EMOTIONAL Ranveer Singh CRIES At Padmaavat Declared SUPER HIT By Public
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Unspecified Threat Prompts Modified Lockdown In Pittsburgh Public Schools - Duration: 2:00. For more infomation >> Unspecified Threat Prompts Modified Lockdown In Pittsburgh Public Schools - Duration: 2:00.-------------------------------------------
Pres. Moon orders safety checks on all public facilities after Miryang tragedy - Duration: 2:32.Turning our focus to a meeting held between the president and his top aides.
The liberal leader called for the formation of a special task force on fire safety measures.
Hwang Hojun starts us off from Cheongwadae.
President Moon Jae-in called for an overall safety check on fire-prone public facilities
as well as new safety measures to put an end to fire-related accidents.
"The pervasive feeling that we aren't safe, the tendency to go for stopgap measures.
This is another way of saying that safety is not a priority and that it's a waste of
money.
These are just the kind of deep-rooted evils we have to eradicate."
That was the President speaking during Monday's meeting with his top aides, just a couple
days after he visited the site of the hospital fire in Miryang last weekend,... which, as
of Monday morning, had resulted in 39 deaths.
The fire in Miryang came just over a month after another fire in a commercial building
that killed nearly 30 people in the city of Jecheon.
Since then, the Moon administration has been blamed by some for the deep flaws revealed
in the nation's safety.
The fires have been seen as a setback for President Moon's pledge to make the country
safer,... with the PyeongChang Winter Olympics coming up in a matter of days.
President Moon said the fundamental cause of catastrophes like these lies in the past,
a jab at the past two conservative administrations which were focused more on external growth.
But amid the finger-pointing, President Moon stressed that no one is blameless and asked
all parties to put their full efforts into righting this wrong.
"We can ask whether this was caused by local governments failing to properly manage safety
or by the National Assembly falling behind in safety-related legislation.
But ultimately, the people's lives and safety are the responsibility of the central government.
And with that in mind, I urge you take action."
The South Korean President called for the creation of a special task force within the
Blue House that will deal with fire safety measures.
He also insisted that the government come up with new methods that will find every last
problem with buildings across the country and let the public know about them.
Even if it takes time, he said, they can't continue with business as usual.
Several safety measures were suggested by the President, such as mandatory fire drills
and installing an emergency button at larger facilities that will alert the authorities.
When it comes to applying new safety rules to existing buildings, he asked his top aides
to find a way that won't put too much financial pressure on building owners.
Hwang Hojun, Arirang News.
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Korea's public organizations hire 22,000 new recruits in 2017, up nearly 5% from 2016 - Duration: 1:31.Korea's public organizations hired some 22-thousand new employees in 2017,... their largest ever
annual intake.
The move is part of the government's effort to tackle Korea's growing youth unemployment
rate.
Park Ji-won has more.
Over twenty-two thousand people were hired as full-time workers by Korea's public institutions
and organizations last year,... up some 5 percent from the previous year.
It is the largest annual number of new employees hired by public institutions.
This figure excludes the annual intake of new civil servants who have pass Korea's civil
service exams.
Korea Electric Power Corporation created the largest number of new jobs last year,... hiring
some 15-hundred new recruits.
The National Health Insurance Service,... and Korea Railroad also hired more than a
thousand new employees.
Seoul National University Hospital,... and Korea Workers' Compensation and Welfare Service
were also among the institutions with largest numbers of new hires last year.
The move is part of the government's effort to address a deepening youth unemployment
issue,... by creating quality new public sector jobs.
The Moon administration is planning to hire more than 23-thousand new recruits at over
three-hundred-twenty public institutions and organizations in 2018.
Park Ji-won, Arirang News.
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Visitando Granville Public Market, Vancouver, Canada - Duration: 4:57.Hi how are you? We are very excited
because we are in a mini market
where...
they sell Mexican products
in Vancouver
So we are really happy
because we found
Japanese style peanuts (I think you can only find these ones in Mexico and not really in Japan)
they have Japanese style peanuts, and these are not easy to find here in Canada
well at least
not on the side where we live
They have gansitos (a mini cake)
Kid: Mazapan
Mazapan Dela Rosa (brand)
strawberry barritas (like fig newtons but strawberry filling) Lucas gusano (tamarind liquid candy)
polvorones (crumble cookies orange flavor)
Pff these ones are perfect with a coffee
Seriuosly yes!!
So polvornes, they also have canelitas (cinnamon cookies)
there is also watermelon pulparindo (another tamarind base candy) This ones is the real deal!!
we are seriously really excited
They also have Takis here!! and Duvalin (this is like eating pure buttercream but really good)
we have here all the different chilis
All kinds of them.
We don't have this much of variety where we live
We live in a way smaller town, so we don't
get this many stuff, and is when I come here that I go crazy buying stuff
And here we have adobo,
green mole and mole (chocolate and chili sauce)
Pineapple chamoy (another tamarind and chili candy)
But this pinapple chamoy looks pretty old
Look chili peanuts
They also have guava paste candy, more tamarinds
There are other kind of tamarinds here
Oh! They are like the ones you can get in Acapulco, but guess what??
These ones are from Thailand. Haha
Product of Thailand
But it is sold between all the mexican products
Well we are going to do this quick,and then we show you what we bought
Because the store is about to close
So we are actually going to shop and then we show you what we end up with
Well this is what we ended with, we didn't buy actually to much
but well here we go
First
Our director couldn't resist buying his takis
and then we bought the "ducks"
as this little one calls them (their real name is little goose in spanish -gansito-)
Definitely I got my Japanese style peanuts
and the chamoy (liquid tamarind candy) to put them on, or they can't be enjoyed
And my super polvorones (orange crumble cookies) for my MORNING coffee
Tha's all, we are going to try to record more stuff
from this mini trip to Vancouver
If not well we really wanted to show you our favorite mini market in Vancouver
because they sell Mexican products
and when we come
to Vancouver we definitely have to stop here.
We'll see you later, let's hope we can shoot more.
