Applying Organizational Learning Research to Accountable Care Organizations.

PubMed

Nembhard, Ingrid M; Tucker, Anita L

2016-12-01

To accomplish the goal of improving quality of care while simultaneously reducing cost, Accountable Care Organizations (ACOs) need to find new and better ways of providing health care to populations of patients. This requires implementing best practices and improving collaboration across the multiple entities involved in care delivery, including patients. In this article, we discuss seven lessons from the organizational learning literature that can help ACOs overcome the inherent challenges of learning how to work together in radically new ways. The lessons involve setting expectations, creating a supportive culture, and structuring the improvement efforts. For example, with regard to setting expectations, framing the changes as learning experiences rather than as implementation projects encourages the teams to utilize helpful activities, such as dry runs and pilot tests. It is also important to create an organizational culture where employees feel safe pointing out improvement opportunities and experimenting with new ways of working. With regard to structure, stable, cross-functional teams provide a powerful building block for effective improvement efforts. The article concludes by outlining opportunities for future research on organizational learning in ACOs. © The Author(s) 2016.

LESSONS FROM THE FRONT: A CASE STUDY OF RUSSIAN CYBER WARFARE

DTIC Science & Technology

2015-12-01

Lessons From The Front: A Case Study Of Russian Cyber Warfare looks to capitalize on the lessons learned from the alleged Russian cyber-offensive on...through the careful analysis and comparison of two disparate conflicts related by their collision with Russian cyber - warfare . Following case study

South Carolina Health Occupations Education I & II. [Lessons Planning Guide for] Supplemental Competencies.

ERIC Educational Resources Information Center

Connell, Shirley

This lesson planning guide for supplemental competencies in health education addresses the three domains of learning: psychomotor, cognitive, and affective. It can be used with any teaching method (e.g., lecture/demonstration, discussion, and small group). The guide contains units on: acute care and long-term care; cultural aspects of patient…

Lessons from school: what nurse leaders can learn from education.

PubMed

Davies, Nigel

2015-07-01

The drive to improve quality in the education sector is similar to that in health care, and lessons from the schools system are relevant to nursing leadership. This article discusses these shared traits, and details how school improvement was achieved in London and how a model of learning-centred leadership helped to transform pupil attainment in schools that had been performing poorly. Parallels are drawn between the education inspection system undertaken by Ofsted and the hospital inspections undertaken by the Care Quality Commission, and between the practice discipline-based managerial roles of nurse directors and head teachers. The article suggests that a learning-centred approach to improving the quality of patient care is needed, with a focus on the education and continuing professional development of staff.

A comparative study of the health care systems of Canada and Saudi Arabia: lessons and insights.

PubMed

Qutub, Akram F; Al-Jewair, Thikriat S; Leake, James L

2009-10-01

Understanding the structure of a health care system is essential in improving public health policies and health outcomes. To describe and compare the health care systems of Canada and Saudi Arabia; to discuss possible lessons that could be learned from both for policy-making purposes. A comprehensive method was used to describe the national health care systems of both countries. For each country, the system is described by: context, ownership, delivery, financing, organisational structure, target groups, and comprehensiveness of services. In Canada, the Medicare system provides comprehensive medical services except for dental, optometric, chiropractic, pharmacologic and home care services. The dental care system is financed privately (94%) and is owned and delivered by private for-profit dental practitioners. In Saudi Arabia, the government sector is owned, delivered, and financed by the government and provides free comprehensive medical and dental services. The same services are provided by the private sector, but under governmental supervision. Among the relevant lessons: access to care, accountability, quality assurance, mix and reimbursement of providers. Canada can learn about different approaches to socialising the dental care system. Saudi Arabia can improve the implementation of quality assurance practices and management.

Pediatric Care Coordination: Lessons Learned and Future Priorities.

PubMed

Cady, Rhonda G; Looman, Wendy S; Lindeke, Linda L; LaPlante, Bonnie; Lundeen, Barbara; Seeley, Amanda; Kautto, Mary E

2015-09-30

A fundamental component of the medical home model is care coordination. In Minnesota, this model informed design and implementation of the state's health care home (HCH) model, a key element of statewide healthcare reform legislation. Children with medical complexity (CMC) often require care from multiple specialists and community resources. Coordinating this multi-faceted care within the HCH is challenging. This article describes the need for specialized models of care coordination for CMC. Two models of care coordination for CMC were developed to address this challenge. The TeleFamilies Model of Pediatric Care Coordination uses an advanced practice registered nurse care (APRN) coordinator embedded within an established HCH. The PRoSPer Model of Pediatric Care Coordination uses a registered nurse/social worker care coordinator team embedded within a specialty care system. We describe key findings from implementation of these models, and conclude with lessons learned. Replication of the models is encouraged to increase the evidence base for care coordination for the growing population of children with medical complexities.

An interactive learning environment for health care professionals.

PubMed Central

Cobbs, E.; Pincetl, P.; Silverman, B.; Liao, R. L.; Motta, C.

1994-01-01

This article summarizes experiences to date with building and deploying a clinical simulator that medical students use as part of a 3rd year primary care rotation. The simulated microworld helps students and health care professionals gain experience with and learn meta-cognitive skills for the care of complex patient populations that require treatment in the biopsychosocial-value dimensions. We explain lessons learned and next steps resulting from use of the program by over 300 users to date. PMID:7949975

Insights from a pilot program to integrate medical and social services.

PubMed

Meiners, Mark R; Mokler, Pamela M; Kasunic, Mary Lynn; Hawthornthwaite, Scott; Foster, Susan; Scheer, David; Maldonado, Anna Maria

2014-01-01

This study examines lessons learned from the design, implementation, and early results of an integrated managed care pilot program linking member benefits of a Medicare-Medicaid health care plan with community services and supports. The health plan's average monthly costs for members receiving an assessment and services declined by an economically meaningful, statistically significant amount in the postintervention period relative to the preintervention period compared with those who did not accept an assessment or services. The results along with the lesson learned from the pilot are viewed by the parties as supportive of further program development.

Development of a Web-Based Health Care Intervention for Patients With Heart Disease: Lessons Learned From a Participatory Design Study

PubMed Central

2017-01-01

Background The use of telemedicine technologies in health care has increased substantially, together with a growing interest in participatory design methods when developing telemedicine approaches. Objective We present lessons learned from a case study involving patients with heart disease and health care professionals in the development of a personalized Web-based health care intervention. Methods We used a participatory design approach inspired by the method for feasibility studies in software development. We collected qualitative data using multiple methods in 3 workshops and analyzed the data using thematic analysis. Participants were 7 patients with diagnosis of heart disease, 2 nurses, 1 physician, 2 systems architects, 3 moderators, and 3 observers. Results We present findings in 2 parts. (1) Outcomes of the participatory design process: users gave valuable feedback on ease of use of the platforms’ tracking tools, platform design, terminology, and insights into patients’ monitoring needs, information and communication technologies skills, and preferences for self-management tools. (2) Experiences from the participatory design process: patients and health care professionals contributed different perspectives, with the patients using an experience-based approach and the health care professionals using a more attitude-based approach. Conclusions The essential lessons learned concern planning and organization of workshops, including the finding that patients engaged actively and willingly in a participatory design process, whereas it was more challenging to include and engage health care professionals. PMID:28526674

Leveraging Trauma Lessons from War to Win in a Complex Global Environment.

PubMed

Remick, Kyle N

2016-01-01

The US military has made great strides in combat casualty care since 2001. As the Army concludes combat operations in Iraq and Afghanistan, it faces new operational challenges in trauma care. The military medical community must stay ahead of the curve through sustaining current investments in combat casualty care research. This article describes lessons learned at war from a Joint Trauma System perspective in order to place in context how we should proceed in order to provide optimal care for our Warfighters in the future.

Flying Lessons for Clinicians: Developing System 2 Practice.

PubMed

Gregoire, Jerome N; Alfes, Celeste M; Reimer, Andrew P; Terhaar, Mary F

There is a long history of adopting lessons learned from aviation to improve health care practice. Two of the major practices that have successfully transferred include using a checklist and simulation. Training and simulation technology is currently underdeveloped for nurses and health care providers entering critical care transport. This article describes a pedagogical approach adopted from aviation to develop a new simulation platform and program of research to develop the science of critical care transport nursing education. Copyright © 2017 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

Clinical review: the role of the intensive care physician in mass casualty incidents: planning, organisation, and leadership.

PubMed

Shirley, Peter J; Mandersloot, Gerlinde

2008-01-01

There is a long-standing, broad assumption that hospitals will ably receive and efficiently provide comprehensive care to victims following a mass casualty event. Unfortunately, the majority of medical major incident plans are insufficiently focused on strategies and procedures that extend beyond the pre-hospital and early-hospital phases of care. Recent events underscore two important lessons: (a) the role of intensive care specialists extends well beyond the intensive care unit during such events, and (b) non-intensive care hospital personnel must have the ability to provide basic critical care. The bombing of the London transport network, while highlighting some good practices in our major incident planning, also exposed weaknesses already described by others. Whilst this paper uses the events of the 7 July 2005 as its point of reference, the lessons learned and the changes incorporated in our planning have generic applications to mass casualty events. In the UK, the Department of Health convened an expert symposium in June 2007 to identify lessons learned from 7 July 2005 and disseminate them for the benefit of the wider medical community. The experiences of clinicians from critical care units in London made a large contribution to this process and are discussed in this paper.

Care coordination for children with special needs in Medicaid: lessons from Medicare.

PubMed

Stewart, Kate A; Bradley, Katharine W V; Zickafoose, Joseph S; Hildrich, Rachel; Ireys, Henry T; Brown, Randall S

2018-04-01

To provide actionable recommendations for improving care coordination programs for children with special healthcare needs (CSHCN) in Medicaid managed care.  Literature review and interviews with stakeholders and policy experts to adapt lessons learned from Medicare care coordination programs for CSHCN in Medicaid managed care. We reviewed syntheses of research on Medicare care coordination programs to identify lessons learned from successful programs. We adapted findings from Medicare to CSHCN in Medicaid based on an environmental scan and discussions with experts. The scan focused on Medicaid financing and eligibility for care coordination and how these intersect with Medicaid managed care. The expert discussions included pediatricians, Medicaid policy experts, Medicaid medical directors, and a former managed care executive, all experienced in care coordination for CSHCN. We found 6 elements that are consistently associated with improved outcomes from Medicare care coordination programs and relevant to CSHCN in Medicaid: 1) identifying and targeting high-risk patients, 2) clearly articulating what outcomes programs are likely to improve, 3) encouraging active engagement between care coordinators and primary care providers, 4) requiring some in-person contact between care coordinators and patients, 5) facilitating information sharing among providers, and 6) supplementing care coordinators' expertise with that of other clinical experts. States and Medicaid managed care organizations have many options for designing effective care coordination programs for CSHCN. Their choices should account for the diversity of conditions among CSHCN, families' capacity to coordinate care, and social determinants of health.

Lessons from psychiatry and psychiatric education for medical learners and teachers.

PubMed

Hilty, Donald M; Srinivasan, Malathi; Xiong, Glen L; Ferranti, Jessica; Li, Su-Ting T

2013-06-01

Medical learners, teachers, and institutions face significant challenges in health care delivery and in training the next generation of clinicians. We propose that psychiatry offers lessons which may help improve how we take care of patients and how we teach others to care for patients. Our objective is to discuss what learners and teachers can learn from psychiatry, organized around (1) how we make decisions, (2) how we learn, and (3) how we reflect on our practice. Information from clinical care, education, neuroscience and other aspects of life (e.g. business, creativity, and research) help us on these processes. We make 'good' decisions in concert with patients and learners, by listening to their experiences, asking questions and exploring subjective and objective information. Our learning has a neurobiological basis, and is effectively furthered by personalization, reinforcement, acquisition of critical thinking skills, and assessment of our limitations and errors. Our ability to reflect is determined by attitude, skill, tolerating ambiguity or dissonance, and planning for the unexpected. These processes - in addition to knowledge and other skills - will help physicians be successful in practice, learning and teaching, research and leadership.

Interprofessional education development: not for the faint of heart

PubMed Central

Fahs, Deborah B; Honan, Linda; Gonzalez-Colaso, Rosana; Colson, Eve R

2017-01-01

Interprofessional education (IPE) has the potential to improve communication, collaboration and coordination of care, leading to improved health care outcomes. Promoting IPE has become an aim for many professional schools. However, there are challenges to implementing meaningful curricula that involve multiple health care professional schools. In this study, we outline 12 lessons learned when designing and implementing an Interprofessional Longitudinal Clinical Experience (ILCE) for 247 students from a School of Nursing, Medicine and Physician Associate Program in New England. Lessons learned over 4 years include pilot, evaluate and refine projects; create a formal interprofessional organizational structure; involve faculty who are passionate ambassadors for IPE; procure and maintain financial support; recognize power struggles and bias; overcome logistical conundrums to realize common goals, secure clinical sites and prepare IPE coaches; expect there will always be another hurdle; do not go it alone; recruit experts; recognize role differentiation and similarities; be aware of fragility of students and faculty and collect data to assess, evaluate, improve and gain buy-in. We were able to successfully implement a large program for students from three different health care professional schools that takes place in the clinical setting with faculty coaches, patients and their families. We hope that the lessons learned can be instructive to those considering a similar effort. PMID:28553153

Lessons Learned for Collaborative Clinical Content Development

PubMed Central

Collins, S.A.; Bavuso, K.; Zuccotti, G.; Rocha, R.A.

2013-01-01

Background Site-specific content configuration of vendor-based Electronic Health Records (EHRs) is a vital step in the development of standardized and interoperable content that can be used for clinical decision-support, reporting, care coordination, and information exchange. The multi-site, multi-stakeholder Acute Care Documentation (ACD) project at Partners Healthcare Systems (PHS) aimed to develop highly structured clinical content with adequate breadth and depth to meet the needs of all types of acute care clinicians at two academic medical centers. The Knowledge Management (KM) team at PHS led the informatics and knowledge management effort for the project. Objectives We aimed to evaluate the role, governance, and project management processes and resources for the KM team’s effort as part of the standardized clinical content creation. Methods We employed the Center for Disease Control’s six step Program Evaluation Framework to guide our evaluation steps. We administered a forty-four question, open-ended, semi-structured voluntary survey to gather focused, credible evidence from members of the KM team. Qualitative open-coding was performed to identify themes for lessons learned and concluding recommendations. Results Six surveys were completed. Qualitative data analysis informed five lessons learned and thirty specific recommendations associated with the lessons learned. The five lessons learned are: 1) Assess and meet knowledge needs and set expectations at the start of the project; 2) Define an accountable decision-making process; 3) Increase team meeting moderation skills; 4) Ensure adequate resources and competency training with online asynchronous collaboration tools; 5) Develop focused, goal-oriented teams and supportive, consultative service based teams. Conclusions Knowledge management requirements for the development of standardized clinical content within a vendor-based EHR among multi-stakeholder teams and sites include: 1) assessing and meeting informatics knowledge needs, 2) setting expectations and standardizing the process for decision-making, and 3) ensuring the availability of adequate resources and competency training. PMID:23874366

Prospects for regulated competition in the health care system: what can China learn from Russia's experience?

PubMed

Xu, Weiwei; Sheiman, Igor; van de Ven, Wynand P M M; Zhang, Wei

2011-05-01

As China explores new directions to reform its health care system, regulated competition among both insurers and providers of care might be one potential model. The Russian Federation in 1993 implemented legislation intended to stimulate such regulated competition in the health care sector. The subsequent progress and lessons learned over these 17 years can shed light on and inform the future evolution of the Chinese system. In this paper, we list the necessary pre-conditions for reaping the benefits of regulated competition in the health care sector. We indicate to what extent these conditions are being fulfilled in the post-reform Russian and current Chinese health care systems. We draw lessons from the Russian experience for the Chinese health care system, which shares a similar economic and political background with the pre-reform Russian health care system in terms of the starting point of the reform, and analyse the prospects for regulated competition in China.

Landmark lecture on cardiology: the quest for the ultimate team in health care - what we can learn from musicians about leadership, innovation, and teambuilding?

PubMed

Penny, Daniel J

2017-12-01

The importance of teamwork is being increasingly recognised in healthcare. Nonetheless, it is equally recognised that teamwork is difficult. In this article, I explore whether we can learn lessons from musicians, orchestras, and conductors as we build our teams. The evolution of the role of the conductor provides useful lessons on leadership and the evolving role of the members of the orchestra on how team members can contribute to a shared outcome. The uncertainty of jazz provides useful lessons for innovation in an increasingly turbulent healthcare environment.

Through Their Eyes: Lessons Learned Using Participatory Methods in Health Care Quality Improvement Projects

PubMed Central

Balbale, Salva N.; Locatelli, Sara M.; LaVela, Sherri L.

2016-01-01

In this methodological article, we examine participatory methods in-depth to demonstrate how these methods can be adopted for quality improvement (QI) projects in health care. We draw on existing literature and our QI initiatives in the Department of Veterans Affairs to discuss the application of photovoice and guided tours in QI efforts. We highlight lessons learned and several benefits of using participatory methods in this area. Using participatory methods, evaluators can engage patients, providers and other stakeholders as partners to enhance care. Participant involvement helps yield actionable data that can be translated into improved care practices. Use of these methods also helps generate key insights to inform improvements that truly resonate with stakeholders. Using participatory methods is a valuable strategy to harness participant engagement and drive improvements that address individual needs. In applying these innovative methodologies, evaluators can transcend traditional approaches to uniquely support evaluations and improvements in health care. PMID:26667882

Blended learning: strengths, challenges, and lessons learned in an interprofessional training program.

PubMed

Lotrecchiano, G R; McDonald, P L; Lyons, L; Long, T; Zajicek-Farber, M

2013-11-01

This field report outlines the goals of providing a blended learning model for an interdisciplinary training program for healthcare professionals who care for children with disabilities. The curriculum blended traditional face-to-face or on-site learning with integrated online interactive instruction. Credit earning and audited graduate level online coursework, community engagement experiences, and on-site training with maternal and child health community engagement opportunities were blended into a cohesive program. The training approach emphasized adult learning principles in different environmental contexts integrating multiple components of the Leadership Education in Neurodevelopmental and Related Disabilities Program. This paper describes the key principles adopted for this blended approach and the accomplishments, challenges, and lessons learned. The discussion offers examples from training content, material gathered through yearly program evaluation, as well as university course evaluations. The lessons learned consider the process and the implications for the role of blended learning in this type of training program with suggestions for future development and adoption by other programs.

Investigating Health Disparities through Community-Based Participatory Research: Lessons Learned from a Process Evaluation

PubMed Central

Bryan, Valerie; Brye, Willette; Hudson, Kenneth; Dubose, Leevones; Hansberry, Shantisha; Arrieta, Martha

2014-01-01

This article describes one university's efforts to partner with a local agency (the “Coalition”) within a disadvantaged, predominantly African American neighborhood, to assist them with studying their community's health disparities and health care access. The final, mutually agreed-upon plan used a community-based participatory research approach, wherein university researchers prepared neighborhood volunteers and Coalition members to conduct face-to-face interviews with residents about their health and health care access. Subsequently, the Coalition surveyed 138 residents, and the agency now possesses extensive data about the nature and extent of health problems in their community. Lessons learned from these experiences are offered. PMID:24871770

Formation of Community-Based Hypertension Practice Networks: Success, Obstacles, and Lessons Learned

PubMed Central

Dart, Richard A.; Egan, Brent M.

2014-01-01

Community-based practice networks for research and improving the quality of care are growing in size and number but have variable success rates. In this paper we review recent efforts to initiate a community-based hypertension network modeled after the successful Outpatient Quality Improvement Network (O’QUIN) project, located at the Medical University of South Carolina. We highlight key lessons learned and new directions to be explored. PMID:24666425

Lessons learned from non-medical industries: root cause analysis as culture change at a chemical plant

PubMed Central

Carroll, J; Rudolph, J; Hatakenaka, S

2002-01-01



 Root cause analysis was introduced to a chemical plant as a way of enhancing performance and safety, exemplified by the investigation of an explosion. The cultural legacy of the root cause learning intervention was embodied in managers' increased openness to new ideas, individuals' questioning attitude and disciplined thinking, and a root cause analysis process that provided continual opportunities to learn and improve. Lessons for health care are discussed, taking account of differences between the chemical and healthcare industries. PMID:12486993

Integrated Crew Health Care System for Space Flight

NASA Technical Reports Server (NTRS)

Davis, Jeffrey R.

2007-01-01

Dr. Davis' presentation includes a brief overview of space flight and the lessons learned for health care in microgravity. He will describe the development of policy for health care for international crews. He will conclude his remarks with a discussion of an integrated health care system.

Epidemiologic methods lessons learned from environmental public health disasters: Chernobyl, the World Trade Center, Bhopal, and Graniteville, South Carolina.

PubMed

Svendsen, Erik R; Runkle, Jennifer R; Dhara, Venkata Ramana; Lin, Shao; Naboka, Marina; Mousseau, Timothy A; Bennett, Charles

2012-08-01

Environmental public health disasters involving hazardous contaminants may have devastating effects. While much is known about their immediate devastation, far less is known about long-term impacts of these disasters. Extensive latent and chronic long-term public health effects may occur. Careful evaluation of contaminant exposures and long-term health outcomes within the constraints imposed by limited financial resources is essential. Here, we review epidemiologic methods lessons learned from conducting long-term evaluations of four environmental public health disasters involving hazardous contaminants at Chernobyl, the World Trade Center, Bhopal, and Graniteville (South Carolina, USA). We found several lessons learned which have direct implications for the on-going disaster recovery work following the Fukushima radiation disaster or for future disasters. These lessons should prove useful in understanding and mitigating latent health effects that may result from the nuclear reactor accident in Japan or future environmental public health disasters.

The Design of Lessons Using Mathematics Analysis Software to Support Multiple Representations in Secondary School Mathematics

ERIC Educational Resources Information Center

Pierce, Robyn; Stacey, Kaye; Wander, Roger; Ball, Lynda

2011-01-01

Current technologies incorporating sophisticated mathematical analysis software (calculation, graphing, dynamic geometry, tables, and more) provide easy access to multiple representations of mathematical problems. Realising the affordances of such technology for students' learning requires carefully designed lessons. This paper reports on design…

Formation of community-based hypertension practice networks: success, obstacles, and lessons learned.

PubMed

Dart, Richard A; Egan, Brent M

2014-06-01

Community-based practice networks for research and improving the quality of care are growing in size and number but have variable success rates. In this paper, the authors review recent efforts to initiate a community-based hypertension network modeled after the successful Outpatient Quality Improvement Network (O'QUIN) project, located at the Medical University of South Carolina. Key lessons learned and new directions to be explored are highlighted. ©2014 Wiley Periodicals, Inc.

Skill Set Requirements for Nurses Deployed with an Expeditionary Medical Unit Based on Lessons Learned

DTIC Science & Technology

2008-01-01

however, such threats were compounded by the intense heat and never- ending sand storms, which created a heightened sense of anxiety. A matter of...those who treat injured soldiers. Experiencing or witnessing a frightening event that arouses intense feelings of fear, helplessness, or horror sets...this deployment. Patient care and lessons learned On April 15, 2003, the 4th HSB began re- ceiving casualties caused by heat exposure, explo- sive

The Long March to Health.

ERIC Educational Resources Information Center

Silver, George A.

1979-01-01

The comprehensive medical care system being utilized in China is described. Topics discussed include: the availability of medical care, training of physicians, medical care costs, and the political and social implications of the Chinese system. Lessons the United States can learn from the Chinese experience are presented. (BT)

Tactical Combat Casualty Care in the Canadian Forces: lessons learned from the Afghan war

PubMed Central

Savage, Erin; Forestier, Colleen; Withers, Nicholas; Tien, Homer; Pannell, Dylan

2011-01-01

Tactical Combat Casualty Care (TCCC) is intended to treat potentially preventable causes of death on the battlefield, but acknowledges that application of these treatments may place the provider and even the mission in jeopardy if performed at the wrong time. Therefore, TCCC classifies the tactical situation with respect to health care provision into 3 phases (care under fire, tactical field care and tactical evacuation) and only permits certain interventions to be performed in specific phases based on the danger to the provider and casualty. In the 6 years that the Canadian Forces (CF) have been involved in sustained combat operations in Kandahar, Afghanistan, more than 1000 CF members have been injured and more than 150 have been killed. As a result, the CF gained substantial experience delivering TCCC to wounded soldiers on the battlefield. The purpose of this paper is to review the principles of TCCC and some of the lessons learned about battlefield trauma care during this conflict. PMID:22099324

International academic service learning: lessons learned from students' travel experiences of diverse cultural and health care practices in morocco.

PubMed

Kaddoura, Mahmoud; Puri, Aditi; Dominick, Christine A

2014-01-01

Academic service learning (ASL) is an active teaching-learning approach to engage students in meaningful hands-on activities to serve community-based needs. Nine health professions students from a private college and a private university in the northeastern United States volunteered to participate in an ASL trip to Morocco. The participants were interviewed to reflect on their experiences. This article discusses the lessons learned from students' ASL experiences regarding integrating ASL into educational programs. The authors recommend a paradigm shift in nursing and dental hygiene curricula to appreciate diversity and promote cultural competency, multidisciplinary teamwork, and ethics-based education. Copyright 2014, SLACK Incorporated.

Lessons Learned from Developing a Patient Engagement Panel: An OCHIN Report.

PubMed

Arkind, Jill; Likumahuwa-Ackman, Sonja; Warren, Nate; Dickerson, Kay; Robbins, Lynn; Norman, Kathy; DeVoe, Jennifer E

2015-01-01

There is renewed interest in patient engagement in clinical and research settings, creating a need for documenting and publishing lessons learned from efforts to meaningfully engage patients. This article describes early lessons learned from the development of OCHIN's Patient Engagement Panel (PEP). OCHIN supports a national network of more than 300 community health centers (CHCs) and other primary care settings that serve over 1.5 million patients annually across nearly 20 states. The PEP was conceived in 2009 to harness the CHC tradition of patient engagement in this new era of patient-centered outcomes research and to ensure that patients were engaged throughout the life cycle of our research projects, from conception to dissemination. Developed by clinicians and researchers within our practice-based research network, recruitment of patients to serve as PEP members began in early 2012. The PEP currently has a membership of 18 patients from 3 states. Over the past 24 months, the PEP has been involved with 12 projects. We describe developing the PEP and challenges and lessons learned (eg, recruitment, funding model, creating value for patient partners, compensation). These lessons learned are relevant not only for research but also for patient engagement in quality improvement efforts and other clinical initiatives. © Copyright 2015 by the American Board of Family Medicine.

Alberta's systems approach to chronic disease management and prevention utilizing the expanded chronic care model.

PubMed

Delon, Sandra; Mackinnon, Blair

2009-01-01

Alberta's integrated approach to chronic disease management programming embraces client-centred care, supports self-management and facilitates care across the continuum. This paper presents strategies implemented through collaboration with primary care to improve care of individuals with chronic conditions, evaluation evidence supporting success and lessons learned from the Alberta perspective.

Lessons Learned from Home Visiting with Home-Based Child Care Providers

ERIC Educational Resources Information Center

McCabe, Lisa A.; Peterson, Shira M.; Baker, Amy C.; Dumka, Marsha; Brach, Mary Jo; Webb, Diana

2011-01-01

Caring for Quality and Partners in Family Child Care are home visiting programs designed to improve the quality of home-based child care. This article describes the experiences of two different home visitors to demonstrate how programs such as these can help providers improve the overall quality of care, increase children's development, and lead…

pH1N1 - a comparative analysis of public health responses in Ontario to the influenza outbreak, public health and primary care: lessons learned and policy suggestions

PubMed Central

2013-01-01

Background Ontario’s 36 Public Health Units (PHUs) were responsible for implementing the H1N1 Pandemic Influenza Plans (PIPs) to address the first pandemic influenza virus in over 40 years. It was the first under conditions which permitted mass immunization. This is therefore the first opportunity to learn and document what worked well, and did not work well, in Ontario’s response to pH1N1, and to make recommendations based on experience. Methods Our objectives were to: describe the PIP models, obtain perceptions on outcomes, lessons learned and to solicit policy suggestions for improvement. We conducted a 3-phase comparative analysis study comprised of semi-structured key informant interviews with local Medical Officers of Health (n = 29 of 36), and Primary Care Physicians (n = 20) and in Phase 3 with provincial Chief-Medical Officers of Health (n = 6) and a provincial Medical Organization. Phase 2 data came from a Pan-Ontario symposium (n = 44) comprised leaders representing: Public Health, Primary Care, Provincial and Federal Government. Results PIPs varied resulting in diverse experiences and lessons learned. This was in part due to different PHU characteristics that included: degree of planning, PHU and Primary Care capacity, population, geographic and relationships with Primary Care. Main lessons learned were: 1) Planning should be more comprehensive and operationalized at all levels. 2) Improve national and provincial communication strategies and eliminate contradictory messages from different sources. 3) An integrated community-wide response may be the best approach to decrease the impact of a pandemic. 4) The best Mass Immunization models can be quickly implemented and have high immunization rates. They should be flexible and allow for incremental responses that are based upon: i) pandemic severity, ii) local health system, population and geographic characteristics, iii) immunization objectives, and iv) vaccine supply. Conclusion “We were very lucky that pH1N1 was not more severe.” Consensus existed for more detailed planning and the inclusion of multiple health system and community stakeholders. PIPs should be flexible, allow for incremental responses and have important decisions (E.g., under which conditions Public Health, Primary Care, Pharmacists or others act as vaccine delivery agents.) made prior to a crisis. PMID:23890226

Simulated Disaster Day: Benefit From Lessons Learned Through Years of Transformation From Silos to Interprofessional Education.

PubMed

Livingston, Laura L; West, Courtney A; Livingston, Jerry L; Landry, Karen A; Watzak, Bree C; Graham, Lori L

2016-08-01

Disaster Day is a simulation event that began in the College of Nursing and has increased exponentially in size and popularity for the last 8 years. The evolution has been the direct result of reflective practice and dedicated leadership in the form of students, faculty, and administration. Its development and expansion into a robust interprofessional education activity are noteworthy because it gives health care professions students an opportunity to work in teams to provide care in a disaster setting. The "authentic" learning situation has enhanced student knowledge of roles and responsibilities and seems to increase collaborative efforts with other disciplines. The lessons learned and modifications made in our Disaster Day planning, implementation, and evaluation processes are shared in an effort to facilitate best practices for other institutions interested in a similar activity.

Top 10 Lessons Learned from Electronic Medical Record Implementation in a Large Academic Medical Center.

PubMed

Rizer, Milisa K; Kaufman, Beth; Sieck, Cynthia J; Hefner, Jennifer L; McAlearney, Ann Scheck

2015-01-01

Electronic medical record (EMR) implementation efforts face many challenges, including individual and organizational barriers and concerns about loss of productivity during the process. These issues may be particularly complex in large and diverse settings with multiple specialties providing inpatient and outpatient care. This case report provides an example of a successful EMR implementation that emphasizes the importance of flexibility and adaptability on the part of the implementation team. It also presents the top 10 lessons learned from this EMR implementation in a large midwestern academic medical center. Included are five overarching lessons related to leadership, initial approach, training, support, and optimization as well as five lessons related to the EMR system itself that are particularly important elements of a successful implementation.

Top 10 Lessons Learned from Electronic Medical Record Implementation in a Large Academic Medical Center

PubMed Central

Rizer, Milisa K.; Kaufman, Beth; Sieck, Cynthia J.; Hefner, Jennifer L.; McAlearney, Ann Scheck

2015-01-01

Electronic medical record (EMR) implementation efforts face many challenges, including individual and organizational barriers and concerns about loss of productivity during the process. These issues may be particularly complex in large and diverse settings with multiple specialties providing inpatient and outpatient care. This case report provides an example of a successful EMR implementation that emphasizes the importance of flexibility and adaptability on the part of the implementation team. It also presents the top 10 lessons learned from this EMR implementation in a large midwestern academic medical center. Included are five overarching lessons related to leadership, initial approach, training, support, and optimization as well as five lessons related to the EMR system itself that are particularly important elements of a successful implementation. PMID:26396558

Connected care in a fragmented world: lessons from rural health care

PubMed Central

Farmer, Jane

2007-01-01

This paper uses the phenomenon of very high satisfaction with remote rural health services in Scotland as a trigger for exploring what consumers want and like in health service utilisation — and why. It draws on the business literature in customer services marketing and economic sociology to illuminate why long-term associations between consumers and providers in health care are important and beneficial. In doing so, it highlights wider lessons about the experience of good health care to be learned from the satisfaction expressed by rural residents and suggests, as health services become increasingly fragmented, the relevance of maintaining a connected experience for patients. PMID:17359611

Through Their Eyes: Lessons Learned Using Participatory Methods in Health Care Quality Improvement Projects.

PubMed

Balbale, Salva N; Locatelli, Sara M; LaVela, Sherri L

2016-08-01

In this methodological article, we examine participatory methods in depth to demonstrate how these methods can be adopted for quality improvement (QI) projects in health care. We draw on existing literature and our QI initiatives in the Department of Veterans Affairs to discuss the application of photovoice and guided tours in QI efforts. We highlight lessons learned and several benefits of using participatory methods in this area. Using participatory methods, evaluators can engage patients, providers, and other stakeholders as partners to enhance care. Participant involvement helps yield actionable data that can be translated into improved care practices. Use of these methods also helps generate key insights to inform improvements that truly resonate with stakeholders. Using participatory methods is a valuable strategy to harness participant engagement and drive improvements that address individual needs. In applying these innovative methodologies, evaluators can transcend traditional approaches to uniquely support evaluations and improvements in health care. © The Author(s) 2015.

Advantages and Disadvantages of the Patient-Centered Medical Home: A Critical Analysis and Lessons Learned.

PubMed

Budgen, Jacqueline; Cantiello, John

This article provides a detailed examination of the pros and cons associated with patient-centered medical homes (PCMHs). Opinions and findings from those who have studied PCMHs and those who have been directly involved with this type of health care model are outlined. Key lessons from providers are detailed, and critical success factors are highlighted. This synthesized analysis serves to lend evidence to health care managers and providers who are considering implementation of the PCMH model.

The birth of nerve agent warfare: lessons from Syed Abbas Foroutan.

PubMed

Newmark, Jonathan

2004-05-11

The author reviewed Farsi-language articles published recently by Dr. Syed Abbas Foroutan, which constitute the only firsthand clinical descriptions of battlefield nerve agent casualties in the world literature, and the author compares his comments with US and North Atlantic Treaty Organization (NATO) chemical casualty care doctrine. Foroutan's lessons learned reassure us that a robust medical evacuation system, coupled with timely and appropriate medical care of nerve agent poisoning, will save many more lives on future battlefields.

Learning from losing: ethical, psychoanalytic, and spiritual perspectives on managing the incremental losses of the distributed self in dementia.

PubMed

Lomax, James W

2011-01-01

The author describes his experiences making decisions about the care of his mother, who was suffering from dementia, and the profound effect this process had on him as a psychotherapist. As background, he first presents an overview of writings from Jerry M. Lewis, George Pollock, and George Vaillant on issues related to attachment, death, loss, and mourning. The author equates his experiences caring for his mother with a type of involuntary "continuing education" and describes the lessons he learned as he was faced with decisions about his mother's level of care and as he mourned the slow, piecemeal loss of her distributed self. A case vignette is presented to illustrate how the author applied the lessons he had learned in psychotherapy with a distressed patient caring for her aging mother. The article concludes with a summary of the clinical and ethical questions raised by this case and the author's experience with his mother and a discussion of principles that can help psychotherapists provide treatment for patients who are caring for family members with dementia. (Journal of Psychiatric Practice. 2011;17:41-48).

Information technology enters the doctor's office: Part II--Six lessons about intended ... and unintended ... results.

PubMed

Frankel, P; Chernow, R; Rosenberg, W

1994-02-01

Part I of this article ("Six Design and Implementation Lessons," Physician Executive, Sept.-Oct. 1993, pp. 46-50) described an ambulatory utilization review (AUR) program designed and implemented by Metropolitan Life Insurance Company and reviewed some of the lessons learned over the past five years. Those lessons pertained to the tasks of inventing a new information technology to measure and evaluate ambulatory care and some of the practical implementation issues associated with review of 30,000 small dollar value claims per day in 19 claim offices nationwide. This article turns to the basic purpose of AUR--to review the medical necessity and appropriateness of ambulatory utilization. One lesson learned about AUR in this context is that AUR works: savings from the program outweigh costs by almost 5:1. The more important lessons, however, stem from understanding how the savings are achieved, and what some of the other unintended benefits of the program are.

A doctor in the house: rationale for providing on-site urological consultation to geriatric patients in nursing health care facilities.

PubMed

Watson, Richard A; Suchak, Nihirika; Steel, Knight

2010-08-01

To establish a rationale for providing on-site urological care on a regular basis in the nursing health care center setting and to share "lessons learned," which we have garnered in providing that care over a 5-year experience. We have reviewed and assessed our experiences in providing urological outreach to nursing health care center patients. Our outreach program has been well received both by patients and by health care center personnel. Over this time, we have capitalized on many advantages that this initiative offers, and we have gained, through this experience, several "lessons learned," not only regarding what to do, but also what to avoid. Advantages to on-site urological care include: (1) timely, targeted clinical intervention; (2) significant disease prevention; (3) expedition of treatment; (4) health care provider education; and (5) rich opportunities for clinical investigation. In addition, the on-site urologist can provide the health care center with helpful advice and validation in meeting federal and state health care requirements. Unfortunately, to date, remuneration for such programs has been discouraging. Federal and state regulations continue to impede innovative change. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Lessons in Safety: Cultural Politics and Safety Education in a Multiracial, Multiethnic Early Childhood Education Setting

ERIC Educational Resources Information Center

Saltmarsh, Sue

2010-01-01

Young children learn about safety from a variety of sources, including formal lessons and informal activities provided through early childhood education and care (ECEC) services. For many ECEC centres in Australia, scheduled visits from police and fire departments are a highlight of safety education activities. Such visits offer children the…

Epidemiologic Methods Lessons Learned from Environmental Public Health Disasters: Chernobyl, the World Trade Center, Bhopal, and Graniteville, South Carolina

PubMed Central

Svendsen, Erik R.; Runkle, Jennifer R.; Dhara, Venkata Ramana; Lin, Shao; Naboka, Marina; Mousseau, Timothy A.; Bennett, Charles

2012-01-01

Background: Environmental public health disasters involving hazardous contaminants may have devastating effects. While much is known about their immediate devastation, far less is known about long-term impacts of these disasters. Extensive latent and chronic long-term public health effects may occur. Careful evaluation of contaminant exposures and long-term health outcomes within the constraints imposed by limited financial resources is essential. Methods: Here, we review epidemiologic methods lessons learned from conducting long-term evaluations of four environmental public health disasters involving hazardous contaminants at Chernobyl, the World Trade Center, Bhopal, and Graniteville (South Carolina, USA). Findings: We found several lessons learned which have direct implications for the on-going disaster recovery work following the Fukushima radiation disaster or for future disasters. Interpretation: These lessons should prove useful in understanding and mitigating latent health effects that may result from the nuclear reactor accident in Japan or future environmental public health disasters. PMID:23066404

What went right: lessons for the intensivist from the crew of US Airways Flight 1549.

PubMed

Eisen, Lewis A; Savel, Richard H

2009-09-01

On January 15, 2009, US Airways Flight 1549 hit geese shortly after takeoff from LaGuardia Airport in New York City. Both engines lost power, and the crew quickly decided that the best action was an emergency landing in the Hudson River. Due to the crew's excellent performance, all 155 people aboard the flight survived. Intensivists can learn valuable lessons from the processes and outcome of this incident, including the importance of simulation training and checklists. By learning from the aviation industry, the intensivist can apply principles of crew resource management to reduce errors and improve patient safety. Additionally, by studying the impact of the mandated process-engineering applications within commercial aviation, intensivists and health-care systems can learn certain principles that, if adequately and thoughtfully applied, may seriously improve the art and science of health-care delivery at the bedside.

Transforming Primary Care Practice and Education: Lessons From 6 Academic Learning Collaboratives.

PubMed

Koch, Ursula; Bitton, Asaf; Landon, Bruce E; Phillips, Russell S

Adoption of new primary care models has been slow in academic teaching practices. We describe a common framework that academic learning collaboratives are using to transform primary care practice based on our analysis of 6 collaboratives nationally. We show that the work of the collaboratives could be divided into 3 phases and provide detail on the phases of work and a road map for those who seek to emulate this work. We found that learning collaboratives foster transformation, even in complex academic practices, but need specific support adapted to their unique challenges.

Surgical and Resuscitation Capabilities for the "Next War" Based on Lessons Learned From "This War".

PubMed

Freel, David; Warr, Bradley J

2016-01-01

The Army gleaned many lessons regarding the provision of medical care to casualties during the past 14 years of combat. Using these lessons learned in the Joint Capabilities and Integration Development process and through the analysis of an integrated process action team, the Army recently approved 3 changes to medical organizations that are intended to provide trauma management farther forward on the battlefield. These changes include the substitution of an emergency medicine trained physician and emergency medicine physician assistant (PA) in lieu of a general medical officer and primary care PA within the brigade combat team; reorganization of the forward surgical team into a forward surgical and resuscitative team; and the modularization of the traditional 248 bed combat support hospital. The Army anticipates that these changes related to personnel, organizations, doctrine, and materiel will enable Army medicine to provide enhanced trauma management closer to the point of a combatant's injury. These modifications are projected to begin in fiscal year 2016.

Missed opportunities for diagnosis: lessons learned from diagnostic errors in primary care.

PubMed

Goyder, Clare R; Jones, Caroline H D; Heneghan, Carl J; Thompson, Matthew J

2015-12-01

Because of the difficulties inherent in diagnosis in primary care, it is inevitable that diagnostic errors will occur. However, despite the important consequences associated with diagnostic errors and their estimated high prevalence, teaching and research on diagnostic error is a neglected area. To ascertain the key learning points from GPs' experiences of diagnostic errors and approaches to clinical decision making associated with these. Secondary analysis of 36 qualitative interviews with GPs in Oxfordshire, UK. Two datasets of semi-structured interviews were combined. Questions focused on GPs' experiences of diagnosis and diagnostic errors (or near misses) in routine primary care and out of hours. Interviews were audiorecorded, transcribed verbatim, and analysed thematically. Learning points include GPs' reliance on 'pattern recognition' and the failure of this strategy to identify atypical presentations; the importance of considering all potentially serious conditions using a 'restricted rule out' approach; and identifying and acting on a sense of unease. Strategies to help manage uncertainty in primary care were also discussed. Learning from previous examples of diagnostic errors is essential if these events are to be reduced in the future and this should be incorporated into GP training. At a practice level, learning points from experiences of diagnostic errors should be discussed more frequently; and more should be done to integrate these lessons nationally to understand and characterise diagnostic errors. © British Journal of General Practice 2015.

Delivering quality care: what can emergency gynaecology learn from acute obstetrics?

PubMed

Bika, O H; Edozien, L C

2014-08-01

Emergency obstetric care in the UK has been systematically developed over the years to high quality standards. More recently, advances have been made in the organisation and delivery of care for women presenting with acute gynaecological problems, but a lot remains to be done, and emergency gynaecology has a lot to learn from the evolution of its sister special interest area: acute obstetric care. This paper highlights areas such as consultant presence, risk management, patient flow pathways, out-of-hours care, clinical guidelines and protocols, education and training and facilities, where lessons from obstetrics are transferrable to emergency gynaecology.

Lessons from the Deployment of the SPIRIT App to Support Collaborative Care for Rural Patients with Complex Psychiatric Conditions

PubMed Central

Bauer, Amy M.; Hodsdon, Sarah; Hunter, Suzanne; Choi, Youlim; Bechtel, Jared; Fortney, John C.

2017-01-01

We report the design and deployment of a mobile health system for patients receiving primary care-based mental health services (Collaborative Care) for post-traumatic stress disorder and/or bipolar disorder in rural health centers. Here we describe the clinical model, our participatory approach to designing and deploying the mobile system, and describe the final system. We focus on the integration of the system into providers’ clinical workflow and patient registry system. We present lessons learned about the technical and training requirements for integration into practice that can inform future efforts to incorporate health technologies to improve care for patients with psychiatric conditions. PMID:29075683

"How Does Your Garden Grow?" Teaching Preschool Children about the Environment

ERIC Educational Resources Information Center

Witt, Susan D.; Kimple, Katherine P.

2008-01-01

Raising consciousness about the environment and learning ways to care for our planet are important for all citizens of the world. Young children are particularly receptive to learning new concepts; thus the preschool years are an ideal time to teach lessons about the environment. It is often the case that the information learned when children are…

Lessons Learned, Innovative Practices, and Emerging Trends: Technology for Teacher Education and Professional Development

ERIC Educational Resources Information Center

Donohue, Chip; Fox, Selena

2012-01-01

Since 1999, the authors have written numerous articles and books, given hundreds of presentations, served on national eLearning groups, and created new international online programs, all while paying careful attention to the trends, issues, and best practices in the effective use of technology tools and distance learning methods. In this article,…

The Relationship of Listening to Classical Music on First Graders' Ability To Retain Information.

ERIC Educational Resources Information Center

Lewis, Erin

In traditional reading and CARE lessons (a curriculum used to help students learn to read and identify sounds), music is not played to enhance the learning environment. However, some studies have shown that when music is played during learning experiences there is more retention of the material. This research project compared the traditional…

Palliative Care Matters: Lessons From the Loss of a Facility Dog.

PubMed

Holman, Elizabeth; Levy, Cari; Kennedy, Brenda

2018-01-01

Animal-assisted intervention is gaining attention as a stress reduction modality. Quantitative data demonstrate its effectiveness, as a recent study published in AJHPM supported that a Veterans Affairs (VA) hospital facility dog paired with a palliative care psychologist had a measurable impact on salivary cortisol levels and heart rate in hospitalized veterans. There remains an important role for qualitative insights. The Denver VA palliative care team learned a range of lessons from the sudden loss of their facility dog, many of which relate directly to palliative care. The importance of communication, adjusting to changing teams, and the need for consultation and support based in shared goals and values all became evident in the course of the facility dog's illness. After her death, lessons shifted to grief and loss and how providers, patients, and a community care for each other. People's connection to the facility dog ultimately proved to be a critical factor in helping them connect with one another.

Recruitment and retention of rural African Americans in diabetes research: lessons learned.

PubMed

Loftin, Wanda Anderson; Barnett, Steven K; Bunn, Peggy Summers; Sullivan, Patra

2005-01-01

The purpose of this article was to describe lessons learned about recruitment and retention of rural African Americans from published literature, the authors' research, and research experience. Two rural, community-based research studies with African Americans with diabetes are used to illustrate different issues and strategies in recruitment and retention. Relevant MEDLINE articles and clinical studies were reviewed, and the design, implementation, and results of the 2 community-based studies were evaluated. Information from the literature, research results, and sample selection, participation, and attrition experiences were synthesized to determine effective approaches for recruitment and retention. Research funding, design, and implementation; recruitment methods; culturally competent approaches; caring, trusting provider-patient relationships; incentives; follow-up; and factors in the rural environment emerged as important issues influencing recruitment and retention. Recruitment and retention of African Americans in rural diabetes research is a significant challenge, and adequate funding should be sought early in the research process. Culturally competent approaches; caring, trusting relationships; incentives; and follow-up are important concepts in successful recruitment, participation, and retention of African Americans. The lessons learned may be applicable to the more widespread issue of recruitment and retention of rural African Americans in diabetes education programs.

ME Cares: a statewide system engaging providers in disease management.

PubMed

Wexler, Richard; Bean, Claudette; Ito, Diane; Kopp, Zoe; LaCasse, John A; Rea, Vicki

2004-01-01

ME Cares (Maine Cares) is a coalition of 32 Maine hospitals that offer community-based, telephonic care support (disease management) programs for patients with heart failure and/or coronary heart disease. We describe the steps, challenges, and lessons learned in coalition development and maintenance. We also present a pre- and post-analysis of our clinical outcomes after enrolling 2145 patients.

Implementing Telerehabilitation Research for Stroke Rehabilitation with Community Dwelling Veterans: Lessons Learned

PubMed Central

Chumbler, Neale R.; Quigley, Patricia; Sanford, Jon; Griffiths, Patricia; Rose, Dorian; Morey, Miriam; Ely, E. Wesley; Hoenig, Helen

2010-01-01

Telerehabilitation (TR) is the use of telehealth technologies to provide distant support, rehabilitation services, and information exchange between people with disabilities and their clinical providers. This article discusses the barriers experienced when implementing a TR multi-site randomized controlled trial for stroke patients in their homes, and the lessons learned. The barriers are divided into two sections: those specific to TR and those pertinent to the conduct of tele-research. The TR specific barriers included the rapidly changing telecommunications and health care environment and inconsistent equipment functionality. The barriers applicable to tele-research included the need to meet regulations in diverse departments and rapidly changing research regulations. Lessons learned included the need for: telehealth equipment options to allow for functionality within a diverse telecommunications infrastructure; rigorous pilot testing of all equipment in authentic situations; and on-call and on-site biomedical engineering and/or IT staff. PMID:25945169

Combat Trauma Lessons Learned from Military Operations of 2001 - 2013

DTIC Science & Technology

2015-03-09

and fentanyl citrate lozenges as described in the TCCC “triple-option analgesia” plan. - Documentation of care by using TCCC Casualty Cards and TCCC...o Meloxicam/acetaminophen o Oral transmucosal fentanyl citrate o Ketamine  Modified tactical combat casualty care (TCCC) measures to optimize

Criteria for successful uptake of AAL technologies: lessons learned from Norwegian pilot projects.

