Risks of Caregiver Injury in Patient Transfers

| December 8, 2020

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A cruelly ironic truth is that nurses and other caregivers assisting injured and ill patients often wind up injured themselves. In fact, the caregiver profession has among the highest rates of injury, with back injuries being the most common and the most debilitating. Every year, more than 10% of caregivers leave the field because of back injuries. More than half of all caregivers will experience chronic back pain.

Most back injuries to caregivers happen when lifting patients from beds or wheelchairs. Injuries can occur instantly, but they can develop over time as well, often without the caregiver’s awareness. For example, the caregiver can sustain disc damage gradually and not feel any pain, and by the time he or she does experience pain, there can already be serious damage.

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The Hidden Stress of the Pandemic

Article | February 14, 2021

Tempted to throw in the towel on your New Year’s resolutions? It’s a natural reaction during this unprecedented year. I’m here to tell you it’s okay—and you probably don’t need them anyway. You’re in good company if you’ve given up on the big shifts. According to widely-cited research study, only 19% of people keep their New Year’s resolutions. In addition, this may not have been the best time to make changes, given all that’s going on with the pandemic. Also, worthwhile to consider the following insights on the unease with making big changes these days. According to research published in Molecular Psychiatry, when you go through prolonged challenging times (and the pandemic certainly qualifies), chronic stress can change the architecture of your brain and make you feel worn out, anxious, fearful, or depressed. These aren’t the best conditions for making major changes. You may also face “change saturation,” or in other words, you’ve had to make so many transitions, you just can’t make any more. To prevent yourself from becoming overwhelmed, focus on attainable aspirations. Here are a few recommendations. DREAM ON A SMALLER SCALE Success for the next 12 months may be closely tied to a less-is-more approach. Instead of seeking a whole new career, maybe you can set your sights on getting assigned to a new project at your current company. In other words, consider how you can tweak your behaviors rather than overhauling them. Cultivate gratitude. Appreciate the little things. When you’re more tuned into what you have, you’re less focused on what you still want. This “enough mentality” can be helpful to your mental health. You don’t have to make big changes to achieve satisfaction or happiness. Contentment starts with gratitude. Avoid perfectionism. Often, the fuel for big changes is a feeling you or your situation are not perfect. Remind yourself that perfection is a myth and focus on what’s working. This will help you find fulfillment with your present reality (even if it’s not all you aspire to). Make a list, then edit down. Another great way to keep your ambitions reasonable is to make a list of all you want to accomplish and then eliminate everything but the top three items. A surefire route to frustration is to expect too much and put unrealistic pressures on yourself. Instead, focus on just a few vital things you want to accomplish, rather than a long list that does not empower you. After you’ve accomplished the first three goals on your list, you can always come back to the others, but give yourself a fighting chance to achieve the most integral top three, first. MONITOR YOURSELF Keep yourself accountable through specific techniques—and pay attention to events that may cause you to slide backwards. Research in the Personality and Social Psychology Bulletin explains that 40% of your behaviors occur in similar situations, which is to say familiar circumstances encourage the repetition of choices. Therefore, if you’re able to adjust one potentially repeated behavior, it can make a difference. Create routines and conveniences. When you want to nurture a behavior, make it a default so you’re not thinking consciously about it. Research published in the European Journal of Social Psychology found when you repeat behaviors in a consistent context, it helps with habit formation and these take hold much more effectively. You can use this to your advantage. Instead of making a conscious choice each morning whether you want the donut or the smoothie, have the sliced fruit ready to go and the blender on the counter so when you arrive bleary-eyed to the kitchen in the morning, you’re just doing what’s already laid out. Start each day with the routine of responding to quick-hit emails. Rather than deciding what to work on first, just create a routine where you’re repeating behavior that works without as much conscious thought. Plan ahead. When you can plan for things, you can usually control them more effectively. If you’re going to be in a situation that might create challenges for your new behaviors, make a plan. Perhaps you’re going to the grocery store and you can make a plan to avoid the cookie aisle. Or if you’re back in the office, avoid the calorie-tempting socially distanced happy hour with colleagues by leaving right on time and get a head start on the big project you’re working on. Anticipating what might present challenges will help you overcome them. FIND SUPPORT Support can be the difference between making small changes and not succeeding at all. Find a source that works for you. Find friends. Create a virtual group of people also trying to make changes. Perhaps there’s an online group where you can exchange healthy recipes or provide mutual encouragement for regular trips to the gym. Also tap into your existing network and ask your friend to check in with you to see if you’ve had your workout for the day. Seek out colleagues who can nurture the writing skills you want to develop. Find people who encourage you, provide feedback, and remind you about your ability to succeed. Use technology thoughtfully. There are a wide variety of virtual solutions to help you shift your behavior. Download the app that allows you to track your water intake or the app that will send you notifications if you haven’t moved enough in the last hour. Look for apps that can help you learn the new language you’ve been wanting to add to your skill set or that can connect you with colleagues who have like-minded ambitions. Behavior shifts are most likely to occur with planning, reminders, and feedback. So, find apps that provide these three kinds of support. Give yourself permission to do less for now and know you can always do more later. In the meantime, stay strong and be satisfied with a little progress for now.

