Saturday, March 2, 2013

The patient satisfaction chasm

The patient satisfaction chasm [ Back to EurekAlert! ] Public release date: 1-Mar-2013
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Contact: Lori J. Schroth
ljschroth@partners.org
617-534-1604
Brigham and Women's Hospital

Researchers identify a gap between desires of hospital management and the experiences of frontline clinicians

Quality is a central component of any discussion around health care and one of the key dimensions and measurements of quality care is the patient experience. However, many healthcare organizations struggle to become 'patient focused' and fail to score well on patient satisfaction surveys. New research from Brigham and Women's Hospital, published in the March edition of British Medical Journal Quality and Safety, offers a potential explanation -- insufficient support from hospital management to improve the patient experience by engaging physicians and nurses in the process.

"Twelve years after the Institute of Medicine's Quality Chasm report called for fundamental improvement to patient-centered care, our findings raise concern as to whether hospital management is actively engaging clinicians in enhancing patient satisfaction," said Ronen Rozenblum, PhD, MPH, lead author of the study and a researcher in the Center of Patient Safety Research & Practice at BWH.

The research findings are based on a survey of 1004 physicians and nurses at four academic hospitals in Denmark, Israel, the UK and the United States. Results indicate that despite expanding initiatives, and the belief of most healthcare organizations that patient experience and satisfaction is important, the majority do not have a structured plan for how frontline providers can improve patient satisfaction during hospitalization.

Specifically researchers report that while 90.4 percent of clinicians surveyed believed improving patient satisfaction during hospitalization was achievable, only 9.2 percent of the clinicians said their department had a structured plan for improving patient satisfaction during hospitalization. Additionally researchers found that of the clinicians surveyed:

  • 38 percent remembered targeted actions that were conducted in their department in order to improve patient satisfaction.
  • 34 percent stated that during the last twelve months they had received feedback from hospital management regarding the level of patient satisfaction in their department.
  • 85 percent thought hospital management should take a more active role in patient satisfaction improvement programs.
  • 83 percent believed achieving high level of patient satisfaction was important for the clinical success of healthcare organizations.

"Organizations that are successful in fostering a culture of patient-centered care have incorporated it as a strategic investment priority by committed leadership, active measurement, feedback of patient satisfaction and engagement of patients and staff," said David Bates, MD, Chief Quality Officer at BWH and senior author of the paper. "We, in healthcare organizations, need to take a more active role in developing and implementing programs to improve patient experience and satisfaction and also in identifying ways to engage frontline clinicians in this process as well as ensuring they get routine feedback about patient experience and satisfaction. Ultimately, the patient experience is at the bedside."

Now that this chasm has been identified and defined, Drs. Bates and Rozenblum are working to address it. They created a framework for a patient experience culture and have begun to take the next steps to test and implement this structured patient satisfaction model.

Rozenblum said, "In order to improve, we need a systematic approach that starts at the bedside and grows up through hospital management levels to policy makers, all of whom should be committed to shifting healthcare organizations toward a culture of patient experience by making patient experience a strategic investment priority."

###

This research was partially supported by NHS South Central (UK).


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The patient satisfaction chasm [ Back to EurekAlert! ] Public release date: 1-Mar-2013
[ | E-mail | Share Share ]

Contact: Lori J. Schroth
ljschroth@partners.org
617-534-1604
Brigham and Women's Hospital

Researchers identify a gap between desires of hospital management and the experiences of frontline clinicians

Quality is a central component of any discussion around health care and one of the key dimensions and measurements of quality care is the patient experience. However, many healthcare organizations struggle to become 'patient focused' and fail to score well on patient satisfaction surveys. New research from Brigham and Women's Hospital, published in the March edition of British Medical Journal Quality and Safety, offers a potential explanation -- insufficient support from hospital management to improve the patient experience by engaging physicians and nurses in the process.

"Twelve years after the Institute of Medicine's Quality Chasm report called for fundamental improvement to patient-centered care, our findings raise concern as to whether hospital management is actively engaging clinicians in enhancing patient satisfaction," said Ronen Rozenblum, PhD, MPH, lead author of the study and a researcher in the Center of Patient Safety Research & Practice at BWH.