PubMed

Svagård, Ingrid; Ausen, Dag; Standal, Kristin

2013-01-01

Implementation of AAL-technology as an integrated part of public health and care services requires a systematic and multidisciplinary approach. There are several challenges that need to be handled in parallel and with sustained effort over time, to tackle the multidimensional problem of building the value chain that is required for widespread uptake of AAL technology. Several pilot projects are on-going in Norway, involving municipalities, technology providers and research partners. Examples are "Home Safety" (NO: Trygghetspakken) and "Safe Tracks" (NO: Trygge spor). This paper will elaborate on our lessons learned with focus on five main points: 1) User-friendly and robust technology 2) Technology adapted organization 3) Service oriented technology providers 4) Care service organizations as demanding customer and 5) Sustainable financial model.

The Council of Academic Hospitals of Ontario (CAHO) Adopting Research to Improve Care (ARTIC) Program: Reach, Sustainability, Spread and Lessons Learned from an Implementation Funding Model.

PubMed

Moore, Julia E; Grouchy, Michelle; Graham, Ian D; Shandling, Maureen; Doyle, Winnie; Straus, Sharon E

2016-05-01

Despite evidence on what works in healthcare, there is a significant gap in the time it takes to bring research into practice. The Council of Academic Hospitals of Ontario's Adopting Research to Improve Care program addresses this research-to-practice gap by incorporating the following components into its funding program: strategic selection of evidence for implementation, education and training for implementation, implementation supports, executive champions and governance, and evaluation. Funded projects have been sustained (76% reported full sustainability) and spread to over 200 new sites. Lessons learned include the following: assess readiness, develop tailored implementation materials, consider characteristics of implementation supports, protect champion time and consider evaluation feasibility. Copyright © 2016 Longwoods Publishing.

The Council of Academic Hospitals of Ontario (CAHO) Adopting Research to Improve Care (ARTIC) Program: Reach, Sustainability, Spread and Lessons Learned from an Implementation Funding Model

PubMed Central

Grouchy, Michelle; Graham, Ian D.; Shandling, Maureen; Doyle, Winnie; Straus, Sharon E.

2016-01-01

Despite evidence on what works in healthcare, there is a significant gap in the time it takes to bring research into practice. The Council of Academic Hospitals of Ontario's Adopting Research to Improve Care program addresses this research-to-practice gap by incorporating the following components into its funding program: strategic selection of evidence for implementation, education and training for implementation, implementation supports, executive champions and governance, and evaluation. Funded projects have been sustained (76% reported full sustainability) and spread to over 200 new sites. Lessons learned include the following: assess readiness, develop tailored implementation materials, consider characteristics of implementation supports, protect champion time and consider evaluation feasibility. PMID:27232234

Lessons learned about psychosocial responses to disaster and mass trauma: an international perspective

PubMed Central

Reifels, Lennart; Pietrantoni, Luca; Prati, Gabriele; Kim, Yoshiharu; Kilpatrick, Dean G.; Dyb, Grete; Halpern, James; Olff, Miranda; Brewin, Chris R.; O'Donnell, Meaghan

2013-01-01

At the 13th meeting of the European Society for Traumatic Stress Studies in 2013, a symposium was held that brought together international researchers and clinicians who were involved in psychosocial responses to disaster. A total of six disasters that occurred in five countries were presented and discussed. Lessons learned from these disasters included the need to: (1) tailor the psychosocial response to the specific disaster, (2) provide multi-dimensional psychosocial care, (3) target at-risk population groups, (4) proactively address barriers in access to care, (5) recognise the social dimensions and sources of resilience, (6) extend the roles for mental health professionals, (7) efficiently coordinate and integrate disaster response services, and (8) integrate research and evaluation into disaster response planning. PMID:24371515

The fall and redemption of people and systems: potential lessons from the "star wars" saga.

PubMed

Guerrero, Anthony P S; Jamora, Maria Jasmin

2007-01-01

Through an analysis of the fall and redemption of Anakin Skywalker and the Galactic Republic of the Star Wars saga, educators may be able to convey valuable lessons to students learning about child and adolescent psychiatry and to junior psychiatrists learning about psychiatric administration and liaison. Specifically, educators may be able to convey that 1) when caring for patients who have succumbed or are at risk of succumbing to "darkness" in the modern psychiatric sense (e.g., violence and criminal behavior), it is important to recognize risk factors as well as protective factors that can lead to successful "salvation"; and 2) when administering or serving as a liaison to systems of care, it is important to acknowledge and heal dysfunctions in the relevant "system."

A Longitudinal, Experiential Quality Improvement Curriculum Meeting ACGME Competencies for Geriatrics Fellows: Lessons Learned

ERIC Educational Resources Information Center

Callahan, Kathryn E.; Rogers, Matthew T.; Lovato, James F.; Fernandez, Helen M.

2013-01-01

Quality improvement (QI) initiatives are critical in the care of older adults who are more vulnerable to substandard care. QI education meets aspects of core Accreditation Council of Graduate Medical Education competencies and prepares learners for the rising focus on performance measurement in health care. The authors developed, implemented, and…

A Short Stay, a Long-Lasting Lesson.

ERIC Educational Resources Information Center

Benham, Dianne C.

1991-01-01

Presents an integrated schoolwide program in which students learn about pet care and the behaviors of 14 unusual animals. Each participating teacher sets up one animal center describing the animal and the animal's habitat. Centers change at the end of each month. Discusses costs and learning benefits of the program. (MDH)

Caring for Multiples

MedlinePlus

... birth and infant mortality. Solving premature birth Featured articles Accomplishments and lessons learned since the establishment of ... The impact of premature birth on society Featured articles How long should you wait before getting pregnant ...

Assuring quality health care outcomes: lessons learned from car dealers?

PubMed Central

Dimsdale, Joel E

2017-01-01

Health care systems want quality but struggle to find the right tools because, typically, they track quality in only one or two ways. Because of the complexity of health care, high quality will emerge only when health care systems employ multiple approaches, including, importantly, patient-reported outcome perspectives. Sustained changes are unlikely to emerge in the absence of such multipronged interventions. PMID:28123314

Residential Group Care Quarterly. Volume 5, Number 2, Fall 2004

ERIC Educational Resources Information Center

Kirkwood, Scott, Ed.

2004-01-01

This issue of "Residential Group Care Quarterly" contains the following articles: (1) "Achieving Better Outcomes for Children and Families: Reducing the Use of Restraint and Seclusion" (Katherine Johnson); (2) "STAR Project Outcomes" (Nancy Campbell); (3) "The Devereux Glenholme School" (Mary Guilfoile); (4) "Lessons Learned in the Reduction of…

The Cost of Higher Education: Lessons to Learn from the Health Care Industry.

ERIC Educational Resources Information Center

Langfitt, Thomas W.

1990-01-01

Similarities are drawn between trends in climbing costs for medical care and higher education. Possible effects of a prospective payment system for higher education are discussed. Colleges and universities are encouraged to retain the public trust by holding to their primary educational mission. (DB)

Improved use of allied health professionals in the health care system: the case of the advanced practice physiotherapist in orthopedic care.

PubMed

Aiken, Alice

2012-01-01

This article provides an overview of work done in Canada involving the use of physiotherapists in models of collaborative care to enhance orthopedic care and practice. Valuable lessons learned and an important model of collaborative care are summarized. The research around these models of care has also contributed to important scope of practice changes for the profession of physiotherapy.

Strategies to Support the Integration of Behavioral Health and Primary Care: What Have We Learned Thus Far?

PubMed

Dickinson, W Perry

2015-01-01

The articles in this supplement contain a wealth of practical information regarding the integration of behavioral health and primary care. This type of integration effort is complex and greatly benefits from support from outside organizations, as well as collaboration with other practices attempting similar work. This editorial extracts from these articles some of the key lessons learned regarding the integration of behavioral health and primary care for practices and for organizations that support practice transformation. © Copyright 2015 by the American Board of Family Medicine.

Lessons Learned from Coordinating Relay Activities at Mars

NASA Technical Reports Server (NTRS)

Gladden, Roy E.; Hwang, Pauline; Waggoner, Bruce; McLaughlin, Bruce; Fieseler, Paul; Thomas, Reid; Bigwood, Maria; Herrera, Paul

2005-01-01

The Mission Management Office at the Jet Propulsion Laboratory was tasked with coordinating the relay of data between multiple spacecraft at Mars in support of the Mars Exploration Rover Missions in early 2004. The confluence of three orbiters (Mars Global Surveyor, Mars Odyssey, and Mars Express), two rovers (Spirit and Opportunity), and one lander (Beagle 2) has provided a challenging operational scenario that required careful coordination between missions to provide the necessary support and to avoid potential interference during simultaneous relay sessions. As these coordination efforts progressed, several important lessons were learned that should be applied to future Mars relay activities.

Music lessons: what musicians can teach doctors (and other health professionals).

PubMed

Davidoff, Frank

2011-03-15

Medicine is a learned profession, but clinical practice is above all a matter of performance, in the best and deepest sense of the word. Because music is, at its core, a pure distillate of real-time performance, musicians are in an excellent position to teach us about better ways to become and remain expert performers in health care and ways for our teachers and mentors to help us do that. Ten features of the professionalization of musicians offer us lessons on how the clinical practice of medicine might be learned, taught, and performed more effectively.

Lessons from the other side: what can we learn from the private sector?

PubMed

Clarke, D

1999-01-01

Business has reacted in an impressive manner to increasing globalisation, short-term stock market pressure for performance, emerging industries and new technologies. While the private sector has become increasingly competitive, the public sector has not adopted this commercial rigour. Funding pressures on health services will continue, as will increasing consumer and staff demands and the blurring of public and private health care provision. As a result, there are lessons and techniques the public and private health sectors should learn from each other. I have drawn the issues that follow from my experience in the steel and food industries.

Data that drive: Closing the loop in the learning hospital system.

PubMed

Liu, Vincent X; Morehouse, John W; Baker, Jennifer M; Greene, John D; Kipnis, Patricia; Escobar, Gabriel J

2016-11-01

The learning healthcare system describes a vision of US healthcare that capitalizes on science, information technology, incentives, and care culture to drive improvements in the quality of health care. The inpatient setting, one of the most costly and impactful domains of healthcare, is an ideal setting in which to use data and information technology to foster continuous learning and quality improvement. The rapid digitization of inpatient medicine offers incredible new opportunities to use data from routine care to generate new discovery and thus close the virtuous cycle of learning. We use an object lesson-sepsis care within the 21 hospitals of the Kaiser Permanente Northern California integrated healthcare delivery system-to offer insight into the critical elements necessary for developing a learning hospital system. We then describe how a hospital-wide data-driven approach to inpatient care can facilitate improvements in the quality of hospital care. Journal of Hospital Medicine 2016;11:S11-S17. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Reasons behind Young Learners' Learning of Foreign Languages

ERIC Educational Resources Information Center

Akçay, Aslihan; Ferzan Bütüner, Tuba; Arikan, Arda

2015-01-01

English has become a compulsory lesson starting at the second grade in Turkey while younger learners are growingly introduced to it at earlier ages through various pre-schools, day-care programs and private courses. This descriptive study focuses on young learners' self-reported reasons for learning English and other foreign languages. Twenty…

Trickle down Technology: Tech Lessons Learned from Higher Ed

ERIC Educational Resources Information Center

O'Hanlon, Charlene

2010-01-01

Care has to be taken when relating technology's use in college and university lecture halls to the way it's applied in K-12 classrooms. Differences in pedagogy, learning styles, and even attendance can impact the way the respective students in the two environments consume technology, which in turn impacts the technology's effectiveness as a…

When and Where You Want It: Continuing Education from a Distance

ERIC Educational Resources Information Center

Shade, Stacy Deck; Barber, Gerard M.

2004-01-01

Online technology is increasingly being used as a tool for delivery of continuing education to health care professionals. This paper discusses key lessons learned in developing a distance-learning program. It provides practical information on ways to enhance interactivity and overcome obstacles. Preliminary outcomes for learners in a four-state…

Introducing Online Training in an Early Childhood Professional Development System: Lessons Learned in One State

ERIC Educational Resources Information Center

Stone-MacDonald, Angi; Douglass, Anne

2015-01-01

Online educational opportunities provide improved access to high quality professional development for the early education and care workforce. Online and technology mediated learning can create sustainable education and development opportunities for states when face-to-face training is financially prohibitive. This study examined one state's…

Learning from Japanese Approach to Teachers' Professional Development: Can "Jugyou Kenkyu" Work in Other Countries?

ERIC Educational Resources Information Center

Masami, Matoba; Reza, Sarkar Arani M.

2005-01-01

This paper tries to present a careful analysis of current trends and challenges to importing Japanese model of teachers' professional development. The objective is to examine what "we" can learn from Japanese approach to improving instruction, especially "Jugyou Kenkyu" (Lesson Study) as a collaborative research on the…

Coaching Model + Clinical Playbook = Transformative Learning.

PubMed

Fletcher, Katherine A; Meyer, Mary

2016-01-01

Health care employers demand that workers be skilled in clinical reasoning, able to work within complex interprofessional teams to provide safe, quality patient-centered care in a complex evolving system. To this end, there have been calls for radical transformation of nursing education including the development of a baccalaureate generalist nurse. Based on recommendations from the American Association of Colleges of Nursing, faculty concluded that clinical education must change moving beyond direct patient care by applying the concepts associated with designer, manager, and coordinator of care and being a member of a profession. To accomplish this, the faculty utilized a system of focused learning assignments (FLAs) that present transformative learning opportunities that expose students to "disorienting dilemmas," alternative perspectives, and repeated opportunities to reflect and challenge their own beliefs. The FLAs collected in a "Playbook" were scaffolded to build the student's competencies over the course of the clinical experience. The FLAs were centered on the 6 Quality and Safety Education for Nurses competencies, with 2 additional concepts of professionalism and systems-based practice. The FLAs were competency-based exercises that students performed when not assigned to direct patient care or had free clinical time. Each FLA had a lesson plan that allowed the student and faculty member to see the competency addressed by the lesson, resources, time on task, student instructions, guide for reflection, grading rubric, and recommendations for clinical instructor. The major advantages of the model included (a) consistent implementation of structured learning experiences by a diverse teaching staff using a coaching model of instruction; (b) more systematic approach to present learning activities that build upon each other; (c) increased time for faculty to interact with students providing direct patient care; (d) guaranteed capture of selected transformative learning experiences; (e) increased student reflection to promote transformative learning; and (f) provided avenues for timely feedback to students. Copyright © 2016 Elsevier Inc. All rights reserved.

The bottom line on wound care standardization.

PubMed

McNees, Patrick; Kueven, John A

2011-03-01

North Mississippi Medical Center learned four important lessons in its effort to standardize wound care products and processes of care: Designate clinical champions. Limit the number of vendors that provide products for a specialty. Reduce the number of similar-function wound care products that are available for use, with decisions guided by clinicians. Provide transparent information related to cost, the intentions of the initiative, usage patterns, and the criteria for evaluation.

Everyday Miracles: Supporting Parents of Infants in Foster Care

ERIC Educational Resources Information Center

Wotherspoon, Evelyn; McInnis, Jan

2013-01-01

This article describes a model for supporting parents and their infants during separations due to temporary foster care. Using a case example, the authors describe a model for visit coaching, including their process for assessment and strategies used for intervention. The lessons learned are: (a) that individual parents can present very…

Interprofessional education through service-learning: lessons from a student-led free clinic.

PubMed

Farlow, Janice L; Goodwin, Charles; Sevilla, Javier

2015-05-01

The academic community must replicate and strengthen existing models for interprofessional education (IPE) to meet widespread calls for team-based patient-centered care. One effective but under-explored possibility for IPE is through student-led clinics, which now exist in the majority of medical schools. This short report presents the Indiana University Student Outreach Clinic (IU-SOC), which involves seven different professional programs across three institutions, as a model for how IPE can be delivered formally through service learning. Lessons learned, such as nurturing an intentional interprofessional program, structured orientation and reflection, and resource and knowledge sharing between the clinic and academic institutions, can be applied to all student-led clinics, but also can inform other IPE initiatives in health professional curricula.

Advancing affective attributes and empowering undergraduate students--lessons learned from the Bali bombing.

PubMed

Hanson, Julie

2011-11-01

Caring as an integral component in the nursing curriculum is enjoying a resurgence in the literature of late. The argument is that nursing education has tended to overemphasise the cognitive domain and under emphasise the affective. An alternative is to use the combined effect of cognition, imagination, intuition and emotion. This is supported by the theory of transformational learning, whereby students clarify their personal and professional purpose in life and are empowered to become informed, self-efficacious practitioners and autonomous thinkers as they negotiate personal values and meaning. In order to integrate these important theoretical concepts into everyday practice, educators need practical examples and case studies that show how caring is taught. This paper continues the conversation on narrative and transformational learning pedagogies and illustrates how affective attributes are developed through a single lecture. The aim of the lecture was to sensitise students to the human impact of terrorism and violence and the effects on both health care workers and the survivors of trauma. The rationale was that by allowing students to critically reflect on their own core knowledge and skills, they could question prior perceptions of their role, resulting in a revised or new perspective of those experiences and strengthen their belief in their abilities to cope in crisis situations. This transformative approach involved the delivery of knowledge and theory underpinning disaster response, personal narratives about a critical learning event that embodied clinically relevant lessons, activities that promoted critical self-reflection to strengthen students' beliefs in their own ability to cope by converting core knowledge into action and, finally student evaluation of the lesson (see Table 1). Copyright © 2011 Elsevier Ltd. All rights reserved.

Experiences of Agency for Healthcare Research and Quality-funded projects that implemented practices for safer patient care.

PubMed

Taylor, Stephanie L; Ridgely, M Susan; Greenberg, Michael D; Sorbero, Melony E S; Teleki, Stephanie S; Damberg, Cheryl L; Farley, Donna O

2009-04-01

To synthesize lessons learned from the experiences of Agency for Healthcare Research and Quality-funded patient safety projects in implementing safe practices. Self-reported data from individual and group interviews with Original, Challenge, and Partnerships in Implementing Patient Safety (PIPS) grantees, from 2003 to 2006. Interviews with three grantee groups (n=60 total) implementing safe practice projects, with comparisons on factors influencing project implementation and sustainability. Semi-structured protocols contained open-ended questions on lessons learned and more structured questions on factors associated with project implementation and sustainability. The grantees shared common experiences, frequently identifying lessons learned regarding structural components needing to be in place before implementation, components of the implementation process, components of interventions' results needed for sustainability, changes in timelines or activities, unanticipated issues, and staff acceptance/adoption. Also, fewer Original grants had many of the factors related project to implementation/sustainability than the PIPS or Challenge grantees had. Although much of what was reported seemed like common sense, surprisingly few projects actually planned for or expected many of the barriers or facilitators they experienced during their project implementation. Others implementing practice improvements likely will share the experiences and issues identified by these implementation projects and can learn from their lessons.

Challenges to Providing End-of-Life Care to Low-Income Elders with Advanced Chronic Disease: Lessons Learned from a Model Program

ERIC Educational Resources Information Center

Kramer, Betty J.; Auer, Casey

2005-01-01

Purpose: This study explored the challenges in providing end-of-life care to low-income elders with multiple comorbid chronic conditions in a fully "integrated" managed care program, and it highlighted essential recommendations. Design and Methods: A case-study design was used that involved an extensive analysis of qualitative data from five focus…

Health Workforce: Ensuring Adequate Supply and Distribution Remains Challenging. Testimony before the Subcommittee on Health, Committee on Energy and Commerce, House of Representatives.

ERIC Educational Resources Information Center

Heinrich, Janet

The General Accounting Office's (GAO's) director of health care-public health issues testified before Congress regarding growing concerns about the adequacy of the health care work force and lessons learned from the experience of the National Health Service Corps (NHSC) in addressing the maldistribution of health care professionals. The following…

Health Care for the Homeless: What We Have Learned in the Past 30 Years and What’s Next

PubMed Central

Zerger, Suzanne; Wolfe, Phyllis B.

2013-01-01

In the 1980s, the combined effects of deinstitutionalization from state mental hospitals and the economic recession increased the number and transformed the demographic profile of people experiencing homelessness in the United States. Specialized health care for the homeless (HCH) services were developed when it became clear that the mainstream health care system could not sufficiently address their health needs. The HCH program has grown consistently during that period; currently, 208 HCH sites are operating, and the program has become embedded in the federal health care system. We reflect on lessons learned from the HCH model and its applicability to the changing landscape of US health care. PMID:24148056

Using CBPR for Health Research in American Muslim Mosque Communities: Lessons Learned

PubMed Central

Killawi, Amal; Heisler, Michele; Hamid, Hamada; Padela, Aasim I.

2015-01-01

Background American Muslims are understudied in health research, and there are few studies documenting community-based participatory research (CBPR) efforts among American Muslim mosque communities. Objectives We highlight lessons learned from a CBPR partnership that explored the health care beliefs, behaviors, and challenges of American Muslims. Methods We established a collaboration between the University of Michigan and four Muslim-focused community organizations in Michigan. Our collaborative team designed and implemented a two-phase study involving interviews with community stakeholders and focus groups and surveys with mosque congregants. Lessons Learned Although we were successful in meeting our research goals, maintaining community partner involvement and sustaining the project partnership proved challenging. Conclusions CBPR initiatives within mosque communities have the potential for improving community health. Our experience suggests that successful research partnerships with American Muslims will utilize social networks and cultural insiders, culturally adapt research methods, and develop a research platform within the organizational infrastructures of the American Muslim community. PMID:25981426

Thermal Design, Tvac Testing, and Lessons Learned for Critical GSE of ATLAS and the ICESat-2 Mission

NASA Technical Reports Server (NTRS)

Bradshaw, Heather

2016-01-01

This presentation describes the thermal design of the three main of optical components which comprise the Bench Checkout Equipment (BCE) for the Advanced Topographic Laser Altimeter System (ATLAS) instrument, which is flying on the ICESat-2 mission. Thermal vacuum testing of these components is also described in this presentation, as well as a few lessons learned. These BCE components serve as critical GSE for the mission; their purpose is to verify ATLAS is performing well. It has been said that, in one light, the BCE is the most important part of ATLAS, since, without it, ATLAS cannot be aligned properly or its performance verified before flight. Therefore, careful attention was paid to the BCEs thermal design, development, and component-level Tvac testing prior to its use in instrument-level and spacecraft-level Tvac tests with ATLAS. This presentation describes that thermal design, development, and testing, as well as a few lessons learned.

Optimizing learning in healthcare: how Island Health is evolving to learn at the speed of change.

PubMed

Gottfredson, Conrad; Stroud, Carol; Jackson, Mary; Stevenson, R Lynn; Archer, Jana

2014-01-01

Healthcare organizations are challenged with constrained resources and increasing service demands by an aging population with complex care needs. Exponential growth in competency requirements also challenges staff's ability to provide quality patient care. How can a healthcare organization support its staff to learn "at or above the speed of change" while continuing to provide the quality patient care? Island Health is addressing this challenge by transforming its traditional education model into an innovative, evidence-based learning and performance support approach. Implementation of the methodology is yielding several lessons learned, both for the internal Learning and Performance Support team, and for what it takes to bring a new way of doing business into an organization. A key result is that this approach is enabling the organization to be more responsive in helping staff gain and maintain competencies.

Flipped Learning, MOOCs and Learning Analytics: Lessons learnt from a Web Map Design course redesign

NASA Astrophysics Data System (ADS)

Treves, R.

2013-12-01

Five weeks content of a 12 week course in web map design were converted to 'flipped learning': Lecture sessions were replaced by online short video lectures and multiple choice questions to be completed outside class. Class time was taken up with activities and exercises linked to the online learning. Students use of the online content was carefully tracked and detailed student feedback gathered. The response from students was good, 90% of them completed all the out of class activities and their feedback was very positive. The format has the advantage of being easily repurposed as a MOOC or scaled up in other ways. Lessons learnt from the implementation of the materials and the analysis of the VLE logs will be discussed as will ongoing efforts to reuse the materials in a MOOC.

Ballistic trauma: lessons learned from iraq and afghanistan.

PubMed

Shin, Emily H; Sabino, Jennifer M; Nanos, George P; Valerio, Ian L

2015-02-01

Management of upper extremity injuries secondary to ballistic and blast trauma can lead to challenging problems for the reconstructive surgeon. Given the recent conflicts in Iraq and Afghanistan, advancements in combat-casualty care, combined with a high-volume experience in the treatment of ballistic injuries, has led to continued advancements in the treatment of the severely injured upper extremity. There are several lessons learned that are translatable to civilian trauma centers and future conflicts. In this article, the authors provide an overview of the physics of ballistic injuries and principles in the management of such injuries through experience gained from military involvement in Iraq and Afghanistan.

Ballistic Trauma: Lessons Learned from Iraq and Afghanistan

PubMed Central

Shin, Emily H.; Sabino, Jennifer M.; Nanos, George P.; Valerio, Ian L.

2015-01-01

Management of upper extremity injuries secondary to ballistic and blast trauma can lead to challenging problems for the reconstructive surgeon. Given the recent conflicts in Iraq and Afghanistan, advancements in combat-casualty care, combined with a high-volume experience in the treatment of ballistic injuries, has led to continued advancements in the treatment of the severely injured upper extremity. There are several lessons learned that are translatable to civilian trauma centers and future conflicts. In this article, the authors provide an overview of the physics of ballistic injuries and principles in the management of such injuries through experience gained from military involvement in Iraq and Afghanistan. PMID:25685099

Policy Research Challenges in Comparing Care Models for Dual-Eligible Beneficiaries.

PubMed

Van Cleave, Janet H; Egleston, Brian L; Brosch, Sarah; Wirth, Elizabeth; Lawson, Molly; Sullivan-Marx, Eileen M; Naylor, Mary D

2017-05-01

Providing affordable, high-quality care for the 10 million persons who are dual-eligible beneficiaries of Medicare and Medicaid is an ongoing health-care policy challenge in the United States. However, the workforce and the care provided to dual-eligible beneficiaries are understudied. The purpose of this article is to provide a narrative of the challenges and lessons learned from an exploratory study in the use of clinical and administrative data to compare the workforce of two care models that deliver home- and community-based services to dual-eligible beneficiaries. The research challenges that the study team encountered were as follows: (a) comparing different care models, (b) standardizing data across care models, and (c) comparing patterns of health-care utilization. The methods used to meet these challenges included expert opinion to classify data and summative content analysis to compare and count data. Using descriptive statistics, a summary comparison of the two care models suggested that the coordinated care model workforce provided significantly greater hours of care per recipient than the integrated care model workforce. This likely represented the coordinated care model's focus on providing in-home services for one recipient, whereas the integrated care model focused on providing services in a day center with group activities. The lesson learned from this exploratory study is the need for standardized quality measures across home- and community-based services agencies to determine the workforce that best meets the needs of dual-eligible beneficiaries.

Using American sign language interpreters to facilitate research among deaf adults: lessons learned.

PubMed

Sheppard, Kate

2011-04-01

Health care providers commonly discuss depressive symptoms with clients, enabling earlier intervention. Such discussions rarely occur between providers and Deaf clients. Most culturally Deaf adults experience early-onset hearing loss, self-identify as part of a unique culture, and communicate in the visual language of American Sign Language (ASL). Communication barriers abound, and depression screening instruments may be unreliable. To train and use ASL interpreters for a qualitative study describing depressive symptoms among Deaf adults. Training included research versus community interpreting. During data collection, interpreters translated to and from voiced English and ASL. Training eliminated potential problems during data collection. Unexpected issues included participants asking for "my interpreter" and worrying about confidentiality or friendship in a small community. Lessons learned included the value of careful training of interpreters prior to initiating data collection, including resolution of possible role conflicts and ensuring conceptual equivalence in real-time interpreting.

Reporting intellectual capital in health care organizations: specifics, lessons learned, and future research perspectives.

PubMed

Veltri, Stefania; Bronzetti, Giovanni; Sicoli, Graziella

2011-01-01

This article analyzes the concept of intellectual capital (IC) in the health sector sphere by studying the case of a major nonprofit research organization in this sector, which has for some time been publishing IC reports. In the last few years, health care organizations have been the object of great attention in the implementation and transfer of managerial models and tools; however, there is still a lack of attention paid to the strategic management of IC as a fundamental resource for supporting and enhancing performance improvement dynamics. The main aim of this article is to examine the IC reporting model used by the Center of Molecular Medicine (CMM), a Swedish health organization which is an outstanding benchmark in reporting its IC. We also consider the specifics of IC reporting for health organizations, the lessons learned by analyzing CMM's IC reporting, and future perspectives for research.

Smoking cessation counseling for Asian immigrants with serious mental illness: using RE-AIM to understand challenges and lessons learned in primary care-behavioral health integration.

PubMed

Saw, Anne; Kim, Jin; Lim, Joyce; Powell, Catherine; Tong, Elisa K

2013-09-01

Engagement in modifiable risk behaviors, such as tobacco use, substantially contributes to early mortality rates in individuals with serious mental illness (SMI). There is an alarmingly high prevalence of tobacco use among subgroups of Asian Americans, such as immigrants and individuals with SMI, yet there are no empirically supported effective smoking cessation interventions that have been tailored to meet the unique cultural, cognitive, and psychological needs of Asian immigrants with SMI. In this article, we share the experiences of clinicians in the delivery of smoking cessation counseling to Asian American immigrants with SMI, in the context of an Asian-focused integrated primary care and behavioral health setting. Through a qualitative analysis of clinician perspectives organized with the RE-AIM framework, we outline challenges, lessons learned, and promising directions for delivering smoking cessation counseling to Asian American immigrant clients with SMI.

Patient safety: lessons learned.

PubMed

Bagian, James P

2006-04-01

The traditional approach to patient safety in health care has ranged from reticence to outward denial of serious flaws. This undermines the otherwise remarkable advances in technology and information that have characterized the specialty of medical practice. In addition, lessons learned in industries outside health care, such as in aviation, provide opportunities for improvements that successfully reduce mishaps and errors while maintaining a standard of excellence. This is precisely the call in medicine prompted by the 1999 Institute of Medicine report "To Err Is Human: Building a Safer Health System." However, to effect these changes, key components of a successful safety system must include: (1) communication, (2) a shift from a posture of reliance on human infallibility (hence "shame and blame") to checklists that recognize the contribution of the system and account for human limitations, and (3) a cultivation of non-punitive open and/or de-identified/anonymous reporting of safety concerns, including close calls, in addition to adverse events.

Ground Truth Creation for Complex Clinical NLP Tasks - an Iterative Vetting Approach and Lessons Learned.

PubMed

Liang, Jennifer J; Tsou, Ching-Huei; Devarakonda, Murthy V

2017-01-01

Natural language processing (NLP) holds the promise of effectively analyzing patient record data to reduce cognitive load on physicians and clinicians in patient care, clinical research, and hospital operations management. A critical need in developing such methods is the "ground truth" dataset needed for training and testing the algorithms. Beyond localizable, relatively simple tasks, ground truth creation is a significant challenge because medical experts, just as physicians in patient care, have to assimilate vast amounts of data in EHR systems. To mitigate potential inaccuracies of the cognitive challenges, we present an iterative vetting approach for creating the ground truth for complex NLP tasks. In this paper, we present the methodology, and report on its use for an automated problem list generation task, its effect on the ground truth quality and system accuracy, and lessons learned from the effort.

Smell, Touch, Listen, Look--Kids Learn, Kids Cook: A Nutrition Education Workshop for Day Care Personnel.

ERIC Educational Resources Information Center

Herr, Judith; And Others

This collection of nutrition education materials is designed for use in inservice training workshops for day care personnel. The document includes a listing of good nutrition concepts, suggestions for cooking in the classroom, meal planning ideas, lesson plan forms and objectives, suggestions for involving parents in nutrition education, and…

Serving Others: Student-Run Restaurant Teaches Many Lessons

ERIC Educational Resources Information Center

Farmer, Tom

2015-01-01

Cairns and cares: they sound nearly alike, and at Tommie Kunst Junior High School (Santa Maria, CA), the two words are synonymous. Kim Cairns is a "Pitsco Education" Life Skills lab facilitator who cares deeply about her students--what they do, what they say, how they act, what they learn, and everything in between. Cairns has taken…

Lessons Learned from the On-Site Distillation of Used Solvents Generated by Health Care Facilities.

ERIC Educational Resources Information Center

Huang, Ching-San; Ciesla, John

1992-01-01

Discusses the sources of contaminants found in used solvents generated by the histopathological laboratories at health care facilities and the technical problems, corrective measures, and economic analysis associated with the on-site recycling and reusing of these solvents. An appendix contains an economic analysis for a used-solvent recycling…

Perspectives of an Interdisciplinaryg Research Team to Engage Practice: Lessons from a Knowledge Exchange Trainee Experience

PubMed Central

Urquhart, Robin L.; Johnston, Grace M.; McVorran, Shauna M.; Burge, Fred I.

2010-01-01

End-of-life (EOL) care is an area of health services that will ultimately affect us all. To share the knowledge emerging from EOL research and to address inequities in the quality of EOL care in Nova Scotia, a knowledge exchange (KE) trainee was hired to translate research and surveillance into a Surveillance Report. The purpose of this paper is to reflect upon this initiative and share the research team's perspectives on their KE experiences. We describe four key competencies of the KE trainee selected, and discuss lessons learned from this KE trainee experience, to expand our understanding of KE. PMID:21532769

How Community Efforts To Reduce Substance Abuse Have Affected Health Care. Lessons Learned Conferences Seminar Report (Washington, D.C., April 14-15, 1997).

ERIC Educational Resources Information Center

Johnson, Michelle; Smith, Steven Rathgeb

A conference in Washington, D.C., brought together health care professionals and people working on substance abuse issues to take a look at what four communities have done to use the health care system as part of a strategy to address substance abuse. The four communities are Vallejo (California), Santa Barbara (California), Little Rock…

Battlefield Tourniquets: Lessons Learned in Moving Current Care Toward Best Care in an Army Medical Department at War.

PubMed

Kragh, John F; Dubick, Michael A

2016-01-01

Bleeding prevention and control by tourniquet use by out-of-hospital caregivers is a major breakthrough in military medicine of current wars. The present review documents developments in tourniquet practices since 2001 among the US military services for aid in improving doctrine, policy, and especially care in wars to come. Tourniquets are an adjunct for resuscitation in self-care and buddy aid and today are issued to all military servicepersons who deploy into a combat zone. In the US Army, virtually every Soldier is trained in first aid tourniquet use; since 2009 they are instructed early and often to use them early and often. Despite substantial knowledge gains among the services in tourniquet use and resulting improvements in casualty survival, current evidence shows persistent difficulties in achieving best care with tourniquet use for individual trauma patients. Nevertheless, contemporary tourniquet use incorporates key lessons learned over the last 14 years of war that include: (1) tourniquet use reliably stops bleeding from limb wounds and prevents mortality in prehospital settings; and (2) brief tourniquet use appears to be safe. These 2 lessons have become so evident that civilian emergency medical systems have begun using them, albeit unevenly. Collection and interpretation of data of casualties with tourniquet use have showed that such intervention has lifesaving benefit through 2 mechanisms: control of both ongoing hemorrhage and shock severity. The next generation of interventions in bleeding control involves developing the skill sets, education, and standards of tourniquet users which may improve hemorrhage control in wars to come.

Using Patient Reported Outcomes and PROMIS in Research and Clinical Applications: Experiences from the PCORI Pilot Projects

PubMed Central

Bingham, Clifton O.; Bartlett, Susan J.; Merkel, Peter A.; Mielenz, Thelma J.; Pilkonis, Paul A.; Edmundson, Lauren; Moore, Emily; Sabharwal, Rajeev K.

2016-01-01

Purpose The field of patient-centered outcomes research (PCOR) continues to develop. Patient-reported outcomes, and in particular, the Patient-Reported Outcomes Measurement Information System (PROMIS) contribute complementary data to clinician-derived outcomes traditionally used in health decision-making. However, there has been little work to understand how PROMIS measures may inform or be integrated into PCOR or clinical applications. Methods Lead investigators from four pilot projects funded by the Patient-Centered Outcomes Research Institute (PCORI) collaborated to discuss lessons learned about the use of PROMIS in PCOR studies via virtual and in-person meetings. In addition, a qualitative data collection tool was used to assess the pilot projects’ experiences. Results Lessons learned from the pilot projects centered on practical elements of research design, such as choosing the right outcomes to study, considering the advantages and limitations of the PROMIS short forms and computer adaptive technology versions, planning ahead for a feasible data collection process, maintaining the focus on patients by ensuring that the research is truly patient-centered, and helping patients and providers make the most of PROMIS in care. Conclusions The PCORI Pilot Projects demonstrated that PROMIS can be successfully used to conduct research that will help patients make decisions about their care. Interest in PCOR continues to grow and the lessons learned from these projects about the use of PROMIS will be helpful to investigators. Given the numerous benefits of PROMIS, implementing this tool in research and care will hopefully lead to significant progress in measuring health outcomes that are meaningful and relevant to all stakeholders. PMID:26914103

Using patient-reported outcomes and PROMIS in research and clinical applications: experiences from the PCORI pilot projects.

PubMed

Bingham, Clifton O; Bartlett, Susan J; Merkel, Peter A; Mielenz, Thelma J; Pilkonis, Paul A; Edmundson, Lauren; Moore, Emily; Sabharwal, Rajeev K

2016-08-01

The field of patient-centered outcomes research (PCOR) continues to develop. Patient-reported outcomes and, in particular the Patient-Reported Outcomes Measurement Information System (PROMIS) contribute complementary data to clinician-derived outcomes traditionally used in health decision-making. However, there has been little work to understand how PROMIS measures may inform or be integrated into PCOR or clinical applications. Lead investigators from four pilot projects funded by the Patient-Centered Outcomes Research Institute (PCORI) collaborated to discuss lessons learned about the use of PROMIS in PCOR studies via virtual and in-person meetings. In addition, a qualitative data collection tool was used to assess the pilot projects' experiences. Lessons learned from the pilot projects centered on practical elements of research design, such as choosing the right outcomes to study, considering the advantages and limitations of the PROMIS short forms and computer adaptive technology versions, planning ahead for a feasible data collection process, maintaining the focus on patients by ensuring that the research is truly patient-centered, and helping patients and providers make the most of PROMIS in care. The PCORI pilot projects demonstrated that PROMIS can be successfully used to conduct research that will help patients make decisions about their care. Interest in PCOR continues to grow and the lessons learned from these projects about the use of PROMIS will be helpful to investigators. Given the numerous benefits of PROMIS, implementing this tool in research and care will hopefully lead to significant progress in measuring health outcomes that are meaningful and relevant to all stakeholders.

Preparing a New Generation of Clinicians for the Era of Big Data

PubMed Central

Moskowitz, Ari; McSparron, Jakob; Stone, David J.; Celi, Leo Anthony

2015-01-01

Synopsis As medicine becomes increasingly complex and financially constrained, it will be the responsibility of every clinician to understand and participate in the enterprise of extracting lessons learned from digitally captured patient care. PMID:25688383

Improving Clinical Workflow in Ambulatory Care: Implemented Recommendations in an Innovation Prototype for the Veteran’s Health Administration

PubMed Central

Patterson, Emily S.; Lowry, Svetlana Z.; Ramaiah, Mala; Gibbons, Michael C.; Brick, David; Calco, Robert; Matton, Greg; Miller, Anne; Makar, Ellen; Ferrer, Jorge A.

2015-01-01

Introduction: Human factors workflow analyses in healthcare settings prior to technology implemented are recommended to improve workflow in ambulatory care settings. In this paper we describe how insights from a workflow analysis conducted by NIST were implemented in a software prototype developed for a Veteran’s Health Administration (VHA) VAi2 innovation project and associated lessons learned. Methods: We organize the original recommendations and associated stages and steps visualized in process maps from NIST and the VA’s lessons learned from implementing the recommendations in the VAi2 prototype according to four stages: 1) before the patient visit, 2) during the visit, 3) discharge, and 4) visit documentation. NIST recommendations to improve workflow in ambulatory care (outpatient) settings and process map representations were based on reflective statements collected during one-hour discussions with three physicians. The development of the VAi2 prototype was conducted initially independently from the NIST recommendations, but at a midpoint in the process development, all of the implementation elements were compared with the NIST recommendations and lessons learned were documented. Findings: Story-based displays and templates with default preliminary order sets were used to support scheduling, time-critical notifications, drafting medication orders, and supporting a diagnosis-based workflow. These templates enabled customization to the level of diagnostic uncertainty. Functionality was designed to support cooperative work across interdisciplinary team members, including shared documentation sessions with tracking of text modifications, medication lists, and patient education features. Displays were customized to the role and included access for consultants and site-defined educator teams. Discussion: Workflow, usability, and patient safety can be enhanced through clinician-centered design of electronic health records. The lessons learned from implementing NIST recommendations to improve workflow in ambulatory care using an EHR provide a first step in moving from a billing-centered perspective on how to maintain accurate, comprehensive, and up-to-date information about a group of patients to a clinician-centered perspective. These recommendations point the way towards a “patient visit management system,” which incorporates broader notions of supporting workload management, supporting flexible flow of patients and tasks, enabling accountable distributed work across members of the clinical team, and supporting dynamic tracking of steps in tasks that have longer time distributions. PMID:26290887

How Transformational Learning Promotes Caring, Consultation and Creativity, and Ultimately Contributes to Sustainable Development: Lessons from the Partnership for Education and Research about Responsible Living (PERL) Network

ERIC Educational Resources Information Center

Thoresen, Victoria Wyszynski

2017-01-01

Oases of learning which are transformative and lead to significant behavioural change can be found around the globe. Transformational learning has helped learners not only to understand what they have been taught but also to re-conceptualise and re-apply this understanding to their daily lives. Unfortunately, as many global reports indicate,…

It Takes a Village: Moving Forward Towards Independence Offers Hope and Life Lessons to Young Adults with Learning Disabilities

ERIC Educational Resources Information Center

Exceptional Parent, 2010

2010-01-01

Moving Forward Towards Independence, a California-based nonprofit organization founded in 1998 by a group of parents, is a unique residential program where young adults with disabilities learn to enjoy productive, fulfilling and healthy lives within a caring, responsive community made up of fellow residents, trained staff members, parents and…

Medical support to Sri Lanka in the wake of tsunamis: planning considerations and lessons learned.

PubMed

Lane, David A

2006-10-01

When massive tsunamis affected the coast of Sri Lanka and other Indian Ocean littorals, elements of the Third Force Service Support Group and assigned Navy, Air Force, Army, and Coast Guard units from the U.S. Pacific Command were "task organized" to form Combined Support Group-Sri Lanka (CSG-SL), charged to conduct humanitarian assistance/disaster relief (HA/DR) operations. The specific mission was to provide immediate relief to the affected population of Sri Lanka and the Maldives, to minimize loss of life, and to mitigate human suffering. A 30-person health care team deployed to the northern province of Jaffna and provided medical assistance to that chronically underserved and acutely overstressed region. For a 12-day period, the team served as the principal medical staff of an under-resourced government hospital and conducted mobile primary care clinics at nearby welfare camps housing > 7,000 internally displaced persons made homeless by the tsunamis. By every measurable standard, CSG-SL accomplished its assigned HA/DR task in Sri Lanka, including the medical mission. In doing so, the medical team learned many important lessons, including five of particular value to planners of similar relief operations in the future. This article discusses the context in which CSG-SL planned and executed the medical aspects of its HA/DR operations in Sri Lanka, and it describes the most significant medical lessons learned.

Lessons learned from case studies of inhalation exposures of workers to radioactive aerosols

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hoover, M.D.; Fencl, A.F.; Newton, G.J.

1995-12-01

Various Department of Energy requirements, rules, and orders mandate that lessons learned be identified, evaluated, shared, and incorporated into current practices. The recently issued, nonmandatory DOE standard for Development of DOE Lessons Learned Program states that a DOE-wide lessons learned program will {open_quotes}help to prevent recurrences of negative experiences, highlight best practices, and spotlight innovative ways to solve problems or perform work more safely, efficiently, and cost effectively.{close_quotes} Additional information about the lessons learned program is contained in the recently issued DOE handbook on Implementing U.S. Department of Energy Lessons Learned Programs and in October 1995 DOE SAfety Notice onmore » Lessons Learned Programs. This report summarizes work in progress at ITRI to identify lessons learned for worker exposures to radioactive aerosols, and describes how this work will be incorporated into the DOE lessons learned program, including a new technical guide for measuring, modeling, and mitigating airborne radioactive particles. Follow-on work is focusing on preparation of {open_quotes}lessons learned{close_quotes} training materials for facility designers, managers, health protection professionals, line supervisors, and workers.« less

Summary of Planned Implementation for the HTGR Lessons Learned Applicable to the NGNP

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ian Mckirdy

2011-09-01

This document presents a reconciliation of the lessons learned during a 2010 comprehensive evaluation of pertinent lessons learned from past and present high temperature gas-cooled reactors that apply to the Next Generation Nuclear Plant Project along with current and planned activities. The data used are from the latest Idaho National Laboratory research and development plans, the conceptual design report from General Atomics, and the pebble bed reactor technology readiness study from AREVA. Only those lessons related to the structures, systems, and components of the Next Generation Nuclear Plant (NGNP), as documented in the recently updated lessons learned report are addressed.more » These reconciliations are ordered according to plant area, followed by the affected system, subsystem, or component; lesson learned; and finally an NGNP implementation statement. This report (1) provides cross references to the original lessons learned document, (2) describes the lesson learned, (3) provides the current NGNP implementation status with design data needs associated with the lesson learned, (4) identifies the research and development being performed related to the lesson learned, and (5) summarizes with a status of how the lesson learned has been addressed by the NGNP Project.« less

Piloting an information literacy program for staff nurses: lessons learned.

PubMed

Rosenfeld, Peri; Salazar-Riera, Noraliza; Vieira, Dorice

2002-01-01

Intrinsic to all models of evidence-based practice is the need for information literacy and the critical assessment of information. As part of a house-wide evidence-based practice initiative, the objective of this pilot project was to develop the information literacy skills of staff nurses to increase their ability to find and assess available electronic resources for clinical decision making. An intensive care unit was chosen to pilot a unit-based approach to educate staff nurses to perform patient care-related electronic literature searches. An additional goal was to determine the effectiveness of unit-based training sessions on the frequency and quality of electronic literature searches by participating nurses. In addition to the unit-based instruction, nursing and library staff collaborated to develop a Web-based tutorial to supplement and reinforce the content of the training sessions. A pretest-post-test design was used to evaluate the initiative and to assess the effect of the educational intervention over time. Among the lessons learned from this pilot study was that unit-based instruction presents significant obstacles for effective learning of new technological skills for staff nurses.

Background Information for Think Tank on Planning, Governance and System Building Early Care and Education--NYC

ERIC Educational Resources Information Center

Boressoff, Todd

2008-01-01

This document provides some background on early childhood planning and system building around the country. Since mid-December, the author has been studying these efforts for Child Care, Inc. (CCI) interviewing national experts and reading widely. This outline provides insights and lesson learned from those inquiries. The goal at this meeting will…

Healing Fractured Lives: How Three School-Based Projects Approach Violence Prevention and Mental Health Care.

ERIC Educational Resources Information Center

Fiester, Leila; Nathanson, Sara

Many health and education practitioners agree that school-based violence prevention services can counteract the negative effects of violence by offering children access to mental health care. The lessons learned at three sites that implemented such programs in various schools are reported here. Although the sample of sites was small and diverse,…

Increasing State Investments in Early Care and Education: Lessons Learned from Advocates and Best Practices, Spring 2008

ERIC Educational Resources Information Center

Voices for America's Children, 2008

2008-01-01

This report showcases advocacy efforts of 11 member organizations in 10 states that recently passed an early care and education (ECE) legislative initiative. The aim of the report is to provide advocates with proven strategies for advancing progress in securing access to ECE and expanding the opportunity for all children to start school prepared…

Enhancing and Adapting Treatment Foster Care: Lessons Learned in Trying to Change Practice.

PubMed

Murray, Maureen M; Southerland, Dannia; Farmer, Elizabeth M; Ballentine, Kess

2010-01-01

Evidence-based practices to improve outcomes for children with severe behavioral and emotional problems have received a great deal of attention in children's mental health. Therapeutic Foster Care (TFC), a residential intervention for youth with emotional or behavioral problems, is one of the few community-based programs that is considered to be evidence-based. However, as for most treatment approaches, the vast majority of existing programs do not deliver the evidence-based version. In an attempt to fill this gap and improve practice across a wide range of TFC agencies, we developed an enhanced model of TFC based on input from both practice and research. It includes elements associated with improved outcomes for youth in "usual care" TFC agencies as well as key elements from Chamberlain's evidence-based model. The current manuscript describes this "hybrid" intervention - Together Facing the Challenge - and discusses key issues in implementation. We describe the sample and settings, highlight key implementation strategies, and provide "lessons learned" to help guide others who may wish to change practice in existing agencies.

A rapid evidence-based service by librarians provided information to answer primary care clinical questions.

PubMed

McGowan, Jessie; Hogg, William; Rader, Tamara; Salzwedel, Doug; Worster, Danielle; Cogo, Elise; Rowan, Margo

2010-03-01

A librarian consultation service was offered to 88 primary care clinicians during office hours. This included a streamlined evidence-based process to answer questions in fewer than 20 min. This included a contact centre accessed through a Web-based platform and using hand-held devices and computers with Web access. Librarians were given technical training in evidence-based medicine, including how to summarise evidence. To describe the process and lessons learned from developing and operating a rapid response librarian consultation service for primary care clinicians. Evaluation included librarian interviews and a clinician exit satisfaction survey. Clinicians were positive about its impact on their clinical practice and decision making. The project revealed some important 'lessons learned' in the clinical use of hand-held devices, knowledge translation and training for clinicians and librarians. The Just-in-Time Librarian Consultation Service showed that it was possible to provide evidence-based answers to clinical questions in 15 min or less. The project overcame a number of barriers using innovative solutions. There are many opportunities to build on this experience for future joint projects of librarians and healthcare providers.

