Simple Communication Tool Research Articles

Reducing Potentially Preventable Hospital Transfers: Results from a Thirty Nursing Home Collaborative

Nursing home (NH) residents experience frequent hospital transfers, some potentially avoidable. The objective of this report is to describe a replication of the Interventions to Reduce Acute Care Transfers program among member facilities of a New York City area NH provider association (INTERACT NY) and estimate its effect on hospital transfers. INTERACT is a program that provides tools and strategies to assist NH staff in early identification, communication, and documentation of changes in resident status. Funding was obtained from a New York State health workforce training grant to conduct 13 INTERACT education and training sessions in 2010-2011. INTERACT NY session topics included the implementation process; use of its simple standardized communication tools, advance care planning tools, care paths, and change in condition support tools; quality review of hospital transfers; exercises for refining clinical skills; teamwork; and lessons learned. Sessions engaged NH executives, department heads, front-line nursing staff and their labor union, and staff from NHs' partner hospitals. Pre-/post- INTERACT NY hospitalization rates per 1000-resident days were compared using paired t-tests, stratified by level of facility engagement with the program and by baseline hospitalization rates. All 100% of participating NHs were non-profit or public. Those with complete evaluation data had 377 beds on average. There were a total of 333 attendees of the program (mean 25.6 per session; mean 11.1 per facility over the course of the program; range 1-44 per facility). The most common attendees in order of frequency were (1) nurse administrators, (2) unit-based nurses, (3) medical directors and attending physicians, (4) nursing home administrators, (5) certified nursing assistants, and (6) case managers and social workers. Sixteen nursing homes implemented at least one INTERACT tool. Overall, there was a nonsignificant 10.6% reduction in hospital admissions from 4.07 to 3.64 per 1000 resident-days from pre- to post-INTERACT NY (P= .332). Among nursing homes with high engagement there was a nonsignificant 14.3% reduction in hospital admissions from 4.19 to 3.59 per 1000 resident-days (P= 0.213). Finally, among nursing homes in the highest tertile of baseline (pre-INTERACT NY) hospital admission rate, there was a nonsignificant 27.2% reduction in hospital admissions from 7.32 to 5.33 per 1000 resident-days (P= .102). Planning and implementation lessons from INTERACT NY leaders and participants are reported. INTERACT NY, a novel collaborative training program, resulted in good uptake of the INTERACT tools and processes among its member nursing homes. Changes in hospitalization rates associated with INTERACT NY were similar to those observed in previous implementations of INTERACT. The program addresses a growing interest in reducing potentially preventable hospital admissions among nursing home residents and providing alternatives to hospital care through standardized approaches to communication, early identification of clinical issues, decision-support, and support for partnerships between acute and post-acute care providers.

Design and Development of Simple and Instant Communication Tool

Instant Message is currently the most popular way to communicate on the Internet, so various Instant Messaging software are continuously appearing; Service providers offer more and more communication service nowadays. Java programming language (Java 2 Standard Edition) is one of popular programming languages. With its features of cross-platform, security, multi-threaded capability, Socket Programming, data flow concepts and so on, Java has its own distinctive and functional advantages. Therefore, based on the research and analysis of LinuxQQ, with the Java language and J2EE, this paper designs an instant messenger—JICQ (Java for I seek you), and then analyzes its architecture, modules, as well as its key technologies. During the design and modeling process of instant messenger system, the UML and method of object-oriented analysis and design are used. Furthermore, the modeling tool of Rose is included. Based on the system j2se1.5, j2ee1.4, the Eclipse development tool in the development process, and refactoring development method, the system design is optimized. Due to these factors, the system is safe, efficient and practical in different operating system platforms.

Work Complexity and Caring

Time. It is our most valuable resource. Short of science fiction, there is no way to expand it or shrink it. It is a constant. We all have 24 hours in our days. However, nurses complain that there just is not enough time to complete the work at hand. When asked to describe their work, nurses struggle to articulate their practice. An even bigger struggle is quantifying outcomes. If we can't say what it is we do, how do we know that we have made a difference? Health care is fraught with complex systems and processes. Some of the complexity is a result of strategies designed to maximize resources. Expectations of individualized care for diverse patient and family needs, and the innovative technologies used to address those needs, add another level of complexity. Complexity has an impact on people trying to navigate the health care system to receive care as well as on those of us working within health care. The time needed to address complexity is oft en not factored into resource allocation because we cannot articulate what is done. The irony is that patients and families, as well as health care providers, seek simplicity. Nurses look for simpler (not necessarily easier) ways to administer care. Understanding complexity requires introspection into what work is being done, why the work is being done, and who is performing it. The articles included in this journal explore how nursing practice can be articulated and quantified. Nursing taxonomy has given us a vocabulary to describe what we do for specific conditions as well as the outcomes of our work. Work Complexity Assessment is an intentional process that provides data about practice. It uses nursing taxonomy to further explore what is done for a specific patient population, the knowledge and skill required to complete the interventions, the time taken to complete them, and the skill mix needed to carry out the work. Cindy Scherb and I also explain how the Nursing Interventions Classification and the Nursing Outcome Classification can link Work Complexity Assessments to actual and desired outcomes. The exponential increase in the pace of change confronted by nurses is referred to as complexity compression. An interview with Lynn Jaycox, a nurse involved in a study of complexity compression conducted by the University of Minnesota School of Nursing and the Minnesota Nurses Association, describes how nurses multitask to cope with the increased complexity in systems of care. A related article by Jane Robles explores in detail how the electronic medical record contributes to work complexity, while Lori Steffen traces the history of the Kardex, a simple communication tool that has been replaced by more complex electronic processes. Marie Manthey relates the history of primary nursing and addresses myths that question its adaptability, showing that this practice model is as indispensable as ever in providing individualized care regardless of setting and skill mix. …

