Health Technology, Digital Healthcare
Article | August 16, 2023
© 2019 American Cranes & Transport Magazine.
Night moves
Moving over-sized, over-dimensional loads during the day is no easy task. Adding darkness and poor visibility to your trip adds numerous hazards that must be thoroughly identified and mitigated.
When planning a specialized transportation project, there are three primary objectives:
Ensure the safety of the transport crew and the general public.
Protect the integrity of the cargo and transport equipment.
Protection of Infrastructure – roads, bridges, traffic control devices, utilities and the like.
For the most part, specialized carriers perform night transports to reduce the impact on day-time commuter traffic. Route challenges – construction, road closures, lane crossovers, bridges and other obstacles – are often better solved at night. Police and utility support are often more readily available at night.
Night transport hazards include employee fatigue, slowed reaction time and poor visibility for both the transport crew and motorists. Decreased visibility increases potential for trips, falls, runovers, back overs and equipment strikes.
It can’t be emphasized enough how critically important it is to ensure that all transport crew members have had adequate rest for these projects. Workers need complete rest before the transport takes place. A fatigued worker is a danger to himself as well as his fellow crew members. And while impaired drivers can be out on the streets during the day, there is often an increased number of these drivers on roadways at night.
Limited visibility is a given when it comes to night-time transports. Limited visibility increases the chance of going off route and striking objects, and the transport driver’s maneuverability and reaction time maybe be reduced. Road conditions can abruptly change during a night-time transport. Therefore, it is critically important to know the route and to have drivers run it in advance. Statistically speaking, accident frequency increases when the transporter goes off route and attempts to correct itself. While providing the necessary lighting to make night transport is important, artificial lighting can pose visibility hazards, especially to the drivers. Other hazards may include bright work lighting that produces glare.
OSHA has identified the “Focus Four” accident events that make up the most serious injuries and fatalities in the construction business. They are also known as the “Fatal Four.” Many carriers have had employees injured in the past as a result of one of these four incidents.
Caught-in-between hazards are injuries resulting from a person being squeezed, caught, crushed, pinched or compressed between two or more objects or between parts of an object. This is also referred to as “pinch points or entrapment.” As the transporter navigates its designated route the landscape is continuously changing. It is imperative that all ground crew members maintain situational awareness and not place themselves between the moving transporter and fixed objects such as guardrails, parked vehicles, buildings, etc.
Struck-by hazards are injuries produced by forcible contact or impact between the injured person and an object or piece of equipment. There are many potential struck-by hazards. Guide wires that must be raised can snap and strike workers on the ground. Tag lines should be used to control loads. The primary purpose of using tag lines is to control the load but more importantly give the worker a safe buffer distance away from suspended and the uncontrolled movement of these loads.
Fall hazards are anything that could cause an unintended loss of balance or bodily support and result in a fall. To prevent fall hazards all workers should have either fall prevention or a means of fall protection in place. As a rule, 100 percent tie off is required when using a fall arrest system (FAS). FAS’s should be thoroughly inspected before each use.
Electrocution hazards result when a person is exposed to a lethal amount of electrical energy. Maintaining minimum approach distances (MAD) is a critical safety practice. As everyone knows, equipment does not have to physically make contact with energized equipment or lines to cause serious injuries and even death. Electrical energy can “jump” from lines into equipment that has encroached the Minimum Approach Distance based on its voltage.
As noted above, it is critically important to ensure that crew members have had adequate rest and are not fatigued. Night transports are difficult enough, and the last thing you want to introduce are tired and fatigued workers. Being fatigued creates a risk for anyone who undertakes an activity that requires concentration and a quick response.
All companies should have an “Hours Worked Policy” that clearly spells out the number of hours allowed to work before a mandatory rest period. This policy should ensure that the transport crew has had adequate rest during day, that a fatigue assessment is conducted on all team members, that crews are never allowed to work double shifts and that employees are prohibited from driving long distances to return home.
Dealing with darkness
Visibility and slowed reaction times should be a part of the project planning. A limited amount of ambient light that only projects upward and outward impedes vision and increases blind spots for drivers. Lights cast shadows, increasing the potential for slips, trips and falls.
All transport moves should establish pre-planned Emergency Action Plans. When an emergency occurs, time is of the essence and can mean the difference between life and death. If it is a long-distance move the emergency numbers and first responder information can change. Crews should know when it’s time to seek emergency “safe harbor.”
