Twitter on hold: Blog a trickle ...

Deal!

— Dries Buytaert (@Dries) August 25, 2021

 

Feels good already ... 

Thanks for following and visiting ... 

Still available at  h2cmng AT yahoo.co.uk 

Take care 

Peter J.

 

RFID Tags Track Possible Outbreak Pathways in the Hospital

There is no substitute for providing evidence that confirms many common-sense assumptions about what happens in the clinical environment that is the ward - in this case paediatrics.

See the links below for details and explanation.

My source: John Matson. Graphic Science. Scientific American, November 2012, page 76.
See also the original PLoS ONE paper.

A question. An answer - in response to recent media (HSJ Ack.)

Here are a couple of quotes from HSJ Roundtable meetings:

"What I hear around the country is that we have masses of information but we need to turn that into something that is intelligible and can be used for strategic decision making."...

"We need to look at how information links together to get a holistic picture of the situation." p. 20.

Dr Shahid Ali, (2012) Commissioning Information. Full Measures. HSJ, June 28, 20-23.

 "I don't think we should be integrating systems, we should be integrating around patients."  p. 20.

Dr Shahid Ali, (2012) Integrated Care. Let the Data Flow. HSJ, June 21, 20-25. 

"There's no integrated view of integrated care. The danger is that you have an integrated care system and everyone says, 'I will do one as well', and you end [up] with six of them." p. 22.

Owen Powell, (2012) Integrated Care. Let the Data Flow. HSJ, June 21, 20-25.


A question or two, or three ...

Is there a generic framework that can be shared and utilised across all health and social care?

A free resource that can be deployed in imagination, in solo on paper, in tandem and within a group potentially shaping collaboration, innovation, change and transformation. Applied in the clinical environment, the home, the lecture theater, the sports field...

A tool that can help support reflective practice not only at a strategic level, but the tactical and operational. What is happening on the ground floor? A framework that can help represent not only processes and policy, but practice, individual and group purposes.

Yes, policy maker and CEO meet with your information manager ... and discuss strategy.

But what is data, information, knowledge ....? What is 'health care' for it appears above we do not know?

Is there really no integrated view - even at a basic level that deserves further study?

Yes, health care practitioner meet your patient (client), their carer, your other partners (social enterprise...) and pursue what really counts: the best quality of care you can deliver given several constraints.

What is the outcome to be?

For the majority of the population (those not living with a long term medical condition) the transformation must be self-efficacy:
if 'shift happens' it must be from ill-health to health through education.

One answer:
The health care system cannot do this alone.

1st Int. Workshop on Designing for Self-Care: Acknowledging the home-clinic difference

Hi,
We invite position papers and works-in-progress papers for the first international workshop on "Designing for self-care: Acknowledging the home-clinic difference" to be held alongside NordiCHI on 14th October, at the IT-University of Copenhagen.

Kindly consider submitting your work, and / or share with your network.

Regards,
Naveen Bagalkot

 ----------------------------- Call For Papers -----------------------------

Image source: The CfP website

Workshop theme: Supporting the movement of care across boundaries

Increasingly successful healthcare involves moving the care activities across the clinic-home boundaries. The field of HCI has increasingly explored ways to design digital technological tools to support this movement of care beyond the boundaries of a clinic.

However, the clinic and the home offer different settings, shaping the care activities in different ways. Acknowledging this difference of settings, opens up the space for various positions that designers can take for the design for self-care. We identify three key positions:

• Home as a place for caring: A focus on supporting the citizens to perform self-care activities at home that may (or may not) involve a larger network of family, friends, home care nurses, volunteers and home care workers.
• Clinic as a place for caring: A focus on supporting the care-givers at the clinic to prescribe home-based care activities to the citizens, and monitor how these are being complied with.
• Moving across the boundaries: A focus on supporting the citizens to move across the clinic-home boundaries, bringing with them materials from the clinic to home, and sharing the self-care activities from home with their care-givers at the clinic.

We offer these three positions as a starting point to invite researchers and practitioners working in this space of designing digital technological tools for self-care to become part of the workshop discourse. In particular we invite them to submit their positions in a 4-page ACM SIGCHI extended abstract format, based on their own empirical experiences and / or theoretical deliberations.

  

Workshop goals

• To bring together researchers from HCI and interaction design, and professional caregivers, to discuss and outline the challenges and promises posed by the different individual settings for care, and moving across these settings.
• To share insights from a range of cases about the challenges and successful strategies in designing digital technology for self-care.
• To explore promising design strategies and approaches for dealing with the challenges and promises posed by the different settings of care.

