Using surgical sustainability principles to improve planetary health and optimise surgical services following the COVID-19 pandemic

As the world faces crises instigated by environmental disruption, demands on healthcare require sustainable solutions. In this article, we outline the principles of sustainable surgery, how these can be used to optimise surgical services in light of healthcare crises, and how long-term adoption of these principles can help to reduce the carbon and plastic footprint of surgery in the UK and internationally. We describe how planetary and human health are closely related, including the relationship between environmental disruption and emerging infectious diseases

A survey of UK and Irish surgeons' attitudes, behaviours and barriers to change for environmental sustainability

Introduction Surgery is a major contributor to the large environmental impact of healthcare, demanding urgent attention. To date there are no data on the attitudes and behaviours of surgeons towards climate change, or perceived barriers towards sustainable practice. Methods We invited surgeons and surgical trainees in the UK and Ireland to participate in an online survey (developed in accordance with the CHERRIES checklist) conducted between June and November 2020 and disseminated via the Royal College of Surgeons of England, Edinburgh and Ireland, the Association of Surgeons in Training and through local communication. Results We received 130 responses, across 14 surgical specialties. The majority of respondents (122/130; 94%) were concerned about the threat of climate change. Most respondents had instigated more sustainable practices in their personal lives (113/130; 87%) and, to a lesser extent, at work (73/130; 56%). Surgeons were willing to make changes to their clinical practice (107/130; 82%), but the main perceived barrier to improving sustainability was a lack of leadership (92/130; 70%). Surgeons welcomed greater leadership and guidance from national bodies (118/130; 91%) and more monitoring and regulation (113/130; 87%). Conclusions The surgeons who responded to our survey are concerned about climate change and willing to engage in efforts to transition to more sustainable practice, but would welcome greater support, guidance and leadership

Effectiveness of an online module: climate-change and sustainability in clinical practice

Background: Climate change has significant implications for health, yet healthcare provision itself contributes significant greenhouse gas emission. Medical students need to be prepared to address impacts of the changing environment and fulfil a key role in climate mitigation. Here we evaluate the effectiveness of an online module on climate-change and sustainability in clinical practice designed to achieve learning objectives adapted from previously established sustainable healthcare priority learning outcomes. Methods: A multi-media, online module was developed, and 3rd and 4th year medical students at Brighton and Sussex Medical School were invited to enrol. Students completed pre- and post-module questionnaires consisting of Likert scale and white space answer questions. Quantitative and qualitative analysis of responses was performed. Results: Forty students enrolled and 33 students completed the module (83% completion rate). There was a significant increase in reported understanding of key concepts related to climate change and sustainability in clinical practice (p < 0.001), with proportion of students indicating good or excellent understanding increasing from between 2 – 21% students to between 91 – 97% students. The majority (97%) of students completed the module within 90 min. All students reported the module was relevant to their training. Thematic analysis of white space responses found students commonly reported they wanted access to more resources related to health and healthcare sustainability, as well as further guidance on how to make practical steps towards reducing the environmental impact within a clinical setting. Conclusion: This is the first study to evaluate learner outcomes of an online module in the field of sustainable health and healthcare. Our results suggest that completion of the module was associated with significant improvement in self-assessed knowledge of key concepts in climate health and sustainability. We hope this approach is followed elsewhere to prepare healthcare staff for impacts of climate change and to support improving the environmental sustainability of healthcare delivery. Trial registration: Study registered with Brighton and Sussex Medical School Research Governance and Ethics Committee (BSMS RGEC). Reference: ER/BSMS3576/8, Date: 4/3/2020

Adults with dyslexia demonstrate large effects of crowding and detrimental effects of distractors in a visual tilt discrimination task

