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Allan S.H.,Johns Hopkins Hospital | Doyle P.A.,Johns Hopkins Hospital | Cvach M.,Integration Management
Joint Commission Journal on Quality and Patient Safety | Year: 2017

Background: Alarm fatigue in the ICU setting has been well documented in the literature. The ICU's high-intensity environment requires staff's vigilant attention, and distraction from false and non-actionable alarms pulls staff away from important tasks, creates dissatisfaction, and is a potential patient safety risk if alarms are missed or ignored. This project was intended to improve patient safety by optimizing alarm systems in a cardiovascular surgical intensive care unit (CVSICU). Specific aims were to examine nurses' attitudes toward clinical alarm signals, assess nurses' ability to discriminate audible alarm signals, and implement a bundled set of best practices for monitor alarm reduction without undermining patient safety. Methods: CVSICU nurses completed an alarm perception survey and participated in alarm discriminability testing. Nurse survey data and baseline monitor alarm data were used to select targeted alarm reduction interventions, which were progressively phased in. Monitor alarm data and cardiorespiratory event data were trended over one year. Results: Five of the most frequent CVSICU monitor alarm types-pulse oximetry, heart rate, systolic and diastolic blood pressure, pulse oximetry sensor, and ventricular tachycardia < 2-were targeted. After implementation, there was a 61% reduction in average alarms per monitored bed and a downward trend in cardiorespiratory events. Conclusion: To reduce alarm fatigue it is important to decrease alarm burden through targeted interventions.Methods to reduce non-actionable alarms include adding short delays to allow alarm self-correction, adjusting default alarm threshold limits, providing alarm notification through a secondary device, and teaching staff to optimize alarm settings for individual patients. © 2016 The Joint Commission. Published by Elsevier Inc. All rights reserved.

Ingenico Group (Euronext: FR0000125346-ING) today announced the creation of two global customer-centric Business Units that address the distinct needs of physical and online retailers as well as banks & acquirers. It also announces a new appointment in its North America leadership. With these organizational changes1, Ingenico Group is well equipped to expand its omnichannel capabilities globally. will help large retailers and e-merchants follow consumers across sales channels, expand their cross-border sales and increase their conversion rate. It is uniquely positioned to provide a unified customer experience across channels with a combination of payment terminals, in-store and online payments services and omnichannel payment solutions. The Retail Business Unit holds global end-to-end responsibility for designing, building, selling and operating its in-store, online and omnichannel payment solutions. It will expand its global sales through its regional commercial teams. will address banks & acquirers' needs to reduce the total cost of ownership and the complexity of managing payments, as well as the need to differentiate their offer to their merchants. It will do so by leveraging the capabilities of Ingenico and Landi - the Group's Chinese subsidiary - to offer a streamlined range of terminals, and by delivering terminal solutions that add value for merchants. The Banks & Acquirers Business Unit will cover a complete scope of activities, from offer design to after-sales services. Jennifer Miles will join Ingenico as EVP, North America during the 2nd half of July 2017 once she has honored her contractual obligations to her former employer. With over 20 years of experience in the payment and financial services industry, Jennifer is one of the most renowned executives in the payment space. She started her career with Wachovia Bank, and spent the last 16 years with Verifone in a number of global business lines and regional leadership and executive capacities.  With a nearly 5-fold growth of revenues in the USA over the past 5 years and over 80% market share in terminals in Canada, Ingenico has demonstrated that it is uniquely positioned to serve North American bankcard and retail customers, leveraging both Business Units' products as well as ROAM, its Boston-based mobile payment solution. Jennifer's unmatched knowledge of the complex US market will be of tremendous value as Ingenico pursues its expansion in this region. As Oscar Bello leaves the company, we want to thank him for his numerous achievements during his 9-year tenure with Ingenico, essentially spent leading and growing our Latin America business. Acquisitions Integration Management: acquisitions form an integral part of Ingenico's growth agenda. Ensuring their fast and efficient integration into the company is essential to the realization of their contribution to Ingenico's strategic and long term objectives. Jacques Guérin is appointed EVP, Acquisitions Integration Management. This role will be effective in July, as Jacques will initially focus on leading North America until Jennifer Miles joins the Group. All other Corporate Functions are unchanged. Michel Léger, as EVP Innovation, Nathalie Lomon, as EVP Finance & Legal, and Martine Birot, as EVP Human Resources & Communications, complete the Executive Committee membership. "I am tremendously proud of our ability to develop leaders from within and attract highly talented executives from the industry who want be to part of our strategic growth agenda", commented Philippe Lazare, Ingenico Group Chairman & CEO. "This new operating model supports perfectly our ambitions to become the indisputable global leader in omnichannel payment acceptance. Customer-centric BUs that integrate offer management, delivery and sales will help us deliver the most relevant, innovative and cost effective products & solutions to our customers in a timely fashion, whilst securing our profitability." 1 Pending completion of the regulatory process with the Works Council Ingenico Group (Euronext: FR0000125346 - ING) is the global leader in seamless payment, providing smart, trusted and secure solutions to empower commerce across all channels, in-store, online and mobile. With the world's largest payment acceptance network, we deliver secure payment solutions with a local, national and international scope. We are the trusted world-class partner for financial institutions and retailers, from small merchants to several of the world's best known global brands. Our solutions enable merchants to simplify payment and deliver their brand promise.    

