How to build a robust provider improvement partnership program to enhance patient experience – A case study

Patient experience is emerging as a key differentiating factor in patients’ choice of healthcare system. Many healthcare organizations are attempting to improve their patient experience by data-driven, patient-centered initiatives. This involves engaging all staff along all the contact points of a patient’s journey in healthcare. Perhaps, the physicians or care providers are most important link in this chain but also the most challenging to engage in improvement efforts. Most healthcare organizations have some training or workshops to educate providers on communication skills and other tools to enhance patient experience. However, there seems to a paucity of a standardized approach or a roadmap to put together a robust physician or care provider coaching or improvement partnership program with patient experience (PX) staff. There seems to be several gaps in this process. The current article attempts to develop broad guidelines and suggest a roadmap to address these gaps. The article also suggests general templates for PX staff to use in conducting these improvement work with providers and suggestions for developing a standard physician observation or shadowing template for consistency. The article has woven several commonly used tools like motivational interviewing, change management (ADKAR model), and several communication tools to suggest a detailed blue print for provider patient experience improvement partnership

Prospektion einer Villa rustica bei Wederath, Flur Kleinicher Berg (Gde. Morbach, Kr. Bernkastel-Wittlich, Rheinland-Pfalz)

Prospektionen der Universität Leipzig im Umkreis des römischen vicus Belginum weisen bei Wederath, Flur Kleinicher Berg (Gde. Morbach, Kr. Bernkastel-Wittlich, Rheinland Pfalz) eine mutmaßliche villa rustica hin. Diese lag auf einem kleinen Plateau außerhalb der Begehungsfläche. Das Fundmaterial besteht vorwiegend aus Ziegeln (Dach- und Fußbodenziegel) und relativ wenig Keramik. Die bestimmbare römische Keramik datiert in das 2. bis 4. Jh. n. Chr. Bemerkenswert ist der Fund mehrerer Scherben der Hunsrück-Eifel-Kultur. Sie könnten einen Hinweis auf eine Besiedlung des Plateaus seit der Mitte des 1. Jahrtausends v. Chr. darstellen. Nur wenige hundert Meter entfernt befindet sich das große Hügelgräberfeld „Götzeroth“ der Hunsrück- Eifel-Kultur.Archaeological prospections by the University of Leipzig in the surroundings of the Roman vicus Belginum revealed near Wederath (Rhenania-Palatinate, Germany) a probable villa rustica. Mostly bricks (tegulae, imbrices and floor tiles) and only a small amount of ceramics were found. The Roman ceramics are dating mostly into the 2nd to 4th cent. AD. Remarkable are the finds of some ceramic sherds of the Hunsrück-Eifel-Culture. They could indicate settlement activity at the site since the mid of the first millennium BC. The extended tumulus cemetery “Götzeroth” is located some hundred meters to the east

Prospektion im Tempelbezirk 3 des römischen vicus Belginum (OT Wederath, Gde. Morbach, Kr. Bernkastel-Wittlich, Rheinland-Pfalz)

Im Rahmen des mehrjährigen Prospektionsprogramms der Universität Leipzig im Bereich des römischen vicus Belginum (OT Wederath, Gde. Morbach, Kr. Bernkastel-Wittlich, Rheinland Pfalz) wurde im November 2007 der Bereich von Tempelbezirk 3 und seiner Umgebung begangen. Dieser Tempelbezirk liegt im Westen des vicus und ist bislang nur durch eine geophysikalische Prospektion bekannt. Die Begehungen erbrachten eine perfekte Übereinstimmung mit dem Magnetometerbild mit Konzentrationen im Bereich des gallorömischen Umgangstempels und der Temenosmauer. Die Funde ermöglichen eine Datierung in das 1. bis 2. und vielleicht das frühe 3. Jh. n. Chr. Bemerkenswert ist die Entdeckung mittel- und spätlatènezeitlicher Scherben des 3.-1. Jh. v. Chr. Sie weisen entweder auf eine ältere Besiedlung oder eine frühe Kulttätigkeit.Since several years, the University of Leipzig is carrying out archaeological prospections in the Roman vicus Belginum and its surroundings (OT Wederath, Gde. Morbach, Kr. Bernkastel-Wittlich, Rhenania-Palatinate, Germany). In November 2007 the temple area 3 was prospected. This site is located at the western periphery of the vicus. It was until yet only known by geophysical prospection. The actual prospection showed a perfect coincidence of findings and the magnetometer plot. High frequencies of finds, mostly brick fragments, were found at the Temenos walls and the site of the Gallo-Roman temple. The few ceramic sherds are dating from the 1st to the 2nd, probably the early 3rd cent. AD. Remarkable was the find of hand-made pottery, dating into the middle and late Latène period (approx. 3rd-1st cent. BC)

Restless Legs Syndrome Prevalence and Clinical Correlates Among Psychiatric Inpatients: A Multicenter Study.