Previous research has shown that adults with dyslexia (AwD) are disproportionately impacted by close spacing of stimuli and increased numbers of distractors in a visual search task compared to controls [1]. Using an orientation discrimination task, the present study extended these findings to show that even in conditions where target search was not required: (i) AwD had detrimental effects of both crowding and increased numbers of distractors; (ii) AwD had more pronounced difficulty with distractor exclusion in the left visual field and (iii) measures of crowding and distractor exclusion correlated significantly with literacy measures. Furthermore, such difficulties were not accounted for by the presence of covarying symptoms of ADHD in the participant groups. These findings provide further evidence to suggest that the ability to exclude distracting stimuli likely contributes to the reported visual attention difficulties in AwD and to the aetiology of literacy difficulties. The pattern of results is consistent with weaker and asymmetric attention in AwD

MANAJEMEN SUMBER DAYA MANUSIA RUMAH SAKIT

Manajemen sumber daya manusia merupakan salah satu bidang dalam manajemen umum yang meliputi segi-segi perencanaan, pengorganisasian, pelaksanaan dan pengendalian, karena sumber daya manusia dianggap semakin penting perannya dalam pencapaian tujuan, maka berbagai pengalaman dan hasil penelitian dalam bidang sumber daya manusia dikumpulkan secara sistematis dalam manajemen sumber daya manusia (Rivai, 2008). Manajemen sumber daya manusia pada hakikatnya merupakan bagian integral dari keseluruhan manajemen rumah sakit. Suatu rumah sakit dapat sukses, tidak terlepas dari manajemen rumah sakit sebagai fungsi penunjang terhadap fungsi utamanya yaitu pelayanan Kesehatan. Sebagai sarana pelayanan maka rumah sakit harus mampu meningkatkan pelayanan yang bermutu dan terjangkau oleh lapisan masyarakat agar tercipta peningkatan derajat Kesehatan masyarakat Indonesia yang setinggi-tingginya. Variatif komponen berperan dan mendukung pelayanan Kesehatan yang berkualitas, salah satu unsur utama pendukung kualitas pelayanan Kesehatan adalah sumber daya manusia (SDM). Strategi manajemen sumber daya manusia sebenarnya juga merupakan bagian integral dari strategi rumah sakit. Dengan pemahaman bahwa sumber daya manusia adalah aset utama rumah sakit. Saat ini keberhasilan sebuah rumah sakit sangat ditentukan oleh pengetahuan, keterampilan, kreativitas dan motivasi staf karyawannya. Oleh karena itu peranan manajemen sumber daya manusia sangat menentukan keberhasilan rumah sakit untuk mencapai tujuannya

Effectiveness of an online module: climate-change and sustainability in clinical practice.

BACKGROUND: Climate change has significant implications for health, yet healthcare provision itself contributes significant greenhouse gas emission. Medical students need to be prepared to address impacts of the changing environment and fulfil a key role in climate mitigation. Here we evaluate the effectiveness of an online module on climate-change and sustainability in clinical practice designed to achieve learning objectives adapted from previously established sustainable healthcare priority learning outcomes. METHODS: A multi-media, online module was developed, and 3rd and 4th year medical students at Brighton and Sussex Medical School were invited to enrol. Students completed pre- and post-module questionnaires consisting of Likert scale and white space answer questions. Quantitative and qualitative analysis of responses was performed. RESULTS: Forty students enrolled and 33 students completed the module (83% completion rate). There was a significant increase in reported understanding of key concepts related to climate change and sustainability in clinical practice (p < 0.001), with proportion of students indicating good or excellent understanding increasing from between 2 - 21% students to between 91 - 97% students. The majority (97%) of students completed the module within 90 min. All students reported the module was relevant to their training. Thematic analysis of white space responses found students commonly reported they wanted access to more resources related to health and healthcare sustainability, as well as further guidance on how to make practical steps towards reducing the environmental impact within a clinical setting. CONCLUSION: This is the first study to evaluate learner outcomes of an online module in the field of sustainable health and healthcare. Our results suggest that completion of the module was associated with significant improvement in self-assessed knowledge of key concepts in climate health and sustainability. We hope this approach is followed elsewhere to prepare healthcare staff for impacts of climate change and to support improving the environmental sustainability of healthcare delivery. TRIAL REGISTRATION: Study registered with Brighton and Sussex Medical School Research Governance and Ethics Committee (BSMS RGEC). Reference: ER/BSMS3576/8, Date: 4/3/2020