The research findings are based on a survey of 1004 physicians and nurses at four academic hospitals in Denmark, Israel, the UK and the United States. Results indicate that despite expanding initiatives, and the belief of most healthcare organizations that patient experience and satisfaction is important, the majority do not have a structured plan for how frontline providers can improve patient satisfaction during hospitalization.

Specifically researchers report that while 90.4 percent of clinicians surveyed believed improving patient satisfaction during hospitalization was achievable, only 9.2 percent of the clinicians said their department had a structured plan for improving patient satisfaction during hospitalization. Additionally researchers found that of the clinicians surveyed:

  • 38 percent remembered targeted actions that were conducted in their department in order to improve patient satisfaction.
  • 34 percent stated that during the last twelve months they had received feedback from hospital management regarding the level of patient satisfaction in their department.
  • 85 percent thought hospital management should take a more active role in patient satisfaction improvement programs.
  • 83 percent believed achieving high level of patient satisfaction was important for the clinical success of healthcare organizations.

"Organizations that are successful in fostering a culture of patient-centered care have incorporated it as a strategic investment priority by committed leadership, active measurement, feedback of patient satisfaction and engagement of patients and staff," said David Bates, MD, Chief Quality Officer at BWH and senior author of the paper. "We, in healthcare organizations, need to take a more active role in developing and implementing programs to improve patient experience and satisfaction and also in identifying ways to engage frontline clinicians in this process as well as ensuring they get routine feedback about patient experience and satisfaction. Ultimately, the patient experience is at the bedside."

Now that this chasm has been identified and defined, Drs. Bates and Rozenblum are working to address it. They created a framework for a patient experience culture and have begun to take the next steps to test and implement this structured patient satisfaction model.

Rozenblum said, "In order to improve, we need a systematic approach that starts at the bedside and grows up through hospital management levels to policy makers, all of whom should be committed to shifting healthcare organizations toward a culture of patient experience by making patient experience a strategic investment priority."

###

This research was partially supported by NHS South Central (UK).


[ Back to EurekAlert! ] [ | E-mail | Share Share ]

?


AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


Source: http://www.eurekalert.org/pub_releases/2013-03/bawh-tps030113.php

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Review boosts Canadian oil pipeline proposal

WASHINGTON (Reuters) - The Keystone XL oil pipeline got a boost on Friday when the State Department said the project would not likely change the rate at which Canada's oil sands are developed, discounting warnings from environmentalists that it would lead to a spike in greenhouse gas emissions.

The report is far from the last word on Keystone. The environmental assessment must be finalized after the public comment. Federal agencies will then have 90 days to work with the State Department to determine whether the pipeline is in the national interest, with U.S. President Barack Obama ultimately able to approve or block the project.

TransCanada Corp's proposed project is "unlikely to have a substantial impact" on development of Alberta's oil sands, the world's third-richest oil deposit, the State Department said in a long-awaited report of more than 2,000 pages. It said the pipeline would result in "no substantial change in global greenhouse gas emissions."

The more than 800,000 barrel per day pipeline would have little environmental impact on most resources along its proposed route, provided the company takes certain measures to make it safer, the review added.

Supporters of the project, which would bring oil to Texas refineries, have dismissed concerns it would lead to additional greenhouse gas emissions, saying the oil would reach markets regardless of whether the pipeline is built.

Obama rejected the pipeline in 2011 on concerns about its route through ecologically sensitive regions of Nebraska and after several high-profile spills on lines carrying Canadian crude.

Subsequently, TransCanada issued a new route for the pipeline, which Friday's assessment took into consideration.

PUBLIC TO SHAPE DEBATE

The State Department stressed that the report did not judge the project. The public will have 45 days to comment during a review starting next Friday. A final decision by the Obama administration that has been pending for more than 4-1/2 years is not expected until July or August.

