Non-medical Staff Research Articles

Attempted Isolation of Cryptococcus Species and Incidental Isolation of Exophiala dermatitidis from Human Oral Cavities.

Recent molecular studies suggest that Cryptococcus may inhabit the normal human mouth. We attempted to isolate Cryptococcus from 21 adult non-acutely ill patients and 40 volunteer medical and non-medical staff in Southeastern Wisconsin, USA. An upper lip sulcus culture and an oral rinse specimen were inoculated separately onto Staib (birdseed) agar containing chloramphenicol and incubated in gas impermeable zip lock bags at 35°C. No cryptococci were grown from any of the 122 samples from the 61 subjects. Both specimens from a woman with no risk factors for fungal disease yielded a black yeast at 4days on Staib agar. This isolate was shown to be Exophiala dermatitidis by colony and microscopic morphology, analysis by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and sequencing through the internal transcribed spacer ribosomal RNA gene. This appears to be a novel isolation of E. dermatitidis from the oral cavity of a generally healthy human.

Hausärztliche Delegationskonzepte in Nordrhein-Westfalen Ergebnisse der hausärztlichen Befragung zum Einsatz von EVA, VERAH, VERAH Plus zur Delegation definierter Tätigkeiten

BackgroundThe delegation of traditional GP tasks to qualified medical assistants (MFA) includes several modalities based on extended qualification curricula known as „Nicht-ärztliche Praxisassistentin” (NäPa) [non-physician practice assistant], also known as the “Entlastende Versorgungsassistentin” (EVA) and the “Versorgungsassistentin in der Hausarztpraxis” (VERAH and VERAH Plus) [professional healthcare assistants in the family practice]. Delegation to MFA has gained importance in recent years due to an increasing workload of general practitioners in Germany. ObjectivesThis article examines the characteristics of general practitioners (GPs) currently delegating activities to MFAs with and without extended qualification based on the three mentioned modalities (EVA, VERAH and VERAH Plus). In addition, we explore whether the delegated activities are delivered in the office, at the patient's home or in the nursing home and how GPs perceived the potential of future delegation. Materials and methodsBetween April and August 2016, we conducted an anonymous postal survey of a representative randomized sample of general practitioners in North Rhine-Westphalia (n = 2,404). The questionnaire contained questions about practice staff, setting for delivery of the delegated activity as well as the perceived added values of and barriers to delegation. We compare characteristics of GPs delegating to MFA with extended qualification to those delegating to standard qualified MFA. ResultsThe response rate was 32 % (n = 762). Almost one third of the respondents (n = 239) delegated tasks to MFAs with extended qualification. These GPs are more likely to be younger and male and less likely to be working alone in individual practice. They delegate more activities to be delivered in all settings than GPs employing MFAs without extended qualification. Discussion and conclusionsGPs benefit from delegating to MFA with extended qualification as shown by the associated added values and setting of deployment for delivery of tasks. Delegation to non-medical staff should be considered by more GPs as a means of supporting healthcare delivery. In addition to legal changes, further procedures are needed to encourage GPs to get more actively involved with the issue of delegation and consider to further develop the competence of their staff and deploy them accordingly.

A Case of Cardiac Arrest Soon after Receiving a Sting from a Wasp

While felling trees along a national roadside in a remote area, a 38-year-old man suddenly cried out that he had been stung by a wasp on his left hand. His colleague came over to him, and he fell unconscious, so his colleague called an ambulance. When emergency technicians found him, he was in cardiopulmonary arrest. His initial rhythm was asystole. He receive advanced cardiac life support but was unable to obtain return of spontaneous circulation, possibly due to his anaphylactic shock and complication with Kounis syndrome resulting in a low cardiac output, as he showed temporal complete bundle branch block with tachycardia PEA, repeated ventricular fibrillation, and elevated cardiac enzymes. The presence of a sting mark may also have been a sign of his severe state and complication of Kounis syndrome. The establishment of a new framework, such as permitting non-medical staff to inject adrenaline into patients with anaphylaxis, might be required.

