Hodges' Model: Welcome to the QUAD

Health & Social Care - Safe Record Keeping Project

2012-01-27T20:45:00.000Z

Dear Member

BCS, The Chartered Institute for IT and the Department of Health Informatics Directorate (DHID) have launched a project to develop clear and easy to follow guidance for patients and the public on the subject of health and social care records.

The project will provide patients with advice on how to look after the health and social care records and other sensitive personal data that they are creating or health and social care providers are sharing with them. BCS is inviting individuals or organisations to tender for the contract to carry out this work.

Further information about the tender process can be found at: www.bcs.org/dhid

Please do not hesitate to contact me if you require any further information.

Regards,

Dr Wai Keong Wong
Project Coordinator
BCS and DH project for safe patient record
w.wong AT bcs.org

My source: BCS, Dr Wai Keong Wong with thanks.

Scope, Space, Nursing, Informatics: Fusion II (care)

2012-01-26T00:10:00.000Z

After Paolo Perrotta (see post January 20, 2012):

and Paolo Perrotta, (2010). Metaprogramming Ruby, The Pragmatic Bookshelf. p.75.

Imagine being a care coordinator making sense and sense making (Dervin, 2005) your way through a new health and social care referral: here is the care program(me) approach. You jump from care problem, to strength, to further assessment question ... until the care domain priority is resolved. A decision point. That's the initial scope (and in an urgent / crisis situation this is resolved in an instant).

The scope is not defined in a single program, but several in parallel. This is why health and social care is often described as complex. You find yourself in a complex. At this decision point you are at the center of a range of local variables.

You can see bindings all over the scope. p.75.

There are assumptions, hypotheses and bits of data yet to be fully apprehended. It's hard but vital to be aware of what is objective and what is subjective. Why?

Raise your head, and you see that you're standing within an object,

[ a very special object ]

with its own methods and instance variables; that's the current object, also known as self. p.75.

To your immediate left and forward there are instance variables: beliefs, choices, motivation, aspirations, memories ... and the unique ability of this self to use its methods to communicate and interact with other selves, the world and future. You notice a problem. Many of the methods you might expect are not intact. There is a problem with the capacity of memory. Where there should be several parameters in sequence: there is. One. This may even then be lacking. Reading and writing is a problem here.

To the right and forward there is a monthly weight chart, a medication administration chart, BP and pulse are also recorded. There is a history of falls, a fractured femur, and bruising. There is a diagnosis - an inguinal hernia. Two postcodes have you momentarily perplexed. Ah, one is static 'home'; the other is current location and that's a close to home telecare mediated match.

Turning first to your right and over your shoulder there is an issue with care management and wandering at night: a vulnerability for this person. Another instance variable then flags mental capacity for a that hernia which needs repair. Respite care vouchers have been issued, but the year's allocation remain unused.

Next, turning around to your left there are details of next of kin and the fact that the carer involved is under a great deal of stress.

Further away, you see the tree of constants so clear that you could mark your current position on a map. p.75.

You are in fact encircled by a series of official identifiers. First at 10 o'clock two first names - these are the names that are given. The names for the person, the individual who is the focus of the referral. At two o'clock a key event for this individual their DOB - date of birth. At four o'clock the digits of the NHS number and a local case record number are captured. Completing the "Full name" at 8 o'clock you find a surname, the family name. It's double-barreled too. An explicit effort to preserve and extend family history and lineage.

Squint your eyes, and you can even see a bunch of global variables off in the distance. p.75.

Global variables.

What lies behind them?

It sounds strange to describe the person as an object, even if the context alludes to informatics.
To confirm this object is special. When you think about it though this object, the patient, the person, the individual, this self has a partner: the healthcare professional.

When we say that positive, high quality care values are global that makes sense. They should be: globally. To say they are variable seems to invite poor quality care, slack standards, inequality, inequity. Acknowledging that standards do vary can help ensure vigilance and that high quality care remains the key aspiration for new learners and experts alike. Nursing and other values are then a global variable that need constant attention and governance.

Scope, Space, Nursing, Informatics: Fusion I

2012-01-20T18:52:00.000Z

Paolo Perrotta writes:

Imagine being a little debugger making your way through a Ruby program. You jump from statement to statement until you finally hit a breakpoint. Now, catch your breath and look around. See the scenery around you? That's your scope.

You can see bindings all over the scope. Look down at your feet, and you see a bunch of local variables. Raise your head, and you see that you're standing within an object, with its own methods and instance variables; that's the current object, also known as self. Further away, you see the tree of constants so clear that you could mark your current position on a map. Squint your eyes, and you can even see a bunch of global variables off in the distance. p.75.

Paolo Perrotta, (2010). Metaprogramming Ruby, The Pragmatic Bookshelf.

KT EQUAL event 'Design ahead: design for an ageing population'

2012-01-19T23:09:00.000Z

Dear KT EQUAL Supporters,

We are pleased to announce the latest KT EQUAL event entitled 'Design ahead: design for an ageing population' to be held on Friday 2nd March 2012 at the Innovation Centre, Bath.

