Resources and Tools
NHS LTC program resources are available here:
http://www.nhsiq.nhs.uk/improvement-programmes/long-
term-conditions-and-integrated-care.aspx
49. Access to Simulations
Simulations and resources linked to the simulation can be
accessed at the following link.
http://www.SIMUL8Healthcare.com/chronic_disease