The 43rd IHF World Hospital Congress kicks off today at the Oman Convention and Exhibition Centre for four days of insightful discussions and knowledge exchange among health leaders from 59 countries, all gathered together to improve the way we deliver healthcare.
Hosted by the Ministry of Health of the Sultanate of Oman, the World Hospital Congress, under the umbrella of the International Hospital Federation (IHF), is a unique global forum that brings health leaders from across the globe together annually to share views and experiences, network and promote excellence in healthcare and hospital leadership.
“The Ministry of Health of the Sultanate of Oman is delighted to host the 43rd World Hospital Congress and welcome delegates from different countries and cultures to Muscat”, said Dr Qasem Ahmed Al Salmi, Chair of the 2019 World Hospital Congress Organizing Committee.
“In the next four days we will hear accounts about resiliency, investments, and innovations; and understand better the interconnected roles of hospitals, patients, and communities in times of peace and crisis”, said IHF President, Dr Francisco Balestrin. “On 8 November, we will recognize hospitals and healthcare organizations from around the world for their outstanding and innovative programs to improve patient experience and outcomes during the 2019 IHF Awards Ceremony.”
Six keynote presentations will feature world-renowned speakers followed by insightful panel discussions. There are 130 speakers to offer fresh perspectives and strategies from their experiences, as well as examples of current innovations and digital transformations in healthcare from different regions in the world.
If you are interested in resilient health services, you can hear about the challenges of refugee crisis in Palestine from Dr. Akihiro Seita, Director of Health Programme of UNRWA. You can attend sessions covering terrorist attack situations, response and mitigation plans, and how to maintain quality in healthcare even in the most challenging of times,” offered Dr Balestrin.
Topics on health investment for prosperity are spread throughout the four days. Keynote presentations by Dr. Melinda Estes, President and CEO of Saint Luke’s Health System in the USA, and Dr. Agnés Soucat, Director of Health Systems Governance and Financing at WHO Switzerland, will tackle the roles of hospitals, health systems and health services in driving prosperity and in support of population well-being. More sessions under this sub-theme will cover how local hospitals are reinventing themselves and rethinking their plans to improve population health.
“If you are keen about innovation for health impact, a keynote session with Sir Andrew Dillon CBE, Chief Executive of the National Institute for Health and Care Excellence (NICE) in the UK, will discuss about the innovation pathway being an alignment between ambition and successful adoption of new health technologies. You can also listen to sessions sharing about the digital ecosystem of Catalonia, the Asian perspective of digital transformation pathway, as well as a presentation of Oman’s e-health achievements”, invited Dr Balestrin.
“This is a great opportunity to learn from each other and share ideas over these four days in the conversation on how we can make healthcare more responsive, supportive and prospective in times of peace and crisis,” commented Dr Al Salmi.
https://worldhospitalcongress.org
mylene.dayola@ihf-fih.org
The European Society of Radiology (ESR) has renewed its initiatives to harmonize medical training for radiologists across Europe. Following advocacy on the part of the radiology community, in close coordination with the European Union of Medical Specialists (UEMS), after the modernization of the Professional Qualifications Directive in 2013, the current political climate offers new opportunities for adapting the legal framework regulating the free movement of doctors and recognition of professional qualifications.
Considering the ongoing evaluation of the Professional Qualifications Directive, the ESR brings again to the attention of the European Commission its twofold request to change Annex V, Section 5.1.3. in order to safeguard the highest standards of medical training and patient care throughout Europe.
Once again, the ESR has joined forces with the UEMS, the authority on medical education in Europe, demonstrating its continuous commitment to collaborating with partner organizations on the harmonization of medical education.
In an official letter submitted to the European Commission, the ESR strongly urges the European Commission to adopt a delegated act to increase the minimum years of training for radiologists from four to five years, in full compliance with the European Training Curriculum for Radiology that was developed to further harmonize radiology education throughout Europe.
Growing training needs and the introduction of digital solutions in medical imaging require equally high standards of training that can only be met by implementing a full-fledged five-year radiology training.
In addition, the ESR calls on the Member States and the European Commission to change the name of the discipline from “Diagnostic Radiology” to “Radiology”, reflecting the profession’s current practice comprising both diagnostic and interventional procedures.
As Member States hold the competence to unilaterally enter the name of a profession into Annex V, individual Member States are strongly encouraged to unilaterally enter “Radiology” as the name of the discipline as a first step towards harmonization. Nevertheless, the ESR believes that an EU-wide solution is needed and therefore urges the Member States and the European Commission to enter into dialogue in the interest of the free movement of radiologists in Europe.
