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Monday, 15 January 2018

Paris Gourtsoyannis: Reshuffle more about Tories than Government

It must come down as the shortest promotion of history. Chris Grayling was announced yesterday as the new Conservative Party president for the full 27 seconds. If the transport secretary can reduce the average delay of the train to this type of weather, he can withdraw with triumph. A kind of humiliation was inevitable during the procedure. There is no "good" cabinet reorganization; When you take a step back, this is a process whereby an employer releases a handful of senior executives publicly and then replaces their replacements in the national media later in the day.

As a means of proving authority, there is little dignity, and the bas-reliefs of the previous re-treatments have passed into the legend. David Cameron was accused of sitting without unwanted servants while sipping red wine and saying they were too old. At least twice recently, jobs were announced for the wrong people because MPs had similar names. Former Labor member Malcolm Wicks reportedly missed a job as minister because a note with his name was on a bulletin board without anyone noticing it. But even if it can cause embarrassing newspaper copies, not many people in the real world will notice the Twitter blooper of the Conservative Party, and few will remember it. However, the error shows what this realignment is in reality and why it matters. Regardless of how unlikely it may seem, the fact that Grayling titulared as a president of the Conservative Party in half a minute is reminiscent of rock and roll folklore.

The Van Halen group was known for its tour driver, who demanded that the concert halls offer a M & M scale with all hand-selected brown sweets. The absurd, diva-behavior has fallen as one of the most bizarre examples of surplus rock and roll, but the real reason was only revealed when singer David Lee Roth published his autobiography. "When I walked backstage, when I saw a brown M & M in this bowl ... well, check the whole production," he writes. "Make sure you're going to make a technical mistake, they have not read the contract, you've guaranteed you'll have a problem ... something like, literally, living in danger."

Like a brown M & M in a candy bowl, a shameful tweet does not mean anything - but it's a little reminder of how the Conservative Party does not work. The chirp-snafu who released the name Grayling should come because ministers and party officials sincerely thought he would be accused of refreshing the conservatives' campaign.

The journalists were informed and started distributing the information, which was picked up by the political director of the CCHQ. The incorrect ad was then rejected on social media and instant messaging to conservative MPs. The fact that things went wrong tells us a number of things: first, although clash is a well-established mistake by the May government, the biggest decisions are still taken by a small group of people in Downing Street alone, without his colleagues in inform the party device in general; secondly, those who have stayed outside are those who are accused of spreading the message of the conservatives online, where they urgently need to close the gap with a Labor party stimulated by energy and know-how. momentum. Although the current figures are a well-preserved (and embarrassing) secret, expert analysis suggests that the number of members of the Conservative Party has dropped below 100,000 and may be as low as 70,000

The party has a specific problem with the young people under the age of 40, and that is why it needs so much to bridge the gap with work in digital messages. The flaws in his online operation can be life-threatening in general elections. Many of the conservatives' efforts in this area at the end of last year were spent trying to restore the perception created by a small parliamentary vote on the Brexit that was mismanaged and unnecessarily reported, that his deputies tried animals to make. The question was online viral, and conservative MPs asked social media to set the record right, posing with their pets if possible. The infinite postponement of May of every vote to restore fox hunting was a real attempt to clear up a mess that took place in cyberspace.

The reshuffling of this week is another. The new design of the New Year's cabinet is not about redefining the government of May, directing a new direction or giving it a new advantage. His hands are bound by parliamentary calculation exercises and external events, which is why so many big names have remained in the cabinet despite the long-standing will of the prime minister to dismiss them. The only radical shake-up that May will make was at the beginning of her term, when she left Cameron Toryism on the sidewalk for the binmen and set up an administration to deliver her idea of the Brexit. In any case, the government has little national agenda after 18 months.