Workshop Outcomes

All accepted papers should bring a poster representing their paper to the workshop. This will be used during the workshop and its discussions. While shorter presentation of each paper will take place, the focus will be on more interactive sessions where the participants will interview each other, group work and plenum discussions. The workshop aims to share current work, methods, challenges and insights when working with, or designing for, home-based care.

  

Proceedings

The workshop will produce its proceedings in the form of an online database, which will be open to access by all interested researchers, practitioners and students. We are also looking into options to publish the proceedings with an ISBN number so that it is publicly available, and the possibility to make a journal special issue after the workshop. The proceedings will include:

• The call for position papers, which highlights the motivations and the theme of the workshop.
• The accepted position papers, and the respective posters.
• The minutes of the plenary discussions and the summary of the group work.

Submission format

Maximum four pages in ACM SIGCHI extended abstract format.

  

Contact details

Email the position papers to: ...

More details can be found on: ...

[HIFA2015] International Nurses Day, May 12 "Closing the gap: From evidence to action"

Dear Colleagues / collaborators,

Nurses worldwide under the umbrella of the International Council of Nurses celebrates the International Nurses Day yearly on May 12. This is to pay tribute to the millions of men and women who put their lives to the service of humanity, in accordance with convention 149 of the ILO (Nursing Personnel Convention) passed in 1997. This celebration however has not yet gained the recognition it should, for how can one explain the fact that this day may even go by unnoticed in some countries, or are we therefore saying it is not worth it and why is this day not even a public holiday like for other professional groups.

I find it hard to believe that until now on this forum no one could think of it, when the celebration is due in barely 36 hours. I understand the delicate nature of health jobs, but this should not be an excuse for not paying tribute where is it due. I know this day should be meant for reflection among nurses and seeking for ways to improve nursing services. This will not happen in isolation, for nurses need the political will and inter sectoral collaboration to do their job effectively, shape a better future for the next generation of nurses consonant with current stakes.

This year, nurses are deliberating on the theme 'closing the gap: From evidence to action'. This topic is quite elaborate and needs lots of considerations both within and without the influence of nurses. Understanding evidence-based practice, seeking for sources of evidence, making the appropriate case for change and moving from evidence to action is the cycle in which nurses hope to reflect as they celebrate this year. Nurses will need new skills and expertise to deal with their clients in today's changing and challenging health environment. This is why this forum is of vital importance and I will continue to thank the team behind it. Nursing training programs may be subject to revision, expanding the legal and professional limits of practice while maintaining strict regulatory sanctions. This increased autonomy will enable nurses take up new functions within the confines of their practice and help in meeting the health needs of our population and not acting as physician substitutes or mini-doctors.

Therefore, I wish all nurses a happy celebration, calling on them to use the very rich celebration kit from the ICN, easily downloadable from their website, www.icn.ch, and share among themselves in all settings where nurses live and work. It is our day and we should be happy and honoured for the services we offer to the six billion people on earth, since nurses form the bulk of health care providers and work in remote areas in all countries.

In Cameroon, thousands of nurses from all the ten regions, shall be meeting in the economic capital Douala between June 14 to 16, to brainstorm on the activities. This event is usually opened by the Minister of Public health or his representative, various scientific presentations, round table conferences and other important activities grace the event and concluded by a closing ceremony during which important decisions taken are communicated to participants.

Tita Pale Isa Ndognjem, BSc, RN
Public Relation officer, Cameroon Nurses Association
2012 Fellow, Commonwealth Nurses Federation
paleisa AT yahoo.com 

Additional link:

C149 Nursing Personnel Convention, 1977
Convention concerning Employment and Conditions of Work and Life of Nursing Personnel (Note: Date of coming into force: 11:07:1979.) 
 
My source: HIFA2015

Dame Fiona Caldicott to lead Confidentiality Review

Dame Fiona Caldicott has agreed to lead an independent from Government review of the balance between protecting patient information and its sharing, to improve patient care.

The Department expects to respond to the panel’s recommendations when the review publishes during 2012.

The recommendation for a review of the balance between protecting patient information and its sharing, to improve patient care was part of the Future Forum’s recommendations to Government on the modernisation of health and care.

... more.

My source:
IHTSDO CoP

Bob Newhart, a phone, distance, dementia and communication

BBC Radio 4 have a series For One Night Only which looks back at classic concerts. These are not only music related as last Saturday attested featuring The Button-Down Mind of Bob Newhart. This is the title of Bob Newhart's award winning comedy album that topped the charts in 1960. When Bob Newhart first appeared his act was radically different from the usual comedy fare. In this edition presenter Paul Gambaccini interviews the now 81-year-old Newhart about the album, his success and approach: an individual on stage with a telephone.

