Shahid Kapoor Visits Chandan Cinema For Public Reaction On Padmaavat
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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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CSD Public Policy - Jacob Salem - Campus Accessibility - Duration: 5:25.Hello I'm Jacob Salem.
Do you want to help improve accessibility on college campuses? Have you, or someone
you know been frustrated by a lack of access in higher education? Have you had problems
getting a a sign language interpreter for college activities, or even your classes?
This type of access is incredibly important!
Often the first experience of true self-advocacy and empowerment for Deaf and hard of hearing
students is on college campuses. Laws exist that protect your rights as a student in elementary,
middle and high school, as do laws that protect you as a college student. But these laws differ
in a few key ways. For example, elementary, middle and high schools are required to provide
IEPs, while colleges are not. Colleges instead have what's called an appropriate academic
adjustment, intended to meet your needs as an individual and to prevent illegal discrimination
against you. This could mean getting priority registration, a notetaker, sign language interpreting
services, or extended time for testing, among other things.
You can advocate for your rights by utilizing resources available on campus, including school
publications such as student handbooks that provide information about your rights. If
you feel the school is discriminating against you, you may contact the school's ADA coordinator
to file a complaint. It is the ADA coordinator's responsibility to ensure the college is in
compliance with Section 504 and Title II of the Americans with Disabilities Act, which
protect your rights under law. If you've made a request for accommodation and are not
satisfied with the school's response, don't give up! You aren't out of options. Your
advocacy can continue in the form of a lawsuit filed with the Department of Justice Office
for Civil Rights
For example, only a few years ago Pima County Community College in Arizona entered into
a civil rights settlement with the Department of Justice for refusing to provide a deaf
student with a sign language interpreter.
If you need more help or resources, you may also want to consider contacting the Conference
of Educational Administrators of Schools and Programs for the Deaf (CEASD), the National
Association of the Deaf (NAD), or Communication Services for the Deaf (CSD) for consultation.
Now I'd like to share with you my experience advocating for myself in college. I attended
the University of Central Florida, a huge school with over 65,000 students and an operating
budget of $1.5 billion dollars per year. The school denied my request for a sign language
interpreter for my orientation week, failed to provide me with a note taker for my first
week of classes, and denied my request for a sign language interpreter to support my
participation in greek life, student organizations and other campus activities.
I contacted the office of Student Disability Services multiple times, but was frustrated
at my lack of progress. I started conversations with instructors, administrators, department
chairs, and supervisors about the university's policies. One by one, other students with
disabilities joined the conversation and began discussing their frustration with services
on campus. This was crucial because it raised the profile of this issue on campus.
I had a friend who was a student reporter for the local news and reached out to her.
Word spread like wild fire, and she asked for an interview.
REPORTER: Dr. Preston oversees the office of student involvement and he says each club
is responsible for and should know how to accommodate their deaf members.
DR. PRESTON: Work with the leadership to let them know that accommodations are the responsibility
of the organization and they need to make sure they are providing them.
REPORTER: But Salem still dreams of a day when he can easily go to an event on campus,
just like everyone else.
JACOB: I have a vision that one day all organizations would work together, especially the Students
with Disabilities Service will help them get accommodations for students with disabilities.
So one day that I can walk in an event and ask for accommodations and they would say
no problem, an interpreter will be there.
After the interview, I attended a town hall meeting with the school's administration,
students, and the board of trustees. Myself and other students spoke about the frustration
of being denied access and left out of the campus community. The administration finally
seemed convinced that changes had to be made and, in the end, a recommendation was drafted
and approved.
That recommendation was critical to the process because it outlined strategies the administration
could use to meet the various needs of students with disabilities. These improvements helped
ensure that students with disabilities could freely access their university, without the
frustrating struggle to fight for access.
You have the power to make a difference!
Nothing is impossible. Deaf can.
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Senator Bennet & Small Business Owners Discuss How To Protect Public Land - Duration: 2:13. For more infomation >> Senator Bennet & Small Business Owners Discuss How To Protect Public Land - Duration: 2:13.-------------------------------------------
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!
