Quarterly Meetings Research Articles

FEATURES OF BANKRUPTCY IN SIMPLIFIED BANKRUPTCY PROCEDURES

In this article, the author sets the goal of studying the specific characteristics of simplified bankruptcy procedures, within the framework of which the features of the legal regulation of bankruptcy proceedings in simplified bankruptcy procedures of special debtors are considered: a liquidated debtor, an absent debtor, as well as a specialized company and a mortgage agent. The Bankruptcy Law excludes the application of monitoring, financial rehabilitation and external management procedures in relation to these special debtors, aimed at assessing the debtor's financial condition and implementing rehabilitation measures to restore his solvency, which corresponds to the task of reducing the duration and resource intensity of simplified bankruptcy procedures. The specifics of bankruptcy proceedings in respect of absent and liquidated debtors are insignificant, which do not allow to separate simplified bankruptcy proceedings as a special procedure. Bankruptcy proceedings carried out in relation to a specialized company and a mortgage agent do not have a wide practical application due to the organizational «protection» of these legal entities from bankruptcy. The author concludes that the current legislative regulation of simplified bankruptcy procedures does not contain significant differences between simplified bankruptcy proceedings and ordinary competition, which is a significant drawback of the legal regulation of simplified bankruptcy. The author presents proposals to simplify the procedure for bankruptcy proceedings of absent and liquidated debtors, including the rejection of mandatory quarterly meetings of creditors and the transition to simplified reporting of the bankruptcy trustee, proposals related to reforming the procedure for the sale of the debtor's property, including by developing a separate procedure for the sale of property in simplified bankruptcy procedures, as well as simplification of the procedure for the sale of receivables arrears.

The path to approvals: Facilitating access to healthcare data via a local Governance Forum.

ObjectivesResearch using unconsented healthcare data has the potential to have significant public benefit in terms of improved health outcomes. However, due to the sensitive nature of this data, appropriate governance, approvals, and mitigations are crucial to ensure that patient confidentiality and public trust are maintained. ApproachAs the permissions process can be a barrier to research, we established a local Governance Forum with the aim to streamline processes, increase transparency, and document approval requirements. Governance Forum membership includes representatives from the relevant health board and university departments (e.g., the regional Safe Haven, Information Governance, Ethics Committee, Data Protection, Research and Development). To achieve the Forum’s objectives, the regional Safe Haven raises current and potential project scenarios at quarterly meetings to confirm requirements and help develop a clear understanding of the approval pathway, with specific topics discussed with the relevant members out with these meetings as required. ResultsThe Forum has strengthened communication and collaboration with Forum members which has enabled the Safe Haven to better support researchers. Outputs have included a permission pathway guidance document for researchers. This initial guidance document outlines approval requirements and provides relevant advice and support, with work currently ongoing to build on and improve this. In addition, as channels have been established for onboarding new project types and novel datasets, the diversity of datasets available for research is increasing and the route to approvals is now clearer for both researchers and internal teams. The Governance Forum activity has the potential to facilitate future research which may lead to academic publications and research funding, as well as improved health outcomes and policy change in the longer-term. ConclusionAlthough the progress so far has had significant impacts, the approval processes remain challenging for certain projects. Therefore, it will be imperative that sufficient resources are available in the future to ensure that further progress can be made via the Governance Forum as well as national initiatives.

A physical therapist–led clinical decision-making program reduced risk of adverse events after total knee arthroplasty over 3 years: A retrospective review