The ESR supports a multi-layered approach, simultaneously launching initiatives at national and EU levels, to strengthen the voice of radiology in the debate. Therefore, the ESR counts on the national radiological societies to be the messenger of the unified radiology position towards national Ministries of Health and health authorities.
Only a coordinated approach involving the ESR and its institutional members can lead to the highest standards and a true harmonization of radiology training and enhance the mobility of the radiology profession in Europe.
https://tinyurl.com/y2q4m5ht
In one of the most ambitious collaborative initiatives ever undertaken by the pharmaceutical industry, more than 20 leading biopharmaceutical companies in early July announced the launch of the AMR Action Fund, a ground-breaking partnership that aims to bring two to four new antibiotics to patients by 2030. These new treatments are urgently needed to address the rapid rise of antibiotic-resistant infections – or antimicrobial resistance (AMR).
The companies have raised so far nearly US$1 billion to support clinical research of innovative new antibiotics that address the most resistant bacteria and life-threatening infections. Through the AMR Action Fund, pharmaceutical companies will join forces with philanthropies, development banks, and multilateral organizations to strengthen and accelerate antibiotic development. The Fund will focus on urgent public health needs. It will provide much needed financial resources, as well as important technical support to help biotech companies bring novel antibiotics to patients.
The AMR Action Fund, an initiative of the international body representing the R&D pharmaceutical industry (International Federation of Pharmaceutical Manufacturers & Associations, IFPMA), was announced at simultaneous virtual launch events in Berlin, Germany, and Washington, D.C., USA, on 9 July, with a third event in Tokyo, Japan on July 10.
AMR is a looming global crisis that has the potential to dwarf COVID-19 in terms of deaths and economic costs.
Commenting on the Fund, Dr Tedros Adhanom Ghebreyesus, Director General World Health Organization, said: “AMR is a slow tsunami that threatens to undo a century of medical progress. I very much welcome this new engagement of the private sector in the development of urgently-needed antibacterial treatments. WHO looks forward to working with the AMR Action Fund to accelerate research to address this public health crisis.”
New antibiotics
The world urgently needs new antibiotics, but there are few in the pipeline because of a paradox: despite the huge societal costs of AMR, there is currently no viable market for new antibiotics. New antibiotics are used sparingly to preserve effectiveness, so in recent years, a number of antibiotic-focused biotechs have declared bankruptcy or exited this space due to the lack of commercial sustainability, resulting in the loss of valuable expertise and resources. The consequence is a huge public health need for new antibiotics, but a lack of funding available for antibiotic R&D, particularly the later stages of clinical research. This creates a “valley of death” between discovery and patient access.
“With the AMR Action Fund, the pharmaceutical industry is investing nearly US$1 billion to sustain an antibiotic pipeline that is on the verge of collapse, a potentially devastating situation that could affect millions of people around the world,” said David Ricks, Chairman and CEO of Eli Lilly and Company and President of IFPMA. “The AMR Action Fund will support innovative antibiotic candidates through the most challenging later stages of drug development, ultimately providing governments time to make the necessary policy reforms to enable a sustainable antibiotic pipeline.”
With this investment, the AMR Action Fund will be the largest collective venture ever created to address AMR. The AMR Action Fund will:
The Fund is expected to be operational during the fourth quarter of 2020.
For more details on the AMR Action fund, visit www.AMRactionfund.com
A Loughborough University academic is providing guidance to clinicians who are likely to be having – and training people who will have – difficult conversations with patients suffering from COVID-19 or those closest to them.
Professor Ruth Parry, an expert in healthcare communication and interaction, has outlined a series of evidence-based principles with the help of her Loughborough colleague Becky Whittaker, Sharan Watson, of the University of Derby, and Dr Ruth England, of Royal Derby Hospital.
The team shared the recommendations with NHS Health Education England and these have been used to develop a series of open access resources that aim to support healthcare staff who will be having difficult conversations in relation to the coronavirus.
The principles, which have also been added to the International Association for Hospice and Palliative Care’s COVID-19 resources list*, are based on research by Professor Parry and other communication scientists worldwide who have recorded and analysed thousands of difficult conversations across various health and social care settings in the UK, Australia, Japan, and the US.
Professor Parry, who receives funding from the National Institute for Health Research (NIHR), says her guidance steers away from providing recommended phrases or scripts as it is important to equip health workers with the tools to communicate flexibly according to individual circumstances.