Leading Integrated Health and Social Care Systems: Perspectives from Research and Practice.

PubMed

Evans, Jenna M; Daub, Stacey; Goldhar, Jodeme; Wojtak, Anne; Purbhoo, Dipti

2016-01-01

As the research evidence on integrated care has evolved over the past two decades, so too has the critical role leaders have for the implementation, effectiveness and sustainability of integrated care. This paper explores what it means to be an effective leader of integrated care initiatives by drawing from the experiences of a leadership team in implementing an award-winning integrated care program in Toronto, Canada. Lessons learned are described and assessed against existing theory and research to identify which skills and behaviours facilitate effective leadership of integrated care initiatives.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, Carrie; LaRue, Anna; Pigman, Margaret

As more and more zero net energy (ZNE) buildings are built and monitored, we can learn from both careful case studies of individual projects as well as a broader perspective of trends over time. In a forum sponsored by Pacific Gas and Electric Company (PG&E), eight expert speakers discussed: results and lessons from monitoring occupied ZNE buildings; best practices for setting performance targets and getting actionable performance information, and; things that have surprised them about monitored ZNE buildings. This paper distills the content of the forum by laying out the most common hurdles that are encountered in setting up monitoringmore » projects, frequent performance issues that the monitoring uncovers, and lessons learned that can be applied to future projects.« less

Historical problem areas: Lessons learned for expendable and reusable vehicle propulsion systems

NASA Technical Reports Server (NTRS)

Fester, Dale A.

1991-01-01

The following subject areas are covered: expendable launch vehicle lessons learned, upper stage/transfer vehicle lessons learned, shuttle systems - reuse, and reusable system issues and lessons learned.

Lessons from the Unexpected: The Importance of Data Infrastructure, Conceptual Models, and Serendipity in Health Services Research

PubMed Central

Mechanic, David

2001-01-01

In examining the importance of data systems, conceptual models, and serendipity in understanding health services, the case is made for a vigorous and responsive data infrastructure and more emphasis on conceptual development. Particularly important is the development of data systems that can keep pace with changes in health care organization and patterns of care. Three examples—from managed care, deinstitutionalization, and physician remuneration—demonstrate the need to empirically examine seemingly obvious assumptions about health patterns and trends, and the lessons to be learned when assumptions are proved incorrect. Major future challenges include incorporating patient preferences into outcomes research, meaningful communication about treatment options and health plan choices, and understanding how organizational culture and norms affect decision processes. PMID:11565164

Training tomorrow's clinicians today--managed care essentials: a process for curriculum development.

PubMed

Colenda, C C; Wadland, W; Hayes, O; Anderson, W; Priester, F; Pearson, R; Keefe, C; Fleck, L

2000-05-01

To develop a managed care curriculum for primary care residents. This article outlines a 4-stage curriculum development process focusing on concepts of managed care organization and finance. The stages consist of: (1) identifying the curriculum development work group and framing the scope of the curriculum, (2) identifying stakeholder buy-in and expectations, (3) choosing curricular topics and delivery mechanisms, and (4) outlining the evaluation process. Key elements of building a curriculum development team, content objectives of the curriculum, the rationale for using problem-based learning, and finally, lessons learned from the partnership among the stakeholders are reviewed. The curriculum was delivered to an entering group of postgraduate-year 1 primary care residents. Attitudes among residents toward managed care remained relatively negative and stable over the yearlong curriculum, especially over issues relating to finance, quality of care, control and autonomy of practitioners, time spent with patients, and managed care's impact on the doctor-patient relationship. Residents' baseline knowledge of core concepts about managed care organization and finance improved during the year that the curriculum was delivered. Satisfaction with a problem-based learning approach was high. Problem-based learning, using real-life clinical examples, is a successful approach to resident instruction about managed care.

Lessons learned from the implementation of an online infertility community into an IVF clinic's daily practice.

PubMed

Aarts, Johanna W M; Faber, Marjan J; Cohlen, Ben J; Van Oers, Anne; Nelen, WillianNe L D M; Kremer, Jan A M

2015-01-01

The Internet is expected to innovate healthcare, in particular patient-centredness of care. Within fertility care, information provision, communication with healthcare providers and support from peers are important components of patient-centred care. An online infertility community added to an in vitro fertilisation or IVF clinic's practice provides tools to healthcare providers to meet these. This study's online infertility community facilitates peer-to-peer support, information provision to patients and patient provider communication within one clinic. Unfortunately, these interventions often fail to become part of clinical routines. The analysis of a first introduction into usual care can provide lessons for the implementation in everyday health practice. The aim was to explore experiences of professionals and patients with the implementation of an infertility community into a clinic's care practice. We performed semi-structured interviews with both professionals and patients to collect these experiences. These interviews were analyzed using the Normalisation Process Model. Assignment of a community manager, multidisciplinary division of tasks, clear instructions to staff in advance and periodical evaluations could contribute to the integration of this online community. Interviews with patients provided insights into the possible impact on daily care. This study provides lessons to healthcare providers on the implementation of an online infertility community into their practice.

Navigating change: how outreach facilitators can help clinicians improve patient outcomes.

PubMed

Laferriere, Dianne; Liddy, Clare; Nash, Kate; Hogg, William

2012-01-01

The objective of this study was to describe outreach facilitation as an effective method of assisting and supporting primary care practices to improve processes and delivery of care. We spent 4 years working with 83 practices in Eastern Ontario, Canada, on the Improved Delivery of Cardiovascular Care through the Outreach Facilitation program. Primary care practices, even if highly motivated, face multiple challenges when providing quality patient care. Outreach facilitation can be an effective method of assisting and supporting practices to make the changes necessary to improve processes and delivery of care. Multiple jurisdictions use outreach facilitation for system redesign, improved efficiencies, and advanced access. The development and implementation of quality improvement programs using practice facilitation can be challenging. Our research team has learned valuable lessons in developing tools, finding resources, and assisting practices to reach their quality improvement goals. These lessons can lead to improved experiences for the practices and overall improved outcomes for the patients they serve.

Who is in Your Waiting Room? Health Care Professionals as Culturally Responsive and Trauma-Informed First Responders to Human Trafficking.

PubMed

Rollins, Rochelle; Gribble, Anna; Barrett, Sharon E; Powell, Clydette

2017-01-01

Evidence-based practice standards are not yet well defined for assisting potential victims of human trafficking. Nonetheless, health care professionals are learning to be first responders in identifying, treating, and referring potential victims. As more public and private sector resources are used to train health care professionals about human trafficking, more evaluation and research are needed to develop an effective standard of care. Adopting a public health lens and using the "National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care" can guide critical decision making and actions. Through collaboration between researchers and policymakers, lessons learned in health care settings can inform future evidence-based standards of care so that all patients receive the services that they need. © 2017 American Medical Association. All Rights Reserved.

The Value of Identifying and Recovering Lost GN&C Lessons Learned: Aeronautical, Spacecraft, and Launch Vehicle Examples

NASA Technical Reports Server (NTRS)

Dennehy, Cornelius J.; Labbe, Steve; Lebsock, Kenneth L.

2010-01-01

Within the broad aerospace community the importance of identifying, documenting and widely sharing lessons learned during system development, flight test, operational or research programs/projects is broadly acknowledged. Documenting and sharing lessons learned helps managers and engineers to minimize project risk and improve performance of their systems. Often significant lessons learned on a project fail to get captured even though they are well known 'tribal knowledge' amongst the project team members. The physical act of actually writing down and documenting these lessons learned for the next generation of NASA GN&C engineers fails to happen on some projects for various reasons. In this paper we will first review the importance of capturing lessons learned and then will discuss reasons why some lessons are not documented. A simple proven approach called 'Pause and Learn' will be highlighted as a proven low-impact method of organizational learning that could foster the timely capture of critical lessons learned. Lastly some examples of 'lost' GN&C lessons learned from the aeronautics, spacecraft and launch vehicle domains are briefly highlighted. In the context of this paper 'lost' refers to lessons that have not achieved broad visibility within the NASA-wide GN&C CoP because they are either undocumented, masked or poorly documented in the NASA Lessons Learned Information System (LLIS).

Education on organ donation and transplantation in primary school; teachers' support and the first results of a teaching module

PubMed Central

Siebelink, Marion J.; Van de Wiel, Harry B. M.

2017-01-01

Organ and tissue donation can also involve children. Because of its sensitivity, this topic requires careful decision making. Children have the ability to carefully reflect on this subject and enjoy participating in family discussions about it. Therefore, what children need is proper information. When schools are used to educate children about this subject, information about teacher support for this type of lesson along with its effects on the depth of family discussions is important. Methods: A questionnaire was sent to all 7,542 primary schools in the Netherlands. The goal was to gather information on teachers’ perspectives about a neutral lesson devoted to organ and tissue donation, and also on the best age to start giving such a lesson. The second part of our study examined the effects of a newly developed lesson among 269 primary school pupils. The school response was 23%. Of these, 70% were positive towards a lesson; best age to start was 10–11 years. Pupils reported 20% more family discussions after school education and enjoyed learning more about this topic. There is significant support in primary schools for a school lesson on organ and tissue donation. Educational programs in schools support family discussions. PMID:28531238

Cross-industry Performance Modeling: Toward Cooperative Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Reece, Wendy Jane; Blackman, Harold Stabler

One of the current unsolved problems in human factors is the difficulty in acquiring information from lessons learned and data collected among human performance analysts in different domains. There are several common concerns and generally accepted issues of importance for human factors, psychology and industry analysts of performance and safety. Among these are the need to incorporate lessons learned in design, to carefully consider implementation of new designs and automation, and the need to reduce human performance-based contributions to risk. In spite of shared concerns, there are several roadblocks to widespread sharing of data and lessons learned from operating experiencemore » and simulation, including the fact that very few publicly accessible data bases exist (Gertman & Blackman, 1994, and Kirwan, 1997). There is a need to draw together analysts and analytic methodologies to comprise a centralized source of data with sufficient detail to be meaningful while ensuring source anonymity. We propose that a generic source of performance data and a multi-domain data store may provide the first steps toward cooperative performance modeling and analysis across industries.« less

Cross-Industry Performance Modeling: Toward Cooperative Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

H. S. Blackman; W. J. Reece

One of the current unsolved problems in human factors is the difficulty in acquiring information from lessons learned and data collected among human performance analysts in different domains. There are several common concerns and generally accepted issues of importance for human factors, psychology and industry analysts of performance and safety. Among these are the need to incorporate lessons learned in design, to carefully consider implementation of new designs and automation, and the need to reduce human performance-based contributions to risk. In spite of shared concerns, there are several road blocks to widespread sharing of data and lessons learned from operatingmore » experience and simulation, including the fact that very few publicly accessible data bases exist(Gertman & Blackman, 1994, and Kirwan, 1997). There is a need to draw together analysts and analytic methodologies to comprise a centralized source of data with sufficient detail to be meaningful while ensuring source anonymity. We propose that a generic source of performance data and a multi-domain data store may provide the first steps toward cooperative performance modeling and analysis across industries.« less

Approaches to quality improvement in nursing homes: Lessons learned from the six-state pilot of CMS's Nursing Home Quality Initiative

PubMed Central

Kissam, Stephanie; Gifford, David; Parks, Peggy; Patry, Gail; Palmer, Laura; Wilkes, Linda; Fitzgerald, Matthew; Petrulis, Alice Stollenwerk; Barnette, Leslie

2003-01-01

Background In November 2002, the Centers for Medicare & Medicaid Services (CMS) launched a Nursing Home Quality Initiative that included publicly reporting a set of Quality Measures for all nursing homes in the country, and providing quality improvement assistance to nursing homes nationwide. A pilot of this initiative occurred in six states for six months prior to the launch. Methods Review and analysis of the lessons learned from the six Quality Improvement Organizations (QIOs) that led quality improvement efforts in nursing homes from the six pilot states. Results QIOs in the six pilot states found several key outcomes of the Nursing Home Quality Initiative that help to maximize the potential of public reporting to leverage effective improvement in nursing home quality of care. First, public reporting focuses the attention of all stakeholders in the nursing home industry on achieving good quality outcomes on a defined set of measures, and creates an incentive for partnership formation. Second, publicly reported quality measures motivate nursing home providers to improve in certain key clinical areas, and in particular to seek out new ways of changing processes of care, such as engaging physicians and the medical director more directly. Third, the lessons learned by QIOs in the pilot of this Initiative indicate that certain approaches to providing quality improvement assistance are key to guiding nursing home providers' desire and enthusiasm to improve towards a using a systematic approach to quality improvement. Conclusion The Nursing Home Quality Initiative has already demonstrated the potential of public reporting to foster collaboration and coordination among nursing home stakeholders and to heighten interest of nursing homes in quality improvement techniques. The lessons learned from this pilot project have implications for any organizations or individuals planning quality improvement projects in the nursing home setting. PMID:12753699

Cancer Care Ontario and integrated cancer programs: portrait of a performance management system and lessons learned.

PubMed

Cheng, Siu Mee; Thompson, Leslee J

2006-01-01

A performance management system has been implemented by Cancer Care Ontario (CCO). This system allows for the monitoring and management of 11 integrated cancer programs (ICPs) across the Province of Ontario. The system comprises of four elements: reporting frequency, reporting requirements, review meetings and accountability and continuous improvement activities. CCO and the ICPs have recently completed quarterly performance review exercises for the last two quarters of the fiscal year 2004-2005. The purpose of this paper is to address some of the key lessons learned. The paper provides an outline of the CCO performance management system. These lessons included: data must be valid and reliable; performance management requires commitments from both parties in the performance review exercises; streamlining performance reporting is beneficial; technology infrastructure which allows for cohesive management of data is vital for a sustainable performance management system; performance indicators need to stand up to scrutiny by both parties; and providing comparative data across the province is valuable. Critical success factors which would help to ensure a successful performance management system include: corporate engagement from various parts of an organization in the review exercises; desire to focus on performance improvement and avoidance of blaming; and strong data management systems. The performance management system is a practical and sustainable system that allows for performance improvement of cancer care services. It can be a vital tool to enhance accountability within the health care system. The paper demonstrates that the performance management system supports accountability in the cancer care system for Ontario, and reflects the principles of the provincial governments commitment to continuous improvement of healthcare.

Surgical adverse outcome reporting as part of routine clinical care.

PubMed

Kievit, J; Krukerink, M; Marang-van de Mheen, P J

2010-12-01

In The Netherlands, health professionals have created a doctor-driven standardised system to report and analyse adverse outcomes (AO). The aim is to improve healthcare by learning from past experiences. The key elements of this system are (1) an unequivocal definition of an adverse outcome, (2) appropriate contextual information and (3) a three-dimensional hierarchical classification system. First, to assess whether routine doctor-driven AO reporting is feasible. Second, to investigate how doctors can learn from AO reporting and analysis to improve the quality of care. Feasibility was assessed by how well doctors reported AO in the surgical department of a Dutch university hospital over a period of 9 years. AO incidence was analysed per patient subgroup and over time, in a time-trend analysis of three equal 3-year periods. AO were analysed case by case and statistically, to learn lessons from past events. In 19,907 surgical admissions, 9189 AOs were reported: one or more AO in 18.2% of admissions. On average, 55 lessons were learnt each year (in 4.3% of AO). More AO were reported in P3 than P1 (OR 1.39 (1.23-1.57)). Although minor AO increased, fatal AO decreased over time (OR 0.59 (0.45-0.77)). Doctor-driven AO reporting is shown to be feasible. Lessons can be learnt from case-by-case analyses of individual AO, as well as by statistical analysis of AO groups and subgroups (illustrated by time-trend analysis), thus contributing to the improvement of the quality of care. Moreover, by standardising AO reporting, data can be compared across departments or hospitals, to generate (confidential) mirror information for professionals cooperating in a peer-review setting.

Surgical adverse outcome reporting as part of routine clinical care

PubMed Central

Krukerink, M; Marang-van de Mheen, P J

2010-01-01

Background In The Netherlands, health professionals have created a doctor-driven standardised system to report and analyse adverse outcomes (AO). The aim is to improve healthcare by learning from past experiences. The key elements of this system are (1) an unequivocal definition of an adverse outcome, (2) appropriate contextual information and (3) a three-dimensional hierarchical classification system. Objectives First, to assess whether routine doctor-driven AO reporting is feasible. Second, to investigate how doctors can learn from AO reporting and analysis to improve the quality of care. Methods Feasibility was assessed by how well doctors reported AO in the surgical department of a Dutch university hospital over a period of 9 years. AO incidence was analysed per patient subgroup and over time, in a time-trend analysis of three equal 3-year periods. AO were analysed case by case and statistically, to learn lessons from past events. Results In 19 907 surgical admissions, 9189 AOs were reported: one or more AO in 18.2% of admissions. On average, 55 lessons were learnt each year (in 4.3% of AO). More AO were reported in P3 than P1 (OR 1.39 (1.23–1.57)). Although minor AO increased, fatal AO decreased over time (OR 0.59 (0.45–0.77)). Conclusions Doctor-driven AO reporting is shown to be feasible. Lessons can be learnt from case-by-case analyses of individual AO, as well as by statistical analysis of AO groups and subgroups (illustrated by time-trend analysis), thus contributing to the improvement of the quality of care. Moreover, by standardising AO reporting, data can be compared across departments or hospitals, to generate (confidential) mirror information for professionals cooperating in a peer-review setting. PMID:20430928

Lessons from the domestic Ebola response: Improving health care system resilience to high consequence infectious diseases.

PubMed

Meyer, Diane; Kirk Sell, Tara; Schoch-Spana, Monica; Shearer, Matthew P; Chandler, Hannah; Thomas, Erin; Rose, Dale A; Carbone, Eric G; Toner, Eric

2018-05-01

The domestic response to the West Africa Ebola virus disease (EVD) epidemic from 2014-2016 provides a unique opportunity to distill lessons learned about health sector planning and operations from those individuals directly involved. This research project aimed to identify and integrate these lessons into an actionable checklist that can improve health sector resilience to future high-consequence infectious disease (HCID) events. Interviews (N = 73) were completed with individuals involved in the domestic EVD response in 4 cities (Atlanta, Dallas, New York, and Omaha), and included individuals who worked in academia, emergency management, government, health care, law, media, and public health during the response. Interviews were transcribed and analyzed qualitatively. Two focus groups were then conducted to expand on themes identified in the interviews. Using these themes, an evidence-informed checklist was developed and vetted for completeness and feasibility by an expert advisory group. Salient themes identified included health care facility issues-specifically identifying assessment and treatment hospitals, isolation and treatment unit layout, waste management, community relations, patient identification, patient isolation, limitations on treatment, laboratories, and research considerations-and health care workforce issues-specifically psychosocial impact, unit staffing, staff training, and proper personal protective equipment. The experiences of those involved in the domestic Ebola response provide critical lessons that can help strengthen resilience of health care systems and improve future responses to HCID events. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

The business case for quality.

PubMed

Boehler, Richard; Hardesty, Daniel; Gonzales, Eva; Kasnetz, Karen

2009-10-01

Among the lessons St. Joseph Medical Center learned in implementing a diabetes care management program were that: There is a sound business case for quality with such a program. A sound business plan based on a track record of accomplishments by other organizations is key to gaining clinician buy-in. Deploying dwindling resources to simultaneously improve care and the organization's bottom line requires collaboration between clinicians and finance.

Optimizing education on the inpatient dermatology consultative service.

PubMed

Afifi, Ladan; Shinkai, Kanade

2017-03-01

A consultative dermatology service plays an important role in patient care and education in the hospital setting. Optimizing education in balance with high-quality dermatology consultative services is both a challenge and an opportunity for dermatology consultation teams. There is an emergence of new information about how dermatology can best be taught in the hospital, much of which relies on principles of workplace learning as well as the science of how learning and teaching best happen in work settings. These best practices are summarized in this narrative review with integrated discussion of concepts from outpatient dermatology education and lessons learned from other inpatient teaching models. In addition, consultative dermatology curricula should utilize a blended curriculum model comprised of patient care and active learning and self-study modalities. Specific educational methods will discuss 2 strategies: (1) direct patient-care activities (ie, bedside teaching rounds) and (2) nonpatient care activities (ie, case presentations, didactic sessions, online modules, and reading lists). ©2017 Frontline Medical Communications.

UPMC's blueprint for BuILDing a high-value health care system.

PubMed

Keyser, Donna; Kogan, Jane; McGowan, Marion; Peele, Pamela; Holder, Diane; Shrank, William

2018-03-30

National-level demonstration projects and real-world studies continue to inform health care transformation efforts and catalyze implementation of value-based service delivery and payment models, though evidence generation and diffusion of learnings often occurs at a relatively slow pace. Rapid-cycle learning models, however, can help individual organizations to more quickly adapt health care innovations to meet the challenges and demands of a rapidly changing health care landscape. Integrated delivery and financing systems (IDFSs) offer a unique platform for rapid-cycle learning and innovation. Since both the provider and payer benefit from delivering care that enhances the patient experience, improves quality, and reduces cost, incentives are aligned to experiment with value-based models, enhance learning about what works and why, and contribute to solutions that can accelerate transformation. In this article, we describe how the UPMC Insurance Services Division, as part of a large IDFS, uses its Business, Innovation, Learning, and Dissemination (BuILD) model to prioritize, design, test, and refine health care innovations and accelerate learning. We provide examples of how the BuILD model offers an approach for quickly assessing the impact and value of health care transformation efforts. Lessons learned through the BuILD process will offer insights and guidance for a wide range of stakeholders whether an IDFS or independent payer-provider collaborators. Copyright © 2018 Elsevier Inc. All rights reserved.

The Benefits of Physician Training Programs for Rural Communities: Lessons Learned from the Teaching Health Center Graduate Medical Education Program.

PubMed

Lee, Marshala; Newton, Helen; Smith, Tracey; Crawford, Malena; Kepley, Hayden; Regenstein, Marsha; Chen, Candice

2016-01-01

Rural communities disproportionately face preventable chronic diseases and death from treatable conditions. Health workforce shortages contribute to limited health care access and health disparities. Efforts to address workforce shortages have included establishing graduate medical education programs with the goal of recruiting and retaining physicians in the communities in which they train. However, rural communities face a number of challenges in developing and maintaining successful residency programs, including concerns over financial sustainability and the integration of resident trainees into existing clinical practices. Despite these challenges, rural communities are increasingly interested in investing in residency programs; those that are successful see additional benefits in workforce recruitment, access, and quality of care that have immediate and direct impact on the health of rural communities. This commentary examines the challenges and benefits of rural residency programs, drawing from lessons learned from the Health Resources and Services Administration's Teaching Health Center Graduate Medical Education program.

Lessons Learned for Improving Spacecraft Ground Operations

NASA Technical Reports Server (NTRS)

Bell, Michael; Henderson, Gena; Stambolian, Damon

2013-01-01

NASA policy requires each Program or Project to develop a plan for how they will address Lessons Learned. Projects have the flexibility to determine how best to promote and implement lessons learned. A large project might budget for a lessons learned position to coordinate elicitation, documentation and archival of the project lessons. The lessons learned process crosses all NASA Centers and includes the contactor community. o The Office of The Chief Engineer at NASA Headquarters in Washington D.C., is the overall process owner, and field locations manage the local implementation. One tool used to transfer knowledge between program and projects is the Lessons Learned Information System (LLIS). Most lessons come from NASA in partnership with support contractors. A search for lessons that might impact a new design is often performed by a contractor team member. Knowledge is not found with only one person, one project team, or one organization. Sometimes, another project team, or person, knows something that can help your project or your task. Knowledge sharing is an everyday activity at the Kennedy Space Center through storytelling, Kennedy Engineering Academy presentations and through searching the Lessons Learned Information system. o Project teams search the lessons repository to ensure the best possible results are delivered. o The ideas from the past are not always directly applicable but usually spark new ideas and innovations. Teams have a great responsibility to collect and disseminate these lessons so that they are shared with future generations of space systems designers. o Leaders should set a goal for themselves to host a set numbers of lesson learned events each year and do more to promote multiple methods of lessons learned activities. o High performing employees are expected to share their lessons, however formal knowledge sharing presentation are not the norm for many employees.

Lessons learned from the development of health applications in a tertiary hospital.

PubMed

Park, Joong-Yeol; Lee, Guna; Shin, Soo-Yong; Kim, Jeong Hun; Han, Hye-Won; Kwon, Tae-Wan; Kim, Woo Sung; Lee, Jae Ho

2014-03-01

Adoption of smart devices for hospital use has been increasing with the development of health applications (apps) for patient point-of-care and hospital management. To promote the use of health apps, we describe the lessons learned from developing 12 health apps in the largest tertiary hospital in Korea. We reviewed and analyzed 12 routinely used apps in three categories-Smart Clinic, Smart Patient, and Smart Hospital-based on target users and functions. The log data for each app were collected from the date of release up until December 2012. Medical personnel accessed a mobile electronic medical record app classified as Smart Clinic an average of 452 times per day. Smart Hospital apps are actively used to communicate with each other. Patients logged on to a mobile personal health record app categorized as Smart Patient an average of 222 times per day. As the mobile trend, the choice of supporting operating system (OS) is more difficult. By developing these apps, a monitoring system is needed for evaluation. We described the lessons learned regarding OS support, device choice, and developmental strategy. The OS can be chosen according to market share or hospital strategic plan. Smartphones were favored compared with tablets. Alliance with an information technology company can be the best way to develop apps. Health apps designed for smart devices can be used to improve healthcare. However, to develop health apps, hospitals must define their future goals and carefully consider all the aspects.

Engineering Lessons Learned and Systems Engineering Applications

NASA Technical Reports Server (NTRS)

Gill, Paul S.; Garcia, Danny; Vaughan, William W.

2005-01-01

Systems Engineering is fundamental to good engineering, which in turn depends on the integration and application of engineering lessons learned. Thus, good Systems Engineering also depends on systems engineering lessons learned from within the aerospace industry being documented and applied. About ten percent of the engineering lessons learned documented in the NASA Lessons Learned Information System are directly related to Systems Engineering. A key issue associated with lessons learned datasets is the communication and incorporation of this information into engineering processes. As part of the NASA Technical Standards Program activities, engineering lessons learned datasets have been identified from a number of sources. These are being searched and screened for those having a relation to Technical Standards. This paper will address some of these Systems Engineering Lessons Learned and how they are being related to Technical Standards within the NASA Technical Standards Program, including linking to the Agency's Interactive Engineering Discipline Training Courses and the life cycle for a flight vehicle development program.

Engineering Lessons Learned and Systems Engineering Applications

NASA Technical Reports Server (NTRS)

Gill, Paul S.; Garcia, Danny; Vaughan, William W.

2005-01-01

Systems Engineering is fundamental to good engineering, which in turn depends on the integration and application of engineering lessons learned and technical standards. Thus, good Systems Engineering also depends on systems engineering lessons learned from within the aerospace industry being documented and applied. About ten percent of the engineering lessons learned documented in the NASA Lessons Learned Information System are directly related to Systems Engineering. A key issue associated with lessons learned datasets is the communication and incorporation of this information into engineering processes. Systems Engineering has been defined (EINIS-632) as "an interdisciplinary approach encompassing the entire technical effort to evolve and verify an integrated and life-cycle balanced set of system people, product, and process solutions that satisfy customer needs". Designing reliable space-based systems has always been a goal for NASA, and many painful lessons have been learned along the way. One of the continuing functions of a system engineer is to compile development and operations "lessons learned" documents and ensure their integration into future systems development activities. They can produce insights and information for risk identification identification and characterization. on a new project. Lessons learned files from previous projects are especially valuable in risk

Multidisciplinary Pediatric Obesity Clinic via Telemedicine Within the Los Angeles Metropolitan Area: Lessons Learned.

PubMed

Slusser, Wendy; Whitley, Margaret; Izadpanah, Nilufar; Kim, Sion L; Ponturo, Don

2016-03-01

Telemedicine has been shown to be effective for rural populations, but little is reported on pediatric obesity care via telemedicine in urban settings. This study aims to assess feasibility and acceptability of multidisciplinary pediatric obesity care via telemedicine within the same metropolitan area in terms of information technology, coordination, patient care, and clinical outcomes. All project notes and communications were reviewed to extract key lessons from implementation. Patient and Provider Satisfaction Questionnaires were conducted to assess overall satisfaction; baseline and follow-up information were collected from chart reviews to evaluate clinical outcomes. Based on the questionnaires, 93% of responding patients (n = 28) and 88.3% of referring providers (n = 17) felt satisfied with the appointment. Chart review indicated a trend for decreased or stabilized body mass index and blood pressure (n = 32). Implementation of telemedicine for tertiary multidisciplinary pediatric obesity care in urban settings is both feasible and acceptable to patients and health care providers. © The Author(s) 2015.

Lessons Learned from Participatory Design in Dementia Care: Placing Care Partners at the Centre.

PubMed

Hendriks, Niels; Slegers, Karin; Wilkinson, Andrea

2017-01-01

In this paper we analyze the participatory design (PD) process of a health information technology (HIT) project. This project, AToM was situated in dementia care and involved partners from academia, industry and care. The analysis specifically focuses on the role of the care partners in the PD process. We will show that the conditions to enable 'good participatory design' were not fully met and we present a set of actions to prevent this in future HIT projects. Central to our recommended approach is placing the care partners at the centre of the PD project.

Head and neck trauma in Iraq and Afghanistan: different war, different surgery, lessons learned.

PubMed

Brennan, Joseph

2013-10-01

The objectives are to compare and contrast the head and neck trauma experience in Iraq and Afghanistan and to identify trauma lessons learned that are applicable to civilian practice. A retrospective review of one head and neck surgeon's operative experience in Iraq and Afghanistan was performed using operative logs and medical records. The surgeon's daily operative log book with patient demographic data and operative reports was reviewed. Also, patient medical records were examined to identify the preoperative and postoperative course of care. The head and neck trauma experiences in Iraq and Afghanistan were very different, with a higher percentage of emergent cases performed in Iraq. In Iraq, only 10% of patients were pretreated at a facility with surgical capabilities. In Afghanistan, 93% of patients were pretreated at such facilities. Emergent neck exploration for penetrating neck trauma and emergent airway surgery were more common in Iraq, which most likely accounted for the increased perioperative mortality also seen in Iraq (5.3% in Iraq vs. 1.3% in Afghanistan). Valuable lessons regarding soft tissue trauma repair, midface fracture repair, and mandible fracture repair were learned. The head and neck trauma experiences in Iraq and Afghanistan were very different, and the future training for mass casualty trauma events should reflect these differences. Furthermore, valuable head and neck trauma lessons learned in both war zones are applicable to the civilian practice of trauma. Level 4. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Lessons Learned and Technical Standards: A Logical Marriage

NASA Technical Reports Server (NTRS)

Gill, Paul; Vaughan, William W.; Garcia, Danny; Gill, Maninderpal S. (Technical Monitor)

2001-01-01

A comprehensive database of lessons learned that corresponds with relevant technical standards would be a boon to technical personnel and standards developers. The authors discuss the emergence of one such database within NASA, and show how and why the incorporation of lessons learned into technical standards databases can be an indispensable tool for government and industry. Passed down from parent to child, teacher to pupil, and from senior to junior employees, lessons learned have been the basis for our accomplishments throughout the ages. Government and industry, too, have long recognized the need to systematically document And utilize the knowledge gained from past experiences in order to avoid the repetition of failures and mishaps. The use of lessons learned is a principle component of any organizational culture committed to continuous improvement. They have formed the foundation for discoveries, inventions, improvements, textbooks, and technical standards. Technical standards are a very logical way to communicate these lessons. Using the time-honored tradition of passing on lessons learned while utilizing the newest in information technology, the National Aeronautics and Space Administration (NASA) has launched an intensive effort to link lessons learned with specific technical standards through various Internet databases. This article will discuss the importance of lessons learned to engineers, the difficulty in finding relevant lessons learned while engaged in an engineering project, and the new NASA project that can help alleviate this difficulty. The article will conclude with recommendations for more expanded cross-sectoral uses of lessons learned with reference to technical standards.

Lessons Learned in Engineering

NASA Technical Reports Server (NTRS)

Blair, J. C.; Ryan, R. S.; Schutzenhofer, L. A.

2011-01-01

This Contractor Report (CR) is a compilation of Lessons Learned in approximately 55 years of engineering experience by each James C. Blair, Robert S. Ryan, and Luke A. Schutzenhofer. The lessons are the basis of a course on Lessons Learned that has been taught at Marshall Space Flight Center. The lessons are drawn from NASA space projects and are characterized in terms of generic lessons learned from the project experience, which are further distilled into overarching principles that can be applied to future projects. Included are discussions of the overarching principles followed by a listing of the lessons associated with that principle. The lesson with sub-lessons are stated along with a listing of the project problems the lesson is drawn from, then each problem is illustrated and discussed, with conclusions drawn in terms of Lessons Learned. The purpose of this CR is to provide principles learned from past aerospace experience to help achieve greater success in future programs, and identify application of these principles to space systems design. The problems experienced provide insight into the engineering process and are examples of the subtleties one experiences performing engineering design, manufacturing, and operations.

What lessons can history teach us about the Charcot foot?

PubMed

Sanders, Lee J

2008-01-01

Regrettably, physicians today receive very little instruction in the history of medicine. Most health care providers have a very limited, contemporary knowledge of the condition that we know of as the Charcot foot. Yet, historical concepts of the pathogenesis and natural history of this condition provide us with important lessons that enhance our understanding, recognition, and management of this rare but debilitating neurogenic arthropathy. It is my belief that knowledge of the history of medicine provides us with a better understanding of present-day issues and clearer vision as we look to the future. This article describes some of the important lessons learned from the history of the Charcot foot.

Measuring outcomes for neurosurgical procedures.

PubMed

Theodosopoulos, Philip V; Ringer, Andrew J

2015-04-01

Health care evolution has led to focused attention on clinical outcomes of care. Surgical disciplines are increasingly asked to provide evidence of treatment efficacy. As the technological advances push the surgical envelope further, it becomes imperative that postoperative outcomes are studied in a prospective fashion to assess the quality of care provided. The authors present their experience from a multiyear implementation of an outcomes initiative and share lessons learned, emphasizing the important structural elements of such an endeavor. Copyright © 2015 Elsevier Inc. All rights reserved.

Extremity War Injuries: Current Management and Research Priorities

DTIC Science & Technology

2012-01-01

sal- vage and amputation. The 13 articles generated from this symposium ad- dress these topics as well as multi- modal strategies for pain control...reconstruction, and reha- bilitation. The last seven articles of this supplement address lessons learned, outcomes measures, current strategies, and knowledge... bioburden , which has resulted in im- proved patient care. At the EWI VII Symposium, sev- eral research priorities were outlined in the areas of acute care

Implementing a Post-Care Service System in Child Welfare: The Catawba County Child Wellbeing Project. Research-to-Results Brief. Publication #2012-16

ERIC Educational Resources Information Center

Redmond, Phil; Mabry, Rhett; Ball, Heather; Wilson, Dawn; Brandes, Beth; Metz, Allison; Malm, Karin

2012-01-01

This is the first brief in a series, "Building a Post-Care Service System in Child Welfare: Lessons Learned from the Frontlines of Implementation Science in Catawba County." This brief sets the stage for a three-part series on the Catawba County Child Wellbeing Project by describing the Project's origins and historical context. Topics…

Early palliative care and its translation into oncology practice in Canada: barriers and challenges.

PubMed

Fassbender, Konrad; Watanabe, Sharon M

2015-07-01

This article reviews the progress Canada has made integrating palliative care into oncologic practice. Key clinical practice guidelines (CPGs) have influenced and have been translated into Canadian oncology policy and operations. Comprehensive accreditation standards exist to guide oncology practice in institutional and ambulatory care settings. Common barriers and challenges are discussed: education and attitudes, compassion fatigue, terminology, paucity of research, aggressive cancer care, and organization and operational considerations. As a result, eight made-in-Canada innovations emerged and are described. Lessons learned and recommendations describe a plan for action.

Surgeon preparedness for mass casualty events: Adapting essential military surgical lessons for the home front.

PubMed

Remick, Kyle N; Shackelford, Stacy; Oh, John S; Seery, Jason M; Grabo, Daniel; Chovanes, John; Gross, Kirby R; Nessen, Shawn C; Tai, Nigel Rm; Rickard, Rory F; Elster, Eric; Schwab, C W

2016-01-01

Military surgeons have gained familiarity and experience with mass casualty events (MCEs) as a matter of routine over the course of the last two conflicts in Afghanistan and Iraq. Over the same period of time, civilian surgeons have increasingly faced complex MCEs on the home front. Our objective is to summarize and adapt these combat surgery lessons to enhance civilian surgeon preparedness for complex MCEs on the home front. The authors describe the unique lessons learned from combat surgery over the course of the wars in Afghanistan and Iraq and adapt these lessons to enhance civilian surgical readiness for a MCE on the home front. Military Damage Control Surgery (mDCS) combines the established concept of clinical DCS (cDCS) with key combat situational awareness factors that enable surgeons to optimally care for multiple, complex patients, from multiple simultaneous events, with limited resources. These additional considerations involve the surgeon's role of care within the deployed trauma system and the battlefield effects. The proposed new concept of mass casualty DCS (mcDCS) similarly combines cDCS decisions with key factors of situational awareness for civilian surgeons faced with complex MCEs to optimize outcomes. The additional considerations for a civilian MCE include the surgeon's role of care within the regional trauma system and the incident effects. Adapting institutionalized lessons from combat surgery to civilian surgical colleagues will enhance national preparedness for complex MCEs on the home front.

Unmanned Ground Vehicle (UGV) Lessons Learned

DTIC Science & Technology

2001-11-01

iii 1. INTRODUCTION ....................................................................................................... 1 1.1... INTRODUCTION 1.1 PURPOSE The purpose of this effort is to compile Lessons Learned from the unmanned ground vehicle (UGV) programs that could be relevant to... introduction of gunpowder, this lesson was no longer valid. Castles crumbled and new lessons had to be learned. One such lesson was that the faster

Lesson Learning at JPL

NASA Technical Reports Server (NTRS)

Oberhettinger, David

2011-01-01

A lessons learned system is a hallmark of a mature engineering organization A formal lessons learned process can help assure that valuable lessons get written and published, that they are well-written, and that the essential information is "infused" into institutional practice. Requires high-level institutional commitment, and everyone's participation in gathering, disseminating, and using the lessons

From the laboratory to the therapy room: National dissemination and implementation of evidence-based psychotherapies in the U.S. Department of Veterans Affairs Health Care System.

PubMed

Karlin, Bradley E; Cross, Gerald

2014-01-01

Despite their established efficacy and recommendation--often as first-line treatments--in clinical practice guidelines, evidence-based psychotherapies (EBPs) have largely failed to make their way into mainstream clinical settings. Numerous attempts over the years to promote the translation of EBPs from science to practice, typically relying on one-dimensional dissemination approaches, have yielded limited success. As part of the transformation of its mental health care system, the Veterans Health Administration (VHA) of the U.S. Department of Veterans Affairs (VA) is working to disseminate and implement a number of EBPs for various mental and behavioral health conditions throughout the VA health care system. This article examines VHA's multidimensional model and specific strategies, involving policy, provider, local systems, patient, and accountability levels, for promoting the national dissemination and implementation of EBPs in VHA. In addition, the article identifies key lessons learned and next steps for further promoting EBP delivery and sustainability in the VA health care system. Beyond promoting the availability of effective treatments for veterans returning from Iraq and Afghanistan and for veterans of previous combat eras, VHA's EBP dissemination and implementation model and key lessons learned may help to inform other private and public health care systems interested in disseminating and implementing EBPs. PsycINFO Database Record (c) 2014 APA, all rights reserved.

77 FR 64565 - Solicitation of Feedback and Lessons-Learned from the Pilot of the Revised Construction Reactor...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-22

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0249] Solicitation of Feedback and Lessons-Learned from... or the Commission) is soliciting feedback and lessons-learned from members of the public, licensees... constructed in accordance with the licensing basis. The NRC has applied lessons- learned from the prior plants...

What can health care marketing learn from bank marketing?

PubMed

Mindak, W A

1988-01-01

A useful technique in assessing opportunities for international marketers is called "lead lag" analysis. It suggests that one can predict developments, such as demand patterns, in one country by looking at an analogous country. Applying such a technique to the domestic scene, what could we predict about the development and application of marketing to the health care sector if we looked at an analogous service such as banking? Many experts believe that health care is following in the footsteps of banking and point to environmental similarities such as changes in government regulation, new forms of nontraditional competition, increased concern about retail sectors, and pressures on scarce resources. Are there lessons that health care marketers can learn from bankers that might help them avoid some false starts or expensive mistakes?

Lessons Learned in Engineering. Supplement

NASA Technical Reports Server (NTRS)

Blair, James C.; Ryan, Robert S.; Schultzenhofer, Luke A.

2011-01-01

This Contractor Report (CR) is a compilation of Lessons Learned in approximately 55 years of engineering experience by each James C. Blair, Robert S. Ryan, and Luke A. Schutzenhofer. The lessons are the basis of a course on Lessons Learned that has been taught at Marshall Space Flight Center. The lessons are drawn from NASA space projects and are characterized in terms of generic lessons learned from the project experience, which are further distilled into overarching principles that can be applied to future projects. Included are discussions of the overarching principles followed by a listing of the lessons associated with that principle. The lesson with sub-lessons are stated along with a listing of the project problems the lesson is drawn from, then each problem is illustrated and discussed, with conclusions drawn in terms of Lessons Learned. The purpose of this CR is to provide principles learned from past aerospace experience to help achieve greater success in future programs, and identify application of these principles to space systems design. The problems experienced provide insight into the engineering process and are examples of the subtleties one experiences performing engineering design, manufacturing, and operations. The supplemental CD contains accompanying PowerPoint presentations.

Doggone Good Lessons.

ERIC Educational Resources Information Center

Raack, Lenaya

1999-01-01

Describes a teacher's experiences developing and implementing a three-week interdisciplinary unit for fourth grade students that revolves around the Alaskan Iditarod sled dog race. Students read about the race history, figure out a racing budget, learn about animal breeding and care, and follow the actual progress of the racing teams via Internet…

Lessons from Exceptional School Leaders.

ERIC Educational Resources Information Center

Goldberg, Mark

Leadership is situational and cannot be predicted or necessarily taught. This book is the distillation of ideas and practices derived from interviews with some of education's top leaders. Chapter 1, "Forming Beliefs," makes the point that teachers and administrators must carefully learn about excellence and then find the elements of excellence…

New beginnings in hospice.

PubMed

Ryndes, T

1995-01-01

Healthcare decisionmakers in acute settings might well benefit from lessons learned over two decades of hospice experience providing community-based, cost-effective care. Now the hospice concepts of interdisciplinary symptom management and transition counseling are being made available to patients and families long before they reach the traditional six-month prognosis entry point.

Lessons Learned from Litigation: Legal and Ethical Consequences of Social Media.

PubMed

Brous, Edie; Olsen, Douglas P

2017-09-01

Editor's note: To the surprise of many, a Canadian nurse's Facebook post complaining about the medical care a family member had received resulted in disciplinary action by the licensing board. We asked our legal and ethical contributing editors to provide some insight on the issues of this case.

Charging Ahead: An Introduction to Electromagnetism.

ERIC Educational Resources Information Center

Shafer, Larry E.

This guide explores the connection between electricity and magnetism with middle level and high school students. The phenomenon of electromagnetism is broken down into four lesson plans that provide students and teachers with a carefully constructed yet easy way to learn about their history. All four activities prompt students to use inexpensive,…

Lessons learned from facilitating the state and tribal government working group

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kurstedt, H.A. Jr.

1994-12-31

Thirteen lessons learned from my experience in facilitating the State and Tribal Government Working Group for the U.S. Department of Energy have been identified. The conceptual base for supporting the veracity of each lesson has been developed and the lessons are believed to be transferable to any stakeholder group. The crux of stakeholder group success if the two-directional, two-mode empowerment required in this case. Most of the lessons learned deal with the scope of that empowerment. A few of the lessons learned deal with the operations of the group.

Dissemination and implementation: INQRI's potential impact.

PubMed

Titler, Marita G; Wilson, Deleise S; Resnick, Barbara; Shever, Leah L

2013-04-01

Application of research evidence in care delivery improves patient outcomes. Large gaps still exist, however, between recommended care and that used in practice. To increase the understanding of implementation studies, and dissemination of research findings, we present the perspective of investigators from seven Interdisciplinary Nursing Quality Research Initiative (INQRI)-funded studies. To describe implementation strategies, challenges, and lessons learned from conducting 5 INQRI-funded implementation studies, and present 2 case examples of other INQRI studies to illustrate dissemination strategies. Potential impact of study findings are set forth. Qualitative descriptive methods were used for the implementation studies. Case examples were set forth by investigators using reflection questions. Four of the 5 implementation studies focused on clinical topics and 1 on professional development of nurse managers, 4 were multisite studies. Common implementation strategies used across studies addressed education, ongoing interaction with sites, use of implementation tools, and visibility of the projects on the study units. Major challenges were the Institutional Review Board approval process and the short length of time allocated for implementation. Successes and lessons learned included creating excitement about research, packaging of study tools and resources for use by other organizations, and understanding the importance of context when conducting this type of research. Case examples revealed that study findings have been disseminated to study sites and to the health care community through publications and presentations. The potential impact of all 7 studies is far reaching. This study captures several nuanced perspectives from 5 Principal Investigators, who were completing INQRI-funded implementation studies. These nuanced perspectives are important lessons for other scientists embarking on implementation studies. The INQRI case examples illustrate important dissemination strategies and impact of findings on quality of care.

77 FR 14446 - Changes to the Generic Aging Lessons Learned (GALL) Report Revision 2 AMP XI.M41, “Buried and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-09

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0055] Changes to the Generic Aging Lessons Learned (GALL... Aging Lessons Learned (GALL) Report,'' and the NRC staff's aging management review procedure and... into ADAMS. II. Background The NRC issues LR-ISGs to communicate insights and lessons learned and to...

Learning from Lessons: Teachers' Insights and Intended Actions Arising from Their Learning about Student Thinking

ERIC Educational Resources Information Center

Roche, Anne; Clarke, Doug; Clarke, David; Chan, Man Ching Esther

2016-01-01

A central premise of this project is that teachers learn from the act of teaching a lesson and that this learning is evident in the planning and teaching of a subsequent lesson. We are studying the knowledge construction of mathematics teachers utilising multi-camera research techniques during lesson planning, classroom interactions and…

Ebola: lessons learned and future challenges for Europe.

PubMed

Quaglio, GianLuca; Goerens, Charles; Putoto, Giovanni; Rübig, Paul; Lafaye, Pierre; Karapiperis, Theodoros; Dario, Claudio; Delaunois, Paul; Zachariah, Rony

2016-02-01

The Ebola virus epidemic has topped media and political agendas for months; several countries in west Africa have faced the worst Ebola epidemic in history. At the beginning of the disease outbreak, European Union (EU) policies were notably absent regarding how to respond to the crisis. Although the epidemic is now receding from public view, this crisis has undoubtedly changed the European public perception of Ebola virus disease, which is no longer regarded as a bizarre entity confined in some unknown corner in Africa. Policy makers and researchers in Europe now have an opportunity to consider the lessons learned. In this Personal View, we discuss the EU's response to the Ebola crisis in west Africa. Unfortunately, although ample resources and opportunities for humanitarian and medical action existed, the EU did not use them to promote a rapid and well coordinated response to the Ebola crisis. Lessons learned from this crisis should be used to improve the role of the EU in similar situations in the future, ensuring that European aid can be effectively deployed to set up an improved emergency response system, and supporting the establishment of sustainable health-care services in west Africa. Copyright © 2016 Elsevier Ltd. All rights reserved.

Adapting a Technology-Based Implementation Support Tool for Community Mental Health: Challenges and Lessons Learned.

PubMed

Livet, Melanie; Fixsen, Amanda

2018-01-01

With mental health services shifting to community-based settings, community mental health (CMH) organizations are under increasing pressure to deliver effective services. Despite availability of evidence-based interventions, there is a gap between effective mental health practices and the care that is routinely delivered. Bridging this gap requires availability of easily tailorable implementation support tools to assist providers in implementing evidence-based intervention with quality, thereby increasing the likelihood of achieving the desired client outcomes. This study documents the process and lessons learned from exploring the feasibility of adapting such a technology-based tool, Centervention, as the example innovation, for use in CMH settings. Mixed-methods data on core features, innovation-provider fit, and organizational capacity were collected from 44 CMH providers. Lessons learned included the need to augment delivery through technology with more personal interactions, the importance of customizing and integrating the tool with existing technologies, and the need to incorporate a number of strategies to assist with adoption and use of Centervention-like tools in CMH contexts. This study adds to the current body of literature on the adaptation process for technology-based tools and provides information that can guide additional innovations for CMH settings.

Teamwork situated in multiteam systems: Key lessons learned and future opportunities.

PubMed

Shuffler, Marissa L; Carter, Dorothy R

2018-01-01

Many important contexts requiring teamwork, including health care, space exploration, national defense, and scientific discovery, present important challenges that cannot be addressed by a single team working independently. Instead, the complex goals these contexts present often require effectively coordinated efforts of multiple specialized teams working together as a multiteam system (MTS). For almost 2 decades, researchers have endeavored to understand the novelties and nuances for teamwork and collaboration that ensue when teams operate together as "component teams" in these interdependent systems. In this special issue on the settings of teamwork, we aim to synthesize what is known thus far regarding teamwork situated in MTS contexts and offer new directions and considerations for developing, maintaining, and sustaining effective collaboration in MTSs. Our review of extant research on MTSs reveals 7 key lessons learned regarding teamwork situated in MTSs, but also reveals that much is left to learn about the science and practice of ensuring effective multiteam functioning. We elaborate these lessons and delineate 4 major opportunities for advancing the science of MTSs as a critical embedding context for collaboration and teamwork, now and in the future. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Ideologies of aid, practices of power: lessons for Medicaid managed care.

