VII. Key Issues: Regulation & Reform >> C. Health Reform >> Affordable Care Act (ACA) >> ACA Impact Analysis >> ACA Impact on Quality and Outcomes >> Patient-Cente…
High-cost patients receiving care through patient-centered medical home (PCMH) programs are less likely to remain high-cost in the long term, according to a recent study published...
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The PCPCC has developed the following framework to help fellow medical home supporters and advocates explain the benefits and strategies associated with delivering patient-centered primary care. The graphic is organized according to the five key features of the medical home model: Patient-centered, comprehensive, coordinated, accessible, and committed to quality and safety. The infographic includes definitions for each of these features, sample strategies used by health professionals, employers, and payers, and their collective impact on the health system.
3 Population health management Implications for 2013 identified in recent PWC’s Health Institute annual report, Top Health Industry Issues for 2013.
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Product Overview: - A comprehensive PDF containing 162 communication cards, a letter board, and a blank template for creating custom cards. Key Features: - Extensive Collection: The set includes 162 unique cards encompassing basic needs, emotions, medical terms, and more, offering thorough support for patients with communication challenges. - Ready for Immediate Download and Printing: The cards are available for instant download in a print-ready format, suitable for printing at home or through professional services. - Durability for Frequent Use: The design is optimized for printing on various materials like card stock or paper. Laminating the cards is recommended for enhanced durability and reuse. - Versatile Application: These cards are valuable in diverse environments such as hospitals, nursing homes, rehabilitation centers, and for use by speech therapists. Additional Features: - Printable Letter Board: The set includes a letter board specifically designed for patients who are non-verbal and paralyzed. It allows healthcare professionals to point to letters, enabling patients to nod in response, thus aiding in effective communication of their thoughts and needs. Benefits: - Improved Patient Care: By enhancing patient-staff interactions, these cards help reduce frustration and improve the overall care experience. - Essential for Recovery: Effective communication is vital for accurate diagnosis and treatment, making these cards an important tool in the recovery process. - Empowering Patients: The cards enable patients to express themselves, promoting autonomy and dignity during their care. ---------------------------------------------------------------------------------------- Communication cards can be particularly beneficial for patients experiencing a range of conditions, including: 1. Aphasia: Difficulty with language comprehension or expression, often due to stroke or brain injury. 2. Laryngectomy: Removal of the larynx, leading to loss of voice. 3. Tracheostomy: A surgical procedure to create an opening in the neck for breathing, which can impede speech. 4. Cerebral Palsy: A group of disorders affecting movement, muscle tone, and speech. 5. Autism Spectrum Disorder: Challenges with social skills, repetitive behaviors, and non-verbal communication. 6. Motor Neuron Diseases: Conditions like ALS (Amyotrophic Lateral Sclerosis) that progressively weaken muscles, including those used for speech. 7. Parkinson’s Disease*: A neurodegenerative disorder that can affect speech clarity and volume. 8. Multiple Sclerosis (MS): Can lead to difficulties with speech and muscle control. 9. Dementia and Alzheimer’s Disease: Progressive conditions affecting memory, cognition, and communication. 10. Traumatic Brain Injury (TBI): Can result in cognitive and speech impairments. 11. Post-operative Recovery: Patients recovering from surgeries that affect their ability to speak, such as oral or throat surgeries. 12. Intensive Care Unit (ICU) Patients: Particularly those on ventilators or with other conditions limiting speech. 13. Pediatric Patients: Children who may have limited verbal skills or feel intimidated in a hospital environment. 14. Selective Mutism: A complex childhood anxiety disorder characterized by a child's inability to speak in certain social settings. 15. Patients with Severe Anxiety or Psychiatric Conditions: Who may find verbal communication challenging. 16. Hearing Impairments: Patients who are deaf or hard of hearing and communicate primarily through sign language or written text. These communication cards provide an alternative means of expression for patients who are temporarily or permanently unable to use traditional speech, helping to reduce frustration and ensuring their needs and thoughts are understood. These cards include: 1. bathroom 2. can you help me to the bathroom 3. restroom 4. washroom 5. toilet 6. where is the bathroom? 