When approaching overhead obstructions such as guide wires, electrical lines, communication lines and overpasses, travel speed is of utmost importance. Again, pre-route surveys provide advance knowledge of obstructions. At night, visual identification of roadway obstructions is reduced and delayed and last second reactions to oncoming hazards can lead to accidents. Support personnel in bucket trucks also have the challenge of reduced visibility.
In darkness, overhead hazards often require more utility support for height clearances, which means the need for raising energized lines, lifting traffic control devices, trimming tree limbs, releasing tension on guide wires, removing highway signs, repositioning street lights and raising railroad crossing arms.
Traffic control can also create hazards. The general public may ignore pilot car lights at night, so it’s often advisable to also use police escorts. All support vehicles and trucks should be properly marked and equipped with strobe lights.
The configuration of the transport system can also be a hazard. Navigating sharp turns or crossovers is greatly reduced based on the length of transporter. Snake-like maneuvers of trailers pose an increased risk.
It’s important to never allow personnel to take shortcuts by walking through or under transporter while it’s in motion. Stop or have the worker go around.
Situational awareness
The transport crew must always maintain “situational awareness” to prevent being in line of fire or entrapped between moving and fixed objects.
All the equipment used in the transport must be deemed safe. You should have procedures to conduct thorough assessment of all new equipment.
Ensure machine guard devices are in place especially around moving components.
Provide secured areas using catwalks/railing system.
All steps should be designed with slip resistant material.
Ensure that all deck openings are properly protected and covered.
Components that hydraulically extend and retract should be clearly posted with DANGER signs.
Roadway conditions are always a bigger concern at night. Assess weather conditions prior to start of the project and don’t take chances. A “Go – No Go” criteria should be developed for each project. Once the decision is made to transport the load there is no turning back. Changing weather can cause the transporter to lose traction. Underpasses that are shaded during the day will likely freeze up more quickly. If the temperatures drop significantly during the move, equipment performance may be affected – especially those with hydraulics.
Because the reaction time of the transport crew is reduced, speeds are often reduced, causing potential for curfew violations. Boarding and deboarding the transporter increases risk for slips and falls. Other potential road condition hazards include grade of road, width of road, shoulder surfaces, railroad crossing clearances and bottoming out, overpasses, tight and narrow turning lanes, parked vehicles and frequent grade changes.
Crew prep is essential and should be a part of the job plan and job training. The team should be briefed each day to identify the responsibilities of all crew members. The crew should know it is empowered; everyone has the authority to stop the transport if something looks unsafe or when someone is unsure. In the event of a complication, crews should be informed of how to regroup and formulata mitigation plan. There should be an established means of communication that is limited only to transport issues. Most importantly, crew should embrace these words: When in doubt, call time out!
A Task Hazard Analysis (THA) should address all scope of work activities, identify hazards and have a mitigation plan for each, clear channels of communication, the traffic control plan and an “Emergency Preparedness Plan.” And finally: Know the route; ride the route and expect the unexpected.
Edwards-Moving_Faktor-5 (2).jpg
Edwards Moving performs a night move using it’s Goldhofer Faktor-5 transport system.
Keys to a successful night transport
Early planning and attention to detail. Anticipate roadway hazards such as guardrails, poles & hydrants that pose obstruction with travel path or turning radius.
Preparing a detailed traffic control plan.
Thorough due diligence throughout scope of work.
Established contingency plan for equipment.
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Health Technology
Article | September 12, 2023
Everybody deals with stress and anxiety, however the key is to know what to do when you’re stressed out. It is not always easy to keep your feelings from getting the best of you.
With this in mind, here are seven tips that a person can use to help manage their daily stresses and anxieties before they get out of control.
1. Get all of the facts of the situation: Gathering the facts of a certain event can prevent us from relying on exaggerated and fearful assumptions. By focusing on the facts, a person can rely on what is reality and what is not. Most importantly, do not focus on your fearful thoughts when you’re stressed out.
2. Take a break: Sometimes, we get stressed out when everything happens all at once. When this happens, a person should take a deep breath and try to find something to do for a few minutes to get their mind off of the problem. A person could take a walk, listen to some music, read the newspaper, or do an activity that will give them a fresh perspective on things.
3. Carry a small notebook of positive statements with you: Another technique that is very helpful in managing fear is to have a small notebook of positive statements that makes you feel good. Whenever you come across an affirmation that relaxes you, write it down in a small notebook that you can carry around with you in your pocket. Whenever you feel depressed, open up your small notebook and read those statements.