Improving public hospital efficiency and fiscal space implications: the case of Mauritius

BackgroundGeneral Government Health Expenditure (GGHE) in Mauritius accounted for only 10% of General Government Expenditure for the fiscal year 2018. This is less than the pledge taken under the Abuja 2001 Declaration to allocate at least 15% of national budget to the health sector. The latest National Health Accounts also urged for an expansion in the fiscal space for health. As public hospitals in Mauritius absorb 70% of GGHE, maximising returns of hospitals is essential to achieve Universal Health Coverage. More so, as Mauritius is bracing for its worst recession in 40 years in the aftermath of the COVID-19 pandemic public health financing will be heavily impacted. A thorough assessment of hospital efficiency and its implications on effective public health financing and fiscal space creation is, therefore, vital to inform ongoing health reform agenda.ObjectivesThis paper aims to examine the trend in hospital technical efficiency over the period 2001–2017, to measure the elasticity of hospital output to changes in inputs variables and to assess the impact of improved hospital technical efficiency in terms of fiscal space creation.MethodsAnnual health statistics released by the Ministry of Health and Wellness and national budget of the Ministry of Finance, Economic Planning and Development were the principal sources of data. Applying Stochastic Frontier Analysis, technical efficiency of public regional hospitals was estimated under Cobb–Douglas, Translog and Multi-output distance functions, using STATA 11. Hospital beds, doctors, nurses and non-medical staff were used as input variables. Output variable combined inpatients and outpatients seen at Accident Emergency, Sorted and Unsorted departments. Efficiency scores were used to determine potential efficiency savings and fiscal space creation.FindingsMean technical efficiency scores, using the Cobb Douglas, Translog and Multi-output functions, were estimated at 0.83, 0.84 and 0.89, respectively. Nurses and beds are the most important factors in hospital production, as a 1% increase in the number of beds and nurses, result in an increase in hospital outputs by 0.73 and 0.51%, respectively. If hospitals are to increase their inputs by 1%, their outputs will increase by 1.16%. Hospital output process has an increasing return to scale. With technical efficiencies improving to scores of 0.95 and 1.0 in 2021–2022, potential savings and fiscal space creation at hospital level, would amount to MUR 633 million (US$ 16.2 million) and MUR 1161 million (US$ 29.6 million), respectively.ConclusionFiscal space creation through full technical efficiency, is estimated to represent 8.9 and 9.2% of GGHE in fiscal year 2021–2022 and 2022–2023, respectively. This will allow without any restrictions the funding of the national response for HIV, vaccine preventable diseases as well as building a resilient health system to mitigate impact of emerging infectious diseases as experienced with COVID-19.

Junior doctors: when fresh blood fast-tracks the fight against COVID-19

On 11 March 2020, the WHO declared COVID-19 as a Public Health Emergency of International Concern. In Europe, particularly in France, hospitals were urged to take prompt measures: cancellation of...

48 hours public response to Corona epidemic status in Indonesia. Perceived risk and panic buying

BackgroundPresident of Indonesia, Joko Widodo has announced two confirmed CoVid-19 cases who live in Depok, West Java, on Monday, March 2nd, 2020. A rapid assessment of public response toward the new status was conducted, focusing on perceived risk and panic buying.MethodologyA cross-sectional survey was conducted within 48 hours after the announcement through an online questionnaire. A demographic data including, sex, age, education, occupation (medical vs nonmedical), income, health insurance, island domicile (Java vs non-Java), mobility, history of contact with a foreigner, and history of overseas travel within a month. Knowledge regarding Covid 19 was determined by the average score of 38 5-Likert scale questions (5 indicates better knowledge). Perceived risk was measured with a 10-scale question, and panic buying was assessed through an average score of 6 5-Likert scale questions (5 indicates panic buying). Mann-Whitney and Linear regression were performed to identify the associated factors.ResultsAs a total of 214 respondents, panic buying was lower (2.28 ± 0.79 on a 5-scale) except for perceived risk (5.91 ± 2.13 on a 10-scale). No difference between medical and nonmedical staff in panic buying (p = 0.619) and perceived risk (p = 0.477) and the domicile of respondents (Java VS nonjava) in panic buying (p = 0.810) and perceived risk (p = 0.101). Younger age, working in a medical field and living in Java are associated with higher perceived risk in the linear model whereas panic buying is solely affected by knowledge (β -1.459. p < 0.001). The respondents agreed that scarcity of single-use components (mean 4.32 out of 5) such as masker and goods inflation particularly groceries (mean 4.31 out of 5) will appear soonConclusionsIt is important to disseminate the correct information to the public to reduce panic buying. Collaborative action between the government and medical staff should be done particularly in Java as the first locus of CoVid 19 in Indonesia.Key messages Knowledge regarding corona virus affects the Panic Buying. An intervention to disseminate the correct information should be done.To reduce the perceived risk, a rigorous action should be done in Java and a collaborative work between the government and medical staffs should be established.