PubMed

Nelson, Nancy L

2005-03-01

The articles in this special issue teach valuable lessons based on what happened in New Mexico with the shift to Medicaid managed care. By reframing these lessons in broader historical and cultural terms with reference to aid programs, we have the opportunity to learn a great deal more about the relationship between poverty, public policy, and ideology. Medicaid as a state and federal aid program in the United States and economic development programs as foreign aid provide useful analogies specifically because they exhibit a variety of parallel patterns. The increasing concatenation of corporate interests with state and nongovernmental interests in aid programs is ultimately producing a less centralized system of power and responsibility. This process of decentralization, however, is not undermining the sources of power behind aid efforts, although it does make the connections between intent, planning, and outcome less direct. Ultimately, the devolution of power produces many unintended consequences for aid policy. But it also reinforces the perspective that aid and the need for it are nonpolitical issues.

Characteristics of health care organizations associated with learning and development: lessons from a pilot study.

PubMed

Nyström, Monica

2009-01-01

Characteristics of health care organizations associated with an ability to learn from experiences and to develop and manage change were explored in this study. Understanding of these characteristics is necessary to identify factors influencing success in learning from the past and achieving future health care quality objectives. A literature review of the quality improvement, strategic organizational development and change management, organizational learning, and microsystems fields identified 20 organizational characteristics, grouped under (a) organizational systems, (b) key actors, and (c) change management processes. Qualitative methods, using interviews, focus group reports, and archival records, were applied to find associations between identified characteristics and 6 Swedish health care units externally evaluated as delivering high-quality care. Strong support for a characteristic was defined as units having more than 4 sources describing the characteristic as an important success factor. Eighteen characteristics had strong support from at least 2 units. The strongest evidence was found for the following: (i) key actors have long-term commitment, provide support, and make sense of ambiguous situations; (ii) organizational systems encourage employee commitment, participation, and involvement; and (iii) change management processes are employed systematically. Based on the results, a new model of "characteristics associated with learning and development in health care organizations" is proposed.

Development and implementation of a navigator-facilitated care coordination algorithm to improve clinical outcomes of underserved Latino patients with uncontrolled diabetes.

PubMed

Congdon, Heather Brennan; Eldridge, Barbara Hoffman; Truong, Hoai-An

2013-11-01

Development and implementation of an interprofessional navigator-facilitated care coordination algorithm (NAVCOM) for low-income, uninsured patients with uncontrolled diabetes at a safety-net clinic resulted in improvement of disease control as evidenced by improvement in hemoglobin A1C. This report describes the process and lessons learned from the development and implementation of NAVCOM and patient success stories.

Building the Child Wellbeing Project: Practitioners' Perspectives on the Role of Implementation Science in Strengthening Post-Care Child Welfare Services. Research-to-Results Brief. Publication #2012-18

ERIC Educational Resources Information Center

Wilson, Dawn; Brandes, Beth; Ball, Heather; Malm, Karin

2012-01-01

This is the third brief in a series: "Building a Post-Care Service System in Child Welfare: Lessons Learned from the Frontlines of Implementation Science in Catawba County." The first of the three briefs provided background information on the initiative that is the focus of the series--the Catawba County Child Wellbeing Project. Both…

Development, Validation, and Implementation of a Clinic Nurse Staffing Guideline.

PubMed

Deeken, Debra Jean; Wakefield, Douglas; Kite, Cora; Linebaugh, Jeanette; Mitchell, Blair; Parkinson, Deidre; Misra, Madhukar

2017-10-01

Ensuring that the level of nurse staffing used to care for patients is appropriate to the setting and service intensity is essential for high-quality and cost-effective care. This article describes the development, validation, and implementation of the clinic technical skills permission list developed specifically to guide nurse staffing decisions in physician clinics of an academic medical center. Results and lessons learned in using this staffing guideline are presented.

Nationwide telecare for diabetics: a pilot implementation of the HOLON architecture.

PubMed Central

Jones, P. C.; Silverman, B. G.; Athanasoulis, M.; Drucker, D.; Goldberg, H.; Marsh, J.; Nguyen, C.; Ravichandar, D.; Reis, L.; Rind, D.; Safran, C.

1998-01-01

This paper presents results from a demonstration project of nationwide exchange of health data for the home care of diabetic patients. A consortium of industry, academic, and health care partners has developed reusable middleware components integrated using the HOLON architecture. Engineering approaches for multi-organization systems development, lessons learned in developing layered object-oriented systems, security and confidentiality considerations, and functionality for nationwide telemedicine applications are discussed. PMID:9929239

Developing Military Health Care Leaders: Insights from the Military, Civilian, and Government Sectors

DTIC Science & Technology

2011-01-01

6 mentoring, career counseling, feedback, and self- development . Organizations differ in terms of how much emphasis they place on particular...deliberate sample of health care organizations in the private sector that were most likely to offer lessons learned for DoD. Our interviews were conducted...the eight sampled organizations , for a total of eight interviews. VHA Case Study. In addition to the private - sector interviews, we examined public

Learning from Lessons: Studying the Construction of Teacher Knowledge Catalysed by Purposefully-Designed Experimental Mathematics Lessons

ERIC Educational Resources Information Center

Clarke, Doug; Clarke, David; Roche, Anne; Chan, Man Ching Esther

2015-01-01

A central premise of this project is that teachers learn from the act of teaching a lesson and that this learning is evident in the planning and teaching of a subsequent lesson. In this project, the knowledge construction of mathematics teachers was examined utilising multi-camera research techniques during lesson planning, classroom interactions…

Brownfields City of Cleveland: Deconstruction Lessons Learned Report

EPA Pesticide Factsheets

This technical memorandum presents an overview of Cleveland’s current deconstruction initiative goals and lessons learned (in the Cleveland area) and potential strategies for addressing lessons learned.

77 FR 46127 - Interim Staff Guidance on Changes to the Generic Aging Lessons Learned (GALL) Report Revision 2...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-02

... Aging Lessons Learned (GALL) Report Revision 2 AMP XI.M41, ``Buried and Underground Piping and Tanks... AMPs in NUREG-1801, Revision 2, ``Generic Aging Lessons Learned (GALL) Report,'' and the NRC staff's... issues LR-ISG to communicate insights and lessons learned and to address emergent issues not covered in...

The top ten list: lessons learned from teaching a study abroad course.

PubMed

Kostovich, Carol T; Bermele, Charlene A

2011-01-01

In response to the need for culturally competent care, faculty can instill in students the desire to become culturally competent practitioners by providing the opportunity to participate in a short-term study abroad immersion experience. While this strategy is not considered cutting-edge or revolutionary, changing global dynamics warrant rethinking this curricular option. Nurse faculty conducted two short-term study abroad courses in Croatia. Students explored health care and nursing education in this Eastern European country and participated in a service-learning project. Based on their experiences, the authors offer five dos and five don'ts for planning and implementing a successful study abroad course.

PCMHs, ACOs, and medication management: lessons learned from early research partnerships.

PubMed

Schnur, Evan S; Adams, Alex J; Klepser, Donald G; Doucette, William R; Scott, David M

2014-02-01

The Patient Protection and Affordable Care Act has greatly accelerated the formation of team-based models of care delivery, primarily accountable care organizations (ACOs) and patient-centered medical homes (PCMHs).  Many have written about the need to incorporate medication management services into these systems in order to improve care and reduce total health care costs. Two primary ways of doing so have emerged: (1) an embedded model, whereby pharmacists are employed directly by a physician practice, or (2) a "virtual care team" model, whereby a PCMH or ACO develops an arrangement with external pharmacists in community settings to provide coordinated services.

Elective Self-Care Course Emphasizing Critical Reasoning Principles

PubMed Central

2011-01-01

Objectives. To create, implement, and assess a self-directed online course based on 3 critical reasoning principles to develop pharmacy students’ skills in literature appraisal, content, metacognition, and assessment. Design. Students completed 3 assignments for the course: compile a literature appraisal on a healthcare topic; plan learning objectives and meta-cognitive skills for a learning module; and create a case-based online lesson with multi-structured feedback. Assessment. An online exit survey evaluated students’ perceptions regarding development of ACE (agency, collaboration, expertise) principles and preparation for competency. Students reported acquisition of ACE principles and noted improvements in their learning approaches, sense of responsibility for individual and community learning, skills, and confidence. Conclusions. An online elective course in self-care addressed practice standards for patient safety, maintenance of competency, and interprofessional education by emphasizing critical reasoning skills. PMID:22171110

Initiating pain and palliative care outpatient services for the suburban underserved in Montgomery County, Maryland: Lessons learned at the NIH Clinical Center and MobileMed.

PubMed

Aggarwal, Sunil K; Ghosh, Amrita; Cheng, M Jennifer; Luton, Kathleen; Lowet, Peter F; Berger, Ann

2016-08-01

With the ongoing expansion of palliative care services throughout the United States, meeting the needs of socioeconomically marginalized populations, as in all domains of healthcare, continues to be a challenge. Our specific aim here was to help meet some of these needs through expanding delivery of pain and palliative care services by establishing a new clinic for underserved patients and collecting descriptive data about its operation. In November of 2014, the National Institutes of Health Clinical Center's Pain and Palliative Care Service (PPCS) launched a bimonthly offsite pain and palliative care outpatient clinic in collaboration with Mobile Medical Care Inc. (MobileMed), a private not-for-profit primary care provider in Montgomery County, Maryland, serving underserved area residents since 1968. Staffed by NIH hospice and palliative medicine clinical fellows and faculty, the clinic provides specialty pain and palliative care consultation services to patients referred by their primary care healthcare providers. A patient log was maintained, charts reviewed, and referring providers surveyed on their satisfaction with the service. The clinic had 27 patient encounters with 10 patients (6 males, 4 females, aged 23-67) during its first 7 months of operation. The reason for referral for all but one patient was chronic pain of multiple etiologies. Patients had numerous psychosocial stressors and comorbidities. All primary care providers who returned surveys (n = 4) rated their level of satisfaction with the consultation service as "very satisfied" or "extremely satisfied." This brief descriptive report outlines the steps taken and logistical issues addressed to launch and continue the clinic, the characteristics of patients treated, and the results of quality-improvement projects. Lessons learned are highlighted and future directions suggested for the clinic and others that may come along like it.

Teacher Responses to Learning Cycle Science Lessons for Early Childhood Education

NASA Astrophysics Data System (ADS)

Kraemer, Emily N.

Three learning cycle science lessons were developed for preschoolers in an early childhood children's center in Costa Mesa, California. The lessons were field tested by both novice and experienced teachers with children ranging from three to five years old. Teachers were then interviewed informally to collect feedback on the structure and flow the lessons. The feedback was encouraging remarks towards the use of learning cycle science lessons for early childhood educators. Adjustments were made to the lessons based on teacher feedback. The lessons and their implications for preschool education are discussed.

After-Action Reports: Capturing Lessons Learned and Identifying Areas for Improvement. Lessons Learned from School Crises and Emergencies. Volume 2, Issue 1, 2007

ERIC Educational Resources Information Center

US Department of Education, 2007

2007-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This issue of "Lessons Learned" addresses after-action reports, which are an integral part of the emergency preparedness planning continuum and support effective crisis response. After-action reports have a threefold purpose. They…

Learning about systems-based practice in the informal curriculum: a case study in an academic pediatric continuity clinic.

PubMed

Balmer, Dorene; Ruzek, Sheryl; Ludwig, Stephen; Giardino, Angelo P

2007-01-01

Pediatric residents learn about systems-based practice (SBP) explicitly in the formal curriculum and implicitly in the informal curriculum as they engage in practice alongside physician faculty. Recent studies describe innovative ways to address SBP in the formal curriculum for SBP, but the informal curriculum has not been explored. We examined what, and how, third-year pediatric residents learn about SBP in the informal curriculum at one continuity clinic, and to consider how this learning aligns with the formal curriculum. A case study involving 10 third-year pediatric residents and 10 continuity preceptors was conducted at one continuity clinic, housed in a community-based, pediatric primary care center. Data were derived from 5 months (100 hours) of direct observation in the precepting room at the case clinic, semistructured interviews with residents (before and after observation) and with preceptors (after observation). Interview transcripts and notes from observation were inductively coded and analyzed for major themes. Two themes emerged in the informal curriculum. Residents perceived "our system," the academic health system in which they trained and practiced as separate and distinct from the "real system," the larger, societal context of health care. Residents also understood SBP as a commitment to helping individual patients and families navigate the complexities of "our system," dealing with issues that concerned them. Residents learn important lessons about SBP in the informal curriculum in continuity clinic. These lessons may reinforce some elements of the competency-based formal curriculum for SBP, but challenge others.

The reform of home care services in Ontario: opportunity lost or lesson learned?

PubMed

Randall, Glen

2007-06-01

With the release of the Romanow Commission report, Canadian governments are poised to consider the creation of a national home care program. If occupational and physical therapists are to have input in shaping such a program, they will need to learn from lost opportunities of the past. This paper provides an overview of recent reforms to home care in Ontario with an emphasis on rehabilitation services. Data were collected from documents and 28 key informant interviews with rehabilitation professionals. Home care in Ontario has evolved in a piecemeal manner without rehabilitation professionals playing a prominent role in program design. Rehabilitation services play a critical role in facilitating hospital discharges, minimizing readmissions, and improving the quality of peoples' lives. Canadians will benefit if occupational and physical therapists seize the unique opportunity before them to provide meaningful input into creating a national home care program.

Lessons from interprofessional e-learning: piloting a care of the elderly module.

PubMed

Juntunen, Anitta; Heikkinen, Eija

2004-08-01

Educating health care professionals is a key issue in the provision of quality healthcare services. Interprofessional education has been suggested as a means of meeting this challenge. Four Finnish polytechnics providing education for nurses, social workers and physiotherapists wished to develop the content and methods of teaching the care of the elderly by collaboratively creating and implementing an interprofessional module of 15 European Credit Transfer units, using e-learning. This paper examines the planning and assessment of the impact of the pilot module. The web-based environment eminently suited teaching interprofessional care of the elderly. It supported content and methodological development and renewal of the module. It enabled discussion and collaboration between nursing, social work and rehabilitation teachers and students from the Polytechnics which are located in different parts of Finland. However, it became evident during the pilot that the most crucial challenges of the web-based pedagogy were in the ability of the teacher to supervise, support and motivate students and the organisation of interprofessional learning offered by collaborating institutions.

Risky business: human factors in critical care.

PubMed

Laussen, Peter C; Allan, Catherine K; Larovere, Joan M

2011-07-01

Remarkable achievements have occurred in pediatric cardiac critical care over the past two decades. The specialty has become well defined and extremely resource intense. A great deal of focus has been centered on optimizing patient outcomes, particularly mortality and early morbidity, and this has been achieved through a focused and multidisciplinary approach to management. Delivering high-quality and safe care is our goal, and during the Risky Business symposium and simulation sessions at the Eighth International Conference of the Pediatric Cardiac Intensive Care Society in Miami, December 2010, human factors, systems analysis, team training, and lessons learned from malpractice claims were presented.

Managing a palliative oncology program: the role of a business plan.

PubMed

Walsh, D; Gombeski, W R; Goldstein, P; Hayes, D; Armour, M

1994-02-01

Today's health-care environment demands that palliative-care programs operate in a businesslike manner. This report summarizes the business plan and the process followed to develop the Palliative Care Program at the Cleveland Clinic Foundation (CCF). The benefits generated from this effort and the lessons learned that may be helpful to other program managers are described. By disciplining itself to focus on financial, marketing, and operational issues, the Palliative Care Program is in a better position to advance its clinical services within the organization and in its market area, and can thereby serve its patients more effectively.

Primary care-based multifaceted, interdisciplinary medical educational intervention for patients with systolic heart failure: lessons learned from a cluster randomised controlled trial.

PubMed

Peters-Klimm, Frank; Campbell, Stephen; Müller-Tasch, Thomas; Schellberg, Dieter; Gelbrich, Goetz; Herzog, Wolfgang; Szecsenyi, Joachim

2009-08-13

Chronic (systolic) heart failure (CHF) is a common and disabling condition. Adherence to evidence-based guidelines in primary care has been shown to improve health outcomes. The aim was to explore the impact of a multidisciplinary educational intervention for general practitioners (GPs) (Train the trainer = TTT) on patient and performance outcomes. This paper presents the key findings from the trial and discusses the lessons learned during the implementation of the TTT trial. Primary care practices were randomly assigned to the TTT intervention or to the control group. 37 GPs (18 TTT, 19 control) were randomised and 168 patients diagnosed with ascertained CHF (91 TTT, 77 control) were enrolled. GPs in the intervention group attended four meetings addressing clinical practice guidelines and pharmacotherapy feedback. The primary outcome was patient self-reported quality of life at seven months, using the SF-36 Physical Functioning scale. Secondary outcomes included other SF-36 scales, the Kansas City Cardiomyopathy Questionnaire (KCCQ), total mortality, heart failure hospital admissions, prescribing, depressive disorders (PHQ-9), behavioural change (European Heart Failure Self-Care Behaviour Scale), patient-perceived quality of care (EUROPEP) and improvement of heart failure using NT-proBNP-levels. Because recruitment targets were not achieved an exploratory analysis was conducted. There was high baseline achievement in both groups for many outcomes. At seven months, there were no significant mean difference between groups for the primary outcome measure (-3.3, 95%CI -9.7 to 3.1, p = 0.30). The only difference in secondary outcomes related to the prescribing of aldosterone antagonists by GPs in the intervention group, with significant between group differences at follow-up (42 vs. 24%, adjusted OR = 4.0, 95%CI 1.2-13; p = 0.02). The intervention did not change the primary outcome or most secondary outcomes. Recruitment targets were not achieved and the under-recruitment of practices and patients alongside a selection bias of participating GPs, prohibit definite conclusions, but the CI indicates a non-effectiveness of the intervention in this sample. We describe the lessons learned from conducting the trial for the future planning and conduct of confirmatory trials in primary care. ISRCTN08601529.

Primary care-based multifaceted, interdisciplinary medical educational intervention for patients with systolic heart failure: lessons learned from a cluster randomised controlled trial

PubMed Central

Peters-Klimm, Frank; Campbell, Stephen; Müller-Tasch, Thomas; Schellberg, Dieter; Gelbrich, Goetz; Herzog, Wolfgang; Szecsenyi, Joachim

2009-01-01

Background Chronic (systolic) heart failure (CHF) is a common and disabling condition. Adherence to evidence-based guidelines in primary care has been shown to improve health outcomes. The aim was to explore the impact of a multidisciplinary educational intervention for general practitioners (GPs) (Train the trainer = TTT) on patient and performance outcomes. Methods This paper presents the key findings from the trial and discusses the lessons learned during the implementation of the TTT trial. Primary care practices were randomly assigned to the TTT intervention or to the control group. 37 GPs (18 TTT, 19 control) were randomised and 168 patients diagnosed with ascertained CHF (91 TTT, 77 control) were enrolled. GPs in the intervention group attended four meetings addressing clinical practice guidelines and pharmacotherapy feedback. The primary outcome was patient self-reported quality of life at seven months, using the SF-36 Physical Functioning scale. Secondary outcomes included other SF-36 scales, the Kansas City Cardiomyopathy Questionnaire (KCCQ), total mortality, heart failure hospital admissions, prescribing, depressive disorders (PHQ-9), behavioural change (European Heart Failure Self-Care Behaviour Scale), patient-perceived quality of care (EUROPEP) and improvement of heart failure using NT-proBNP-levels. Because recruitment targets were not achieved an exploratory analysis was conducted. Results There was high baseline achievement in both groups for many outcomes. At seven months, there were no significant mean difference between groups for the primary outcome measure (-3.3, 95%CI -9.7 to 3.1, p = 0.30). The only difference in secondary outcomes related to the prescribing of aldosterone antagonists by GPs in the intervention group, with significant between group differences at follow-up (42 vs. 24%, adjusted OR = 4.0, 95%CI 1.2–13; p = 0.02). Conclusion The intervention did not change the primary outcome or most secondary outcomes. Recruitment targets were not achieved and the under-recruitment of practices and patients alongside a selection bias of participating GPs, prohibit definite conclusions, but the CI indicates a non-effectiveness of the intervention in this sample. We describe the lessons learned from conducting the trial for the future planning and conduct of confirmatory trials in primary care. Trial registration ISRCTN08601529. PMID:19678944

Geoscience for Preschoolers

ERIC Educational Resources Information Center

Danisa, David; Gentile, Jason; McNamara, Kate; Pinney, Monica; Ross, Sarah; Rule, Audrey C.

2006-01-01

In this article, a group of five preservice teachers and a teacher arranged to try a few activities at their campus day care. Together, they created and tested a series of learning centers involving rocks and minerals. Since minerals occur in such a wonderful variety of colors, they formed the basis for an engaging lesson on color sorting. This…

Marketing mobile imaging services.

PubMed

McCue, P

1987-09-01

Competition in the mobile imaging arena has put radiologists, radiology directors, and other health care professionals in the unfamiliar position of being marketing agents for their services. Mobile imaging is being promoted through consumer advertising as well as through the traditional route of physician referral. This article offers some of the marketing lessons being learned in the mobile arena.

Integrating Cognitive Behavioral Therapy and Pharmacotherapy in the Treatment of Adolescent Depression

ERIC Educational Resources Information Center

Ginsburg, Golda S.; Albano, Anne Marie; Findling, Robert L.; Kratochvil, Christopher; Walkup, John

2005-01-01

Recent evidence from the Treatment for Adolescents With Depression Study (TADS) suggests that combining cognitive behavioral and pharmacological treatments holds the most promise for ameliorating depression among adolescents. This article describes lessons learned during the TADS trial about how to integrate these two treatments in the care of…

Systematic Instruction for Retarded Children: The Illinois Program. Part III: Self-Help Instruction.

ERIC Educational Resources Information Center

Linford, Maxine D.; And Others

The manual for programed instruction of self care skills for trainable mentally handicapped children consists of dressing, dining, grooming, and toilet training. Teaching methods used include behavioral analysis and management, task analysis, and errorless learning. The lesson plans in each section are programed to maximize the child's success at…

Medical informatics education needs information system practicums in health care settings--experiences and lessons learned from 32 practicums at four universities in two countries.

PubMed

Haux, R; Ammenwerth, E; Häber, A; Hübner-Bloder, G; Knaup-Gregori, P; Lechleitner, G; Leiner, F; Weber, R; Winter, A; Wolff, A C

2006-01-01

To report about the themes and about experiences with practicums in the management of information systems in health care settings (health information management) for medical informatics students. We first summarize the topics of the health information management practicums/projects that the authors organized between 1990 and 2003 for the medical informatics programs at Heidelberg/Heilbronn, Germany, UMIT, Austria, as well as for the informatics program at the University of Leipzig, Germany. Experiences and lessons learned, obtained from the faculty that organized the practicums in the past 14 years, are reported. Thirty (of 32) health information management practicums focused on the analysis of health information systems. These took place inside university medical centers. Although the practicums were time-intensive and required intensively tutoring students with regard to health information management and project management, feedback from the students and graduates was mainly positive. It is clearly recommended that students specializing in medical informatics need to be confronted with real-world problems of health information systems during their studies.

Lessons from Initiating the First Veterans Health Administration (VA) Women's Health Practice-based Research Network (WH-PBRN) Study.

PubMed

Pomernacki, Alyssa; Carney, Diane V; Kimerling, Rachel; Nazarian, Deborah; Blakeney, Jill; Martin, Brittany D; Strehlow, Holly; Yosef, Julia; Goldstein, Karen M; Sadler, Anne G; Bean-Mayberry, Bevanne A; Bastian, Lori A; Bucossi, Meggan M; McLean, Caitlin; Sonnicksen, Shannan; Klap, Ruth; Yano, Elizabeth M; Frayne, Susan M

2015-01-01

The Veterans Health Administration (VA) Women's Health Practice-Based Research Network (WH-PBRN) was created to foster innovations for the health care of women veterans. The inaugural study by the WH-PBRN was designed to identify women veterans' own priorities and preferences for mental health services and to inform refinements to WH-PBRN operational procedures. Addressing the latter, this article reports lessons learned from the inaugural study. WH-PBRN site coordinators at the 4 participating sites convened weekly with the study coordinator and the WH-PBRN program manager to address logistical issues and identify lessons learned. Findings were categorized into a matrix of challenges and facilitators related to key study elements. Challenges to the conduct of PBRN-based research included tracking of regulatory documents; cross-site variability in some regulatory processes; and troubleshooting logistics of clinic-based recruitment. Facilitators included a central institutional review board, strong relationships between WH-PBRN research teams and women's health clinic teams, and the perception that women want to help other women veterans. Our experience with the inaugural WH-PBRN study demonstrated the feasibility of establishing productive relationships between local clinicians and researchers, and of recruiting a special population (women veterans) in diverse sites within an integrated health care system. This identified strengths of a PBRN approach. © Copyright 2015 by the American Board of Family Medicine.

Endotracheal nitinol stents: lessons from the learning curve.

PubMed

Siegel, Bianca; Bent, John P; Ward, Robert F

2013-04-01

To reflect on lessons learned placing endotracheal nitinol stents in children. Case series with chart review. Tertiary care children's hospital. All children who underwent nitinol cervical tracheal stenting were included. Records were carefully reviewed for intraoperative and postoperative complications, management choices, outcomes, and factors that influenced results. Between 1999 and 2011, 7 children underwent 13 stent placements. Median follow-up was 5 years (range, 1-12 years). Six patients underwent stenting as a salvage procedure following open attempts at airway reconstruction. Four patients remain decannulated with their stent in place (median follow-up 7 years). The fifth patient had his stent removed endoscopically after 50 days because it became apparent that his obstruction was primarily laryngeal. The sixth child had his stent removed via a tracheal fissure after 14 months because of recalcitrant subglottic inflammation at the superior stent border. The seventh patient was decannulated for over 2 years but ultimately required tracheotomy replacement because of stenosis with the stent lumen. Complications included stent migration (23%), restenosis (29%), edema (29%), and granulation (57%). Endotracheal nitinol stents provide a realistic opportunity for decannulation in children for whom other options have failed but should be reserved only as a salvage procedure in severely complicated airways. Our experience has taught valuable lessons about stent indications, sizing, characteristics, and deployment, as well as means to avoid and manage their complications.

Extremity War Injuries XII: Homeland Defense as a Translation of War Lessons Learned.

PubMed

Stinner, Maj Daniel J; Schmidt, Andrew H

2018-06-12

The 12th Extremity War Injuries Symposium focused on issues related to the transitions in medical care that are occurring as the focus of the war on terror changes. The symposium highlighted the results of Department of Defense-funded research in musculoskeletal injury, the evolution of combat casualty care, and the readiness of the fighting force. Presentations and discussions focused on force readiness of both troops and their medical support as well as the maintenance of the combat care expertise that has been developed during the previous decade of conflict.

Improving disease management in the United Kingdom: what can be learned from U.S. experience?

PubMed

Florin, Dominique; Lewis, Richard; Rosen, Rebecca

2004-10-01

Chronic diseases are a large and growing burden for health services. The British National Health Service is set up in a way that has many advantages in the management of chronic diseases, but lessons from U.S. managed care plans show that several changes could be implemented to improve the efficiency and effectiveness of care for patients with chronic conditions. These include the introduction of limited market competition; financial incentives, particularly across primary and secondary care; increased patient self-help; and improved clinician-manager relationships.

Building the Partners HealthCare Biobank at Partners Personalized Medicine: Informed Consent, Return of Research Results, Recruitment Lessons and Operational Considerations

PubMed Central

Karlson, Elizabeth W.; Boutin, Natalie T.; Hoffnagle, Alison G.; Allen, Nicole L.

2016-01-01

The Partners HealthCare Biobank is a Partners HealthCare enterprise-wide initiative whose goal is to provide a foundation for the next generation of translational research studies of genotype, environment, gene-environment interaction, biomarker and family history associations with disease phenotypes. The Biobank has leveraged in-person and electronic recruitment methods to enroll >30,000 subjects as of October 2015 at two academic medical centers in Partners HealthCare since launching in 2010. Through a close collaboration with the Partners Human Research Committee, the Biobank has developed a comprehensive informed consent process that addresses key patient concerns, including privacy and the return of research results. Lessons learned include the need for careful consideration of ethical issues, attention to the educational content of electronic media, the importance of patient authentication in electronic informed consent, the need for highly secure IT infrastructure and management of communications and the importance of flexible recruitment modalities and processes dependent on the clinical setting for recruitment. PMID:26784234

Lessons from 30 Years of Flight Software

NASA Technical Reports Server (NTRS)

McComas, David C.

2015-01-01

This presentation takes a brief historical look at flight software over the past 30 years, extracts lessons learned and shows how many of the lessons learned are embodied in the Flight Software product line called the core Flight System (cFS). It also captures the lessons learned from developing and applying the cFS.

Communication and Collaboration During Natural Disasters: The Lessons Learned From Past Experience. Lessons Learned From School Crises and Emergencies, Volume 3, Issue 2, 2008

ERIC Educational Resources Information Center

US Department of Education, 2008

2008-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on the response and recovery efforts to wildfires by the San Diego County Office of Education (SDCOE) and its school and community partners. Natural disasters such as floods,…

Development of a Health System-Based Nurse-Delivered Aromatherapy Program.

PubMed

Joswiak, Denise; Kinney, Mary Ellen; Johnson, Jill R; Kolste, Alison K; Griffin, Kristen H; Rivard, Rachael L; Dusek, Jeffery A

2016-04-01

Healthcare systems are increasingly looking to integrate aromatherapy (essential oils) as a safe, low-cost, and nonpharmacologic option for patient care to reduce pain, nausea, and anxiety and to improve sleep. This article describes the development and implementation of a healthcare system-wide program of nurse-delivered essential oil therapeutic interventions to inpatients throughout an acute care setting. In addition, we provide lessons learned for nursing administrators interested in developing similar nurse-delivered aromatherapy programs.

Integrating topics of sex and gender into medical curricula-lessons from the international community.

PubMed

Miller, Virginia M; Kararigas, Georgios; Seeland, Ute; Regitz-Zagrosek, Vera; Kublickiene, Karolina; Einstein, Gillian; Casanova, Robert; Legato, Marianne J

2016-01-01

In the era of individualized medicine, training future scientists and health-care providers in the principles of sex- and gender-based differences in health and disease is critical in order to optimize patient care. International successes to incorporate these concepts into medical curricula can provide a template for others to follow. Methodologies and resources are provided that can be adopted and adapted to specific needs of other institutions and learning situations.

Pioneering the psychiatric nurse role in foster care.

PubMed

Bertram, Julie E; Narendorf, Sarah Carter; McMillen, J Curtis

2013-12-01

Older youth served in the foster care system have elevated rates of mental health disorders and are high users of mental health services, yet concerns have been raised about the quality of this care. This paper describes the details of a psychiatric nurse's work within a multidisciplinary team to address gaps in care for older youth with psychiatric disorders. We describe the process, outcomes, and lessons learned in developing and piloting a psychiatric nurse intervention for older youth in the foster care system as part of a multidimensional treatment foster care program. Our experiences support further work to develop a role for nursing to improve the quality of mental health treatment in foster care. © 2013.

Pioneering the Psychiatric Nurse Role in Foster Care (*)

PubMed Central

Bertram, Julie E.; Narendorf, Sarah Carter; McMillen, J. Curtis

2013-01-01

Older youth served in the foster care system have elevated rates of mental health disorders and are high users of mental health services, yet concerns have been raised about the quality of this care. This paper describes the details of a psychiatric nurse’s work within a multidisciplinary team to address gaps in care for older youth with psychiatric disorders. We describe the process, outcomes, and lessons learned in developing and piloting a psychiatric nurse intervention for older youth in the foster care system as part of a multidimensional treatment foster care program. Our experiences support further work to develop a role for nursing to improve the quality of mental health treatment in foster care. PMID:24238008

Lessons learned from a colocation model using psychiatrists in urban primary care settings.

PubMed

Weiss, Meredith; Schwartz, Bruce J

2013-07-01

Comorbid psychiatric illness has been identified as a major driver of health care costs. The colocation of psychiatrists in primary care practices has been proposed as a model to improve mental health and medical care as well as a model to reduce health care costs. Financial models were developed to determine the sustainability of colocation. We found that the population studied had substantial psychiatric and medical burdens, and multiple practice logistical issues were identified. The providers found the experience highly rewarding and colocation was financially sustainable under certain conditions. The colocation model was effective in identifying and treating psychiatric comorbidities.

A curriculum for training quality scholars to improve the health and health care of veterans and the community at large.

PubMed

Splaine, Mark E; Aron, David C; Dittus, Robert S; Kiefe, Catarina I; Landefeld, C Seth; Rosenthal, Gary E; Weeks, William B; Batalden, Paul B

2002-01-01

In 1998, the Veterans Health Administration invested in the creation of the Veterans Administration National Quality Scholars Fellowship Program (VAQS) to train physicians in new ways to improve the quality of health care. We describe the curriculum for this program and the lessons learned from our experience to date. The VAQS Fellowship program has developed a core improvement curriculum to train postresidency physicians in the scholarship, research, and teaching of the improvement of health care. The curriculum covers seven domains of knowledge related to improvement: health care as a process; variation and measurement; customer/beneficiary knowledge; leading, following, and making changes in health care; collaboration; social context and accountability; and developing new, locally useful knowledge. We combine specific knowledge about the improvement of health care with the use of adult learning strategies, interactive video, and development of learner competencies. Our program provides insights for medical education to better prepare physicians to participate in and lead the improvement of health care.

Integrating cultural values, beliefs, and customs into pregnancy and postpartum care: lessons learned from a Hawaiian public health nursing project.

PubMed

Mayberry, L J; Affonso, D D; Shibuya, J; Clemmens, D

1999-06-01

Determining the elements of culturally competent health care is an important goal for nurses. This goal is particularly integral in efforts to design better preventive health care strategies for pregnant and postpartum women from multiple cultural and ethnic backgrounds. Learning about the values, beliefs, and customs surrounding health among the targeted groups is essential, but integrating this knowledge into the actual health care services delivery system is more difficult. The success of a prenatal and postpartum program developed for native Hawaiian, Filipino, and Japanese women in Hawaii has been attributed to the attention on training, direct care giving, and program monitoring participation by local cultural and ethnic healers and neighborhood leaders living in the community, with coordination by public health nurses. This article profiles central design elements with examples of specific interventions used in the Malama Na Wahine or Caring for Pregnant Women program to illustrate a unique approach to the delivery of culturally competent care.

Delivering comprehensive home-based care programmes for HIV: a review of lessons learned and challenges ahead in the era of antiretroviral therapy.

PubMed

Wringe, Alison; Cataldo, Fabian; Stevenson, Nicola; Fakoya, Ade

2010-09-01

Home-based care (HBC) programmes in low- and middle-income countries have evolved over the course of the past two decades in response to the HIV epidemic and wider availability of antiretroviral therapy (ART). Evidence is emerging from small-scale and well-resourced studies that ART delivery can be effectively incorporated within HBC programmes. However, before this approach can be expanded, it is necessary to consider the lessons learned from implementing routine HBC programmes and to assess what conditions are required for their roll-out in the context of ART provision. In this paper, we review the literature on existing HBC programmes and consider the arguments for their expansion in the context of scaling up ART delivery. We develop a framework that draws on the underlying rationale for HBC and incorporates lessons learned from community health worker programmes. We then apply this framework to assess whether the necessary conditions are in place to effectively scale up HBC programmes in the ART era. We show that the most effective HBC programmes incorporate ongoing support, training and remuneration for their workers; are integrated into existing health systems; and involve local communities from the outset in programme planning and delivery. Although considerable commitment has so far been demonstrated to delivering comprehensive HBC programmes, their effectiveness is often hindered by weak linkages with other HIV services. Top-down donor policies and a lack of sustainable and consistent funding strategies represent a formidable threat to these programmes in the long term. The benefits of HBC programmes that incorporate ART care are unlikely to be replicated on a larger scale unless donors and policymakers address issues related to human resources, health service linkages and community preparedness. Innovative and sustainable funding policies are needed to support HBC programmes if they are to effectively complement national ART programmes in the long term.

Co-Creation Learning Procedures: Comparing Interactive Language Lessons for Deaf and Hearing Students.

PubMed

Hosono, Naotsune; Inoue, Hiromitsu; Tomita, Yutaka

2017-01-01

This paper discusses co-creation learning procedures of second language lessons for deaf students, and sign language lessons by a deaf lecturer. The analyses focus on the learning procedure and resulting assessment, considering the disability. Through questionnaires ICT-based co-creative learning technologies are effective and efficient and promote spontaneous learning motivation goals.

Unintended knowledge learnt in primary science practical lessons

NASA Astrophysics Data System (ADS)

Park, Jisun; Abrahams, Ian; Song, Jinwoong

2016-11-01

This study explored the different kinds of unintended learning in primary school practical science lessons. In this study, unintended learning has been defined as student learning that was found to occur that was not included in the teachers learning objectives for that specific lesson. A total of 22 lessons, taught by five teachers in Korean primary schools with 10- to 12-year-old students, were audio-and video recorded. Pre-lesson interviews with the teachers were conducted to ascertain their intended learning objectives. Students were asked to write short memos after the lesson about what they learnt. Post-lesson interviews with students and teachers were undertaken. What emerged was that there were three types of knowledge that students learnt unintentionally: factual knowledge gained by phenomenon-based reasoning, conceptual knowledge gained by relation- or model-based reasoning, and procedural knowledge acquired by practice. Most unintended learning found in this study fell into the factual knowledge and only a few cases of conceptual knowledge were found. Cases of both explicit procedural knowledge and implicit procedural knowledge were found. This study is significant in that it suggests how unintended learning in practical work can be facilitated as an educative opportunity for meaningful learning by exploring what and how students learnt.

Addressing the needs of Nicaraguan older adults living on the edge: A university-community partnership in international service-learning.

PubMed

Neal, Margaret B; Cannon, Melissa; DeLaTorre, Alan; Bolkan, Cory R; Wernher, Iris; Nolan, Elisabeth; López Norori, Milton; Largaespada-Fredersdorff, Carmen; Brown Wilson, Keren

2017-01-01

Nicaragua is a very low-income country entering a period of rapid aging with limited geriatric training for health care professionals. To help build capacity and to enhance student learning, a short-term international service-learning program was implemented in 2004 in partnership with the Jessie F. Richardson Foundation and Nicaraguan community stakeholders. Graduate and undergraduate students at Portland State University complete coursework for one term in the United States then travel to Nicaragua for about two weeks to participate in educational, research, and service activities, primarily in group homes for older Nicaraguans. Students learn about global aging, gerontology, community development, service learning, and Nicaraguan history and culture, then apply their gerontology-related knowledge by training direct care staff, older adults and their family members, and students. The authors describe the impetus for and evolution of the program, students' evaluation of the program, faculty observations on program benefits and challenges, lessons learned, and future plans.

Lessons learned from first year cistern monitoring in Camden ...

EPA Pesticide Factsheets

Invited panelist for Webinar 08/16/2016 by Office of Water : Lessons Learned from Past Green Infrastructure Projects Invited panelist for Webinar 08/16/2016 by Office of Water : Lessons Learned from Past Green Infrastructure Projects

Launch Vehicle Propulsion Life Cycle Cost Lessons Learned

NASA Technical Reports Server (NTRS)

Zapata, Edgar; Rhodes, Russell E.; Robinson, John W.

2010-01-01

This paper will review lessons learned for space transportation systems from the viewpoint of the NASA, Industry and academia Space Propulsion Synergy Team (SPST). The paper provides the basic idea and history of "lessons learned". Recommendations that are extremely relevant to NASA's future investments in research, program development and operations are"'provided. Lastly, a novel and useful approach to documenting lessons learned is recommended, so as to most effectively guide future NASA investments. Applying lessons learned can significantly improve access to space for cargo or people by focusing limited funds on the right areas and needs for improvement. Many NASA human space flight initiatives have faltered, been re-directed or been outright canceled since the birth of the Space Shuttle program. The reasons given at the time have been seemingly unique. It will be shown that there are common threads as lessons learned in many a past initiative.

Lessons Learned and Technical Standards: A Logical Marriage for Future Space Systems Design

NASA Technical Reports Server (NTRS)

Gill, Paul S.; Garcia, Danny; Vaughan, William W.; Parker, Nelson C. (Technical Monitor)

2002-01-01

A comprehensive database of engineering lessons learned that corresponds with relevant technical standards will be a valuable asset to those engaged in studies on future space vehicle developments, especially for structures, materials, propulsion, control, operations and associated elements. In addition, this will enable the capturing of technology developments applicable to the design, development, and operation of future space vehicles as planned in the Space Launch Initiative. Using the time-honored tradition of passing on lessons learned while utilizing the newest information technology, NASA has launched an intensive effort to link lessons learned acquired through various Internet databases with applicable technical standards. This paper will discuss the importance of lessons learned, the difficulty in finding relevant lessons learned while engaged in a space vehicle development, and the new NASA effort to relate them to technical standards that can help alleviate this difficulty.

77 FR 55230 - Japan Lessons-Learned Project Directorate Interim Staff Guidance JLD-ISG-2012-01; Compliance With...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

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Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0067] Japan Lessons-Learned Project Directorate Interim...-Learned Project Directorate Interim Staff Guidance; issuance. SUMMARY: The U.S. Nuclear Regulatory Commission (NRC or the Commission) is issuing the Final Japan Lessons-Learned Project Directorate (JLD...

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Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0069] Japan Lessons-Learned Project Directorate Interim...-Learned Project Directorate interim staff guidance; issuance. SUMMARY: The U.S. Nuclear Regulatory Commission (NRC or the Commission) is issuing the Final Japan Lessons-Learned Project Directorate Interim...

Lessons learned from a successful MEDRETE in El Salvador.

PubMed

Post, James C; Melendez, Manuel E; Hershey, Donna N; Hakim, Abdul

2003-04-01

Medical readiness education and training exercises are short-term exercises designed to provide health care and preventive medicine education to underserved civilian populations overseas. These high profile missions provide superb training opportunities, build democracies, and can be a powerful incentive to retain soldiers in the Reserves. Despite this, the literature offers little guidance in terms of how to best conduct a MEDRETE, particularly with a unit that has not been recently deployed. A U.S. Army Reserve unit was deployed to El Salvador following two devastating earthquakes and treated 20,890 patients in 10 days. This patient volume was achieved by a close cooperative effort among an experienced Mission Coordinator and Reservists and superb host nation support. Lessons learned regarding predeployment, deployment, patient management, and safety issues are presented to assist future units in conducting successful medical readiness education and training exercises.

Assistant practitioners: lessons learned from licensed practical nurses.

PubMed

Whittingham, Katrina

The role of the assistant practitioner (AP) needs to be defined so they have clear career pathways and opportunities for professional development. The author sought to learn from other countries where a sustained effort had been made to support practitioners fulfilling this intermediate role. The equivalent of an AP in Canada is the licensed practical nurse (LPN); LPNs are subject to clear regulation and practice within their remit of their license. The author travelled to Alberta, Canada, and performed a qualitative study to investigate the role of the LPN. LPNs undertake a 2-year diploma-level course and have the opportunity to enhance their careers through specialist courses or to train as a RN. LPNs benefit from careful regulation, enabling them to have a clear scope of practice, a career structure with opportunities for development and consistent ethical standards. Lessons can be learned from the LPN model and put in practice in the UK; APs need a consistent education programme, a career pathway that promotes development and effective regulation.

Community-campus partnership in action: lessons learned from the DuPage County Patient Navigation Collaborative.

PubMed

Samaras, Athena T; Murphy, Kara; Nonzee, Narissa J; Endress, Richard; Taylor, Shaneah; Hajjar, Nadia; Bularzik, Rosario; Frankovich, Carmi; Dong, XinQi; Simon, Melissa A

2014-01-01

Using community-based participatory research (CBPR), the DuPage County Patient Navigation Collaborative (DPNC) developed an academic campus-community research partnership aimed at increasing access to care for underserved breast and cervical cancer patients within DuPage County, a collar county of Chicago. Given rapidly shifting demographics, targeting CBPR initiatives among underserved suburban communities is essential. To discuss the facilitating factors and lessons learned in forging the DPNC. A patient navigation collaborative was formed to guide medically underserved women through diagnostic resolution and if necessary, treatment, after an abnormal breast or cervical cancer screening. Facilitating factors included (1) fostering and maintaining collaborations within a suburban context, (2) a systems-based participatory research approach, (3) a truly equitable community-academic partnership, (4) funding adaptability, (5) culturally relevant navigation, and (6) emphasis on co-learning and capacity building. By highlighting the strategies that contributed to DPNC success, we envision the DPNC to serve as a feasible model for future health interventions.

Lessons Learned From A Study Of Genomics-Based Carrier Screening For Reproductive Decision Making.

PubMed

Wilfond, Benjamin S; Kauffman, Tia L; Jarvik, Gail P; Reiss, Jacob A; Richards, C Sue; McMullen, Carmit; Gilmore, Marian; Himes, Patricia; Kraft, Stephanie A; Porter, Kathryn M; Schneider, Jennifer L; Punj, Sumit; Leo, Michael C; Dickerson, John F; Lynch, Frances L; Clarke, Elizabeth; Rope, Alan F; Lutz, Kevin; Goddard, Katrina A B

2018-05-01

Genomics-based carrier screening is one of many opportunities to use genomic information to inform medical decision making, but clinicians, health care delivery systems, and payers need to determine whether to offer screening and how to do so in an efficient, ethical way. To shed light on this issue, we conducted a study in the period 2014-17 to inform the design of clinical screening programs and guide further health services research. Many of our results have been published elsewhere; this article summarizes the lessons we learned from that study and offers policy insights. Our experience can inform understanding of the potential impact of expanded carrier screening services on health system workflows and workforces-impacts that depend on the details of the screening approach. We found limited patient or health system harms from expanded screening. We also found that some patients valued the information they learned from the process. Future policy discussions should consider the value of offering such expanded carrier screening in health delivery systems with limited resources.

Politics of policy learning: Evaluating an experiment on free pricing arrangements in Dutch dental care

PubMed Central

Felder, Martijn; van de Bovenkamp, Hester; de Bont, Antoinette

2018-01-01

In Dutch healthcare, new market mechanisms have been introduced on an experimental basis in an attempt to contain costs and improve quality. Informed by a constructivist approach, we demonstrate that such experiments are not neutral testing grounds. Drawing from semi-structured interviews and policy texts, we reconstruct an experiment on free pricing in dental care that turned into a critical example of market failure, influencing developments in other sectors. Our analysis, however, shows that (1) different market logics and (2) different experimental logics were reproduced simultaneously during the course of the experiment. We furthermore reveal how (3) evaluation and political life influenced which logics were reproduced and became taken as the lessons learned. We use these insights to discuss the role of evaluation in learning from policy experimentation and close with four questions that evaluators could ask to better understand what is learned from policy experiments, how, and why. PMID:29568225

Retention of Information as a Function of Lesson Design for Middle School Studies of Wetlands in New Jersey

NASA Astrophysics Data System (ADS)

Parsekian, A.; Cimiluca, C.; Gates, A. E.; Calderon, I.

2010-12-01

Considering the breadth of innovative teaching strategies available, it is helpful to identify which will be best suited for a particular subject. With students that have a variety of interests, it is important to engage as many as possible in the lab activity, especially those who might not identify science as their preferred interest. Here we test the retention of information by middle school students after a problem-based learning (PBL) style lesson compared with an investigation where the students were given no role-playing problem. Both lessons were designed around wetlands in New Jersey: the first being a pond-edge ecosystem in a park near the middle school in Newark, NJ that the students are familiar with and the second being small, isolated peat bogs in the Pinelands of southern New Jersey that are the subject of ongoing scientific research. Days after both hands-on lessons, the students were given short, carefully designed multiple choice quizzes that tested the retention of knowledge about each of the learning objectives set forth. Results of the quizzes are nearly normally distributed, indicating a similar average performance. A higher number of students preformed better on the problem-based learning post-quiz suggesting the inclusion of a role playing scenario is useful for engaging the most students in hands-on wetlands laboratory experiments. Future work should test the retention of this type of information over time and explore other teaching strategies. We also present new ideas for an inexpensive hands-on lesson as implemented for the peat bog wetlands example that introduces basic soil science concepts to middle school and high school students.

Appointment systems are essential for improving chronic disease care in resource-poor settings: learning from experiences with HIV patients in Africa.

PubMed

Chalker, John C; Wagner, Anita K; Tomson, Göran; Johnson, Keith; Wahlström, Rolf; Ross-Degnan, Dennis

2013-09-01

Lessons learned from treating patients with HIV infection can inform care systems for other chronic conditions. For antiretroviral treatment, attending appointments on time correlates with medication adherence; however, HIV clinics in East Africa, where attendance rates vary widely, rarely include systems to schedule appointments or to track missed appointments or patient follow-up. An introduction of low-cost, paper-based patient appointment and tracking systems led to an improvement in timely clinic attendance rates and tracking missing patients. An effective appointment system is critical to managing patients with chronic conditions and can be introduced in resource-limited settings, possibly without having to add staff.

DT&E Forum for Best Practices and Lessons Learned

DTIC Science & Technology

2013-05-01

E A N A L Y S E S IDA Paper P-4975 DT&E Forum for Best Practices and Lessons Learned L. B. Scheiber, Project Leader...and accessing from the DT&E Forum website. A. Collection of Lessons Learned and Best Practices We began the effort by reviewing approximately 30...Forum’s Home Page 1. Searching for BPLL Documents The DT&E Forum website contains DT&E Best Practice and Lessons Learned (BPLL) documents along with the

Papermaking and Poetry. ArtsEdge Curricula, Lessons and Activities.