We have an ageing population, but a reducing health and social care budget. Increasingly individuals will be expected to self-purchase products and services that will allow them to live independently. This will provide a large ‘silver’ consumer market for products that are designed and priced appropriately. Although there is some awareness amongst industry of this market opportunity, there is significant scope for more inclusive design of mainstream products that enhance independent livening or support specific living tasks and activities.

In collaboration with KT EQUAL, ALAN (Assisted Living Action Network) will jointly host this event to raise awareness of the scale of the market opportunity; explore the needs of this population; how they are translated into design requirements to drive product innovation; and what kinds of design tools and approaches can support design for an aging population. The event will bring together commercial partners, users and academics.

Please find a provisional programme for 2nd March here.

In addition to the conference, there will be an evening three course dinner and networking reception on Thursday 1st March. Both events will be held at the Innovation Centre in Bath.

To register for the conference and / or dinner, please visit:

http://assistedlivingaction.net/index.php/events/designing-ahead-mainstream-design-for-an-ageing-population/

£80 conference and dinner
£50 conference only

There are limited spaces for the networking dinner, so please register quickly.

Regards,

Heather Williams
Project Officer (KT EQUAL)
University of Bath
_______________________________________________
Sparc-network mailing list <Sparc-network@lists.reading.ac.uk>
http://www.lists.rdg.ac.uk/mailman/listinfo/sparc-network

Social Media in Healthcare Infographic

2012-01-16T21:40:00.000Z

Via: PowerDMS

Although the emphasis of this graphic is USA centric there are many aspects that apply generally, especially social media policy. If anyone has health care infographics with a UK, EU, developing nations focus please get in touch.

Thanks to Ray Lau, Graphic Designer for approaching me regards this.

[HIFA2015] Article: Why National eHealth Programs Need Dead Philosophers

2012-01-14T19:30:00.000Z

My source: HIFA2015 Healthcare Information for All by 2015 (edited)

Dear All,

Just read through this article after I received it from the PAHO EQUIDAD listserve.

I have forwarded it to this group with the hope that some of my colleagues here that are interested in ehealth can access it.
It is worth reading...please see the link to the article by Trisha Greenhalgh et al below.

Why National eHealth Programs Need Dead Philosophers:
Wittgensteinian Reflections on Policymakers' Reluctance to Learn from History
Trisha Greenhalgh, Jill Russell, Richard E. Ashcroft, and Wayne Parsons
Queen Mary University of London
The Milbank Quarterly - Volume 89, Number 4, December 2011

Available online at: http://bit.ly/vxvWJ8

Cheers

[Francis] Ohanyido
Click here to read original HIFA2015 post online.

<->

This article is an excellent addition to the literature. It combines three of my passions reflected here on W2tQ - informatics, health and philosophy. I spent three years 2004-2007 on a local secondment to this national programme so there is added relevance and poignancy for me.
Many thanks to Francis Ohanyido & the HIFA2015 list.

Musings on Integrated Care: A Visible and Invisible Matter

2012-01-13T22:58:00.000Z

If measures for clinical outcomes, health literacy, patient satisfaction, benefits and many more present a challenge then a measure for integrated care falls into the category of a very steep peak.

It's a nebulous concept, we know what we mean, we recognize the principles and we even allow for variation in what integration and integrated care means for different people.

The January 2012 integrated care report by The King's Fund and Nuffield Trust (my post on this) had me thinking about some of the ingredients that might contribute to measures of integrated care and our efforts to record it. What instruments and formats do we need - what mix of microscope (individual), telescope (population), strobe (snapshot), time lapse (series), objective - subjective? Some elements then (in no particular order):

Breadth of the 'episode' (primary-secondary-tertiary-palliative)
The number of systems
information - e-records
commissioners
datasets: total, number of gatherers, submissions
The number of people - individuals involved
The number of 'responsible' organisations
Primary organisational efficiency - Lean Standing?
The number of teams
The number of policies (policy touches)
The number of interviews, assessments (paper, electronic, formal), care plans, reviews
Opportunities for communications
potential
actual
media forms
delivery forms (inc. technologies)
Number of handovers
weighted according to type
Patient experience - measure
(that is holistic across physical, mental health, social care?)
staff attitude
therapeutic relationship engagement (quality)
therapeutic modalities (quantity)
educational content, materials provided / information gains
number of patient (carer) choice points (potential - exercised)
Incidents of positive risk taking
Increase in health literacy
Co-ordination effectiveness
Self-care - autonomy, decision making
Patient (carer) as budget holder
Patient as record holder and direct data source (telecare - data entrant)
Carer involvement
Health : Social care (main dependency, ratio, index)
The number of disparate care philosophies encountered
Diagnoses
Diagnostic investigations complex (location, time)
Declarative success: agreed plan - success?
The geographic encounter footprint
Duration of engagement
Follow-up - care continuity care
Care Disintegration - safety
care interrupts^# (falls, errors)
relapse, readmission
dependency (deferred discharge)
Influence of public engagement - involvement in local health services^*

While many of the above might qualify as candidates for a measure of integrated care, you have to wonder whether in order to measure integration you must measure everything else. It appears here at least that integration and complexity are closely related. Several of the items above might individually represent - and no doubt do - indices of various kinds that also beg definition (e.g., co-ordination, success, philosophies, episode ...).

