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Crisis resource management

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https://www.readbyqxmd.com/read/28915950/improving-team-performance-through-simulation-based-learning
#1
REVIEW
Mark S Volk
American health care is facing an epidemic of medical errors. A major cause of these errors is poor teamwork. Crisis resource management (CRM) is a set of teamwork principles derived from the airline industry. Medical simulation is an educational tool that affords health care providers a means of improving teamwork by learning and practicing CRM. This article (1) discusses the case for teaching team training, (2) reviews the principles of medical simulation as they pertain to team training, (3) provides practical guidelines for using medical simulation in otolaryngology education, (4) discusses current evidence for the efficacy of medical simulation...
October 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28903809/decision-making-in-crisis-applying-a-healthcare-triage-methodology-to-business-continuity-management
#2
Bethany Moore, Eric A Bone
The concept of triage in healthcare has been around for centuries and continues to be applied today so that scarce resources are allocated according to need. A business impact analysis (BIA) is a form of triage in that it identifies which processes are most critical, which to address first and how to allocate limited resources. On its own, however, the BIA provides only a roadmap of the impacts and interdependencies of an event. When disaster strikes, organisational decision-makers often face difficult decisions with regard to allocating limited resources between multiple 'mission-critical' functions...
January 1, 2017: Journal of Business Continuity & Emergency Planning
https://www.readbyqxmd.com/read/28894004/waiting-can-be-an-optimal-conservation-strategy-even-in-a-crisis-discipline
#3
Gwenllian D Iacona, Hugh P Possingham, Michael Bode
Biodiversity conservation projects confront immediate and escalating threats with limited funding. Conservation theory suggests that the best response to the species extinction crisis is to spend money as soon as it becomes available, and this is often an explicit constraint placed on funding. We use a general dynamic model of a conservation landscape to show that this decision to "front-load" project spending can be suboptimal if a delay allows managers to use resources more strategically. Our model demonstrates the existence of temporal efficiencies in conservation management, which parallel the spatial efficiencies identified by systematic conservation planning...
September 11, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28869934/typical-hemodialysis-in-india-a-case-report
#4
Georgi Abraham, Madhusudan Vijayan, Milly Mathew
We report here a typical case of a patient on hemodialysis (HD) for end-stage renal disease (ESRD) in India that highlights some of the management issues encountered in a country with an enormous burden of ESRD and major challenges of underdialysis and management of comorbidities. The patient, a 42-year-old multiparous woman with chronic kidney disease (CKD) stage V, type 2 diabetes mellitus, and hypertension is a homemaker from a middle-class family, living in a large city, with no family history of CKD. From May 2013 to December 2016, she has been receiving twice-weekly maintenance HD for 4 h (intermittent HD); access was via an internal jugular line initially and then via a left brachiocephalic arteriovenous fistula (AVF) from late June 2013...
2017: Blood Purification
https://www.readbyqxmd.com/read/28854937/the-impact-of-a-human-resource-management-intervention-on-the-capacity-of-supervisors-to-support-and-supervise-their-staff-at-health-facility-level
#5
Ogenna Uduma, Marie Galligan, Henry Mollel, Honorati Masanja, Susan Bradley, Eilish McAuliffe
BACKGROUND: A systematic and structured approach to the support and supervision of health workers can strengthen the human resource management function at the district and health facility levels and may help address the current crisis in human resources for health in sub-Saharan Africa by improving health workers' motivation and retention. METHODS: A supportive supervision programme including (a) a workshop, (b) intensive training and (c) action learning sets was designed to improve human resource management in districts and health facilities in Tanzania...
August 30, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28831442/cancer-care-at-times-of-crisis-and-war-the-syrian-example
#6
Eman Sahloul, Riad Salem, Wessam Alrez, Tayseer Alkarim, Ammar Sukari, Wasim Maziak, M Bassel Atassi
PURPOSE: As Syria enters its fifth year of conflict, the number of civilians killed and injured continues to rise sharply. Along with this conflict comes the rapid decline of medical care, specifically cancer care. To determine physician and equipment availability, cancer screening and management, and possible solutions relative to various major cities, a survey was distributed to physicians inside Syria through the help of the humanitarian organization Syrian American Medical Society...