Having a conversation by phone, conversations where the staff member who is to do the talking is wearing PPE (Personal Protection Equipment), and conversations with people who have varying degrees of knowledge and distress are all examples of circumstances that can impact how a conversation should be constructed.
What’s more, Professor Parry says giving difficult news over the phone or when wearing Personal Protection Equipment are circumstances that staff would normally want to avoid – in normal circumstances, the health services strive to ensure that these difficult conversations are led by highly experienced professionals, face-to-face, and in calm environments.
Professor Parry has divided her advice into key areas. They include (with a brief overview of what they cover):
Health workers should clarify in their mind what they want to say and why, and find a comfortable and private setting, as best they can.
Conversations should be started by giving the person on the receiving end an outline of what will follow – for instance, if it is an update, and/or that there is a decision to be made.
This can be portrayed through tone of voice, phrases that attend to emotion, and showing understanding without claiming one can possibly fully understand how the person on the receiving end is feeling.
Health workers should find out what the person they are talking to already knows and how they feel about it as this will help them fit what they go on to say to the individual person they are talking to.
If this is a phone call, finding out who is with a person or who they could talk to afterwards is important, says Professor Parry, but this question should not be asked right at the start of a conversation as it could easily be heard as very bad news. Even when there is very bad news to come, building towards it gradually is better than clearly signalling it from the start; a gradual move towards the news reduces the risk of sending the person on the receiving end into severe shock.
Professor Parry’s advice is to describe some of the things that are wrong with the unwell person, in such a way that the person speaking is forecasting that bad news is going to come. The point is to bring about gradual recognition, rather than shock.
Deliveries should be modified to be softer and more lilting if this happens. Speakers should allow silence, repeat brief further sympathy – ‘I’m so sorry’, and acknowledge the distress before moving on and giving more information.
Phrases like ‘anything else’ should be avoided because, in some circumstances, this can be interpreted as the speaker not expecting there to be anything else. Offering ‘Are there things I have not covered or explained enough?’ removes the implication that the person has not understood things.
If possible, health workers should try to deliver something that is of comfort and that they can say truthfully, says Professor Parry. They should also explain what happens next, advise who the person they are talking to can contact for support and, if necessary, explain how pain or other symptoms will be controlled.
Professor Parry has also provided advice to help somewhat reduce the emotional burden on the healthcare worker – for example, she recommends they find someone to debrief with before and after a difficult conversation. Of the importance of the guidance and what she hopes it will achieve, Professor Parry said: “Healthcare workers are now having to have break bad news and have difficult conversations on an unprecedented scale.
“The kind of research I do makes it possible to pin down, to articulate, precisely how skilled, compassionate healthcare staff communicate, and pass this on to others.
“I hope that our guidance will help all staff having to break bad COVID-19 news to patients or their loved ones, to feel confident and able to communicate well, whilst looking after their own wellbeing.”
The full guidance document has been shared on the Real Talk website – a platform for communication training resource designed to use in face-to-face training events for health and social care staff – and can be downloaded as a PDF here.
The Society for Healthcare Epidemiology of America has issued a new expert guidance on how hospitals and healthcare providers may reduce infections associated with anaesthesiology procedures and equipment in the operating room. The guidance recommends steps to improve infection prevention through increased hand hygiene, environmental disinfection, and continuous improvement plans.
“Even though the demands on anesthesia providers make infection prevention best practices more challenging, there are opportunities for improvement,” said Silvia Munoz-Price, MD, PhD, lead author of the guidance and Professor of Medicine at Froedtert & Medical College of Wisconsin. “We describe how the anesthesiology team and hospital leaders can optimize infection prevention in operating room anesthesia, and we give suggestions for the future, including the need for better equipment design.”
A growing body of research has shown that contamination in anesthesiology work areas is connected to healthcare-associated infections that put patients at risk. A survey of 49 U.S. and international facilities showed infection control policies and practices are inconsistent. A writing panel—consisting of representatives from SHEA, the American Society of Anesthesiologists (ASA), the Anesthesia Patient Safety Foundation (APSF), and the American Association of Nurse Anesthetists (AANA)—developed the guidance to establish procedures and best practices specific to anesthesia in the operating room
The key recommendations include:
Hand hygiene should be performed, at a minimum, before aseptic tasks, after removing gloves, when hands are soiled, before touching the anesthesia cart, and upon room entry and exit. The authors also suggest strategic placement of alcohol-based hand sanitizer dispensers.
During airway management, the authors suggest the use of double gloves so one layer can be removed when contamination is likely and the procedure moves too quickly to perform hand hygiene. The report also recommends high-level disinfection of reusable laryngoscope handles or adoption of single-use laryngoscopes.
