According to W. Edwards Deming, American companies require nothing less than a transformation of management style and of governmental relations with industry. In Out of the Crisis, originally published in 1982, Deming offers a theory of management based on his famous 14 Points for Management. Management's failure to plan for the future, he claims, brings about loss of market, which brings about loss of jobs. Management must be judged not only by the quarterly dividend, but by innovative plans to stay in business, protect investment, ensure future dividends, and provide more jobs through improved product and service. In simple, direct language, he explains the principles of management transformation and how to apply them.

Out of the Crisis

To provide an update to “Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012”. A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroups and among the entire committee served as an integral part of the development. The panel consisted of five sections: hemodynamics, infection, adjunctive therapies, metabolic, and ventilation. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. Each subgroup generated a list of questions, searched for best available evidence, and then followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence from high to very low, and to formulate recommendations as strong or weak, or best practice statement when applicable. The Surviving Sepsis Guideline panel provided 93 statements on early management and resuscitation of patients with sepsis or septic shock. Overall, 32 were strong recommendations, 39 were weak recommendations, and 18 were best-practice statements. No recommendation was provided for four questions. Substantial agreement exists among a large cohort of international experts regarding many strong recommendations for the best care of patients with sepsis. Although a significant number of aspects of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for these critically ill patients with high mortality.

https://link.springer.com/content/pdf/10.1007%2Fs00134-017-4683-6.pdf

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

Established in 2006, TATA Africa Services (Nigeria) Limited operates as the nodal point for Tata businesses in West Africa. TATA Africa Services (Nigeria) Limited has a strong presence in Nigeria with investments exceeding USD 10 million. The company was established in Lagos, Nigeria as a subsidiary of TATA Africa Holdings (SA) (Pty) Limited, South Africa and serves as the hub of Tata’s operations in Nigeria and the rest of West Africa.

What About Us

Qualitative researchers rely — implicitly or explicitly — on a variety of understandings and corresponding types of validity in the process of describing, interpreting, and explaining phenomena of ...

Understanding and Validity in Qualitative Research

Climate change 2014 - Synthesis Report

Most health care in low-income countries is delivered at a primary care level by health workers who lack quality training and supervision, often distant from more experienced support. Lack of knowledge and poor communication result in a poor quality of care and inefficient delivery of health services. Although bringing great benefits in sectors such as finance and telecommunication in recent years, the Digital Revolution has lightly and inconsistently affected the health sector. These advances offer an opportunity to dramatically transform health care by increasing the availability and timeliness of information to augment clinical decision-making, based on improved access to patient histories, current information on disease epidemiology, and improved incorporation of data from point-of-care and centralized diagnostic testing. A comprehensive approach is needed to more effectively incorporate current digital technologies into health systems, bringing external and patient-derived data into the clinical decision-making process in real time, irrespective of health worker training or location. Such dynamic clinical algorithms could provide a more effective framework within which to design and integrate new digital health technologies and deliver improved patient care by primary care health workers.

Dynamic Clinical Algorithms: Digital Technology Can Transform Health Care Decision-Making.

In recent years there has been growing concern regarding the wellbeing and morale of trainees and while this may have been voiced individually for some time, the junior doctors’ contract dispute in England has catapulted it into everyday conversations. This is not surprising given the current climate of increasing pressure on NHS staff and use of the phrase ‘burnt-out’ being now commonplace. Consultants are similarly under tremendous pressures, reinforced by the recent publication highlighting short-staffing.

/pdf/valuing-our-trainees-the-future-of-medicine-in-the-uk-qvlxrzlp9n.pdf

Valuing our trainees: the future of medicine in the UK.

How Should We Think about Climate Justice

https://spiral.imperial.ac.uk/bitstream/10044/1/67420/2/Goey%20et%20al.%202019%20-%20accepted.pdf

CHO cell cultures in shake flasks and bioreactors present different host cell protein profiles in the supernatant

In the context of this article, access to urgent health care is defined by the patient and carer's needs whenever required and thus includes needs for urgent help both within ‘routine’ hours and outside of normal hours.

The current systems to deliver urgent or emergency care have evolved over time and are often complex for patients, carers and healthcare providers, with poor knowledge of the available services by all parties. These historic developments combined with some recent well-intentioned service changes have, to date, not delivered the intended benefits. Indeed, the demand for urgent and emergency care is largely predictable for both primary care and secondary care,1 2 and much of the variation relates directly to the healthcare systems we have designed.

‘Reforming emergency care’3outlined a blueprint of care that promoted the further development of services including NHS walk-in centres and telephone advice services such as NHSDirect/24. To some extent these have added to the complexity of the system by altering patient flow and access without always capturing local systems and knowledge. Local services have also developed in an ad hoc way rather than follow an integrated plan, partly because of the tension between policies intended to promote integration and those designed to increase patient choice. We have in essence maintained or created multiple access points when the intention was to simplify.

Our current system also controls access to some services and not others, and access can vary by time of day and day of the week. Emergency departments effectively and uniquely provide open access to advice, diagnosis and treatment 24h a day, 7 days …

https://emj.bmj.com/content/emermed/27/3/186.full.pdf

Derek Bell

Papers

Dynamic Clinical Algorithms: Digital Technology Can Transform Health Care Decision-Making.

Valuing our trainees: the future of medicine in the UK.

How Should We Think about Climate Justice

CHO cell cultures in shake flasks and bioreactors present different host cell protein profiles in the supernatant

Access to urgent health care.