Context Reducing adverse events after total knee arthroplasty has implications for newly developed bundled payment models. Objective To examine the impact of a physical therapist–led clinical decision-making program on the risk of adverse events, function, visits used, or reaching knee range of motion (ROM) goals in patients after total knee arthroplasty. Methods The decision-making program consisted of quarterly meetings and recommendations for early risk identification and evidence-based intervention. A retrospective review of electronic records included adult patients who underwent total knee arthroplasty postoperative rehabilitation in an 18-month baseline period from 2014 to 2015 and an intervention period from 2015 to 2018. Relative risk reduction (RRR) determined whether a reduction in risk had occurred. Discharge function was measured with the Lower Extremity Functional Scale. Results A total of 160 patients were included, 69 from the 18-month baseline period and 91 from the 36-month intervention period. Mean (SD) age was 68 (9.2) years in the baseline period and 72 (9.7) years in the intervention period. There was an 8.4% (95% CI, 1.1%–64.9%) RRR in adverse events. The RRR for patients not reaching full knee extension was 70.5% (95% CI, 33.4%–87.0%) and the RRR for patients not reaching 120° of knee flexion was 65.5% (95% CI, 5.4%–87.4%). There was significant improvement in the discharge function score (P = 0.05), but not the number of visits used (P = 0.29). Conclusion The physical therapist–led clinical decision-making program reduced the risk of adverse events after total knee arthroplasty. The risk of not reaching ROM goals by discharge was also substantially reduced.

139 Engaging the public in bidirectional communications to increase research literacy and improve the health of Indiana residents through All IN for Health

OBJECTIVES/GOALS: All IN for Health has initiated social media engagement strategies to create bi-directional communication around improved health and research literacy with the public. In addition, the All IN for Healths community-led advisory board, comprised of diverse individuals and organizations, will provide insight on research design and dissemination. METHODS/STUDY POPULATION: The Indiana Clinical and Translational Sciences Institute (CTSI) has committed to enhancing the publics engagement efforts in the All IN for Health program. This program was established in 2017 to improve the health of Indiana residents through the promotion of health resources and opportunities to participate in research. In 2021, the Indiana CTSI decided to integrate public engagement more formally. An official collaboration with the Indiana CTSIs Community Health Partnerships program was created, a digital engagement specialist was hired, and several new community and population health advisory board members were welcomed for quarterly meetings representing the rural and urban areas of the state, faith-based communities, health departments, and underrepresented groups in research. RESULTS/ANTICIPATED RESULTS: A social media campaign, informed by the All IN for Health advisory board was launched in November 2021, and the advisory board has been meeting on a quarterly basis. All IN for Healths established priority area is currently COVID-19 vaccination uptake, and our prioritized audiences are underserved and under resourced in urban and rural communities, and minoritized populations. All IN for Health has posted approximately 20 times per month on topics including COVID-19, Alzeheimers Disease, Diabetes, fitness, mental health, and research studies with a goal to increase followers and engagements by 20%. The hope is that this engagement will also result in an increase in the monthly e-newsletter subscribers and study volunteer registry participants. DISCUSSION/SIGNIFICANCE: All IN for Health has initiated new public engagement efforts to increase the value of the services offered to Indiana residents. Through consultation and co-design with members of the public and dissemination of research opportunities All IN for Health will be better suited to improve health and research literacy.

Care-based leadership in a core-periphery network: a South African case study in collaborative watershed governance

Considering increasing water insecurities related to climate change, there is a growing need for effective collaboration across core-periphery boundaries to restore and regenerate watershed vitality. It has been demonstrated that collaborative watershed governance is effective when there is a core group engaging in boundary acting, fostering interpersonal relationships, exchanging information, and sharing activities amongst stakeholders across a social network. To better understand how the core supports and collaborates with peripheral actors, we analyzed a case study of the uMzimvubu Catchment Partnership (UCP), located in the Eastern Cape of South Africa. Through qualitative and social network analysis, we identify relational links as participation in quarterly meetings, self-described close connections, and shared projects or activities. Members collaborate in this voluntary network based upon perceptions of the derived benefits, shared vision, and leadership style. The characteristics of care-based leadership expressed by a core group enhance the collaborative interactions across the social network by nurturing relationality from the core to the periphery.