Downing Street is honest with itself, it will admit that its role is to achieve a Brexit result that is acceptable to multiple voters before the next general election. No, it is not a rearrangement of the country or the government, but of the Conservative Party and the way it presents itself. The most important agreements are not in the Cabinet, but in the CPHQ, where the ambitious MP James Cleverly has been recruited to take youth, energy and some of his anarchist social media style into the Conservatives' campaign. . In a photo shoot of Downing Street yesterday, he was accompanied by a multi-ethnic group of conservative, gender-balanced MPs and newcomers who will spread across the country to revive the activities and campaigns of local parties.

This is another goal of the week's reshuffle: to introduce a new generation of leaders to take over in May while insisting that they be present at the next general election. You will not recognize new names today, but in three years one of them could be the prime minister.

Thursday, 4 January 2018

The Vital Role of Healthcare Quality Experts

Healthcare quality professionals serve in important roles. According to the National Association for Healthcare Quality (NAHQ), which sponsors the week, the work of healthcare quality professionals is critical for improving outcomes, increasing efficiencies, and reducing costs. Every year, over 200,000 to more than 400,000 patients are subject to preventable harm that leads to their death. Healthcare quality professionals are dedicated to making an impact on and reducing this number. Yet, NAHQ comments that healthcare quality professionals frequently go “unnoticed” because they often work behind the scenes.

The bipartisan Defeat Malnutrition Today coalition is especially cognizant and appreciative of the work of healthcare quality professionals and how their work can contribute to improving malnutrition care in this country. Through improving patient nutrition care, healthcare quality professionals can have an even more noticeable impact.

Malnutrition is a major concern because it can cause adverse and costly outcomes. Malnutrition, simply stated, is the lack of proper nutrients for one to function. It is an imbalance of protein, calories, or other vitamins or minerals that negatively impacts a person’s body mass, functions, and/or ultimate clinical outcomes. Malnutrition can lead to increased fall risk, slower recovery times, re-hospitalizations and readmissions, and death. Malnutrition is also a patient safety risk, as those who are malnourished are more likely to experience a healthcare-acquired condition.

The prevalence is shocking—up to one in two older adults are at risk for malnutrition. Malnutrition significantly increases hospital costs as well; poor nutritional status can cause up to a 300% increase in costs and, on average, an extension of hospital stays by four to six days.

A 2017 Administration for Community Living, Center for Policy and Evaluation report on malnutrition comments “At least 1/3 of patients of all ages in developed countries, including the U.S., are malnourished when admitted to the hospital, and, if untreated, about 2/3 will have their nutritional status decline during their hospitalization.” Yet, the American Society for Parenteral and Enteral Nutrition comments that every 60 seconds, 10 hospitalized patients with malnutrition go undiagnosed.

While malnutrition is a prevalent and potentially costly problem, it is also preventable. The National Blueprint: Achieving Quality Malnutrition Care for Older Adults calls for a range of strategies to prevent and reduce malnutrition among older adults, including “improv[ing] access to high-quality malnutrition care and nutrition services by adopting clinically relevant malnutrition quality measures in public and private accountability programs across the care continuum.”

The Centers for Medicare and Medicaid Services (CMS) have stated that malnutrition screening and assessment are important for better patient outcomes and that there is an opportunity for hospitals to improve nutrition screening and assessment practices. This can start by making healthcare quality professionals aware of the recently introduced malnutrition care electronic clinical quality measures and on-line toolkit developed by the Malnutrition Quality Improvement Initiative. Another resource is the Health Research and Education Trust’s Preventing Malnutrition Change Package.

As the healthcare industry continues its transformation to demonstrate value, healthcare quality professionals are faced with new challenges and opportunities. One critical opportunity that cannot be underestimated is improving malnutrition care. The annual cost of disease-associated malnutrition in older Americans is more than $50 billion. Quality malnutrition care has been shown to create savings and improve patient care. CMS is considering implementing the malnutrition measures nationally; quality professionals should advocate for these measures with CMS as well.

The bottom line is, recognizing the key role of healthcare quality professionals and engaging them in implementing these malnutrition electronic clinical quality measures will directly help healthcare institutions reduce preventable harm. It will also directly benefit older adult patients by improving their health and physical function outcomes. Institutional implementation of these measures is vital, and healthcare quality professionals can lead the way in their own institutions and in advocacy nationwide.

