Day 1 :
Argelich Networks, Spain
Time : 09:15-10:00
Agustin Argelich is Telecom Engineer and Professor at Lleida University. He is the Author of “Analyze, Act, Advance”, a book about how to build a virtuous cycle of hope, innovation, renewal and continuous improvement. He is the Principal Consultant of Argelich Networks, which is an independent digital technology and management consultancy boutique which was founded after the Barcelona’92 Olympic Games, when he was one of the Youngest Project Leader as Technological Director of the IX Paralympic Games. Before Olympics, he worked as Telecom Manager in Asco Nuclear Power Plant and served as Lieutenant in Spanish Air Force. For 30 years, he has been leading significant digital technology projects for business and for public organizations. He is an expert in unified communications and collaboration. He is also a Proud Member and Past Vice President of the society of communications technologies consultants international. He is also a recognized international speaker.
The human body only has one unified communications system, the nervous system to send information to our brain. After the information has been processed, it sends instructions to any part of the body to act. In a similar way, new IP converging networks using IP protocols allow only one wire and wireless network to be implemented to transmit voice, data, video and control signals from anywhere in the hospital to a patient anywhere in the data centre. After it is analysed and processed, the information is sent to the person who can make the right decisions. Digital broadband infrastructures also allow critical resources to be shared between distanced hospitals and tele-assistance (e-health) to be implemented at homes. The digital hospital is where a patient is. No more walls. Digital solutions and tools not only optimize investment, but also reduce the on-going cost of ICT infrastructures (hard $). However, what’s more important is that it allows productivity and the efficiency of all hospital and healthcare systems procedures (soft $) to be continuously improved. The implementation of unified communications and collaboration (UC2) tools in healthcare means introducing new methods of communication as an additional element in the work flow of hospital procedures to make them more efficient, i.e., the task is performed properly and successfully without wasting time or energy, reducing late deliveries and human errors introduced by manual or poorly automated procedures. Highly talented human resources, doctors and nurses are scarce and very expensive, therefore any digital tool that can help them to be more efficient is essential. Implementing digital transformation in healthcare is simply indispensable. How can it be done? Do’s and Dont’s and what are the best practices and lessons learned?
University of Cape Town, South Africa
Time : 10:00-10:45
Una Kyriacos is an Emeritus Associate Professor at the University of Cape Town, South Africa. Her research interest and experience is in patient safety, and in particular, vital signs monitoring and nurses’ knowledge and use of the biosciences. She has developed a local validated modified early warning score (MEWS) vital signs observations chart for manual entry of parameters on general medical and surgical wards. She is often invited to give an expert opinion in healthcare lawsuits as a registered critical care nurse, ophthalmic nurse and researcher. She has published in her research areas of interest, has numerous citations and receives many requests from a number of countries for permission to replicate her studies.
Statement of the Problem: In Cape Town, South Africa, little if any educational preparation is available for nurses embarking on the role of expert nurse witness in medical negligence lawsuits. Until recently litigation was prevalent in the private healthcare sector but recently healthcare consumers in the public sector are becoming litigious, with consequences for the national health budget.
The purpose of this paper is to describe a personal journey of research into patient safety with particular reference to the development and testing of an early warning scoring (EWS) vital signs observations chart for general medical and surgical wards for recognition of early signs of clinical deterioration. In some instances of reported healthcare negligence, exploration is best achieved using aspects of the Root Cause Analysis (RCA) approach.
Findings: The modified EWS (MEWS) designed for local use has provided a valid measuring tool to plot clinical and physiological deterioration. Our randomized controlled trials (RCTs) have shown that there was a significant difference in recording between trial arms for physiological parameters listed on the MEWS chart but omitted from the traditional/standard ward observations chart: respiration rate, oxygen saturation, level of consciousness and for clinical parameters omitted from the traditional/standard ward observations chart: skin colour (pallor/cyanosis), pain, sweating, wound oozing, pedal pulses, glucose, haemoglobin and 'looks unwell'. Improved reporting did not result in escalated calls for review of patients. In a case of successful patient suicide, use of a modified RCA approach was helpful in giving a written opinion.
Conclusion & Significance:
A validated local MEWS vital signs observations chart and a modified RCA approach are useful for structuring an expert nurse witness’ report in healthcare negligence lawsuits.
Nurse practitioners should receive instruction in recognition of early signs of deterioration and in the RCA approach to prevent adverse events and healthcare negligence lawsuits.