“Their Deeds Shall Be Made Manifest”: The Scandalous Mission of Joseph W. Clements to Great Britain, 1848–1851

“Their Deeds Shall Be Made Manifest”: The Scandalous Mission of Joseph W. Clements to Great Britain, 1848–1851

Community engagement in the development and implementation of a rural road safety campaign: Steps and lessons learned

IntroductionRural crashes result in fatality rates twice as high as urban, after accounting for vehicle miles traveled, and those involving farm vehicles tend to be the most severe. Farm vehicle crash interventions have focused on the farm equipment (e.g., lighting and marking) or the farm vehicle operator (e.g., training), despite crashes being most frequently caused by other vehicle driver actions. Community-based campaigns focused on rural drivers have potential to influence driver behavior. The objective of this study was to describe the role, formation, and lessons learned from a community advisory board (CAB) in the development and dissemination of a community-based rural roadway safety campaign. MethodsThe CAB provided campaign input through quarterly meetings and email. The campaign had three main CAB and crash data-informed messages: 1) Slow Down, 2) Leave More Space, and 3) Avoid Passing. The CAB led campaign activities to publicize the message, distribute swag, and organize event logistics. To evaluate CAB effectiveness and inform future community engagement efforts, we conducted in-depth, semi-structured telephone interviews with CAB members in July 2020. Interviews were transcribed, coded, and codes were categorized into five main themes. ResultsOverall, CAB membership was described as an overwhelmingly positive experience in terms of the CAB structure, culture fostered among the group, responsibilities, and time commitment. Board members reported successful campaign implementation, gave positive feedback regarding the research team's engagement efforts, and provided valuable recommendations for future campaigns (e.g., adding social media components, expansion of CAB age and industry diversity, and increasing group bonding activities). ConclusionsResults from this study demonstrate the instrumental role and logistics involved in engagement of community advisors for the development and implementation of a rural roadway safety campaign. Steps and lessons from this study can be applied to other community-level injury and violence prevention topics, with a particular focus on rural communities.

Bridging the Gap: Development of a Patient Public Involvement Group

Abstract Aims Every year, the Queen Elizabeth Hospital Birmingham (QEHB) neuro-oncology team review over 2000 individuals with brain tumour. Patient and public involvement (PPI) has been fragmented to date. Initially we invited two patient advocates and a core group of allied health professionals to meet virtually to discuss development of a local PPI group, its aims, specific goals, and timescales to maintain momentum. In March 2021 we launched “BERTI: Brain tumour Education and Research paTient and public Involvement group, West Midlands”. Our inaugural meeting will be virtual in April 2021 and will be followed by three meetings per year. Method We developed information leaflets to promote the BERTI initiative. A membership form has been developed to record baseline information (non-clinical) e.g. contact details, which tumour type the individual is interested in, which aspect of BERTI they are interested in (Education, Research or Clinical service development). Patient advocates have reviewed all patient and public facing forms. All forms have been checked by Information Governance at QEHB to ensure General Data Protection Regulation compliant. Contact details and non-clinical data will be stored in a password protected database on a NHS computer network. Information to ensure members can unsubscribe from this group is easy to find and will be done immediately. A BERTI email account has been set up with a core group of professionals having access who are all fully trained in data protection and have GDPR certification. We will produce an annual BERTI newsletter. Results BERTI is a group for people affected by brain tumours in any way. We include patients, friends and family, health professionals and researchers who are committed to improving the care of people with a brain tumour. It is run between the QEHB and University of Birmingham (UoB). BERTI provides a forum to meet other people affected by brain tumours and - Share experiences; - Understand the condition better; - Work with clinical staff and researchers to improve clinical care and facilitate research for people living with brain tumours. We will meet three times per year, virtually at the moment but face to face once Covid restrictions ease. We will have a formal talks explaining certain aspects of brain tumour or research initiatives. Throughout, there will be dedicated time set aside for group discussions to promote a genuine two-way dialogue between health-care/research professionals and individuals affected by brain tumour. Conclusion The PPI group will be allowed to evolve rather than start out too prescriptive. It will capitalise on its strengths and skills of its composite members. There are no set models rather principles that will provide the foundations for a group which is supported to fulfil their specific purpose. The views of the PPI group will be presented at the quarterly Neuro-Oncology Multi-disciplinary team business meetings to provide a forum to discuss issues. We aim to foster a PPI friendly environment, deliver real engagement and involvement across the group.