La certification BASICS, son pragmatisme et son avenir dans le système LMD

Created in 1998 by APICS, the BASICS certification has been very successful both in the industrial world and in academia. The testimony of former graduates will show us the interest of this training, as a simple and effective management and communication tool in business. Basic element of CPIM training, BASICS is no less an integral part of many university programs aimed at training logistics executives. At the time of the reunification of the European University system according to the License-Master-Doctorate (LMD) reference system, BASICS can constitute a gateway for many executives wishing to validate their professional experience by obtaining a University Diploma.

The Gastro‐oesophageal Reflux Disease Impact Scale: a patient management tool for primary care

Symptoms of gastro-oesophageal reflux disease have a substantial impact on patients' everyday lives. To develop and test a short questionnaire to aid patient-doctor communication. The Gastro-oesophageal Reflux Disease Impact Scale was developed from a systematic literature review, focus groups of patients and primary care physicians, and patient cognitive interviews. A psychometric validation study was conducted based on two consultations in new (n = 100) or chronic (n = 105) gastro-oesophageal reflux disease patients. The Gastro-oesophageal Reflux Disease Impact Scale demonstrated internal consistency (Cronbach's alpha ranged from 0.68 to 0.82), reproducibility (intraclass correlation coefficient in stable patients ranged from 0.61 to 0.72) and construct validity (Spearman correlations with Quality of Life in Reflux and Dyspepsia instrument and Reflux Disease Questionnaire: 0.5-0.8 in both patient groups). Effect sizes in new and chronic gastro-oesophageal reflux disease patients ranged from 0.9 to 1.5 and 0.32 to 0.42, respectively. Doctors reported altering their treatment decision based on information provided by the Gastro-oesophageal Reflux Disease Impact Scale in 35% of patients, and 77% of doctors found it to be useful. The Gastro-oesophageal Reflux Disease Impact Scale demonstrated good psychometric properties in newly diagnosed gastro-oesophageal reflux disease patients and those already receiving treatment. This simple communication tool is a useful aid for managing primary care patients with gastro-oesophageal reflux disease.

Poster 90: A community-based pilot trial of a communication tool to facilitate work accommodation after work injuries

Objective: To test a simple communication tool to facilitate work accommodation. Design: 6-month cluster randomized trial. Setting: 2 small Canadian cities and 2 large emergency departments. Participants: All medical practices and all firms with ≥30 employees in 1 city, as well as all physicians in 1 emergency department. Workers seen in the other city and emergency department served as controls. Intervention: A paper-and-pencil voluntary tool to facilitate work accommodation endorsed by local medical, labor, and employer associations and by the workers’ compensation board (WCB). Main Outcome Measure: The proportion of injured workers using the tool and interviews with workers and supervisors. Results: 28 of 32 firms, all 3 group practices, and the emergency department consented to test the tool. The tool was used in 90 of 599 (15%) work injuries reported to the WCB by the physicians and in 21 of 424 (5%) injuries reported by study firms. 24 workers were interviewed and compared with 29 controls; they reported increased discussion of modified duties with physicians (50% vs 24.1%, P<.05) and supervisors (62.5% vs 37.9%, P<.05); increased satisfaction with care (75 vs 48.3%, P<.05); and 45% felt the tool was useful. There were no significant differences in sympton severity and time off work. 23 supervisors were interviewed. Most (65%) had discussed modified duties with the worker but only 1 with a physician; 52% felt the tool was useful. Conclusions: Despite widespread endorsement, the tool was used only in a minority of injuries. When used, it increased discussion about work accommodation and about half the workers and supervisors felt it was useful. Effective community implementation of such a tool would require powerful incentives or regulation.