4. You can’t predict the future: While the consequences of a particular fear may seem real, there are usually other factors that cannot be anticipated and can affect the results of any situation. We may be ninety-nine percent correct in predicting the future, but all it takes is for that one percent to make a world of difference.
5. Challenge your negative thinking with positive statements and realistic thinking: When encountering thoughts that make you fearful or depressed, challenge those thoughts by asking yourself questions that will maintain objectivity and common sense. Focus on the reality of your situation and not on your thoughts. Your fearful thoughts can make things worse so try to focus on something positive when you get anxious.
6. Divide your activities into separate steps: When facing a current or upcoming task that overwhelms you with a lot of anxiety, divide the task into a series of smaller steps and then complete each of the smaller tasks one step at a time. Completing these smaller activities will make the stress more manageable and increases your chances of success.
7. Take advantage of the help that is available around you: There are many individuals who have been expertly trained in the field of psychology to help you find ways to manage fear and anxiety. Seek out someone whom you trust to provide sound advice and guidance. This same professional can also help you create an action plan for dealing with your fears and anxieties in the future.
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Health Technology, Digital Healthcare
Article | August 21, 2023
Discover the potential of EHR implementation in revolutionizing clinical processes. Uncover strategies for addressing EHR ethical issues, ensuring integration that prioritizes patient-centered care.
Amidst the fusion of healthcare and technology, integrating electronic health records (EHRs) has emerged as a transformative element in modern medical practice. As a digital repository for a patient's medical journey, EHRs present unprecedented prospects for elevated care quality, improved data accessibility, and cost-effectiveness. Nevertheless, these advancements bring forth an array of EHR ethical issues that demand meticulous attention. In this context, establishing and adhering to the best practices for the ethical training of EHRs assumes paramount importance and a moral obligation. By skillfully navigating the intricate convergence of technology, patient confidentiality, and conscientious healthcare, these ethical EHR best practices illuminate the path toward a future where innovation and ethical principles harmoniously coexist.
1. Upholding Privacy and Confidentiality
Revealing a patient's information to external parties should strictly happen with the patient's explicit consent or within the parameters defined by legal regulations. Data stemming from clinical interactions is confidential and requires rigorous protection. The effective operation of EHRs requires authorized access by healthcare institutions, insurers, and related entities. Access by users is contingent upon predefined role-based privileges. The administrator identifies users, specifies the extent of information accessibility, and allocates exclusive usernames and passwords. Users must be conscientious about responsibly utilizing the information they access within their designated roles. Therefore, assigning user privileges plays a pivotal role in securing medical records. However, while regulating data access remains crucial, it doesn’t completely ensure confidentiality. Strengthening security through comprehensive privacy and security protocols remains essential for reinforcing patient data's inviolabilit.
2. Safeguarding Against Data Breaches
Ensuring patient privacy and safeguarding sensitive medical data is paramount in EHR ethical training. The imperatives of inadequate data security, encompassing compromised medical information, unauthorized access due to weak password safeguards, and the lack of encryption, accentuate the immediate need for a holistic approach. Employing strategies such as secure cloud storage, robust password protocols, two-factor authentication, and encryption is pivotal in enhancing data security, preventing the mishandling of patient records, and abiding by ethical standards. The potential legal and financial consequences of breaches underscore the criticality of these practices in maintaining patient trust and confidentiality within the digital healthcare domain.
3. EHR System Implementation
The integration of EHRs within healthcare organizations poses significant challenges, including resource waste, provider dissatisfaction, diminished patient trust, and potential safety risks. Successful EHR development, implementation, and upkeep demand substantial investment and collaboration among stakeholders, including clinicians, IT experts, educators, and consultants. Clinicians' active engagement is often underestimated, leading to the failure of EHR projects; therefore, clinician-led guidance is crucial in tasks such as EHR selection, workflow design, and quality improvement. Thoroughly mapping workflows before selecting an EHR is crucial, while maintaining user-friendly interfaces remains essential for success. Neglecting these aspects can reduce efficiency, compromise care, and increase safety threats. By prioritizing comprehensive planning, engaging clinicians, and optimizing user interfaces, healthcare institutions can ensure ethical and efficient EHR integration, ultimately enhancing patient care and safety.