We are now
in
Granville
public market
We are back from picking up
my cousin who is going to live here in Vancouver
I am thrilled because I will have her way closer now
I will introduce her to you later, she doesn't want to be on the video now 'cus she is not wearing make up
But I am pretty sure you will see her very often with me in more videos from now on
I only wanted to show you the market
which is incredible
I am going to take you guys to the other side of the market where they sell the fruits and vegetables
This market it's really cute
Look at those chocolates!! Let's go see them
This chocolates are so pretty
look at the key!!
Look at the bumble bees!!!
Look at the bees, OMG
They are the cutest thing ever, they are amazing
Please look at the bees!
Look at the ladybugs!!!
I am going to show these to Nona
Look at these beautiful things Mariana
And we didn't have the chance to come here before
And here they have hearts
and also exotic flavors
they have mojitos
This is so good!!
they also have Canada chocolates
They are really cute these chocolates
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Pres. Moon orders safety checks on all public facilities after Miryang tragedy - Duration: 2:33.Turning our focus to a meeting held between the president and his top aides.
The liberal leader called for the formation of a special task force on fire safety measures.
Hwang Hojun has the latest from Cheongwadae.
President Moon Jae-in called for an overall safety check on fire-prone public facilities
as well as new safety measures to put an end to fire-related accidents.
"The pervasive feeling that we aren't safe, the tendency to go for stopgap measures.
This is another way of saying that safety is not a priority and that it's a waste of
money.
These are just the kind of deep-rooted evils we have to eradicate."
That was the President speaking during Monday's meeting with his top aides, just a couple
days after he visited the site of the hospital fire in Miryang last weekend,... which, as
of Monday morning, had resulted in 39 deaths.
The fire in Miryang came just over a month after another fire in a commercial building
that killed nearly 30 people in the city of Jecheon.
Since then, the Moon administration has been blamed by some for the deep flaws revealed
in the nation's safety.
The fires have been seen as a setback for President Moon's pledge to make the country
safer,... with the PyeongChang Winter Olympics coming up in a matter of days.
President Moon said the fundamental cause of catastrophes like these lies in the past,
a jab at the past two conservative administrations which were focused more on external growth.
But amid the finger-pointing, President Moon stressed that no one is blameless and asked
all parties to put their full efforts into righting this wrong.
"We can ask whether this was caused by local governments failing to properly manage safety
or by the National Assembly falling behind in safety-related legislation.
But ultimately, the people's lives and safety are the responsibility of the central government.
And with that in mind, I urge you take action."
The South Korean President called for the creation of a special task force within the
Blue House that will deal with fire safety measures.
He also insisted that the government come up with new methods that will find every last
problem with buildings across the country and let the public know about them.
Even if it takes time, he said, they can't continue with business as usual.
Several safety measures were suggested by the President, such as mandatory fire drills
and installing an emergency button at larger facilities that will alert the authorities.
When it comes to applying new safety rules to existing buildings, he asked his top aides
to find a way that won't put too much financial pressure on building owners.
Hwang Hojun, Arirang News.
-------------------------------------------
Human Resources Plan for 2016–2019: Guaranteeing the delivery of public services - Duration: 0:57.I think Psychology was a career
that attracted me because it was a way to help,
to be in contact with people, which is what I really like.
I especially remember a 16-year-old boy
who was in hospital in a very serious condition
and the mother was there when we arrived.
She was in that situation, with her son there being treated.
We went outside for some fresh air.
To breath a little bit and forget about the ICU.
At that moment, she told me: "Can you hug me?"
And the feeling of saying: "Yes." It's not that difficult what she asks.
We are people.
We are civil servants, but we are people working for people.
Sergeant of the Research and Accident Prevention Unit. Traffic and Road Safety Division Guàrdia Urbana.
Guaranteeing the provision of public services
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Public Arts Commission 1-24-17 - Duration: 2:59:35. For more infomation >> Public Arts Commission 1-24-17 - Duration: 2:59:35.-------------------------------------------
Human Resources Plan for 2016–2019: Strengthening the capacity of public services - Duration: 1:00.I like Excel.
When I open it and I see the grid, I say: "That's a good start."
You like controlling your home economy because it's yours.
But it's not the same a 25 euro ticket
than a 25,000 euro invoice, a thousand times more,
like the ones we have during the city's festival.
We work with an important budget. It's a council, a powerful district.
Keeping control of a powerful thing
is something that amuses me and I like it.
You need empathy to put yourself in somebody else's shoes.
You need to understand the circumstances.
We work as a team.
Like they say: if you want to go further, you need a team.
Management Control People and Territory Services Management Sant Martí District
Reinforcing the capacity of public services
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Human Resources Plan for 2016–2019: Backing quality direct public management - Duration: 0:55.There are large architectures, great urban plans, great buildings.
I prefer the small architecture. The one that goes unnoticed.
Something more human,
more at the citizen level, at local level.
To talk with the public, the ones that are really affected.
To get to know a person. Not as a file number,
but as Mr. Ramon or Mr. Blai.
I think it's architecture's most basic part.
Whether it's building a library from scratch or improving a dividing wall.
Building a square or a bridge.
It's an opportunity to improve the surrounding, to build the city.
Department of Projects and Works Municipal Institute of Urban Landscape
Promoting quality direct public management
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The ABCs of Public Speaking (Best Tips For Public Speaking) - Duration: 14:31.Public speaking isn't something that many people enjoy.
In this video, I'll teach you the ABC's of Public Speaking
that you can use to make sure your next event goes great!
Thanks for checking out this video, I'm excited to share with you today the ABC's of Public
Speaking that I created to help you become a better public speaker and nail your next
presentation.
My name is Matt and with this channel, I hope to challenge you to live a better life, so
if you like the video, click the thumbs up button, let us know in the comments what you
thought, and why not subscribe and tap the bell to be notified when a new video comes
out every Monday!
Let's jump into today's topic.
I was asked by a group in my community if I could come in and do a presentation on public
speaking.
Now, I agreed to do that because I'm looking for ways to challenge myself and this seemed
fitting.
Public speaking isn't something that many people enjoy I'd probably say that and I would
agree with that, but it's something that I kind of am used to.
You see, I'm a teacher, I teach high school, so I'm used to being in front of a group of
people and students in this example, but public speaking is something that has a lot of parallels
to teaching where I have planning for a lesson in the classroom is very similar to planning
for a public speaking event.