TransCanada's chief executive, Russ Girling, said that construction of the pipeline could be complete by late 2014 or early 2105 if a final decision by the Obama administration comes by midsummer.

Kerri-Ann Jones, assistant secretary of the State Department, repeatedly refused to address whether the report offered support for building the pipeline, telling reporters on a press call that it would be premature to draw conclusions from the environmental assessment.

"We're really looking for the public debate at this point," Jones said. "We're looking for the feedback from the public to help us shape this going forward."

ClearView Energy Partners, an energy consulting firm, said the draft review signals that the administration may be preparing to argue that the construction of Keystone will not play a major role in climate change.

"Today's SEIS could be an indication that the White House is trending towards approval," ClearView said in a research note, although the group warned the administration may not be fully committed to that decision yet.

MOTHER NATURE

Many environmentalists oppose the project because, from wells to wheels, oil sands are more carbon-intensive than average crudes refined in the United States. They had been cheered by recent strong speeches by Obama and Secretary of State John Kerry on the need to take action on climate change.

One of Keystone's top critics said Friday's review was little different from a U.S. assessment in 2011.

"We're hearing the same rehashed arguments from the State Department about why a great threat to the climate is not a threat at all," said Bill McKibben, the founder of 350.org, an environmental group.

"Mother Nature filed her comments last year - the hottest year in American history; the top climate scientists in the U.S. have already chimed in. The rest of us have 45 days to make our voices heard, and we will," said McKibben, who has led protests at the White House.

Environmentalists have also raised concerns that oil sands are more corrosive and toxic than other forms of oil, which could lead to spills that threaten water supplies.

Supporters of Keystone say it would provide thousands of jobs, drain a glut of domestic crude oil from the North Dakota oil boom and strengthen North American energy security.

"The Keystone XL pipeline will make more Canadian and U.S. oil available to us ? oil that will not need to be imported from unfriendly places," said Karen Harbert, president of the U.S. Chamber of Commerce's Institute for 21st Century Energy.

Construction of the pipeline would support 42,100 jobs across the United States, directly and indirectly, the review said. The operation of the pipeline would result in 35 to 50 permanent jobs, it added.

Canadian politicians and industry have ratcheted up lobbying in support of Keystone. The stakes have risen for the Canadian pipeline supporters as prices for oil sands crude have slumped, partly due to limited capacity to export the oil.

Ottawa has warned that the oil price discount is taking a toll on Canada's national economy. Unidentified members of Prime Minister Stephen Harper's government told the Globe and Mail newspaper this week that a rejection of Keystone XL by Obama would seriously damage Canadian-United States relations.

TransCanada's Girling said there are now 12,000 pages of documents on the project, including the latest review, and that no stone has been left unturned in terms of environmental or market information.

"I believe this is a very good day for the Keystone project. It's just moved one step closer to approval," Girling said.

The southern half of the pipeline, from Texas to Oklahoma, is more than halfway built. Approval from the State Department was not needed because it does not cross the national border.

U.S. Senator John Hoeven, a Republican from North Dakota, said after four environmental reviews, the administration needs to make a decision on the project.

"While we welcome a finding of no significant impact, yet another indeterminate delay runs counter to both public opinion and reasonable due diligence," said Hoeven, who has crafted legislation that would allow Congress to approve the pipeline.

The pipeline would also move oil from his state, where shale oil production is booming.

(Reporting by Timothy Gardner, Ayesha Rascoe and Valerie Volcovici in Washington, Jeffrey Jones in Alberta, and David Ljunggren in Ottawa; Editing by Ros Krasny, Richard Chang and Dan Grebler)

Source: http://news.yahoo.com/u-review-gives-boost-keystone-oil-pipeline-011245846--finance.html

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Pour, shake and stir for HIV diagnosis

Friday, March 1, 2013

A diagnostic "cocktail" containing a single drop of blood, a dribble of water, and a dose of DNA powder with gold particles could mean rapid diagnosis and treatment of the world's leading diseases in the near future. The cocktail diagnostic is a homegrown brew being developed by University of Toronto's Institute of Biomaterials and Biomedical Engineering (IBBME) PhD student Kyryl Zagorovsky and Professor Warren Chan that could change the way infectious diseases, from HPV and HIV to malaria, are diagnosed.