In the discussion I was struck by the point that although it was just one man with a phone the audience acted as a proxy for the other party. Being socialised as we are the audience became the other party in Newhart's comical one-to-one conversations. We fill-in the missing details; what has most likely been said, what must have happened and what may happen next. Our humanity, experiences and imaginations fill the space making use of the redundancy that resides in context, language and the comedic.

As noted previously my colleagues and I have started giving some talks on communication to residential and nursing home staff. The focus in these sessions being person centered care and the challenges that residents living with dementia face together with their carers and families.

I don't want to worry senior managers - but in my sessions I try to convey to staff how everyone, whatever their experience, position and grade has a role to play in assuring high quality person centered care. Listening to For One Night Only you see the challenge writ large. Now a sense of humour in medicine and nursing is a great help, but this isn't the staff room and it's no comedy either.

Care staff must realise how important it is that they pick up and use the 'phone'. Their individual observations, patience and interpersonal efforts are vital. Even with some training in dementia care  staff may be surprised how the person with cognitive problems can fill in the spaces. Even if a resident cannot understand the words spoken to them, the tenor, tone, intent and attitude behind the words can be communicated and contribute greatly to supporting the care that follows. Especially when there is a need to deliver personal care.

In providing much needed personal care the technological marvel that is telephony may have its limits (even as telecare), but it can still teach us much about information and communication.

Most obviously when 'distance' remains.

Image source: http://www.pbs.org/weta/onstage/twain2002/bios/

Proximity: Relationships, Records, e-Health - Person-centredness near and far

When data protection and confidentiality is debated "the need to know" is often wheeled out as a rationale for access to personal identifiable data.

See the following:
NHS Confidentiality Consultation - FIPR Response (esp. #18).
DoH, Confidentiality, UK

In addition, if I need to access the record of patient held at hospital 'x' from hospital 'y' what is the health care relationship that prompts and justifies this need?

At present visiting nursing and care homes, you go knowing that data capture and recording (care assessment) is a fundamental requirement. Having a secure laptop for community has long been promised. While tech solutions are available and implemented elsewhere, my lack of such technology prompts me to imagine a future visit. ...

Pulling up at the nursing home I walk up the drive, ring the bell. While I wait the new tablet device in its bag has already introduced itself to the home. As I am allowed in - my identity assured - the tablet continues its dialogue, it:

1. Downloads and updates existing active client data.
2. Downloads additional data as per the agreed dataset on the new referral.
3. Checks on items 1-2 with a review of recent prescribing for key psychotropic medicines.
4. It checks the most recent NICE, Cochrane evidence and reconciling the local care knowledge. (This may seem excessive at present, but come personalised medicine this will be crucial).
5. Will check on most recent clinical reviews and due dates.
6. The h2cm template is there ;-) ready to present the care domain summary for the general physician ... and possibly (roles?) the next care professional to visit this home and this resident.

The significance of relationships is usually denoted by distance. Personal space is rather obviously spatial. This is how we recognise (well one of the ways!) the meaning and significance of an intimate relationship. In care situations with individuals who are confused and potentially aggressive we are conscious of the need to have due regard and respect for that person's personal space. Spaces and boundaries have to be negotiated in a variety of ways and means. 

Health information technology has already made effective use of role-based access to systems. If we take person-centred care to the nth degree, proximity can also count as it does in mobile health (m-health). Whilst to effect a role is to be in a certain location and context (sat at the office PC in the hospital) roles are organisationally and politically defined. Proximity is also contextual and situated in other ways, my proximity to:

• the nursing home;
• the individual's room;
• the individual themselves.
• (and their relatives)

While telecare / informatics can deliver a dividend in remote care, it is essential that it can also demonstrably support person-centred care. The best way (clinically assured) to do that for many activities is person-to-person contact. Just because one-side of the relationship may not recall the encounter as little as five minutes after, does not mean that there is no value in sustaining the ring of the bell, the exchange of s-miles, the record that results and other background conversations.

Image source:
Gestalt - proximity
http://graphicdesign.spokanefalls.edu/tutorials/process/gestaltprinciples/gestaltprinc.htm

Drupal musings 18: healthcare group, DrupalCamp and #183

It's a fair trip to Edinburgh from NW England just for one day on the 30th October, but DrupalCamp looks like it will be worth it. I've just booked a room for the Friday night and will set out straight from work.