7. yes 8. no 9. okay 10. not okay 11. agree 12. don't agree 13. I don't know 14. please 15. not now 16. I know 17. thank you 18. now 19. feel unwell 20. sick 21. poorly 22. not well 23. hurt 24. itchy 25. glasses 26. use letter board 27. help 28. cold 29. can you lip-read? 30. hot 31. not hungry 32. not thirsty 33. hungry 34. thirsty 35. not tired 36. tired 37. don't understand 38. break 39. understand 40. rest 41. relax 42. keep going 43. hello 44. good morning 45. nice to meet you 46. good afternoon 47. bye 48. see you later 49. worried 50. scared 51. happy 52. sad 53. lonely 54. upset 55. low mood 56. depressed 57. good mood 58. frustrated 59. bored 60. overwhelmed 61. anxious 62. Fatigue 63. anxiety 64. energized 65. not good 66. good 67. headache 68. pain 69. dizzy 70. fever 71. confused 72. difficulty breathing 73. sorry 74. don't rush me 75. more time 76. slow down 77. speak slowly 78. my brain is foggy 79. stay 80. need space 81. lost 82. need to be alone 83. can't remember 84. what is my current condition? 85. don't touch me 86. phone home 87. want to go home 88. phone someone 89. too loud 90. too noisy 91. too bright 92. can't focus 93. please be quiet 94. need to focus 95. need to leave 96. want to stay 97. pain medication 98. prescription 99. medication 100. collect prescription 101. pharmacy 102. order my prescription 103. like 104. have a wash 105. don't like 106. music 107. TV 108. wash hands 109. board games 110. draw 111. radio 112. go outside 113. read 114. walk 115. fan off 116. sore 117. where am I? 118. fan on 119. adjust pillows 120. change position 121. I need help to shower 122. shower 123. bath 124. sleep 125. clean teeth 126. change clothes 127. eat something 128. taxi 129. hospital 130. water 131. dietary restrictions 132. straw 133. bed is too high 134. blanket 135. TV remote 136. sit up 137. bed is too low 138. nurse call button 139. close the curtains 140. change the bedsheets? 141. open the curtains 142. lights on 143. lights off 144. sit on a chair 145. charge phone / tablet 146. paper 147. pen 148. menu 149. drink 150. snack 151. coffee 152. juice 153. soda 154. hot food 155. cold food 156. tea 157. emergency services 158. ambulance 159. fire station 160. police 161. doctor 162. nurse
More hospice patients are being discharged before their death, raising a question about whether hospice companies are financially motivated to do so. One
[VOICEIA Technology] It has 6 microphones where the speaker's voice is clearly captured by two traffic stick microphones. The 2 bottom mics capture the ambient sound and the 2 middle mics capture the internal noise.With the help of VoiceIA technology, the bluetooth headphone improves the clarity of your voice and is used by most truck drivers, receptionists for online office and home meetings, call centers and also at construction sites as well. [3 Sound Modes with ANC Technology] The headset has 3 modes which helps to customize the hearing for different situations. It also has the mute button which helps to mute the voice. Active Noise Reduction emits reverse sound waves to cancel noise. The ANC mode helps to create a professional ambience which is suitable for speaking to people without any external interference and also to hear the surrouding voice without taking off the headphone. [ENC Tech with Noise Reduction] The Bluetooth headset adopts circumoral design. The ENC passive noise isolation cab be combined with active noise cancellation which helps you enjoy crystal sound quality even in noisy environment. [Longer Life and Talking Time] The mic is placed at a safe distance from the mouth which helps to avoid damage through saliva and makes it 10 times long lasting than other headsets. The headset supports 48 hours of talk time, 50 hours of music time and 120 hours of standby time on a single charge. It also can support 6 hours of calls post 15 minutes of charging which is highly efficient. It also comes with a plug in USB cable which can be used to charge as well. [Multiple Connection Modes] Both wired and wireless connections are available for over-ear Bluetooth headphones. Direct connections to a headset with a microphone for a computer are possible using dual 5.0 Bluetooth, a dongle, and a USB cable. Additionally, a computer headset functions with or without Bluetooth on laptops, PCs, desktops, tablets, or mobile phones. The wireless headphones work with popular communication platforms like Google Hangouts, Microsoft Teams, Zoom and Skype for Business.
Are you looking for effective home remedies for blood in urine? Here we got you covered. Let’s find out 10 potent home remedies for treating hematuria.
Explore how remote patient monitoring solutions redefine patient-centric care, empowering individuals to manage their health proactively and improving healthcare outcomes.
iCM, an easiest eMAR software system that provides exceptional tools to implement care plans, collects data, reports on it & ensures superior care delivery.