Experiences of caregivers of children with spinal muscular atrophy participating in the expanded access program for nusinersen: a longitudinal qualitative study

BackgroundExpanded access programs (EAPs) allow patients with serious, life-threatening conditions access to drugs prior to their formal approval. Despite the possible benefits for patients, EAPs present several challenges, including uncertainty regarding a drug’s efficacy and safety as well as inequities regarding access to treatment. Although the number of EAPs is growing, the experience of patients participating in EAPs has not yet been studied. In Germany, an EAP for the treatment of Spinal Muscular Atrophy (SMA) with nusinersen ran from December 2016 to May 2017). SMA is a rare, progressive neuromuscular disorder characterized by muscle atrophy and proximal muscle weakness. Insights into patients’ and caregivers’ experiences could help to improve future EAPs.ResultsWe conducted a prospective study using semi-structured interviews with caregivers of children with Spinal Muscular Atrophy (SMA) Type 1who participated in the nusinersen EAP in Germany. Interviews were transcribed verbatim and analyzed using an inductive approach according to the principles of content analysis. Eight families participated in the study. Their children were between 2 and 28 months old. Six children received non-invasive ventilation. Participation in the EAP marked an important turning point in the caregivers’ experiences. Their perspective changed from a severely limited life expectancy and a palliative approach to a more optimistic view including hopes for a longer life and positive development of their children. However, participating in the EAP was also challenging for caregivers in several ways. Lack of information regarding the launch of the program and the enrollment procedures caused significant uncertainty and stress among caregivers prior to the actual treatment. Further, concerns persisted that nusinersen could not be approved or that the child could be excluded due to an insufficient treatment response. Good communication and trusting relationships with medical and non-medical staff at the hospital helped caregivers cope with the uncertainties associated with the treatment.ConclusionFrom the caregivers’ perspective, there was no alternative to participating in the EAP for nusinersen. All participants were positive regarding their decision to participate. However, this study suggests that developing procedures to increase speed and transparency and to ensure fairness could help to further improve the system of EAPs as a way to provide urgently needed care to highly vulnerable patients.

The Influence of Human Resources, Facilities and Infrastructure To Hemodialization Patient Satisfaction in Bhayangkara Hospital TK. 1 Raden Said Soekanto Jakarta

&lt;p&gt;&lt;em&gt;Hemodialysis is one type of therapy for kidney failure patients that many suffer from in Indonesia. Identification of problems in this study consisted of a lack of nurses and non-medical staff working in the Hemodialysis room, lack of facilities and infrastructure in Hemodialysis rooms such as toilets for visitors, narrow hemodialysis space so that beds between patients were close together, consultation room for patients with doctors, the location of Hemodialysis rooms is less strategic than major roads, and there is no isolation room specifically for Hepatitis B patients. Phenomena that often occur in some hospitals, especially related to the ability of human resources in caring for patients who already have Hemodialysis training certificates as a benchmark for the ability of ideal and actual human resources. Another problem is that the application of technology that has not been optimal has an effect on patient satisfaction, an environment that is not yet conducive which has an effect on patient satisfaction and the provision of incentives to HD room staff is inadequate which influences service and impacts patient&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;This research is needed to study and analyze how much influence human resources and facilities and infrastructure have on the satisfaction of hemodialysis patients at TK I Raden Said Soekanto Bhayangkara Hospital, Jakarta.&lt;/em&gt; &lt;em&gt;The design of the research is using descriptive analysis and regression analysis. To meet the research objectives set, the research design used a survey method with a quantitative approach using questionnaires to collect data. The construction of a questionnaire or list of questions is based on perception.&lt;/em&gt;&lt;/p&gt;&lt;em&gt;The results showed a positive and significant relationship between Human Resources and Hemodialysis Patient Satisfaction at Bhayangkara Tk.I Hospital, Soekanto Hospital, East Jakarta. Correlation of test results in the form of strong positive results. Human resources have a contribution of 42.6% to patient satisfaction. The results also showed a positive and significant relationship between Facilities and Infrastructure on Hemodialysis Patient Satisfaction at Bhayangkara Tk.I Hospital, Soekanto Hospital, East Jakarta. Correlation of test results in the form of strong positive results. Facilities and infrastructure contributed 43.7% to patient satisfaction. The results showed a positive and significant relationship between human resources and infrastructure simultaneously to Hemodialysis Patient Satisfaction at Bhayangkara Tk.I Hospital, Soekanto Hospital, East Jakarta. Human resources and infrastructure simultaneously contribute 56.9% to patient satisfaction.&lt;/em&gt;

Management measures for non-medical staff on psychiatric hospital wards during the COVID-19 pandemic.