For environmental disinfection, the guidance recommends disinfecting high-touch surfaces on the anesthesia machines, as well as keyboards, monitors and other items in work areas in between surgeries, while also exploring the use of disposable covers and re-engineering of the work surfaces to facilitate quick decontamination in what is often a short window of time.
IV drug injection recommendations include using syringes and vials for only one patient; and that injection ports and vial stoppers should only be accessed after disinfection.
The authors suggest that implementation of the recommendations requires multi-level collaboration within the hospital, regular monitoring, and evaluation of infection prevention practices with regular feedback for providers as well as clarity in expectations about behaviours. According to the guidance, leadership should define goals, remove barriers to infection prevention, and empower practitioners to meet standards.
ASA President Linda Mason, MD, FASA, said the collaboration between anesthesiology and infection prevention is critical to patient safety: “These guidelines address the evidence base for infection prevention while taking into account the realities of the operating room and the complexities involved in providing anesthesia services.” ASA supports local hospital-level discussions and decision-making regarding the use of laryngoscopes, including disinfection procedures per the manufacturer’s recommendations or use of disposable tools, and emphasizes that practices and local administrators should follow any and all updates to the U.S. Pharmacopeia Chapter, expected in the coming months.
SHEAhttps://tinyurl.com/y52mtrzu
Frontline clinicians treating coronavirus patients can now gain access to the latest advice from a panel of human physiology experts. Frontline medics can ask anything about how the body might function in response to the disease.
The aim is to provide clinicians with an evolving understanding of the physiological and pathophysiological mechanisms that both underpin this disease and determine its outcome and mitigation.
The initiative is a joint venture between The Physiological Society and the Intensive Care Society, which is being co-ordinated by Mike Tipton, Professor of Human and Applied Physiology at the University of Portsmouth and David Paterson, Professor of Cardiovascular Physiology at the University of Oxford,.
Questions, comments and data from frontline clinicians dealing with patients are responded to by a Covid-19 advisory panel consisting of 24 specialists with diverse physiological expertise.
Professor Tipton said: “Following a discussion with Hugh Montgomery, a professor of intensive care medicine, it was clear that our clinical colleagues were working flat out whilst most of our academic colleagues were not able to deploy their expertise, sitting at home isolating.
Anyone can access the website to read the questions and responses, but only clinicians can register to ask questions or comment.
Questions from the frontline: https://www.physoc.org/covid19/questions
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The greater the volume of blood removed from the brain via minimally invasive surgery after a cerebral haemorrhage the greater the odds of better functional recovery, according to late breaking science presented at the American Stroke Association’s International Stroke Conference 2019.
Minimally Invasive Surgery Plus Alteplase for Intra-cerebral Haemorrhage Evacuation (MISTIE) is the stereotactic catheter aspiration and clearance of large bleeds within the brain, with the clot-buster alteplase.
The MISTIE III trial is the first surgical trial assessment of whether greater removal of blood impacts the likelihood of favourable functional outcome after one year and factors associated with greater efficiency of blood removal.
Among 506 intra-cerebral haemorrhage (ICH) cases enrolled in the trial, 242 ICH patients (average age 62, 63 percent male) underwent the MISTIE III surgical procedure by 110 surgeons at 73 sites, with follow-up at one year. The trial excluded patients whose bleeding had not stabilized, and cases with cerebellar and brainstem haemorrhage.
Researchers found that among cases undergoing the MISTIE III surgical procedure, removing blood volume by 70 percent or more, or leaving 15 milliliters or less of residual blood at the end of treatment were twice as likely to achieve milder disability one year later. Lesser removal was needed to avoid mortality, but the patients who had less than 70 percent of the blood removed, or more than 15 mL residual blood, had no difference in disability than patients treated with medical therapy, or those with lesser removal.
Researchers noted that more efficient ICH evacuation was more likely accomplished in cases with certain shapes of hematoma, where the surgical protocol was rigorously followed and by surgeons and sites with greatest experience in MISTIE technique.
“When assessing the results of surgery for brain haemorrhage, it is critical to consider how much blood was successfully evacuated. Unless a large majority of clot is removed and only a very small residual of blood is left, the full benefits of surgery will not be realized,” said Issam A. Awad, M.D, M.Sc., study lead author and director of Neurovascular Surgery at the University of Chicago Medicine and Biological Sciences. “This had never been considered as a factor in the success or failure of such surgeries and cannot be taken for granted.”
American Heart Association
https://tinyurl.com/y2n7kt35
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