Although I've referred to 'numbers' you could no doubt refine the list by consulting the literature and considering the quantitative : qualitative mix.

Perhaps the key indicator of integrated care isolates the primary concepts for the person concerned and then fuses those within the INTERPERSONAL and POLITICAL care domains (policy touches would be one example)?

^*How does a measure of integration incorporate those socially excluded?
^#For want of a better word.

Report - Integrated care for patients and populations: Improving outcomes by working together

2012-01-11T23:21:00.001Z

I've posted on integrated care previously on W2tQ. The core recommendations of this New Year report on integrated care are:

government policy should be founded on a clear, ambitious and measurable goal to improve the experience of patients and service users and to be delivered by a defined date
patients with complex needs should be guaranteed an entitlement to an agreed care plan, a named case manager responsible for co-ordinating care, and access to telehealth and telecare and a personal health budget where appropriate
change must be implemented at scale and pace; this will require work across large populations, significant reform and flexibility to take forward different approaches.

Publication prompted Time to integrate words with action by Chris Ham and Jennifer Dixon (HSJ 5 January pp. 16-17 - and my source for this news). The report and mention of measures of integrated care that include patient experience provoked further reflection.

Integration in health and social care should be considered critically over the past 25 years and more (but that's a thesis). Evolution in policy matters, but there is a deep archaeology that illustrates the policy aspiration - practice gap the reports priorities seek to address. A comment in response on the King's Fund's site notes the need for (strategies, methods and) a framework. While no magic wand there is a framework that can at least unify disciplines, public and policy makers. And act as a bridge between words and actions.

Integration needs a shared and agreed origin.

(A point* around which disintegration turns)

Although brief (20 pages) the report is an excellent source for references (3 pages) that includes:

Kodner D, Spreeuwenberg C (2002). ‘Integrated Care: Meaning, logic, applications, and implications – a discussion paper’. International Journal of Integrated Care, vol 2,
Available at: www.ijic.org/index.php/ijic/article/view/67 (accessed 13 December 2011).

Kodner D (2009). ‘All together now: a conceptual exploration of integrated care’. Healthcare Quarterly, vol 13(Sp), pp 6–15.

Leutz W (2005). ‘Reflections on integrating medical and social care: five laws revisited. Journal of Integrated Care, vol 14, no 5, pp 3–12.

As we try to integrate words and actions we need to remember:

how we dice and slice influences the scope of integration.

We'll explore this more soon.
*Points?

Nick Goodwin, Judith Smith, Alisha Davies, Claire Perry, Rebecca Rosen, Anna Dixon, Jennifer Dixon, Chris Ham Integrated care for patients and populations: Improving outcomes by working together. Report to the Department of Health and NHS Future Forum from The King’s Fund and Nuffield Trust

Masquerade in health care but on which level?

2012-01-06T22:32:00.000Z

There is a Drupal module called Masquerade, the project page explains:

The masquerade module is designed as a tool for site designers and site administrators. It allows a user with the right permissions to switch users. While masquerading, a field is set on the $user object, and a menu item appears allowing the user to switch back. Watchdog entries are made any time a user masquerades or stops masquerading.

Life frequently asks more of us and the same applies for employees in whichever employment sector. For teachers and nurses they know the call. As a nurse you adopt the mask of the uniform and the role. You may not actually carry the lamp, but it's there. Sometimes it helps light the way; for the public, for you. If you are a 'bad' nurse - whether your attitude put the lamp out this morning, yesterday, or several years ago - the darkness that follows you about speaks volumes.

It prompts Prime Ministers to make announcements:

PM announces new focus on quality and nursing care

06 January 2012 12:54

A new drive to free up nurses to provide the care patients and relatives expect has been announced today by Prime Minister David Cameron and Health Secretary Andrew Lansley.

The push will see nurses spending more time on front line care in wards and other services, a senior ward nurse with whom the buck stops, patients leading on inspections and a new 'friends and family test' to show whether nurses and patients had a good overall experience, or would want loved ones needing care to be treated at each hospital.

Prime Minister David Cameron said:

“We know the vast majority of patients are very happy with the care provided by the NHS. And I’ve seen the NHS at its very best. But we have heard recently that in some hospitals patients are not provided with the level care or respect they deserve and I am absolutely appalled by this.
“If we want dignity and respect, we need to focus on nurses and the care they deliver. The whole approach to caring in this country needs to be reset. And it needs to start with this simple fact. Caring for patients is what nurses do. Everything else comes second."

<->

While we all play masquerade there are many levels. As a 'nurse' it's difficult (but never impossible) to play the caring, skilled, knowledgeable, patient, warm, efficient ... representative AND ensure all records are maintained, letters written, all communications logged, targets achieved, electronic records and data gathering requirements met. ... If you need a steer-clear from the stereotypical image of Angels, then you should see the faces nurses pull behind the mask trying to satisfy the audience.