Sunday, 14 May 2017

When Healthcare Fraud Gets Personal

You may recall last year Tenet Healthcare has filed federal fraud charges related to applying for Medicaid maternity in 2 hospitals. The agreement includes an agreement of $ 513, an admission of guilty of 2 and a non-prosecution agreement as a provider cooperated with ongoing investigations.

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However, you may not have seen the last, the January indictment, a former vice president of Tenet who was involved in the plan. John Holland could face up to 50 years in prison if convicted of federal corruption charges and use of Medicaid reimbursements to run the activities of Tenet hospitals. Holland pleaded not guilty.

In a statement, the Dutch lawyer denied the allegations, saying that the contracts in question were more than 10 years, had been examined by various levels of the company and that the Netherlands did not personally benefit from the fraud. Federal brought a seizure against 2 houses that former leader Tenet owns.

Skipping individuals as a result of corporate fraud investigations has been anticipated by the Ministry of Justice Directive in 2015 to focus more on individuals. The Netherlands indictment follows a similar action against an official accused of Oklahoma to make loans in exchange for lucrative contracts to provide ambulance services, according to an article published in the daily health report BNA Bloomberg.

Monday, 9 January 2017

Hand washing protects you, others from germs, infection

Handwashing seems like a simple task, and although we know that this is an important way to reduce the chances of getting sick, many people still do not understand or recognize their value. During this time of year when diseases such as influenza and norovirus can spread quickly, it is especially important to have those few seconds needed to clean hands with soap and water or hand sanitizer.


The origins of handwashing as a way to reduce the spread of infection can be attributed to a Hungarian doctor Ignaz Semmelweis, who is practiced in a hospital in Vienna, Austria. In 1847, Dr. Semmelweis observed a high incidence of puerperal fever and death in women treated by inmates who had performed autopsies. Dr. Semmelweis invited students to wash their hands with a solution of chlorinated lime, which in today's world, plays an important role in public health and the health of the environment through its disinfectant, disinfectant and whitening properties .

Dr. Semmelweis noted an immediate reduction in the incidence of fatal postpartum fever from about 10 percent to 1 percent to 2 percent. Imagine Dr. Semmelweis saying, "Here is the proof," only to be rejected, ridiculed and ignored. He was discharged from the hospital and harassed so much by the medical community in Vienna he moved to Budapest. He spent many years arguing with the leading European medical professional only to be finally confined to a mental institution where he died. It was only after his death, when Louis Pasteur developed the germ theory, that Dr. Semmelweis's handwashing practice became more accepted.

Fast forward to today and see what has changed. Several studies have shown that compliance with handwashing has improved in some cases but is still poor in others. The American Society of Microbiology oversees the hands of American adults who wash habits since 1996. In the recent telephone survey, 96% of adults say they wash their hands after using public restrooms while 93% of women And 77% homework.

When the study began in 1996, overall compliance with public toilets was 68%, but despite this apparent improvement, 81% of us have seen (or heard) someone leaving public restrooms without washing their hands. Additional data show that washing hands before handling or eating food passes about 83 percent for women and 71 percent of men, 43 percent of mothers do not wash their hands after changing a Diaper and only 39 percent of Americans wash their hands after coughing or sneezing.

Microorganisms are "resident" and normally live on our skin in a stable or "transient" number and freely attach to the skin by contact with other people, surfaces and equipment. Some microorganisms are pathogens, causing diseases and surviving for hours, days or months on some surfaces.

The good news is that many transient microorganisms can be easily removed with the usual hygiene practices. When asked why hand washing or hand hygiene had not been done, most people thought it was not necessary or important that they forgot that they were not as long as the water and soap or hand sanitizer Too dry and irritated.

In the health care industry, hand washing with soap and water, and the use of hand sanitizer are clearly associated with a lower risk of associated health care infections. It is important that people realize that the risk of IRAS is no longer limited to the hospital setting; Nursing facilities, medical clinics and home care and palliative care are presented as risk areas.

