Day 2 :
Keynote Forum
Lori Garchinski
Regina Qu’Appelle Health Region, Canada
Keynote: Evaluation of the implementation of the medical surveillance unit
Biography:
Lori Garchinski is currently the Executive Director of Critical Care, Cardiosciences, Medicine Inpatient units and the Lead for the Provincial SMART IV Pump Program with the Regina Qu’Appelle Health Region. She graduated in 1989 from the University of Saskatchewan, College of Nursing with a Bachelor of Nursing with Distinction. She obtained her Master of Health Studies through Athabasca University in 2013 and completed her LEAN Leader training in March 2015. Lori started her career 28 years ago as a bedside nurse in an open heart, neurosurgical and trauma ICU. Through her career she has also held the role of Clinical Educator and Manager of the Surgical Intensive Care Unit, Manager of Orthopedics, and Director of the Cardiac Program all within the Regina Qu’appelle Health Region. Lori was the national president of the Canadian Association of Critical Care Nurses (CACCN) from April 2002 – March 2004 and served as a board member of CACCN prior to this term. She is currently finishing her Canadian Healthcare Executive program and enjoys the challenge that leadership provides. Lori has a passion for nursing, teaching and patients.
Abstract:
Background:
The Medical Surveillance Unit (MSU) was developed after an internal review supported the need for intermediate level of patient care, within the Pasqua Hospital in Regina, Saskatchewan. Minimal published Canadian literature describing such intermediate care units led the MSU through an 18 month evolution where models of care, staff education, and patient management strategies were developed. The purpose of this study was to examine the effects of MSU implementation on hospital-system and clinical outcomes, including: hospital length of stay (LOS), MSU LOS, 30 day hospital readmission, mortality, EARS scores, and AT scores.
Methods:
A retrospective chart review in a random sample of 298 patients was conducted examining the effects of MSU implementation on hospital-system and clinical outcomes.
Results:
Univariate analyses revealed several findings within 3 phases of implementation including: an increase in patient co-morbidities (p < 0.05), and improvements in hospital LOS (p <0.05), and MSU LOS (p < 0.001) between phases. The clinical documentation of the vital signs necessary to calculate an EARS score drastically improved from 15% in Phase 1, as the EARS tool was readily used by staff in later phases (p < 0.001). Lastly, the use of the AT in Phase 3 significantly increased the resource intensity of the patients admitted to the MSU in comparison to Phase 2 (p < 0.001).
Conclusion:
Results revealed that this model of care leads to important improvements in hospital-system and clinical outcomes. The replication of this model of high functioning surveillance should be considered across Saskatchewan and beyond.
Keynote Forum
Hifsa Altaf
Maries Stopes Society, Pakistan
Keynote: Healthcare innovation and its impact on quality of services in Pakistan
Biography:
Hifsa Altaf is a Public Health Professional with over 15 years of experience providing expertise in family planning and reproductive, maternal and community health. She has international field experience, primarily in Asian countries, working with leading reproductive health and family planning organization Marie Stopes Society (MSS), Pakistan.
She has earned Bachelors of Medicine and Surgery (MBBS), Masters in Social Sciences (MSc) Rural Development, Masters in Business Administration (Hospital & Healthcare Management), Certified Health Care Quality Professional (CHPQ) and Diploma in Hospital & Healthcare Management (DHHM), certification in Quality Improvement in Healthcare (England), certification in Humanitarian Crisis (England) and certification in Continuous Quality Improvement and Matrix (USA). As a General Manager she leads the quality component of the MSS Pakistan program along with supporting programs in London and other Asian countries.
Abstract:
The players in Healthcare System of Pakistan comprise public, private, formal, non-formal, traditional, modern with traditional, faith based and NGOs. The health seeking behavior depends on factors like cost, access, gender, trust, literacy and perceived quality. Quality healthcare has remained questionable even with the qualified healthcare providers, especially in case of reproductive health and ambulatory services. Private medical sector in Pakistan is currently providing 35% of total ambulatory out of pocket services; yet, quality is well below standards. Social franchising has emerged as an increasingly popular method of private sector healthcare service delivery across the developing countries. Social Franchise is a partnership system with private local healthcare providers to increase awareness, demand, access, choices and quality healthcare services to under-served poor communities. A research was conducted to see the impact of this network on provision of medical, emergency and reproductive health services in 20 remote areas of Sindh (Karachi, Hyderabad, Sukkur) and Punjab (Multan) where either the services were limited or non-existent. A sample 120 private healthcare providers was selected from both urban and rural Pakistan. Pretest, intervention and post-test method were used to compare a trained control group of service providers with un-trained one. The performance was assessed on two indicators i.e., knowledge and counseling skills as per the standard checklists. It revealed that training had markable improvement of 32% in both the skills of service providers. Client feedback revealed improvement in quality of healthcare services in terms of service delivery which was easy, affordable, safe, timely, friendly and with dignity. Thus the training and social franchise set-up had positive impact on the quality of health services to the target population with improved ambulatory services and reduced mortality and morbidity ratios in reproductive health in Pakistan.