So I got planning and I came up with the ABC's of public speaking, which are Audience, Build,
and Communication.
The A stands for audience, and these are the people that will be viewing your presentation,
these are the ones that you might be trying to persuade given the presentation topic,
these are the people that might even be scoring you in a judging situation and many other
reasons.
And I think before you start planning your presentation, you should ask yourself three
important questions.
Who is the audience?
Who are they, where are they from?
Are you talking to a bunch of elementary school students?
Are you talking to some senior citizens on a certain topic?
Or are you talking to a bunch of people who you are trying to sell a product?
It's important to figure out who your audience is, it's important to also think about why
they're listening to you and that's the second point.
Why are they listening to you?
They are giving up their time to listen to this presentation.
You are giving up your time to plan and prepare the presentation, so why are they there?
Are you trying to sell them something?
Are you trying educate them on a certain topic, or persuade them on something?
You need to figure out the why.
And the last thing you should ask yourself before starting to plan your presentation
is "what do they already know about your topic?"
Are you talking to people about a topic that they have no knowledge on, or are you talking
to a bunch of experts in that specific field?
You need to figure out who is listening to your presentation, why they're there, and
what they already know about your topic before you can go on start creating or building your
presentation which is the next one.
The B stands for build because you need to have a well-built plan for your presentation
in order for it to go well.
You should begin with a hook that gets the audience interested in your topic.
It has to be something that is very short, interesting, and will give the audience an
idea about what you're talking about very quickly because it can be really hard to get
their attention back if you lose it.
So notice at the start of this video, I introduced my hook before I did my logo reveal and I
said something along the lines of "public speaking is something that many people don't
enjoy, in this video I'll teach you the ABC's of public speaking to help you nail your next
presentation.
So I said that with excitement and I said that with giving a good overview of the stuff
that you're going to see in this video so that in the first ten seconds you knew what
this video was about and how it provided value to you, so that you didn't click away.
Once you've done your hook, I think you should do a quick introduction about yourself.At
the start of this video, I did introduce myself I introduced this YouTube channel and why
it provided value to the audience, you the viewer, and the same goes for a presentation.
Introduce yourself and tell them why your topic is important and essentially why they
should listen to you.
You should then move into the body of the presentation.
This is where most of the important information will be as well as I think you should really
think about chunking it up.
There's a lot of scientific research and evidence that supports people remember things better
when things are chunked up or broken up into smaller pieces.
So, Typically they say do things in groups of three because that is easier for people
to reminder and hold onto and recall in the future when they need to.
So think about this video, this video's title is the ABC's of Public Speaking.
A, B, C, three easy things and I've also given you an acronym to remember that.
ABC stands for audience, build, and communication, so that a week later, two weeks later, three
months later when you have an assignment or you're asked to do a public speaking event
you will quickly recall the ABC's of Public Speaking and you'll use that to plan your
presentation.
And the presentation should end with a strong conclusion that summarizes what the presentation
was about, why it was important, and you should always thank your audience.
And the C stands for communication and I think it's important to remember that there are
multiple types of communication.
The three that I'm going to talk about today are the verbal communication, non-verbal communication,
as well as resources which might surprise you.
So let's talk about verbal communication.
Obviously in a public speaking event you will need to speak so that's what you're going
to be using, you're going to be using your voice to provide information in some way.
So when you're speaking, make sure that you speak at an appropriate volume, don't speak
too loud, don't speak too soft, be sure to speak at an appropriate volume that's constant
throughout, but at certain times you might want to raise your voice slightly, or minimize
your voice to make a point more exciting depending on what your topic and speech goes about.You
might also want to consider how fast you're talking.
Now me, I can talk quite fast very easily and not realize that I'm doing it so it's
something that you want to practice and make sure that you're providing information in
an exciting way, yet you're not talking too fast or too slow.
And I think it's important to think about the language level of your audience.
If you're speaking to experts in your field than you can use certain vocab terms and concepts
to explain something that they will probably be able to understand very quickly rather
if you're speaking to some middle school or elementary school students and you start talking
about Einstein's Theory of Relativity that's probably going to go right over their heads.
The second form of communication is non-verbal communication.
And this is just as important as the verbal communication in my opinion because the non-verbal
ways we communicate indicate a lot about our feelings and how excited we are about a certain
topic, for example.
When you are doing your presentation, be sure to stand upright.
I'm sitting down because I'm really tall and I don't have enough room to film in my house.
I have to sit down to record these videos, but I make sure I'm sitting up straight and
if I was standing I'd do the same.
I'd stand up straight with my shoulders and hips in line with each other, so that I give
off a confident appearance.
Secondly, I'd make sure that I'm not fidgeting around too much, I wouldn't be tapping my
nose, or ears because that would be distracting to you the viewer.
Also, I'm not moving my feet around and I'm not fidgeting so that people can see it.
I kind of like to have a resting place for my hands which is just in front of me and
I will use my hands to emphasize points to move around but most of the time I will always
go back to that resting point.
Eye contact is another way of communicating that is very important because it will help
bridge that connection between you and your audience when you're giving your talk.
Make sure that you're giving eye contact to people, you're not for a video for example
I'm not looking around the camera like this this would just be a little bit weird if I
did that.
You probably would click away in the first ten seconds if not quicker.
So make sure that you are looking your audience in the eye make sure that you're not just
staring one person down, make sure that you're not staring anybody down for that example
and as well move around some people like to do time, they might like to say I'll talk
towards somebody for 3, 5, 10 seconds before I move to the next person.
You could do that you could try working with that, you might find that that works for you.
At the same time, some people are so worried about eye contact that they dart around and
they don't really make eye contact with anyone because they're making too many movements
with their eyes and it just looks kind of creepy.
So, beware of eye contact and the last point for non-verbal communication I'm going to
say is work the room and that was something I was taught as a teacher.
I was taught to circulate around the room, move around the room, if somebody's chattering
around the back, maybe I'm going to just slowly make my way back there and just by proximity
that chatter is most likely to stop.
So work the room, don't run around, don't do laps, but know how to work the room when
you're giving your presentation and you just want to make sure that you move in a cool,
comfortable way.
Now both of these types of communication take time to work on and improve so the best tip
that I have for you is practice.