ERIC Educational Resources Information Center

Withroe, J.

In this lesson, designed to be taught within a unit on China, primary-grade students will learn about the history of papermaking and its origins in China and even learn how to make their own paper. After learning about Chinese art and culture in the lesson, students will write their own "cinquain" poem about China. The lesson presents an…

Planning to Serve: Using Backwards Planning to Design Service-Learning Lesson Plans in the Preservice Curriculum

ERIC Educational Resources Information Center

Stiler, Gary

2009-01-01

The author describes how the Understanding by Design (backwards planning) lesson plan format was used by his preservice K-12 students to develop service-learning lesson plans. Preservice teachers in a multicultural education course were given an assignment to develop service-learning lesson plans using the Understanding by Design planning process.…

Learning from Lessons: studying the structure and construction of mathematics teacher knowledge in Australia, China and Germany

NASA Astrophysics Data System (ADS)

Chan, Man Ching Esther; Clarke, David J.; Clarke, Doug M.; Roche, Anne; Cao, Yiming; Peter-Koop, Andrea

2018-03-01

The major premise of this project is that teachers learn from the act of teaching a lesson. Rather than asking "What must a teacher already know in order to practice effectively?", this project asks "What might a teacher learn through their activities in the classroom and how might this learning be optimised?" In this project, controlled conditions are created utilising purposefully designed and trialled lesson plans to investigate the process of teacher knowledge construction, with teacher selective attention proposed as a key mediating variable. In order to investigate teacher learning through classroom practice, the project addresses the following questions: To what classroom objects, actions and events do teachers attend and with what consequence for their learning? Do teachers in different countries attend to different classroom events and consequently derive different learning benefits from teaching a lesson? This international project combines focused case studies with an online survey of mathematics teachers' selective attention and consequent learning in Australia, China and Germany. Data include the teacher's adaptation of a pre-designed lesson, the teacher's actions during the lesson, the teacher's reflective thoughts about the lesson and, most importantly, the consequences for the planning and delivery of a second lesson. The combination of fine-grained, culturally situated case studies and large-scale online survey provides mutually informing benefits from each research approach. The research design, so constituted, offers the means to a new and scalable vision of teacher learning and its promotion.

The Dutch Health Care Performance Report: seven years of health care performance assessment in the Netherlands.

PubMed

van den Berg, Michael J; Kringos, Dionne S; Marks, Lisanne K; Klazinga, Niek S

2014-01-09

In 2006, the first edition of a monitoring tool for the performance of the Dutch health care system was released: the Dutch Health Care Performance Report (DHCPR). The Netherlands was among the first countries in the world developing such a comprehensive tool for reporting performance on quality, access, and affordability of health care. The tool contains 125 performance indicators; the choice for specific indicators resulted from a dialogue between researchers and policy makers. In the 'policy cycle', the DHCPR can rationally be placed between evaluation (accountability) and agenda-setting (for strategic decision making). In this paper, we reflect on important lessons learned after seven years of health care system performance assessment. These lessons entail the importance of a good conceptual framework for health system performance assessment, the importance of repeated measurement, the strength of combining multiple perspectives (e.g., patient, professional, objective, subjective) on the same issue, the importance of a central role for the patients' perspective in performance assessment, how to deal with the absence of data in relevant domains, the value of international benchmarking and the continuous exchange between researchers and policy makers.

The Day Ray Came to Kindergarten. Perspective.

ERIC Educational Resources Information Center

Hinnant, Hilari

1998-01-01

Describes the popularity of a first grader who is put back into a kindergarten class due to poor reading skills. Notes how the kindergartners consider the new boy a window onto the first grade and marvel at his skills in various classroom activities. Reflects on the lessons learned about the caring, safe environment of the classroom community.…

The Inquiry Flame: Scaffolding for Scientific Inquiry through Experimental Design

ERIC Educational Resources Information Center

Pardo, Richard; Parker, Jennifer

2010-01-01

In the lesson presented in this article, students learn to organize their thinking and design their own inquiry experiments through careful observation of an object, situation, or event. They then conduct these experiments and report their findings in a lab report, poster, trifold board, slide, or video that follows the typical format of the…

Sustainable Professional Learning for Early Childhood Educators: Lessons from an Australia-Wide Mental Health Promotion Initiative

ERIC Educational Resources Information Center

Askell-Williams, Helen; Murray-Harvey, Rosalind

2016-01-01

New policy initiatives, such as those concerned with promoting young children's positive mental health, highlight the need for good quality professional education in the early childhood education and care sector. However, although a wealth of literature exists from the school sector, little is known about professional education in early childhood…

Lessons Learned from Work with International Partners to Inform Rural Practices for Early Childhood Intervention

ERIC Educational Resources Information Center

Grisham-Brown, Jennifer; McCormick, Katherine M.

2013-01-01

The United States is becoming increasingly diverse with the largest growth in Hispanic populations. Diversity also is increasing in rural America. This diversity is reflected in the participants in early care and education programs and K-12 students. Unfortunately, demographics for college and university teacher education programs do not match…

Boarding Chances for Children: A Report on Lessons Learned

ERIC Educational Resources Information Center

Murphy, David; Oliver, Mary; Pourhabib, Sanam; Adkins, Michael; Hodgen, Jeremy

2017-01-01

This report examines the range of factors that might influence the decision by social care professionals on the use of boarding schools as an intervention option for Children in Need (CiN) or children on a Child Protection Plan (CPP). Attempts to conduct a randomised controlled trial (RCT) failed to recruit participants. Initially, failure to…

A Walk in the "Tall, Tall Grass"

ERIC Educational Resources Information Center

Kaatz, Kathryn

2008-01-01

This inquiry-based lesson was inspired by Denise Fleming's book entitled, "In the Tall, Tall Grass" (1991). The author used the book and a real study of prairie grasses to teach kindergartners how to make careful observations and record what they see. In addition, they learn how to "draw as scientists." Here the author describes her class's yearly…

Special Topics

DTIC Science & Technology

2012-01-01

training encom- passes several concepts, including cognitive knowledge, a performance assessment or pretest , training, a re- peat assessment or posttest ...significantly decreased mor- tality. For the lessons learned in ca- sualty care to be passed on to the next group of surgeons, the training for deployed...unpaid consultant to Athena GTX, Blackhawk Products Group , CHI Systems, Combat Medical Systems, Composite Resources, Compression Works, Creative

Considerations for implementing an organizational lessons learned process.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fosshage, Erik D

2013-05-01

This report examines the lessons learned process by a review of the literature in a variety of disciplines, and is intended as a guidepost for organizations that are considering the implementation of their own closed-loop learning process. Lessons learned definitions are provided within the broader context of knowledge management and the framework of a learning organization. Shortcomings of existing practices are summarized in an attempt to identify common pitfalls that can be avoided by organizations with fledgling experiences of their own. Lessons learned are then examined through a dual construct of both process and mechanism, with emphasis on integrating intomore » organizational processes and promoting lesson reuse through data attributes that contribute toward changed behaviors. The report concludes with recommended steps for follow-on efforts.« less

Making Personalized Health Care Even More Personalized: Insights From Activities of the IOM Genomics Roundtable.

PubMed

David, Sean P; Johnson, Samuel G; Berger, Adam C; Feero, W Gregory; Terry, Sharon F; Green, Larry A; Phillips, Robert L; Ginsburg, Geoffrey S

2015-01-01

Genomic research has generated much new knowledge into mechanisms of human disease, with the potential to catalyze novel drug discovery and development, prenatal and neonatal screening, clinical pharmacogenomics, more sensitive risk prediction, and enhanced diagnostics. Genomic medicine, however, has been limited by critical evidence gaps, especially those related to clinical utility and applicability to diverse populations. Genomic medicine may have the greatest impact on health care if it is integrated into primary care, where most health care is received and where evidence supports the value of personalized medicine grounded in continuous healing relationships. Redesigned primary care is the most relevant setting for clinically useful genomic medicine research. Taking insights gained from the activities of the Institute of Medicine (IOM) Roundtable on Translating Genomic-Based Research for Health, we apply lessons learned from the patient-centered medical home national experience to implement genomic medicine in a patient-centered, learning health care system. © 2015 Annals of Family Medicine, Inc.

Nursing leadership in professional organizations.

PubMed

Hill, Karen S

2011-04-01

This department highlights nursing leaders who have demonstrated the ability to inspire and lead change. This competency is seen in the ability to create, structure, and implement organizational change through strategic vision, risk taking, and effective communication. Each article showcases a project of a nurse leader who demonstrates change in a variety of environments, ranging from acute care hospitals to home care and alternative practice settings. Included are several "lessons learned" applicable to multiple settings that provide insight for other nurses in executive practice.

The 5th Annual One Mind Summit: Lessons Learned About "Science Informing Brain Health Policies and Practice".

PubMed

Hicks, Ramona; Johnson, Stephen; Porter, Amy; Zatzick, Douglas F; One Mind Summit Panel Participants, The

2017-03-29

Advances in science frequently precede changes in clinical care by several years or even decades. To better understand the path to translation, we invited experts to share their perspectives at the 5th Annual One Mind Summit: "Science Informing Brain Health Policies and Practice", which was held on May 24-25, 2016 in Crystal City, VA. While the translation of brain research throughout the pipeline - from basic science research to patient care - was discussed, the focus was on the implementation of "best evidence" into patient care. The Summit identified key steps, including the need for professional endorsement and clinical guidelines or policies, acceptance by regulators and payers, dissemination and training for clinicians, patient advocacy, and learning healthcare models. The path to implementation was discussed broadly, as well as in the context of a specific project to implement concussion screening in emergency and urgent care centers throughout the U.S.

Management of Battlefield Injuries to the Skull Base

PubMed Central

Stevens, Jayne R.; Brennan, Joseph

2016-01-01

High velocity skull base injuries on the battlefield are unique in comparison to most civilian sector trauma. With more than 43,000 United States military personnel injuries during Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF), the most recent conflicts in Iraq and Afghanistan have significantly expanded the understanding of the physiology of modern battlefield trauma and how to appropriately address these injuries. The acute care principles of effective triage, airway management, and hemorrhage control in these injuries can be life saving and are reviewed here. Specific injury patterns and battlefield examples are reviewed as well, with a review of some of the lessons learned while providing care in a deployed setting. Utilization of the knowledge learned in Iraq and Afghanistan, which have improved casualty care of deployed service members, can be used both in future military conflicts and in civilian trauma care. PMID:27648400

One University Making a Difference in Graduate Education: Caring in the Online Learning Environment.

PubMed

Brown, Cynthia J; Wilson, Carol B

2016-12-01

As online education gains momentum, strategies to promote student engagement, develop social presence, and create a virtual community are essential for students' successful learning. A university with a philosophy grounded in caring developed two strategies for the graduate online education setting. These two strategies intentionally promote caring for self and others as a means to foster engagement, social presence, and a vibrant online community. One strategy was online Caring Groups, that is, small groups of four to five nursing students created each semester in one of the students' required courses in the online setting. The second strategy was the creation of two Caring Connections online sites, one for master of science in nursing students and one for doctorate in education nursing students. The sites were developed external to required courses to provide support for the online students throughout the graduate programs. Each site provides an ongoing space for students and faculty to post and discuss inspirational quotes, self-care tips, music, and photographs. The online Caring Groups and Caring Connections sites will be described, including how they were created, how they are used by students, how faculty support students, lessons learned, and how Caring Groups are integrated into the curriculum. © The Author(s) 2016.

Conceptual Change and Science Achievement Related to a Lesson Sequence on Acids and Bases Among African American Alternative High School Students: A Teacher's Practical Arguments and the Voice of the "Other"

NASA Astrophysics Data System (ADS)

Wood, Lynda Charese

The study of teaching and learning during the period of translating ideals of reform into classroom practice enables us to understand student-teacher-researcher symbiotic learning. In line with this assumption, the purpose of this study is threefold:(1) observe effects of the Common Knowledge Construction Model (CKCM), a conceptual change inquiry model of teaching and learning, on African American students' conceptual change and achievement; (2) observe the shift in teacher's practical arguments; and (3) narrate the voice of "the Other" about teacher professional learning. This study uses retrospective data from a mixed-method approach consisting of Phenomenography, practical arguments and story-telling. Data sources include audio-recordings of a chemistry teacher's individual interviews of her students' prior- and post-intervention conceptions of acids and bases; results of Acid-Base Achievement Test (ABA-T); video-recordings of a chemistry teacher's enactment of CKCM acid-base lesson sequence; audio-recordings of teacher-researcher reflective discourse using classroom video-clips; teacher interviews; and teacher and researcher personal reflective journals. Students' conceptual changes reflect change in the number of categories of description; shift in language use from everyday talk to chemical talk; and development of a hierarchy of chemical knowledge. ABA-T results indicated 17 students in the experimental group achieved significantly higher scores than 22 students in the control group taught by traditional teaching methods. The teacher-researcher reflective discourse about enactment of the CKCM acid-base lesson sequence reveals three major shifts in teacher practical arguments: teacher inadequate preparedness to adequate preparedness; lack of confidence to gain in confidence; and surface learning to deep learning. The developing story uncovers several aspects about teaching and learning of African American students: teacher caring for the uncared; cultivating student and teacher confidence; converting dependence on teacher and self to peer interdependence. The study outlines six implications: caring conceptual change inquiry model for the often unreached mind; developing simple chemical talk into coherent chemical explanation; using CKCM for alternative high school students' conceptual change and achievement; engaging teachers in elicitation and appraisal of practical arguments for reconstruction of beliefs; overcoming challenges in teacher practical argument research; and "storytelling" as a way of unpacking teacher transformation amidst complexities of classroom teaching and learning.

Lesson Study and Teachers Knowledge Development: Collaborative Critique of a Research Model and Methods.

ERIC Educational Resources Information Center

Lewis, Catherine; Perry, Rebecca; Murata, Aki

During "lesson study" teachers formulate long-term goals for student learning and development, collaboratively work on "research lessons" to bring these goals to life, document and discuss student responses to these lessons, and revise the lessons in response to student learning. This document summarizes the content of a…

A Checklist of Artillery Organizational Histories; A Compilation.

DTIC Science & Technology

1982-03-08

Artillery. 3d Battalion. Ab Operational reports - Lessons learned. ( 3d ) 1966- . (Vietnam n.p.) APO 96318. 1. Vietnamese Conflict, 1961- I. Title. 11...1973. A631 U.S. Army. 18th Artillery. 3d Bn. A18 Operational report(s) - Lessons learned. ( 3d ) (Vietnam, n.p.) 1966- nos. 1. Vietnamese Conflict, 1961...1973. I. Title. II. T: Lessons learned. *DS557 Vietnamese Conflict, 1961-1973 A63A]8 ’U.S. Army. 18th Artillery. 3d Bn. Lessons learned. (Vietnam, n.p

Learning globally to enhance local practice: an international programme in primary care & family health.

PubMed

Godoy-Ruiz, Paula; Rodas, Jamie; Talbot, Yves; Rouleau, Katherine

2016-09-01

In a global context of growing health inequities, international learning experiences have become a popular strategy for equipping health professionals with skills, knowledge, and competencies required to work with the populations they serve. This study sought to analyse the Chilean Interprofessional Programme in Primary Health Care (CIPPHC), a 5 week international learning experience funded by the Ministry of Health in Chile targeted at Chilean primary care providers and delivered in Toronto by the Department of Family and Community Medicine at the University of Toronto. The study focused on three cohorts of students (2010-2012). Anonymous programme evaluations were analysed and semi-structured interviews conducted with programme alumni. Simple descriptive statistics were gathered from the evaluations and the interviews were analysed via thematic content analysis. The majority of participants reported high levels of satisfaction with the training programme, knowledge gain, particularly in the areas of the Canadian model of primary care, and found the materials delivered to be applicable to their local context. The CIPPHC has proven to be a successful educational initiative and provides valuable lessons for other academic centres in developing international interprofessional training programmes for primary care health care providers.

Improving the primary school science learning unit about force and motion through lesson study

NASA Astrophysics Data System (ADS)

Phaikhumnam, Wuttichai; Yuenyong, Chokchai

2018-01-01

The study aimed to develop primary school science lesson plan based on inquiry cycle (5Es) through lesson study. The study focused on the development of 4 primary school science lesson plans of force and motion for Grade 3 students in KKU Demonstration Primary School (Suksasart), first semester of 2015 academic year. The methodology is mixed method. The Inthaprasitha (2010) lesson study cycle was implemented in group of KKU Demonstration Primary School. Instruments of reflection of lesson plan developing included participant observation, meeting and reflection report, lesson plan and other document. The instruments of examining students' learning include classroom observation and achievement test. Data was categorized from these instruments to find the issues of changing and improving the good lesson plan of Thai primary school science learning. The findings revealed that teachers could develop the lesson plans through lesson study. The issues of changing and improving were disused by considering on engaging students related to societal issues, students' prior knowledge, scientific concepts for primary school students, and what they learned from their changing. It indicated that the Lesson Study allowed primary school science teachers to share ideas and develop ideas to improve the lesson. The study may have implications for Thai science teacher education through Lesson Study.

Learning to Lead, Leading to Learn: How Facilitators Learn to Lead Lesson Study

ERIC Educational Resources Information Center

Lewis, Jennifer M.

2016-01-01

This article presents research on how teacher developers in the United States learn to conduct lesson study. Although the practice of lesson study is expanding rapidly in the US, high-quality implementation requires skilled facilitation. In contexts such as the United States where this form of professional development is relatively novel, few…

Solid-State Lighting: Early Lessons Learned on the Way to Market

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sandahl, Linda J.; Cort, Katherine A.; Gordon, Kelly L.

2013-12-31

The purpose of this report is to document early challenges and lessons learned in the solid-state lighting (SSL) market development as part of the DOE’s SSL Program efforts to continually evaluate market progress in this area. This report summarizes early actions taken by DOE and others to avoid potential problems anticipated based on lessons learned from the market introduction of compact fluorescent lamps and identifies issues, challenges, and new lessons that have been learned in the early stages of the SSL market introduction. This study identifies and characterizes12 key lessons that have been distilled from DOE SSL program results.

Lessons Learned Study Final Report for the Exploration Systems Mission Directorate

NASA Technical Reports Server (NTRS)

Van Laak, Jim; Brumfield, M. Larry; Moore, Arlene A.; Anderson, Brooke; Dempsey, Jim; Gifford, Bob; Holloway, Chip; Johnson, Keith

2004-01-01

This report is the final product of a 90-day study performed for the Exploration Systems Mission Directorate. The study was to assemble lessons NASA has learned from previous programs that could help the Exploration Systems Mission Directorate pursue the Exploration vision. It focuses on those lessons that should have the greatest significance to the Directorate during the formulation of program and mission plans. The study team reviewed a large number of lessons learned reports and data bases, including the Columbia Accident Investigation Board and Rogers Commission reports on the Shuttle accidents, accident reports from robotic space flight systems, and a number of management reviews by the Defense Sciences Board, Government Accountability Office, and others. The consistency of the lessons, findings, and recommendations validate the adequacy of the data set. In addition to reviewing existing databases, a series of workshops was held at each of the NASA centers and headquarters that included senior managers from the current workforce as well as retirees. The full text of the workshop reports is included in Appendix A. A lessons learned website was opened up to permit current and retired NASA personnel and on-site contractors to input additional lessons as they arise. These new lessons, when of appropriate quality and relevance, will be brought to the attention of managers. The report consists of four parts: Part 1 provides a small set of lessons, called the Executive Lessons Learned, that represent critical lessons that the Exploration Systems Mission Directorate should act on immediately. This set of Executive Lessons and their supporting rationale have been reviewed at length and fully endorsed by a team of distinguished NASA alumni; Part 2 contains a larger set of lessons, called the Selected Lessons Learned, which have been chosen from the lessons database and center workshop reports on the basis of their specific significance and relevance to the near-term work of the Exploration Directorate. These lessons frequently support the Executive lessons but are more general in nature; Part 3 consists of the reports of the center workshops that were conducted as part of this activity. These reports are included in their entirety (approximately 200 pages) in Appendix G and have significance for specific managers; Part 4 consists of the remainder of the lessons that have been selected by this effort and assembled into a database for the use of the Explorations Directorate. The database is archived and hosted in the Lessons Learned Knowledge Network, which provides a flexible search capability using a wide variety of search terms. Finally, a spreadsheet lists databases searched and a bibliography identifies reports that have been reviewed as sources of lessons for this task. NASA has been presented with many learning opportunities. We have conducted numerous programs, some extremely successful and others total failures. Most have been documented with a formal lessons learned activity, but we have not always incorporated these learning opportunities into our normal modes of business. For example, the Robbins Report of 2001 clearly indicates that many project failures of the past two decades were the result of violating well documented best practices, often in direct violation of management instructions and directives. An overarching lesson emerges: that disciplined execution in accordance with proven best practices is the greatest single contributor to a successful program. The Lessons Learned task team offers a sincere hope that the lessons presented herein will be helpful to the Exploration Systems Directorate in charting and executing their course. The success of the Directorate and of NASA in general depends on our collective ability to move forward without having to relearn the lessons of those who have gone before.

Six lessons from state physician health programs to promote long-term recovery.

PubMed

Dupont, Robert L; Skipper, Gregory E

2012-01-01

The success of the nation's state physician health programs (PHPs) provides important new evidence on the potential for dramatically reducing relapse and promoting long-term recovery from substance use disorders. This article summarizes the findings of the first national PHP study and outlines six lessons learned from this model of care management: (1) zero tolerance for any use of alcohol and other drugs; (2) thorough evaluation and patient-focused care; (3) prolonged, frequent random testing for both alcohol and other drugs; (4) effective use of leverage; (5) defining and managing relapses; and (6) the goal of lifelong recovery rooted in the 12-Step fellowships. PHPs are a part of a new paradigm of care management that includes the programs developed for commercial pilots (HIMS) and for attorneys (CoLAP). Elements of this model of care have been used with a dramatically different patient population, and with similar success, in the criminal justice system in HOPE Probation and 24/7 Sobriety. The authors review these programs and discuss implications for extending elements of the new paradigm more widely.

Reflections on a decade of funding public hospital systems.

PubMed

Brousseau, Ruth; Chang, Sophia

2013-07-01

As the nation embarks upon health reform, many questions remain unanswered. Important among them is the fate of public hospitals, which have historically cared for the uninsured. Under health reform, public hospitals will face marketplace competition to serve newly insured people. Can public hospitals change, so that they can survive and thrive in a competitive environment? This article describes lessons learned from a decade of funding by the California HealthCare Foundation to improve clinical care in California's public hospitals. It also identifies factors that will influence California's public hospitals in the coming months and years.

Utilization of Lesson Analysis as Teacher Self Reflection to Improve the Lesson Design on Chemical Equation Topic

NASA Astrophysics Data System (ADS)

Edyani, E. A.; Supriatna, A.; Kurnia; Komalasari, L.

2017-02-01

The research is aimed to investigate how lesson analysis as teacher’s self-reflection changes the teacher’s lesson design on chemical equation topic. Lesson Analysis has been used as part of teacher training programs to improve teacher’s ability in analyzing their own lesson. The method used in this research is a qualitative method. The research starts from build lesson design, implementation lesson design to senior high school student, utilize lesson analysis to get information about the lesson, and revise lesson design. The revised lesson design from the first implementation applied to the second implementation, resulting in better design. This research use lesson analysis Hendayana&Hidayat framework. Video tapped and transcript are employed on each lesson. After first implementation, lesson analysis result shows that teacher-centered still dominating the learning because students are less active in discussion, so the part of lesson design must be revised. After second implementation, lesson analysis result shows that the learning already student-centered. Students are very active in discussion. But some part of learning design still must be revised. In general, lesson analysis was effective for teacher to reflect the lessons. Teacher can utilize lesson analysis any time to improve the next lesson design.

Lesson Study: Evaluation Report and Executive Summary

ERIC Educational Resources Information Center

Murphy, Richard; Weinhardt, Felix; Wyness, Gill; Rolfe, Heather

2017-01-01

Lesson Study is a popular approach to teacher professional development used widely in Japan. It involves a small group of teachers co-planning a series of lessons based on a shared learning goal for the pupils, with one teacher leading the co-constructed lesson and their colleagues invited to observe pupil learning in the lesson. The team then…

Solid-State Lighting. Early Lessons Learned on the Way to Market

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sandahl, L. J.; Cort, K. A.; Gordon, K. L.

2014-01-01

Analysis of issues and lessons learned during the early stages of solid-state lighting market introduction in the U.S., which also summarizes early actions taken to avoid potential problems anticipated based on lessons learned from the market introduction of compact fluorescent lamps.

Health system strengthening: a qualitative evaluation of implementation experience and lessons learned across five African countries.

PubMed

Rwabukwisi, Felix Cyamatare; Bawah, Ayaga A; Gimbel, Sarah; Phillips, James F; Mutale, Wilbroad; Drobac, Peter

2017-12-21

Achieving the United Nations Sustainable Development Goals in sub-Saharan Africa will require substantial improvements in the coverage and performance of primary health care delivery systems. Projects supported by the Doris Duke Charitable Foundation's (DDCF) African Health Initiative (AHI) created public-private-academic and community partnerships in five African countries to implement and evaluate district-level health system strengthening interventions. In this study, we captured common implementation experiences and lessons learned to understand core elements of successful health systems interventions. We used qualitative data from key informant interviews and annual progress reports from the five Population Health Implementation and Training (PHIT) partnership projects funded through AHI in Ghana, Mozambique, Rwanda, Tanzania, and Zambia. Four major overarching lessons were highlighted. First, variety and inclusiveness of concerned key players (public, academic and private) are necessary to address complex health system issues at all levels. Second, a learning culture that promotes evidence creation and ability to efficiently adapt were key in order to meet changing contextual needs. Third, inclusion of strong implementation science tools and strategies allowed informed and measured learning processes and efficient dissemination of best practices. Fourth, five to seven years was the minimum time frame necessary to effectively implement complex health system strengthening interventions and generate the evidence base needed to advocate for sustainable change for the PHIT partnership projects. The AHI experience has raised remaining, if not overlooked, challenges and potential solutions to address complex health systems strengthening intervention designs and implementation issues, while aiming to measurably accomplish sustainable positive change in dynamic, learning, and varied contexts.

Team Collaboration: Lessons Learned Report

NASA Technical Reports Server (NTRS)

Arterberrie, Rhonda Y.; Eubanks, Steven W.; Kay, Dennis R.; Prahst, Stephen E.; Wenner, David P.

2005-01-01

An Agency team collaboration pilot was conducted from July 2002 until June 2003 and then extended for an additional year. The objective of the pilot was to assess the value of collaboration tools and adoption processes as applied to NASA teams. In an effort to share knowledge and experiences, the lessons that have been learned thus far are documented in this report. Overall, the pilot has been successful. An entire system has been piloted - tools, adoption, and support. The pilot consisted of two collaboration tools, a team space and a virtual team meeting capability. Of the two tools that were evaluated, the team meeting tool has been more widely accepted. Though the team space tool has been met with a lesser degree of acceptance, the need for such a tool in the NASA environment has been evidenced. Both adoption techniques and support were carefully developed and implemented in a way that has been well received by the pilot participant community.

Patients, practices, and relationships: challenges and lessons learned from the Kentucky Ambulatory Network (KAN) CaRESS clinical trial.

PubMed

Love, Margaret M; Pearce, Kevin A; Williamson, M Ann; Barron, Mary A; Shelton, Brent J

2006-01-01

The Cardiovascular Risk Education and Social Support (CaRESS) study is a randomized controlled trial that evaluates a social support intervention toward reducing cardiovascular risk in type 2 diabetic patients. It involves multiple community-based practice sites from the Kentucky Ambulatory Network (KAN), which is a regional primary care practice-based research network (PBRN). CaRESS also implements multiple modes of data collection. The purpose of this methods article is to share lessons learned that might be useful to others developing or implementing complex studies that consent patients in PBRNs. Key points include building long-term relationships with the clinicians, adaptability when integrating into practice sites, adequate funding to support consistent data management and statistical support during all phases of the study, and creativity and perseverance for recruiting patients and practices while maintaining the integrity of the protocol.

Smoking Cessation Counseling for Asian Immigrants With Serious Mental Illness: Using RE-AIM to Understand Challenges and Lessons Learned in Primary Care–Behavioral Health Integration

PubMed Central

Saw, Anne; Kim, Jin; Lim, Joyce; Powell, Catherine; Tong, Elisa K.

2016-01-01

Engagement in modifiable risk behaviors, such as tobacco use, substantially contributes to early mortality rates in individuals with serious mental illness (SMI). There is an alarmingly high prevalence of tobacco use among subgroups of Asian Americans, such as immigrants and individuals with SMI, yet there are no empirically supported effective smoking cessation interventions that have been tailored to meet the unique cultural, cognitive, and psychological needs of Asian immigrants with SMI. In this article, we share the experiences of clinicians in the delivery of smoking cessation counseling to Asian American immigrants with SMI, in the context of an Asian-focused integrated primary care and behavioral health setting. Through a qualitative analysis of clinician perspectives organized with the RE-AIM framework, we outline challenges, lessons learned, and promising directions for delivering smoking cessation counseling to Asian American immigrant clients with SMI. PMID:23667056

Coordinating an interdisciplinary disease management conference on a military installation: collaboration between military and civilian communities, lessons learned.

PubMed

Lewis-Fleming, Glenda; Knapp, Casey A

2009-08-01

The needs of individuals with chronic diseases or disabilities are similar whether within military or civilian communities. With finite resources and the continuing global war on terrorism, military treatment facilities (MTFs) may find collaborative, multidisciplinary, continuing education efforts with community agencies invaluable. Collaborative efforts that bring military and civilian communities together can result in innovative programs that offer cost-effective high-quality information to enhance the knowledge and skill level of military families, providers, and other professionals who provide services and care for military eligible beneficiaries. This article addresses the development and implementation of two major multidisciplinary disease management conferences at Naval Medical Center Portsmouth (NMCP), Virginia. It provides an overview of lessons learned in the areas of preplanning, team building, program development, implementation, and evaluation. Despite challenges, tremendous benefits may be reaped from efforts to include diverse target populations from military and civilian communities.

Alzheimer's Caregiver Support Online: lessons learned, initial findings and future directions.

PubMed

Glueckauf, Robert L; Loomis, Jeffrey S

2003-01-01

Family caregivers of older adults with progressive dementia (e.g., Alzheimer's disease) are faced with a variety of emotional and behavioral difficulties, such as dealing with persistent, repetitive questions, managing agitation and depression, and monitoring hygiene and self-care activities. Although professional and governmental organizations have called for the creation of community-based education and support programs, most dementia caregivers continue to receive little or no formal instruction in responding effectively to these challenges. The current paper describes the development and implementation of Alzheimer's Caregiver Support Online, a Web- and telephone-based education and support network for caregivers of individuals with progressive dementia. Lessons learned from the first two years of this state-supported initiative are discussed, followed by the findings of a Robert Wood Johnson Foundation-funded strategic marketing initiative and an initial program evaluation of AlzOnline's Positive Caregiving classes. Finally, clinical implications and future directions for program development and evaluation research are proposed.

Lesson Study as Professional Development within Secondary Physics Teacher Professional Learning Communities

NASA Astrophysics Data System (ADS)

Collins, Tonya Monique Nicki

Two Professional Learning Communities of physics teachers from different high schools voluntarily participated in Lesson Study as a means of professional development. The five teacher-participants and one participant-researcher partook of two Lesson Study cycles, each of which focused on student physics misconceptions. The Lesson Study resulted in two topics of physics: projectiles and gravitation. The researcher aimed to determine what happens to secondary physics teachers who undergo Lesson Study through this phenomenological case study. Specifically, (1) What is the process of Lesson Study with secondary physics teachers? and (2) What are the teacher-reported outcomes of Lesson Study with secondary physics teachers? Overall, Lesson Study provided an avenue for secondary physics teachers to conduct inquiry on their students in an attempt to better understand student thinking and learning. As a result, teachers collaborated to learn how to better meet the needs of their students and self-reported growth in many areas of teaching and teacher knowledge. The study resulted in twelve hypotheses to be tested in later research centering on idealizing the process of Lesson Study and maximizing secondary physics teacher growth.

[Development and evolution of a balanced scorecard in primary health care: Lessons learned].

PubMed

Bartolomé-Benito, E; Jiménez-Carramiñana, J; Sánchez-Perruca, L; Bartolomé-Casado, M S; Dominguez-Mandueño, A B; Marti-Argandoña, M; Hernández-Pascual, M; Miquel-Gómez, A

To describe the design, implementation, and monitoring of eSOAP (Primary Health Care Balanced Scorecard) and its role in the deployment of strategic objectives and clinical management, as well as to show the lessons learned during six years of follow-up. Descriptive study areas: methodology (conceptual framework, strategic matrix, strategic map, and processes map), technology and standardisation. As of December 2014, 9,046 (78%) professionals are registered in eSOAP. A total of 381 indicators were measured from 16 data sources, of which 36% were of results (EFQM model), 39.1% of clinical management, and 20% were included in the Program Centre Contract. The Balanced Scorecard has enabled to deploy all strategic lines of Primary Health Care, and has enabled the healthcare professionals to evaluate the evolution of results over time, and at patient level (e.g. 16% increase in control of diabetic patients). A total of 295,779 reports were generated and 13,080 professionals were evaluated by goals. There was an increased use of the eSOAP application by the professionals. The Balanced Scorecard was the key in deploying Primary Health Care strategies. It has helped clinical management and improved relevant indicators (health, patient experience, and costs), such as the management models that we used as references (EFQM Kaplan and Norton), and new emerging scenarios (Triple aim). Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Integrating Instruments of Power and Influence: Lessons Learned and Best Practices

DTIC Science & Technology

2008-01-01

practices developed by ACT’s Joint Analysis and Lessons Learned Centre in Monsanto , Portugal. Summary xix European Union An increasing European role in...oversees the Joint Analysis and Lessons Learned Centre in Monsanto , Por- tugal, the mission of which is critical for the purposes of this report. These

Human Spaceflight Conjunction Assessment: Lessons Learned

NASA Technical Reports Server (NTRS)

Smith, Jason T.

2011-01-01

This viewgraph presentation reviews the process of a human space flight conjunction assessment and lessons learned from the more than twelve years of International Space Station (ISS) operations. Also, the application of these lessons learned to a recent ISS conjunction assessment with object 84180 on July 16, 2009 is also presented.

NASA's Lessons Learned and Technical Standards: A Logical Marriage

NASA Technical Reports Server (NTRS)

Gill, Paul; Vaughan, William W.; Garcia, Danny; Weinstein, Richard

2001-01-01

Lessons Learned have been the basis for our accomplishments throughout the ages. They have been passed down from father to son, mother to daughter, teacher to pupil, and older to younger worker. Lessons Learned have also been the basis for NASA's accomplishments for more than forty years. Both government and industry have long recognized the need to systematically document and utilize the knowledge gained from past experiences in order to avoid the repetition of failures and mishaps. Lessons Learned have formed the foundation for discoveries, inventions, improvements, textbooks, and Technical Standards.

Lessons learned from recruiting nursing homes to a quantitative cross-sectional pilot study.

PubMed

Tzouvara, Vasiliki; Papadopoulos, Chris; Randhawa, Gurch

2016-03-01

A growing older adult population is leading to increased admission rates to long-term care facilities such as nursing homes and residential care homes. Assisted healthcare services should be flexible, integrated, and responsive to older adults' needs. However, there is a limited body of empirical evidence because of the recruitment challenges in these settings. To describe the barriers and challenges faced in recruiting to a recent pilot study, consider previously implemented and proposed recruitment strategies, and propose a new multi-method approach to maximising recruitment of care homes. The proposed multi-method approach harnesses key recruitment strategies previously highlighted as effective in navigating the many challenges and barriers that are likely to be encountered, such as mistrust, scepticism and concerns about disruption to routines. This includes making strategic use of existing personal and professional connections within the research team, engaging with care homes that have previously engaged with the research process, forming relationships of trust, and employing a range of incentives. Implementing carefully planned recruitment strategies is likely to improve relationships between nursing homes and researchers. As a consequence, recruitment can be augmented which can enable the production of rigorous evidence required for achieving effective nursing practice and patient wellbeing. Boosting recruitment rates is crucial in helping to build new and less biased research evidence and for informing and underpinning all forms of evidence-based practice. The lessons learned from our pilot and the review of the literature highlight these issues and better enable investigators to access research settings that commonly possess many complex recruitment barriers and challenges.

Validation of electronic medical record-based phenotyping algorithms: results and lessons learned from the eMERGE network.

PubMed

Newton, Katherine M; Peissig, Peggy L; Kho, Abel Ngo; Bielinski, Suzette J; Berg, Richard L; Choudhary, Vidhu; Basford, Melissa; Chute, Christopher G; Kullo, Iftikhar J; Li, Rongling; Pacheco, Jennifer A; Rasmussen, Luke V; Spangler, Leslie; Denny, Joshua C

2013-06-01

Genetic studies require precise phenotype definitions, but electronic medical record (EMR) phenotype data are recorded inconsistently and in a variety of formats. To present lessons learned about validation of EMR-based phenotypes from the Electronic Medical Records and Genomics (eMERGE) studies. The eMERGE network created and validated 13 EMR-derived phenotype algorithms. Network sites are Group Health, Marshfield Clinic, Mayo Clinic, Northwestern University, and Vanderbilt University. By validating EMR-derived phenotypes we learned that: (1) multisite validation improves phenotype algorithm accuracy; (2) targets for validation should be carefully considered and defined; (3) specifying time frames for review of variables eases validation time and improves accuracy; (4) using repeated measures requires defining the relevant time period and specifying the most meaningful value to be studied; (5) patient movement in and out of the health plan (transience) can result in incomplete or fragmented data; (6) the review scope should be defined carefully; (7) particular care is required in combining EMR and research data; (8) medication data can be assessed using claims, medications dispensed, or medications prescribed; (9) algorithm development and validation work best as an iterative process; and (10) validation by content experts or structured chart review can provide accurate results. Despite the diverse structure of the five EMRs of the eMERGE sites, we developed, validated, and successfully deployed 13 electronic phenotype algorithms. Validation is a worthwhile process that not only measures phenotype performance but also strengthens phenotype algorithm definitions and enhances their inter-institutional sharing.

Motivation of animal care technicians through recognition.

PubMed

Symonowicz, Cammie; Critelli, Linda; Straeter, Pamela

2006-01-01

Keeping employees motivated is a challenge faced by managers in the field of laboratory animal science and in the business world at large. Using Maslow's 'Hierarchy of Needs' theory as a guide, the authors describe how managers can create a recognition program to keep employees feeling happy and rewarded. They discuss programs used at Bristol-Myers Squibb and share lessons learned from various programs.

Supporting Parental Involvement in Children's Early Learning: Lessons from Community Childcare Centres in Dublin's Docklands

ERIC Educational Resources Information Center

Share, Michelle; Kerrins, Liz

2013-01-01

Recently in Ireland attention has been placed on the importance of parental involvement in early childhood care and education settings as seen in the Síolta Quality Standards and Aistear Curriculum Framework. Yet there is little Irish empirical evidence on parental involvement in childcare settings; on the involvement models being used, or on the…

Strategies for healthcare facilities, construction, and real estate management.

PubMed

Lee, James G

2012-05-01

Adventist HealthCare offers the following lessons learned in improving the value of healthcare facilities, construction, and real estate management: Use an integrated approach. Ensure that the objectives of the approach align the hospital or health system's mission and values. Embrace innovation. Develop a plan that applies to the whole organization, rather than specific business units. Ensure commitment of senior leaders.

Lessons Learned from the Creation of a Center of Excellence in Low Vision and Vision Rehabilitation in Wenzhou, China

ERIC Educational Resources Information Center

Marinoff, Rebecca; Heilberger, Michael H.

2017-01-01

A model Center of Excellence in Low Vision and Vision Rehabilitation was created in a health care setting in China utilizing an inter-institutional relationship with a United States optometric institution. Accomplishments of, limitations to, and stimuli to the provision of low vision and vision rehabilitation services are shared.

Successful Strategies for Educating Hard-to-Reach Populations: Lessons Learned from Massachusetts' Train-the-Trainer Project Using the "Helping You Take Care of Yourself" Curriculum

ERIC Educational Resources Information Center

Besculides, Melanie; Trebino, Lisa; Nelson, Heather

2012-01-01

Objective: To assess the effectiveness of providing education on breast, cervical and cardiovascular health to hard-to-reach women throughout Massachusetts using an innovative derivation of the "train-the-trainer" approach. Innovation included use of contracts with community-based organizations (CBOs) that required data collection in…

A Leader's Guide to What Do You Stand for? For Kids CD-ROM

ERIC Educational Resources Information Center

Lewis, Barbara A.

2010-01-01

Kids of any age can learn the basics of good character and figure out what they stand for. This leader's guide is a companion to the children's book, "What Do You Stand For? For Kids". The 11 lessons on the CD-ROM provide a complete course for kids on caring, citizenship, cooperation, fairness, forgiveness, honesty, relationships, respect,…

AMDIS Case Conference

PubMed Central

Graham, J.; Levick, D.; Schreiber, R.

2010-01-01

Clinical decision support that provides enhanced patient safety at the point of care frequently encounters significant pushback from clinicians who find the process intrusive or time-consuming. We present a hypothetical medical center’s dilemma about its allergy alerting system and discuss similar problems faced by real hospitals. We then share some lessons learned and best practices for institutions who wish to implement these tools themselves. PMID:23616828

Can We Alter Physician Behavior by Educational Methods? Lessons Learned from Studies of the Management and Follow-up of Hypertension.

ERIC Educational Resources Information Center

Tu, Karen; Davis, Dave

2002-01-01

A literature review found 12 studies using educational interventions for physicians regarding hypertension. Interventions such as reminders improved follow-up care but were ineffective in changing blood pressure levels. The success of interventions may depend on the aspect to be changed and their feasibility in a particular setting. (Contains 35…

Developing and Implementing an Interactive End-of-Life Education Module Using Raptivity and iSpring: Lessons Learned

ERIC Educational Resources Information Center

Lewis-Pierre, LaToya; Aziza, Khitam

2017-01-01

The 21st century nurse is a forward-thinking individual who is expected to deliver holistic nursing care. Multigenerational learners are seeking degrees and the new Net generation learner will reflect the majority of the workforce. Thus, the integration of a multilevel interactive classroom is instrumental in facilitating the student's knowledge…

Primer for the Assessment, Diagnosis and Delivery of Internet Interventions for (Mainly) Panic Disorder. Lessons Learned from Our Research Groups

ERIC Educational Resources Information Center

Andersson, Gerhard; Ritterband, Lee M.; Carlbring, Per

2008-01-01

With the advent of the Internet, delivered assessment applications are likely to make a difference in clinical psychology and in health care in general. The purpose of the present paper was to present an overview of the authors' experience regarding Internet administration of diagnostic interviews, questionnaires, and information processing tests.…

Possible applications of soaring technology to drag reduction in powered general aviation aircraft

NASA Technical Reports Server (NTRS)

Mcmasters, J. H.; Palmer, G. M.

1975-01-01

A brief examination of the performance figures achieved by modern soaring machines and a little reflection on the often huge disparity in L/D values between sailplanes and GA aircraft indicates that careful attention to lessons learned in sailplane design and manufacture hold realistic promise for substantial gains in the aerodynamic efficiency of several GA types.

Selected Lessons Learned in Space Shuttle Orbiter Propulsion and Power Subsystems

NASA Technical Reports Server (NTRS)

Hernandez, Francisco J.; Martinez, Hugo; Ryan, Abigail; Westover, Shayne; Davies, Frank

2011-01-01

Over its 30 years of space flight history, plus the nearly 10 years of design, development test and evaluation, the Space Shuttle Orbiter is full of lessons learned in all of its numerous and complex subsystems. In the current paper, only selected lessons learned in the areas of the Orbiter propulsion and power subsystems will be described. The particular Orbiter subsystems include: Auxiliary Power Unit (APU), Hydraulics and Water Spray Boiler (WSB), Mechanical Flight Controls, Main Propulsion System (MPS), Fuel Cells and Power Reactant and Storage Devices (PRSD), Orbital Maneuvering System (OMS), Reaction Control System (RCS), Electrical Power Distribution (EPDC), electrical wiring and pyrotechnics. Given the complexity and extensive history of each of these subsystems, and the limited scope of this paper, it is impossible to include most of the lessons learned; instead the attempt will be to present a selected few or key lessons, in the judgment of the authors. Each subsystem is presented separate, beginning with an overview of the hardware and their function, a short description of a few historical problems and their lessons, followed by a more comprehensive table listing of the major subsystem problems and lessons. These tables serve as a quick reference for lessons learned in each subsystem. In addition, this paper will establish common lessons across subsystems as well as concentrate on those lessons which are deemed to have the highest applicability to future space flight programs.

Building capacity for cognitive behavioral therapy delivery for depression in disaster-impacted contexts.

PubMed

Ngo, Victoria K; Centanni, Angela; Wong, Eunice; Wennerstrom, Ashley; Miranda, Jeanne

2011-01-01

Numerous challenges exist in implementing evidence-based practices, such as cognitive behavioral therapy, in resource poor, ethnic minority, and/or disaster-affected communities with disparities in mental health. Community-academic participatory partnerships are a promising approach to addressing disparities by implementing community-appropriate, evidence-based depression care. A community-academic collaborative was formed in New Orleans after Hurricane Katrina to expand resources for effective depression care, including cognitive behavioral therapy. In this article, we: 1) describe our model of building capacity to deliver cognitive behavioral therapy for depression in post-disaster community-based settings; 2) discuss the impact of this training program on therapist reported practice; and 3) share lessons learned regarding disseminating and sustaining evidence-based interventions in the context of a disaster impacted community. Using a mixed methods approach, we found that this model was feasible, acceptable, and disseminated knowledge about cognitive behavioral therapy in community settings. Over the course of two years, community providers demonstrated the feasibility of implementing evidence-based practice and potential for local community leadership. The lessons learned from this model of implementation may help address barriers to disseminating evidence-based interventions in other low-resource, disaster-impacted community settings.

Using multimedia information and communication technology (ICT) to provide added value to reminiscence therapy for people with dementia : Lessons learned from three field studies.

PubMed

Bejan, Alexander; Gündogdu, Ramazan; Butz, Katherina; Müller, Nadine; Kunze, Christophe; König, Peter

2018-01-01

In the care of people with dementia (PwD), occupational therapies and activities aiming at maintaining the quality of life of PwD, such as reminiscence therapy (RT), are taking on a more and more important role. Information and communication technology (ICT) has the potential to improve and to facilitate RT by facilitating access to and selection of biographical information and related contents or by providing novel multimodal interaction forms to trigger memories; however, interactive multimedia technology is barely used in practice. This article presents three exploratory field studies that evaluated different aspects of RT technology use for PwD in care homes, including the utilization of online movie databases, interactive surface touch computers as well as natural user interfaces allowing gestures and haptic interaction. In these studies, the usage of prototype systems was observed in occupational sessions by 5, 12 and 16 PwD. The results indicate positive effects of technology use, e. g. in the form of verbally elicited reminiscence statements, expressed joy and playful interaction. Lessons learned for the design of technology-based RT interventions are presented and discussed.

Mental health care in the Lebanon War, 1982.

PubMed

Noy, S; Levy, R; Solomon, Z

1984-04-01

Lessons in mental health care learned from the October 1973 War were applied in the Lebanon War 1982. A three-echelon system of management was followed according to the practices prevalent in Western armies. The clinical pictures were essentially similar to those observed in other wars. Combat stress reactions (CSR) comprised 15 to 20% of the total casualties during the active phase of the war; the rate of late reactions was 30 to 40% of the total CSR. Treatment on the battlefield was more effective than treatment following airlift to the rear, in returning soldiers to their units. The role of stress in causing CSR, and the importance of leadership and cohesion in its prevention were evident. The important lessons learned from the Lebanon War are discussed and include: 1) the need for a broad definition of CSR; 2) the importance of forward unit intervention; 3) the necessity of mobility and divisibility of mental health treatment units; 4) fighting units should not be dispersed immediately after combat; and 5) the management of stress reactions to be the responsibility not only of the mental health services, but of all sections of the medical corps, both in treatment and prevention.

Interprofessional Education and Practice Guide No. 6: Developing practice-based interprofessional learning using a short placement model.

PubMed

Anderson, Elizabeth Susan; Ford, Jenny; Kinnair, Daniel James

2016-07-01

Offering undergraduate and post-qualified learners opportunities to take part in, and reflect on, the nature of interprofessional working when in practice remains an important goal for interprofessional educators. There are a plethora of opportunities within hospital and community care for learners to actively participate in health and social care delivery where collaborative practice prevails. However, it remains challenging to know how to establish and sustain meaningful interprofessional practice-based learning. This is because profession-specific teaching is prioritised and many teams are under-resourced, leaving little time for additional teaching activities. In some instances, practitioners lack the knowledge concerning how to design meaningful interprofessional learning and often feel unprepared for this teaching because of limited interprofessional faculty development. Others are simply unaware of the presence of the different students within their practice area. This guide offers key lessons developed over many years for setting up practice-based interprofessional education. The learning model has been adapted and adopted in different settings and countries and offers a method for engaging clinical front-line practitioners in learning with, and from learners who can help support and in some instances advance care delivery.

International nurse migration: lessons from the Philippines.

