Cell-probe Lower Bounds for Dynamic Problems via a New Communication Model

In this paper, we develop a new communication model to prove a data structure lower bound for the dynamic interval union problem. The problem is to maintain a multiset of intervals $\mathcal{I}$ over $[0, n]$ with integer coordinates, supporting the following operations: - insert(a, b): add an interval $[a, b]$ to $\mathcal{I}$, provided that $a$ and $b$ are integers in $[0, n]$; - delete(a, b): delete a (previously inserted) interval $[a, b]$ from $\mathcal{I}$; - query(): return the total length of the union of all intervals in $\mathcal{I}$. It is related to the two-dimensional case of Klee's measure problem. We prove that there is a distribution over sequences of operations with $O(n)$ insertions and deletions, and $O(n^{0.01})$ queries, for which any data structure with any constant error probability requires $\Omega(n\log n)$ time in expectation. Interestingly, we use the sparse set disjointness protocol of H\aa{}stad and Wigderson [ToC'07] to speed up a reduction from a new kind of nondeterministic communication games, for which we prove lower bounds. For applications, we prove lower bounds for several dynamic graph problems by reducing them from dynamic interval union

Improving Revenue Capture and Patient Safety in an ICU Setting

IMPROVING REVENUE CAPTURE AND PATIENT SAEFTY IN AN INTENSIVE CARE SETTING Materials management department is responsible for restocking chargeable supplies in an intensive care unit (ICU) at an academic tertiary medical center. Staff confusion as to what items were considered chargeable often led to low supply par levels resulting in delays of critical patient care. Using baseline metrics, a team of caregivers created several performance improvement goals to increase nursing compliance with appropriate supply charging. The results of a root cause analysis spearheaded the development of a KPI that encompassed staff education, lost charge tracking and charge supply labeling. Post KPI inception, a significant increase in compliance was realized. The next step is to complete a two year retrospective cost benefit analysis to determine lost revenue and compare that to the cost of three automate

Strategies to Improve Resource Availability for New Graduate Nurses in a Critical Care Setting

STRATEGIES TO IMPROVE RESOURCE AVAILABILITY FOR NEW GRADUATE NURSES Due to changes in the employment arena, health care organizations are hiring new graduate RNs into acute care. At an academic tertiary medical center, new hires typically are assigned into a night shift, which traditionally has less resource availability. The results of a recent AHRQ hospital survey on patient culture safety demonstrated that new graduates were feeling unsupported and that patient safety could be potentially compromised. A team of caregivers developed several goals to provide increased support, encouragement and education to night shift new hires. Improvement in overall patient care and safety was an additional objective. A root cause analysis was conducted and the results prompted the creation of night shift resource nursing position. Expectations for this position were delineated followed by recruitment and training. Subsequent tracking demonstrated a marked increase in the percentage of availability of this designated nurse over a period of 6 months, approaching the goal of 100%. Next steps include repeating the AHRG hospital survey as well as to sustain and spread concept

Increasing Bedside Medication Safety in an Intensive Care Setting

A PERFORMANCE IMPROVEMENT PROJECT FOR INCREASED BEDSIDE MEDICATION SAFETY The convenience of having certain medications directly available at bedside has long been a priority for a medical intensive care nursing team in an academic tertiary medical center. However, it was apparent to new staff and leadership that there was a lack of awareness and interest in securing medications within the department. This posed a risk to patients, families, visitors and colleagues. Baseline metrics on patient safety were collected and a root cause analysis was conducted. Countermeasures included increased education of medication safety as well as a instituting a KPI which read that 100% of the time all medications would be secured. Since the implementation of the unit’s medication safety and quality improvement project, metrics have demonstrated an improvement in medication safety knowledge and practice. Next steps include continued improvement in medication handling practices to ensure a culture of safety and increased perception of safety by staff, patients & visitors

Intensive Care to Intermediate Care Bridge Program

To deliver the highest quality of care across the continuum, a large academic tertiary medical center envisioned a project that would provide an internal source of cross trained nurses for their medical intensive care unit (SCU2) and their medical intermediate care unit (R4/IMC/AVU). The hope for this program was to improve communication and collaboration between nurses and enhance the care that they provide to patients and their families. A highly qualified team of nurses was established to create a performance improvement project. The overall goal of this endeavor was to build a more collaborative relationship between the units and ultimately improve patient outcomes and experiences. Since this was a new program, there were expectations of challenges with the start-up. In addition, misunderstanding and misconceptions of each other’s workflows and systems would need to be identified and addressed. Several countermeasures were established to address the concerns and challenges. Development of an action plan, role expectations, competency based orientation tool and recruitment of dynamic tenured nurses proved to be critical key to success. Feedback about the bridge program from patients, families, involved nurses, and administrative leaders has been positive. Next steps include refining staff orientation, identifying potential program members with strong clinical attributes and ongoing evaluation of program outcomes

Catalyst-free and solvent-free Michael addition of 1,3-dicarbonyl compounds to nitroalkenes by a grinding method

Abstract An environmentally benign, fast and convenient protocol has been developed for the Michael addition of 1,3-dicarbonyl compounds to β-nitroalkenes in good to excellent yields by a grinding method under catalyst-and solvent-free conditions. 53

Middle Management Development Program Exibit 1

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Middle Management Development Program Description

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