Make sure that you practice a few days if not weeks in advance for your presentation
because it's going to come so much more naturally if you do that rather than just practicing
it the day or the hour before you have to present.
So the more practice that you can get in, the better your presentation will be.
Another thing is, I scripted out this video because I wanted to have a well-developed
plan for the ABC's of Public Speaking so I have a script, but really when I'm filming
this, I look at the script for a second and then I talk for a minute, two minutes at a
time.
So, I scripted it out, you need to know where you're going and the plan that you have, but
don't memorize a script.
Know the major topics that you want to talk about and then talk about them.
You should be an expert, or very well-experience in the topic that you are presenting so you
should be able to do this very quickly and know the big points that you want to hit and
you should be able to talk about those in a good sequential order.
The last form of communication that I'm going to talk about are resources, which I think
are really important and a lot of people will not consider them for public speaking presentation.
And they might not be suitable for all presentations that you have to give, but they might pay
off and help you in the long run.
For resources, I'm talking about pamphlets, I'm talking about posters, I'm talking about
social media accounts.
So what I would say is the other day when I gave my ABC's of Public Speaking presentation,
I gave my audience during and after my presentation, I gave them a little pamphlet that highlighted
the main topics of my presentation as well as the ABC's of Public Speaking so that they
could use that to prepare for their next presentation.
As well as I gave them my name, so that they could find me as well as this social media
account information.
So, for that first thing I gave them a resource.
You might want to think about a poster, a pamphlet, a note, something like that for
your audience.
And one that I'm really interested in is building your personal brand, so at the end of that
presentation and on the pamphlet I said "You can check out the rest of my content here"
because it provided value to them where I was able to give them this video they'd be
able to find this video and talk about the ABC's of Public Speaking when they are preparing
for their presentation so in a way I converted the conversation we had at the presentation
that night to an ongoing conversation as time goes on as well as they're following my social
media accounts now and we can continue developing that relationship.
So, you might want to think if it's appropriate for your presentation to share your social
media accounts, share your Instagram, twitter, Facebook, youtube, things like that.
You might also want to share your email address, and you might also want to share your website.
Again, if all that is appropriate, feel free to do that.
So, to review today's video we talked about the ABC's of Public Speaking which are audience,
build, and communicate.
Know your audience and why they're there listening to you.
Build your presentation to keep the audience engaged and that they will be able to leave
having learned something.
And communicate in a way that shows you're confident, interested, and knowledgeable about
your topic.
So there's our video about the ABC's of Public Speaking.
If you liked this video please be sure to give it a thumbs up, let us know in the comments
below what you thought of this as well as any tips and tricks you use when preparing
for a public speaking event, and please subscribe to this channel, tap the bell to be notified
when a new video comes out every Monday helping real people live great lives.
I'm excited to see how your presentation goes, so let us know and we'll hear from you soon!
-------------------------------------------
LTCH Public Reporting - Duration: 50:36.»» All right.
Good afternoon everyone.
I hope everyone had a great lunch and thanks for sticking around for the last two hours
of training.
So we are going over LTCH Public Reporting for this session.
Pretty much where we're taking all the data you've collected to calculate the measures
that will be reported on your confidential reports, CASPER Reports and subsequently public
reporting, which was on the Compare website.
The next few slides are the acronyms I'll be using in this presentation.
So they are there for your reference.
So the objective of this session is to locate and navigate the Compare website, identify
the types of quality measures by data source, and then describe the three reports associated
with confidential and public reporting, so your CASPER Reports.
So it would be your Review and Correct Reports, your QM Reports, your Provider Preview Reports
and then ultimately the Compare website.
So the Compare website is located in the link that you see on this slide.
You can search for nearby LTCHs by geographic locations.
So you can type in your city, state or ZIP code.
And it will output a map for you and display LTCHs within say 25 miles from the address
you put in, up to 500 miles.
And included in the Compare website are the QM results, which are tailored for the general
public.
So here's the homepage for the LTCH Compare website where you can type in the ZIP code,
city or state in the box below.
Then you hit "search".
And then you get various results.
So you see to the right a map of nearby LTCHs.
And to your left is a list of LTCHs, and includes the address, the ownership and the total LTCH
beds.
And then you can select up to three LTCHs and you can compare quality measure results
among the three, up to three LTCHs.
So the measure results page when you click on a specific provider for example, it will
give you the results for rate of pressure ulcers that are new or worsened.
And when you hover on that text, you will see a more plain text definition.
Usually these are definitions for non-clinicians such as patients, families, friends, and the
rest of the general public.
So you can see the plain text definition is a much easier, a more general interpretation
of pressure ulcers.
In the webpage you'll see graphs, tables on the QM results which you can toggle through.
And it will give you either the table display, which presents the numerical results.
So you have your provider and then compare it to the national results.
Or you can click on Grab View where you can see a bar graph and compare it too based on
a graphical representation.
And then below that you'll see a link to data.medicare.gov.
And not all the results are displayed on the Compare website.
And there are other results that researchers or analysts in your LTCH that you might be
interested in.
So you go to this webpage and download the data.
And use the data set for your analyses.
So some other features of the Compare website, you'll see on the homepage you'll see on the
left side the Spotlight, which are the announcements by CMS, in case there's something new going
on with the website.
In the middle are Tools And Tips.
Those are various tools you can use throughout the CMS portal.
So if you want to compare, let's say inpatient rehab facilities or skilled nursing facilities,
there's a link right there for you to go to the other Compare websites.
And then to the right you have Additional Information.
So there's a direct link to data.medicare.gov, important contacts.
So most importantly, the various help desks in case you have any questions.
Alternatively, on the website on the upper right-hand corner there's the About link.
And you can access more details about your data and the other contacts.
So there's many ways to get the other information on the Compare website.
Now we're going to talk about types of quality measures.
There are three types of quality measures.
The first is the assessment-based measures.
So these are based on the data you've collected in the LTCH CARE Data Set.
The second type is the CDC's National Healthcare Safety Network measures, so any data that
you submitted through the NHSN system.
And then lastly, claims-based measures, these are measures based on Medicare fee-for-service
claims.
So here are the assessment-based measures.
So in this session we will not delve into the calculations of the assessment-based measures.