Medical errors happen all the time. Yet, it’s not enough to rely on the health care system itself to remedy the problems. Patients must be aware of the risks and involved in the solutions. Here, the author looks at the most common risks, offers solutions patients can employ, and considers approaches to solving problems where they exist.
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The CDC has confirmed the first patient to accidentally carry Ebola to the United States has been diagnosed at a hospital in Dallas.
New Hanover Regional Medical Center in Wilmington, N.C., recently hired a dietitian to visit malnourished patients at their homes to address the barriers they face to eating healthy.
If you are looking for the best pulmonary rehabilitation center in NYC, then Highland Care Center is the best option for you. Highland Care Center provides the best care facilities for patients. Pulmonary rehab includes programs of exercise, nutritional counseling, education, and breathing strategies to improve day-to-day activities. To learn more: https://highlandrehabandnursing.com/services/pulmostar/
In today's digital age, healthcare is advancing rapidly, and one of the innovations making waves is remote patient monitoring (RPM). Remote Patient Monitoring Services refers to the use of techn...
Patients Care Collective is a well known dispensary. It was founded in 2001 and focuses on high quality medicine, safe access, and activism. The job description for the Patients Care Collective is a…
You feel crummy — runny nose, fever, sore throat — but do you simply have a cold? Or is it the flu? This infographic can help you figure out what's causing your symptoms.
Researchers have developed a CRISPR technique to efficiently correct the function of heart cells in patients with Duchenne muscular dystrophy (DMD). It involves making a single cut at strategic points along patient's DNA and has the potential to correct most of the 3,000 mutations that cause DMD.
Home health care services have emerged as a transformative and patient-centered approach. As more individuals seek alternatives to traditional medical settings, the importance of quality health care…
A new program at the University of Maryland Medical Center is helping cancer patients cope with the discomfort of treatment through music.
Discover how pursuing a DNP can enhance your career in healthcare management and quality assurance, as shared by a dedicated Chief Medical Officer.
San Antonio doctors are doing everything they can to save the sickest COVID-19 patients,...
Shepley Bulfinch was tasked to bring a human-centered design to Banner University Medical Center Tucson’s New Patient Tower located in Tucson, Arizona. Banner University Medical […]
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Mechanical Ventilation: The Roman physician Galen may have been the first to describe mechanical ventilation: "If you take a dead animal and blow air through its larynx [through a reed], you will fill its bronchi and watch its lungs attain the greatest distention." A mechanical ventilator is a machine that generates a controlled flow of gas into a patient’s airways. Oxygen and air are received from cylinders or wall outlets (internal Gases Network), the gas is pressure reduced and blended according to the prescribed inspired oxygen tension (FiO2), accumulated in a receptacle within the machine, and delivered to the patient using one of many available modes of ventilation. But before going in depth of Ventilation modes and Ventilators we should know more about structure of our Respiratory System. Respiratory System: The respiratory system provides the means for gas exchange required in living cells. Examples: Carbon Dioxide and Oxygen. When you inhale you are bringing oxygen to the lungs. When you exhale you are getting rid of carbon dioxide. When you hold your breath, does your body start saying breath I need oxygen or does it say help the carbon dioxide levels that are out of whack? If you said carbon dioxide levels you are correct. Let's take a look now at what the respiratory system consists. There are 2 tracts of the respiratory system: - Upper respiratory system. - Lower respiratory system It also can be divided into a conducting portion and respiratory function. Conducting portion: Nose, Nasal cavity, pharynx, larynx, trachea and the smaller progressively airways (primary bronchi to terminal bronchioles). Respiratory portion: is composed of small airways called respiratory branchioles, alveolar ducts and alveoli (air sacs). Respiratory System Respiratory System Anatomy Some of Respiratory System main Functions: Pulmonary Ventilation: Inhalation: bringing gas into the lungs. Exhalation: letting gas flow out of the lungs. Gas exchange: Oxygen is drawn in by inhalation and is transported to the body cells from the lungs by blood circulation. The body uses the oxygen to generate carbon dioxide as a waste product which is then transported to the lungs and is then exhaled. Gas Conditioning: Gases entering the body are "modified" before reaching the gas exchange surfaces. These gases are warmed to body temperature, filtered of any harmful particles and humidified