Search

Purpose There is a lack of consensus regarding need for Venous Thrombo Embolism (VTE) prophylaxis following arthroscopic knee surgery and open soft tissue knee reconstruction. Clear cut guidelines like ones for trauma surgery and arthroplasty do not exist and the published literature is limited to case reports with a few society guidelines. Given this lack of consensus, we conducted a modified Delphi questionnaire of international experts to provide recommendations on this topic. Methods The consensus statements were generated using an anonymised 3 round modified Delphi questionnaire, sent to an international panel of 38 knee surgeons, with an 80% agreement being set as the limit for consensus. The responses were analysed using descriptive statistics with measures like mode, median and box plots. Feedback was provided to all panelists based on responses from the previous rounds to help generate the consensus. Results Six consensus statements were generated after the three rounds of Delphi. Patient factors, prolonged surgery duration and family history of thrombogenic events emerged as the main points to be taken into consideration for prophylaxis. Conclusion It was established through this study, that there exists a select group of patients undergoing arthroscopic surgery that justify the usage of VTE prophylaxis. The expert responses to most of the questions in different scenarios favoured usage of VTE prophylaxis based on patient factors like advanced age, past history of VTE, smoking, oral contraceptive use etc.

The Staff College: Leadership in Healthcare (Staff College) is a national charity dedicated to developing leaders and helping them to deliver better outcomes. We design and deliver behavioural based programmes for individuals, teams and Boards within primary, secondary care and the integrated care agenda. Over the last two years we have piloted a variety of approaches to support the development of effective leaders, working to integrate care in their local areas through: Developing the capacity of individual leaders to lead change within the STP through the delivery of a 3–day Senior Clinical Leadership Development Programme. Working with leadership groups to optimise their ability to work together in an atmosphere of trust and mutual respect through the delivery of: STP Board Development Programme STP Work–Stream: Leadership Group Development STP Work–Stream: Development of a Work–Stream Leadership Group Integrating Services Team: Team Development Programme. We’ll be presenting the impact these approaches have had for individual leaders and their systems’ ability to improve the care of patients at the Leaders in Healthcare Conference 2019, along with the conditions that can make for successful development, and the challenges that can undermine it.

Within the business continuity industry, the debate regarding the business impact analysis (BIA) shows no sign of being resolved. Fervent discussions online, at conferences and in businesses around the world continue to promote or dispute its value. This paper does not pretend to resolve that debate but offers a compelling alternative to achieve the outcomes entrusted to the BIA and overcome the challenges in obtaining them. Business disruptions, both from natural occurrences and manmade, are occurring more frequently at the same time as business continues to get more complex. To exacerbate the issue, business continuity practitioners are increasingly expected to do more, and often with fewer resources and in condensed timeframes. The SIPOC tool from Lean and Six Sigma, which considers suppliers, inputs, process, outputs and customers, gives business continuity practitioners a practical alternative. By using the experiences, expertise and tools of other professions in a transdisciplinary approach, it is possible to accomplish the continuity imperatives of the business while adding value to the organisation when resources available to the practitioner are constantly being compressed.

70 countries. These Fellows are leading social entrepreneurs who have pioneered innovative solutions to societal challenges. As agents of change, these individuals have been as inspiring as they have been effective. However, as Ashoka has grown, it has faced a new challenge: to leverage the collective knowledge of Ashoka Fellows and galvanize members of the broader community in order to identify, envision, and realize the many untapped possibilities to effect positive social change through social entrepreneurship. Innovators often struggle to communicate their mission and describe their successes to potential investors who, in turn, struggle to assess the prospects of nascent ventures. Bridging this gap between innovation and investment is a crucial step in this leveraging and galvanizing process. Ashoka’s approach to addressing this gap has been to develop networks of contacts guided by well-defined protocols in order to assess the entrepreneurial potential of social enterprises. The increasing number and diversity of entrepreneurial ventures worldwide specifically directed toward addressing social problems is a welcome trend that nonetheless creates its own set of challenges. While Ashoka has continued to identify and assess social entrepreneurs using tried and true methods, the organization has also begun to experiment with new approaches to leverage the knowledge of these social entrepreneurs to attract other innovators. Changemakers is an important initiative of this sort, drawing on open source models to join innovators around the world into communities of change with peers, experts, investors, and interested members of the public. Our experience leads us to distinguish between different types of “open” models, including open innovation, open sourcing, and crowd sourcing. Changemakers has established a blend of these, which we call “crowd collaboration,” creating spaces where a wide range of voices can come together to propose, refine, reorient, reuse and reinvigorate innovative social solutions. This paper reviews Ashoka’s experience with Changemakers as a mechanism for accelerating innovation in order to take social change from a prospect for a few Charlie Brown

Marti Sarigul-Klijn 1 Ph.D. and Nesrin Sarigul-Klijn Ph.D. Mechanical and Aeronautical Engineering Department, University of California, Davis, CA 95616-5294 Gary C. Hudson and Bevin McKinney AirLaunch LLC, Kirkland, Washington, 98033 Jim Voss and Phil Chapman Transformational Space Corp, Reston, Virginia, 20190 Bob Morgan, Jim Tighe, and Jason Kramb 7 Scaled Composites LLC, Mojave, California, 93501 Ken Doyle and Mike Quayle Protoflight LLC, Mojave, California, 93501 and Charlie Brown Space Vector Corp., Chatsworth, California, 91311

This month's theme "Knowledge translation in global health" offers an opportunity to highlight the overlooked but dramatic impact of social entrepreneurs in the health sector and to detail ways in which their knowledge, innovations and enterprise can add strength and utility to systems ripe for change. The global health sector and its corporate, academic, governmental and philanthropic partners are fully engaged in efforts to improve basic and applied research, deliver networks and resources for more timely and better care, and design more effective mechanisms to bridge the gaps between knowledge and practice. This is an ambitious agenda of growing urgency, with daunting challenges. Kwok-Cho Tang et al. provided the context, (1) noting that since the 1986 Ottawa Charter for Health Promotion new patterns of consumption and communication, urbanization, environmental changes and public health emergencies--along with accelerating social and demographic changes to work, learning, family and community life--have become critical factors influencing health. Over the same period, Ashoka: Innovators for the Public began a global search for individuals with ideas for changing systems to make them capable of bringing about vastly improved outcomes in education, human rights, environment, economic development, civic engagement and health. (2) Ashoka recognized these people as "social entrepreneurs" and led a change in the ways that foundations and other investors analyse opportunity and measure impact, that business schools prepare students for careers in the fast-growing citizen sector, and that corporate and community leaders create opportunities for meeting their goals. (3) Drawing on Ashoka's 25 years of experience with 1700 social innovators in 70 countries, including some 400 in the health sector, its Changemakers Initiative designed a global sourcing methodology--a mapping tool called a "mosaic"--that provides a scan of a particular field: a snapshot of its action principles likely to ensure success, its principal barriers to change, and a selection of mini-profiles of innovative practitioners. (4) The mosaic for health was the conceptual centrepiece of an online collaborative competition at Changemakers. (5) An open engagement with contestants brought together investors, policy experts, academics and citizen activists in a global process. "Cross-pollination" between sectors is desirable if sustained progress towards health for all is to be a reality, and cross-sectoral success stems from the ownership that develops when various stakeholders participate in developing action and policy. (6) Changemakers follows this model of collaboration and ownership by engaging health competition finalists and other key participants in policy and investment deliberations. The competition attracted 139 entries from 40 countries--a mix of organization size, growth stage, profit motivation and complexity. …