The Centers for Disease Control and Prevention, the World Health Organization and other organizations have joined together to promote improved hand hygiene in health care around the world. Hand hygiene is only an element in reducing incidence and the burden of IRAS and the practice of handwashing or hand hygiene at the right time and in the right way greatly helps to protect the lives of those of us , As health professionals.

So which is better - water and soap or hand sanitizer? Numerous studies have found that hand-held disinfectants

Thursday, 29 December 2016

About Medicine: The flu; how it’s passed and what to do about it

Influenza (also known as "the flu") is a contagious respiratory disease caused by the flu virus and is most often transmitted by droplets. When an infected person talks, sneezes or coughs, droplets that contain the virus are produced.

These droplets can travel up to 6 feet, landing on the mucous membranes of nearby people. These drops can also land on surfaces or objects, and can be collected in the hands of another person, who then touches the eyes, nose or mouth. Once it contacts the mucosal virus, it infects the nose, throat and lungs.

In 1-4 days after exposure to the virus, you may experience one or more of the following signs and symptoms: fever or feeling of fever, chills, sore throat, cough, runny nose or swollen, muscle or tangible pain, Head, and feel very tired.

These symptoms can last as long as 10-14 days and can be so severe that a person may be bed-related (or attached to a couch) for much of that time. It is estimated that 50-80% of people can become infected with the virus but have no symptoms; So they transmit the disease to others without realizing it.

Anyone can get the flu, even those who are very healthy. Serious health problems and complications can occur in association with the flu. In the US, an average of 226,000 people are hospitalized and 36,000 die each year due to complications related to the flu and the flu.

Some people and age groups are at increased risk of developing more serious complications of the flu, including younger children, those 65, pregnant women, and people with certain chronic medical conditions.

These chronic medical conditions include asthma, COPD / emphysema, chronic heart disease, diabetes, a weakened immune system due to illness or medications, such as someone receiving chemotherapy or someone with chronic steroids and people with extreme obesity. Complications may include sinus and ear infections, pneumonia, myocarditis (inflammation of the heart), encephalitis (inflammation of the brain), rhabdomyolysis (muscle inflammation), and failure and multiple organ sepsis.

It can sometimes be difficult to distinguish influenza from other viral or bacterial diseases based on symptoms. If your health care provider wants to know for sure if you have the flu, he or she can do a specific test called the test for the rapid diagnosis of the flu. This requires a swab to be inserted deep into the nasal cavity and results are usually ready within 30 minutes.

In some cases, the result of the rapid test may be negative, but your symptoms indicate otherwise, so your health care provider may still decide that treatment with antiviral drugs. Sometimes, when there is a flu outbreak in a community, health care providers use their clinical judgment and treatment of infected individuals without being tested for the flu.

Some prescription drugs known as "antivirals" are a treatment option for influenza. There are three antiviral drugs approved by the FDA for the flu: Tamiflu, Relenza and Rapivab. These antivirals are not available on the counter; You must have a prescription from your health care provider to get it.

These medications can help reduce the severity and duration of flu symptoms, and although they work best when started within 2 days of the illness, they can still help if started later. These antiviral drugs can help prevent some of the serious complications in people at high risk.

Flu tends to be more common during the colder months of the year, and while the flu in the United States usually occurs between September and May, the peak month is February. The most important way to prevent the flu is to get a flu shot every year. The Centers for Disease Control and Prevention (CDC) recommends that anyone 6 months of age receive an annual flu vaccine.

The benefits of the flu vaccine are many, and include that it can help prevent the flu; The severity and duration of the disease can be reduced if you become ill; The risk of influenza-related complications and hospitalizations can be reduced; This helps to protect women during and after pregnancy with some antibodies transmitted to the baby.

Wednesday, 16 November 2016

How to Pass CPHQ Exam?

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Thursday, 10 November 2016

CPHQ Exam Question No 53

Question No 53:

What are the 3 basic closely interrelated activities that quality management employ?

Quality:

  • Planning
  • Control
  • Inprovement