Review of the Quality Assurance Program of Colombo District, Sri Lanka: A Reflective Writing

Quality Assurance (QA) in health care is to maintain a high quality health care services, through monitoring of its’ the effectiveness. The QA program of Divisional Hospitals, Primary Medical Care units and Medical Officer of Health (MOH) units are monitored at the RDHS level. Likewise, RDHS of Colombo district is responsible for all the above stated institutions in Colombo district. All the above institutions have started 5S concept upto a certain extent. Work performance, clinic services, disease surveillance, supply chain management, health information system, performance reviews of MOH Units are functioning very satisfactorily. Even though the Out patient services, emergency services, Inpatient services, Supply chain management, diagnostic services, waste management, utility services are functioning well, there are significant deficiencies in every aspect in curative care settings. I was satisfied about the achievements of preventive setting with regard to QA while I am not happy about the QA of curative care settings. QA of curative care institutions are not up to the expected standards. It is mainly due to poor leadership competencies and commitment of managers, mal - functioning of the Quality Management Unit of the RDHS office, inadequate supervision and performance reviews. Monitoring of curative care institutions by the directorate of Primary Care Services is also not satisfactory, while monitoring of preventive care institutions by National Programs is substantially high, which has resulted in high QA in preventive sector. It is recommended to strengthen the functions of the QMU of the RDHS unit; to introduce monthly institutional meetings; to perform quarterly review meetings at RDHS office, strengthening health information system, training of the staff, increase the number of supervisory visits by RDHS and performance appraisal and recognition of good work.

Novel approaches to identify and characterize young key population networks in southern Africa.

Novel approaches to identify and characterize young key population networks in southern Africa.

Increasing Ideal Coagulation Factor Dosing in the Pediatric Emergency Department: A Quality Improvement Study