But if you are interested in learning kind of the details on how -- the items that you
filled out in the LTCH CARE Data Set is used to calculate the measures.
You can go to the LTCH QRP webpage, specifically the Measures Information webpage and look
at the LTCH quality measures User's, Manual which is currently version 2.0 released in
June 2017.
But here are the assessment-based measures.
So the first is the percent of residents or patients with pressure ulcers that are new
or worsened.
Percent of residents or patients who are assessed and appropriately given the seasonal influenza
vaccine.
These first two are currently publicly reported on the Compare website.
The next four will be publicly reported in the future.
So you'll see, the third one is the percent of long-term care hospital patients with an
admission and discharge functional assessment and a care plan that addresses function.
The fourth is the cross-setting IMPACT Act version of the previous measure.
The fifth is the application of percent of residents experiencing one or more falls with
major injury.
And lastly, functional outcome measure, change in mobility among long-term care hospital
patients requiring ventilator support.
The next set of measures are the CDC NHSN measures.
You'll see, the first is the CAUTI outcome measure, the second being the CLABSI outcome
measure, and the third is the facility-wide patient hospital onset MRSA outcome measure.
Then the next three are the facility-wide and patient hospital onset CDI outcome measure,
your influenza vaccination coverage among healthcare personnel.
And lastly, the Ventilator Associated Event outcome measure,
which are only available in the Confidential Feedback Reports, the QM Reports, which we'll
go over in a bit.
And then the claims-based measures, we have the all-cause unplanned readmission measure
for 30 days post discharge from long-term care hospitals.
It's currently publicly reported.
But it is slated for removal from the LTCH QRP on October 2018.
And this measure is replaced by potentially preventable 30-day post-discharge readmission
measure for long-term care hospitals.
Next is the discharge to community post-acute care long-term care hospital Quality Reporting
Program.
And then lastly the Medicare spending per beneficiary or MSPB post-acute care long-term
hospital quality reporting program measure.
So the first Knowledge Check.
Medicare spending per beneficiary is an example of which type of quality measure?
A, CDC NHSN measures?
B, assessment-based measures?
C, claims-based measures?
Or D, none of the above?
That was in the previous slide, so -- we'll just -- alright.
Vast majority picked the right answer, C. So there are a lot of reports in the reporting
realm that are available to you to look at to review your quality measure data.
So these reports include the Review and Correct Reports, the QM reports, and then the Provider
Preview Reports.
And then we will go into detail one by one.
So this graphic is a good representation of king of the whole public reporting process.
So make sure to look back and use this as a reference.
So you have your CASPER Reports which include your quality measure QM Reports, your Review
and Correct Reports and your Provider Preview Reports.
And these three reports are confidential reports.
And then on the other side you have the Compare website posting.
And that's the public reporting part.
And you'll see that in the bottom, you'll see kind of a progression from the day that
you collect the data.
Then it will appear on your Review and Correct Reports.
And once the data is reviewed and corrected by the provider and is no longer -- is past
the data correction deadline, it will progress into the Provider Preview Reports.
And that's when all your quality measure results are frozen and ready to go for the Compare
website posting.
But I will refer back to this graphic as we go through all these reports.
And then the Quality Measure Reports are kind of another way to review your facility's performance
on your quality measures.
So we'll go over one by one the next slides.
So the first report is the Review and Correct Reports.
So these are user on-demand reports.
So we'll see later on, as you go to CASPER, and you can select a quarter end date.
And it will pop out a report in your inbox.
And these reports are confidential to providers.
They display quarterly reports.
So when the reporting quarter ends, the report is available the next business day.
For example, right now we're in quarter 4, 2017.
So that quarter will appear on your Review and Correct Reports on January 1, 2018, the
day after the end of this current reporting quarter.
So when you go to CASPER, the quarter end date will appear as quarter 4, 2017.
It will appear on the first business day.
I think it's January 2nd, 2018.
And your quarter 4, 2017 along with quarter 1 through quarter 3, 2017 will appear in the
Review and Correct Reports.
These are available for providers to run with updated data weekly until the data correction
deadline.
So let's say you correct your data today.
It will be updated the next week.
So don't worry if you correct the data and you don't see it.
It will, I think, will be refreshed early in the week.
The corrections will be updated into the data correction deadline.
So that means, let's say quarter 4, 2017 the data correction deadline is May 15, 2018.
If you submit a correction on May 17th, 2018, it will be submitted but it will not be updated.
Your quality measure calculations will not be updated.
Because your data is completely frozen.
And then the Review and Correct Reports display data correction deadlines and whether the
data correction period is open or closed.
And we'll see that in the example in a couple of slides.
And as I said earlier, the Review and Correct Reports are accessed through the CASPER system.
And these reports provide a snapshot of current performance based on assessments in CASPER.
And these contain quality measure information at the facility-level only.
And then the Review and Correct Reports only contain assessment-based measures.
These are not risk-adjusted.
So you'll only see the observed rates in these reports.
Providers are able to obtain aggregate performance for up to the past full four quarters as the
data are available.
As I said before, once the quarter 4, 2017 reports are available, you'll be able to see
the full four quarters by quarter.
And you'll see an aggregate performance below that.
Subsequent Review and Correct Reports, so after the first quarter data for the subsequent
report, reporting quarters are added.
So we'll see later on, I'm explain later that once you see the four quarters, the next quarter
after that, a new quarter will replace the oldest quarter.
So we'll show that.
So here is the Review and Correct Reports.
So on the top of your screen is the provider information.
So your CMS Certification Number, provider name, address, city, state, et cetera.
The next line is the LTCH quality measure and question, and the unique CMS measure ID
below that.
After that is the table legend where if there's anything, it's required to read the table.
So in this table, a dash means data not available or not applicable.
So in this table, it's divided into several columns.
The first column is the reporting quarter.
So it goes most recent on top to the least recent on the bottom.
And below that is the cumulative row.
The start and end date are the specific dates for each reporting quarter.
The data correction deadline is the deadline for each individual quarter.
So for quarter 4 2017 you see that the data correction deadline is May 15, 2018.
The next column is data correction period as a report run date.
That means that if you're requesting a report today, December 7th, Quarter 3, 2017 and quarter
4, 2017 still should still remain open since today's date is before those two data correction
deadlines.