That audience does not just include managers, patient representatives, inspection agencies but policy makers and politicians. Of course the latter are expert proponents of masquerade (they practice through a 4-5 year cycle).

Closer to home and the Drupal module? Well, I can't see a role for masquerade on a new h2cm website, but the thought crosses my mind of general nurses masquerading as mental health nurses; social workers masquerading as nurses. ... Although I'm playing games :-) it makes you think about what we mean by 'multidisciplinary'. To what extent, for example, is care of people living with dementia being missed because these disciplinary distinctions - silos really do still prevail? Surely the nursing issue isn't just a lack of light?

This announcement is not exactly news given what has gone before in the UK media through 2011.

What is strange is that this policy should emerge in 2012: The Alan Turing Year.

Yes, nurses DO need time to care, but perhaps we also need a test for empathy and rapport and not just intelligence?

Essential Nursing Resources 2012 now available online

2012-01-05T18:50:00.000Z

The Interagency Council on Information Resources in Nursing (ICIRN) has released the 26^th edition of Essential Nursing Resources (ENR), an expansive resource list intended to be used by nurses and librarians. Because the list of possible resources has grown so large the ENR has become too large and expensive to publish in print and so it appears only online at www.icirn.org , on the ICIRN website.

Nurses can use ENR as a tool to assist them with building a personal professional collection of resources to support and advance their area of practice. Librarians can utilize this tool as an evaluation point in determining collection development, and as a reference tool. ENR is neither a comprehensive presentation nor product endorsement, but represents the opinions of the contributors. This tool is meant to assist nurses and librarians to evaluate on their own what resources best apply to their particular situation. Only the most recent editions and website addresses have been included. The ENR was compiled to point to pathways for exploration, rather than be an end point, and to expand to other formats beyond traditional references.

New to this edition is a very handy key to let users know if:

$ =fee required; M=mobile; O=online; P=print

- for each resource listed.

New and redesigned sections in this edition include Blogs; Forums and Discussion list; Evidence-based Nursing; Management; Patient Safety/Quality Assurance; and Toxicology, Environmental, Occupational Health.

Carol J. Bickford, PhD, RN-BC, CPHIMS

Senior Policy Fellow, Department of Nursing Practice and Policy

American Nurses Association

8515 Georgia Avenue, Suite 400

Silver Spring, MD 20910

www.nursingworld.org

My source:
Carol J. Bickford via nrsing-l maillist
http://mailman.amia.org/mailman/listinfo/nrsing-l
This list serve is hosted by the AMERICAN MEDICAL INFORMATICS ASSOCIATION

Drupal ScienceCamp Cambridge 20-21st January & Thoughtworks 13th Feb.

2012-01-04T22:55:00.000Z

Next month I'm looking f/w to *ThoughtWorks' Quarterly Technology Briefing:

Is programming language
choice a good thing?

Before that I've booked for Drupal ScienceCamp in two weeks. It's a drive as the trains are not straight forward.

While there I'll post and tweet through proceedings. Being a DrupalCamp the program is still to be finalised. Leeds last May was excellent, as was Manchester. There are a few names for Cambridge that I recognise which is great.

I've cleared 1GB of old stuff off the laptop, three years worth that includes Drupal modules.

Time to update, focus, make use of the whiteboard, find and maintain some impetus...

I gather the title for the Camp derives from the venue - Cambridge Science Park. If there was a scientific theme now that would be a bonus. *Trademarks acknowledged also.

ERCIM News No. 88 Special Theme: "Evolving Software"

2012-01-03T19:19:00.000Z

Dear ERCIM News Reader,

ERCIM News No. 88 has just been published at http://ercim-news.ercim.eu/

Guest editors: Tom Mens (University of Mons, Belgium) and Jacques Klein (University of Luxembourg)

http://ercim-news.ercim.eu/en88/special

Keynote "Change is the Constant" by Joost Visser, Head of Research at Software Improvement Group
http://ercim-news.ercim.eu/en88/keynote/change-is-the-constant

Next issue: No. 89, April 2012 - Special Theme: "Big Data"
(see call at http://ercim-news.ercim.eu/call)

Thank you for your interest in ERCIM News.
Feel free to forward this message to others who might be interested.
Happy New Year!
Peter Kunz
ERCIM News central editor

[Includes: An introduction to this theme; Holistic Software Evolution; Wireless Sensor Networks and the Tower that Breathes; and Innovation in Disaster Management: Report from Exercise EU POSEIDON 2011. ] PJ

ERCIM News
is published quarterly by ERCIM, the European Research Consortium for Informatics and Mathematics.
The printed edition will reach about 10,000 readers.
This email alert reaches some 6000 subscribers.