There's been a Drupal healthcare group for quite a while, now there's also a list of health sites using Drupal:

http://groups.drupal.org/healthcare-sites

One day, one day....!

I'm not sure if this post is contrived: a means of getting to post #183. That was the total for 2009 and here we are already.

If one day, one day is going to happen then this blog is going to slow down soon. No suspended animation though. There will be a pulse.

The involvement of a few link partners on W2tQ is very helpful. It seems the archives are of interest. This not only supports the IT side - future hosting ... but attending events (DrupalCamp travel, B&B) and possibly conferences...

As a full-time nurse I sometimes have to rely on holidays to attend events. Drupalcons are a case in point. It's not easy trying to simultaneously span nursing, education and informatics, but it really is fascinating [and it makes me :-) ]. Take the following 'local' conference:

Celebrating the Past and Embracing the Future:

Evolution and Innovation in Problem-based Learning

March 30th and 31st 2011 in Grange-Over-Sands, Cumbria, UK

I raise this because problem-based learning is a real gift for the health career model, but this gift runs to £235 (which of course for two days training / education is very reasonable - there is a free half-day workshop too). 

Philosophy of information empowers philosophy of care

The moral and ethical dimensions of nursing quickly become apparent to individual practitioners and professional associations. Philosophy in nursing boasts specific courses, journals and groups, for example:

International Philosophy of Nursing Society (IPONS)

Here on W2tQ, in papers and on the (former) website I have stressed the importance of the health career model as a framework that can utilise information as a fundamental and potentially unifying concept.

Expanding on the post last week about the philosophers' magazine [tpm50] let's look at Floridi's piece on the philosophy of information (PI). The 50 ideas featured are each only granted two pages, but this has a definite philosophical equivalent twitter-styled appeal. On page 42 (- 43) Floridi notes that:

... PI possesses one of the most powerful conceptual vocabularies ever devised in philosophy. This is because one can rely on informational concepts whenever a complete understanding of some series of events is unavailable or unnecessary for providing an explanation. Virtually any issue can be rephrased informationally. Such semantic power is a great advantage of PI, understood as a methodology. ...

It shows that we a dealing with an influential paradigm. But it may also be a disadvantage, because a metaphorically pan informational approach can lead to a dangerous equivocation, namely, thinking that since any x can be described in (more or less metaphorically) informational terms, then the nature of any x is genuinely informational. (Luciano Floridi, 2010).

Admittedly Floridi's context is the position and status of PI as an emerging discipline within philosophy. As he notes the vocabulary while powerful lies in the discipline of philosophy.

Given my preoccupation with information, Floridi's observation above is a timely warning for me and the many nurses who in the past saw a concomitant risk that in adopting the nursing process, patients (and carers) would be processed. Ironically, this processing concerned information. The workflow - form and layout of the documentation - was prescribed. This is an old tale, with the nursing process being subsumed within the routine work of nursing. Perhaps though this also demonstrates a need for a new debate?

My interest in information is as a trope to explain the significance of the care (knowledge) domains that underpin Hodges' model. Crucially, though these can stand on their own as nursing philosophy issues. Joining the efforts of the nursing philosophers above, this can bring information and philosophy out of the academic realm to include a more practical and grounded variety of topics:

FROM: personal identity,
definitions and ownership of computer based records,
utility versus security of information (summary care record ...),
definitions of information (data, knowledge) - through
TO: patient information and patient informatics, ...
where is collective informatics^# heading?

Taking Floridi's lead - which of the above .... are core nursing (health) information concepts (and not just freeloading info-masqueraders along for the ride)? Well, that is a question for a new community of scholars to decide?

Philosophy resources: Interpersonal care domain

^#Collective informatics = all the claimed informatics disciplines combined?

International Journal of User Driven Healthcare (IJUDH) CfP

Dear Mr. Jones

In view of your work in patient-centered care, I’d like to invite you and/or your colleagues to submit a paper to this Special Issue of the new journal described further below and via the web link provided. I think our global readers would be very interested in your thoughts (and projects) on innovative ways to get relevant healthcare information into the hands of ‘users’ (both patients and providers), within the user-driven EBM paradigm, per below.

Please also share this call for papers with your colleagues.