And the next three columns are your quality measure performance.
So the first column is essentially your numerator.
The next column is your denominator.
And then your last column is the observed performance rate, which is the numerator divided
by the denominator times 100.
And then you'll see that you have quarterly rates and then your cumulative rate.
I want to emphasize that in the last row, the cumulative rate is based on the total
number in the numerator, divided by the total number in your denominator.
We had some questions getting confused with you know, is the cumulative rate the average
of the four facility rates -- sorry, the four quarterly rates?
But we want to emphasize that's based on the total number below.
And then you'll see in example 2, when quarter 1, 2018 appears, which is released on the
first day after quarter 1, 2018 ends.
So it should appear on the first business day in April.
So once that is available to providers, you will see that quarter 1, 2017 in the bottom
is missing.
It is gone.
You see pretty much quarter 1, 2018 replaces -- is top.
And then quarter 1, 2017 is removed.
There's a few exceptions notably.
The functional outcome measure, the change in mobility among LTCH patients requiring
ventilator support.
You have to remember that is an 8-quarter measure.
So you will see reporting quarters stacked until you get the full 8 quarters.
And once the full 8 quarters are available, then you'll start seeing the rolling quarters
for that measure.
So I just wanted to give one caveat for that.
So how to obtain these Review and Correct Reports.
So you log into the QIES system and click on "CASPER Reporting."
Then you use your ID and password.
So in this interface, you click on Reports on the top.
And then you click on LTCH Quality Reporting Program on the left-hand side.
And you'll see there are a various number of reports.
And these are our user-requested reports.
So in this example, either you click on the LTCH Review and Correct Report on the bottom.
And then you get the CASPER Reports submit page for the LTCH Review and Correct Reports.
So you'll see right now, if you click on the end date, let's say right now quarter 3, 2017
is available.
The begin date is automatically populated to either a full four quarters or how many
quarters are available.
We've only began the Review and Correct Reports on quarter 1, 2017.
So you just go back to quarter 1, 2017.
Once you submit that request, it will appear on your inbox.
So you have to go back to Folders on the little menu bar on top.
And it will appear on your My Inbox.
All right.
Another way of looking at your performance is through the Quality Measure Reports or
QM Reports.
There's a variety of names that people refer to the QM Reports.
They can be referred to as the CASPER User-Requested Reports in the rule referred to as the Confidential
Feedback Reports.
But for this purpose, we'll call them QM Reports.
These are available to providers prior to public reporting for internal purposes only,
and not for public display.
This is especially true since these reports do contain patient-level data.
So these are used for feedback the help providers to improve quality of care.
These reports contain quality information at the facility and patient-levels for a single
reporting period.
And these reports are available on demand.
Providers are able to select the data collection end date and obtain aggregate performance
data.
The QM Reports for the facility-level reports contain all three types of measures.
But for the patient-level report at the time, it is only for assessment-based quality measures.
So here is an example of a facility report.
So they look a little bit different than the Read and Correct Reports.
You'll see on the top, you'll see on the left-hand side, you see the provider information.
Then on the right side you see the report period that the data was calculated on that.
Below that is the comparison group period.
And for this purpose, the comparison group is the national average.
So that's one difference between this report and the Review and Correct Reports is that
this shows the national average.
So you can compare your performance versus the national average for that report period.
Below that is the report run date, pretty straight forward.
And then the report version number, which just in case we update the report and become
a new version.
Below that is the table legend, similar to the review and correct is anything that is
used to interpret the table, or any various notes that's useful to interpret the table.
Below that is the source.
So in this case this is LTCH CARE Data Set.
And then on the left-hand side the table you'll see the measure name, then the CMS ID, your
numerator, denominator, observed percent.
And in this report, if the quality measure is risk-adjusted, then we also include the
risk-adjusted rate.
And then to your right is the comparison group national average.
So you can compare your facility's performance to the national average.
So subsequently you also will receive a patient-level report.
So the upper left-hand side you'll see is the status legend, which gives you whether
the patient, if they triggered the quality measure or not.
For example, let's say if you look at the table below, you see that Charles Doe did
trigger the percent of residents with pressure ulcers that are new or worsened.
So you'll see that X, the bolded X right there.
And that patient was included in the numerator and had a new or worsened pressure ulcer.
And that NT means "not triggered."
So for example, Holly Doe did not have a pressure ulcer that was new or worsened.
E means "excluded" from the quality measure due to various criteria.
So you will see that on the example table that some patients were excluded.
And then NA means "not available."
So for example, Mary Doe was not yet discharged.
So you'll see that's why you have an NA for discharge date.
And then NAs for the rest of the columns.
There's kind of a special case of table where the percent of resident or patients who were
assessed and appropriately given the seasonal influenza vaccine is a little different.
So how to interpret that is, it's a yes or no for the overall measure, and the sub measures.
So a yes for the overall measures equals yes in one of the sub measures.
And no for overall measure equals no in all sub measures.
Because to be included in the numerator for the patient influenza vaccination measure,
only one of the sub measures need to be included.
So you have either the patient received the vaccination, or the patient offered and refused
the vaccination, or the patient had a medical contraindication to the seasonal influenza
vaccination.
So you'll see in this example table right here, you'll see if the patient had a yes
for overall measure, you see that it's only one Y is required for the three of the other
columns to your right.
Charles Doe on the other hand had no for the three sub measures.
So you have the bolded N. And the reason why we bolded some of the statuses is just to
bring attention to the provider that the patient did not receive a influenza vaccine, or the
patient had a new or worsened pressure ulcer.
So we wanted to bold that to bring attention to providers.
And then how to obtain the QM reports.
It's very similar to the Review and Correct Reports.
So pretty much log-in.
It's the same thing, except for the fact that if you look at the interface, instead of saying
quarter 4, 2017 end date you'll see it says December 31, 2017.
So it just gives that specific date.
It will still auto populate the begin date.
There's another additional field.
We don't have a screenshot here.
But there's another additional field that says the influenza season date.
So it will automatically populate depending on what quarter end date you put in for the
CASPER submission system.
All right.
Knowledge Check.
So the Review and Correct Reports provide information for which type of quality measure?
Is it A, the CDC NHSN measures?