by contact of the respiratory epithelium and the sticky mucus covering in the winding pathways in the nasal cavity and the paranasal sinuses. Some Ventilation Concepts: Negative-pressure ventilation: where air is essentially sucked into the lungs. Positive pressure ventilation: where air (or another gas mix) is pushed into the trachea. When physicians use a ventilator? Medical Ventilator is a machine designed to mechanically assist in moving breathable air into and out of the lungs, to provide the mechanism of breathing for a patient who is physically unable to breathe, or breathing insufficiently. Ventilator mainly in its simplest form, a modern positive pressure ventilator consists of: - A compressible air reservoir or turbine, - Air and oxygen supplies, - A set of valves and tubes, - A disposable or reusable "patient circuit", The air reservoir is pneumatically compressed several times a minute to deliver room-air, or in most cases, an air/oxygen mixture to the patient. If a turbine is used, the turbine pushes air through the ventilator, with a flow valve adjusting pressure to meet patient-specific parameters. When overpressure is released, the patient will exhale passively due to the lungs' elasticity, the exhaled air being released usually through a one-way valve within the patient circuit called the patient manifold. The oxygen content of the inspired gas can be set from 21 percent (ambient air) to 100 percent (pure oxygen). Pressure and flow characteristics can be set mechanically or electronically. Ventilators may also be equipped with monitoring and alarm systems for patient-related parameters (e.g. pressure, volume, and flow) and ventilator function (e.g. air leakage, power failure, and mechanical failure), backup batteries, oxygen tanks, and remote control. The pneumatic system is nowadays often replaced by a computer-controlled turbo pump. Modern ventilators are electronically controlled by a small embedded system to allow exact adaptation of pressure and flow characteristics to an individual patient's needs. Fine-tuned ventilator settings also serve to make ventilation more tolerable and comfortable for the patient. In Germany, Canada, and the United States, respiratory therapists are responsible for tuning these settings while biomedical technologists are responsible for the maintenance. The patient circuit usually consists of a set of three durable, yet lightweight plastic tubes, separated by function (e.g. inhaled air, patient pressure, exhaled air). Determined by the type of ventilation needed, the patient-end of the circuit may be either noninvasive or invasive. Noninvasive methods, which are adequate for patients who require a ventilator only while sleeping and resting, mainly employ a nasal mask. Invasive methods require intubation, which for long-term ventilator dependence will normally be a tracheotomy cannula, as this is much more comfortable and practical for long-term care than is larynx or nasal intubation. Setup of Ventilator in hospital ICU room: The illustration shows a standard setup for a ventilator in a hospital room. The ventilator pushes warm, moist air (or air with increased oxygen) to the patient. Exhaled air flows away from the patient. Some expressions: Minute Volume: is the volume of air (oxygen) inhaled (inhaled minute volume) or exhaled (exhaled minute volume) from a person’s lungs in one minute (5-40 L/min). Tidal Volume (Vt): the volume of air (oxygen) what is given to patient in one breathe (0.1-2 L). Flow: volume/time (5-35 L/min). BPM: Breathe Per Minute (2-60) Ti: Inspiration time. Te: Expiration time. I:E: Inspiration to Expiration ratio. Respiratory Cycle: Relation between Tidal Volume, Inspiration time and Flow: How to work on ventilator? The classification of ventilators refers to the following elements: 1- Control: How the ventilator knows how much flow to deliver Volume Controlled (volume limited, volume targeted) and Pressure Variable. Pressure Controlled (pressure limited, pressure targeted) and Volume Variable. Dual Controlled (volume targeted (guaranteed) pressure limited). 2- Cycling: how the ventilator switches from inspiration to expiration: the flow has been delivered to the volume or pressure target - how long does it stay there? Time cycled such in pressure controlled ventilation. Flow cycled such as in pressure support. Volume cycled the ventilator cycles to expiration once a set tidal volume has been delivered: this occurs in volume controlled ventilation. If an inspiratory pause is added, then the breath is both volume and time cycled. 3- Triggering: what causes the ventilator to cycle to inspiration. Ventilators may be time triggered, pressure triggered or flow triggered. Time: the ventilator cycles at a set frequency as determined by the controlled rate. Pressure: the ventilator senses the patient's inspiratory effort by way of a decrease in the baseline pressure. Flow: modern ventilators deliver a constant flow around the circuit throughout the respiratory cycle (flow-by). A deflection in this flow by patient inspiration is monitored by the ventilator and it delivers a breath. This mechanism requires less work by the patient than pressure triggering. 