Threshold Concepts: Undergraduate Teaching, Postgraduate Training and Professional Development A short introduction and bibliography

2012-01-01T17:37:00.000Z

From:
Threshold Concepts: Undergraduate Teaching, Postgraduate Training and Professional Development
A short introduction and bibliography

The Meyer and Land Threshold Concept

	“The idea of threshold concepts emerged from a UK national research project into the possible characteristics of strong teaching and learning environments in the disciplines for undergraduate education (Enhancing Teaching-Learning Environments in Undergraduate Courses). In pursuing this research in the field of economics, it became clear to Erik Meyer and Ray Land [1-8, 9-16], that certain concepts were held by economists to be central to the mastery of their subject. These concepts, Meyer and Land argued, could be described as ‘threshold’ ones because they have certain features in common.”
	Glynis Cousin, An introduction to threshold concepts

As the calendar slipped across from 2011 to 2012 the discovery of threshold concepts is very timely and quite central to my own studies. Wish I'd been in time for the call for papers!

Threshold Concepts Conference

As one year ends it helps to have a gateway to new vistas and to make sure that my review of the literature is systematic.

2011 highlights ...

2011-12-30T23:42:00.000Z

The highlight of the year was the trip to Colombia in February with a presentation, workshop and meeting with quite a few students and their Professor. Lovely people, a warm, very well organised welcome and assistance c/o Luz Stella Saray, Prof. Wilson Canon, Andrea Ramirez and Fred Manrique / UPTC and many others. Colombia is an amazing country even on a brief visit:

http://hodges-model.blogspot.com/search/label/Colombia

It appears the conference link may have changed:
http://www.uptc.edu.co/eventos/2011/cong_enfermeria/index.html

There were two poster presentations: Health Literacy, Manchester in June and the CARDI conference last month in Dublin. The latest poster was a great improvement on June's effort thanks to Prof. Kernohan; and there's a paper to follow.

September brought The Difference that Makes a Difference held at the Open University, Milton Keynes, UK 7-9 Sept 2011. It was a great experience being able to contribute to an event outside of health and social care. Quite a change also to be on the panel and able to respond to a question or two. I find information a fascinating subject. I wish there had been time to respond to the call for papers (and another on health literacy) but there was not enough time. There's more besides posted here on W2tQ, Drupalcon London in August.

I wonder what 2012 will bring...? I've nine days leave left up to the end of March so will be packing the laptop to focus on Drupal up in the Lake District.

Sue and I have tickets for Leonardo at the National Gallery. I can't wait for this after last years visit to The British Museum exhibition Fra Angelico to Leonardo: Italian Renaissance drawings

http://hodges-model.blogspot.com/2010/05/nursing-art-and-science-fra-angelico-to.html

Next month it looks like I may be moving from Nursing Home Liaison to the Intermediate Support Team.

Thanks for your visit and interest.
Whatever else happens in 2012 I hope the wishes and dreams of individuals and Nations in search of peace and freedom come true. Remember+ChangeHappens2.
Best wishes to all!
PJ

Interprofessional Collaborative Care Will Be Key to Meeting Tomorrow’s Health Care Needs

2011-12-29T00:46:00.000Z

Maryjoan Ladden, Ph.D., R.N., F.A.A.N., Robert Wood Johnson Foundation Senior Program Officer

A little over a year ago, the Institute of Medicine’s landmark Future of Nursing: Leading Change, Advancing Health report put forward a series of recommendations for transforming the nation’s health care system. Among them was a call for a system in which “interprofessional collaboration and coordination are the norm.” That’s no simple assignment in a system that often operates in silos, from schooling through practice. But a number of innovators around the nation are already making headway.

Their work is the subject of a new policy brief from the Robert Wood Johnson Foundation, part of its Charting Nursing’s Future (CNF) series. The brief delves into what the IOM recommendation means for health care systems, offers case studies of several collaborative care models already in place, and examines the implications of the recommendation for how we train nurses and other health care professionals.

According to the brief, Implementing the IOM Future of Nursing Report–Part II: The Potential of Interprofessional Collaborative Care to Improve Safety and Quality, the “silo” approach must soon give way if we are to meet coming health care challenges. For example, chronic conditions are increasingly common—not surprising given an aging population. But the health care system is poorly structured to provide the sort of coordinated care and preventive services needed to give these patients quality care while reducing costs. Some health care institutions are gearing up for the challenge.

In Boston, where Harvard Vanguard Medical Associates developed its Complex Chronic Care (CCC) program, primary care has become interprofessional, collaborative and noticeably more efficient. Each CCC patient is assigned a nurse practitioner (NP), a registered nurse with advanced education and clinical training. The NP consults with all the patient’s subspecialists and incorporates their guidance in a single plan of care. The NP then manages and coordinates that care, connecting patients to nutritionists, social workers, and other professionals as needed. The model is dynamic, allowing patients to meet more or less frequently with the NPs and their primary care physicians, who remain responsible for the patients’ overall care.

In New Jersey, the Camden Coalition of Health Care Providers is “revolutionizing health care delivery for Camden’s costliest patients,” according to the brief. These individuals, sometimes called super utilizers, typically rely on hospital emergency rooms for care. Not surprisingly, such patients account for an outsized share of local hospital costs, often with diagnoses that would have been more properly handled in a primary care setting. The Coalition developed its Care Management Project to reduce these unnecessary emergency room visits by treating patients where they reside, even when that means treating them on the street. A social worker, NP and bilingual medical assistant work as a team to help patients apply for government assistance, find temporary shelter, enroll in medical day programs and coordinate their primary and specialty care.

