Sunday, 16 February 2014

Conference: Design as Caring in an Urban World - Final Call for Papers

Design as caring in an urban world: Royal Geographical Conference, London, Tuesday 26 to Friday 29 August 2014

In his essay, “Building, Dwelling, Thinking”, Heidegger considers the interrelationships between care and design by arguing that we are only capable of building well when we know how to dwell, that is, cultivating attachments to our environments and, through this cultivation, giving and receiving care. Recent work in areas such as urban and cultural geographies, and science and technology studies, has further elaborated on this connection between care and design by exploring the affective and relational work that goes into shaping and repairing the fragile attachments between the human and non-human materials that compose the urban world. At the same time, the materiality of urban environments is often found to be inattentive to human difference and diversity, and rarely shaped by, or exposed to, a caring design ethic.

In this session, we seek to bring concepts and practices of care and design into a closer dialogue with one another in order to develop new ways of thinking about the (co) production of urban environments. It is our belief that now, more than ever, a rethinking is required about the relationships between urban design and care, as issues such as sustainability and inclusivity ask for modes of designing and dwelling that convey the affective and relational sensibilities and values of caring.

We are interested in stimulating an exchange of ideas and inspirations between urban design and care by engaging with the ways in which caring skills and sensibilities can become expressed through design practice and thinking, and also the ways in which caring knowledge can be a resource for reconfiguring urban spaces. The questions explored in the session include, but are not limited to, the following:
  • How is caring embedded and expressed in daily encounters between people and urban environments, including buildings, spaces and technologies?
  • What kinds of skills and values of urban design do these encounters cultivate and what can be done to make public and support these?
  • How can an ethics and politics of care and caring be instilled into the design of places and what does a caring design ethic refer to and entail for practice?
  • What are the pedagogic and practical challenges in creating caring design values and practices?
  • How could an ethics and politics of care be mobilised as a form of constructive critique of current urban design discourses where the sensibilities and values of care have often received less attention?
Session convenors: Charlotte Bates, Rob Imrie, and Kim Kullman

Please send a proposed abstract of 200-300 words to Charlotte Bates (c.bates AT gold.ac.uk) or Kim Kullman (k.kullman AT gold.ac.uk) by February 19th 2014.

Sunday, 9 February 2014

End of Life Care: Gold Standards Framework (Heaven's door)


INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL

individual
PRIMARY CAREACUTE CARE
CARE HOMESDEMENTIA (CARE)
group - population


Looking at a table 'GOLD STANDARDS SET BY BENCHMARK PROGRAMME' (p.23) in Prof. Thomas's HSJ article, I could see an instant fit between the four listed care contexts and the domains of Hodges' model.

There are also many overlaps and of course Hodges' model is an idealised resource. For example,  governance applies across all the above and in that way all can be placed in the POLITICAL domain.

Further points explaining the above includes:
  • The GP and primary care seeing the person first not the diagnosis. Again in this sense - respect and dignity we can place all these care specialisms in the INTERPERSONAL. You would hope that primary care 'know' the patient as a person, an individual; or at least through recourse to the primary care record.
  • If a care home 'works' it will be able to deliver care almost transparently, it is not a process but a social gathering. It is not the person's home (their home is not something to be forgotten, replaced like their past), but it seeks to emulate this as far as possible. Care is a routine that is also personalised and even at the end of life there is peace, calm and dignity.
  • Dementia care is a political challenge, a priority and challenge across all the domains. As in the previous post - what training is provided to Health Care Assistants and other staff? How is the strategy for dementia progressing across all these care environments?
The National Gold Standards Framework Centre in End of Life Care

Thomas, K. (2014) 'End of life care is a litmus test for the whole of the NHS'.  HSJ, 31 January, 124, 6384, 21-23.

Saturday, 8 February 2014

HCA training: Knock, knock, knocking on the political domain's door

INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL

individual
emotional care

physical care


social care


FRANCIS - a year on: 
How much training do healthcare assistants have before their first shift on a ward?