PubMed

Brush, Barbara L; Sochalski, Julie

2007-02-01

Developed countries facing nursing shortages have increasingly turned to aggressive foreign nurse recruitment, primarily from developing nations, to offset their lagging domestic nurse supplies and meet growing health care demands. Few donor nations are prepared to manage the loss of their nurse workforce to migration. The sole country with an explicit nurse export policy and the world's leading donor of nurse labor - the Philippines - is itself facing serious provider maldistribution and countrywide health disparities. Examining the historical roots of Philippines nurse migration provides lessons from which other nurse exporting countries may learn. The authors discuss factors that have predicated nurse migration and policies that have eased the way. Furthermore, the authors analyze how various stakeholders influence migratory patterns, the implications of migration for nurses and the public in their care, and the challenges that future social policy and political systems face in addressing global health issues engendered by unfettered recruitment of nurses and other health workers.

Integrating Patient-Reported Outcomes into Spine Surgical Care through Visual Dashboards: Lessons Learned from Human-Centered Design.

PubMed

Hartzler, Andrea L; Chaudhuri, Shomir; Fey, Brett C; Flum, David R; Lavallee, Danielle

2015-01-01

The collection of patient-reported outcomes (PROs) draws attention to issues of importance to patients-physical function and quality of life. The integration of PRO data into clinical decisions and discussions with patients requires thoughtful design of user-friendly interfaces that consider user experience and present data in personalized ways to enhance patient care. Whereas most prior work on PROs focuses on capturing data from patients, little research details how to design effective user interfaces that facilitate use of this data in clinical practice. We share lessons learned from engaging health care professionals to inform design of visual dashboards, an emerging type of health information technology (HIT). We employed human-centered design (HCD) methods to create visual displays of PROs to support patient care and quality improvement. HCD aims to optimize the design of interactive systems through iterative input from representative users who are likely to use the system in the future. Through three major steps, we engaged health care professionals in targeted, iterative design activities to inform the development of a PRO Dashboard that visually displays patient-reported pain and disability outcomes following spine surgery. Design activities to engage health care administrators, providers, and staff guided our work from design concept to specifications for dashboard implementation. Stakeholder feedback from these health care professionals shaped user interface design features, including predefined overviews that illustrate at-a-glance trends and quarterly snapshots, granular data filters that enable users to dive into detailed PRO analytics, and user-defined views to share and reuse. Feedback also revealed important considerations for quality indicators and privacy-preserving sharing and use of PROs. Our work illustrates a range of engagement methods guided by human-centered principles and design recommendations for optimizing PRO Dashboards for patient care and quality improvement. Engaging health care professionals as stakeholders is a critical step toward the design of user-friendly HIT that is accepted, usable, and has the potential to enhance quality of care and patient outcomes.

Improving the identification and management of chronic kidney disease in primary care: lessons from a staged improvement collaborative

PubMed Central

Harvey, Gill; Oliver, Kathryn; Humphreys, John; Rothwell, Katy; Hegarty, Janet

2015-01-01

Quality problem Undiagnosed chronic kidney disease (CKD) contributes to a high cost and care burden in secondary care. Uptake of evidence-based guidelines in primary care is inconsistent, resulting in variation in the detection and management of CKD. Initial assessment Routinely collected general practice data in one UK region suggested a CKD prevalence of 4.1%, compared with an estimated national prevalence of 8.5%. Of patients on CKD registers, ∼30% were estimated to have suboptimal management according to Public Health Observatory analyses. Choice of solution An evidence-based framework for implementation was developed. This informed the design of an improvement collaborative to work with a sample of 30 general practices. Implementation A two-phase collaborative was implemented between September 2009 and March 2012. Key elements of the intervention included learning events, improvement targets, Plan-Do-Study-Act cycles, benchmarking of audit data, facilitator support and staff time reimbursement. Evaluation Outcomes were evaluated against two indicators: number of patients with CKD on practice registers; percentage of patients achieving evidence-based blood pressure (BP) targets, as a marker for CKD care. In Phase 1, recorded prevalence of CKD in collaborative practices increased ∼2-fold more than that in comparator local practices; in Phase 2, this increased to 4-fold, indicating improved case identification. Management of BP according to guideline recommendations also improved. Lessons learned An improvement collaborative with tailored facilitation support appears to promote the uptake of evidence-based guidance on the identification and management of CKD in primary care. A controlled evaluation study is needed to rigorously evaluate the impact of this promising improvement intervention. PMID:25525148

Key Events in Student Leaders' Lives and Lessons Learned from Them

ERIC Educational Resources Information Center

Sessa, Valerie I.; Morgan, Brett V.; Kalenderli, Selin; Hammond, Fanny E.

2014-01-01

This descriptive study used an interview protocol developed by the Center for Creative Leadership with 50 college student leaders to determine what key developmental events young college leaders experience and the leadership lessons learned from these events. Students discussed 180 events and 734 lessons learned from them. Most events defined by…

75 FR 80857 - Notice of Availability of NUREG-1800, Revision 2; “Standard Review Plan for Review of License...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

..., Revision 2; ``Generic Aging Lessons Learned (GALL) Report'' AGENCY: Nuclear Regulatory Commission (NRC... Nuclear Power Plants'' and NUREG-1801, Revision 2; ``Generic Aging Lessons Learned (GALL) Report... Lessons Learned (GALL) Report.'' These revised documents describe methods acceptable to the NRC staff for...

Reinventing Teacher Professional Norms and Identities: The Role of Lesson Study and Learning Communities

ERIC Educational Resources Information Center

Lieberman, Joanne

2009-01-01

The present article addresses how lesson study can facilitate changing traditional norms of individualism, conservatism and presentism that constrain American teachers from learning from one another. The article investigates how lesson study can serve as a vehicle for developing teacher learning communities by developing or redeveloping teachers'…

Leveraging Lesson Learning in Tactical Units

DTIC Science & Technology

1997-01-01

then it may be a lesson, but as Vetock points out, determining useful lessons requires analysis. Discovery of the wrong lesson can be as bad as not...34lesson learning is a very dangerous business.൘ Distinguishing a good" lesson from a " bad " one requires experience, a good grasp of doctrine, and...section - - boasted 3 cigarette lighters, 1 bar of soap, 2 wallets, 40 bottles, 1 suspender, and 11 French toothpaste .55 49 As Vetock points out, the

Improving the quality of learning in science through optimization of lesson study for learning community

NASA Astrophysics Data System (ADS)

Setyaningsih, S.

2018-03-01

Lesson Study for Learning Community is one of lecturer profession building system through collaborative and continuous learning study based on the principles of openness, collegiality, and mutual learning to build learning community in order to form professional learning community. To achieve the above, we need a strategy and learning method with specific subscription technique. This paper provides a description of how the quality of learning in the field of science can be improved by implementing strategies and methods accordingly, namely by applying lesson study for learning community optimally. Initially this research was focused on the study of instructional techniques. Learning method used is learning model Contextual teaching and Learning (CTL) and model of Problem Based Learning (PBL). The results showed that there was a significant increase in competence, attitudes, and psychomotor in the four study programs that were modelled. Therefore, it can be concluded that the implementation of learning strategies in Lesson study for Learning Community is needed to be used to improve the competence, attitude and psychomotor of science students.

Apollo 1 Lessons Learned Show

NASA Image and Video Library

2017-01-27

Mike Ciannilli, the Apollo, Challenger, Columbia Lessons Learned Program manager, far right, is pictured with panelists from the Apollo 1 Lessons Learned event in the Training Auditorium at NASA's Kennedy Space Center in Florida. In the center, are Ernie Reyes, retired, former Apollo 1 senior operations manager; and John Tribe, retired, former Apollo 1 Reaction and Control System lead engineer. At far left is Zulie Cipo, the Apollo, Challenger, Columbia Lessons Learned Program event support team lead. The theme of the program was "To there and Back Again." The event helped pay tribute to the Apollo 1 crew, Gus Grissom, Ed White II, and Roger Chaffee.

Multi-unit Operations in Non-Nuclear Systems: Lessons Learned for Small Modular Reactors

DOE Office of Scientific and Technical Information (OSTI.GOV)

OHara J. M.; Higgins, J.; DAgostino, A.

2012-01-17

The nuclear-power community has reached the stage of proposing advanced reactor designs to support power generation for decades to come. Small modular reactors (SMRs) are one approach to meet these energy needs. While the power output of individual reactor modules is relatively small, they can be grouped to produce reactor sites with different outputs. Also, they can be designed to generate hydrogen, or to process heat. Many characteristics of SMRs are quite different from those of current plants and may be operated quite differently. One difference is that multiple units may be operated by a single crew (or a singlemore » operator) from one control room. The U.S. Nuclear Regulatory Commission (NRC) is examining the human factors engineering (HFE) aspects of SMRs to support licensing reviews. While we reviewed information on SMR designs to obtain information, the designs are not completed and all of the design and operational information is not yet available. Nor is there information on multi-unit operations as envisioned for SMRs available in operating experience. Thus, to gain a better understanding of multi-unit operations we sought the lesson learned from non-nuclear systems that have experience in multi-unit operations, specifically refineries, unmanned aerial vehicles and tele-intensive care units. In this paper we report the lessons learned from these systems and the implications for SMRs.« less

Patient-Centered Medical Home Undergraduate Internship, Benefits to a Practice Manager: Case Study.

PubMed

Sasnett, Bonita; Harris, Susie T; White, Shelly

Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators. The practice manager benefits as interns become Patient-Centered Medical Home facilitators and assist practice managers in the recognition process.

The Recovery-Oriented Care Collaborative: A Practice-Based Research Network to Improve Care for People With Serious Mental Illnesses.

PubMed

Kelly, Erin L; Kiger, Holly; Gaba, Rebecca; Pancake, Laura; Pilon, David; Murch, Lezlie; Knox, Lyndee; Meyer, Mathew; Brekke, John S

2015-11-01

Practice-based research networks (PBRNs) create continuous collaborations among academic researchers and practitioners. Most PBRNs have operated in primary care, and less than 5% of federally registered PBRNs include mental health practitioners. In 2012 the first PBRN in the nation focused on individuals with serious mental illnesses-the Recovery-Oriented Care Collaborative-was established in Los Angeles. This column describes the development of this innovative PBRN through four phases: building an infrastructure, developing a research study, executing the study, and consolidating the PBRN. Key lessons learned are also described, such as the importance of actively engaging direct service providers and clients.

Preparing for the unexpected: violence in the home care environment, one agency's story.

PubMed

Browning, Sarah Via; Clark, Rebecca Culver; Glick, Roger E

2013-06-01

Home care and hospice agencies, bound by regulations, prepare for emergencies and disasters by creating policies and protocols for management of emergency situations, perhaps conducting table top or other types of drills, and discussing hazards likely to impact home care. Is this preparation merely an exercise to meet a requirement, or is it life-saving preparation? For one home care agency, the emergency exercise saved the day as the scenario enacted in the drill was actually lived out a few weeks after the exercise-a scenario the agency leaders hoped they would never face. This account explores how the agency prepared to meet the emergent situation and details lessons learned in the aftermath.

The Transgender Women of Color Initiative: Implementing and Evaluating Innovative Interventions to Enhance Engagement and Retention in HIV Care.

PubMed

Rebchook, Gregory; Keatley, JoAnne; Contreras, Robert; Perloff, Judy; Molano, Luis Freddy; Reback, Cathy J; Ducheny, Kelly; Nemoto, Tooru; Lin, Royce; Birnbaum, Jeffrey; Woods, Tiffany; Xavier, Jessica

2017-02-01

To improve health outcomes among transgender women of color living with HIV, the Health Resources and Services Administration's Special Programs of National Significance program funded the Enhancing Engagement and Retention in Quality HIV Care for Transgender Women of Color Initiative in 2012. Nine demonstration projects in four US urban areas implemented innovative, theory-based interventions specifically targeting transgender women of color in their jurisdictions. An evaluation and technical assistance center was funded to evaluate the outcomes of the access to care interventions, and these findings will yield best practices and lessons learned to improve the care and treatment of transgender women of color living with HIV infection.

Lessons from the business sector for successful knowledge management in health care: a systematic review.

PubMed

Kothari, Anita; Hovanec, Nina; Hastie, Robyn; Sibbald, Shannon

2011-07-25

The concept of knowledge management has been prevalent in the business sector for decades. Only recently has knowledge management been receiving attention by the health care sector, in part due to the ever growing amount of information that health care practitioners must handle. It has become essential to develop a way to manage the information coming in to and going out of a health care organization. The purpose of this paper was to summarize previous studies from the business literature that explored specific knowledge management tools, with the aim of extracting lessons that could be applied in the health domain. We searched seven databases using keywords such as "knowledge management", "organizational knowledge", and "business performance". We included articles published between 2000-2009; we excluded non-English articles. 83 articles were reviewed and data were extracted to: (1) uncover reasons for initiating knowledge management strategies, (2) identify potential knowledge management strategies/solutions, and (3) describe facilitators and barriers to knowledge management. KM strategies include such things as training sessions, communication technologies, process mapping and communities of practice. Common facilitators and barriers to implementing these strategies are discussed in the business literature, but rigorous studies about the effectiveness of such initiatives are lacking. The health care sector is at a pinnacle place, with incredible opportunities to design, implement (and evaluate) knowledge management systems. While more research needs to be done on how best to do this in healthcare, the lessons learned from the business sector can provide a foundation on which to build.

Lessons from the business sector for successful knowledge management in health care: A systematic review

PubMed Central

2011-01-01

Background The concept of knowledge management has been prevalent in the business sector for decades. Only recently has knowledge management been receiving attention by the health care sector, in part due to the ever growing amount of information that health care practitioners must handle. It has become essential to develop a way to manage the information coming in to and going out of a health care organization. The purpose of this paper was to summarize previous studies from the business literature that explored specific knowledge management tools, with the aim of extracting lessons that could be applied in the health domain. Methods We searched seven databases using keywords such as "knowledge management", "organizational knowledge", and "business performance". We included articles published between 2000-2009; we excluded non-English articles. Results 83 articles were reviewed and data were extracted to: (1) uncover reasons for initiating knowledge management strategies, (2) identify potential knowledge management strategies/solutions, and (3) describe facilitators and barriers to knowledge management. Conclusions KM strategies include such things as training sessions, communication technologies, process mapping and communities of practice. Common facilitators and barriers to implementing these strategies are discussed in the business literature, but rigorous studies about the effectiveness of such initiatives are lacking. The health care sector is at a pinnacle place, with incredible opportunities to design, implement (and evaluate) knowledge management systems. While more research needs to be done on how best to do this in healthcare, the lessons learned from the business sector can provide a foundation on which to build. PMID:21787403

Lessons learned from the disruption of dental training of Malaysian students studying in Egypt during the Arab spring.

PubMed

Simon, Sibu Sajjan; Ramachandra, Srinivas Sulugodu; Abdullah, Datuk Dr Fawzia; Islam, Md Nurul; Kalyan, C G

2016-01-01

Political crisis and worsening security situation in Egypt in late 2013 resulted in Malaysian students who were pursuing their dental education in Egypt being recalled home to Malaysia. The Ministry of Higher Education in Malaysia took steps to integrate these students into public and private universities in Malaysia. We used a questionnaire and informal interviews to learn from students returning from Egypt about their experiences transitioning from dental schools in Egypt to Malaysia. We discuss the challenges students faced with regards to credit transfer, pastoral care, the differences in the curriculum between the dental faculties of the two nations, and the financial implications of this disruption of their training. We live in a fragile world where similar political situations will surely arise again. The approaches used by the Malaysian government and the lessons learned from these students may help others. The perspectives of these students may help educators reintegrate expatriate students who are displaced by political instability back into the education system of their own countries.

Promoting Local Ownership: Lessons Learned from Process of Transitioning Clinical Mentoring of HIV Care and Treatment in Ethiopia.

PubMed

Kassie, Getnet M; Belay, Teklu; Sharma, Anjali; Feleke, Getachew

2018-01-01

Focus on improving access and quality of HIV care and treatment gained acceptance in Ethiopia through the work of the International Training and Education Center for Health. The initiative deployed mobile field-based teams and capacity building teams to mentor health care providers on clinical services and program delivery in three regions, namely Tigray, Amhara, and Afar. Transitioning of the clinical mentoring program (CMP) began in 2012 through capacity building and transfer of skills and knowledge to local health care providers and management. The initiative explored the process of transitioning a CMP on HIV care and treatment to local ownership and documented key lessons learned. A mixed qualitative design was used employing focus group discussions, individual in-depth interviews, and review of secondary data. The participants included regional focal persons, mentors, mentees, multidisciplinary team members, and International Training and Education Center for Health (I-TECH) staff. Three facilities were selected in each region. Data were collected by trained research assistants using customized guides for interviews and with data extraction format. The interviews were recorded and fully transcribed. Open Code software was used for coding and categorizing the data. A total of 16 focus group discussions and 20 individual in-depth interviews were conducted. The critical processes for transitioning a project were: establishment of a mentoring transition task force, development of a roadmap to define steps and directions for implementing the transition, and signing of a memorandum of understanding (MOU) between the respective regional health bureaus and I-TECH Ethiopia to formalize the transition. The elements of implementation included mentorship and capacity building, joint mentoring, supportive supervision, review meetings, and independent mentoring supported by facility-based mechanisms: multidisciplinary team meetings, case-based discussions, and catchment area meetings. The process of transitioning the CMP to local ownership involved signing an MOU, training of mentors, and building capacity of mentoring in each region. The experience shed light on how to transition donor-supported work to local country ownership, with key lessons related to strengthening the structures of regional health bureaus, and other facilities addressing critical issues and ensuring continuity of the facility-based activities.

Responding To School Walkout Demonstrations. Lessons Learned From School Crises and Emergencies, Volume 3, Issue 1, 2008

ERIC Educational Resources Information Center

US Department of Education, 2008

2008-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue examines the incidence of student walkout demonstrations and the various ways in which administrators, school staff, law enforcement, and the community at large can help keep youths…

Lessons Learned from School Crises and Emergencies, Vol. 1, Issue 2, Fall 2006

ERIC Educational Resources Information Center

US Department of Education, 2006

2006-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. School and student names have been changed to protect identities. Information for this publication was gathered through a series of interviews with school stakeholders involved in the actual incident. This "Lessons Learned" issue…

75 FR 27838 - Notice of Availability of Draft NUREG-1800, Revision 2; “Standard Review Plan for Review of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-18

... Draft NUREG-1801, Revision 2; ``Generic Aging Lessons Learned (GALL) Report'' AGENCY: Nuclear Regulatory... Applications for Nuclear Power Plants ''and draft NUREG-1801, ``Generic Aging Lessons Learned (GALL) Report... Power Plants'' (SRP-LR); and the revised NUREG-1801, ``Generic Aging Lessons Learned (GALL) Report'' for...

77 FR 21813 - Changes to the Generic Aging Lessons Learned (GALL) Report Revision 2 AMP XI.M41, “Buried and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-11

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0055] Changes to the Generic Aging Lessons Learned (GALL) Report Revision 2 AMP XI.M41, ``Buried and Underground Piping and Tanks'' AGENCY: Nuclear Regulatory... NUREG-1801, Revision 2, ``Generic Aging Lessons Learned (GALL) Report,'' and the NRC staff's aging...

Teaching from Objects and Stories: Learning about the Bering Sea Eskimo People. Smithsonian in Your Classroom.

ERIC Educational Resources Information Center

Smigielski, Alan

The three lesson plans in this issue feature the Eskimos of the Bering Sea and their culture. The lesson plans are: (1) "Learning about a Culture from Its Objects"; (2) "Learning about a Culture from a Story"; and (3) "Everyday Objects." Each lesson cites student objectives; lists materials needed; gives subjects…

Value pricing pilot program : lessons learned

DOT National Transportation Integrated Search

2008-08-01

This "Lessons Learned Report" provides a summary of projects sponsored by the Federal Highway Administration's (FHWA's) Congestion and Value Pricing Pilot Programs from 1991 through 2006 and draws lessons from a sample of projects with the richest an...

Ready: how to keep your customers coming back.

PubMed

Eliscu, A T

2000-01-01

Customer service is a major, but often overlooked, issue in health care today. While other industries and organizations recognize how good customer relations can affect long-term success, many health care providers have yet to learn this valuable lesson. The Ritz-Carlton, which won the prestigious Baldridge Award for service, has a well-earned reputation for excellent customer service. Like health care providers, this hotel industry icon hires hourly workers, puts them in uniform and has them work in teams. Unlike health care, however, The Ritz-Carlton seems to be able to generate a much higher level of customer satisfaction. How? This chapter illustrates the techniques the hotel chain uses to accomplish its goal and how these important tools can apply to the health care industry.

Customer care in the NHS.

PubMed

Ruddick, Fred

2015-01-20

Viewing individuals in need of NHS care as customers has the potential to refocus the way their care is delivered. This article highlights some of the benefits of reframing the nurse-patient relationship in terms of customer care, and draws parallels between good customer care and the provision of high quality patient care in the NHS. It explores lessons to be learned from those who have studied the customer experience, which can be adapted to enhance the customer care experience within the health service. Developing professional expertise in the knowledge and skills that underpin good-quality interpersonal encounters is essential to improve the customer experience in health care and should be prioritised alongside the development of more technical skills. Creating a culture where emotional intelligence, caring and compassion are essential requirements for all nursing staff will improve patient satisfaction.

Nurse Project Consultant: Critical Care Nurses Move Beyond the Bedside to Affect Quality and Safety.

PubMed

Mackinson, Lynn G; Corey, Juliann; Kelly, Veronica; O'Reilly, Kristin P; Stevens, Jennifer P; Desanto-Madeya, Susan; Williams, Donna; O'Donoghue, Sharon C; Foley, Jane

2018-06-01

A nurse project consultant role empowered 3 critical care nurses to expand their scope of practice beyond the bedside and engage within complex health care delivery systems to reduce harms in the intensive care unit. As members of an interdisciplinary team, the nurse project consultants contributed their clinical expertise and systems knowledge to develop innovations that optimize care provided in the intensive care unit. This article discusses the formal development of and institutional support for the nurse project consultant role. The nurse project consultants' responsibilities within a group of quality improvement initiatives are described and their challenges and lessons learned discussed. The nurse project consultant role is a new model of engaging critical care nurses as leaders in health care redesign. ©2018 American Association of Critical-Care Nurses.

Lessons Learned from the Node 1 Temperature and Humidity Control Subsystem Design

NASA Technical Reports Server (NTRS)

Williams, David E.

2010-01-01

Node 1 flew to the International Space Station (ISS) on Flight 2A during December 1998. To date the National Aeronautics and Space Administration (NASA) has learned a lot of lessons from this module based on its history of approximately two years of acceptance testing on the ground and currently its twelve years on-orbit. This paper will provide an overview of the ISS Environmental Control and Life Support (ECLS) design of the Node 1 Temperature and Humidity Control (THC) subsystem and it will document some of the lessons that have been learned to date for this subsystem and it will document some of the lessons that have been learned to date for these subsystems based on problems prelaunch, problems encountered on-orbit, and operational problems/concerns. It is hoped that documenting these lessons learned from ISS will help in preventing them in future Programs. 1

Lessons Learned from Ares I Upper Stage Structures and Thermal Design

NASA Technical Reports Server (NTRS)

Ahmed, Rafiq

2012-01-01

The Ares 1 Upper Stage was part of the vehicle intended to succeed the Space Shuttle as the United States manned spaceflight vehicle. Although the Upper Stage project was cancelled, there were many lessons learned that are applicable to future vehicle design. Lessons learned that are briefly detailed in this Technical Memorandum are for specific technical areas such as tank design, common bulkhead design, thrust oscillation, control of flight and slosh loads, purge and hazardous gas system. In addition, lessons learned from a systems engineering and vehicle integration perspective are also included, such as computer aided design and engineering, scheduling, and data management. The need for detailed systems engineering in the early stages of a project is emphasized throughout this report. The intent is that future projects will be able to apply these lessons learned to keep costs down, schedules brief, and deliver products that perform to the expectations of their customers.

Evaluation of Standard Versus Nonstandard Vital Signs Monitors in the Prehospital and Emergency Departments: Results and Lessons Learned from a Trauma Patient Care Protocol

DTIC Science & Technology

2014-04-24

single lead and pleth waveform data from a thumb-mounted pulse oximeter to the WVSM were recorded at rates of 230 Hz and 75 Hz, respectively. For...were also used to derive other measurements including shock index (shock index = HR / SBP) and pulse pres- sure ( pulse pressure = SBP j diastolic

Review of Aircraft Engine Fan Noise Reduction

NASA Technical Reports Server (NTRS)

VanZante, Dale

2008-01-01

Aircraft turbofan engines incorporate multiple technologies to enhance performance and durability while reducing noise emissions. Both careful aerodynamic design of the fan and proper installation of the fan into the system are requirements for achieving the performance and acoustic objectives. The design and installation characteristics of high performance aircraft engine fans will be discussed along with some lessons learned that may be applicable to spaceflight fan applications.

AMDIS Case Conference: Intrusive Medication Safety Alerts.

PubMed

Graham, J; Levick, D; Schreiber, R

2010-01-01

Clinical decision support that provides enhanced patient safety at the point of care frequently encounters significant pushback from clinicians who find the process intrusive or time-consuming. We present a hypothetical medical center's dilemma about its allergy alerting system and discuss similar problems faced by real hospitals. We then share some lessons learned and best practices for institutions who wish to implement these tools themselves.

Trisomy 13 and 18: Selecting the road previously not taken.

PubMed

McCaffrey, Martin J

2016-09-01

The care of patients with trisomy 13 and 18 is a source of significant controversy. While these conditions are life limiting, indisputable data refutes the notion that these conditions are lethal or incompatible with life. Despite such evidence, arguments of beneficence, quality of life and limited resources are invoked to make the case to limit care to trisomy children. Lessons learned in our ignominious history with Down syndrome should guide us as we explore care for patients with trisomy 13 and 18. As clinicians we should strive with equipoise to carefully examine available data, the current status of practices related to care from palliation to intensive interventions, rise above our personal prejudices and listen to the voices of families imploring us to consider their opinions regarding the value of the life of a child with trisomy 13 or 18. We should recall and learn from our Down syndrome odyssey and select the road previously not taken as we chart a course to the best possible care for our trisomy 13 and 18 sisters and brothers. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Lean Six Sigma in health care and the challenge of implementation of Six Sigma methodologies at a Veterans Affairs Medical Center.

PubMed

Pocha, Christine

2010-01-01

Six Sigma and Lean Thinking are quality initiatives initially deployed in industry to improve operational efficiency leading to better quality and subsequent cost savings. The financial rationale for embarking on this quality journey is clear; applying it to today's health care remains challenging. The cost of medical care is increasing at an alarming rate; most of these cost increases are attributed to an aging population and technological advances; therefore, largely beyond control. Furthermore, health care cost increases are caused by unnecessary operational inefficiency associated with the direct medical service delivery process. This article describes the challenging journey of implementing Six Sigma methodology at a tertiary care medical center. Many lessons were learned; however, of utmost importance were team approach, "buy in" of the stakeholders, and the willingness of team members to change daily practice and to adapt new and innovative ways how health care can be delivered. Six Sigma incorporated as part of the "company's or hospital's culture" would be most desirable but the learning curve will be steep.

Welcome to Lotus 1-2-3 Advanced. Learning Activity Packets.

ERIC Educational Resources Information Center

Mills, Steven; And Others

This learning activity packet (LAP) contains five self-paced study lessons that allow students to study advanced concepts of Lotus 1-2-3 at their own pace. The lessons used in the LAP are organized in the following way: lesson name, lesson number, objectives, completion standard, performance standard, required materials, unit test, and exercises.…

Skylab lessons learned as applicable to a large space station, 1967-1974. Ph.D. Thesis - Catholic Univ. of Am.

NASA Technical Reports Server (NTRS)

Schneider, W. C.

1976-01-01

This report records some of the lessons learned during Skylab development. The approach taken is to list lessons which could have wide application in the development of a large space station. The lessons are amplified and explained in light of the background and experiences of the Skylab development.

Retrospective: lessons learned from the Santa Barbara project and their implications for health information exchange.

PubMed

Frohlich, Jonah; Karp, Sam; Smith, Mark D; Sujansky, Walter

2007-01-01

Despite its closure in December 2006, the Santa Barbara County Care Data Exchange helped focus national attention on the value of health information exchange (HIE). This in turn led to the federal government's plan to establish regional health information organizations (RHIOs). During its existence, the project pioneered innovative approaches, including certification of health information technology vendors, a community-wide governance model, and deployment of a peer-to-peer technical model now in wider use. RHIO efforts will benefit from the project's lessons about the need for an incremental development approach, rigorous implementation processes, early attention to privacy and liability concerns, and planning for a sustainable business model.

Patients' views of receiving lessons in the Alexander technique and an exercise prescription for managing back pain in the ATEAM trial.

PubMed

Yardley, Lucy; Dennison, Laura; Coker, Rebecca; Webley, Frances; Middleton, Karen; Barnett, Jane; Beattie, Angela; Evans, Maggie; Smith, Peter; Little, Paul

2010-04-01

Lessons in the Alexander Technique and exercise prescription proved effective for managing low back pain in primary care in a clinical trial. To understand trial participants' expectations and experiences of the Alexander Technique and exercise prescription. A questionnaire assessing attitudes to the intervention, based on the Theory of Planned Behaviour, was completed at baseline and 3-month follow-up by 183 people assigned to lessons in the Alexander Technique and 176 people assigned to exercise prescription. Semi-structured interviews to assess the beliefs contributing to attitudes to the intervention were carried out at baseline with14 people assigned to the lessons in the Alexander Technique and 16 to exercise prescription, and at follow-up with 15 members of the baseline sample. Questionnaire responses indicated that attitudes to both interventions were positive at baseline but became more positive at follow-up only in those assigned to lessons in the Alexander Technique. Thematic analysis of the interviews suggested that at follow-up many patients who had learned the Alexander Technique felt they could manage back pain better. Whereas many obstacles to exercising were reported, few barriers to learning the Alexander Technique were described, since it 'made sense', could be practiced while carrying out everyday activities or relaxing, and the teachers provided personal advice and support. Using the Alexander Technique was viewed as effective by most patients. Acceptability may have been superior to exercise because of a convincing rationale and social support and a better perceived fit with the patient's particular symptoms and lifestyle.

Lessons Learned JSC Micro-Wireless Instrumentation Systems on Space Shuttle and International Space Station CANEUS 2006

NASA Technical Reports Server (NTRS)

Studor, George

2007-01-01

A viewgraph presentation on lessons learned from NASA Johnson Space Center's micro-wireless instrumentation is shown. The topics include: 1) Background, Rationale and Vision; 2) NASA JSC/Structural Engineering Approach & History; 3) Orbiter Wing Leading Edge Impact Detection System; 4) WLEIDS Confidence and Micro-WIS Lessons Learned; and 5) Current Projects and Recommendations.

Orbiter Water Dump Nozzles Redesign Lessons Learned

NASA Technical Reports Server (NTRS)

Rotter, Hank

2017-01-01

Hank Rotter, NASA Technical Fellow for Environmental Control and Life Support System, will provide the causes and lessons learned for the two Space Shuttle Orbiter water dump icicles that formed on the side of the Orbiter. He will present the root causes and the criticality of these icicles, along with the redesign of the water dump nozzles and lessons learned during the redesign phase.

2000 Worldwide Joint Lessons Learned Conference. Forging a Future Joint Lessons Learned System. (Joint Center for Lessons Learned Special Bulletin. Volume 3, Special Issue 1, January 2001)

DTIC Science & Technology

2001-01-01

Management System (JTIMS) followed, and generated spirited discussion regarding the respective roles of JTIMS and the JLLP. The discussion concluded...waiting for the Director, Joint Staff�s signature and should be in official distribution by January 2001. An update on the Joint Training Information

Crossing the "digital divide:" implementing an electronic medical record system in a rural Kenyan health center to support clinical care and research.

PubMed

Tierney, William M; Rotich, Joseph K; Smith, Faye E; Bii, John; Einterz, Robert M; Hannan, Terry J

2002-01-01

To improve care, one must measure it. In the US, electronic medical record systems have been installed in many institutions to support health care management, quality improvement, and research. Developing countries lack such systems and thus have difficulties managing scarce resources and investigating means of improving health care delivery and outcomes. We describe the implementation and use of the first documented electronic medical record system in ambulatory care in sub-Saharan Africa. After one year, it has captured data for more than 13,000 patients making more than 26,000 visits. We present lessons learned and modifications made to this system to improve its capture of data and ability to support a comprehensive clinical care and research agenda.

Towards an organization with a memory: exploring the organizational generation of adverse events in health care.

PubMed

Smith, Denis; Toft, Brian

2005-05-01

The role of organizational factors in the generation of adverse events, and the manner in which such factors can also inhibit an organization's abilities to learn, have become important agenda items within health care. The government report 'An organization with a memory' highlighted many of the problems facing health care and suggested changes that need to be made if the sector is to learn effective lessons and prevent adverse events from occurring. This paper seeks to examine some of these organizational factors in more detail and suggests issues that managers need to consider as part of their wider strategies for the prevention and management of risk. The paper sets out five core elements that are held to be importance in shaping the manner in which the potential for risk is incubated within organizations. Although the paper focuses its attention on health care, the points made have validity across the public sector and into private sector organizations.

Developing Noticing of Reasoning through Demonstration Lessons

ERIC Educational Resources Information Center

Bragg, Leicha A.; Vale, Colleen

2014-01-01

Observation of fellow educators conducting demonstration lessons is one avenue for teachers to develop sensitivity to noticing students' reasoning. We examined teachers' noticing of children's learning behaviours in one demonstration lesson of the "Mathematical Reasoning Professional Learning Research Program" (MRPLRP). The observations…

Lessons Learned from the NASA Plum Brook Reactor Facility Decommissioning

NASA Technical Reports Server (NTRS)

2010-01-01

NASA has been conducting decommissioning activities at its PBRF for the last decade. As a result of all this work there have been several lessons learned both good and bad. This paper presents some of the more exportable lessons.

Initial impressions from the Northern California 2008 lightning siege: A report by a Wildland Fire Lessons Learned Center Information Collection Team

Treesearch

Jonetta T. Holt; David Christenson; Anne Black; Brett Fay; Kim Round

2009-01-01

This event in NorCal is another of the major events we have experienced in fire management. In line with our desire to learn, we ought to line up a team to help us capture lessons learned from this event." This statement, and a regional delegation, was the impetus for an information collection team from the Wildland Fire Lessons Learned Center to visit with...

Learning To Serve, Serving To Learn: A View from Higher Education. Integrating Service-Learning into Curriculum: Lessons Learned. Teacher Education Consortium in Service-Learning.

ERIC Educational Resources Information Center

2003

This collection of papers includes lessons learned from a 3-year collaboration among faculty who had pursued a scholarly inquiry of service-learning, integrated service-learning into their curricula, altered their teaching, forged partnerships with community based organizations, and developed measures and methodologies for assessing results. The…

Integrated health system for chronic disease management: lessons learned from France.

PubMed

Stuart, Mary; Weinrich, Michael

2004-02-01

Rated number one in overall health system performance by the World Health Organization, the French spend less than half the amount on annual health care per capita that the United States spends. One contributing factor may be the attention given to chronic care. Since the mid-1900s, the French have developed regional community-based specialty systems for patients with chronic respiratory insufficiency or failure. COPD is the major cause of respiratory failure, the fourth leading cause of death in the United States, and its prevalence is increasing. Despite the clinical success of home mechanical ventilation and the potential for cost savings, providing such services in the United States remains a challenge. Lessons from France can inform the development of cost-effective chronic care models in the United States In this article, we review the French experience in the context of the United States Supreme Court's Olmstead decision, mandating that people in "more restrictive settings" such as nursing homes be offered community-based supports. We suggest that regional demonstration projects for patients with chronic respiratory failure or insufficiency can provide an important step in the development of effective chronic care systems in the United States

Defining a risk-informed framework for whole-of-government lessons learned: A Canadian perspective.

PubMed

Friesen, Shaye K; Kelsey, Shelley; Legere, J A Jim

Lessons learned play an important role in emergency management (EM) and organizational agility. Virtually all aspects of EM can derive benefit from a lessons learned program. From major security events to exercises, exploiting and applying lessons learned and "best practices" is critical to organizational resilience and adaptiveness. A robust lessons learned process and methodology provides an evidence base with which to inform decisions, guide plans, strengthen mitigation strategies, and assist in developing tools for operations. The Canadian Safety and Security Program recently supported a project to define a comprehensive framework that would allow public safety and security partners to regularly share event response best practices, and prioritize recommendations originating from after action reviews. This framework consists of several inter-locking elements: a comprehensive literature review/environmental scan of international programs; a survey to collect data from end users and management; the development of a taxonomy for organizing and structuring information; a risk-informed methodology for selecting, prioritizing, and following through on recommendations; and standardized templates and tools for tracking recommendations and ensuring implementation. This article discusses the efforts of the project team, which provided "best practice" advice and analytical support to ensure that a systematic approach to lessons learned was taken by the federal community to improve prevention, preparedness, and response activities. It posits an approach by which one might design a systematic process for information sharing and event response coordination-an approach that will assist federal departments to institutionalize a cross-government lessons learned program.

Unintended Learning in Primary School Practical Science Lessons from Polanyi's Perspective of Intellectual Passion

ERIC Educational Resources Information Center

Park, Jisun; Song, Jinwoong; Abrahams, Ian

2016-01-01

This study explored, from the perspective of intellectual passion developed by Michael Polanyi, the unintended learning that occurred in primary practical science lessons. We use the term "unintended" learning to distinguish it from "intended" learning that appears in teachers' learning objectives. Data were collected using…

Seizing the Moment: State Lessons for Transforming Professional Learning

ERIC Educational Resources Information Center

Learning Forward, 2013

2013-01-01

Explore this first look at lessons learned through Learning Forward's ongoing initiative to develop a comprehensive system of professional learning that spans the distance from the statehouse to the classroom. This policy brief underscores the importance of a coordinated state professional learning strategy, the adoption of professional learning…

Lessons from Albion: Can Australia learn from England's approach to primary healthcare funding?

PubMed

Norman, Richard; Robinson, Suzanne

2015-01-01

As Australia struggles to meet increased demand for healthcare and contain expenditure there has been a focus on primary care and its role in demand management and keeping people out of expensive secondary care. However, with domestic policy struggling to find a suitable approach consideration of English policy could well be fruitful in the quest to strengthen and develop primary care in Australia. The purpose of this paper is to consider policy developments in England and explores these in relation to the Australian healthcare system. The authors highlight the key changes to policy that have occurred in the English healthcare system in recent years, and discuss whether they have proven successful. The authors discuss the barriers to implementing similar approaches in Australia, particularly the difference in system structure that would necessitate policy adaptation. Whilst there are differences in the structure and organisation of funding and service provision between countries, there are developments in England that are worthy of consideration from an Australian perspective. These include a focus on funding and commissioning that rewards quality not just activity and volume. As Australia sees the development of new primary care organisations that are tasked with commissioning then developments and lessons around the technical and relational aspects will be important to consider. The work highlights that Australia might consider learning from the English experience in this area and the types of incentives that may increase efficiency and quality of health service provision. This is important as it potentially gives greater certainty about those approaches most likely to yield beneficial outcomes for patients and the broader system.

Caring teaching practices in multiethnic mathematics classrooms: attending to health and well-being

NASA Astrophysics Data System (ADS)

Averill, Robin

2012-06-01

Factors that contribute to strong teacher-student relationships are vital to understand because of the influence these relationships have on achievement and motivation, particularly for minority group students. This article draws from a substantial quantity of empirical data, grounded in a wide theoretical and cultural base, regarding aspects of caring teacher practice to discuss mathematics teacher behaviours in relation to an existing model of health and well-being that encompasses cognitive, social, spiritual, and physical dimensions. Drawing from 100 Year 10 mathematics lesson observations involving six teachers and their classes across three urban schools, evidence emerged that for many indigenous (Māori), New Zealand Pacific, and New Zealand European students, caring teacher behaviours important for student engagement and achievement both include, and range beyond, traditional teaching practices. Examples include capitalising on student reactions and shared endeavours within the context of mathematics learning, expecting mathematical progress, showing respect for students and for their mathematics learning, being explicit about practice and expectations, incorporating one-to-one interactions, making opportunities within mathematics learning for sharing personal identities, and incorporating movement. This research illustrates how mathematics educators can attend to the specific and holistic mathematical learning needs of their students, including those often marginalised.

Development and Implementation of Culturally Tailored Offline Mobile Health Surveys.

PubMed

McIntosh, Scott; Pérez-Ramos, José; Demment, Margaret M; Vélez Vega, Carmen; Avendaño, Esteban; Ossip, Deborah J; Dye, Timothy D

2016-06-02

In low and middle income countries (LMICs), and other areas with low resources and unreliable access to the Internet, understanding the emerging best practices for the implementation of new mobile health (mHealth) technologies is needed for efficient and secure data management and for informing public health researchers. Innovations in mHealth technology can improve on previous methods, and dissemination of project development details and lessons learned during implementation are needed to provide lessons learned to stakeholders in both the United States and LMIC settings. The aims of this paper are to share implementation strategies and lessons learned from the development and implementation stages of two survey research projects using offline mobile technology, and to inform and prepare public health researchers and practitioners to implement new mobile technologies in survey research projects in LMICs. In 2015, two survey research projects were developed and piloted in Puerto Rico and pre-tested in Costa Rica to collect face-to-face data, get formative evaluation feedback, and to test the feasibility of an offline mobile data collection process. Fieldwork in each setting involved survey development, back translation with cultural tailoring, ethical review and approvals, data collector training, and piloting survey implementation on mobile tablets. Critical processes and workflows for survey research projects in low resource settings were identified and implemented. This included developing a secure mobile data platform tailored to each survey, establishing user accessibility, and training and eliciting feedback from data collectors and on-site LMIC project partners. Formative and process evaluation strategies are necessary and useful for the development and implementation of survey research projects using emerging mHealth technologies in LMICs and other low resource settings. Lessons learned include: (1) plan institutional review board (IRB) approvals in multiple countries carefully to allow for development, implementation, and feedback, (2) in addition to testing the content of survey instruments, allow time and consideration for testing the use of novel mHealth technology (hardware and software), (3) incorporate training for and feedback from project staff, LMIC partner staff, and research participants, and (4) change methods accordingly, including content, as mHealth technology usage influences and is influenced by the content and structure of the survey instrument. Lessons learned from early phases of LMIC research projects using emerging mHealth technologies are critical for informing subsequent research methods and study designs.

Planning and scheduling lessons learned study, executive summary

NASA Technical Reports Server (NTRS)

Robinson, Toni

1990-01-01

The study was performed to document the lessons on planning and scheduling activities for a number of missions and institutional facilities in such a way that they can be applied to future missions; to provide recommendations to both projects and Code 500 that will improve the end-to-end planning and scheduling process; and to identify what, if any, mission characteristics might be related to certain lessons learned. The results are a series of recommendations of both a managerial and technical nature related to the underlying lessons learned.

Providing Community Education: Lessons Learned from Native Patient Navigators

PubMed Central

Burhansstipanov, Linda; Krebs, Linda U.; Harjo, Lisa; Watanabe-Galloway, Shinobu; Pingatore, Noel; Isham, Debra; Duran, Florence Tinka; Denny, Loretta; Lindstrom, Denise; Crawford, Kim

2014-01-01

Native Navigators and the Cancer Continuum (NNACC) was a community-based participatory research study among five American Indian organizations. The intervention required lay Native Patient Navigators (NPNs) to implement and evaluate community education workshops in their local settings. Community education was a new role for the NPNs and resulted in many lessons learned. NPNs met quarterly from 2008 through 2013 and shared lessons learned with one another and with the administrative team. In July 2012, the NPNs prioritized lessons learned throughout the study that were specific to implementing the education intervention. These were shared to help other navigators who may be including community education within their scope of work. The NPNs identified eight lessons learned that can be divided into three categories: NPN education and training, workshop content and presentation, and workshop logistics and problem-solving. A ninth overarching lesson for the entire NNACC study identified meeting community needs as an avenue for success. This project was successful due to the diligence of the NPNs in understanding their communities’ needs and striving to meet them through education workshops. Nine lessons were identified by the NPNs who provided community education through the NNACC project. Most are relevant to all patient navigators, regardless of patient population, who are incorporating public education into navigation services. Due to their intervention and budget implications, many of these lessons also are relevant to those who are developing navigation research. PMID:25087698

Coping with Multiple Suicides among Middle School Students. Lessons Learned from School Crises and Emergencies. Volume 2, Issue 2

ERIC Educational Resources Information Center

US Department of Education, 2007

2007-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue addresses the experience of a school district where three middle school students hung themselves within a three-week timeframe. Although deaths were apparently unconnected, the school district is part of a…

Managing an Infectious Disease Outbreak in a School. Lessons Learned from School Crises and Emergencies. Volume 2, Issue 3

ERIC Educational Resources Information Center

US Department of Education, 2007

2007-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on an infectious disease incident, which resulted in the death of a student, closure of area schools and the operation of an on-site school vaccine clinic. The report highlights the critical need…

Learning with and about Advertising in Chemistry Education with a Lesson Plan on Natural Cosmetics--A Case Study

ERIC Educational Resources Information Center

Belova, Nadja; Eilks, Ingo

2015-01-01

This paper describes a case study on the chemistry behind natural cosmetics in five chemistry learning groups (grades 7-11, age range 13-17) in a German comprehensive school. The lesson plan intends to promote critical media literacy in the chemistry classroom and specifically emphasizes learning with and about advertising. The lessons of four…

Real-Time Meteorological Battlespace Characterization in Support of Sea Power 21

DTIC Science & Technology

2011-02-04

32  5.3  LESSONS LEARNED ....................................................................................... 44  6.  FUTURE WORK...problem with the SWR alignment, which is sometimes re- set during SWR maintenance (see Section 6 ‘Lessons Learned ’ for a case in point). Fig...ground clutter present (discussed in Section 6 ‘Lessons Learned ’), along with the lowest-tilt, quality controlled velocity. Bottom panel shows the

Interprofessional transformation of clinical education: The first six years of the Veterans Affairs Centers of Excellence in Primary Care Education.

PubMed

Harada, Nancy D; Traylor, Laural; Rugen, Kathryn Wirtz; Bowen, Judith L; Smith, C Scott; Felker, Bradford; Ludke, Deborah; Tonnu-Mihara, Ivy; Ruberg, Joshua L; Adler, Jayson; Uhl, Kimberly; Gardner, Annette L; Gilman, Stuart C

2018-02-20

This paper describes the Centers of Excellence in Primary Care Education (CoEPCE), a seven-site collaborative project funded by the Office of Academic Affiliations (OAA) within the Veterans Health Administration of the United States Department of Veterans Affairs (VA). The CoEPCE was established to fulfill OAA's vision of large-scale transformation of the clinical learning environment within VA primary care settings. This was accomplished by funding new Centers within VA facilities to develop models of interprofessional education (IPE) to teach health professions trainees to deliver high quality interprofessional team-based primary care to Veterans. Using reports and data collected and maintained by the National Coordinating Center over the first six years of the project, we describe program inputs, the multicomponent intervention, activities undertaken to develop the intervention, and short-term outcomes. The findings have implications for lessons learned that can be considered by others seeking large-scale transformation of education within the clinical workplace and the development of interprofessional clinical learning environments. Within the VA, the CoEPCE has laid the foundation for IPE and collaborative practice, but much work remains to disseminate this work throughout the national VA system.

E-learning in a virtual science camp for urban youth

PubMed Central

Holden, Lynne; Morrison, Andrew; Berger, Wallace; Siegel, Elliot

2014-01-01

The Virtual Science Camp (VSC) is a unique demonstration of synchronous e-learning developed by Mentoring in Medicine (MIM). This paper reports on a pilot offering during the summer of 2012 that taught advanced biological concepts, healthy living and health care career opportunities to medically underserved urban youth. Livestream’s interactive video technology was used to engage a diverse audience of mostly high school students at remote sites in a new two week instructional program that provided custom course content free of charge over the internet. We describe the technical and program preparations undertaken, their implementation, the IT environment, a multi-faceted evaluation plan, the results of the experiment, and lessons learned. PMID:24733956

Effects of Providing a Rationale for Learning a Lesson on Students' Motivation and Learning in Online Learning Environments

ERIC Educational Resources Information Center

Shin, Tae Seob

2010-01-01

This study examined whether providing a rationale for learning a particular lesson influences students' motivation and learning in online learning environments. A mixed-method design was used to investigate the effects of two types of rationales (former student vs. instructor rationales) presented in an online introductory educational psychology…

University Educators' Instructional Choices and Their Learning Styles within a Lesson Framework

ERIC Educational Resources Information Center

Mazo, Lucille B.

2017-01-01

Research on learning styles often focuses on the learning style of the student; however, the learning style of the educator may affect instructional choices and student learning. Few studies have addressed the lack of knowledge that exists in universities with respect to educators' learning styles and a lesson framework (development, delivery, and…

The Value of Indirect Teaching Strategies in Enhancing Student-Coaches’ Learning Engagement

PubMed Central

Mesquita, Isabel; Coutinho, Patrícia; De Martin-Silva, Luciana; Parente, Bruno; Faria, Mário; Afonso, José

2015-01-01

This study aimed to examine the indirect teaching strategies adopted by a coach educator in terms of promoting student-coaches’ engagement in a positive and active learning environment. The participants were an expert coach educator and seven student-coaches from an academic coaching setting. A mix method approach was used to collect data. Whilst video-recording and participant observations were used to collect data from the lessons, focus groups were adopted to recall the perceptions of student-coaches. The results showed that indirect teaching strategies (i.e., asking questions, showing signs of autonomy by monitoring the pace at which they completed tasks and actively engaging in the search for solutions to tasks) implemented by the coach educator promoted a supportive and challenging learning environment which, in turn, encouraged student-coaches to be more actively involved in the lessons. Additionally, the affective aspects of the relationship established with student-coaches (tone of voice, gestures, facial expressions, eye contact, physical contact and humor) led them to feel confident in exposing their doubts and opinions, and in learning in a more autonomous manner. Moreover, the practical lessons proved to be crucial in helping student-coaches to reach broader and deeper forms of understanding by allowing the application of theory to coaching practice. In conclusion, this study reinforces the value of indirect teaching strategies to stimulate an active learning environment. It further highlights the value of practical learning environments to better prepare neophyte coaches for dealing with the complex and dynamic nature of their professional reality. Key points Both instructional and affective teaching indirect strategies used by the coach educator promoted a positive and challenging learning environment to student-coaches. The directness profile used by this coach educator (questioning, giving autonomy for problem solving and responsibility to regulate the learning tasks development) promoted the awareness and the ability of student-coaches to explore alternative solutions and self-regulate their own learning. Using humor, touch, gestures and tone of voice, the coach educator showed great care for student-coaches, which impacted positively on their enthusiasm, confidence and desire to be actively engaged in their own learning. PMID:26336354

The politics of comparative effectiveness research: lessons from recent history.