Keynote Forum
Lauren Christy
Children’s Hospital of Pittsburgh of UPMC, USA
Keynote: A visit after a stay, keeps the doctor away: Decreasing readmission rates for pediatric patients
Biography:
Lauren Christy is currently a Nurse Unit Director for Children’s Hospital of Pittsburgh of UPMC, USA. She is pursuing her PhD in Instructional Leadership and Management at Robert Morris University in Pittsburgh, PA, USA.
Abstract:
A multidisciplinary team met in early 2015 to identify an innovative, proactive approach to decrease pediatric readmissions. The team included nurses, physicians, care managers, social workers and pharmacists. Strategies used in adult health care to decrease readmission rates were evaluated for pediatric implementation. An effective strategy identified in adult healthcare was a home visit after a hospital discharge. This strategy was chosen as a feasible approach due to an established relationship with a Medicaid provider. Post discharge home visits were not routinely ordered for pediatric patients. Collaboration occurred to ensure the routine home visit could be effectively operationalized and authorized by the insurer. The team identified a pediatric home care provider, who could accommodate the home services. In December 2015, home visits were implemented for inpatients that had Medicaid HMO. Excluded patients were those who previously had home care services or select diseases. Two-hundred and ninety seven (297) pediatric patients were authorized for a home visit in the first quarter. Of those patients, 159 were inpatient status and 138 were observation status. First quarter comparisons showed a 63% reduction in readmission rates from 18.16% in 2015 to 6.47% in 2016. Preliminary results from this project indicate the implementation of a pediatric home visit after discharge may reduce 30 day readmission rates up to 63%. A lower readmission rate may impact quality indicators and increase reimbursement to the hospital.
- Nursing Management | Nursing Education | Health care and management | Paediatric Nursing Cardiovascular Nursing | Telemedicine and e health | Psychiatric and Mental Health Nursing | Midwifery Nursing | Medicine
Location: Frederick Hall
Chair
Lori Garchinski
Regina Qu’Appelle Health Region, Canada
Co-Chair
Renae Dougal
Idaho State University, USA
Session Introduction
Vivien Rodgers
Massey University School of Nursing, Newzealand
Title: What matters most for satisfaction with person-centred care in residential aged care: Resident, family and staff perceptions
Biography:
Vivien Rodgers is an widely-exprienced Registered Nurse. Initial training in Australia preceded clinical, management, academic and research experiences in surgical, maternity, primary health and gerontology settings, in Australia, Malaysia, Singapore and New Zealand. Her published research includes nurse-education and gerontology topics. Vivien has presented at national and international health conferences, and keynote speaker at national organisation gatherings. Her most recent work involves research support for improving the uptake and quality of palliative care into residential aged care practice in regional New Zealand. Vivien received her PhD from Massey University in 2016.
Abstract:
A rapidly ageing population together with increasing life expectancy has led to an escalating need for residential aged care services in New Zealand. While successive governments have encouraged ageing in place, the complex health needs of the oldest-old require greater levels of care/support than can be safely provided at home. Provision of opportunities for person-centred care is a major quality indicator for aged care services, however, little is known about its relative importance to stakeholders. Differing perceptions may lead to dissonance between levels of satisfaction with care provision. The study reported systematically compared how different stakeholders (residents, family, staff) in a facility instituting Eden principles, perceive the factors that matter most to care experienced in residential aged care. A cross-sectional survey design was used to distribute Eden Warmth Surveys (EWS) to residents (EWS-R), residents’ family members (EWS-F) and staff (EWS-S) of a large residential facility in New Zealand. Results were analysed independently and then compared across groups. Each stakeholder group reported different factors as most important to their satisfaction with care provided. Residents were most concerned with relationships with staff; family members considered involvement in organized activities the priority. Staff reported time and resources as the most important factor in providing quality care. Perception varied across stakeholders. For effective, ongoing change to occur in the quality of care opportunities available to ageing residents, the shape and importance of this to the older people themselves must be the initial indicator. The emphasis on resident-staff relationships cannot be ignored.
Homeira Khoddam
Golestan University of Medical Sciences, Iran
Title: Applicable knowledge is the missed element of implemeting knowledge into nursing practice
Biography:
I have completed my PhD in Nursing at the age of 49 years from Iran University of Medical Sciences. I did my thesis on Developing a Model of Knowledge Translation. I spent my sebbatical at the University of Adelaide, School of Nursing, Austrailia under supervision of Professor Alison Kitson. I am assisstant professor of Nursing and Midwifery School and the member of Nursing Research Center of Golestan University of Medical Sciences. I have published more than 20 papers in reputed journals. I have been working as an Editorial Board of Gorgan Medical journal scince 2001.
Abstract:
The content and quality of knowledge to be implemented and using strategies to transfer it are significant elements of successful implementation of knowledge into practice.we did the study to determine the antecedents of knowledge translation in Iran nursing in terms of knowledge.