4. Maintaining Data Accuracy
Upholding data accuracy stands as a fundamental principle in the ethical EHR domain. The integrity of information guarantees its unaltered and precise nature, contributing significantly to the enhancement of patient safety, reduction of healthcare errors, mitigation of health disparities, and betterment of public health. Nevertheless, concerns have been voiced regarding the reliability of data input into electronic records. The improper utilization of functionalities such as 'cut and paste' can lead to misleading portrayals of a patient's condition and treatment, breaching ethical standards. This practice poses elevated risks to patients and increases the liability of clinicians and institutions. Challenges also arise from drop-down menus that limit a clinician's choices, potentially giving rise to substantial errors, especially under time constraints. The collaborative efforts of clinicians and vendors can address software concerns, promoting user-friendly, reliable EHRs while tackling EHR ethical issues. Furthermore, data loss during transfers raises pertinent concerns about the accuracy of the database, a critical aspect as patient care decisions hinge on this data.
5. Guaranteeing Data Authenticity
The assurance of documentation integrity pertains to the accurate and precise nature of the comprehensive health record. This includes principles of information governance, identifying patients, validating authorship, handling amendments and corrections in records, and auditing documentation validity while submitting reimbursement claims. EHR tools offer flexible documentation options through the utilization of templates and smart phrases, assisting in precise record-keeping. However, if these tools are misused, doubts about data integrity can arise, making information unreliable and possibly raising concerns about fraudulent activity. Established policies and procedures, including audit functions, must be in place to ensure proper billing. With adequate safeguards, records may accurately represent the patient's condition at admission and over time. Providers must understand the importance of reviewing and refining default data to ensure that only patient-specific information for that visit is recorded. In contrast, irrelevant data from default templates is removed.
6. Validating Dictation to Prevent Errors
Voice recognition systems lacking a validation step pose considerable challenges in maintaining data accuracy and preventing documentation errors within organizations, particularly when it comes to ethical issues with electronic health records. EHR companies need to implement a protocol requiring providers to promptly assess, modify, and validate dictated information. Given these documents' frequent use and sharing, precise and high-quality documentation in EHR systems is of utmost significance. The adoption of EHRs has led to substantial shifts in provider workflows and documentation processes. However, providers still need to clearly outline or fully understand comprehensive best practices for maintaining high-quality documentation in EHRs. Advancements are necessary to enhance documentation tools and methods, with a renewed emphasis on the essential aspects of data accuracy and quality. This should precede the widespread implementation of interoperable health information exchange initiatives.
7. Ensuring Accurate Documentation
Maintaining the integrity of documentation is compromised when incorrect information finds its way onto the wrong patient's health record. Patient identification errors can influence clinical decisions, endanger patient safety, violate privacy and security, and lead to redundant testing and escalated expenses for patients as well as providers. The propagation of patient identification mistakes can rapidly expand within EHR, personal health records, and Health Information Exchange (HIE) networks as information disseminates. Failing to implement advanced front-end solutions that incorporate robust matching algorithms or innovative techniques like biometrics or fingerprinting can expose organizations to risk. EHRs can incorporate targeted alerts to anticipate safety problems, like blood type inconsistencies or allergies, during treatment, addressing EHR issues. Organizations must institute a patient identity integrity program, integrating performance improvement metrics to monitor error rates and duplicate records in their electronic master patient index. Policies and procedures must ensure the accuracy of critical demographic data, facilitating the linkage of records within and across systems. Addressing the initial point of data capture as a primary front-end verification is also vital within policies.
8. Preserving the Authenticity of Audit Trails
Effective audits are crucial to ensuring that the health record documentation aligns with the reported level of service, fulfills reimbursement requirements set by payers, and guarantees that only authorized personnel access patient medical records and make entries. The audit trail must encompass the user's name, the triggering application, workstation details, the specific document, a description of the audited event (such as amendments, corrections, or deletions), and the timestamp. This audit trail outlines modifications (including deletions) within the health record and provides auditors with a foundation for compliance audits. Inadequate audit trail functionality within EHRs raises concerns about the integrity of health record documentation, potentially exposing organizations to legal liabilities and inadvertently fostering or shielding criminal activities. It may become challenging to ascertain if corrections or amendments were executed, who authorized the changes, or the nature of the modifications. In addition to the inherent unintentional errors that documentation might encounter, audit trail functionality can aid in detecting instances where records are altered to obstruct the disclosure of detrimental information. Organizations can utilize EHR trends to leverage audit trail features for identifying and analyzing patterns in health record usage. Typically, users can generate reports over specific time frames categorized by provider or provider type, with results directed to a compliance committee or the organization's governing body.