PubMed

Sorenson, Corinna; Gusmano, Michael K; Oliver, Adam

2014-02-01

Efforts to support and use comparative effectiveness research (CER), some more successful than others, have been promulgated at various times over the last forty years. Following a resurgence of interest in CER, recent health care reforms provided substantial support to strengthen its role in US health care. While CER has generally captured bipartisan support, detractors have raised concerns that it will be used to ration services and heighten government control over health care. Such concerns almost derailed the initiative during passage of the health care reform legislation and are still present today. Given recent investments in CER and the debates surrounding its development, the time is ripe to reflect on past efforts to introduce CER in the United States. This article examines previous initiatives, highlighting their prescribed role in US health care, the reasons for their success or failure, and the political lessons learned. Current CER initiatives have corrected for many of the pitfalls experienced by previous efforts. However, past experiences point to a number of issues that must still be addressed to ensure the long-term success and sustainability of CER, including adopting realistic aims about its impact, demonstrating the impact of Patient-Centered Outcomes Research Institute (PCORI) and communicating the benefits of CER, and maintaining strong political and stakeholder support.

Use of after action reports (AARs) to promote organizational and systems learning in emergency preparedness.

PubMed

Savoia, Elena; Agboola, Foluso; Biddinger, Paul D

2012-08-01

Many public health and healthcare organizations use formal knowledge management practices to identify and disseminate the experiences gained over time. The "lessons-learned" approach is one such example of knowledge management practice applied to the wider concept of organizational learning. In the field of emergency preparedness, the lessons-learned approach stands on the assumption that learning from experience improves practice and minimizes avoidable deaths and negative economic and social consequences of disasters. In this project, we performed a structured review of AARs to analyze how lessons learned from the response to real-incidents may be used to maximize knowledge management and quality improvement practices such as the design of public health emergency preparedness (PHEP) exercises. We chose as a source of data the "Lessons Learned Information Sharing (LLIS.gov)" system, a joined program of the U.S. Department of Homeland Security DHS and FEMA that serves as the national, online repository of lessons learned, best practices, and innovative ideas. We identified recurring challenges reported by various states and local public health agencies in the response to different types of incidents. We also strove to identify the limitations of systematic learning that can be achieved due to existing weaknesses in the way AARs are developed.

Caring for the caregivers and patients left behind: experiences of a volunteer nurse during Hurricane Katrina.

PubMed

Leiby, Sandra L

2008-03-01

As a volunteer nurse deployed to New Orleans after Hurricane Katrina, the author observed the need for honest and informative leadership, for volunteer flexibility and an "I'll-do-anything" mind-set, and for more advanced disaster training. This article describes the author's experiences and highlights how she learned those lessons. She advocates learning from the experiences of responders to recent national and international relief efforts to ensure the organizational and personal preparedness needed to deal with the complex ethical, moral, legal, and medical issues during a disaster.

Multimedia Principle in Teaching Lessons

ERIC Educational Resources Information Center

Kari Jabbour, Khayrazad

2012-01-01

Multimedia learning principle occurs when we create mental representations from combining text and relevant graphics into lessons. This article discusses the learning advantages that result from adding multimedia learning principle into instructions; and how to select graphics that support learning. There is a balance that instructional designers…

Lessons learned and their application to program development and cultural issues

NASA Technical Reports Server (NTRS)

Roth, Gilbert L.

1991-01-01

The main objectives of space product assurance are, in effect, the same as those of Total Quality Management (TQM) or its many variants. The most significant ingredients are the lessons learned and their application to ongoing and future programs as they are affected by changes in the cultural environment. The cultural issues which affect almost everything done in technical programs and projects are considered. Understanding the lessons learned and the synergism which results from this combination of knowledge, culture, and lessons learned is identified as crucial. A brief discussion of the closed loop linkage that should exist between the world of hands on activities and that of educational institutions is presented.

Lessons learned from the Space Flyer Unit (SFU) mission.

PubMed

Kuriki, Kyoichi; Ninomiya, Keiken; Takei, Mitsuru; Matsuoka, Shinobu

2002-11-01

The Space Flyer Unit (SFU) system and mission chronology are briefly introduced. Lessons learned from the SFU mission are categorized as programmatic and engineering lessons. In the programmatic category are dealt with both international and domestic collaborations. As for the engineering lessons safety design, orbital operation, in-flight anomaly, and post flight analyses are the major topics reviewed. c2002 Elsevier Science Ltd. All rights reserved.

Lessons from the Institute for New Heads (INH) Class of 2006: Ten Headships--134 Years of Hard-Earned Experience

ERIC Educational Resources Information Center

Raphel, Annette; Huber, John; Chandler, Carolyn; Vorenberg, Amy; Jones-Wilkins, Andy; Devey, Mark A.; Holford, Josie; Craig, Ian; Elam, Julie

2016-01-01

Ten years ago in July 2006, 64 mostly starry-eyed men and women attended the NAIS Institute for New Heads (INH) in order to learn the ropes of headship. These newly minted heads were filled with enthusiasm, commitment, and passion, along with humility and a bit of healthy trepidation. One core group connected under the careful guidance of…

Rural hospital information technology implementation for safety and quality improvement: lessons learned.

PubMed

Tietze, Mari F; Williams, Josie; Galimbertti, Marisa

2009-01-01

This grant involved a hospital collaborative for excellence using information technology over 3-year period. The project activities focused on the improvement of patient care safety and quality in Southern rural and small community hospitals through the use of technology and education. The technology component of the design involved the implementation of a Web-based business analytic tool that allows hospitals to view data, create reports, and analyze their safety and quality data. Through a preimplementation and postimplementation comparative design, the focus of the implementation team was twofold: to recruit participant hospitals and to implement the technology at each of the 66 hospital sites. Rural hospitals were defined as acute care hospitals located in a county with a population of less than 100 000 or a state-administered Critical Access Hospital, making the total study population target 188 hospitals. Lessons learned during the information technology implementation of these hospitals are reflective of the unique culture, financial characteristics, organizational structure, and technology architecture of rural hospitals. Specific steps such as recruitment, information technology assessment, conference calls for project planning, data file extraction and transfer, technology training, use of e-mail, use of telephones, personnel management, and engaging information technology vendors were found to vary greatly among hospitals.

Massive pediatric neurosurgical injuries and lessons learned following a tornado disaster in Alabama.

PubMed

Chern, Joshua J; Miller, Joseph H; Tubbs, R Shane; Whisenhunt, Thomas R; Johnston, James M; Wellons, John C; Rozzelle, Curtis J; Blount, Jeffrey P; Oakes, W Jerry

2011-12-01

A large volume of patients presented to a Level I pediatric trauma center during and after a recent tornado disaster. Injuries of the central and peripheral nervous systems and the medical responses of a pediatric neurosurgical team are reviewed. The clinical courses of patients who suffered cranial, spinal, and peripheral nerve injuries due to the tornado storm are reported. The clinical actions taken by the neurosurgical team during and after the event are reviewed and the lessons learned are discussed. The tornado storm system moved through the Tuscaloosa and Birmingham metropolitan areas on the early evening hours of April 27, 2011. Twenty-four patients received care from the neurosurgical team. A total of 11 cranial (including placement of an external ventricular drain), 2 spine, and 2 peripheral procedures were performed for the victims. Nine procedures were performed within the first 12 hours of the event, and an additional 6 surgeries were performed in the following 24 hours. Injuries of the peripheral nervous system often presented in a delayed fashion. Several key components were identified that enabled adequate neurosurgical care for a large influx of acute patients. Massive casualties due to tornados are rare. A well-organized physician team working with the hospital administration may decrease the mortality and morbidity of such events.

Structure and management of tuberculosis control programs in fragile states--Afghanistan, DR Congo, Haiti, Somalia.

PubMed

Mauch, Verena; Weil, Diana; Munim, Aayid; Boillot, Francois; Coninx, Rudi; Huseynova, Sevil; Powell, Clydette; Seita, Akihiro; Wembanyama, Henriette; van den Hof, Susan

2010-07-01

Health care delivery is particularly problematic in fragile states often connected with increased incidence of communicable diseases, among them tuberculosis. This article draws upon experiences in tuberculosis control in four fragile states from which four lessons learned were derived. A structured inventory to extract common themes specific for TB control in fragile states was conducted among twelve providers of technical assistance who have worked in fragile states. The themes were applied to the TB control programs of Afghanistan, DR Congo, Haiti and Somalia during the years 2000-2006. Case notifications and treatment outcomes have increased in all four countries since 2003 (treatment success rates 81-90%). Access to care and case detection however have remained insufficient (case detection rates 39-62%); There are four lessons learned: 1. TB control programs can function in fragile states. 2. National program leadership and stewardship are essential for quality and sustained TB control. 3. Partnerships with non-governmental providers are vital for continuous service delivery; 4. TB control programs in fragile states require consistent donor support. Despite challenges in management, coordination, security, logistics and funding, TB control programs can function in fragile states, but face considerable problems in access to diagnosis and treatment and therefore case detection. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

The Keys to Governance and Stakeholder Engagement: The Southeast Michigan Beacon Community Case Study

PubMed Central

Des Jardins, Terrisca R.

2014-01-01

Community-based health information exchanges (HIEs) and efforts to consolidate and house data are growing, given the advent of Accountable Care Organizations (ACOs) under the Affordable Care Act and other similar population health focused initiatives. The Southeast Michigan Beacon Community (SEMBC) can be looked to as one case study that offers lessons learned, insights on challenges faced and accompanying workarounds related to governance and stakeholder engagement. The SEMBC case study employs an established Data Warehouse Governance Framework to identify and explain the necessary governance and stakeholder engagement components, particularly as they relate to community-wide data sharing and data warehouses or repositories. Perhaps the biggest lesson learned through the SEMBC experience is that community-based work is hard. It requires a great deal of community leadership, collaboration and resources. SEMBC found that organizational structure and guiding principles needed to be continually revisited and nurtured in order to build the relationships and trust needed among stakeholder organizations. SEMBC also found that risks and risk mitigation tactics presented challenges and opportunities at the outset and through the duration of the three year pilot period. Other communities across the country embarking on similar efforts need to consider realistic expectations about community data sharing infrastructures and the accompanying and necessary governance and stakeholder engagement fundamentals. PMID:25848612

Undertaking the first online sexuality survey among private university students in Lebanon – Process, challenges, and lessons learned.

PubMed

Yasmine, Rola; Ghandour, Lilian; El Kak, Faysal

2016-01-01

The taboo surrounding reproductive and sexual health in the Middle East and North African (MENA) region, specifically among unmarried youth, has resulted in an incomplete and inaccurate documentation of the status of youth sexual and reproductive health (SRH). Documenting regional research processes and successes can support SRH researchers in promoting evidence-based services and local policies. This paper describes the process, challenges and lessons learned during the first online research study in the MENA to assess university students’ sexual practices, values and perceptions. An online survey was completed by 2,182 university students attending the 4th largest private university in Lebanon. An online SRH survey among Arab youth must be carefully developed with the cultural context and its prevailing issues in mind. Careful attention must be paid to any translation process specifically regarding tone and choice of certain sexual terms. The online program/software must be thoroughly piloted for possible technical flaws, language support, and web browser compatibility. Inter-disciplinary collaboration between the research team, IT and IRB offices is crucial in order to conduct an ethicallyappropriate technically-functional online survey. Online survey methods hold great promise for surveying SRH and other sensitive topics in Lebanon and the MENA.

Workplace Wisdom: What Educators Can Learn from the Business World

ERIC Educational Resources Information Center

Williams, Sheri S.; Williams, John W.

2014-01-01

In many schools and businesses today, the pressure to produce results is far greater than attention to employee learning. If continued learning impacts service for business customers and their communities, then what lessons can be learned from business to support and advocate for educator learning? This article is a collection of lessons learned…

Logistics Lessons Learned in NASA Space Flight

NASA Technical Reports Server (NTRS)

Evans, William A.; DeWeck, Olivier; Laufer, Deanna; Shull, Sarah

2006-01-01

The Vision for Space Exploration sets out a number of goals, involving both strategic and tactical objectives. These include returning the Space Shuttle to flight, completing the International Space Station, and conducting human expeditions to the Moon by 2020. Each of these goals has profound logistics implications. In the consideration of these objectives,a need for a study on NASA logistics lessons learned was recognized. The study endeavors to identify both needs for space exploration and challenges in the development of past logistics architectures, as well as in the design of space systems. This study may also be appropriately applied as guidance in the development of an integrated logistics architecture for future human missions to the Moon and Mars. This report first summarizes current logistics practices for the Space Shuttle Program (SSP) and the International Space Station (ISS) and examines the practices of manifesting, stowage, inventory tracking, waste disposal, and return logistics. The key findings of this examination are that while the current practices do have many positive aspects, there are also several shortcomings. These shortcomings include a high-level of excess complexity, redundancy of information/lack of a common database, and a large human-in-the-loop component. Later sections of this report describe the methodology and results of our work to systematically gather logistics lessons learned from past and current human spaceflight programs as well as validating these lessons through a survey of the opinions of current space logisticians. To consider the perspectives on logistics lessons, we searched several sources within NASA, including organizations with direct and indirect connections with the system flow in mission planning. We utilized crew debriefs, the John Commonsense lessons repository for the JSC Mission Operations Directorate, and the Skylab Lessons Learned. Additionally, we searched the public version of the Lessons Learned Information System (LLIS) and verified that we received the same result using the internal version of LLIS for our logistics lesson searches. In conducting the research, information from multiple databases was consolidated into a single spreadsheet of 300 lessons learned. Keywords were applied for the purpose of sorting and evaluation. Once the lessons had been compiled, an analysis of the resulting data was performed, first sorting it by keyword, then finding duplication and root cause, and finally sorting by root cause. The data was then distilled into the top 7 lessons learned across programs, centers, and activities.

Best Practices for Effective Clinical Partnerships with Indigenous Populations of North America (American Indian, Alaska Native, First Nations, Métis, and Inuit).

PubMed

Haozous, Emily A; Neher, Charles

2015-09-01

This article presents a review of the literature to identify best practices for clinical partnerships with indigenous populations of North America, specifically American Indian/Alaska Native, First Nations, Métis, and Inuit of Canada. The authors have identified best practices and lessons learned from collaborating with indigenous populations, presented in 2 categories: conceptual guidelines and health care delivery guidelines. Major themes include the importance of trust and communication, the delivery of culturally congruent health care, and the necessity of working in partnership with tribal entities for successful delivery of health care. Best practices in health care delivery with indigenous populations are presented. Copyright © 2015 Elsevier Inc. All rights reserved.

D-ATM, a working example of health care interoperability: From dirt path to gravel road.

PubMed

DeClaris, John-William

2009-01-01

For many years, there have been calls for interoperability within health care systems. The technology currently exists and is being used in business areas like banking and commerce, to name a few. Yet the question remains, why has interoperability not been achieved in health care? This paper examines issues encountered and success achieved with interoperability during the development of the Digital Access To Medication (D-ATM) project, sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). D-ATM is the first government funded interoperable patient management system. The goal of this paper is to provide lessons learned and propose one possible road map for health care interoperability within private industry and how government can help.

A survival strategy for an academic psychiatry department in a managed care environment.

PubMed

Harris, E S; Neufeld, J; Hales, R E; Hilty, D

2001-12-01

The changing economics of medical practice have had a profound effect on the educational, research, and service missions of academic departments of psychiatry across the country. The authors describe the development of a managed behavioral health care organization in their parent academic health system as a survival strategy for allowing their department to function in a managed care environment. They present a series of lessons learned in this effort to adapt to a highly volatile managed behavioral health care market: know how you fit into your market as well as your institution, form cooperative alliances within and outside of your institution, provide incentives to manage risk, focus on core competencies, innovate in your areas of strength, and collect data.

Atmospheric/Space Environment Support Lessons Learned Regarding Aerospace Vehicle Design and Operations

NASA Technical Reports Server (NTRS)

Vaughan, William W.; Anderson, B. Jeffrey

2005-01-01

In modern government and aerospace industry institutions the necessity of controlling current year costs often leads to high mobility in the technical workforce, "one-deep" technical capabilities, and minimal mentoring for young engineers. Thus, formal recording, use, and teaching of lessons learned are especially important in the maintenance and improvement of current knowledge and development of new technologies, regardless of the discipline area. Within the NASA Technical Standards Program Website http://standards.nasa.gov there is a menu item entitled "Lessons Learned/Best Practices". It contains links to a large number of engineering and technical disciplines related data sets that contain a wealth of lessons learned information based on past experiences. This paper has provided a small sample of lessons learned relative to the atmospheric and space environment. There are many more whose subsequent applications have improved our knowledge of the atmosphere and space environment, and the application of this knowledge to the engineering and operations for a variety of aerospace programs.

Lessons learned: design, start-up, and operation of cryogenic systems

NASA Astrophysics Data System (ADS)

Bell, W. M.; Bagley, R. E.; Motew, S.; Young, P.-W.

2014-11-01

Cryogenic systems involving a pumped cryogenic fluid, such as liquid nitrogen (LN2), require careful design since the cryogen is close to its boiling point and cold. At 1 atmosphere, LN2 boils at 77.4 K (-320.4 F). These systems, typically, are designed to transport the cryogen, use it for process heat removal, or for generation of gas (GN2) for process use. As the design progresses, it is important to consider all aspects of the design including, cryogen storage, pressure control and safety relief systems, thermodynamic conditions, equipment and instrument selection, materials, insulation, cooldown, pump start-up, maximum design and minimum flow rates, two phase flow conditions, heat flow, process control to meet and maintain operating conditions, piping integrity, piping loads on served equipment, warm-up, venting, and shut-down. "Cutting corners" in the design process can result in stalled start-ups, field rework, schedule hits, or operational restrictions. Some of these "lessoned learned" are described in this paper.

Challenges, Strategies and Lessons Learned from a Participatory Community Intervention Study to Promote Female Condoms among Rural Sex Workers in Southern China

PubMed Central

Weeks, Margaret R.; Liao, Susu; Li, Fei; Li, Jianghong; Dunn, Jennifer; He, Bin; He, Qiya; Feng, Weiping; Wang, Yanhong

2010-01-01

China faces a rapidly emerging HIV epidemic and nation wide resurgence of sexually transmitted infections associated with a growing sex industry. Community empowerment and capacity building through community-based participatory research partnerships show promise for developing, testing, and refining multilevel interventions suited to the local context that are effective and appropriate to address these concerns. However, such efforts are fraught with challenges, both for community collaborators and for researchers. We have built an international team of scientists from Beijing and the U.S. and collaborating health policy makers, health educators and care providers from Hainan and Guangxi Province CDCs and the local counties and towns where we are conducting our study. This team is in the process of testing a community wide, multi-level intervention to promote female condoms and other HIV prevention within sex-work establishments. This article presents lessons learned from our experiences in the first two study sites of this intervention trial. PMID:20528132

Collaboration Strategies in Nontraditional Community-Based Participatory Research Partnerships: Lessons From an Academic–Community Partnership With Autistic Self-Advocates

PubMed Central

Nicolaidis, Christina; Raymaker, Dora; McDonald, Katherine; Dern, Sebastian; Ashkenazy, Elesia; Boisclair, Cody; Robertson, Scott; Baggs, Amanda

2012-01-01

Background Most community-based participatory research (CBPR) projects involve local communities defined by race, ethnicity, geography, or occupation. Autistic self-advocates, a geographically dispersed community defined by disability, experience issues in research similar to those expressed by more traditional minorities. Objectives We sought to build an academic–community partnership that uses CBPR to improve the lives of people on the autistic spectrum. Methods The Academic Autistic Spectrum Partnership in Research and Education (AASPIRE) includes representatives from academic, self-advocate, family, and professional communities. We are currently conducting several studies about the health care experiences and well-being of autistic adults. Lessons Learned We have learned a number of strategies that integrate technology and process to successfully equalize power and accommodate diverse communication and collaboration needs. Conclusions CBPR can be conducted successfully with autistic self-advocates. Our strategies may be useful to other CBPR partnerships, especially ones that cannot meet in person or that include people with diverse communication needs. PMID:21623016

Influencing organisational change in the NHS: lessons learned from workplace wellness initiatives in practice.

PubMed

Blake, Holly; Lloyd, Scott

2008-01-01

This article presents a discussion of the key issues in influencing organisational change in NHS settings, in the development of workplace wellness interventions to improve employee health and wellbeing. To tackle poor public health and associated rising healthcare costs, there must be a focus on the root cause of many preventable diseases - unhealthy lifestyle choices. Workplace wellness initiatives are now an important prevention strategy adopted by socially responsible organisations to target the health and wellbeing of working age adults. Lessons learned from initiatives in secondary care suggest that effective implementation requires change in organisational 'health culture', through a combination of education, behaviour change intervention, needs-based facilities, and services and strategies for developing supportive and health-promoting work environments. Most of all, employers must demonstrate a commitment to health and wellness that is fully integrated with their mission, values and long-term vision, paving the way for sustainable lifestyle changes. Evaluation systems must be in place to measure the impact and outcomes of wellness schemes.

Mentorship and coaching to support strengthening healthcare systems: lessons learned across the five Population Health Implementation and Training partnership projects in sub-Saharan Africa.

PubMed

Manzi, Anatole; Hirschhorn, Lisa R; Sherr, Kenneth; Chirwa, Cindy; Baynes, Colin; Awoonor-Williams, John Koku

2017-12-21

Despite global efforts to increase health workforce capacity through training and guidelines, challenges remain in bridging the gap between knowledge and quality clinical practice and addressing health system deficiencies preventing health workers from providing high quality care. In many developing countries, supervision activities focus on data collection, auditing and report completion rather than catalyzing learning and supporting system quality improvement. To address this gap, mentorship and coaching interventions were implemented in projects in five African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) as components of health systems strengthening (HSS) strategies funded through the Doris Duke Charitable Foundation's African Health Initiative. We report on lessons learned from a cross-country evaluation. The evaluation was designed based on a conceptual model derived from the project-specific interventions. Semi-structured interviews were administered to key informants to capture data in six categories: 1) mentorship and coaching goals, 2) selection and training of mentors and coaches, 3) integration with the existing systems, 4) monitoring and evaluation, 5) reported outcomes, and 6) challenges and successes. A review of project-published articles and technical reports from the individual projects supplemented interview information. Although there was heterogeneity in the approaches to mentorship and coaching and targeted areas of the country projects, all led to improvements in core health system areas, including quality of clinical care, data-driven decision making, leadership and accountability, and staff satisfaction. Adaptation of approaches to reflect local context encouraged their adoption and improved their effectiveness and sustainability. We found that incorporating mentorship and coaching activities into HSS strategies was associated with improvements in quality of care and health systems, and mentorship and coaching represents an important component of HSS activities designed to improve not just coverage, but even further effective coverage, in achieving Universal Health Care.

Apollo 1 Lessons Learned Show

NASA Image and Video Library

2017-01-27

Mike Ciannilli, at left, the Apollo, Challenger, Columbia Lessons Learned Program manager, presents a certificate to John Tribe, retired, Apollo 1 Reaction and Control System lead engineer, during the Apollo 1 Lessons Learned presentation in the Training Auditorium at NASA's Kennedy Space Center in Florida. The theme of the program was "To there and Back Again." The event helped pay tribute to the Apollo 1 crew, Gus Grissom, Ed White II, and Roger Chaffee.

Apollo 1 Lessons Learned Show

NASA Image and Video Library

2017-01-27

Mike Ciannilli, the Apollo, Challenger, Columbia Lessons Learned program manager, at left, presents a certificate to Ernie Reyes, retired, former Apollo 1 senior operations manager, during the Apollo 1 Lessons Learned presentation in the Training Auditorium at NASA's Kennedy Space Center in Florida. The theme of the program was "To there and Back Again." The event helped pay tribute to the Apollo 1 crew, Gus Grissom, Ed White II, and Roger Chaffee.

Responding To and Recovering From an Active Shooter Incident That Turns Into a Hostage Situation. Lessons Learned From School Crises and Emergencies, Volume 2, Issue 6, 2007

ERIC Educational Resources Information Center

US Department of Education, 2007

2007-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on an active shooter situation that escalated to a hostage situation that required multiple law enforcement agencies and other first responders and agencies to coordinate response and recovery…

Responding To Infectious Disease: Multiple Cases of Staph Infections in a Rural School District. Lessons Learned From School Crises and Emergencies, Volume 3, Issue 3, 2008

ERIC Educational Resources Information Center

US Department of Education, 2008

2008-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on an incident involving several cases of Methicillin-resistant Staphylococcus aureus (MRSA) at a rural high school. MRSA is a specific strain of Staphylococcus aureus bacteria (often called staph)…

Safety and Mission Assurance for In-House Design Lessons Learned from Ares I Upper Stage

NASA Technical Reports Server (NTRS)

Anderson, Joel M.

2011-01-01

This viewgraph presentation identifies lessons learned in the course of the Ares I Upper Stage design and in-house development effort. The contents include: 1) Constellation Organization; 2) Upper Stage Organization; 3) Presentation Structure; 4) Lesson-Importance of Systems Engineering/Integration; 5) Lesson-Importance of Early S&MA Involvement; 6) Lesson-Importance of Appropriate Staffing Levels; 7) Lesson-Importance S&MA Team Deployment; 8) Lesson-Understanding of S&MA In-Line Engineering versus Assurance; 9) Lesson-Importance of Close Coordination between Supportability and Reliability/Maintainability; 10) Lesson-Importance of Engineering Data Systems; 11) Lesson-Importance of Early Development of Supporting Databases; 12) Lesson-Importance of Coordination with Safety Assessment/Review Panels; 13) Lesson-Implementation of Software Reliability; 14) Lesson-Implementation of S&MA Technical Authority/Chief S&MA Officer; 15) Lesson-Importance of S&MA Evaluation of Project Risks; 16) Lesson-Implementation of Critical Items List and Government Mandatory Inspections; 17) Lesson-Implementation of Critical Items List Mandatory Inspections; 18) Lesson-Implementation of Test Article Safety Analysis; and 19) Lesson-Importance of Procurement Quality.

Kinesthetic Astronomy: Significant Upgrades to the Sky Time Lesson that Support Student Learning

NASA Astrophysics Data System (ADS)

Morrow, C. A.; Zawaski, M.

2004-12-01

This paper will report on a significant upgrade to the first in a series of innovative, experiential lessons we call Kinesthetic Astronomy. The Sky Time lesson reconnects students with the astronomical meaning of the day, year, and seasons. Like all Kinesthetic Astronomy lessons, it teaches basic astronomical concepts through choreographed bodily movements and positions that provide educational sensory experiences. They are intended for sixth graders up through adult learners in both formal and informal educational settings. They emphasize astronomical concepts and phenomenon that people can readily encounter in their "everyday" lives such as time, seasons, and sky motions of the Sun, Moon, stars, and planets. Kinesthetic Astronomy lesson plans are fully aligned with national science education standards, both in content and instructional practice. Our lessons offer a complete learning cycle with written assessment opportunities now embedded throughout the lesson. We have substantially strengthened the written assessment options for the Sky Time lesson to help students translate their kinesthetic and visual learning into the verbal-linguistic and mathematical-logical realms of expression. Field testing with non-science undergraduates, middle school science teachers and students, Junior Girl Scouts, museum education staff, and outdoor educators has been providing evidence that Kinesthetic Astronomy techniques allow learners to achieve a good grasp of concepts that are much more difficult to learn in more conventional ways such as via textbooks or even computer animation. Field testing of the Sky Time lesson has also led us to significant changes from the previous version to support student learning. We will report on the nature of these changes.

Outcomes and lessons learned from evaluating TRICARE's disease management programs.

PubMed

Dall, Timothy M; Askarinam Wagner, Rachel C; Zhang, Yiduo; Yang, Wenya; Arday, David R; Gantt, Cynthia J

2010-06-01

To share outcomes and lessons learned from an evaluation of disease management (DM) programs for asthma, congestive heart failure (CHF), and diabetes for TRICARE patients. Multiyear evaluation of participants in voluntary, opt-out DM programs. Patient-centered programs, administered by 3 regional contractors, provide phone-based consultations with a care manager, educational materials, and newsletters. The study sample consisted of 23,793 asthma, 4092 CHF, and 29,604 diabetes patients with at least 6 months' tenure in the program. Medical claims were analyzed to quantify program effect on healthcare utilization, medical costs, and clinical outcomes. Multivariate regression analysis with an historical control group was used to predict patient outcomes in the absence of DM. The difference between actual and predicted DM patient outcomes was attributed to the program. A patient survey collected data on program satisfaction and perceived usefulness of program information and services. Modest improvements in patient outcomes included reduced inpatient days and medical costs, and (with few exceptions) increased percentages of patients receiving appropriate medications and tests. Annual per patient reductions in medical costs were $453, $371, and $783 for asthma, CHF, and diabetes program participants, respectively. The estimated return on investment was $1.26 per $1.00 spent on DM services. Findings suggest that the DM programs more than pay for themselves, in addition to improving patient health and quality of life. Lessons learned in program design, implementation, effectiveness, and evaluation may benefit employers contemplating DM, DM providers, and evaluators of DM programs.

Collecting, Integrating, and Disseminating Patient-Reported Outcomes for Research in a Learning Healthcare System

PubMed Central

Harle, Christopher A.; Lipori, Gloria; Hurley, Robert W.

2016-01-01

Introduction: Advances in health policy, research, and information technology have converged to increase the electronic collection and use of patient-reported outcomes (PROs). Therefore, it is important to share lessons learned in implementing PROs in research information systems. Case Description: The purpose of this case study is to describe a novel information system for electronic PROs and lessons learned in implementing that system to support research in an academic health center. The system incorporates freely available and commercial software and involves clinical and research workflows that support the collection, transformation, and research use of PRO data. The software and processes that comprise the system serve three main functions, (i) collecting electronic PROs in clinical care, (ii) integrating PRO data with non-patient generated clinical data, and (iii) disseminating data to researchers through the institution’s research informatics infrastructure, including the i2b2 (Informatics for Integrating Biology and the Bedside) system. Strategies: Our successful design and implementation was driven by three overarching strategies. First, we selected and implemented multiple interfaced technologies to support PRO collection, management, and research use. Second, we aimed to use standardized approaches to measuring PROs, sending PROs between systems, and disseminating PROs. Finally, we focused on using technologies and processes that aligned with existing clinical research information management strategies within our organization. Conclusion: These experiences and lessons may help future implementers and researchers enhance the scale and sustainable use of systems for research use of PROs. PMID:27563683

Collecting, Integrating, and Disseminating Patient-Reported Outcomes for Research in a Learning Healthcare System.

PubMed

Harle, Christopher A; Lipori, Gloria; Hurley, Robert W

2016-01-01

Advances in health policy, research, and information technology have converged to increase the electronic collection and use of patient-reported outcomes (PROs). Therefore, it is important to share lessons learned in implementing PROs in research information systems. The purpose of this case study is to describe a novel information system for electronic PROs and lessons learned in implementing that system to support research in an academic health center. The system incorporates freely available and commercial software and involves clinical and research workflows that support the collection, transformation, and research use of PRO data. The software and processes that comprise the system serve three main functions, (i) collecting electronic PROs in clinical care, (ii) integrating PRO data with non-patient generated clinical data, and (iii) disseminating data to researchers through the institution's research informatics infrastructure, including the i2b2 (Informatics for Integrating Biology and the Bedside) system. Our successful design and implementation was driven by three overarching strategies. First, we selected and implemented multiple interfaced technologies to support PRO collection, management, and research use. Second, we aimed to use standardized approaches to measuring PROs, sending PROs between systems, and disseminating PROs. Finally, we focused on using technologies and processes that aligned with existing clinical research information management strategies within our organization. These experiences and lessons may help future implementers and researchers enhance the scale and sustainable use of systems for research use of PROs.

Merging home and health via contemporary care delivery: program management insights on a home telehealth project.

PubMed

Abraham, Chon; Rosenthal, David A

2008-01-01

This article discusses a home telehealth program that uses innovative informatics and telemedicine technologies to meet the needs of a Veterans Affairs Medical Center. We provide background information for the program inclusive of descriptions for the decision support system, patient selection process, and selected home telehealth technologies. Lessons learned based on interview data collected from the project team highlight issues regarding implementation and management of the program. Our goal is to provide useful information to other healthcare systems considering home telehealth as a contemporary option for care delivery.

Evaluation of a seven state criminal history screening pilot program for long-term care workers.

PubMed

Radcliff, Tiffany A; White, Alan; West, David R; Hurd, Donna; Côté, Murray J

2013-01-01

This article summarizes results from an evaluation of a federally sponsored criminal history screening (CHS) pilot program to improve screening for workers in long-term care settings. The evaluation addressed eight key issues specified through enabling legislation, including efficiency, costs, and outcomes of screening procedures. Of the 204,339 completed screenings, 3.7% were disqualified due to criminal history, and 18.8% were withdrawn prior to completion for reasons that may include relevant criminal history. Lessons learned from the pilot program experiences may inform a new national background check demonstration program.

Cleanser, Detergent, Personal Care Product, and Pretreatment Evaluation

NASA Technical Reports Server (NTRS)

Adam, Niklas; Carrier, Chris; Vega, Leticia; Casteel, Michael; Verostko, chuck; Pickering, Karen

2011-01-01

The purpose of the Cleanser, Detergent, Personal Care Product, and Pretreatment Evaluation & Selection task is to identify the optimal combination of personal hygiene products, crew activities, and pretreatment strategies to provide the crew with sustainable life support practices and a comfortable habitat. Minimal energy, mass, and crew time inputs are desired to recycle wastewater during long duration missions. This document will provide a brief background on the work this past year supporting the ELS Distillation Comparison Test, issues regarding use of the hygiene products originally chosen for the test, methods and results used to select alternative products, and lessons learned from testing.

Cleanser, Detergent, Personal Care Product Pretreatment Evaluation

NASA Technical Reports Server (NTRS)

Adam, Niklas

2010-01-01

The purpose of the Cleanser, Detergent, Personal Care Product, and Pretreatment Evaluation & Selection task is to identify the optimal combination of personal hygiene products, crew activities, and pretreatment strategies to provide the crew with sustainable life support practices and a comfortable habitat. Minimal energy, mass, and crew time inputs are desired to recycle wastewater during long duration missions. This document will provide a brief background on the work this past year supporting the ELS Distillation Comparison Test, issues regarding use of the hygiene products originally chosen for the test, methods and results used to select alternative products, and lessons learned from testing.

Public Reporting of Hospital Patient Satisfaction: The Rhode Island Experience

PubMed Central

Barr, Judith K.; Boni, Cathy E.; Kochurka, Kimberly A.; Nolan, Patricia; Petrillo, Marcia; Sofaer, Shoshanna; Waters, William

2002-01-01

This article describes a collaborative process for legislatively mandated public reporting of health care performance in Rhode Island that began with hospital patient satisfaction. The goals of the report were both quality improvement and public accountability. Key features addressed include: the legislative context for public reporting; widespread participation of stakeholders; the structure for decisionmaking; and the use of formative testing with cognitive interviews to get responses of consumers and others about the report's readability and comprehensibility. This experience and the lessons learned can guide other States considering public reporting on health care performance. PMID:12500470

Exploring the use of multiple analogical models when teaching and learning chemical equilibrium

NASA Astrophysics Data System (ADS)

Harrison, Allan G.; de Jong, Onno

2005-12-01

This study describes the multiple analogical models used to introduce and teach Grade 12 chemical equilibrium. We examine the teacher's reasons for using models, explain each model's development during the lessons, and analyze the understandings students derived from the models. A case study approach was used and the data were drawn from the observation of three consecutive Grade 12 lessons on chemical equilibrium, pre- and post-lesson interviews, and delayed student interviews. The key analogical models used in teaching were: the school dance; the sugar in a teacup; the pot of curry; and the busy highway. The lesson and interview data were subject to multiple, independent analyses and yielded the following outcomes: The teacher planned to use the students' prior knowledge wherever possible and he responded to student questions with stories and extended and enriched analogies. He planned to discuss where each analogy broke down but did not. The students enjoyed the teaching but built variable mental models of equilibrium and some of their analogical mappings were unreliable. A female student disliked masculine analogies, other students tended to see elements of the multiple models in isolation, and some did not recognize all the analogical mappings embedded in the teaching plan. Most students learned that equilibrium reactions are dynamic, occur in closed systems, and the forward and reverse reactions are balanced. We recommend the use of multiple analogies like these and insist that teachers always show where the analogy breaks down and carefully negotiate the conceptual outcomes.

Lessons Learned from the Advanced Topographic Laser Altimeter System

NASA Technical Reports Server (NTRS)

Garrison, Matt; Patel, Deepak; Bradshaw, Heather; Robinson, Frank; Neuberger, Dave

2016-01-01

The ICESat-2 Advanced Topographic Laser Altimeter System (ATLAS) instrument is an upcoming Earth Science mission focusing on the effects of climate change. The flight instrument passed all environmental testing at GSFC (Goddard Space Flight Center) and is now ready to be shipped to the spacecraft vendor for integration and testing. This presentation walks through the lessons learned from design, hardware, analysis and testing perspective. ATLAS lessons learned include general thermal design, analysis, hardware, and testing issues as well as lessons specific to laser systems, two-phase thermal control, and optical assemblies with precision alignment requirements.

Japanese Lesson Study Comes to California

ERIC Educational Resources Information Center

Jetter, Madeleine; Hancock, Gwen

2012-01-01

Japanese lesson study--Jugyou kenkyuu--which is a cornerstone of Project DELTA (Developing Educators Learning to Teach Algebraically), adds a new twist: the teachers take turns publicly teaching the collaboratively planned lessons with their own students for the rest of the team to observe and then analyze, based on the students' learning. Lesson…

Credit: A Teaching Unit.

ERIC Educational Resources Information Center

Clanton, Brandolyn; And Others

Intended for teachers of secondary school students, five lessons on consumer credit are presented. In the first lesson students identify and evaluate sources of credit, compare some of the costs and benefits of credit, and learn to apply criteria used in evaluating applications for credit. In the second lesson, students learn about two basic types…

More Lessons from Bhutan: 6 Years Later, Change Takes Root and Flourishes

ERIC Educational Resources Information Center

Telsey, Alison; Levine, Laurie

2015-01-01

In April 2011, the Journal of Staff Development (JSD) published "Lessons from Bhutan: Embrace cultural differences to effect change" (Levine, Telsey, & McCormack, 2011), which described the experiences of several U.S. educators who learned their own transformative lessons while leading professional learning in special education…

New Horizons Risk Communication Strategy, Planning, Implementation, and Lessons Learned

NASA Technical Reports Server (NTRS)

Dawson, Sandra A.

2006-01-01

This paper discusses the risk communication goals, strategy, planning process and product development for the New Horizons mission, including lessons from the Cassini mission that were applied in that effort, and presents lessons learned from the New Horizons effort that could be applicable to future missions.

Comment Data Mining to Estimate Student Performance Considering Consecutive Lessons

ERIC Educational Resources Information Center

Sorour, Shaymaa E.; Goda, Kazumasa; Mine, Tsunenori

2017-01-01

The purpose of this study is to examine different formats of comment data to predict student performance. Having students write comment data after every lesson can reflect students' learning attitudes, tendencies and learning activities involved with the lesson. In this research, Latent Dirichlet Allocation (LDA) and Probabilistic Latent Semantic…

Use of After Action Reports (AARs) to Promote Organizational and Systems Learning in Emergency Preparedness

PubMed Central

Savoia, Elena; Agboola, Foluso; Biddinger, Paul D.

2012-01-01

Many public health and healthcare organizations use formal knowledge management practices to identify and disseminate the experiences gained over time. The “lessons-learned” approach is one such example of knowledge management practice applied to the wider concept of organizational learning. In the field of emergency preparedness, the lessons-learned approach stands on the assumption that learning from experience improves practice and minimizes avoidable deaths and negative economic and social consequences of disasters. In this project, we performed a structured review of AARs to analyze how lessons learned from the response to real-incidents may be used to maximize knowledge management and quality improvement practices such as the design of public health emergency preparedness (PHEP) exercises. We chose as a source of data the “Lessons Learned Information Sharing (LLIS.gov)” system, a joined program of the U.S. Department of Homeland Security DHS and FEMA that serves as the national, online repository of lessons learned, best practices, and innovative ideas. We identified recurring challenges reported by various states and local public health agencies in the response to different types of incidents. We also strived to identify the limitations of systematic learning that can be achieved due to existing weaknesses in the way AARs are developed. PMID:23066408

Using Cooperative Learning To Improve Reading and Writing in Science.

ERIC Educational Resources Information Center

Nesbit, Catherine R.; Rogers, Cynthia A.

1997-01-01

Presents several cooperative learning lessons that integrate science, reading and writing. Notes that sample lessons involve six methods of cooperative learning drawn from four prominent developers and researchers, David Johnson, Roger Johnson, Robert Slavin, and Spencer Kagan. Describes the cooperative learning method to illustrate how to use it…

Teachers' Self-Regulated Learning Lesson Design: Integrating Learning from Problems and Successes

ERIC Educational Resources Information Center

Michalsky, Tova; Schechter, Chen

2018-01-01

Teachers' design of a lesson is critical for helping their students develop academically effective forms of self-regulating learning (SRL) in classrooms. Using a quasi-experimental design, the researchers integrated systematic collaborative learning from problematic and successful experiences into teachers' preparatory programs and examined how…

An Educational Implementation Process Staff Survey: Lessons Learned.

PubMed

Delmore, Barbara; Kent, Martha

2018-05-01

To evaluate the education process for the effective use of the Munro Pressure Ulcer Risk Assessment Scale by practicing perioperative staff at an urban tertiary medical center. Given that pressure injury formation is tied to the surgical process, there is a need for a pressure injury risk assessment scale that addresses the uniqueness of the perioperative process. Participants were staff who worked in the surgical admissions area, the main operating room, and the main postanesthesia care unit. The authors' facility was 1 of 8 participants in a multisite study. Each site was required to educate staff using standard written instructions and an instructional webinar. However, sites were also encouraged to consider any other methods that would successfully engage the staff in the learning process. After the education process, staff were surveyed and asked to evaluate the educational interventions. Findings indicated that the staff did not prefer written instructions alone but rather preferred a combination of different learning modalities and media to assist them in using the Munro Scale effectively. This article discusses the strategies required to engage staff in the implementation process of this scale, the barriers encountered during this implementation, and the implications for perioperative nursing using this scale. The lessons learned from conducting this research provided insight into engaging and educating the adult learner in a new process.

A nursing solution to primary care delivery shortfall.

PubMed

Carter, Michael; Moore, Phillip; Sublette, Nina

2018-05-21

Many countries project that they will have difficulty to meet their demand for primary care based on an inadequate supply of primary care doctors. There are many reasons for this, and they tend to vary by country. The policy options available to these countries are to increase the number of local primary care doctors, recruit doctors from other countries, ration primary care, shift more primary care to specialists, or authorize other disciplines to provide primary care. This article examines lessons learned in the United States over the past 50 years and proposes that expanding the use of nurse practitioners is the best solution when measured by feasibility, costs, ethics, and scope of the care delivered. Using nurse practitioners trained in country meets the World Health Organization global code of practice regarding the international recruitment of health personnel. © 2018 John Wiley & Sons Ltd.

"Recognize Our Humanity": Immigrant Youth Voices on Health Care in Arizona's Restrictive Political Environment.

PubMed

Gómez, Sofía; Castañeda, Heide

2018-02-01

The "DACAmented Voices in Healthcare" project examined the intersection of restrictive immigration policies and health care via photovoice, a participatory action research approach, with immigrant youth living in Arizona, who were recipients of the Deferred Action for Childhood Arrivals (DACA) program. These "DACAmented" youth took part in nine photovoice sessions exploring their health care experiences and accessibility to care using documentary photography and narratives. They poignantly illustrated their experiences through images identifying their main health concerns and strengths, facilitating the development of health policy recommendations. This article illustrates the thematic findings and discusses policy recommendations and lessons learned from presentations to policy makers and health care providers. Findings suggest that immigrant youth are knowledgeable of their family's health care needs and hold a unique and important position within mixed-status households. Health care providers can benefit from the proposed recommendations by building bridges to care to address health equity in immigrant communities.

Mobile Learning vs. Traditional Classroom Lessons: A Comparative Study

ERIC Educational Resources Information Center

Furió, D.; Juan, M.-C.; Seguí, I.; Vivó, R.

2015-01-01

Different methods can be used for learning, and they can be compared in several aspects, especially those related to learning outcomes. In this paper, we present a study in order to compare the learning effectiveness and satisfaction of children using an iPhone game for learning the water cycle vs. the traditional classroom lesson. The iPhone game…

Harnessing the private health sector by using prices as a policy instrument: Lessons learned from South Africa.

PubMed

Barber, Sarah L; Kumar, Ankit; Roubal, Tomas; Colombo, Francesca; Lorenzoni, Luca

2018-05-01

Governments frequently draw upon the private health care sector to promote sustainability, optimal use of resources, and increased choice. In doing so, policy-makers face the challenge of harnessing resources while grappling with the market failures and equity concerns associated with private financing of health care. The growth of the private health sector in South Africa has fundamentally changed the structure of health care delivery. A mutually reinforcing ecosystem of private health insurers, private hospitals and specialists has grown to account for almost half of the country's spending on health care, despite only serving 16% of the population with the capacity to pay. Following years of consolidation among private hospital groups and insurance schemes, and after successive failures at establishing credible price benchmarks, South Africa's private hospitals charge prices comparable with countries that are considerably richer. This compromises the affordability of a broad-based expansion in health care for the population. The South African example demonstrates that prices can be part of a structure that perpetuates inequalities in access to health care resources. The lesson for other countries is the importance of norms and institutions that uphold price schedules in high-income countries. Efforts to compromise or liberalize price setting should be undertaken with a healthy degree of caution. Copyright © 2018 Elsevier B.V. All rights reserved.

Global health partnership for student peer-to-peer psychiatry e-learning: Lessons learned.

PubMed

Keynejad, Roxanne C

2016-12-03

Global 'twinning' relationships between healthcare organizations and institutions in low and high-resource settings have created growing opportunities for e-health partnerships which capitalize upon expanding information technology resources worldwide. E-learning approaches to medical education are increasingly popular but remain under-investigated, whilst a new emphasis on global health teaching has coincided with university budget cuts in many high income countries. King's Somaliland Partnership (KSP) is a paired institutional partnership health link, supported by Tropical Health and Education Trust (THET), which works to strengthen the healthcare system and improve access to care through mutual exchange of skills, knowledge and experience between Somaliland and King's Health Partners, UK. Aqoon, meaning knowledge in Somali, is a peer-to-peer global mental health e-learning partnership between medical students at King's College London (KCL) and Hargeisa and Amoud Universities, Somaliland. It aims to extend the benefits of KSP's cross-cultural and global mental health education work to medical students and has reported positive results, including improved attitudes towards psychiatry in Somaliland students. The process of devising, piloting, evaluating, refining, implementing, re-evaluating and again refining the Aqoon model has identified important barriers to successful partnership. This article describes lessons learned during this process, sharing principles and recommendations for readers wishing to expand their own global health link beyond qualified clinicians, to the healthcare professionals of the future.

Rescuing Joint Personnel Recovery: Using Air Force Capability to Address Joint Shortfalls

DTIC Science & Technology

2011-06-01

of an IP, the IP is not successfully reintegrated or the lessons learned are not incorporated into other operations. Adversaries will benefit from...Washington, D.C.: Office of Air Force History , United States Air Force, 1980, 117. 47 Durant , Michael J. In the Company of Heroes, Penguin Group... Lessons Learned, 22 September 2005, 3. 2 US Joint Task Force Katrina. The Federal Response to Hurricane Katrina Lessons Learned, February 2006, 54

Implementing a lessons learned process at Sandia National Laboratories

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fosshage, Erik D.; Drewien, Celeste A.; Eras, Kenneth

2016-01-01

The Lessons Learned Process Improvement Team was tasked to gain an understanding of the existing lessons learned environment within the major programs at Sandia National Laboratories, identify opportunities for improvement in that environment as compared to desired attributes, propose alternative implementations to address existing inefficiencies, perform qualitative evaluations of alternative implementations, and recommend one or more near-term activities for prototyping and/or implementation. This report documents the work and findings of the team.

Apollo 1 Lessons Learned Show

NASA Image and Video Library

2017-01-27

Mike Ciannilli, at left, the Apollo, Challenger, Columbia Lessons Learned Program manager, presents a certificate to Charlie Duke, former Apollo 16 astronaut and member of the Apollo 1 Emergency Egress Investigation Team, during the Apollo 1 Lessons Learned presentation in the Training Auditorium at NASA's Kennedy Space Center in Florida. The program's theme was "To There and Back Again." The event helped pay tribute to the Apollo 1 crew, Gus Grissom, Ed White II, and Roger Chaffee.