B, the claims-based measures?
C, assessment-based measures?
Or D, all of the above?
All right.
And the answer is, C, which most of you have chosen.
Great.
And Knowledge Check 3.
Which report displays patient-level information?
Is it A, Review and Correct Reports?
B, Provider Preview Reports?
C, QM Reports?
Or D, none of the above?
And the majority of you picked the correct answer.
It is C, the QM Reports.
So to reiterate, so the Review and Correct Reports is just assessment-based measures.
They don't include the CDC measures or the claims-based measures.
Then only the QM Reports provide patient-level information.
All right.
So the Provider Preview Reports.
In that little graphic that you saw earlier, so this is the report that kind of comes right
after the Review and Correct Reports.
So these Provider Preview Reports contain facility-level quality measure data.
And these are automatically generated and saved into your providers shared fold in the
CASPER application, which I'll show you in a bit.
So all of the information that you see in the Provider Preview Reports will be posted
on the LTCH Compare website.
And they're available about five months after the end of each data collection quarter.
So for example, again quarter 4, 2017, the data correction deadline is May 15, 2018.
And it takes about a couple of weeks for us to kind of gather the data and put it on these
reports.
And these Provider Preview Reports are available in the beginning of June of 2018.
So once there's the review period, they will eventually, a quarter later, will become posted
on the Compare website.
So looking back on slide 19, Review and Correct Reports, Provider Preview Reports, Compare
website.
So these Provider Preview Reports, as I said earlier, data collection period has ended.
So providers are unable to correct the underlying data in these reports.
All corrections must be made prior to the applicable quarter to lead data submission
deadlines, also called the quarterly freeze dates, which falls approximately 135 days
or 4.5 months after the end of each calendar year quarter.
And then there will be a 30-day preview period, prior to public reporting, beginning the day
reports are issued to providers via the CASPER system folders.
So you have 30 days from let's say June 1st to look at your Provider Preview Reports.
And once that 30-day preview period is over, it will not be available in your inbox.
I would encourage you all to, once you receive the Preview Reports, to look over your data.
So these Provider Preview Reports include important notes at the bottom which includes,
you know, please review the data by your hospital, emailing the LTCH help desk if you have any
questions.
And then various things about what you see on the Compare website.
For example, let's say the titles of the measures are not the consumer language titles that
will appear on the Compare website.
So for example, the let's say the readmission measure on the Compare website, it is rate
of hospital readmission after discharge from LTCH, which is very different from the official
National Quality Forum measure name.
So these are the Provider Preview Reports.
So you will receive -- you'll see in the later slides this is sort of the text version of
this.
But essentially it gives the same information.
So on the top you see the reporting period.
Then below that is the provider information.
And then below that is the table on what information will be publicly reported.
So currently for the pressure ulcer measure, you'll see that the denominator, the risk-adjusted
rate and the national rate.
So slightly different than what you see on your Review and Correct Reports and QM Reports.
Below that is the footnote legend used.
And if there is an applicable footnote, let's say you had 18 patients on your denominator,
then we don't report that on the Compare website and we place a footnote in place of that.
And we'll go over various footnotes in a bit.
And below that is your important notes as I reiterated, which I just stated earlier.
So there are various footnotes in these Provider Preview Reports, which are also on the Compare
website.
So the first footnote is the number of cases, patient stays is too small to report.
So for most of the assessment-based measures is less than 20.
For claims-based measures, it's less than 25.
Number two is data not available for this reporting period.
So either the provider has been open for less than 6 months, there was no data submitted
for the measure.
So either CDC assessment-based or claims-based measures.
Number three is, results are based on a shorter time period than required.
So I think this was more of a rare case.
But if there's a result that has let's say nine quarters of data instead of -- three
quarters of data instead of four quarters, then we put that footnote in.
Four is, data suppressed by CMS for one or more quarters.
So for example if CMS finds that there's a slight calculation error on the quality measure,
they'll temporarily suppress the measure until it gets fixed.
Five, data not submitted for this reporting period.
So either the provider did not submit any required data or they did not submit any CDC
data to the NHSN system.
The next two are CDC specific.
So six is the lower limit of the confidence interval cannot be calculated if the number
observed infections equals 0.
So your CAUTI, CLABSI, MRSA, CDI measure has this footnote, if it is applicable.
And then 7, results cannot be calculated for this reporting period.
So for this is the predicted number of infections is less than one.
So the same four CDC measures, CAUTI, CLABSI, CDI, MRSA.
And lastly number 8, this LTCH is not required to submit quality data to Medicare because
it is paid under a Medicare waiver program.
If your LTCH is under that Medicare waiver program you'll have that footnote instead.
So this is what you'll receive in your inbox.
So similar to the slide before, but we present to you a more simpler text-formatted report.
So essentially on the top you see reporting period, then your provider information and
then your quality measure data.
And below that you have that footnote legend, and then the important notes below that.
So how to access your Provider Preview Reports?
It's a little bit more simpler than the User-Requested Reports, Review and Correct, QM Reports.
You don't have to go to reports and request it.
It will automatically be in your inbox.
So when you click on Folders, it should appear in your inbox.
It will be in your inbox until the 30-day preview period is over.
So there is a process for requesting CMS to review your preview report data.
So CMS does encourage LTCHs to review data in the Provider Preview Report each quarter.
So if an LTCH disagrees with the accuracy of the performance data, so if there's anything
wrong with a numerator, denominator, or any calculation error has been done by your provider,
then the LTCH can request review of the data by CMS.
So requests for CMS to review a Provider Preview Report data must be submitted during the 30-day
review period.
So for your quarter 1 to quarter 4, 2017 data which you will receive in June 2017 -- sorry,
June 2018, you have from the day you receive it, so let's say June 2nd, you have 30 days
to review that data.
And also I want to reiterate that you will not have an opportunity to correct the underlying
data.
Because it is past the data correction deadline.
So to submit a request, you submit the request to CMS via our LTCH public reporting help
desk in the email over there.
And include in the subject line your facility name and then public reporting requests for
review of data, and then your CMS Certification Number.
And in the email, in the body of the email, please include the following information,
your CCN, the the name of your LTCH, the address, the CEO or CEO-designated representative contact
information, which includes all that in the slide, and then information supporting your
belief that the data contained within the Provider Preview Report was erroneous.