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Patient Portal Implementation and Uptake: Qualitative Comparative Case Study.

BackgroundGiving patients access to their health information is a provincial and national goal, and it is critical to the delivery of patient-centered care. With this shift, patient portals have become more prevalent. In Alberta, the Alberta Health Services piloted a portal (MyChart). There was a need to identify factors that promoted the use of this portal. Furthermore, it was imperative to understand why there was variability in uptake within the various clinics that participated in the pilot.ObjectiveThis study aims to identify potential factors that could improve the uptake of MyChart from the perspectives of both users and nonusers at pilot sites. We focused on factors that promoted the use of MyChart along with related benefits and barriers to its use, with the intention that this information could be incorporated into the plan for its province-wide implementation.MethodsA qualitative comparative case study was conducted to determine the feasibility, acceptability, and initial perceptions of users and to identify ways to increase uptake. Semistructured interviews were conducted with 56 participants (27 patients, 21 providers, 4 nonmedical staff, and 4 clinic managers) from 5 clinics. Patients were asked about the impact of MyChart on their health and health care. Providers were asked about the impact on the patient-provider relationship and workflow. Managers were asked about barriers to implementation. The interviews were recorded, transcribed verbatim, and entered into NVivo. A thematic analysis was used to analyze the data.ResultsResults from a comparison of factors related to uptake of MyChart in 5 clinics (2 clinics with high uptake, 1 with moderate uptake, 1 with low uptake, and 1 with no uptake) are reported. Some theoretical constructs in our study, such as intention to use, perceived value, similarity (novelty) of the technology, and patient health needs, were similar to findings published by other research teams. We also identified some new factors associated with uptake, including satisfaction or dissatisfaction with the current status quo, performance expectancy, facilitating conditions, behavioral intentions, and use behavior. All these factors had an impact on the level of uptake in each setting and created different opportunities for end users.ConclusionsThere is limited research on factors that influence the uptake of patient portals. We identified some factors that were consistent with those reported by others but also several new factors that were associated with the update of MyChart, a new patient portal, in the clinics we studied. On the basis of our results, we posit that a shared understanding of the technology among patients, clinicians, and managers, along with dissatisfaction with nonportal-based communications, is foundational and must be addressed for patient portals to support improvements in care.

Sleep Disturbance and Psychological Profiles of Medical Staff and Non-Medical Staff During the Early Outbreak of COVID-19 in Hubei Province, China.

ObjectiveThe outbreak of coronavirus disease 2019 (COVID-19) has considerably burdened the healthcare system in the Hubei Province, the most severely affected region in China. The aim of our study was to assess the psychological effects of COVID-19 epidemic on the healthcare workers in Hubei.MethodsA total of 2737 healthcare workers were sampled using a two-dimensional code shared online between Mar 4 and Mar 9, 2020. The questionnaires consisted of three elements: baseline characteristics, Pittsburgh Sleep Quality Index (PSQI), and Hospital Anxiety and Depression Scale (HADS). The primary outcome variables were PQSI, anxiety and depression scores of non-medical staff, non-frontline medical staff and frontline medical staff. Binary logistical regression analyses were used to compare between respondents with and without sleep disturbance.ResultsAbout 61.6% of the respondents reported sleep problems, 22.6% experienced anxiety, and 35% exhibited depressive symptoms. The prevalence of sleep disorders was higher among the frontline healthcare workers compared to the non-frontline and non-medical staff, while anxiety and depression were prevalent in the entire cohort. Logistic regression analysis identified medical occupation, family burden, bereavement, anxiety, and depression as significantly predictive of poor sleep quality.ConclusionsFrontline medical staff are more vulnerable to sleep disturbances. Psychosocial interventions are needed to help allied healthcare personnel to better respond to COVID-19 and future outbreaks.

In the COVID-19 pandemic in Brazil, do brown lives matter?

In the COVID-19 pandemic in Brazil, do brown lives matter?