Lessons learned applying CASE methods/tools to Ada software development projects

NASA Technical Reports Server (NTRS)

Blumberg, Maurice H.; Randall, Richard L.

1993-01-01

This paper describes the lessons learned from introducing CASE methods/tools into organizations and applying them to actual Ada software development projects. This paper will be useful to any organization planning to introduce a software engineering environment (SEE) or evolving an existing one. It contains management level lessons learned, as well as lessons learned in using specific SEE tools/methods. The experiences presented are from Alpha Test projects established under the STARS (Software Technology for Adaptable and Reliable Systems) project. They reflect the front end efforts by those projects to understand the tools/methods, initial experiences in their introduction and use, and later experiences in the use of specific tools/methods and the introduction of new ones.

Setting priorities in health care organizations: criteria, processes, and parameters of success.

PubMed

Gibson, Jennifer L; Martin, Douglas K; Singer, Peter A

2004-09-08

Hospitals and regional health authorities must set priorities in the face of resource constraints. Decision-makers seek practical ways to set priorities fairly in strategic planning, but find limited guidance from the literature. Very little has been reported from the perspective of Board members and senior managers about what criteria, processes and parameters of success they would use to set priorities fairly. We facilitated workshops for board members and senior leadership at three health care organizations to assist them in developing a strategy for fair priority setting. Workshop participants identified 8 priority setting criteria, 10 key priority setting process elements, and 6 parameters of success that they would use to set priorities in their organizations. Decision-makers in other organizations can draw lessons from these findings to enhance the fairness of their priority setting decision-making. Lessons learned in three workshops fill an important gap in the literature about what criteria, processes, and parameters of success Board members and senior managers would use to set priorities fairly.

10 lessons learned by a misguided physician.

PubMed

Levin, Barry E

2017-07-01

It was a great and humbling honor to receive the 2016 Distinguished Career Award from my SSIB colleagues. This paper summarizes the major points of my DCA talk at the 2016 annual meeting. It is a reflection on my 50year medical and research career and 10 lessons I have learned over those years which might be of help to young investigators near the beginning of their own research careers. These lessons include: the value of being receptive to the opportunities provided you; how clinician-scientists can serve as critical role models for young investigators like me and a history of how my career developed as a result of their influence; the importance of carefully examining your own data, particularly when it doesn't agree with your preconceived ideas; the critical role that students, postdocs and PhD (and even veterinarian) colleagues can play in developing one's career; the likelihood that your career path will have many interesting twists and turns determined by changes in your own scientific interests and how rewarding various areas of research focus are to you; the importance of building a close-knit laboratory staff family; the fact that science and romance can mix. Finally, I offer 3 somewhat self-evident free pieces of advice for building and maintaining a rewarding career. Copyright © 2016 Elsevier Inc. All rights reserved.

ISS Solar Array Alpha Rotary Joint (SARJ) Bearing Failure and Recovery: Technical and Project Management Lessons Learned

NASA Technical Reports Server (NTRS)

DellaCorte, Christopher; Krantz, Timothy L.; Dube, Michael J.

2011-01-01

The photovoltaic solar panels on the International Space Station (ISS) track the Sun through continuous rotating motion enabled by large bearings on the main truss called solar array alpha rotary joints (SARJs). In late 2007, shortly after installation, the starboard SARJ had become hard to turn and had to be shut down after exceeding drive current safety limits. The port SARJ, of the same design, had been working well for over 2 years. An exhaustive failure investigation ensued that included multiple extravehicular activities to collect information and samples for engineering forensics, detailed structural and thermal analyses, and a careful review of the build records. The ultimate root cause was determined to be kinematic design vulnerability coupled with inadequate lubrication, and manufacturing flaws; this was corroborated through ground tests, metallurgical studies, and modeling. A highly successful recovery plan was developed and implemented that included replacing worn and damaged components in orbit and applying space-compatible grease to improve lubrication. Beyond the technical aspects, however, lie several key programmatic lessons learned. These lessons, such as running ground tests to intentional failure to experimentally verify failure modes, are reviewed and discussed so they can be applied to future projects to avoid such problems.

Evaluation of interprofessional education: lessons learned through the development and implementation of an interprofessional seminar on team communication for undergraduate health care students in Heidelberg – a project report

PubMed Central

Berger, Sarah; Mahler, Cornelia; Krug, Katja; Szecsenyi, Joachim; Schultz, Jobst-Hendrik

2016-01-01

Introduction: This project report describes the development, “piloting” and evaluation of an interprofessional seminar on team communication bringing together medical students and Interprofessional Health Care B.Sc. students at the Medical Faculty of Heidelberg University, Germany. Project Description: A five-member interprofessional team collaborated together on this project. Kolb’s experiential learning concept formed the theoretical foundation for the seminar, which explored three interprofessional competency areas: team work, communication and values/ethics. Evaluation for the purposes of quality assurance and future curricula development was conducted using two quantitative measures: descriptive analysis of a standardized course evaluation tool (EvaSys) ANOVA analysis of the German translation of the University of the West of England Interprofessional Questionnaire (UWE-IP-D). Results: The key finding from the standardized course evaluation was that the interprofessional seminars were rated more positively [M=2.11 (1 most positive and 5 most negative), SD=1, n=27] than the monoprofessional seminars [M=2.55, SD=0.98, n=90]. The key finding from the UWE-IP-D survey, comparing pre and post scores of the interprofessional (IP) (n=40) and monoprofessional (MP) groups (n=34), was that significant positive changes in mean scores for both groups towards communication, teamwork and interprofessional learning occurred. Conclusions: Lessons learnt included: a) recognising the benefit of being pragmatic when introducing interprofessional education initiatives, which enabled various logistical and attitudinal barriers to be overcome; b) quantitative evaluation of learning outcomes alone could not explain positive responses or potential influences of interprofessional aspects, which highlighted the need for a mixed methods approach, including qualitative methods, to enrich judgment formation on interprofessional educational outcomes. PMID:27280133

Evaluation of interprofessional education: lessons learned through the development and implementation of an interprofessional seminar on team communication for undergraduate health care students in Heidelberg - a project report.

PubMed

Berger, Sarah; Mahler, Cornelia; Krug, Katja; Szecsenyi, Joachim; Schultz, Jobst-Hendrik

2016-01-01

This project report describes the development, "piloting" and evaluation of an interprofessional seminar on team communication bringing together medical students and Interprofessional Health Care B.Sc. students at the Medical Faculty of Heidelberg University, Germany. A five-member interprofessional team collaborated together on this project. Kolb's experiential learning concept formed the theoretical foundation for the seminar, which explored three interprofessional competency areas: team work, communication and values/ethics. Evaluation for the purposes of quality assurance and future curricula development was conducted using two quantitative measures: descriptive analysis of a standardized course evaluation tool (EvaSys) ANOVA analysis of the German translation of the University of the West of England Interprofessional Questionnaire (UWE-IP-D). The key finding from the standardized course evaluation was that the interprofessional seminars were rated more positively [M=2.11 (1 most positive and 5 most negative), SD=1, n=27] than the monoprofessional seminars [M=2.55, SD=0.98, n=90]. The key finding from the UWE-IP-D survey, comparing pre and post scores of the interprofessional (IP) (n=40) and monoprofessional (MP) groups (n=34), was that significant positive changes in mean scores for both groups towards communication, teamwork and interprofessional learning occurred. Lessons learnt included: a) recognising the benefit of being pragmatic when introducing interprofessional education initiatives, which enabled various logistical and attitudinal barriers to be overcome; b) quantitative evaluation of learning outcomes alone could not explain positive responses or potential influences of interprofessional aspects, which highlighted the need for a mixed methods approach, including qualitative methods, to enrich judgment formation on interprofessional educational outcomes.

Integrating Patient-Reported Outcomes into Spine Surgical Care through Visual Dashboards: Lessons Learned from Human-Centered Design

PubMed Central

Hartzler, Andrea L.; Chaudhuri, Shomir; Fey, Brett C.; Flum, David R.; Lavallee, Danielle

2015-01-01

Introduction: The collection of patient-reported outcomes (PROs) draws attention to issues of importance to patients—physical function and quality of life. The integration of PRO data into clinical decisions and discussions with patients requires thoughtful design of user-friendly interfaces that consider user experience and present data in personalized ways to enhance patient care. Whereas most prior work on PROs focuses on capturing data from patients, little research details how to design effective user interfaces that facilitate use of this data in clinical practice. We share lessons learned from engaging health care professionals to inform design of visual dashboards, an emerging type of health information technology (HIT). Methods: We employed human-centered design (HCD) methods to create visual displays of PROs to support patient care and quality improvement. HCD aims to optimize the design of interactive systems through iterative input from representative users who are likely to use the system in the future. Through three major steps, we engaged health care professionals in targeted, iterative design activities to inform the development of a PRO Dashboard that visually displays patient-reported pain and disability outcomes following spine surgery. Findings: Design activities to engage health care administrators, providers, and staff guided our work from design concept to specifications for dashboard implementation. Stakeholder feedback from these health care professionals shaped user interface design features, including predefined overviews that illustrate at-a-glance trends and quarterly snapshots, granular data filters that enable users to dive into detailed PRO analytics, and user-defined views to share and reuse. Feedback also revealed important considerations for quality indicators and privacy-preserving sharing and use of PROs. Conclusion: Our work illustrates a range of engagement methods guided by human-centered principles and design recommendations for optimizing PRO Dashboards for patient care and quality improvement. Engaging health care professionals as stakeholders is a critical step toward the design of user-friendly HIT that is accepted, usable, and has the potential to enhance quality of care and patient outcomes. PMID:25988187

Talking about domestic abuse: Crucial conversations for health visitors.

PubMed

Bradbury-Jones, Caroline

2015-12-01

Domestic abuse is a serious problem across the world and it is considered a public health issue. Nurses play a crucial role in recognising and responding to domestic abuse but they sometimes lack confidence in dealing with the issue. In this article, two recently completed studies are used to extract lessons for health visiting practice. The first study investigated primary healthcare professionals' beliefs about domestic abuse. Many healthcare professionals were confident in dealing with domestic abuse. However, there was disinclination among some to discuss the issue. People who experience abuse rarely discuss it unless asked. So the study highlighted a potential dynamic of silence between health professionals and abused people in their care. The second study investigated student nurses and student midwives experiences of learning about domestic abuse. The student nurses had learned less than the student midwives. They had not been taught about domestic abuse in university and many had not had the opportunity to learn about it in clinical placement. They reported reluctance among some mentors to discuss the issue with them, with a resulting silencing of the issue. Both of these studies have important lessons for health visiting practice regarding opening up crucial conversations about domestic abuse.

The past, present, and future of urgent matters: lessons learned from a decade of emergency department flow improvement.

PubMed

McClelland, Mark Stephen; Lazar, Danielle; Sears, Vickie; Wilson, Marcia; Siegel, Bruce; Pines, Jesse M

2011-12-01

Over the past decade, emergency departments (ED) have encountered major challenges due to increased crowding and a greater public focus on quality measurement and quality improvement. Responding to these challenges, many EDs have worked to improve their processes and develop new and innovative models of care delivery. Urgent Matters has contributed to ED quality and patient flow improvement by working with hospitals throughout the United States. Recognizing that EDs across the country are struggling with many of the same issues, Urgent Matters-a program funded by the Robert Wood Johnson Foundation (RWJF)-has sought to identify, develop, and disseminate innovative approaches, interventions, and models to improve ED flow and quality. Using a variety of techniques, such as learning networks (collaboratives), national conferences, e-newsletters, webinars, best practices toolkits, and social media, Urgent Matters has served as a thought leader and innovator in ED quality improvement initiatives. The Urgent Matters Seven Success Factors were drawn from the early work done by program participants and propose practical guidelines for implementing and sustaining ED improvement activities. This article chronicles the history, activities, lessons learned, and future of the Urgent Matters program. © 2011 by the Society for Academic Emergency Medicine.

Engaging the Deaf American sign language community: lessons from a community-based participatory research center.

PubMed

McKee, Michael; Thew, Denise; Starr, Matthew; Kushalnagar, Poorna; Reid, John T; Graybill, Patrick; Velasquez, Julia; Pearson, Thomas

2012-01-01

Numerous publications demonstrate the importance of community-based participatory research (CBPR) in community health research, but few target the Deaf community. The Deaf community is understudied and underrepresented in health research despite suspected health disparities and communication barriers. The goal of this paper is to share the lessons learned from the implementation of CBPR in an understudied community of Deaf American Sign Language (ASL) users in the greater Rochester, New York, area. We review the process of CBPR in a Deaf ASL community and identify the lessons learned. Key CBPR lessons include the importance of engaging and educating the community about research, ensuring that research benefits the community, using peer-based recruitment strategies, and sustaining community partnerships. These lessons informed subsequent research activities. This report focuses on the use of CBPR principles in a Deaf ASL population; lessons learned can be applied to research with other challenging-to-reach populations.

Professional Learning through the Collaborative Design of Problem-Solving Lessons

ERIC Educational Resources Information Center

Wake, Geoff; Swan, Malcolm; Foster, Colin

2016-01-01

This article analyses lesson study as a mode of professional learning, focused on the development of mathematical problem solving processes, using the lens of cultural-historical activity theory. In particular, we draw attention to two activity systems, the classroom system and the lesson-study system, and the importance of making artefacts…

Marine Hydrokinetic Energy Regulators Workshop: Lessons from Wind

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baring-Gould, E. Ian

2015-09-03

Ian Baring-Gould presented these lessons learned from wind energy to an audience of marine hydrokinetic regulators. Lessons learned spanned the areas of technology advances, using collaborative approaches to involve key stakeholders; using baseline studies to measure and prioritize wildlife impacts, and look at avoidance and mitigation options early in the process.

Does the Modality Principle for Multimedia Learning Apply to Science Classrooms?

ERIC Educational Resources Information Center

Harskamp, Egbert G.; Mayer, Richard E.; Suhre, Cor

2007-01-01

This study demonstrated that the modality principle applies to multimedia learning of regular science lessons in school settings. In the first field experiment, 27 Dutch secondary school students (age 16-17) received a self-paced, web-based multimedia lesson in biology. Students who received lessons containing illustrations and narration performed…

Automatic Dance Lesson Generation

ERIC Educational Resources Information Center

Yang, Yang; Leung, H.; Yue, Lihua; Deng, LiQun

2012-01-01

In this paper, an automatic lesson generation system is presented which is suitable in a learning-by-mimicking scenario where the learning objects can be represented as multiattribute time series data. The dance is used as an example in this paper to illustrate the idea. Given a dance motion sequence as the input, the proposed lesson generation…

Mining Mathematics in Textbook Lessons

ERIC Educational Resources Information Center

Ronda, Erlina; Adler, Jill

2017-01-01

In this paper, we propose an analytic tool for describing the mathematics made available to learn in a "textbook lesson". The tool is an adaptation of the Mathematics Discourse in Instruction (MDI) analytic tool that we developed to analyze what is made available to learn in teachers' lessons. Our motivation to adapt the use of the MDI…

Challenge Activities for the Physical Education Classroom: Affective Learning Outcomes

ERIC Educational Resources Information Center

McKenzie, Emily; Symonds, Matthew L.; Fink, Kevin; Tapps, Tyler

2017-01-01

The purpose of this article is to share three challenge-based lesson plans that can be implemented by physical educators in their classroom. Each of the lesson examples addresses the three learning domains: psychomotor, cognitive and affective. Additionally, each lesson is aligned with SHAPE America's National Standards for K-12 Physical…

Japanese Lesson Study Sustaining Teacher Learning in the Classroom Context

ERIC Educational Resources Information Center

Loose, Crystal Corle

2014-01-01

The purposes of this action research study were first to explore teacher perceptions of Japanese lesson study as a method of professional development, and second to take teachers through an action research process as they observed the implementation of a literacy lesson in the classroom. Situated Learning Theory, particularly related to teacher…

Teachers' Professional Growth through Engagement with Lesson Study

ERIC Educational Resources Information Center

Widjaja, Wanty; Vale, Colleen; Groves, Susie; Doig, Brian

2017-01-01

Lesson study is highly regarded as a model for professional learning, yet remains under-theorised. This article examines the professional learning experiences of teachers and numeracy coaches from three schools in a local network of schools, participating in a lesson study project over two research cycles in 2012. It maps the interconnections…

Implementation of lesson study in physics teaching by group of teachers in Solok West Sumatera

NASA Astrophysics Data System (ADS)

Yurnetti, Y.

2018-04-01

This article based of collaborative classroom action research with science teachers group or MGMP at Solok West Sumatera; based on their willingness to implementation of lesson study by this group. The study started by discussing some problems according to the implementation of the lesson study, establishing the teaching materials, developing learning tools, defining the model teachers, conducting classroom activities, and reflecting by discussions. The preparation of this study includes some learning material according to temperature and heat; the observation form that led by observer teachers; teachers’s model impression and open questionnaire implementation of lesson study that applied to the students and teachers. This research got some information about the strengths and weaknesses of learning using lesson study from the students involved. To conclude, the implementation of lesson study should be able to support the principle of collaborative in learning. The challenge of this study is how to make a condition to gather some teachers in one school at a certain time because they have the schedule at their own school.

Providing Simulated Online and Mobile Learning Experiences in a Prison Education Setting: Lessons Learned from the PLEIADES Pilot Project

ERIC Educational Resources Information Center

Farley, Helen; Murphy, Angela; Bedford, Tasman

2014-01-01

This article reports on the preliminary findings, design criteria and lessons learned while developing and piloting an alternative to traditional print-based education delivery within a prison environment. PLEIADES (Portable Learning Environments for Incarcerated Distance Education Students), was designed to provide incarcerated students with…

The Effect of Cooperative Learning Method and Systematic Teaching on Students' Achievement and Retention of Knowledge in Social Studies Lesson

ERIC Educational Resources Information Center

Korkmaz Toklucu, Selma; Tay, Bayram

2016-01-01

Problem Statement: Many effective instructional strategies, methods, and techniques, which were developed in accordance with constructivist approach, can be used together in social studies lessons. Constructivist education comprises active learning processes. Two active learning approaches are cooperative learning and systematic teaching. Purpose…

Experiential Learning: Lessons Learned from the UND Business and Government Symposium

ERIC Educational Resources Information Center

Harsell, Dana Michael; O'Neill, Patrick B.

2010-01-01

The authors describe lessons learned from a limited-duration experiential learning component of a Master's level course. The course is open to Master's in Business and Master's in Public Administration students and explores the relationships between government and business. A complete discussion of the Master's in Business and Master's in Public…

Reflections on Designing a MPA Service-Learning Component: Lessons Learned

ERIC Educational Resources Information Center

Roman, Alexandru V.

2015-01-01

This article provides the "lessons learned" from the experience of redesigning two sections (face-to-face and online) of a core master of public administration class as a service-learning course. The suggestions made here can be traced to the entire process of the project, from the "seed idea" through its conceptualization and…

Sustaining Student Engagement in Learning Science

ERIC Educational Resources Information Center

Ateh, Comfort M.; Charpentier, Alicia

2014-01-01

Many students perceive science to be a difficult subject and are minimally engaged in learning it. This article describes a lesson that embedded an activity to engage students in learning science. It also identifies features of a science lesson that are likely to enhance students' engagement and learning of science and possibly reverse students'…

The Development of Biology Teaching Material Based on the Local Wisdom of Timorese to Improve Students Knowledge and Attitude of Environment in Caring the Preservation of Environment

ERIC Educational Resources Information Center

Ardan, Andam S.

2016-01-01

The purposes of this study were (1) to describe the biology learning such as lesson plans, teaching materials, media and worksheets for the tenth grade of High School on the topic of Biodiversity and Basic Classification, Ecosystems and Environment Issues based on local wisdom of Timorese; (2) to analyze the improvement of the environmental…

The Challenges of Establishing and Sustaining an Overseas Enterprise: One Haitian NGO's Perspective.

PubMed

Greig, Elizabeth; Cornely, Cheryl Clark; Green, Barth A

2015-06-01

This article describes the creation of Project Medishare for Haiti, Inc, a US 501(c)3 nonprofit organization and its counterpart in Haiti, Project Medishare in Haiti, a nongovernmental organization that provides health care resources and training and education in Haiti. It summarizes the strategy for fundraising and sustaining such an enterprise in a developing country and discusses the lessons learned and goals achieved during the last 20 years.

Health lessons learned from the recent earthquakes and Tsunami in Asia.

PubMed

de Ville de Goyet, Claudele

2007-01-01

The evaluations following the Tsunami that affected 12 countries (December 2004) and the earthquakes in Bam, Iran (2003), and in Pakistan (2005) offered valuable lessons for public health preparedness against all types of risks (natural, complex, or technological) in all countries (regardless their level of development). The lessons learned, needs assessments, effectiveness of external life-saving assistance, disease surveillance and control, as well as donations management, were reviewed. Although hundreds of surveys or studies were conducted, the needs assessments were partial and uncoordinated. The findings often were not shared by individual agencies. The evaluations in each of the three disasters point to some additional issues: 1. Foreign mobile hospitals rarely arrived in time for immediate trauma care. Existing international guidelines for the use of field hospitals often were ignored and must be updated and promoted. Local and neighboring facilities are best at providing immediate, life-saving care; 2. Occassionally, the risk of epidemics was grossly overestimated by the agencies and the mass media. Surveillance and improved routine control programs work without resorting to costly, improvised immunization campaigns of doubtless value. Improving or re-establishing water and sanitation must be the first priority; 3. Health donations were not always appropriate, nor did they follow the World Health Organization guidelines. The costly destruction of inappropriate donations was a recurrent problem; and 4. Medical volunteers from within the affected country were abounding, but did not benefit from the external logistical and material support. The international community should provide logistical and material support before sending expatriate teams that are unfamiliar with the area and its alth problems. Investing in the preparedness of the national health services and communities should become a priority for disaster-prone countries and those assisting them in their development.

The oncology pharmacy in cancer care delivery in a resource-constrained setting in western Kenya.

PubMed

Strother, R Matthew; Rao, Kamakshi V; Gregory, Kelly M; Jakait, Beatrice; Busakhala, Naftali; Schellhase, Ellen; Pastakia, Sonak; Krzyzanowska, Monika; Loehrer, Patrick J

2012-12-01

The movement to deliver cancer care in resource-limited settings is gaining momentum, with particular emphasis on the creation of cost-effective, rational algorithms utilizing affordable chemotherapeutics to treat curable disease. The delivery of cancer care in resource-replete settings is a concerted effort by a team of multidisciplinary care providers. The oncology pharmacy, which is now considered integral to cancer care in resourced medical practice, developed over the last several decades in an effort to limit healthcare provider exposure to workplace hazards and to limit risk to patients. In developing cancer care services in resource-constrained settings, creation of oncology pharmacies can help to both mitigate the risks to practitioners and patients, and also limit the costs of cancer care and the environmental impact of chemotherapeutics. This article describes the experience and lessons learned in establishing a chemotherapy pharmacy in western Kenya.

Applying ergonomics to systems: some documented "lessons learned".

PubMed

Hendrick, Hal W

2008-07-01

Based on evidence accumulated during the author's 45 years of professional experience, the author presents 23 important "lessons learned" regarding applying ergonomics to systems. Documented results from reported cases or other evidence are presented to validate each of these practical learning points.

Extension Learning Exchange: Lessons from Nicaragua

ERIC Educational Resources Information Center

Treadwell, Paul; Lachapelle, Paul; Howe, Rod

2013-01-01

There is a clear need to support global professional development, international education, and collaborative learning opportunities in Extension. The program described here established an international learning exchange in Nicaragua to lead to global professional development and future international collaboration. The primary lessons and outcomes…

Planning Mars Memory: Learning from the MER Mission

NASA Technical Reports Server (NTRS)

Charlotte, Linde

2004-01-01

This viewgraph presentation discusses ways in which the lessons learned from a mission can be systematically remembered, retained, and applied by individuals and by an organization as a whole. The presentation cites lessons learned from the Mars Exploration Rover (MER) Mission as examples.

Cognitive and learning sciences in biomedical and health instructional design: A review with lessons for biomedical informatics education.

PubMed

Patel, Vimla L; Yoskowitz, Nicole A; Arocha, Jose F; Shortliffe, Edward H

2009-02-01

Theoretical and methodological advances in the cognitive and learning sciences can greatly inform curriculum and instruction in biomedicine and also educational programs in biomedical informatics. It does so by addressing issues such as the processes related to comprehension of medical information, clinical problem-solving and decision-making, and the role of technology. This paper reviews these theories and methods from the cognitive and learning sciences and their role in addressing current and future needs in designing curricula, largely using illustrative examples drawn from medical education. The lessons of this past work are also applicable, however, to biomedical and health professional curricula in general, and to biomedical informatics training, in particular. We summarize empirical studies conducted over two decades on the role of memory, knowledge organization and reasoning as well as studies of problem-solving and decision-making in medical areas that inform curricular design. The results of this research contribute to the design of more informed curricula based on empirical findings about how people learn and think, and more specifically, how expertise is developed. Similarly, the study of practice can also help to shape theories of human performance, technology-based learning, and scientific and professional collaboration that extend beyond the domain of medicine. Just as biomedical science has revolutionized health care practice, research in the cognitive and learning sciences provides a scientific foundation for education in biomedicine, the health professions, and biomedical informatics.

Commercial Orbital Transportation Services (COTS) Program Lessons Learned

NASA Technical Reports Server (NTRS)

Lindenmoyer, Alan; Horkachuck, Mike; Shotwell, Gwynne; Manners, Bruce; Culbertson, Frank

2015-01-01

This report has been developed by the National Aeronautics and Space Administration (NASA) Human Exploration and Operations Mission Directorate (HEOMD) Risk Management team in close coordination with the COTS Program. This document provides a point-in-time, cumulative, summary of actionable key lessons learned derived from the design project. Lessons learned invariably address challenges and risks and the way in which these areas have been addressed. Accordingly the risk management thread is woven throughout the document.

The Impact of Toxic Agent Training on Combat Readiness

DTIC Science & Technology

1992-03-24

Desert Storm veterans, as well as Lessons Learned from the use of toxic chemicals in World War I. Conclusions reached arei (1) Live agent training is...Department of the Army staff. The report of our findings and conclusions is attached. After reviewing this report and the lessons learned from Desert Storm...analysis of feedback from soldiers in the grades of PVl to General, input from Desert Storm veterans, as well as lessons learned from the use of toxic

Constellation Program: Lessons Learned. Volume 1; Executive Summary

NASA Technical Reports Server (NTRS)

Rhatigan, Jennifer L. (Editor)

2011-01-01

This document (Volume I) provides an executive summary of the lessons learned from the Constellation Program. A companion Volume II provides more detailed analyses for those seeking further insight and information. In this volume, Section 1.0 introduces the approach in preparing and organizing the content to enable rapid assimilation of the lessons. Section 2.0 describes the contextual framework in which the Constellation Program was formulated and functioned that is necessary to understand most of the lessons. Context of a former program may seem irrelevant in the heady days of new program formulation. However, readers should take some time to understand the context. Many of the lessons would be different in a different context, so the reader should reflect on the similarities and differences in his or her current circumstances. Section 3.0 summarizes key findings developed from the significant lessons learned at the program level that appear in Section 4.0. Readers can use the key findings in Section 3.0 to peruse for particular topics, and will find more supporting detail and analyses in Section 4.0 in a topical format. Appendix A contains a white paper describing the Constellation Program formulation that may be of use to readers wanting more context or background information. The reader will no doubt recognize some very similar themes from previous lessons learned, blue-ribbon committee reviews, National Academy reviews, and advisory panel reviews for this and other large-scale human spaceflight programs; including Apollo, Space Shuttle, Shuttle/Mir, and the ISS. This could represent an inability to learn lessons from previous generations; however, it is more likely that similar challenges persist in the Agency structure and approach to program formulation, budget advocacy, and management. Perhaps the greatest value of these Constellation lessons learned can be found in viewing them in context with these previous efforts to guide and advise the Agency and its stakeholders.

Developing Electronic Health Record (EHR) Strategies Related to Health Center Patients' Social Determinants of Health.

PubMed

Gold, Rachel; Cottrell, Erika; Bunce, Arwen; Middendorf, Mary; Hollombe, Celine; Cowburn, Stuart; Mahr, Peter; Melgar, Gerardo

2017-01-01

"Social determinants of heath" (SDHs) are nonclinical factors that profoundly affect health. Helping community health centers (CHCs) document patients' SDH data in electronic health records (EHRs) could yield substantial health benefits, but little has been reported about CHCs' development of EHR-based tools for SDH data collection and presentation. We worked with 27 diverse CHC stakeholders to develop strategies for optimizing SDH data collection and presentation in their EHR, and approaches for integrating SDH data collection and the use of those data (eg, through referrals to community resources) into CHC workflows. We iteratively developed a set of EHR-based SDH data collection, summary, and referral tools for CHCs. We describe considerations that arose while developing the tools and present some preliminary lessons learned. Standardizing SDH data collection and presentation in EHRs could lead to improved patient and population health outcomes in CHCs and other care settings. We know of no previous reports of processes used to develop similar tools. This article provides an example of 1 such process. Lessons from our process may be useful to health care organizations interested in using EHRs to collect and act on SDH data. Research is needed to empirically test the generalizability of these lessons. © Copyright 2017 by the American Board of Family Medicine.

Constellation Program Lessons Learned. Volume 2; Detailed Lessons Learned

NASA Technical Reports Server (NTRS)

Rhatigan, Jennifer; Neubek, Deborah J.; Thomas, L. Dale

2011-01-01

These lessons learned are part of a suite of hardware, software, test results, designs, knowledge base, and documentation that comprises the legacy of the Constellation Program. The context, summary information, and lessons learned are presented in a factual format, as known and described at the time. While our opinions might be discernable in the context, we have avoided all but factually sustainable statements. Statements should not be viewed as being either positive or negative; their value lies in what we did and what we learned that is worthy of passing on. The lessons include both "dos" and "don ts." In many cases, one person s "do" can be viewed as another person s "don t"; therefore, we have attempted to capture both perspectives when applicable and useful. While Volume I summarizes the views of those who managed the program, this Volume II encompasses the views at the working level, describing how the program challenges manifested in day-to-day activities. Here we see themes that were perhaps hinted at, but not completely addressed, in Volume I: unintended consequences of policies that worked well at higher levels but lacked proper implementation at the working level; long-term effects of the "generation gap" in human space flight development, the need to demonstrate early successes at the expense of thorough planning, and the consequences of problems and challenges not yet addressed because other problems and challenges were more immediate or manifest. Not all lessons learned have the benefit of being operationally vetted, since the program was cancelled shortly after Preliminary Design Review. We avoid making statements about operational consequences (with the exception of testing and test flights that did occur), but we do attempt to provide insight into how operational thinking influenced design and testing. The lessons have been formatted with a description, along with supporting information, a succinct statement of the lesson learned, and recommendations for future programs and projects that may be placed in similar circumstances.

Operationalizing the Learning Health Care System in an Integrated Delivery System

PubMed Central

Psek, Wayne A.; Stametz, Rebecca A.; Bailey-Davis, Lisa D.; Davis, Daniel; Darer, Jonathan; Faucett, William A.; Henninger, Debra L.; Sellers, Dorothy C.; Gerrity, Gloria

2015-01-01

Introduction: The Learning Health Care System (LHCS) model seeks to utilize sophisticated technologies and competencies to integrate clinical operations, research and patient participation in order to continuously generate knowledge, improve care, and deliver value. Transitioning from concept to practical application of an LHCS presents many challenges but can yield opportunities for continuous improvement. There is limited literature and practical experience available in operationalizing the LHCS in the context of an integrated health system. At Geisinger Health System (GHS) a multi-stakeholder group is undertaking to enhance organizational learning and develop a plan for operationalizing the LHCS system-wide. We present a framework for operationalizing continuous learning across an integrated delivery system and lessons learned through the ongoing planning process. Framework: The framework focuses attention on nine key LHCS operational components: Data and Analytics; People and Partnerships; Patient and Family Engagement; Ethics and Oversight; Evaluation and Methodology; Funding; Organization; Prioritization; and Deliverables. Definitions, key elements and examples for each are presented. The framework is purposefully broad for application across different organizational contexts. Conclusion: A realistic assessment of the culture, resources and capabilities of the organization related to learning is critical to defining the scope of operationalization. Engaging patients in clinical care and discovery, including quality improvement and comparative effectiveness research, requires a defensible ethical framework that undergirds a system of strong but flexible oversight. Leadership support is imperative for advancement of the LHCS model. Findings from our ongoing work within the proposed framework may inform other organizations considering a transition to an LHCS. PMID:25992388

Why undertake a pilot in a qualitative PhD study? Lessons learned to promote success.

PubMed

Wray, Jane; Archibong, Uduak; Walton, Sean

2017-01-23

Background Pilot studies can play an important role in qualitative studies. Methodological and practical issues can be shaped and refined by undertaking pilots. Personal development and researchers' competence are enhanced and lessons learned can inform the development and quality of the main study. However, pilot studies are rarely published, despite their potential to improve knowledge and understanding of the research. Aim To present the main lessons learned from undertaking a pilot in a qualitative PhD study. Discussion This paper draws together lessons learned when undertaking a pilot as part of a qualitative research project. Important methodological and practical issues identified during the pilot study are discussed including access, recruitment, data collection and the personal development of the researcher. The resulting changes to the final study are also highlighted. Conclusion Sharing experiences of and lessons learned in a pilot study enhances personal development, improves researchers' confidence and competence, and contributes to the understanding of research. Implications for practice Pilots can be used effectively in qualitative studies to refine the final design, and provide the researcher with practical experience to enhance confidence and competence.

Health Care Assisting Lesson Planning Guide for Long-Term Care Aide Certification. South Carolina Health Occupations Education.

ERIC Educational Resources Information Center

South Carolina State Dept. of Education, Columbia. Office of Occupational Education.

This document consists of 13 competency outlines/lesson plans that have been developed for use in preparing students for certification as long-term care aides through South Carolina's health occupations education program. The following competencies are covered in the individual lessons: identify the function and responsibilities of nurses aides;…

Does responsibility drive learning? Lessons from intern rotations in general practice.

PubMed

Cantillon, Peter; Macdermott, Maeve

2008-01-01

The intern (or pre-registration) year has been criticised in the past for its emphasis on service delivery at the expense of educational achievement. It is hoped that new approaches to early postgraduate training such as the foundation programmes in the UK, will make clinical education more structured and effective. Intern placements in non-traditional settings such as general practice have been shown in the past to improve the quality of learning. Little is known however about which features of the general practice learning environment contribute most to the perception of improved learning. This aim of this study was to examine the learning environment in general practice from the perspective of interns, (the learners), to determine the factors that contribute most to motivating effective learning in a general practice setting. This study used a qualitative case study approach to explore the effects of two different learning environments, (general practice and hospital) on learner motivation amongst a small group of interns. We found that the biggest difference between the hospital and general practice learning environments was the increased individual responsibility for patient care experienced by interns in general practice. Greater responsibility was associated with greater motivation for learning. Increased intern responsibility for patient care does appear to motivate learning. More work needs to be done on providing interns in hospital posts with greater patient responsibility within an effective supervisory structure.

Reconstructing High School Chemical Reaction Lessons to Motivate and Support Conceptual Learning

NASA Astrophysics Data System (ADS)

Ndiforamang, Nathan Moma

The primary focus of this education leadership portfolio is to reconstruct lessons on chemical reaction concepts for teachers to use and reach all learners of chemistry in Cecil County Public Schools. As a high school chemistry teacher, I have observed that student enrollment in chemistry is relatively low, and students show little enthusiasm about being successful in chemistry compared to other science subjects. To understand these issues, I researched conceptual learning, misconceptions, and best practices; prepared open-ended questions in a survey for chemistry teachers in my district; distributed the survey; received their responses; and processed the information received. I analyzed the data using qualitative techniques, and the results revealed that many of the tools provided in the district's curriculum guide for chemistry were not effective in class. I used the data to search for learning tools and classroom resources that could improve students understanding of chemistry concepts. I then reconstructed eight lessons on chemical reaction concepts utilizing those tools and resources. I redistributed the reconstructed lessons to teachers who had volunteered to review the lessons and provide professional feedback. The teachers' feedback revealed that the tools and resources incorporated in the reconstructed lessons included interactive activities that would excite students. The teachers indicated that the lessons were technology rich and included a variety of learning strategies. They also noted that the lessons included too many activities to cover within a day's lesson, and some of the recommended weblinks had technical issues. Most of the suggestions received were used to improve the quality of the reconstructed lessons and will serve as a resource for future fine-tuning of the lessons.

MC-1 Engine Valves, Lessons Learned

NASA Technical Reports Server (NTRS)

Laszar, John

2003-01-01

Many lessons were learned during the development of the valves for the MC-1 engine. The purpose of this report is to focus on a variety of issues related to the engine valves and convey the lessons learned. This paper will not delve into detailed technical analysis of the components. None of the lessons learned are new or surprising, but simply reinforce the importance of addressing the details of the design early, at the component level. The Marshall Space Flight Center (MSFC), Huntsville, Alabama developed the MC-1 engine, a LOX / FW-1, 60,000 pound thrust engine. This engine was developed under the Low Cost Boost Technology office at MSFC and proved to be a very successful project for the MSFC Propulsion team and the various subcontractors working the development of the engine and its components.

Critical Care Interprofessional Education: Exploring Conflict and Power-Lessons Learned.

PubMed

Friend, Mary Louanne; Friend, Richard D; Ford, Cassandra; Ewell, Patrick J

2016-12-01

The purpose of this mixed-methods study was to evaluate the effects of an innovative critical care interprofessional education intervention on prelicensure nursing and medical students at a large public university. The class provided opportunities for students to (a) explore stereotypes about each respective profession, (b) examine the occurrence and effects of interprofessional conflict in high-acuity areas, and (c) explore conflict resolution techniques while learning how to perform critical care procedures as a team. A nonequivalent control group design with pretest, posttest, and focus group interviews were used. Data analyses indicated no subscales and total scores were significantly different across time or between groups. However, focus group analyses indicated that changes did occur. The findings suggest that students experience interprofessional conflict in clinical settings, yet lack the confidence and skills to effectively mitigate these behaviors. Ongoing studies to measure student empowerment and their intentions to practice collaboratively before and after graduation are recommended. [J Nurs Educ. 2016;55(12):696-700.]. Copyright 2016, SLACK Incorporated.

International learning on increasing the value and effectiveness of primary care (I LIVE PC) New Zealand.

PubMed

Goodyear-Smith, Felicity; Gauld, Robin; Cumming, Jacqueline; O'Keefe, Bev; Pert, Harry; McCormack, Paul

2012-03-01

New Zealand (NZ) has a central government-driven, tax-funded health system with the state as dominant payer. The NZ experience precedes and endorses the US concept of patient-centered medical homes providing population-based, nonepisodic care supported by network organizations. These networks provide administration, budget holding, incentivized programs, data feedback, peer review, education, human relations, and health information technology support and resources. Key elements include enrolled populations; an interdisciplinary team approach; health information technology interoperability and access between all providers as well as patients; devolution of hospital-based services into the community; intersectorial integration; blended payments (a combination of universal capitated funding, patient copayments, and targeted fee-for-service for specific items); and a balance of clinical, corporate, and community governance. In this article, we discuss reforms to NZ's primary care arrangements over the past 2 decades and reflect on the lessons learned, their relevance to the United States, and issues that remain to be resolved.

Lessons Learned From the Affordable Care Act: The Premium Subsidy Design May Promote Adverse Selection.

PubMed

Graetz, Ilana; McKillop, Caitlin N; Kaplan, Cameron M; Waters, Teresa M

2017-05-01

Since 2014, average premiums for health plans available in the Affordable Care Act marketplaces have increased. We examine how premium price changes affected the amount consumers pay after subsidies for the lowest-cost bronze and silver plans available by age in the federally facilitated exchanges. Between 2015 and 2016, benchmark plan premiums increased in 83.3% of counties. Overall, rising benchmark premiums were associated with lower average after-subsidy premiums for the lowest-cost bronze and silver plans for older subsidy-eligible adults, but with higher after-subsidy premiums for younger adults purchasing the same plans, regardless of income. With recent discussions to replace or overhaul the Affordable Care Act, it is critical that we learn from the successes and failures of the current policy. Our findings suggest that the subsidy design, which makes rising premiums costlier for younger adults looking to purchase an entry-level plan, may be contributing to adverse selection and instability in the marketplace.

The 5th Annual One Mind Summit: Lessons Learned About “Science Informing Brain Health Policies and Practice”

PubMed Central

Johnson, Stephen; Porter, Amy C.; Zatzick, Douglas

2017-01-01

Abstract Advances in science frequently precede changes in clinical care by several years or even decades. To better understand the path to translation, we invited experts to share their perspectives at the 5th Annual One Mind Summit: “Science Informing Brain Health Policies and Practice,” which was held on May 24–25, 2016, in Crystal City, VA. While the translation of brain research throughout the pipeline—from basic science research to patient care—was discussed, the focus was on the implementation of “best evidence” into patient care. The Summit identified key steps, including the need for professional endorsement and clinical guidelines or policies, acceptance by regulators and payers, dissemination and training for clinicians, patient advocacy, and learning healthcare models. The path to implementation was discussed broadly, as well as in the context of a specific project to implement concussion screening in emergency and urgent care centers throughout the United States. PMID:28351324

The brave new world of managed care.

PubMed

Korcok, M

1995-07-01

Canadian hospitals that think they can charge higher-than-normal rates to foreign visitors are learning a lesson as US-style managed care moves north of the border. Dr. Robert MacMillan, president and medical director of Florida-based Insurance Claims Management Systems and past president of the Ontario Medical Association, says that south of the border US-style managed care has already hauled in the reins on wild expectations about high payments, and it is expected to do the same for Canadian hospitals that charge private insurers "as much as the traffic will bear." He says it is no longer uncommon for a large Toronto hospital to charge a foreign patient $3000 a day for care that can now be purchased in a US hospital for one-third that price.

The Cambia Sojourns Scholars Leadership Program: Conversations with Emerging Leaders in Palliative Care.

PubMed

Cruz-Oliver, Dulce M; Bernacki, Rachelle; Cooper, Zara; Grudzen, Corita; Izumi, Seiko; Lafond, Deborah; Lam, Daniel; LeBlanc, Thomas W; Tjia, Jennifer; Walter, Jennifer

2017-08-01

There is a pressing workforce shortage and leadership scarcity in palliative care to adequately meet the demands of individuals with serious illness and their families. To address this gap, the Cambia Health Foundation launched its Sojourns Scholars Leadership Program in 2014, an initiative designed to identify, cultivate, and advance the next generation of palliative care leaders. This report intends to summarize the second cohort of Sojourns Scholars' projects and their reflection on their leadership needs. This report summarizes the second cohort of sojourns scholars' project and their reflection on leadership needs. After providing a written reflection on their own projects, the second cohort participated in a group interview (fireside chat) to elicit their perspectives on barriers and facilitators in providing palliative care, issues facing leadership in palliative care in the United States, and lessons from personal and professional growth as leaders in palliative care. They analyzed the transcript of the group interview using qualitative content analysis methodology. Three themes emerged from descriptions of the scholars' project experience: challenges in palliative care practice, leadership strategies in palliative care, and three lessons learned to be a leader were identified. Challenges included perceptions of palliative care, payment and policy, and workforce development. Educating and collaborating with other clinicians and influencing policy change are important strategies used to advance palliative care. Time management, leading team effort, and inspiring others are important skills that promote effectiveness as a leader. Emerging leaders have a unique view of conceptualizing contemporary palliative care and shaping the future. Providing comprehensive, coordinated care that is high quality, patient and family centered, and readily available depends on strong leadership in palliative care. The Cambia Scholars Program represents a unique opportunity.

The roles of lesson study in the development of mathematics learning instrument based on learning trajectory

NASA Astrophysics Data System (ADS)

Misnasanti; Dien, C. A.; Azizah, F.

2018-03-01

This study is aimed to describe Lesson Study (LS) activity and its roles in the development of mathematics learning instruments based on Learning Trajectory (LT). This study is a narrative study of teacher’s experiences in joining LS activity. Data collecting in this study will use three methods such as observation, documentations, and deep interview. The collected data will be analyzed with Milles and Huberman’s model that consists of reduction, display, and verification. The study result shows that through LS activity, teachers know more about how students think. Teachers also can revise their mathematics learning instrument in the form of lesson plan. It means that LS activity is important to make a better learning instruments and focus on how student learn not on how teacher teach.

Active Learning Institute: Energizing Science and Math Education. A Compilation of Lesson Plans.

ERIC Educational Resources Information Center

Cuyahoga Community Coll. - East, Cleveland, OH.

The middle school and high school lessons featured in this collection were crafted by science and math teachers who participated in a week-long seminar sponsored by the Eisenhower Professional Development Program administered by the Ohio Board of Regents. The lessons showcase a variety of active learning strategies from using hands-on, low-tech…

Teacher Perspectives about Lesson Study in Secondary School Departments: A Collaborative Vehicle for Professional Learning and Practice Development

ERIC Educational Resources Information Center

Cajkler, Wasyl; Wood, Phil; Norton, Julie; Pedder, David; Xu, Haiyan

2015-01-01

Two departments in a secondary school in England participated in "lesson study" projects over a five-month period to explore its usefulness as a vehicle for professional development. Through a cycle of two research lessons, conducted separately in each department, teachers identified challenges that inhibited the learning of their…

Data storage: Retrospective and prospective

NASA Technical Reports Server (NTRS)

Speliotis, Dennis E.

1993-01-01

We study history to learn from its lessons so we don't repeat the mistakes. Ironically, however, sometimes it seems that the lessons we learn from history is how to repeat the mistakes more precisely. A brief discussion about the history of magnetic recording is presented, and the lessons of the past are used to look into the future.

Deaf Children's Science Content Learning in Direct Instruction Versus Interpreted Instruction

ERIC Educational Resources Information Center

Kurz, Kim B.; Schick, Brenda; Hauser, Peter C.

2015-01-01

This research study compared learning of 6-9th grade deaf students under two modes of educational delivery--interpreted vs. direct instruction using science lessons. Nineteen deaf students participated in the study in which they were taught six science lessons in American Sign Language. In one condition, the lessons were taught by a hearing…

Conceptualizing and Describing Teachers' Learning of Pedagogical Concepts

ERIC Educational Resources Information Center

González, María José; Gómez, Pedro

2014-01-01

In this paper, we propose a model to explore how teachers learn pedagogical concepts in teacher education programs that expect them to become competent in lesson planning. In this context, we view pedagogical concepts as conceptual and methodological tools that help teachers to design a lesson plan on a topic, implement this lesson plan and assess…

Lessons Learned and Lessons To Be Learned: An Overview of Innovative Network Learning Environments.

ERIC Educational Resources Information Center

Jacobson, Michael J.; Jacobson, Phoebe Chen

This paper provides an overview of five innovative projects involving network learning technologies in the United States: (1) the MicroObservatory Internet Telescope is a collection of small, high-quality, and low-maintenance telescopes operated by the Harvard-Smithsonian Center for Astrophysics (Massachusetts), which may be used remotely via the…

From the Games Industry: Ten Lessons for Game-Based Learning

ERIC Educational Resources Information Center

Hollins, Paul; Whitton, Nicola

2011-01-01

This paper draws on lessons learned from the development process of the entertainment games industry and discusses how they can be applied to the field of game-based learning. This paper examines policy makers and those wishing to commission or develop games for learning and highlights potential opportunities as well as pitfalls. The paper focuses…

Systems Engineering Lessons Learned from Solar Array Structures and Mechanisms Deployment

NASA Technical Reports Server (NTRS)

Vipavetz, Kevin; Kraft, Thomas

2013-01-01

This report has been developed by the National Aeronautics and Space Administration (NASA) Human Exploration and Operations Mission Directorate (HEOMD) Risk Management team in close coordination with the Engineering Directorate at LaRC. This document provides a point-in-time, cumulative, summary of actionable key lessons learned derived from the design project. Lessons learned invariably address challenges and risks and the way in which these areas have been addressed. Accordingly the risk management thread is woven throughout the document.

The Beaverton School District Arts for Learning (A4L) Lessons Project, an Investing in Innovation (i3) Development Grant: Student Impact Findings from Years 1, 2, and 3

ERIC Educational Resources Information Center

Nakamoto, Jonathan; Sobolew-Shubin, Sandy; Orland, Martin

2015-01-01

The purpose of this study was to assess the impact of the Arts for Learning (A4L) Lessons Project on the literacy and life skills of students in grades 3, 4, and 5. A4L Lessons is a supplementary literacy curriculum designed to blend the creativity and discipline of the arts with learning science to raise student achievement in reading and…

Heritage Adoption Lessons Learned: Cover Deployment and Latch Mechanism

NASA Technical Reports Server (NTRS)

Wincentsen, James

2006-01-01

Within JPL, there is a technology thrust need to develop a larger Cover Deployment and Latch Mechanism (CDLM) for future missions. The approach taken was to adopt and scale the CDLM design as used on the Galaxy Evolution Explorer (GALEX) project. The three separate mechanisms that comprise the CDLM will be discussed in this paper in addition to a focus on heritage adoption lessons learned and specific examples. These lessons learned will be valuable to any project considering the use of heritage designs.

Weapon System Management to Directorate of Logistics Management Systems Requirements (XRB) DCS/Plans and Programs Air Force Logistics Command Wright-Patterson AFB, Ohio 45433.

DTIC Science & Technology

1982-05-14

Attachment 2 contains the reports and lessons learned which resulted from the Level II Weapon System Management activities. Attachment 3 contains the reports...and lessons learned which resulted from the Level III Weapon System Management activities. _____ r. Air Force Logistics Command Attn: Col. McConnell 2...May 14, 1982 Attachment 4 contains the plans and lessons learned which resulted from the RCC Evaluation activities. I am pleased to deliver these