Training the Next Generation to Collaborate

Of course, the silo effect usually begins in school. In May 2011, six national education associations representing various health care professions formed the Interprofessional Education Collaborative (IPEC) and released a set of core competencies to help professional schools in crafting curricula that will prepare future clinicians to provide more collaborative, team-based care. Such efforts are already under way at a number of institutions.

Maine’s University of New England has developed a common undergraduate curriculum for its health professions programs in nursing, dental hygiene, athletic training, applied exercise and science, and health, wellness and occupational studies. The curriculum includes shared learning in basic science prerequisites and four new courses aimed specifically at teaching interprofessional competencies.

In Nashville, Vanderbilt University is also pursuing an interprofessional education initiative that unites students from the medical and nursing schools with graduate students pursuing degrees in pharmacy and social work at nearby institutions. Students are assigned to interprofessional working-learning teams at ambulatory care facilities in the area.

The Veterans Health Administration (VHA) is piloting an interprofessional initiative, as well, focused on preparing medical residents and nursing graduate students for collaborative practice. As part of the initiative, five VHA facilities have been designated Centers of Excellence and received five-year grants from the U.S. Department of Veterans Affairs. Each VHA Center of Excellence is developing its own approach to preparing health professionals for patient-centered, team-based primary care.

In Aurora, Colorado, the University of Colorado built its new Anschutz Medical Campus with the explicit objective of creating an environment that promotes collaboration among its medical, nursing, pharmacy, dentistry and public health students. It features shared auditorium and simulation labs, as well as student lounges and other dedicated spaces in which students from different professions can pursue common interests such as geriatrics in a collaborative fashion.

Such initiatives are clearly the wave of the future, if only because the pressures of caring for a larger, older and sicker population of patients in the years to come will drive efforts to identify efficiencies. In the words of Mary Wakefield, PhD, RN, head of the Health Resources and Services Administration, “As the health care community is looking for new strategies and new ways of organizing to optimize our efforts—teamwork is fundamental to the conversation.”

Sign up to receive future Charting Nursing’s Future policy briefs by email at
www.rwjf.org/goto/cnf.

My source: Matt Freeman (PRS)

[HIFA2015] Women and Children First

2011-12-28T23:05:00.001Z

As we draw towards the end of the year, Ros Davies, executive director of
Women and Children First (www.wcf-uk.org) reminds us:

'This Christmas Day, 1000 women will die in childbirth.
1000 women will die this way on Boxing Day too.
In fact 1000 women die every day whilst pregnant or giving birth.

... the vast majority of these deaths could be prevented by the provision of simple information and equipment which many of us take for granted.'

http://hosted.verticalresponse.com/786283/74890f4030/1470640645/8fd055e22b/
Click here to read online.
My source:
HIFA2015: Healthcare Information For All by 2015: www.hifa2015.org

Christmas: Buena Vista Social Club & Multidisciplinary, Interdisciplinary, Interprofessional and Transdisciplinary

2011-12-26T15:25:00.000Z

A welcome gift for Christmas^# was Wim Wenders' and Producer Ry Cooder's film - Buena Vista Social Club. The music, story, sound and images are a real treat. Several of the artists are sadly no longer with us, what is clear is the role that music can give to people in their senior years. The companionship and musical narrative that was rekindled in the late 90s is brilliantly captured and just in time: for the rest of us. The way these musicians and the technicians fuse, improvise, learn together, complement and contrast, and inspire each other is brilliant.

Whilst watching and listening I've realised that for the intro to the conceptual space notes I need to grasp details about the cussed customers - multidisciplinary, interdisciplinary, interprofessional and transdisciplinary.

Checking on current and forthcoming books I'm seeking a review copy to inform my musings:

The sequence in the title is not accidental but roughly equates to the descending frequency of use in health and social care. The most common (multidisciplinary) and least (transdisciplinary) are not dissimilar in needing to be defined and explored. Talk of multidisciplinary in theory, practice and management – notably policy – is so frequent that the meaning of the concept is diminished. On the other hand transdisciplinary is so infrequently used that the meaning is blurred. This is compounded by the noisy signature produced by the proximity of interdisciplinary and interprofessional.

This quartet are like musical disciplines and genres that can potentially grate on the ear and yet also make possible some amazing productions. Maybe that process is what goes into World Music? What in turn needs to go into global health?

^#Another much appreciated present is the Steve Jobs biog.

Social Impact Bonds (SIBs) in Health

2011-12-21T22:14:00.000Z

The following text is from the report:

Social Impact Bonds
A new way to invest in better healthcare

PURPOSE

This report is about the potential applicability of Social Impact Bonds
(SIBs) in the health field. The SIB is a financial mechanism where
investor returns are aligned with social outcomes. The SIB is based on a
contract with government in which the government commits to pay for
an improvement in social outcomes for a defined population. Investors
fund a range of preventative interventions with the goal of improving
the contracted outcomes. If and as the outcomes improve, investors
receive payments from government.

To widespread interest, the first SIB was launched in September 2010.
Its aim is to reduce reoffending among short sentence male prisoners
leaving Peterborough prison.

