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Wednesday, October 26, 2016

WHY ‘WORK HERE ONLY IF YOU WANT’ IS A BAD POLICY IN HEALTHCARE


🙍🏽♂️Some studies indicate that  the cost of turnover can average 150% of the employee's annual salary. 

🙍🏽♂️A staff, say an ICU nurse,  gets moulded, for the work pattern of  a particular ICU,  AFTER KEEN OBSERVATION OF 

🔃the course of various diseases that is commonly admitted in that ICU

🔃the pattern of other staff’s responses to various emergency situations which happens there commonly 

🔃the usual prescription pattern of the doctors there 

🔃the way of communication to caretakers followed in that ICU

🔃the medicolegal issues unique to that ICU etc. 

…FOR A LONG PERIOD OF TIME

🙍🏽♂️Many patients avoid a hospital because of inappropriate care resulting from ’too volatile’ staff pool (e.g. lack of awareness of a new nurse about patient’s requirements in a particular ward, a new doctor who doesn't communicate with nursing team unlike the previous person which may translate into poor awareness of the nursing team about the management plan and less confidence in them while talking to the caretakers etc)

🙍🏽♂️When employees leave, their duties are shifted to the remaining personnel who feel obligated to shoulder the additional burden. This decreases the quality of work by the remaining staff, till a replacement comes.

🙍🏽♂️All patients prefer to be cared for by the same members of a healthcare team each time they require treatment because of the already established relationships between the patient and the treating team ( This may be more obvious in case of doctors; but in reality this is equally important in case of all other performing staffs. For e.g. Seeing the same well behaving and caring front reception staff every time, will boost the level of comfort in the patient as soon as he or she enters the hospital and will add to the reputation about the hospital )

🙍🏽♂️Such relationships are important in the success of the institution,  especially in the present scenario where the same treatment/care can be received from various similar healthcare facilities 

🙍🏽♂️Creating an organizational environment that is dedicated to the retention of talented personnel is the first step in reducing employee turnover. 

🙍🏽♂️Determining why employees are leaving an organization is an important part of developing an effective strategy. One way this information can be obtained is by conducting detailed exit interviews. 

🙍🏽♂️Some employees may truly enjoy their jobs, but eventually decide that the challenges associated with completing their assigned responsibilities are simply too much to bear. For example, nurses may be drowning in mundane paperwork that never seems to end. This could result in nurses feeling unsatisfied and unrewarded for their work. A solution to this challenge could be to implement a new digital technology that streamlines the paperwork process. Or, you could hire additional clerks to transfer some of the overwhelming responsibility away from the nurses.

🙍🏽♂️A strategy for retainment is to provide various opportunities for your employee’s to learn or improve within their field. Along with that, if your employees know that their hard work will eventually pay off in the form of a promotion, they are far more likely to stay with your organization in the long-run.

🙍🏽♂️With a strong reputation, a particular hospital  can better attract the best new employees and better retain the current employees. Such information regarding reputation will silently flow between healthcare professionals working in various hospitals and whenever a crisis develops in their present workplace, they will be tempted to move to such hospitals with good reputation. 

🙍🏽♂️In the long term, such a policy will result in the hospital retaining a pool of good doctors, nurses and other staffs and will help the institution stand strong in adversities and help it retain a big pool of very loyal ‘customers’(=patients) 

Reference: Radiol Manage. 2004 Jul-Aug;26(4):52-5.Employee retention: an issue of survival in healthcare. Collins SK1, Collins KS., Healthcare Recruiters International: 4 Ways to Increase Healthcare Employee Retention

A FEW PROSPECTIVE TECHNIQUES TO MEASURE ANALGESIA INTRA-OPERATIVELY


🤖Current electroencephalogram (EEG)-derived measures like BIS, provide information on cortical activity and hypnosis but are less accurate regarding subcortical activity, which is expected to vary with the degree of antinociception. 

🤖Efforts to develop methods for monitoring these subcortical activities produced a few indices, which may provide some use intra-operatively 

🤖Recently, the neurophysiologically based EEG measures of cortical input (CI) and cortical state (CS) have been shown to be prospective indicators of analgesia/anti-nociception and hypnosis, respectively. Composite Cortical State (CCS) is an alternate measure of CS.

🤖Composite Variability Index (CVI) is another recently developed EEG-derived measure of antinociception  based on a weighted combination of BIS and estimated electromyographic activity.

🤖CCS and BIS show strong correlations, suggesting that they behave similarly as indicators of hypnosis.

Reference: Comparisons of Electroencephalographically Derived Measures of Hypnosis and Antinociception in Response to Standardized Stimuli During Target-Controlled 
Propofol-Remifentanil Anesthesia, Mehrnaz Shoushtarian, Marko M. Sahinovic, Anthony R. Absalom, Alain F. Kalmar, Hugo E. M. Vereecke, David T. J. Liley and Michel M. R. F. Struys, anesthesia-analgesia, February 2016 • Volume 122 • Number 2