August 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28790518/coordinated-management-of-academic-health-centers
#7
Jeffrey R Balser, William W Stead
Academic health centers (AHCs) are the nation's primary resource for healthcare discovery, innovation, and training. US healthcare revenue growth has declined sharply since 2009, and is forecast to remain well below historic levels for the foreseeable future. As the cost of education and research at nearly all AHCs is heavily subsidized through large transfers from clinical care margins, our institutions face a mounting crisis. Choices centering on how to increase the cost-effectiveness of the AHC enterprise require unprecedented levels of alignment to preserve an environment that nurtures creativity...
2017: Transactions of the American Clinical and Climatological Association
https://www.readbyqxmd.com/read/28726590/a-method-of-managing-severe-traumatic-brain-injury-in-the-absence-of-intracranial-pressure-monitoring-the-ice-protocol
#8
Randall Chesnut, Nancy Temkin, Sureyya Dikmen, Carlos Rondina, Walter Videtta, Gustavo Petroni, Silvia Lujan, Victor Alanis, Antonio Luis Eiras Falcao, Gustavo La Fuente, Luis Gonzalez, Manuel Jibaja, Arturo Lavendez, Freddy Sandi Lora, Roberto Merida, Ricardo Romero, James Pridgeon, Jason Barber, Joan Machamer, Kelley Chaddock
Purpose - The imaging- and clinical-examination (ICE) algorithm used in the BEST TRIP ICP randomized controlled trial is the only prospectively investigated clinical protocol for TBI management without ICP monitoring. As the default literature standard, it warrants careful evaluation. Methods - We present the ICE protocol in detail and analyse the demographics, outcome, treatment intensity, frequency of intervention usage, and related adverse events in the ICE-protocol cohort. Results - The 167 ICE protocol patients were young (median 29 years) with a median Glasgow Coma Scale motor score of 4 but with anisocoria or abnormal pupillary reactivity in 40%...
July 20, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28725643/crisis-team-management-in-a-scarce-resource-setting-angkor-hospital-for-children-in-siem-reap-cambodia
#9
Richard Alynn Henker, Hiroko Henker, Hor Eng, John O'Donnell, Tachawan Jirativanont
INTRODUCTION: A crisis team management (CTM) simulation course was developed by volunteers from Health Volunteers Overseas for physicians and nurses at Angkor Hospital for Children (AHC) in Siem Reap, Cambodia. The framework for the course was adapted from crisis resource management (1, 2), crisis team training (3), and TeamSTEPPs© models (4). The CTM course focused on teaching physicians and nurses on the development of team performance knowledge, skills, and attitudes. Challenges to providing this course at AHC included availability of simulation equipment, cultural differences in learning, and language barriers...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28724381/the-human-resources-for-health-effort-index-a-tool-to-assess-and-inform-strategic-health-workforce-investments
#10
Alfredo L Fort, Rachel Deussom, Randi Burlew, Kate Gilroy, David Nelson
BACKGROUND: Despite its importance, the field of human resources for health (HRH) has lagged in developing methods to measure its status and progress in low- and middle-income countries suffering a workforce crisis. Measures of professional health worker densities and distribution are purely numerical, unreliable, and do not represent the full spectrum of workers providing health services. To provide more information on the multi-dimensional characteristics of human resources for health, in 2013-2014, the global USAID-funded CapacityPlus project, led by IntraHealth International, developed and tested a 79-item HRH Effort Index modeled after the widely used Family Planning Effort Index...