Social Finance believes that the reach of the Social Impact Bond
model is wider than Criminal Justice. We asked Professor Paul Corrigan,
a leading health adviser, to assess the suitability of the SIB model for
the NHS. This report presents his thoughts. We hope that his report
provokes a thoughtful debate on how, or alternatively if, financial
mechanisms such as Social Impact Bonds, might fund new
interventions, improve people’s well-being and ultimately lead to
a real change in the health system.

http://www.socialfinance.org.uk/resources/guide/new-way-invest-better-healthcare

Additional link:
Paul Corrigan - blog

My original source: HSJ

Time Magazine's 2011 'Person of the Year': The Protester

2011-12-19T21:33:00.000Z

This image released by Time Magazine, Wednesday, Dec. 14, 2011, shows the cover for Time Magazine's 2011 'Person of the Year' issue. The Protester is this year's choice.

Thinking about this recognition of The Protester I believe that -

the Protester is an example of a true holistic practitioner...

INTERPERSONAL : SCIENCES

SOCIOLOGY : POLITICAL

How does an individual decide 'enough is enough'? When does the one act on behalf of the many? What happens when a Person clenches their fist, decides to fight for their rights? In a digital world "NO" and denial of individual human rights is not an answer.	When is the individual a mere 'particle'? When are they a 'wave'?
The Protester TAKES IN ALL THE CARE DOMAINS. They reflect - but they do not see themselves - they see the future for family, friends, nation: and then they act.	When the State clenches its fist what does it strike? Who tends to the mental health of the world's leaders? What price for home, land, human rights, education, health information and justice?

MEMO:
TO: The Editor, Time Magazine
FROM: Welcome to the QUAD

Congratulations on your publication and this annual media event. It is fascinating to note the changing cultural, social and political influences evident in the history of 'Person of the Year', most evident in being originally 'Man of the Year'.

I note you have twice selected former president Ronald Reagan in 1980 and 1983 respectively. The former president disclosed that he was diagnosed in 1994 as having Alzheimer's disease. It is quite a coincidence that in-between Reagan's selection the means to a global memory The Computer was appointed as Machine of the Year in 1982. One thought: how many other individuals listed were, or are affected by the dementias?

I believe at some point in the next five years you could do a great service to the many Persons (younger as well as older adults) and their families who are living with dementia in acknowledging them as PERSON of the year.

To people living with this dreadful condition you can help highlight the importance of health, research, funding, policy, socioeconomic impact and most of all - person-hood where it really does matter.

Thank you for your consideration.

Yours Sincerely,

Peter Jones

Sources:
http://en.wikipedia.org/wiki/Time_Person_of_the_Year

http://en.wikipedia.org/wiki/Ronald_Reagan

States of mind and policy [I]: 25% of hospital beds...

2011-12-17T12:32:00.000Z

The repeated things that some people say, what does that denote?

The repeated things that other people say, what does that demonstrate?

INTERPERSONAL : SCIENCES

SOCIOLOGY : POLITICAL

In which care domain does the Person living with dementia reside?	1 : 4 - 25% of occupied beds [ diagnosis? ]
... and what of their carers... with their expertise?	there is a strategy - yet more hospital champions are needed and training.

My source:
BBC Radio 4 & RCN Students mail list

The International Council of Nurses (ICN) eHealth Bulletin - December Issue

2011-12-14T22:16:00.000Z

In this Issue:

ICN eHealth SAG Meeting
ICN Accredited Centres News
eHealth Programme Activities
Conference Presentations
eHealth Team Publications
ICN Website
Conference Announcements

Download:

English : Spanish : French

Student placements and public engagement - over the years

2011-12-13T00:01:00.000Z

Mentoring student nurses has always been and remains a non-trivial professional obligation. It is something that I have always enjoyed. I make a point of not wittering on and on about h2cm - well maybe a little :) . To save the student's patience and assure my time it is good to ensure a well-rounded placement.

Over the years I've engaged in community service and research projects so looking to the humanistic domains comes naturally. It's been quite interesting watching the various efforts the health sector has made to engage the public. There's no imperative, but I make a point of highlighting the possible learning to be had in contacting the local public involvement and engagement people. Students have found this to be quite enlightening. Encounters with the Community Health Council [CHC] especially so, although that seems a long time ago now.

The Health Service Journal (still catching up) reminded me of all this in the summer, c/o Calkin & West, 4 August 2011 pp. 4-5. This news item spanned my whole career outlining the history of such bodies:

Community Health Councils: 1974 - 2003
Patient and Public Involvement Forums 2003 - 2008
Local Involvement Networks 2008 - 2012
HealthWatch 2012 - ?

I even remember the demise of the CHC being reported. Actually no, correct that: I remember the report of the CHC's teeth being taken out before their end. As you look at the timeline represented above it seems to suggest either less stability, or less significance has set in; maybe both. The title of the above piece reads: Plans for engagement are 'insulting'.

Whether or not the CHC ever had sharp canines (with an extra full-moon glisten) and a bite force like a croc is something for the archaeologists to check. One thing for sure, it seems subsequent bodies have no need of dental check-ups, being sans teeth.