Background:Hemophilia is an inherited bleeding disorder. Timely and appropriate therapy at time of injury is important to decrease morbidity and mortality. Additionally, the factor concentrates used to treat injuries are expensive and require specialized pharmacy inventory management. In order to have optimal health and economic outcomes, we strove to optimize delivery of appropriate factor doses for injuries in pediatric patients seen in the main campus Emergency Department (ED) via a quality improvement project. Our specific aim was to increase the number of patient encounters between encounters where factor dosing was outside 90-120% of the ideal dose from 4 encounters to 15.Methods:In order to establish baseline data, a chart review was completed on all patients with hemophilia A or B seen in the main campus ED for injuries requiring clotting factor concentrate from September 2015 to August 2016. Exclusion criteria included patients with active inhibitors, those on a study concentrate, or those who required a continuous infusion of factor concentrate. The degree of injury described in the medical documentation was reviewed and ideal factor replacement was determined by institutional guidelines. Injuries were classified as minor-requiring a 50% factor correction or major-requiring a 100% factor correction. An ideal dose range in IU/kg was determined for each patient. The ideal dose was then compared to the dose administered in the ED. If factor was given at home prior to the arrival to the ED, and it was documented in the medical record, this was considered in the comparison of dosing. Our pharmacy allows a +/-10% buffer on dosing to permit rounding to appropriate volumes for ease of administration. Taking this hospital standard into consideration, ideal dosing range was defined as 90%-120% of the ideal dosing for the degree of injury. We expanded the upper limit to 120% of the ideal dosing due to the increased risk of bleeding if under dosed, and to also take into consideration the variation in coagulation factor vial sizes. Each month, the ED visits were reviewed and if dosing fell outside the defined ideal range the case was reviewed by the hemophilia clinic director. In an effort to improve efficiency in achieving ideal dosing, we implemented several quality improvement initiatives starting in November 2016. (1) In-service reviews of types of injuries and appropriate dosing were given for hematology/oncology fellows and pharmacists. (2) Treatment dosing algorithms were posted electronically in multiple locations to allow easy access. (3) An electronic medical record based hemophilia injury order set was implemented for ED providers that included links to the treatment guidelines. (4) A departmental communication was sent out to Hematology/Oncology and the ED about the resources available to them. (5) Reminders of changes were integrated into quarterly ED in-services and ED staff meetings. We performed hypothesis testing for categorical variables to evaluate for any other opportunities for specific interventions.Results:Our baseline data (Sept 2015 - Aug 2016) showed that we were within ideal dosing range 70% of the time. There was no difference between those patients with hemophilia A or B in frequency of out of range dosing (P =0.15). There was no difference in frequency of out of range dosing between patients treated with standard factor VIII products, standard factor IX products, extended half-life factor VIII or extended half-life factor IX products. We observed no correlation between the hours a pharmacist is in the ED and out of range dosing (P =0.58). Since the start of our quality improvement intervention in November 2016 to July 2017 we have surpassed our goal and reached 16 encounters between non-ideal dosing, up from our baseline of 4 encounters. We improved our in range average from 70% to 83%.Conclusion:Ideal coagulation factor dosing is important for optimal patient care and to ensure economic responsibility. Our quality improvement interventions promoted more accurate dosing of factor for patients with hemophilia seen in the ED for injury related care. Our next steps are to maintain this success over time, and to analyze the financial impact of improved coagulation factor utilization. [Display omitted] DisclosuresDunn:Alnylam: Other: Unrestricted educational grant; Bayer: Consultancy, Other: Unrestricted educational grant; CSL Behring: Consultancy, Other: Unrestricted educational grant; Biogen: Other: Unrestricted educational grant, Research Funding; Kedrion: Other: Unrestricted educational grant; NovoNordisk: Other: Unrestricted educational grant; Octapharma: Other: Unrestricted educational grant; Shire: Consultancy, Other: Unrestricted educational grant, Research Funding; World Federation of Hemophilia USA: Membership on an entity's Board of Directors or advisory committees.

Supporting Team Leads with the Implementation of Formalized Structured Engagement: Introduction of the Treatment Team Lead Quarterly Meetings

Purpose: The practice of assigning of a team lead to act as a technical resource and to organize daily work flow for each treatment unit has been in place in our department for numerous years. To date, however, nothing formal has been implemented to support or enhance the individuals in these roles. The aim of this initiative was to create a formalized program to foster growth and development of the team leads and to improve lines of communication with the team leads and leadership. Methods: The support program was built around quarterly meetings that were held between team lead and one of the supervisors +/- professional lead. The meetings followed a standard structure that included: daily operation (review of unit performance data extracted from Mosaiq), organization (daily schedule, next day preparation), practice (documentation audit), leadership (mentoring new staff and students) and goal setting (personal or professional development). The content of the meeting is meant to be fluid in order to address issues as they arise in the department and team leads are encouraged to identify their own priorities. In addition to the meetings in this first iteration, professional development time in planning was organized for the team leads with specific goals tailored to the specialized practice on their treatment unit. Results: To date, two sets of quarterly meetings have been conducted. The meetings provided an opportunity to align expectations between leadership, team leads and department. Through the review of operational data and standardized audits of documentation practice, objective feedback could be provided on team performance. The team leads and leadership were able to collectively develop goals. Establishment of goals offered opportunity for leadership to provide avenues of support when team leads experienced challenges in achieving objectives. The meetings also provided a forum for team leads to discuss their aspirations in terms of personal and professional development so that leadership could provide appropriate assistance. In some cases it has been challenging for team leads to view feedback as constructive and supportive as opposed to punitive or management of performance. Conclusions: Though not the impetus for the initiative, operational improvements were observed including an increase in the proportion of treatment units starting on time, an increase in the number of patients being treated within 10 minutes of their appointment time and improved timeliness for chart checks which includes pre-treatment quality assurance (QA) when received from planning and QA of charts upon treatment conclusion. An increased awareness of the importance of clinical documentation was also apparent. Anecdotal feedback from the team leads suggests that they appreciate the new structure. The average score was 4.6/5 when the team leads were asked if their professional development time in planning was a good experience and many suggested that it should become a yearly exercise.