July 19, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28724005/human-resources-for-health-global-crisis-and-international-cooperation
#11
Gustavo Zoio Portela, Amanda Cavada Fehn, Regina Lucia Sarmento Ungerer, Mario Roberto Dal Poz
From the 1990s onwards, national economies became connected and globalized. Changes in the demographic and epidemiological profile of the population highlighted the need for further discussions and strategies on Human Resources for Health (HRH). The health workforce crisis is a worldwide phenomenon. It includes: difficulties in attracting and retaining health professionals to work in rural and remote areas, poor distribution and high turnover of health staff particularly physicians, poor training of health workforces in new sanitation and demographic conditions and the production of scientific evidence to support HRH decision making, policy management, programs and interventions...
July 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28720266/strengths-and-resources-used-by-australian-and-danish-adult-patients-and-their-family-caregivers-during-treatment-for-cancer
#12
E Coyne, K B Dieperink, B Østergaard, D K Creedy
PURPOSE: Family plays an essential role in supporting the patient with cancer, however, relatively little attention has been given to understanding the strengths and resources of the family unit across different settings and countries. This study aims to investigate the strengths and resources of patients and family members in Australia and Denmark. METHODS: Using a descriptive, cross-sectional design, 232 patient and family participants from inpatient and outpatient oncology services in Australia and Denmark completed paper based surveys that included the Family Hardiness Index (FHI) and Family Crisis Orientated Personal Evaluation Scales (F-COPES), together with demographic and health information...
August 2017: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
https://www.readbyqxmd.com/read/28712116/multi-century-tree-ring-precipitation-record-reveals-increasing-frequency-of-extreme-dry-events-in-the-upper-blue-nile-river-catchment
#13
Mulugeta Mokria, Aster Gebrekirstos, Abrham Abiyu, Meine Van Noordwijk, Achim Bräuning
Climate-related environmental and humanitarian crisis are important challenges in the Great Horn of Africa (GHA). In the absence of long-term past climate records in the region, tree-rings are valuable climate proxies, reflecting past climate variations and complementing climate records prior to the instrumental era. We established annually resolved multi-century tree-ring chronology from Juniperus procera trees in northern Ethiopia, the longest series yet for the GHA. The chronology correlates significantly with wet-season (r = ...
July 16, 2017: Global Change Biology
https://www.readbyqxmd.com/read/28682317/a-management-strategy-that-reduces-nicu-admissions-and-decreases-charges-from-the-front-line-of-the-neonatal-abstinence-syndrome-epidemic
#14
S Loudin, J Werthammer, L Prunty, S Murray, J I Shapiro, T H Davies
OBJECTIVE: The purpose of this study was to test a specialized needs-based management model for a high volume of babies born with neonatal abstinence syndrome (NAS) while controlling costs and reducing neonatal intensive care unit (NICU) bed usage. STUDY DESIGN: Data were analyzed from inborn neonates >35 weeks' gestational age with the diagnosis of NAS (ICD9-CM 779.5), requiring pharmacologic treatment and discharged from 2010 through 2015. Significance was determined using Kruskal-Wallis and Mann-Whitney as well as χ(2) for trend...
July 6, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28676492/local-emergency-medical-response-after-a-terrorist-attack-in-norway-a-qualitative-study
#15
Aleidis S Brandrud, Michael Bretthauer, Guttorm Brattebø, May Jb Pedersen, Kent Håpnes, Karin Møller, Trond Bjorge, Bjørnar Nyen, Lars Strauman, Ada Schreiner, Gro S Haldorsen, Maria Bergli, Eugene Nelson, Tamara S Morgan, Per Hjortdahl
INTRODUCTION: On 22 July 2011, Norway suffered a devastating terrorist attack targeting a political youth camp on a remote island. Within a few hours, 35 injured terrorist victims were admitted to the local Ringerike community hospital. All victims survived. The local emergency medical service (EMS), despite limited resources, was evaluated by three external bodies as successful in handling this crisis. This study investigates the determinants for the success of that EMS as a model for quality improvement in healthcare...