Local agenda 21; articulating the meaning of sustainable development at the level of the individual enterprise

While there are examples of good practice the engagement of business in Local Agenda 21 has been restricted. This is certainly true in the UK experience. ‘Missing’ the supply side of the economy in this way is clearly unsatisfactory. This problem has been addressed by the Centre for Sustainable Development from a particular perspective, which follows the multi stakeholder principles of sustainable development (SD). This paper analyses a project to make a simple clear communication tool, without jargon, to communicate the meaning of SD in different dimensions to small and medium sized businesses. The project produced a business workbook directly useful to business and that can be utilised by local authorities in the business interaction parts of their Local Agenda 21 programmes. The paper examines further what is involved in a particular aspect of the process of SD, in the regional context, and seeks to underpin the understanding that SD is a process. As part of this issues relevant to culture change are examined. A consideration of the stakeholder relationships and dynamics is central.

"Shouting Curses": The Politics of "Bad" Language in Richard Wright's Black Boy

In Everybody's Protest Novel, James Baldwin envisions Richard Wright and Harriet Beecher Stowe in mortal combat: seems that the contemporary Negro novelist and the dead New England woman are locked together in a deadly, timeless battle; the one uttering merciless exhortations, the other shouting curses.(1) Richard shouted curse is his novel Native Son (1940). In 1945, Richard Wright published Black Boy,(2) an autobiographical text in which he literally curses his way through the early part of his life. A concern with the nature and use of language(3) marks Black Boy. deployment of bad language plays a crucial role in shaping him as an African-American artist. For Black Boy considers not only the development of an artist, but the conflict inherent in the very idea of becoming an African-American artist, and of gaining control over a tool - language - which traditionally barred or curtailed African-American expression. The importance of education, and of learning to read and write in particular, is a pronounced theme in African-American literature, dating at least the time of the slave narrative. As Frederick Douglass explained the racial politics of education through the mouth of his master: 'Learning would spoil the best nigger in the world. Now,' said he, 'if you teach that nigger . . . how to read, there would be no keeping him. It would forever unfit him to be a slave.'(4) The ability to express oneself as an educated person can alter fundamentally the identity of a slave; the snuggle for self-expression is the snuggle for freedom. Thus, slavery onward, the meaning of language doubles back on itself. Bad language can be good; the obscenity of an African-American expressing him/herself also frees African-Americans the stereotypes imposed on them by an oppressive white culture. Such self-expression is also because it endangers the life of the African-American who disrupts the racist status quo. These contradictions underlie the slang term in African-American culture. As Tony Thorne defines the term, means good, and originates from the terminology of the poorest black Americans, either as simple irony or based on the assumption that what is bad in the eyes of the white establishment is for them.(5) An African-American who speaks proper English may in fact court alienation his/her own community. Zora Neale Hurston's experiences in Florida provide a striking illustration of this phenomenon: I went about asking, in carefully-accented Barnardese, 'Pardon me, but do you know any folk-tales or folk-songs?' The men and women who had whole treasuries of material just seeping through their pores looked at me and shook their heads.(6) The African-American community understands that language is not a simple communication tool and acts with full awareness of the political uses of labeling language good' or bad. To compose Black Boy, Richard Wright negotiated through a language fully implicated in the hierarchies of social power. As Horace Porter notes, Wright's incredible struggle to master words is inextricably bound to his defiant quest for individual existence and expression.(7) Wright needed language to express himself but in acquiring these skills he risked becoming by definition of both African-American and white cultures. To become the artist he wanted to be, Richard Wright had to overcome the badness ascribed to his expression because he was African-American and avoid complicity with Western ideas of literature. He needed to turn and good into in the African-American sense. Richard Wright accomplishes this negotiation in Black Boy by linking literal language - dirty words, obscenities, curses - with ideas of inappropriate speech as defined by a racist society. He plays these notions off each other to redefine notions of good and language. As narrator, Wright does not use direct citations of swearing frequently in the text until the younger Richard has mastered their meaning and use. …

On the Estimation of the Changes of River Environment based on Hydro-Ecological Modeling via the Internet

A natural river space is needed by many people and conservation of it is eagerly needed. Recently in Japan, many researchers have tried to conserve the ecological environment of a river. The purpose of this study is to investigate the infulence Of the changes of river environment and to built an expert system of hydro-ecological model. A knowledge-based expert system for the prediction of hydro-ecological environment of a river is presented.The technology and applications of the Internet now extend beyond the realm of communication.World Wide Web is a simple but most popular communication tool of the Internet.To communicate directly with this system, data access through WWW browsers.

Die rol van die bedryfskommunikasiekundige in 'n veranderende samelewing

In ‘The role of communicators in a changing society’, it is argued that people in communication professions have the responsibility to determine (by means of research) what the most efficient way is to communicate to members of the disadvantage communities in South Africa. When this is done, professionals have both modern technology and simple communication tools at their disposal which can be combined to ensure that the communicated message is clearly understood.