CMS will review all requests and provide a response with a decision via email.
Data that CMS agrees to correct will be reflected with the subsequent quarterly release of quality
data on LTCH Compare.
So it will be temporarily suppressed, then subsequently sometime later we'll release
your corrected quality data on Compare.
And please do not include any patient-protected health information.
Just describe the scenario and we'll look into it.
So Knowledge Check 4.
Which report displays results that will be posted on the LTCH Compare website?
A, Provider Preview Reports?
B, QM Reports?
C, Review and Correct Reports?
Or D, Confidential Feedback Reports?
Oops.
All right.
So most of you got it right.
So it is A, Provider Preview Reports.
Remember Review and Correct Reports, Provider Preview Reports, Compare website.
All three reports associated with confidential and public reporting are accessed through
CASPER?
True or false.
All right.
And yes, it is true.
So they are all accessed through CASPER.
So Review and Correct and QM Reports are user-requested through the Reports tab in the CASPER system.
And then the Provider Preview Reports are in your inbox in the Folders tab.
Requests for CMS to review your Provider Preview Report data must be submitted via email.
True or false?
All right.
And yes, it is true.
All right.
The Provider Preview Report provides a blank preview period prior to public reporting.
Is it A, 15 day?
B, 30 day?
C, 60-day?
Or D, 90-day?
All right.
It was B. 30-day.
All right.
Summary.
So the LTCH Compare website is located in that link over there.
And there are three types of quality measures reported in the various reports, the assessment-based
measures, your LTCH CARE Data Set, the claims-based measures, Medicare fee-for-service claims
and then your CDC NHSN measures.
So again, there are three reports associated with confidential and public reporting, your
Review and Correct Reports, your QM Reports and your Provider Preview Reports, which are
all accessed through CASPER.
And then again, Review and Correct and QM Reports are user-requested then your Provider
Preview Reports are automatically placed in your inbox.
So the Review and Correct Reports provide a snapshot of facility-level performance at
the time of the report.
Remember it only contains observed rates and not risk-adjusted.
It includes your data correction deadlines and whether the data correction period is
open or closed.
They are presented by quarter.
After four quarters, the oldest quarter is dropped.
There's a few exceptions such as the functional outcome measure, change in mobility of LTCH
patients requiring ventilator report.
Because it is an 8-quarter measure.
For the QM Reports, it provides both facility and patient-level information for a single
reporting period.
And I did forget to mention earlier that when you put in a quarter end date, say December
31, 2017, it automatically -- it aggregates the current quarter and three quarters before.
So pretty much a year of data.
So if you request December 31, 2017 it will spit out a report January 1, 2017 through
December 31, 2017.
I forgot to mention that, but similar to how the Review and Correct Reports are requested.
The QM Reports are also referred to as the Confidential Feedback Reports in the rule.
And again, claims-based and CDC NHSN quality measures are not included in the patient-level
reports.
And then the Provider Preview Reports, they reflect the data posted on the LTCH compare.
Data collection period by the time you receive your Provider Preview Reports data collection
period has ended.
So you're not able to correct the underlying data in these reports.
And again, you have a 30-day preview period prior to public reporting, beginning the day
reports are issued to providers via your CASPER system, your inbox.
Action Plan, please become familiar with and review your on-demand reports, your Review
and Correct and your QM Reports as early in the reporting period as possible.
So that way you're not getting close to the data correction deadline and, you know, not
have time to review and correct.
Review facility-level information to ensure accuracy.
And then utilize your results to assist with your quality improvement efforts and ensure
data submission accuracy.
And then review your Provider Preview Reports well within 30 days to ensure accuracy.
So you know, you have 30 days.
So when you receive it, you know, if there are any inaccuracies, if you find that your
quality measures are inaccurate, you need time to gather that information and send us
an email for us to look over your data.
That's it.
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Overcome your fear of public speaking - Duration: 3:50.Hello do you fear public speaking
If you do you are not alone you and many of my clients and even myself have had to overcome
The fear of public speaking in order to to progress and climb the corporate ladder
my fear of public speaking
began when I started thinking too much about myself and
Wondering how do I look and how do I sound and am I able to get the content right?
It was all focused on me, and how I was presenting
When I did had a mindset shift, and the mindset shift was thinking about how I can impart what I know
to the audience that I was speaking to it totally changed my
Feelings about public speaking in fact quite frankly. I got excited about teaching what I know the most about
More than anybody who is in my audiences
This mindset shift is something that I'd like to
Encourage you to also think about it may not be the same as my mindset shift
It might be something completely different for example
I had a client who who whose fear was more around speaking in front of so many people like
Speaking to a big crowd of over a hundred people and how intimidating that felt
When we discovered that she doesn't feel
Conscious about speaking to one person or to a group of five at all. She rocks it when she is presenting to them
Her mindset shifted when she started thinking about
her bigger audiences as
Hey, I'm just having a conversation with them. Just like I have a conversation with my manager or with my team
This was her mindset shift that totally changed everything for her as well, so
The first step you can do is is think about why you?
Truly have a fear of public speaking and then try to change that have a mindset shift
About that and and turn it to some sort of positive that makes you feel good and ready to present
The second thing that I do is breathe now, that sounds pretty simple or intuitive, but many people who are nervous
Oftentimes don't breathe in fact. They start breathing in a way. That is not helpful
So what I do is I concentrate for maybe a minute in my chair even before I'm about to be introduced
I just concentrate on my breathing. That's all I do
I don't let any other thoughts come in if other thoughts come into my head
I let go of them and focus back again on my breathing
I do this for a minute or two either at my seats sometimes I go out into the hallway or the ladies room. I just
Concentrate on breathing and what this does for me is number one it centers me
number two it's
Relaxing and that's exactly what I need when my nerves and my stress is high I need to
Come back to Earth
Center myself and breathe I
Hope that these two strategies are helpful to you two on your next presentation
They have helped me tremendously, and I hope that they help you
Please let me let me know if they do or even let me know what your mindset shift
has been for you that has worked for you because I love to share things like that with my audiences and with my clients as
We discover their own
Fears and what they think about when they are trying to overcome them have a great day
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