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Critical Information Sharing for Healthcare

Article | March 13, 2020

The fast and efficient flow of information is vital for the healthcare sector to offer life-critical services and patient care. Seamless communication, real-time updates, and putting the crisis response plans into action with minimum activation time are some of the key factors for successful crisis management during a pandemic or other urgent healthcare situations. In pandemic situations, characterized by a large scale outbreak of diseases over a wider geographical area, the bi-directional sharing of critical information between various healthcare agencies and institutions located in different cities and states becomes even more important.

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COVID-19: How do we get out of this quagmire?

Article | July 17, 2020

The COVID-19 virus (C19) pandemic is turning out to be the event of the century. Even World War seems timid in comparison. We are in the 4th month of the virus (in non-China countries) and have gone past the lockdown in many places. Isn’t it time we re-think the approach? What if there is another wave of C19 coming soon? What if C19 is the first of many such events in the future? Before we get into analysis and solution design, summarizing the C19 quirks: While a large section of the affected population is asymptomatic, for some it can be lethal There isn’t clarity on all the ways C19 spreads It’s known to affect the lungs, heart, and kidneys in patients with weak immunity It has been hard to identify a definitive pattern of the virus. Some observations in managing the C19 situation are: With no vaccine in sight, the end of this epidemic looks months or years away Health care personnel in hospitals need additional protection to treat patients Lockdowns lead to severe economic hardship and its repeated application can be damaging Quarantining people has an economic cost, especially in the weaker sections of society If one takes a step back to re-think about this, we are primarily solving 2 problems: Minimise deaths: Minimise the death of C19 and non-C19 patients in this period Maximise economic growth: The GDP output/growth should equal or higher than pre-C19 levels One needs to achieve the 2 goals in an environment of rising number of C19 cases. Minimise deaths An approach that can be applied to achieve this is: Data driven health care capacity planning Build a health repository of all the citizens with details like pre-existing diseases, comorbidity, health status, etc. The repository needs to be updated quarterly to account for patient data changes This health repository data is combined with the C19 profile (disease susceptibility) and/or other seasonal diseases to determine the healthcare capacity (medicines, doctors, etc.) needed The healthcare capacity deficit/excess needs to be analysed in categories (beds, equipment, medicine, personnel, etc.) and regions (city, state, etc.) and actions taken accordingly Regular capacity management will ensure patients aren’t deprived of timely treatment. In addition, such planning helps in the equitable distribution of healthcare across regions and optimising health care costs. Healthcare sector is better prepared to scale-up/down their operations Based on the analysis citizens can be informed about their probability of needing hospitalisation on contracting C19. Citizens with a higher health risk on C19 infection should be personally trained on prevention and tips to manage the disease on occurrence The diagram below explains the process Mechanism to increase hospital capacity without cost escalation Due to the nature of C19, health personnel are prone to infection and their safety is a big issue. There is also a shortage of hospitable beds available. Even non-C19 patients aren’t getting the required treatment because health personnel seek it as a risk. This resulted in, healthcare costs going up and availability reducing. To mitigate such issues, hospital layouts may need to be altered (as shown in the diagram below). The altered layout improves hospital capacity and availability of health care personnel. It also reduces the need for the arduous C19 protection procedures. Such procedures reduce the patient treatment capacity and puts a toll on hospital management. Over a period, the number of recovered C19 persons are going to increase significantly. We need to start tapping into their services to reduce the burden on the system. The hospitals need to be divided into 3 zones. The hospital zoning illustration shown below explains how this could be done. In the diagram, patients are shown in green and health care personnel are in light red. **Assumption: Infected and recovered C19 patients are immune to the disease. This is not clearly