Thanks for your consideration,

Susan Ross, MD

International Journal of User Driven Healthcare (IJUDH) Call for Papers

Editor-in-Chief:
Rakesh Biswas,
Center for Scientific Research and Development (CSRD),
PCMS Campus, India

Published: Quarterly

Call for Papers - Special Issue:

Submission Due Date: July 1, 2010
Special Issue On User Driven Healthcare and Evidence-based Medicine

Guest Editors:
Susan Ross, MD, FRCPC

Introduction

User Driven Healthcare (UDH) is part consumer-driven healthcare, part narrative medicine, and part Health 2.0. It stems from a concept of participatory healthcare whereby all stakeholders, enabled by information, software, and cyber-community, focus on healthcare value. But where does Evidence-based Medicine (EBM) fit into this framework? It is sometimes forgotten that EBM is a three-legged stool, comprised of the triad of evidence +provider expertise + patient preferences. In this EBM framework, provider expertise is needed to bridge the inferential gap between population-based evidence and the individual patient. And each patient's values and preferences should narrow that inferential gap further. But since the introduction of EBM nearly two decades ago, the primary focus of EBM proponents has been on Evidence, at the expense of patient preferences and provider expertise. Perhaps this is why the promise of EBM to foster the most efficient and high quality healthcare has not yet been realized.

Objective of the Special Issue

This Special Issue will focus on the following questions: Is the recent emergence of User Driven Healthcare really a new, post-EBM paradigm for healthcare, or just an overdue consideration of the other two legs of the original EBM stool? How might this trend affect all stakeholders?

Recommended Topics

Topics to be discussed in this special issue include (but are not limited to) the following:

• Developing valid patient-level evidence using the Web
• Evidence generation—clinical research strategies using social media and mobile technologies
• Examples of UDH to a) help formulate the right questions to ask in EBM; b) develop answers to those questions; c) disseminate the answers to patients and providers with a need to know; and d) test the impact of UDH-generated Evidence on patient outcomes
• Helping online patients sift the ‘wheat’ from the ‘chaff’—information management for patients in an EBM world
• How to incorporate patient preferences and values into ambulatory care decision-making (i.e., into the 10 minute visit)
• Measuring the impact of UDH on patient outcomes
• Patient-level decisions vs. population-level evidence (bridging the inferential gap)
• Pharmaceutical communication strategies using social media—impact on healthcare quality and costs in an EBM framework
• Place of social media in EBM—patient and physician online communities
• Practice of UDH vs. EBM around the world
• Regulatory issues of evidence dissemination by industry using social media in healthcare Statistical and other evaluative methods to assess the validity and reliability of evidence developed using social media and mobile technologies
• Trends in N-of-1 studies, and their relevance to EBM and UDH
• Use of collective intelligence to solve healthcare problems for individuals and communities

Submission

...

All submissions and inquiries should be directed to the attention of:
Susan Ross, MD
Guest Editor

Health, social care and informational emaciation

We hear a lot about information and how important it is, being in what is described as the information age, the information economy. ...

Nurses, patients and carers (plus managers) would instantly recognise that if a care plan and subsequent care delivery was based on the following assessment:

oriented, not depressed	hypertension, falls, dizziness, headaches, pyrexia
carer due hip operation	admitted 1st May 2010 1200hrs to clinical decisions unit

- we would be acutely concerned.

Clinically this is a case of informational emaciation. The information above is rather thin on the ground, this in turn affects the knowledge that can be gleaned in formulating, negotiating and agreeing actions. Even in the information sparse example above each of the care domains has some content; is that always the case?

Use of the word emaciated in this context is not intended to diminish the plight of people who are physically emaciated, poorly nourished.

This post is intended to highlight another aspect of poverty.

As the Global Healthcare Information Network (HIFA 2015) argues and campaigns - information is a means to emancipation - a way to overcome information emaciation.

Putting 'care' in a holistic frame

How many frames do you need?

*infocare: care demographics, directories, media, literacies...

care communication, self care, care ethics, care philosophy, emotional care, pastoral (green) care, therapeutic care, care beliefs, interpersonal care, MENTAL HEALTH CARE cognitive care, holistic care, care responsibility, care ecology	emergency care, physical care, care model, theory, plan, care assessment, evaluation, care curricula, intervention, care process, evidenced care, BASIC NURSING CARE intensive care, coronary care, special care baby unit, *infocare, nursing care, medical care, health care, e-care, surgical care
collaborative care, child care, personal care, older adult care, informal care, SOCIAL CARE, family care, care education, community care, care community, residential care, care dependency, abusive care, care risks	duty of care, care policy, care provision, inspection, standards, care economics, care outcomes, care legislation, care home, care contract, care advocacy, care quality, CARE AID, care qualification, regulation, State care, private care, care insurance, CARE RIGHTS, care service engagement, prison care

Don't forget the 5th, virtual, spiritual frame?

Where is that?
It is wherever you need it to be. ...

Additional suggestions welcome: h2cmng at yahoo.co.uk