And it involves the same technology used in over-the-counter pregnancy tests.

"There's been a lot of emphasis in developing simple diagnostics," says IBBME Professor and Canada Research Chair in Nanobiotechnology, Warren Chan. "The question is, how do you make it simple enough, portable enough?"

The recent winner of the NSERC E.W.R. Steacie Memorial Fellowship, Professor Chan and his lab study nanoparticles: in particular, the use of gold particles in sizes so small that they are measured in the nanoscale. Chan and his group are working on custom-designing nanoparticles to target and illuminate cancer cells and tumours, with the potential of one day being able to deliver drugs to cancer cells.

But it's a study recently published in Angewandte Chemie, a top chemistry journal published out of Germany, that's raising some interesting questions about the future of this relatively new frontier of science.

Zagorovsky's rapid diagnostic biosensor will allow technicians to test for multiple diseases at one time with one small sample, and with high accuracy and sensitivity. The biosensor relies upon gold particles in much the same vein as your average pregnancy test. With a pregnancy test, gold particles turn the test window red because the particles are linked with an antigen that detects a certain hormone in the urine of a pregnant woman.

"Gold is the best medium," explains Chan, "because it's easy to see. It emits a very intense colour."

Currently scientists can target the particular disease they are searching for by linking gold particles with DNA strands: when a sample containing the disease gene (ie. Malaria) is present, it clumps the gold particles, turning the sample blue. Rather than clumping the particles together, Zagorovsky immerses the gold particles in a DNA-based enzyme solution (DNA-zyme) that, when the disease gene is introduced, 'snip' the DNA from the gold particles, turning the sample red.

"It's like a pair of scissors," Zagorovsky explains, "and the target gene activates the scissors that cut the DNA links holding gold particles together."

The advantage is that far less of the gene needs to be present for the solution to show noticeable colour changes, amplifying detection. A single DNA-zyme can clip up to 600 "links" between the target genes.

Just a single drop from a biological sample such as saliva or blood can potentially be tested in parallel, so that multiple diseases can be tested for in one sitting.

But the team has also demonstrated that they are able to transform the testing solution into a powder, making it light and far easier to ship than solutions, which degrade over time. Powder can be stored for years at a time, and offers hope that the technology can be developed into efficient, cheap, over-the-counter tests for diseases such as HIV and malaria for developing countries, where access to portable diagnostics is a necessity.

"We've now put all the pieces together," says Chan.

###

University of Toronto Faculty of Applied Science & Engineering: http://www.engineering.utoronto.ca/home.htm

Thanks to University of Toronto Faculty of Applied Science & Engineering for this article.

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Source: http://www.labspaces.net/127093/Pour__shake_and_stir_for_HIV_diagnosis

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Sandy Hook: Love in the form of 10,000 books

The Student Nonprofit Alliance of Slippery Rock University has received nearly 10,000 books for their "We Can Read!" book drive to honor young readers killed at Sandy Hook Elementary School.

By Ben Frederick,?Contributor / March 1, 2013

"What better way to celebrate young [Sandy Hook] readers who were killed than to give the gift of reading to others?" asked Slippery Rock University professor Alice Del Vecchio.

Enlarge

After the shootings at Sandy Hook Elementary School in Newtown, Conn., last December, students and faculty at Slippery Rock University wondered what they could do. Then Alice Del Vecchio, assistant professor of professional studies at the Pennsylvania school, had an idea.

Skip to next paragraph Ben Frederick

Contributor

Ben Frederick is a contributor to The Christian Science Monitor.

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"What better way to celebrate young readers who were killed than to give the gift of reading to others?" she asked.

So Del Vecchio and the school's Student Nonprofit Alliance organized the "We Can Read!" book drive that ended last month. The drive collected and distributed more than 10,000 books nationwide.