established Better enforcement of social factors The other reason for high number of infections in countries like India is a glaring disregard in following C19 rules in public places and the laxity in enforcement. Enforcement covers 2 parts, tracking incidents of violation and penalising the behaviour. Government should use modern mechanisms like crowd sourcing to track incidents and ride on the growing public fear to ensure penalty enforcement succeeds. The C19 pandemic has exposed governance limitations in not just following C19 rules, but also in other areas of public safety like road travel, sanitation, dietary habits, etc. Maximise economic growth The earlier lockdown has strained the economy. Adequate measures need to be taken to get the economy back on track. Some of the areas that need to be addressed are: One needs to evaluate the development needs of the country in different categories like growth impetus factors (e.g. building roads, electricity capacity increase), social factors (e.g. waste water treatment plants, health care capacity), and environmental factors (e.g. solar energy generation, EV charging stations). Governments need to accelerate funding in such projects so that that large numbers of unemployed people are hired and trained. Besides giving an immediate boost to the ailing economy such projects have a future payback. The governments should not get bogged down by the huge fiscal deficit such measures can create. Such a mechanism to get money out in the economy is far than better measures like QE (Quantitative Easing) or free money transfer into people’s bank accounts Certain items like smartphone, internet, masks, etc. have become critical (for work, education, critical government announcements). It’s essential to subsidise or reduce taxes so that these items are affordable and accessible to everyone without a financial impact The government shouldn’t put too many C19 related controls on service offerings (e.g. shops, schools, restaurants, cabs). Putting many controls increases the cost of the service which neither the seller not buyer is willing or able to pay. Where controls are put, the Govt should bear the costs or reduce taxes or figure out a mechanism so that the cost can be absorbed. An event like the C19 pandemic is a great opportunity to rationalise development imbalances in the country. Government funding should be channelized more to under-developed regions. This drives growth in regions that need it most. It also prevents excess migration that has resulted in uncontrolled and bad urbanisation that has made C19 management hard (guidelines like social distance are impossible to follow) Post-C19 lockdown, the business environment (need for sanitizers, masks, home furniture) has changed. To make people employable in new flourishing businesses there could be a need to re-skill people. Such an initiative can be taken up by the public/private sector The number of C19 infected asymptomatic patients is going to keep increasing. Building an economy around them (existing, recovered C19 patients) may not be a far-fetched idea. E.g. jobs for C19 infected daily wage earners, C19 infected taxi drivers to transport C19 patients, etc. In the last 100 years, mankind has conquered the destructive aspects of many a disease and natural mishap (hurricanes, floods, etc.). Human lives lost in such events has dramatically dropped over the years and our preparedness has never been this good. Nature seems to have caught up with mankind’s big strides in science and technology. C19 has been hard to reign in with no breakthrough yet. The C19 pandemic is here to stay for the near future. The more we accept this reality and change ourselves to live with it amidst us, the faster we can return to a new normal. A quote from Edward Jenner (inventor of Small Pox) seems apt in the situation – “The deviation of man from the state in which he was originally placed by nature seems to have proved to him a prolific source of diseases”.

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DATA PRIVACY IN HEALTHCARE

Article | March 2, 2020

The information and data within any business is a valuable asset. It is now considered a key driver to business growth and success. Data is collected every second of every day, and so it is important for businesses to capture, process, and manage data correctly. The security of data must be a priority within a business. It needs to be protected from unauthorised access to prevent it from being tampered with, destroyed, or disclosed to others.

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Healthcare is rapidly changing and Hill Physicians Medical Group is at the forefront. We are one of the largest and most successful Independent Physician Associations (IPAs) in the nation.

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