July 4, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28673959/pharmacists-perceptions-of-their-emerging-general-practice-roles-in-uk-primary-care-a-qualitative-interview-study
#16
Jo Butterworth, Anna Sansom, Laura Sims, Mark Healey, Ellie Kingsland, John Campbell
BACKGROUND: UK general practice is experiencing a workload crisis. Pharmacists are the third largest healthcare profession in the UK; however, their skills are a currently underutilised and potentially highly valuable resource for primary health care. This study forms part of the evaluation of an innovative training programme for pharmacists who are interested in extended roles in primary care, advocated by a UK collaborative '10-point GP workforce action plan'. AIM: To explore pharmacists' perceptions of primary care roles including the potential for greater integration of their profession into general practice...
July 3, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28673217/validity-evidence-of-non-technical-skills-assessment-instruments-in-simulated-anaesthesia-crisis-management
#17
T Jirativanont, K Raksamani, N Aroonpruksakul, P Apidechakul, S Suraseranivongse
We sought to evaluate the validity of two non-technical skills evaluation instruments, the Anaesthetists' Non-Technical Skills (ANTS) behavioural marker system and the Ottawa Global Rating Scale (GRS), to apply them to anaesthesia training. The content validity, response process, internal structure, relations with other variables and consequences were described for validity evidence. Simulated crisis management sessions were initiated during which two trained raters evaluated the performance of postgraduate first-, second- and third-year (PGY-1, PGY-2 and PGY-3) anaesthesia residents...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28667224/improving-patient-safety-through-better-teamwork-how-effective-are-different-methods-of-simulation-debriefing-protocol-for-a-pragmatic-prospective-and-randomised-study
#18
Julia Freytag, Fabian Stroben, Wolf E Hautz, Dorothea Eisenmann, Juliane E Kämmer
INTRODUCTION: Medical errors have an incidence of 9% and may lead to worse patient outcome. Teamwork training has the capacity to significantly reduce medical errors and therefore improve patient outcome. One common framework for teamwork training is crisis resource management, adapted from aviation and usually trained in simulation settings. Debriefing after simulation is thought to be crucial to learning teamwork-related concepts and behaviours but it remains unclear how best to debrief these aspects...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28654549/workload-of-team-leaders-and-team-members-during-a-simulated-sepsis-scenario
#19
Nancy M Tofil, Yiqun Lin, John Zhong, Dawn Taylor Peterson, Marjorie Lee White, Vincent Grant, David J Grant, Ronald Gottesman, Stephanie N Sudikoff, Mark Adler, Kimberly Marohn, Jennifer Davidson, Adam Cheng
OBJECTIVES: Crisis resource management principles dictate appropriate distribution of mental and/or physical workload so as not to overwhelm any one team member. Workload during pediatric emergencies is not well studied. The National Aeronautics and Space Administration-Task Load Index is a multidimensional tool designed to assess workload validated in multiple settings. Low workload is defined as less than 40, moderate 40-60, and greater than 60 signify high workloads. Our hypothesis is that workload among both team leaders and team members is moderate to high during a simulated pediatric sepsis scenario and that team leaders would have a higher workload than team members...
September 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28626540/acute-crises-and-complications-of-sickle-cell-anemia-among-patients-attending-a-pediatric-tertiary-unit-in-kinshasa-democratic-republic-of-congo
#20
Michel Ntetani Aloni, Bertin Tshimanga Kadima, Pépé Mfutu Ekulu, Aléine Nzazi Budiongo, René Makuala Ngiyulu, Jean Lambert Gini-Ehungu
In the Democratic Republic of Congo, the incidence of sickle cell anemia (SCA) is estimated to affect 30,000 to 40,000 neonates per year. However, there is paucity of data on acute clinical manifestations in sickle cell children. In these circumstances, it is difficult to develop a health care policy for an adequate management of sickle cell patients. This was a seven years' retrospective study of children admitted with acute sickle cell crisis in the Department of Pediatrics in University Hospital of Kinshasa, Kinshasa, the Democratic Republic of Congo...
June 1, 2017: Hematology Reports
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