Background There are only limited reports on the prevalence of restless legs syndrome (RLS) in patients with psychiatric disorders. The present study aimed to evaluate the prevalence and clinical correlates in psychiatric inpatients in Germany and Switzerland. Methods This is a multicenter cross-sectional study of psychiatric inpatients with an age above 18 years that were diagnosed and evaluated face-to-face using the International RLS Study Group criteria (IRLSSG) and the International RLS severity scale (IRLS). In addition to sociodemographic and biometric data, sleep quality and mood were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale (ESS), and the Patient Health Questionnaire (PHQ-9). In addition to univariate statistics used to describe and statistically analyze differences in variables of interest between patients with and without RLS, a logistic model was employed to identify predictors for the occurrence of RLS. Results The prevalence of RLS in a sample of 317 psychiatric inpatients was 16.4%, and 76.9% of these were diagnosed with RLS for the first time. RLS severity was moderate to severe (IRLS ± SD: 20.3 ± 8.4). The prevalences in women (p = 0.0036) and in first-degree relatives with RLS (p = 0.0108) as well as the body mass index (BMI, p = 0.0161) were significantly higher among patients with RLS, while alcohol consumption was significantly lower in the RLS group. With the exception of atypical antipsychotics, treatment with psychotropic drugs was not associated with RLS symptoms. Regarding subjective sleep quality and mood, scores of the PSQI (p = 0.0007), ISI (p = 0.0003), and ESS (p = 0.0005) were higher in patients with RLS, while PHQ-9 scores were not different. A logistic regression analysis identified gender (OR 2.67; 95% CI [1.25; 5.72]), first-degree relatives with RLS (OR 3.29; 95% CI [1.11; 9.73], ESS score (OR 1.09; 95% CI [1.01; 1.17]), and rare alcohol consumption (OR 0.45; 95% CI [0.22; 0.94] as predictors for RLS. Conclusions Clinically significant RLS had a high prevalence in psychiatric patients. RLS was associated with higher BMI, impaired sleep quality, and lower alcohol consumption. A systematic assessment of restless legs symptoms might contribute to improve the treatment of psychiatric patients

The European Academy for Cognitive Behavioural Therapy for Insomnia : An initiative of the European Insomnia Network to promote implementation and dissemination of treatment

Insomnia, the most prevalent sleep disorder worldwide, confers marked risks for both physical and mental health. Furthermore, insomnia is associated with considerable direct and indirect healthcare costs. Recent guidelines in the US and Europe unequivocally conclude that cognitive behavioural therapy for insomnia (CBT‐I) should be the first‐line treatment for the disorder. Current treatment approaches are in stark contrast to these clear recommendations, not least across Europe, where, if any treatment at all is delivered, hypnotic medication still is the dominant therapeutic modality. To address this situation, a Task Force of the European Sleep Research Society and the European Insomnia Network met in May 2018. The Task Force proposed establishing a European CBT‐I Academy that would enable a Europe‐wide system of standardized CBT‐I training and training centre accreditation. This article summarizes the deliberations of the Task Force concerning definition and ingredients of CBT‐I, preconditions for health professionals to teach CBT‐I, the way in which CBT‐I should be taught, who should be taught CBT‐I and to whom CBT‐I should be administered. Furthermore, diverse aspects of CBT‐I care and delivery were discussed and incorporated into a stepped‐care model for insomnia.Peer reviewe

Online insomnia treatment-a review

Spiegelhalder K, Acker J, Baumeister H, et al. Digitale Behandlungsangebote für Insomnie – eine Übersichtsarbeit. SOMNOLOGIE. 2020;24(4):106-114.Zusammenfassung Digital angebotene psychologische Interventionen gegen Schlafstörungen sind aktuell ein sehr intensiv bearbeitetes Forschungsthema. In dieser Übersichtsarbeit werden Originalarbeiten und Metaanalysen zu diesem Thema zusammengefasst. Hierbei zeigt sich, dass die internetbasierte kognitive Verhaltenstherapie für Insomnie (KVT-I) bei Erwachsenen durchweg sehr effektiv ist mit allenfalls leicht geringeren Effektstärken als die gleiche Behandlung mit physischer Präsenz von Therapeuten und Patienten. Behandlungseffekte zeigen sich dabei auch für sekundäre Outcome-Parameter wie Depressivität, Angst, Fatigue und Lebensqualität. Hingegen lassen die Forschung zur Wirksamkeit der internetbasierten KVT‑I bei Erwachsenen mit komorbiden psychischen Störungen oder körperlichen Erkrankungen sowie die Forschung zur Frage, wieviel Therapeutenkontakt in die Behandlung integriert werden sollte, anscheinend noch keine abschließenden Antworten zu. In diesen Bereichen scheint weitere Forschung notwendig zu sein scheint.Digitally provided psychological interventions for sleep disorders are currently a very intensively researched topic. In this review, original work and meta-analyses are summarized. Thus, it was shown that internet-based cognitive behavioral therapy for insomnia (CBT-I) in adults is consistently very effective, with only slightly reduced effects compared with the same treatment with the physical presence of therapists and patients. Treatment effects are also shown for secondary outcome parameters such as depression, anxiety, fatigue, and quality of life. On the other hand, research on the effectiveness of internet-based CGT-I in adults with comorbid mental disorders or physical illnesses, and on the issue of how much contact with therapists should be integrated into treatment, does not seem to provide any conclusive answers. Further research seems to be needed in these areas