Profiles of institutional ethics committees and status of standard operating procedures in North East India.

Limited data are available regarding institutional ethics committees (IECs) and their standard operating procedures (SOPs) in North East (NE) India. An attempt was made to study the profiles of IECs and the status of their SOPs in health research institutes of NE India. Fourteen biomedical and health research institutes of NE India were reviewed. Only 12 of these 14 institutes had constituted their IECs. The IECs were multidisciplinary and multisectoral in nature; of the 12 institutes, 8 had adequate representation by age and seven committees had adequate representation by gender. In 11 out of 12 IECs, chairpersons were non-affiliated, and chairperson qualifications in 10 of 12 IECs were found to be in keeping with the National Ethical Guidelines for Biomedical and Health Research involving Human Participants, 2017, of the Indian Council of Medical Research (ICMR). There were no lay persons in 6 out of 12 IECs. Nine out of 12 institutes had framed their SOPs. Three out of nine IECs adopted all three types of reviews namely exemption from review, expedited review and full committee review. Six out of nine SOPs had adopted the provision of quarterly review meetings. Declarations of conflict of interest (CoI) were specified in seven out of nine SOPs. Five out of nine SOPs mentioned no voting power for members who declared CoI. Seven out of nine SOPs specified the designated office space, staff, and budget of the committee. Only 2 out of the 12 IECs were registered. Our findings concluded that the characteristics and composition of IECs of health research institutes in NE India are suboptimal. Most of the SOPs were not framed as per recommendations of the ICMR National Ethical Guidelines for Biomedical and Health Research Involving Human Participants, 2017, and were unregistered.

Designing for Scale and taking scale to account: lessons from a community score card project in Uganda

BackgroundPlanning for the implementation of community scorecards (CSC) is an important, though seldom documented process. Makerere University School of Public Health (MakSPH) and Future Health Systems Consortium set out to develop and test a sustainable and scalable CSC model. This paper documents the process of planning and adapting the design of the CSC, incorporating key domains of the scalable model such as embeddedness, legitimacy, feasibility and ownership, challenges encountered in this process and how they were mitigated.MethodsThe CSC intervention comprised of five rounds of scoring in five sub counties and one town council of Kibuku district. Data was drawn from ten focus group discussions, seven key informant interviews with local and sub national leaders, and one reflection meeting with the project team from MakSPH. More data was abstracted from notes of six quarterly stakeholder meetings and six quarterly project meetings. Data was analyzed using a thematic approach, drawing constructs outlined in the project’s theory of change.ResultsEmbeddedness, legitimacy and ownership were promoted through aligning the model with existing processes and systems as well as the meaningful and strategic involvement of stakeholders and leaders at local and sub national level. The challenges encountered included limited technical capacity of stakeholders facilitating the CSC, poor functionality of existing community engagement platforms, and difficulty in promoting community participation without financial incentives. However, these challenges were mitigated through adjustments to the intervention design based on the feedback received.ConclusionGovernments seeking to scale up CSCs and to take scale to account should keenly adapt existing models to the local implementation context with strategic and meaningful involvement of key legitimate local and sub national leaders in decision making during the design and implementation process. However, they should watch out for elite capture and develop mitigating strategies. Social accountability practitioners should document their planning and adaptive design efforts to share good practices and lessons learned. Enhancing local capacity to implement CSCs should be ensured through use of existing local structures and provision of technical support by external or local partners familiar with the skill until the local partners are competent.

