Quality improvement tools in disease management

Disease management programs require constant monitoring to assure quality and address problems efficiently. To initiate continuous quality improvement in a disease management program, there are several methods available to identify potential problems within the program that may be affecting quality. Some common quality improvement instruments include the Plan-Do-Check-Act model, check sheets, and so forth. Whatever model is used, Statistical Process Control using flow charts, histograms, Pareto diagrams, scatter diagrams, control charts, and cause-and-effect diagrams provides a better understanding about how the organization\u27s processes are functioning. These tools facilitate problem recognition and allow an organization to meet established standards of quality in the most economical manner

Measuring Motivation and Reward-Related Decision Making in the Rodent Operant Touchscreen System.

This is the author accepted manuscript. The final version is available from Wiley via http://dx.doi.org/10.1002/0471142301.ns0834s74This unit is designed to facilitate implementation of the fixed and progressive ratio paradigms and the effort-related choice task in the rodent touchscreen apparatus to permit direct measurement of motivation and reward-related decision making in this equipment. These protocols have been optimized for use in the mouse and reliably yield stable performance levels that can be enhanced or suppressed by systemic pharmacological manipulation. Instructions are also provided for the adjustment of task parameters to permit use in mouse models of neurodegenerative disease. These tasks expand the utility of the rodent touchscreen apparatus beyond the currently available battery of cognitive assessment paradigms.The protocols presented in this Unit were developed and optimized as part of a research program funded by Wellcome Trust grant 089703/Z/09/Z awarded to TJB and LMS. TJB and LMS also received funding from the Innovative Medicine Initiative Joint Undertaking under grant agreement n° 115008 of which resources are composed of EFPIA in-kind contribution and financial contribution from the European Union’s Seventh Framework Programme (FP7/2007- 2013). TJB and LMS consult for Campden Instruments Ltd

Seismic Imaging Of The Velocity Structure And The Location Of A Hydrofrac In A Geothermal Reservoir

The Los Alamos Hot Dry Rock Reservoir is an experimental geothermal project in north-central New Mexico. A fractured zone was created within otherwise impermeable igneous and metamorphic rock by injecting water into a borehole under high pressure, at about 3.5 km depth. During the injection process, the seismic waves created by the fracturing events were recorded by seismometers located in four nearby boreholes. A subset of the arrival times from these microearthquakes is iteratively inverted for the three-dimensional P-wave and S-wave velocity structures and the hypocenter parameters, using the separation of parameters technique. The inversion results indicate that the P-wave and S-wave velocities decrease by at least 20% within the fractured zone. Also, the hypocenters are rotated into a more compact distribution, elative to the initiallocations found using a homogeneous velocity model, suggesting that the hypocenter locations are significantly improved.United States. Dept. of Energy (Grant DE-FG02-86ER136360)Massachusetts Institute of Technology. Full Waveform Acoustic Logging ConsortiumPhillips Petroleum Fellowshi

Student radiographers' attitudes towards the older patient: a longitudinal study

Purpose: To design, implement and evaluate the effect of an educational intervention on student radiographer attitudes across their educational tenure. Methods: In the first phase, an educational intervention that involved didactic lectures, reflective exercises and simulation suits, aimed at improving student radiographer attitudes towards the older person, was designed and implemented. Kogan’s attitudes towards older people (KoP) scale was administrated at five test points; pre-intervention; post-intervention; 6 months post intervention; 12 months post intervention and 24 months post intervention. At the final test point these quantitative data was supplemented with qualitative data for triangulation of the findings. Results: Students held positive attitudes towards older people pre intervention, these increased significantly post intervention (p=0.01). However, this increase in positive scores was not noted at 6 months and 12-months post intervention. At 24-months post intervention, although there was a slight increase in positive attitudes when compared to the 6 and 12 month scores, this increase was not found to be significant (p=.178) Conclusions: The results post-intervention suggested that an educational intervention can have a significant impact on student radiographer’s attitudes towards older people. However, the qualitative data suggests that experiences on initial clinical placement can be detrimental to attitudinal scores, particularly if the intervention does not include Dementia care strategies

Describing an Active-Learning Patient Education Module to Promote Psychotropic Medication Adherence

Background: Active learning approaches may optimize classroom instruction by allowing students to think about, reflect on, and inquire about, the content relevant to their own experiences and learning. Methods: We reviewed the current literature in: motivational interviewing; active learning techniques; and, medication adherence methods/questionnaires. Our School of Pharmacy (SOP) and School of Professional Psychology (SPP) decided on the core disease state content to be presented within the patient education module (PEM). Results: Power-point slides were developed discussing: adherence; activities self-identifying adherence barriers; designing patient-specific adherence plans; medication safety; adverse drug effects; interactions; and, pharmacotherapy for bipolar, depression, anxiety and psychosis. Discussion: Participants will be referred to the pharmacist-taught PEM during the up-coming year and have the opportunity to follow-up with clinical psychologists, clinical pharmacists, nurse practitioners, and physician assistants for various services. Implications: Our PEM may help patients with limited resources within our community receive psychotropic medication adherence education. Such collaborative approaches may also spark proliferation of inter-professional practice models and research within our institution. Conclusion: Other schools and institutions with similar resources may mimic or adapt our PEM to implement within their own communities

Rethinking Brain Health

poster abstractProject Supervisor: Youngbok Hong “Safe And Effective Deprescribing of Anticholinergics (SEDA)” project, led by Regenstrief Institute and IU Center for Aging and Eskenazi, focuses on patient safety harms from medications with anticholinergic effects. Drugs with anticholinergic effects have been implicated in cognitive impairment in older adults. The Rethinking Brain Health research project was conducted in the course of Collaborative Action Research in Design. Our team adopted a people-centered design approach, aimed to develop a behavioral and cultural understanding of brain safety issues related to anticholinergic medication. At the beginning of the research, we identified the key stakeholders as patients, family and community support, caregivers, registered nurses, care coordinators, pharmacists, primary doctors, and geriatricians in order to understand the complexity of the problems from multiple perspectives and a systematic view. The poster identifies 3 different personas that exemplify the major characteristics from the patients interviewed such as their communication with their provider, the sources of support, and their quality of life. It also shows the relationship between the patient and providers. By using research methods, we were able to gain a contextual understanding of the behaviors and the needs of patients and caregivers. This gigamap poster serves as a tool to reveal the interconnectedness of the problems associated with the patients’ experience with anticholinergics from the perspective of both the patient and provider. A deep understanding of the problems associated with anticholinergics helped us to identify the opportunity areas as assisting the patients’ support system in playing an active role in health decisions, assisting the patient in taking ownership of their health decisions and developing a holistic approach to treatment options, and creating a better information system between providers. Framing the problems into opportunities allows the SEDA team to take the next appropriate actionable steps in identifying appropriate solutions

Correlation femtoscopy

The basics of correlation femtoscopy, recent results from femtoscopy in relativistic heavy ion collisions and their consequences are shortly reviewed.Comment: 10 pages, plenary review talk at Quark Matter 2005, 2 references adde