Covering the Cover

Covering the Cover

Factors Influencing Motivation in Learning English of Mangusada Badung General Hospital Staff

English as a means of communication is used in many fields, such as health, economic, etc. This research was conducted at Mangusada Badung General Hospital located in the Badung regency of Bali Province. Mangusada Badung General Hospital has a high frequency of giving health services to foreign tourists. The ability to communicate in English is not only needed by medical personnel who are directly serve the foreign patients but also needed by other hospital staff, such as public relations staff, telephone operators, non-medical laboratory staff, registration staff, and others. This research is aimed to identify the influencing factors of motivation in learning English of Mangusada Badung General Hospital staff. The data in this research were collected through a questionnaire method with closed questions which were distributed to 50 respondents of staff from various divisions at Mangusada Badung General Hospital. The data obtained were analyzed using the motivation theory delivered by Gardner, William & Burden, and Finocchiaro. From the research, it is found that the five categories of influencing factors of motivation (personality, behavior, the role of teacher, learning style, and language relation) have almost the same portion in influencing the motivation in learning English.

Voices from the Newspaper Club: Patient Life at a State Psychiatric Hospital (1988-1992).

The authors conducted a qualitative analysis of thirty-seven issues of The DDU Review, a newsletter produced by residents of the Dual Diagnosis Unit, a residential unit for people who had diagnoses of developmental disability and serious mental illness in the Central State Hospital (Indiana, USA). The analysis of the newsletters produced between September 1988 and June 1992 revealed threemajor themes: 1) the mundane; 2) good behavior; and3)advocacy. Contrary to the authors' expectations, the discourse of medicalization-such as relations with physicians, diagnoses, and medications-receive little attention. Instead, the patient-journalists focus on prosaic aspects of institutional life. The patients used their writing as a form self-definition and advocacy. The authors argue that even though it is tempting to consider the patients' emphasis on good behavior as evidence of institutional control, internalized discipline, and medicalization, a more nuanced interpretation, which focuses on how the patients' understood their own experiences, is warranted. Researchers must also recognize the ways in which The DDU Review reveals the patient-journalists' experience of an institutional life that includes non-medical staff (attendants, secretaries, and therapists), varied social relationships among patients, and negotiated freedoms.

Learning radiotherapy: the state of the art

BackgroundThe last two decades have seen revolutionary developments in both radiotherapy technology and postgraduate medical training. Trainees are expected to attain competencies using a mix of experiential learning, formal postgraduate teaching, self-directed learning and peer education. Radiation (Clinical) Oncology is a recognised ‘craft specialty’ where the apprenticeship model of training is applicable. This scoping review examines the evidence in relation to how medical trainees learn radiotherapy.MethodsA systematic search of MEDINE and EMBASE was undertaken to identify studies of trainee and/or trainer experience of radiotherapy learning published 1999–2018. Results pertaining to Medical Oncology, workforce trends, undergraduate radiotherapy exposure, academic training, global health, non-medical staff, health service infrastructure and recruitment to training programmes were not included.ResultsA total of 146 publications were included in the synthesis. Five themes were apparent through careful iterative analysis representing broadly inter-related issues. Most articles studied radiotherapy training from the perspective of the trainee doctor. Most literature reports results of observational, local or national surveys with a tightly defined scope. Considerable variation exists within hospitals, within countries, over time and between different curricular areas.ConclusionsMedical education has not kept pace with changes in the field of radiotherapy and large differences are demonstrated in experience between trainees in different hospitals, countries and training stages. Interpersonal relationships, departmental organisation, and national curricula impact on training quality. Qualitative and quantitative research examining modern radiotherapy learning has been uncommon and uncoordinated, until recently. To date no single study has been designed to comprehensively assess a department’s training scheme.

MP20: Evaluation of the disruptors during advanced life support in emergency departments

