Co-designing Healthcare Quality Improvement: The Kovacs Burns & George Orientation Guide.

To prepare healthcare organizations and patients/families to be equally ready to become partners in co-designing healthcare policy, practices, and improvements, there is a need to (1) understand how "co-design ready" organizations and their staff and care providers are to co-design health care policies, practices, and improvements with patients and families; (2) understand how prepared patients and families, as users of the health system, are to step into co-designer roles with confidence so that their voices will be heard as they influence the development or changes to improve healthcare system policies, services, practices, and products; (3) anticipate and/or address challenges with meeting the expectations of what is involved with the co-design approach, including with recruiting, preparing, and training care setting leaders, staff/care providers, and patient/family advisors; (4) ensure care settings provided appropriate tools and resources to support co-design; and (5) guide the shift in culture from engagement to co-design. Recommendations for enabling co-design in care settings include providing an orientation and preparation workshop and guide/workbook. An example of an orientation and preparation workshop is shared.

Novel Magnetic Composite Materials for Dental Structure Restoration Application.

In general, magnetic nanoparticles are not often used in dental applications due to some limitations of these materials, such as aggregation problems and low mechanical and chemical resistance but also esthetic problems due to their black color. Our research presents the synthesis of novel magnetic dental composite materials based on magnetic nanoparticles, functionalized and properly coated to overcome the limitations of using magnetic nanoparticles in dental applications. The composites were prepared using a preparation flow containing several integrated reaction steps used previously sequentially. An adequate and deep characterization of dental magnetic composites has been carried out in order to demonstrate that each limitation has been successfully overcome. It was proved that each component brings particular benefits in dental interventions: Fe3O4 nanoparticles have biocompatible, non-toxic properties and also antimicrobial effects; the SiO2 layer significantly increases the mechanical strength of the material; and the Ca(OH)2 layer initiates local calcification and significantly improves the color of the dental composite material. Due to magnetic properties, an innovative application approach on the tooth surface can be achieved under an external magnetic field, which, compared to conventional methods, has a major impact on reducing the occurrence of dental caries under filling materials as well as on reducing microfractures.

Improving care for residents in long term care facilities experiencing an acute change in health status.

BACKGROUND: Long term care (LTC) facilities provide health services and assist residents with daily care. At times residents may require transfer to emergency departments (ED), depending on the severity of their change in health status, their goals of care, and the ability of the facility to care for medically unstable residents. However, many transfers from LTC to ED are unnecessary, and expose residents to discontinuity in care and iatrogenic harms. This knowledge translation project aims to implement a standardized LTC-ED care and referral pathway for LTC facilities seeking transfer to ED, which optimizes the use of resources both within the LTC facility and surrounding community. METHODS/DESIGN: We will use a quasi-experimental randomized stepped-wedge design in the implementation and evaluation of the pathway within the Calgary zone of Alberta Health Services (AHS), Canada. Specifically, the intervention will be implemented in 38 LTC facilities. The intervention will involve a standardized LTC-ED care and referral pathway, along with targeted INTERACT® tools. The implementation strategies will be adapted to the local context of each facility and to address potential implementation barriers identified through a staff completed barriers assessment tool. The evaluation will use a mixed-methods approach. The primary outcome will be any change in the rate of transfers to ED from LTC facilities adjusted by resident-days. Secondary outcomes will include a post-implementation qualitative assessment of the pathway. Comparative cost-analysis will be undertaken from the perspective of publicly funded health care. DISCUSSION: This study will integrate current resources in the LTC-ED pathway in a manner that will better coordinate and optimize the care for LTC residents experiencing an acute change in health status.

A study on blood product usage and wastage at the public hospital, Guyana.

BACKGROUND: Blood is a valuable resource and blood wastage in a low socio economic country could impose a very serious impact on healthcare. This study therefore analyzes the usage and wastage of blood and blood products at the Georgetown Public Hospital Cooperation (GPHC), Guyana. METHODS: A retrospective study was conducted on the data retrieved from laboratory blood banking information system on usage and wastage of blood products during the years 2012-2014 at the public hospital. The data were analyzed in MS Excel and SPSS 20.0. RESULTS: A total of 16,426 units of blood were issued from National Blood Transfusion Services. During the study period the most frequently requested blood component was packed cells followed by fresh frozen plasma (FFP), platelet, cryoprecipitate (CRYO) and whole blood respectively. Data indicated that 4167 units (25 %) of blood were wasted due to various reasons at GPHC. CONCLUSIONS: There is a need for intervention through raising awareness among medical staff in reducing blood wastage.