4- Breaths are either: what causes the ventilator to cycle from inspiration Mandatory (controlled) - which is determined by the respiratory rate. Assisted (as in assist control, synchronized intermittent mandatory ventilation, pressure support) Spontaneous (no additional assistance in inspiration, as in CPAP) 5- Flow pattern: Sinusoidal: this is the flow pattern seen in spontaneous breathing and CPAP Decelerating: the flow pattern seen in pressure targeted ventilation: inspiration slows down as alveolar pressure increases (there is a high initial flow). Most intensives and respiratory therapists use this pattern in volume targeted ventilation also, as it results in a lower peak airway pressure than constant and accelerating flow, and better distribution characteristics. Constant: flow continues at a constant rate until the set tidal volume is delivered. Accelerating: flow increases progressively as the breath is delivered. This should not be used in clinical practice. 6- Mode or Breath Pattern: Continuous Mandatory Ventilation (CMV): In which ventilator provides a mechanical breath on a preset timing, without allowances for spontaneous breathing from patient side. This is usually only used in an unconscious patient. It may also be used in infants who often quickly adapt their breathing pattern to the ventilator timing. Assist-Control: That minimizes patient effort by providing full mechanical support with every breath. This is often the initial mode chosen for adults because it provides the greatest degree of support. Intermittent Mandatory Ventilation (IMV): It mixes controlled breaths and spontaneous breaths, as the ventilator provides a preset mechanical breath (volume limited) every specified number of seconds (determined by dividing the respiratory rate into 60 seconds, thus a respiratory rate of 12 results in a 5 second cycle time). Within that cycle time the ventilator waits for the patient to initiate a breath using either a pressure or flow sensor. When the ventilator senses the first patient breathing attempt within the cycle, it delivers the preset ventilator breath. If the patient fails to initiate a breath, the ventilator delivers a mechanical breath at the end of the breath cycle. Additional spontaneous breaths after the first one within the breath cycle do not trigger another SIMV breath. However. SIMV is frequently employed as a method of decreasing ventilatory support (weaning) by turning down the rate, which requires the patient to take additional breaths beyond the SIMV triggered breath. Pressure Support: Where the patient has control over all aspects of his breath except the pressure limit. Continuous Positive Airway Pressure (CPAP): A continuous level of elevated pressure is provided through the patient circuit to maintain adequate oxygenation, decrease the work of breathing, and decrease the work of the heart (such as in left-sided heart failure CHF). Note that no cycling of ventilator pressures occurs and the patient must initiate all breaths. In addition, no additional pressure above the CPAP pressure is provided during those breaths Synchronized Intermittent Mandatory Ventilation (SIMV): In which ventilator provides a preset pressure limited mechanical breath every specified number of seconds SIMV is frequently employed as a method of decreasing ventilatory support (weaning) by turning down the rate, which requires the patient to take additional breaths beyond the SIMV triggered breath. Positive End Expiratory Pressure (PEEP): may or may not be employed to prevent atelectasis in adult patients. It is almost always used for pediatric and neonatal patients due to their increased tendency for atelectasis. Dräger Company: As an international leader in medical and safety technology, Dräger develops innovative equipment and solutions people the world over trust when livesare on the line and “Technology for Life” is their guiding principle and mission. And we invited "Dräger International Co." agent company in Egypt "Life care Technology Co." and their representative Eng. Shawkat Ahmed (Service Supervisor of Co.) who welcomed the invitation and spent about three hours illustrating the Medical Ventilation Machines to SBME's and bring one of their most advanced models of their Ventilators Evita XL (which is shown among their products below). Dräger’s range of Ventilators Products: Drager - Evita 2 dura Drager - Savina Drager - Evita XL Drager - Oxylog 1000 Drager - Oxylog 2000 “We enable professional caregivers turn the ICU into a healing environment” –Stefan Draeger. References: The Respiratory System handout (downloadablefile) Anatowiki Fundamentals of Mechanical Ventilation Draeger Medical Ventilation Operation Manual of Evita XL Ventilator Medical Ventilation through Wikipedia Medical Ventilators through Wikipedia Weaning patient from mechanical ventilator What To Expect While on a Ventilator? Modes of Mechanical Ventilation
Hospice and Palliative Care Centers Market - Global Industry Insights, Size, Share, Trends, Outlook, and Opportunity Analysis
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A blog about Down syndrome, disability, inclusion and family.