Introduction: Simulation is used as a teaching technique in the medical curriculum, and especially for advanced life support (ALS). However, simulated ALS can differ greatly from real life ALS. The aim of this exploratory study was to identify the different disruptors associated with real life ALS. Methods: We conducted a cross-sectional, anonymous, online survey that included 32 items. It was distributed by email to emergency physicians from five emergency departments in Paris. The aim of this online survey was to identify the elements perceived as disruptors during ALS. Other aspects of the survey explored the perceived differences between simulated ALS and real life ALS. Descriptive statistics of percentage, mean and standard deviation were used to analyse the data. Results: Among 100 surveyed physicians, 43 (43%) answers were analysed. 53% were women with a mean age of 32 ± 3 years old. The identified disruptors from real life ALS were task interruptions mainly from non-medical staff (n = 16; 37%), patient's siblings (n = 5; 12%), other specialists (n = 5; 12%) and the phone calls (n = 2; 5%). The situation of ED overcrowding (n = 12; 28%) was also mentioned as a potential disruptor. Overall, physicians reported that some technical and non-technical tasks were harder to perform in real life compared to simulated sessions. Conclusion: This exploratory study allowed the identification of disruptors encountered in real life cases of ALS, and may be used for future simulation-based teaching to enhance realism during sessions

LO44: Birth cohort hepatitis C screening in an academic emergency department in Canada: preliminary results

Introduction: Epidemiologic and modeling studies suggest that between 45 and 70% of individuals with chronic hepatitis C virus (HCV) infection in Canada remain undiagnosed. The Canadian Association for the Study of the Liver (CASL) recommends one-time screening of baby boomers (1945-1975). Screening programs in the US have shown a very high prevalence of previously undiagnosed HCV among patients seen in the emergency department (ED). We sought to assess the feasibility of implementing a targeted birth-cohort HCV screening program in a Canadian ED setting. Methods: Patients born from 1945 to 1975 presenting to the ED of a downtown Toronto hospital were offered HCV testing. Patients with life-threatening conditions, unable to provide verbal consent in English or intoxication were excluded. Blood samples were collected by finger prick on Dried Blood Spot (DBS) collection cards and tested for anti-HCV antibody with reflex to HCV RNA. Patients with positive HCV RNA were referred to a liver specialist. Results: During a 27-month period (July 2017 - Sept 2019), 8363 patients in the birth cohort presented to the ED during daytime hours. 80% (6714) met eligibility criteria, and 48.4% (3247) were offered testing. Screening was performed by non-medical staff (mean 8/day, median spots on DBS 4). 345 (10.6%) had been previously tested, and 639 (19.7%) declined. 2136 (65.8%) patients underwent testing: median age 58.4 years (40-82), 1117 male (52.3%). Of these, 45 patients (2.1%; 95% CI 1.5%-2.7%) were anti-HCV positive: 32 (76.2%) were HCV RNA positive, 10 (23.8%) negative and 3 not done due to inadequate DBS sample. 26 patients (81.3%) were linked to care and 3 (9.4%) lost to follow-up. HCV prevalence in the ED was significantly higher than the general Canadian population (2.1% vs 0.7%; p &lt; 0.0001) but much lower than reported rates in American EDs (2.1% vs 10.3%; p &lt; 0.0001). Conclusion: Acceptance of HCV screening in the ED birth cohort was high and easily performed using DBS to ensure the majority of positive samples were tested for HCV RNA. Challenges included implementation that limited number of people tested, and linkage to care for HCV positive patients. HCV prevalence among this ED birth cohort was higher than the general population but lower than seen in the ED in the US. This may in part be due to exclusion of individuals with more severe medical issues, refusal by higher risk subgroups, or population and healthcare system differences between countries.

The Vital Role of a Full Continuum of Psychiatric Care Beyond Beds.

The authors make the case for expanding the national discussion of inpatient psychiatric beds to recognize and incorporate other vital components of the continuum of care in order to improve outcomes for individuals with serious mental illness. They review the varied terminology applied to psychiatric beds and describe how the location of these beds has changed from primarily state hospitals to the criminal justice system, emergency departments, inpatient units, and the community. The authors propose 10 recommendations related to beds or to contextual issues regarding them. The recommendations address issues of mental illness terminology, criminal and juvenile justice diversion, the Emergency Medical Treatment and Labor Act, mental health technology, and the mental health workforce, among others. Each recommendation is based on findings from publicly available data and clinical observation and is intended to reduce the human and economic costs associated with severe mental illness by promoting a robust, interconnected, and evidence-based system of care that goes beyond beds.

Library marketing

In order to attract more non-medical staff, the Sir Thomas Browne Library at the Norfolk and Norwich Hospital decided to create a marketing campaign called “Love Your Library.” The campaign sought to make non-medical staff aware of the library’s many services and materials available to them. During the campaign, the library increased the number of new members by 160%, with 25% of these being non-medical members. Future promotions will help create a community hub for staff and achieve a prominent position within the Trust.