Creating a pediatric advisory board for engaging youth in pediatric health research: A case study.

Youth are an understudied population requiring additional safeguards when participating in research. Their input is necessary to facilitate participation and interest in studies. To address this, Mayo Clinic established one of the first pediatric advisory boards (PAB) comprised of 18 diverse youth aged 11-17. The PAB members participated in quarterly meetings (in person and then by video conference with the advent of COVID-19) where they provided feedback to researchers on recruitment strategies, study materials, and procedures. The PAB meetings fostered bidirectional conversations with researchers on several health research topics, including mental health. Youth advisory boards can promote engagement in pediatric research.

Averting Maternal Death and Disability in an Urban Network of Care in Dar es Salaam, Tanzania: A Descriptive Case Study

ABSTRACT The non-governmental organization Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) developed a multi-facility maternal and neonatal Network of Care (NOC) among 22 government hospitals and catchment facilities operating across Dar es Salaam. While facility delivery rates were above 90% in the Dar es Salaam region, the quality of services was substandard, leading to an excess of preventable maternal and neonatal morbidity and mortality. In partnership with the Dar es Salaam regional health authorities CCBRT developed a plan to improve the quality of service delivery at childbirth by through a system strengthening approach, capacitating lower-level facilities to provide routine care during pregnancy and uncomplicated deliveries, as well as improving care at secondary level referral hospitals and developing an inter-connected strengthened referral system. The Regional–CCBRT partnership implemented interventions across the continuum of care that included clinical training in basic and comprehensive emergency obstetric care, investments in infrastructure, and a rigorous maternal and perinatal death audit and follow-up program. Routine data generated were reflected upon at quarterly quality improvement meetings to follow up on problems identified. The government has initiated the replication of the model. This descriptive case study uses the four domains of the Networks of Care framework to document the wide-ranging efforts made to build and maintain the CCBRT Network of Care in order to solve for specific challenges in maternal and neonatal health service delivery in the urban context of the Dar es Salaam region.

Use of Champions Identified by Social Network Analysis to Reduce Health Care Worker Patient-Assist Injuries

Safe patient handling and mobility (SPHM) programs recommend having champions, but have not indicated how to identify them and have confined their role to peer-based activities, limiting their ability to influence control measures. In a pilot program conducted at a community access hospital in Oregon, researchers applied social network analysis (SNA) of safety advice to identify champion candidates. Candidates were invited to complete mobility, communication, and quality improvement (QI) training modules to become champions. Champions' roles included peer-based instruction and participation in QI quarterly meetings with hospital leaders. The program process was evaluated through weekly e-mail check-ins and documentation of quarterly meetings. Outcomes were evaluated with a pre-post design, observing 12-month changes in self-reported leading indicators and Good Catch reports, as well as trends in patient-assist injuries (2011-2019). SNA identified six candidates, four of whom became champions. Champions completed 48 weekly logs. The quarterly meetings concerned unitwide SPHM training, equipment storage, and onboarding. Results showed significant improvements in equipment use, safety participation, and safety compliance, particularly among workers who would seek SPHM advice from champions or recently hired workers. Compared with the prior year, the Good Catch monthly entries increased from 11.69 to 28.81. The average annual incidence rate of patient-assist injuries dropped from 13.01 for the six years before the program to 3.7 per 100 full-time equivalents (FTE) for the two years after. A program with SNA-identified and QI-trained champions improved safety outcomes after one year. Better-designed evaluations are needed to establish the replicability and long-term impact of this program.

