THREAD: many of us in healthcare have seen new IT systems hailed as gamechangers. Many don't live up to their promise. Often failure is at final step of implementation - I interviewed people at 4 hospitals who all implemented the same IT system & developed these cartoons...
The hope is that they capture typical stories of what pitfalls happen in real life - and gives tips for how to avoid them! The full cartoons (and a downloadable booklet) are freely available from @nejmcatalystcatalyst.nejm.org/doi/full/10.10… but here are some with real quotes :-)
"Because it involved IT, even tho the CMO had signed off & we had his blessing & the promised resources & the contract, then we had to go through what we call the IT gov committee. Which is not a quick process, so we had to formally present this…and that took another 6 mnths"
Key tips for avoiding the barriers above!
"Our rooms are kind of small - they're small from the standpoint of where we could put the monitors - they're not in a good spot to be able to utilize them on rounds... I would say that that's part of the frustration is the location of some of the monitors is not the best place"
"Often it's like "ta-da, we got this new thing" and it's like "oh that's [MD’s] toy…versus "okay, we're going to implement this, we're all going to own it, it's going to meaningful to everyone so what do you think about it?"
"I kept pressing for smthng I could give the nurses to say these are guidelines for using this…. [docs] didn't have a whole lot of input as to what they expected bedside nurses to use it for. And it's not that we want to ignore it ... but we also want to know how is it useful.."
The pandemic is as bad as it ever was for babies - in year to Aug 2023, 6,300 babies under 1 were admitted to hospital wholly or partly BECAUSE of Covid.
They are ONLY age group where admissions have NOT gone down over time 1/17
Our study, led by Prof @katebrown220, looked at all hospitalisations in England in children with a Covid diagnosis or positive test from Aug 2020-Aug 2023.
We then *excluded* all admissions where a Covid diagnosis was incidental (ie not why they were in hospital)
2/17
Infants (babies under 1) are generally at higher risk from respiratory infections, plus they are the age group that, if infected, are overwhelmingly meeting the virus for the first time.
They are not vaccinated and have not had it before. 3/17
Prof @Kevin_Fong giving the most devastating and moving testimony to the Covid Inquiry of visiting hospital intensive care units at the height of the second wave in late Dec 2020.
The unimaginable scale of death, the trauma, the loss of hope.
Please watch this 2min clip.
And here he breaks down while explaining the absolute trauma experienced by smaller hospitals in particular - the "healthier" ICU patients were transferred out, leaving them coping with so much death.
They felt so alone.
Here Prof Fong explains how every nurse he met was traumatised by watching patients die, being only able to hold up ipads to their relatives and how it went against their normal practice of trying to ensure a dignified death, with family there.
🧵War causes direct civilian deaths but also indirect deaths over the following years.
Recent paper estimates eventual total direct & indirect deaths in Gaza attributable to the war - 10% of entire pop'n.
I want to explain these estimates and why deaths must be counted. 1/13
Why count casualties from war anyway? For moral, legal and strategic reasons.
1 - owe it to those who have died
2 - International law says must count & identify dead as far as possible
3 - monitor progress of war & learn from tactics
2/13
There are direct and indirect casualties of war. Direct deaths include those who killed by fighting or bombs.
Indirect deaths are those that die when they would otherwise have lived because of one or more of: lack of food, healthcare, housing, sanitation, income, hope. 3/13
THREAD: the summer Covid wave in the UK continues.
Basically, there is a LOT of Covid around and not a lot of other respiratory viruses.
If you have cold or flu symptoms, it's probably Covid.
The latest hospital data from England shows steady, quite high levels. 1/8
But admissions don't tell us how much virus is circulating more generally. The best (but imperfect) measure we have is wasterwater measurements, and only in Scotland and not England.
Scotland's wastewater is showing a huge July peak - highest since Omicron's 1st yr in 2022 2/8
Because different people shed different amounts of virus and variants can matter too, you can't for sure infer how many people were infected between different wasterwater peaks. BUT given the size, I'd say it's pretty likely this is the largest peak since 2022 in Scotland 3/8