Davidson J.,Integration Management | Tung A.,University of Chicago | Kishman C.,University of Cincinnati | Barr J.,Stanford University | Barr J.,VA Palo Alto Health Care System
Seminars in Respiratory and Critical Care Medicine | Year: 2013

This article evaluates the methodology used to develop the updated American College of Critical Care Medicine/Society of Critical Care Medicine Pain Agitation and Delirium (PAD) Guidelines in terms of (1) evaluating the role of a medical librarian in the guidelines development process; (2) summarizing the impressions of the guideline task force members on the use of Grades of Recommendation, Assessment, Development, and Evaluation and anonymous voting to develop guideline questions, statements, and recommendations; and (3) analyzing the impact of this approach to developing clinical practice guidelines on interrater reliability in evaluating evidence, statements, and recommendations. © 2013 by Thieme Medical Publishers, Inc.

Davidson J.E.,Integration Management | Jones C.,Whiston Hospital | Bienvenu O.J.,Johns Hopkins University
Critical Care Medicine | Year: 2012

Background: The family response to critical illness includes development of adverse psychological outcomes such as anxiety, acute stress disorder, posttraumatic stress, depression, and complicated grief. This cluster of complications from exposure to critical care is now entitled postintensive care syndrome-family. Adverse psychological outcomes occur in parents of neonatal and pediatric patients and in family members of adult patients, and may be present for >4 yrs after intensive care unit discharge. Psychological repercussions of critical illness affect the family member's ability to fully engage in necessary care-giving functions after hospitalization. Prevention: It has been suggested that the manner in which healthcare workers communicate with family members and the way in which families are included in care and decision-making, may affect long-term outcomes. Preventive strategies for optimal communication and inclusion in care are reviewed. Assessment: Many tools are available to assess the risk for and to diagnose postintensive care syndrome-family conditions during hospitalization and at intervals after discharge. Treatment: Visits after discharge, support groups, and clinics have been proposed for assessing the need for professional referrals as well as for treating family members when psychological illness persists. Studies evaluating these measures are reviewed. Copyright © 2012 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins.

Pun B.,Vanderbilt University | Balas M.,University of Nebraska Medical Center | Davidson J.,Integration Management
Seminars in Respiratory and Critical Care Medicine | Year: 2013

It has been 10 years since the last publication of the clinical practice guidelines for pain, agitation/sedation, and delirium (PAD). The results of new studies have directed significant changes in critical care practice. Using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology, the guidelines were revised, resulting in 32 recommendations and 22 summary statements. This article provides guidance toward guideline implementation strategies and outlines 10 key points to consider. Compared with its predecessor, the 2013 PAD guidelines are less prescriptive in that they recommend approaches to patient care rather than giving specific medication recommendations. This will help focus care teams on the process and structure of patient management and result in more flexibility when choosing specific medications. This article outlines approaches to guideline implementation that take into account the changes in philosophy surrounding medication selection. The manuscript focuses on the areas anticipated to generate the most change such as lighter sedation targets, avoidance of benzodiazepines, and early mobility. A gap analysis grid is provided. The release of any guideline should prompt reevaluation of current institutional practice standards. This manuscript uses the PAD guidelines as an example of how to approach the interprofessional work of guideline implementation. © 2013 by Thieme Medical Publishers, Inc.

Borchers J.,Integration Management
Proceedings of the European Conference on Software Maintenance and Reengineering, CSMR | Year: 2011

Reengineering in all its facets is now a well recognized field within information technology literature and practice for more than 25 years. This paper gives a review of reengineering over this period. It is neither intended as a scientific assessment of the "myriad" of papers ever published about this subject area nor as an extensive review of pros and cons of the various reengineering approaches. It is rather a personal - and not all objective! - assessment of the author's experiences gained in this field in various projects and especially in the current position as head of an IT software quality department at one of the most crucial IT information service providers in Germany. © 2011 IEEE.

Agency: GTR | Branch: Innovate UK | Program: | Phase: Feasibility Study | Award Amount: 74.84K | Year: 2013

Awaiting Public Project Summary

Agency: GTR | Branch: Innovate UK | Program: | Phase: Smart - Development of Prototype | Award Amount: 199.78K | Year: 2014

Process Asset Integration and Management Ltd (ProAIM) is in the process of developing innovative software to address the Reliability, Availability and Maintainability (RAM) aspects of the upstream oil & gas industry to increase recovery efficiencies and improve asset utilisation. Upstream oil and gas production operations typically comprise production streams of 3 primary fluids: oil, gas & water. Process plants have to achieve a high level of separation to provide maximum resource usage, maximum value to the operating company and minimum hydrocarbon emissions to the environment. The 3 fluids from the production wells have varying flow rates over time, and this requires careful control of the flow from each well to maximise production and recovery from the reservoir. Commercially available RAM modelling tools only represent a single fluid stream with proportional control of flows from a number of sources when there is a downstream processing capacity or constraining event (equipment failure). These tools can significantly underestimate the production availability of an upstream operation and often lead to inappropriate costly decisions being taken in respect of over-sizing capacities, architecture design and/or excess sparing of equipment. The proposed software will represent 3 fluid streams with full separation, permit the smart turndown of individual production and allocate lost production to the individual item of equipment causing a reduction in capacity. Automatic reports will also facilitate the interpretation of results; RAM analysis traditionally requires careful interpretation

Integration Management | Date: 2013-02-26

Downloadable computer software in the nature of a mobile application for mobile phones and tablet computers, for use in recording, organizing and tracking pet information, namely, pet vital information, medication, appointments and health and service providers. Providing e-mail services, namely, enabling the generation of e-mails containing the recorded vital information about the pet. Computer services, namely, providing search engines for service providers for pets, namely, health providers, veterinarians, emergency health care, groomers, trainers, walkers and sitters; Computer services, namely, providing search engines for locating accommodations and transportation that are pet friendly; Computer services, namely, providing search engines for locating online resources for researching pet health and pet health problems.

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