25% = none
 
group - population


Although that 25% sits nicely in the POLITICAL domain, what is the impact of this finding across the domains overall? Whether or not the impact is equally shared across the interpersonal, sciences and social domain, upon which domain will it end up knocking?


Calkin, S. (2014) Francis impacts on culture and patient safety, HSJ, 7 February. 124, 6376, 4-5.

[hifa2015] Wikipedia, Medicine and a Language of Your Choice

Wikipedians and Translators Without Borders have been collaborating for more than two years in an effort to improve access to medical information. [1] Over this time we have improved more than 30 key medical articles in English and are working on translating them into around 60 languages. This effort has resulted in more than 3 million words of translated text. [2]

The work is having an impact. Wikipedia’s medical content is the single most read medical resource globally, [3] receiving about 5 billion page views in 2013 for around 180,000 articles across 286 languages. It is also often re-used by other sources including university textbooks by Boundless.com which reaches more than 3 million students, [4] Google, and many others. Additionally the Wikimedia Foundation through partnerships with cellphone companies has secured Wikipedia browsing without data charges for more than 500 million people in the developing world (currently rolling out in many regions with more carriers being added). [5]

Most of these efforts are accomplished entirely by volunteers. Volunteers who believe that all people deserve free and easy access to high quality health care information in the language of their choosing. The number of people currently working on these efforts are however small. To expand our work we need more people to join us who share our dream. For many aspects of the project there is no formal registration required. One can simply begin editing on Wikipedia.

If one is interested in translating from English to their native language they can contact enrique at proz dot com. Currently we are primarily looking for people to help in non European languages as in major languages much content already exists. Additionally we need people who can help add already translated article to Wikipedia. It requires a bit of time to figure out the Media Wiki markup but not too much. We are specifically looking for help adding articles in Arabic, Polish and Dutch right now.

Please let us know if you would be interested or wish to learn more.

James Heilman & Lori Thicke

MD, CCFP(EM), Wikipedian Founder and 
President of Wiki Project Med Foundation Translators without Borders

References
 
James Heilman
MD, CCFP-EM, Wikipedian

The Wikipedia Open Textbook of Medicine
www.opentextbookofmedicine.com
__________

From December 2013 to March 2014, mPowering Frontline Health Workers is supporting an in-depth exploration here on the HIFA forum around the information and learning needs of Community health workers (CHWs), and how we can meet those needs more effectively and efficiently over the coming years. Further information: http://tinyurl.com/hifa97

Saturday, 1 February 2014

Care pathways: 15 minutes on Monday - how far is that?

On Monday I have a quick visit for 15 minute slot on care pathways at an interprofessional study day for 2nd and 3rd year students.

After the short presentation I'll ask the question of what difference the students can make to the patient's care pathway. There may be value in continuing the 'journey' metaphor?

They can ensure the care pathway is well-documented (otherwise it doesn't exist, and travel on it never happened) they can check it is accessible (an achievable goal) and that it does not trip anyone up (we don't do - iatrogenic).

There are further tests: is it navigable, tried and tested, a safe (evidenced-based) route? As the student's contemplate a major step in their health career, we really need them to focus on the health career of the persons in their care.

[ There won't be time for this: but do we need to wait until the 'end' for the outcome and capturing that (feedback). Or can do we this verbally, incrementally (positive impact on quality)? ]

I could ask them all to stand and make like sign-posts, but for the risk of poked eyes. It's true though, sign-posting is an important job, but how we do that is another post (the value of self-discovery as learning).

Once medically fit the key thing should be checking the person's (not viewing them totally as patient) wayfaring skills.
OK, who took my care pathway?

Can they read the map (are they health literate)? Can they find a map? Do they have a stay-well, recovery and well-being ... compass (a conceptual framework, an app, care plan)? If there literally is no self-care pathway under the patient at present, then the student can help them and their carer if necessary to find or create this compass - across the required care domains.

THEN this person (potential future patient) can avoid having to step off their self-care pathway and onto the health care pathway. You see there's a risk and a cost in that particular transfer.




Image source: http://www.farlandgroup.com/customer-journey-mapping/