9. Fostering Compliance Awareness
Enhancing ethical EHR training involves a strategic focus on ensuring providers are well-versed in compliance and legal risks, starting from the EHR training phase. To address EHR problems, organizations should implement educational initiatives aimed at mitigating compliance issues. Staff education must emphasize the integrity of health record documentation, with a continuous program monitored and provided quarterly or annually. Addressing the 'who, what, why, and how' ensures a solid grasp of organizational practices that uphold individual best practices, encompassing identifying potential fraud, universal and administrative security measures, data validity, authorship, continual education's significance, and strategies for daily fraud prevention.
10. Conducting Feedback Sessions
Contrary to common assumptions, ongoing training is essential post-EHR implementation. After installing the EHR and initiating patient interactions, challenges inevitably emerge—be it staff unfamiliarity with functions or the need to revamp workflow processes. Promptly identifying these concerns to prevent errors and swiftly resolving them involves collecting feedback from EHR users among the staff, particularly in relation to EHR ethical issues. During the weeks after the system's launch, contemplate arranging routine meetings to gather insights. Ensuring diverse representation, including clinical staff, physicians, administrators, billing, and front desk personnel, is crucial. Seek input on their adaptation to changes and areas requiring improvement. Determine if specific training concepts need reinforcement. Surveys can be used in place of frequent meetings. Subsequently, prioritizing problem areas aids focused resolution by promptly addressing critical matters. The introduction of incremental changes helps staff adapt to the EHR seamlessly, safeguarding patient care continuity during the transition.
The Path Ahead
Following these ethical EHR training best practices ensures the accuracy and reliability of patient data, leading to improved clinical decision-making and patient safety. By maintaining documentation integrity, professionals can confidently provide quality care and reduce the risk of errors. Ethical EHR training further strengthens compliance with legal regulations, safeguarding both the organization as well as the healthcare provider from potential legal liabilities. Moreover, adhering to best practices promotes efficient workflows, enhancing productivity, and streamlining operations. Patient trust and confidence are strengthened as professionals demonstrate their commitment to data security, confidentiality, and ethical conduct. Ultimately, by upholding ethical EHR training standards, professionals contribute to a robust healthcare system by fostering positive patient outcomes, maintaining trust, and supporting the principles of ethical healthcare delivery.
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Article | August 27, 2021
There are times that we encounter negative thoughts that can be overwhelming.
For some people, the more they try to get rid of their thoughts, the stronger they become.
As a result, here is a brief list of techniques that a person can use to help manage their negative thinking.
1. Do not focus on your fearful thinking: The first thing a person must do is not to dwell on the fear provoking thought when it comes. The more a person tries to reason out on the fear behind the thought, the stronger it becomes. The next time you encounter a negative situation, get into the practice of not dwelling on it.
2. Think of a red stop sign: At times, a person might encounter a fearful thought that may be difficult to manage. When this happens, visualize a red stop sign which can serve as a reminder to think about something else. Regardless of how scary your negative thinking may be, do not dwell on it. This technique is great in dealing with your negative situations and depression.
3. Its only fear: The difference between an obsessive thought and a regular one is that an obsessive thought is based on fear. With this in mind, try to find the source of the fear behind your negative thinking and then find ways to get rid of your worries.
4. Your thoughts are exaggerated: Sometimes, a person may encounter a lot of scary thoughts coming at them all at once. Instead of getting upset, remember that your negative thinking is exaggerated with worry. Ignore the fear behind these obsessive thoughts, regardless how the strong the fear may be.
5. Challenge your negative thinking with positive statements and realistic thinking: When encountering thoughts that make you fearful or depressed, challenge them by asking yourself questions that will maintain objectivity and common sense. Focus on the reality of your situation and not on your negative thinking.
6. Carry a small notebook of positive statements with you: A person should keep a small notebook of positive statements that makes them feel good. Whenever they come across a positive and uplifting verse that makes them happy, write it down in a small notebook. A person can then carry this notebook around in their pocket and whenever they feel anxious, they can read their notebook.
7. Take it one day at a time: Instead of worrying about how you will get through the rest of the week or month, try to focus on today. Each day can provide us with different opportunities to learn new things and that includes learning how to deal with your situation. In addition, you will not feel overwhelmed with everything if you focus on one thing at a time.
8. Get help: Take advantage of the help that is available around you. If possible, talk to a professional who can help you manage your fears and anxieties. They will be able to provide you with additional advice and insights on how to deal with your current problem. By talking to a professional, a person will be helping themselves in the long run because they will become better able to deal with their problems in the future.
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