?The project honors the children and their teachers and staff killed at Sandy Hook Elementary in a very special way," said Del Vecchio. "The children?s book drive will keep the spirit of those young readers alive and pass on the joy of learning to read to children far and wide.?

Participants were asked to purchase their favorite children's book, read it to a child, and then donate it to "We Can Read!" The books would then be sent to regional libraries, elementary schools, day care centers, and other similar programs for children.

Del Vecchio got the idea when she watched an interview with a parent of a child killed in the school shootings. He was saying that his daughter Emilie had recently learned to read, and enjoyed sharing stories with her siblings. It occurred to Del Vecchio that sharing books with children nationwide would be a wonderful way to honor the young readers of Sandy Hook.

The?Pittsburgh Post-Gazette?picked up the story in December at the beginning of the drive.?"Even if you've never been a parent or a teacher, you learned how to read," Del Vecchio told the Post-Gazette. "You remember sitting on somebody's lap and feeling safe. And then the first time you could read the story all by yourself, remember how excited you were."

According to the Slippery Rock student newspaper The Rocket, the drive has collected and distributed more than 10,000 books nationwide. More than 21 individuals and organizations across the country also organized their own "We Can Read!" or similar book drives. Those books have also been distributed to schools across the country.

The "Read Kansas City" initiative joined on for the months of January and February and collected about 6,000 books. The Connecticut PTA also signed on, and urged other PTAs across the state to participate as well.

The Slippery Rock effort culminated with the sending of Valentine's Day cards to the Sandy Hook school and Emilie's parents.

Source: http://rss.csmonitor.com/~r/feeds/csm/~3/_2ES-vhWtBQ/Sandy-Hook-Love-in-the-form-of-10-000-books

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Friday, March 1, 2013

With no pope, Catholic Church leaderless for now

Faithful watch a giant screen showing Pope Benedict XVI in St. Peter's Square, at the Vatican,Thursday, Feb. 28, 2013. The 85-year-old German Pope Benedict is stepping down on Thursday evening, the first pope to do so in 600 years, after saying he no longer has the mental or physical strength to vigorously lead the world's 1.2 billion Catholics. (AP Photo/Dmitry Lovetsky)

Faithful watch a giant screen showing Pope Benedict XVI in St. Peter's Square, at the Vatican,Thursday, Feb. 28, 2013. The 85-year-old German Pope Benedict is stepping down on Thursday evening, the first pope to do so in 600 years, after saying he no longer has the mental or physical strength to vigorously lead the world's 1.2 billion Catholics. (AP Photo/Dmitry Lovetsky)

Nuns wait for Pope Benedict XVI to greet the crowd from the window of the Pope's summer residence of Castel Gandolfo, the scenic town where he will spend his first post-Vatican days and make his last public blessing as pope,Thursday, Feb. 28, 2013. (AP Photo/Oded Balilty)

(AP) ? The Catholic Church has awoken with no leader following Pope Benedict XVI's dramatic resignation, in which he pledged obedience to his successor as a "simple pilgrim" starting the final pilgrimage of his life.

Now begins a period known as the "sede vacante" or "vacant see," the transition between the end of one papacy and the election of a new pope.

During these few days ? no more than 20 ? a few key players take charge running the Holy See, guiding the College of Cardinals in their deliberations and organizing the conclave to elect Benedict's successor.

In one of his first official acts as dean, Cardinal Angelo Sodano on Friday officially summons the voting-age cardinals to Rome to participate in the conclave, a formality given that most are already here.

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/3d281c11a96b4ad082fe88aa0db04305/Article_2013-03-01-EU-Vatican-Pope/id-c8f4fc70c7b84a49916cb4713e8cf0fc

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Humane Lobby Day Kicks Off in Montpelier : The Humane Society of ...