Working in the community it was heartening to see the CHC doing its work locally. I also read recently (HSJ I'm sure) how public involvement was finally enshrined in the The National Health Service Act 2006. So you see how progressive the CHC was. It is a great shame this momentum cannot be maintained - for reasons we'll return to in 2012.

For now, as students enter their third year I think it helps to bring life to the POLITICAL care domain. It matters. This ongoing issue is central to health services provision, planning, innovation and the commons ...

Blogging, social media (sins) and advertising

2011-12-12T19:10:00.001Z

Every day I receive emails offering guest posts, press releases relating to journal papers, or would I like to conduct interviews with various leaders of their respective fields, people who have also appeared on CNN and other high-end media.

To those who make these requests I have two struggles: firstly the topics whilst frequently concerned with 'health' they are not necessarily suitable for W2tQ; and secondly I do not have time to conduct interviews. This may change, but as things stand not any time soon.

So ... to people who do get in touch - thank you for your interest and recognition of the profile and work here on W2tQ. I greatly appreciate the support of existing paid link partners and seek new partnerships.

On this topic I posted on the LinkedIn group Social Media Today which I've expanded here, a reply to Courtney Seiter who asked:

What's the worst social media sin?
I'm working on a blog post about ways you can be a "social tool." What's your biggest pet peeve?

It depends on whether you're asking this of corporate users or individuals? As an individual or corporate user assuming that if you build something - they will come - you will have a 'community' is probably the biggest sin.

This is a key concern here. Just because you create a new website that includes what users need - stimulating content (indicative care concepts for care assessment, planning and evaluation...?), content that is relevant and makes users productive does not mean it will work as a community.

Many people in many forums have identified this already. It's important to learn from any existing readers, subscribers, and contacts you have to learn what people, your potential users want. Market research wins! There's no excuse for not being able to do this with the virtual tools available. And as my Drupal friends have stated (and since Szeged 2008) get something out there!

Courtney wonders about how you can be a social tool. Ultimately, it's about being a catalyst, creating a site that connects people (nurses, students) so that a community might emerge. A community that is not 'yours', but a self-sustaining force. (That said, there is always a need for maintenance of online communities - social media.)

My sin is not having an email newsletter, but in defence W2tQ is a newsletter of sorts.

Another consideration is how far do you spread the social media effort? Invites still come in for new social media initiatives, but I make a mental note of the name yet stay focused. My social media portfolio is full.

More specifically though what is the primary message? An obvious point perhaps; but is it about a product, values. purpose, ideology, change? What are the secondary messages that flow from this? How do these relate to your existing media footprint?

If your business model is distributed public relations are those individual efforts on behalf of clients actually causing damage? Can that affect a company's ranking? Sometimes less is more. ...

How will you respond when there is a pull on the (fishing) line? How do you measure success? How will you cope if you find you have a catch: a fishing net full? Well you never know. Are you ready to respond?

Drupalcon London (revisited) Entities & Omega

2011-12-09T21:00:00.000Z

I mentioned these two Drupalcon 2011 sessions in summer posts and thought they are well worth revisiting. The first concerns adaptive, responsive design and the Omega theme with Jake Strawn:

Omega keeps cropping up previous Drupalcons, in May at Drupalcamp in Leeds and Wednesday night at NWDUG in Manchester. What is Omega? Here is the intro to this (Drupal) project:

Omega - Responsive HTML5 Base Theme

The Omega Drupal 7 Base Theme is a highly configurable HTML5/960 grid base theme that is 100% configurable. Each zone (group of regions) can be configured for content first layouts (push/pull classes), hidden at any time and each region can be disabled, resized, and placed easily any way you see fit.

The theme appears fairly complex, but there is a lot of effort in developing the theme and tools to support it. Not unique to Omega but there's a way to have some pages with a different format according to context with alternate layout in terms of columns, zones, regions. ... The thought of working with columns seems constraining and yet reading and other sessions on the history of the printed page show how fundamental grids remain to design including the web.

A site that can respond and adapt the viewport to the device it is being viewed on is a must have. Central to design choices, there are fonts too. I notice this past week BBC Radio 4's Book of the Week has featured Just My Type by Simon Garfield and there are still a couple of days to listen to the episodes.

Another topic that keeps coming up is Entities, presented in August by Ronald Ashri:

The video and my notes from Drupalcon London remind me of being really switched on by this module, both in itself and with my requirements in mind.

In addition to the astronomical reference, Eric Evans's book Domain-Driven Design has an excellent figure that helps explain the scope and use of entities. I'll see if I can capture this at some point.

The astrolabe, programming and big pictures

2011-12-07T00:01:00.005Z

The astrolabe was a
mechanical implementation of
an object-orientation
model of the sky. p.47.

Eric Evans, (2009). Domain-Driven Design: Tackling Complexity in the Heart of Software, Model-Driven Design. Addison-Wesley.

Image source: http://planetariubm.wordpress.com/2011/03/01/femei-celebre-in-istoria-astronomiei-1/