Radiation Therapy in King County, Washington During the COVID-19 Pandemic: Balancing Patient Care, Transmission Mitigation, and Resident Training

Radiation Therapy in King County, Washington During the COVID-19 Pandemic: Balancing Patient Care, Transmission Mitigation, and Resident Training

770 Increasing Attendance in Parent Support Groups Through Creative Engagement

Abstract Introduction Engaging parents of pediatric burn survivors in support programs enhances children’s coping and self-esteem. A parent support group for pediatric burn survivors was created to address these issues, but participation was consistently low, with an average attendance of two. To increase attendance, the format of the program was modified to target the survivor as well as parental needs. Methods The program was created for burn survivors age 3 to 17 years and their parents. The pediatric module incorporated developmentally appropriate activities to engage pediatric burn survivors and siblings in therapeutic techniques to normalize their experience and provide expressive opportunities. Parents attended a parent support group, where facilitators encouraged expression of feelings connected to their child’s burn injury and developing strategies for supporting their child through daily life. The parent portion also fostered an opportunity for them to develop their own coping skills. A trained peer support volunteer attended the program to foster peer support. A survey gauging parental perception of their child’s coping and their own coping was developed and distributed to all parents at the end of the session. Results There were 29 attendees (11 adults and 18 children). Ten surveys were completed, but one was eliminated due to user error. The results were overwhelmingly positive and validated a need for parent support (see table). Most parent participants (78%) had never attended a burn survivor support program though all had previously attended survivor-related social events. All respondents indicated they wound attend this event again. Conclusions Engaging survivors and their families in recreational-based events appears to lead to higher attendance, as all participants had previously attended social events provided by the burn program. Parents may be more inclined to attend an event that focuses on their child’s needs rather than, or in addition to, their own. Additional programs are planned with a goal of quarterly meetings. Attendance and feedback will need to be tracked to corroborate the findings of this initial experience and foster the growth of a robust parental support program. Applicability of Research to Practice Providers of parent support groups need to be creative in developing formats that increase participation. Recreational activities alone do not foster coping skills and emotional support. Activities need to be created that support the psychosocial needs of pediatric burn survivors and their parents.

Obtaining BMT Programmatic Feedback for Performance and Quality Improvements

Over the last year, the Medical City Dallas Blood and Marrow Transplant (BMT) Program quality management team implemented a formal process to solicit feedback from the processing facility, collection facility, and the clinical programs within the BMT Program. The information received is used to improve interactions and processes, as well as meeting and/or exceeding Foundation for the Accreditation of Cellular Therapy (FACT) requirements. <b>Background:</b> Feedback is one of the most powerful influences for learning and achieving process improvements, but its impact can be positive, negative, or neutral. The 7^th edition <i>FACT-JACIE International Standards</i> requires that the Quality Management Plan include, or summarize and reference, policies and procedures for obtaining feedback from associated Clinical, Collection and Processing Facilities. Figure 1, "Feedback Flow between Program Facilities", illustrates the flow of feedback between facilities. <b>Method:</b> To facilitate the collection of data, an electronic survey instrument was used to expedite survey completion. Over a 10-month period, the Quality Manager, assisted by the program's BMT Secretary, sent out bi-weekly feedback surveys and to each facility. If facility staff did not return surveys, reminders were sent again after 3 days and then again after 10 business days (refer to figure 2. "Survey Questions and # of Returns"). Returned surveys are then analyzed. Results and any concerns are presented during the program's quarterly quality meetings for review and endorsement of performance improvement plans. <b>Analysis:</b> To date, the responses have been approximately 90% positive; the other 10% suggested that professional communication could be improved (refer to Figure 3. "Example Feedback"). Some survey respondents remarked that fear of retaliation arising from negative comments prevented them from responding honestly and openly. <b>Results:</b> The survey process has been well received, providing actionable feedback. The evidence confirms that the type of feedback, and the way it is delivered, can be perceived as positive or negative. As one outcome of the survey process, documents are now placed on a shared drive folder so that staff who need them can access them directly. This has improved information flow and communication within the team. The Program is investigating opportunities to improve interpersonal communication approaches in order to improve "sense of team". From the perspective of this program, in addition to surpassing FACT requirements, this initiative provides ways in which feedback can be used to improve communications and streamline processes between facilities.