February?28,?2013

Vermont animal advocates lobby lawmakers to protect animals

Vermonters converged on the State Capitol for Humane Lobby Day in Montpelier to lobby in support of several measures including bills to improve conditions for farm animals by banning the extreme confinement of breeding pigs in gestation crates, and to strengthen standards for commercial dog breeders. Other measures the advocates expressed support for would require that complex surgical procedures on animals be performed by veterinarians and expedite hearings on animal cruelty cases to allow for the adoption of animals into new homes more quickly.

Advocates met with Gov. Peter Shumlin and delivered more than 1,300 signatures gathered in an on-line petition supporting stronger anti-cruelty laws.

?We are thrilled to see so many Vermonters bring their voices to Montpelier and speak on behalf of animals,? said Joanne Bourbeau, The HSUS? Northeastern regional director. ?We urge state legislators to make animal welfare a high priority this legislative session.??

?The ASPCA is proud to co-sponsor Humane Lobby Day in Montpelier, as it offers citizen lobbyists the chance to meet with their representatives to advocate on behalf of animals, who cannot speak for themselves,? said Bill Ketzer, senior state legislative director of ASPCA Government Relations for the Northeast region. ?We look forward to working with legislators to pass these important bills into law to better protect the animals of Vermont.?

The HSUS presented State Sen. Jeanette White, D-Windham, with its 2012 Humane State Legislator of the Year Award for sponsoring and championing the Senate passage of S. 142, a bill to improve the state?s regulatory system for commercial dog breeders.

?I was proud to sponsor legislation to ensure that breeding dogs are protected from inhumane conditions. Vermonters care deeply about how animals are raised and cared for, and this common sense legislation is long overdue,? said Sen. White.

Vermont Public Safety Commissioner Keith Flynn, who supports improvements to Vermont?s civil forfeiture law, said: ?The abuse and neglect of animals is a Public Safety issue that in some instances transcends those acts or omissions. As a State we have an obligation to aggressively enforce abuse and neglect laws to assure that animals are treated humanely."

Humane Lobby Day organizers also presented the legislative pet photo contest award to Rep. Larry Cupoli, R-Rutland, and his Springer Spaniels Louie and Lilly.

Vermont ranks 12th in The Humane Society of the United States? 2012 ?Humane State Rankings? which grades each state and the District of Columbia based on a wide range of animal protection laws dealing with pets, animal cruelty and fighting, wildlife, animals in research, horses and farm animals. Vermont?s strong animal fighting law and ban on the private ownership of exotic animals helps the state lead the nation in animal protection laws.

The Humane Society of the United States, the ASPCA? (The American Society for the Prevention of Cruelty to Animals?) and the Vermont Humane Federation sponsored Humane Lobby Day 2013.

Media Contacts:

HSUS: Ra?l Arce-Contreras: 301-721-6440; rcontreras@humanesociety.org

ASPCA: Maureen Linehan: 646-706-4602; maureen.linehan@aspca.org

Source: http://www.humanesociety.org/news/press_releases/2013/02/vt-humane-lobby-day-2013-022813.html

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Sky to buy Telefonica UK's fixed phone line and broadband business for up to ?200 million

Sky to buy Telefonica UK's fixed phone line and broadband business for up to ?200 million

Sky already supplies fixed phone line and broadband on top of its TV services in the UK, but it's just announced it'll be gaining a few more customers. The company has shaken hands with Telefonica UK to purchase the latter's broadband and phone line business provided by the consumer-facing O2 and BE brands. As you would imagine, big bucks will change hands: Sky plans to fork over £180 million (around $273 million) right off the bat, and will write a cheque for up to a further £20 million (circa $30 million) "dependent upon the successful delivery and completion of the customer migration process by Telefonica UK." Regulators will need to give the deal the thumbs up before it's official, but if and when that happens, Sky will become the second biggest ISP in the UK after adding over 500,000 new customers to its books. Should everything progress as planned, the buyout will be completed by the end of April, which gives Rupert Murdoch just enough time to carry out the vault extension he'll need.

Update: If you're worried this transaction will impact anything you're currently signed up to, you can probably rest easy. O2 has tweeted one of our editors to report "there will be no material change to a customer's broadband service and no fundamental contract change."

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Via: GigaOM

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