One in five U.S. adults experiences a mental illness within a given year. With more than 550,000 people working to support this underserved community, the mental healthcare system has grappled with inadequacies and shortcomings in safety, quality, and care delivery. There is a wide range of problems, from access-to-care issues and errors, to complications stemming from poor care. Our country is also on an unsustainable path as our healthcare expenditure keeps growing. To add to all of this, we are facing a rampant epidemic of burnout among healthcare workers. Modern advancements introduced with many promises—such as electronic medical records, newer medications, or advanced treatments—have created unique challenges when ushered into a highly regulated healthcare system. What does it take to provide patients with everything they need—the right quality of care, at the right time, and at the right cost—to keep them healthy? Which process steps add value? Which steps are wasteful? A widely accepted fact is that a conservative 30-50% of every step in the mental healthcare process does not help patients feel better or stay better. When considering delays in care, workarounds, excessive documentation, and an overuse of auditing, the care system has moved highly skilled clinicians away from providing value, as administrative tasks continue to encroach on their time. There is a clear need to rethink and redesign the system of care. This book is a primer for understanding the current state of the mental health system and the performance improvement skills and leadership acumen needed to address existing challenges. Sheppard Pratt, the award-winning, leading institution for mental healthcare in America, provided the focus on mental healthcare and became the laboratory for this body of work over the course of eight years. It hired a seasoned systems thinker with improvement expertise to work with mental health professionals and solve some of their most complex and chronic problems. The book is a result of the collaboration between a practicing psychiatrist in a leadership role and the systems engineer. Working together, they demonstrate how to think about redesigning care and redefining the nature of work to enhance value for both the people served and the healthcare workforce. They crafted a multi-pronged approach towards culture change at Sheppard Pratt, including implementing a course on "Learning to Improve," which introduced staff to a performance improvement methodology. There are several vignettes interwoven throughout the book that describe the complexities and constraints of the system. Solving some of these challenges creates a new paradigm of work while minimizing waste and enhancing value.
Bejaoui, Bouhlel, Barca, Geology, Mineralogy and Fluid inclusions investigation of the Fluorite deposit at Jebel Kohol, northeastern Tunisia Bracco, Brajkovic, Comotti, Rolandi, Characterization of Elephant and Mammoth Ivory by Solid State NMR Caucia, Marinoni, Leone, Adamo, Investigation on the gemological, physical and compositional properties of some opals from Slovakia Fazlnia, Alizade, Petrology and geochemistry of the Mamakan gabbroic intrusions, Urumieh (Urmia), Iran: Magmatic development of an intra-oceanic arc Fulignati, Kamenetsky, Marianelli, Sbrana, PIXE mapping on multiphase fluid inclusions in endoskarn xenoliths of AD 472 eruption of Vesuvius Gualtieri, Giacobbe, Rinaudo, Croce, Allegrina, Gaudino, Yang, Carbone, Preliminary results of the spectroscopic and structural characterization of mesothelioma inducing crocidolite fibers injected in mice Barone, Bruno, Giuffrida, Mazzoleni, Raneri, Archaeometric investigation of a Late Roman marble statue from Kaucana (RG) with considerations on the diffusion of Thasos marble in Sicily Castorina, Masi, REY and Sr-Nd isotopic ratios of acqua regia extracts to assess pedogenic processes and pollution in soils from Ravenna
CONTENTS Angelo De Min, Francesco Princivalle and Davide Lenaz Geochemistry of the Late Mesozoic - Early Cenozoic turbidites from the NE part of the Adria microplate Bogdan Constantinescu, Daniela Cristea-Stan, Imre Kovács and Zoltan Szőkefalvi-Nagy External milli-beam PIXE analysis of the mineral pigments of glazed Iznik (Turkey) ceramics Somayeh Noghani and Mohammadamin Emami Mineralogical Phase Transition on Sandwich-like Structure of Clinky Pottery from Parthian Period, Iran Mauro Francesco La Russa, Silvestro Antonio Ruffolo, Natalia Rovella, Cristina Maria Belfiore, Paola Pogliani, Claudia Pelosi, Maria Andaloro and Gino Mirocle Crisci Cappadocian ignimbrite cave churches: stone degradation and conservation strategies Valeria Diella, Ilaria Adamo and Rosangela Bocchio Gem-quality rhodonite from Val Malenco (Central Alps, Italy) Luisa De Capitani, Giovanni Grieco, Silvia Porro, Elena Ferrari, Enrica Roccotiello and Pietro Marescotti Potentially toxic element contamination in waste rocks, soils and wild flora at the Roşia Montană mining area (Romania) Davide Lenaz, Giovanni B. Andreozzi, Maibam Bidyananda and Francesco Princivalle Oxidation degree of chromite from Indian ophiolites: a crystal chemical and 57Fe Mössbauer study Gaetano Ortolano, Roberto Visalli, Rosolino Cirrincione and Gisella Rebay PT-path reconstruction via unraveling of peculiar zoning pattern in atoll shaped garnets via image assisted analysis: An example from the Santa Lucia de Mela garnet micaschists (northeastern Sicily-Italy)
The 1st International Meeting on Applied Physics (APHYS-2003) succeeded in creating a new international forum for applied physics in Europe, with specific interest in the application of techniques, training, and culture of physics to research areas usually associated with other scientific and engineering disciplines.This book contains a selection of peer-reviewed papers presented at APHYS-2003, held in Badajoz (Spain), from 15th to 18th October 2003, which included the following Plenary Lectures:* Nanobiotechnology - Interactions of Cells with Nanofeatured Surfaces and with Nanoparticles* Radiation Protection of Nuclear Workers - Ethical Issues* Chaotic Data Encryption for Optical Communications
One in five U.S. adults experiences a mental illness within a given year. With more than 550,000 people working to support this underserved community, the mental healthcare system has grappled with inadequacies and shortcomings in safety, quality, and care delivery. There is a wide range of problems, from access-to-care issues and errors, to complications stemming from poor care. Our country is also on an unsustainable path as our healthcare expenditure keeps growing. To add to all of this, we are facing a rampant epidemic of burnout among healthcare workers. Modern advancements introduced with many promises—such as electronic medical records, newer medications, or advanced treatments—have created unique challenges when ushered into a highly regulated healthcare system. What does it take to provide patients with everything they need—the right quality of care, at the right time, and at the right cost—to keep them healthy? Which process steps add value? Which steps are wasteful? A widely accepted fact is that a conservative 30-50% of every step in the mental healthcare process does not help patients feel better or stay better. When considering delays in care, workarounds, excessive documentation, and an overuse of auditing, the care system has moved highly skilled clinicians away from providing value, as administrative tasks continue to encroach on their time. There is a clear need to rethink and redesign the system of care. This book is a primer for understanding the current state of the mental health system and the performance improvement skills and leadership acumen needed to address existing challenges. Sheppard Pratt, the award-winning, leading institution for mental healthcare in America, provided the focus on mental healthcare and became the laboratory for this body of work over the course of eight years. It hired a seasoned systems thinker with improvement expertise to work with mental health professionals and solve some of their most complex and chronic problems. The book is a result of the collaboration between a practicing psychiatrist in a leadership role and the systems engineer. Working together, they demonstrate how to think about redesigning care and redefining the nature of work to enhance value for both the people served and the healthcare workforce. They crafted a multi-pronged approach towards culture change at Sheppard Pratt, including implementing a course on "Learning to Improve," which introduced staff to a performance improvement methodology. There are several vignettes interwoven throughout the book that describe the complexities and constraints of the system. Solving some of these challenges creates a new paradigm of work while minimizing waste and enhancing value.
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