A qualitative content analysis was conducted to analyze the text of interviews. Participants of this study were 9 expert people in producing and using nursing knowledge in Iran. After transcribing the recorded files, data was processed by using the Qualitative Data Analysis software (MAXQDA). Applicable knowledge was the main theme which emerged from the data. Refining the content of research knowledge, revising the process of producing knowledge and using the proper strategies to transfer the knowledge were three subthemes which forms the main theme. Based on evolved categories, refining knowledge means try to conduct research which produces valid, user-oriented, context based meaningful and timely knowledge. In fact, producing the refined knowledge need to revise the research process. It means researcher should use correct methodology, involve stakeholders, consider the characteristics of the context and users need, and conduct the problem-based research. The last element of generating applicable knowledge is applying the proper strategies to transfer the knowledge. It means using active strategies which are chosen by considering to the user’s need, wish, and abilities. It seems because of the novelty of knowledge translation in our country, we need to focus on producing applicable and transferable knowledge through a revised methodology and transfer it by using active strategies.
Elizabeth Yinka Sango-Coker
Cyprus International University, Turkey
Title: Will increased healthcare expenditure reduce burden of communicable and noncommunicable diseases? Evidence of 15 West African countries
Biography:
Abstract:
This research titled: Will Increased Healthcare Expenditure reduce Burden of Communicable and Non-Communicable Diseases? Evidence of 15 West African Countries; investigates the relationship between Healthcare Expenditure and Communicable/Non-Communicable diseases of private, public, and total (public-private) healthcare sectors of 15 countries in West African (W.A) within adult female, adult male and total population, age ranges between 15 – 49 years. What will happen if the government of these countries in West Africa (WA) increases the healthcare expenditure of their population? Will communicable diseases (CDs) and non-communicable diseases (NCDs) be controlled? The base of this research is to investigate if there is a relationship between these variables. West Africa region are highly populated with low income earners, high burden diseases in of CDs or NCDs, and mostly underdeveloped Nations. The effect of burden diseases, either as CNs or NCDs does not only affect the state of health of a population, but also increases the economic burden of the nation. This is as a result of decrease in activities of the victims economically. Communicable diseases are spread by mere physical contact or being closely grouped in the same place with carriers; such diseases include cholera, Ebola, hepatitis, and retrovirus while Non-communicable diseases types are not contracted easily when the patients come in contact with people who do not have the disease. They are mostly hereditary and transferred through genes or unhealthy food consumption; hypertensions, cancer, cardiovascular diseases, obesity, mal-nutrition among others are some examples of NCDs. Using secondary data mainly from World Bank and other supported data from HDI (Human Development Index), WHO (World Health Organization), and UN (United Nations), for 16 years within 1999 to 2014. Empirical results shows negative figures which indicates there exist a positive relationship between Communicable/Non-Communicable diseases reducing against increased in total and public healthcare expenditures shown by pooled regression, pairwise, Spearman, and Ktau correlation methods. Exception was found that Communicable/Non-Communicable diseases does not reduce within the adult female population as Private Healthcare Expenditure increases, indicating a negative relationship between increased in private Healthcare Expenditure and reducing adult female Communicable/Non-Communicable diseases. Hence future research is recommended to investigate miss-appropriations of funds due to corruption, gender inequality, literacy, domestic violence and exposure level in adult female population.
Lian Liu
Southwest Medical University, China
Title: Integrated traditional Chinese and Western medicine therapy for acute cholecystitis: A meta-analysis of randomized controlled trials
Biography:
Lian Liu has completed her (Bachelor of Science in Nursing, BSN) in 2013 from Southwest Medical University and pursuing master of science in nursing studies from Southwest Medical University School of nursing now. She is the secretary of learning ministry of Graduate School. Shi is doing research about Prediction model establishment of risk factors for nosocomial infection of Acinetobacter Bauman and analysis of nursing intervention strategies and evidence-based nursing .She has published paper in Journal of Craniofacial Surgery and published paper in Journal of Medicinal Plants Research, and several papers in Chinese medical periodicals and Chinese Journals of nursing.
Abstract:
First, Acute cholecystitis (AC) is a common and potentially life-threatening condition. Cholecystitis constitutes the sixth most common Gastrointestinal diagnosis seen in emergency departments in the United States,increases stress and economic burdens on patients. Chinese clinical experiments have shown remarkable superiority of Integrated Traditional Chinese and Western Medicine (TCM-WM) Therapy in acute cholecystitis(AC), whereas no English clinical trial has been reported and fewer are known about them outside of China.
Second, The present meta-analysis analysed the therapeutic efficacy of Integrated Traditional Chinese and Western Medicine (TCM-WM) Therapy in acute cholecystitis(AC). The TCM-WM therapy was found to be effective in the management of postoperative and conservative management of acute cholecystitis without significant adverse effects or complications.
Third, nowadays, Traditional Chinese Medicine has been gaining the attention of entire world for its feasibility and superiority for AC, our systematic review and meta-analys has shown that a comprehensive and progressive research should be guided by the Traditional Chinese Medicine theory, combining with modern high-tech biology research, using advanced equipment and method, so as to develop more effective drugs in compliance with international standards and requirements, then TCM-WM Therapy could be generalized to the whole world for the benefit of world's generations.