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Pittsburgh Public Works Preps For More Snow - Duration: 0:17. For more infomation >> Pittsburgh Public Works Preps For More Snow - Duration: 0:17.-------------------------------------------
Overcoming the Stigma of Young Mothers Breastfeeding in Public - Duration: 3:01.Clients attending the St. Mary's Home Breastfeeding Program, which is an
innovative and tailored program for young pregnant and parenting women,
identified stigma associated with breastfeeding as a significant concern
and many parenting youth shared negative
experiences with breastfeeding in public
as well as personal spaces.
The overall goal of the grant was to
create an intervention that could help to shift attitudes about breastfeeding
towards a more positive and supportive state for young mothers.
We conducted two focus groups with clients attending programs at St. Mary's Home.
Here is a young mother who will share a summary of the themes identified.
I don't get it. There are breasts everywhere but the act of breastfeeding can sometimes make people feel uncomfortable.
What's the big deal? Breastfeeding is a natural thing to do and what our breasts are made for.
Have you ever seen someone make a comment about Dad feeding his child?
People don't seem to have a problem with that.
Isn't it ironic that breasts are used to sell... lottery and ketchup?
Based on the focus-group findings a script for the video was written and validated by youth.
A professional videographer was hired and four young mothers volunteered to be featured in the video.
Two short videos were created and officially launched at the end of October 2017.
The videos were shown to pregnant and parenting youth
at 12 different programs at St. Mary's Home.
Here are some of the results.
A total of 99 individuals completed a survey.
81% of respondents were female
and almost 60% were less than 25 years of age.
Overall there was strong support for wide distribution of this video.
We will continue with our dissemination strategy
and hope we can count on YOU to help share the message
that women of all ages can breastfeed anytime, anywhere.
In doing so maybe we can create the
societal shift that is needed to achieve a truly supportive breastfeeding culture.
We sincerely thank the Women's Xchange for the opportunity to undertake this project.
It was truly a worthwhile experience!!!!
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Gino D'Acampo launches bid to close off public footpath | news 24h - Duration: 9:39.TV chef Gino D'Acampo launches bid to close off public footpath beside his £1.25m Georgian townhouse over claims 'fans are harassing' his family - but locals say it provides 'vital' access to a doctor's surgery
TV chef Gino DAcampo is trying to close off a footpath next to his £1. 25million home over claims he is being harassed by fans and fears for his familys safety.
The millionaire chef says he and his family are fed up with people knocking on the door of his home in Hertfordshire, begging for pictures and autographs.
But the pathway next to the Grade II-listed home provides vital access to a GP surgery and patients would be forced to travel four times as far if it were to close.
Gino DAcampo, pictured with his wife Jessie, and children Rocco and Luccian, in July 2010.
TV chef Gino DAcampo, 41, says he and his family are fed up with people knocking on the door of his home in Hertfordshire (pictured), begging for pictures and autographs.
The Italian-born 41-year-old chef, who is known his food-focused programmes on ITV, insists the closure of the walkway in is for the safety of his family.
DAcampo and his wife Jessie, 44, said they have found people in their garden taking pictures and once even found a stranger standing in their hallway.
In a letter to Broxbourne Borough Council, Mrs DAcampo wrote: I just want my family which includes young children to feel safe and secure and have some privacy.
A couple of times I have had people in my garden taking pictures and there are frequent knocks on the door with people asking for pictures of Gino or signed books.
I often get abused in the driveway and it is obviously dangerous for members of the public to treat the driveway effectively as a public space without concern about my family or our visitors car driving up and down the driveway.
DAcampo and his wife, who wed in 2002 and have three children, bought the four-storey Georgian townhouse, which has seven bedrooms, in 2016. DAcampo bought the four-storey Georgian townhouse, which has seven bedrooms, in 2016.
The pathway runs down the side where a door can be accessed. There is a ramp at the end of the driveway which slopes down to a GP surgery for wheelchair access.
But if the driveway were to close, wheelchair users would have to travel four times as far to reach the practice. The DAcampos application has so far had 15 responses - with 14 people rejecting the proposal to close the walkway.
One of the most notable objections comes from practice manager of the surgery, Christine Price.
She said: Many of our patients are elderly and the longer walk around to the surgery would have an affect both on them and the surgery with the possibility of patients registering with other GP practices with easier access.
This driveway was closed earlier in the year and this caused problems to staff and patients. DAcampo and his wife Jessie, 44, said they have found people in their garden taking pictures.
A Broxbourne Council spokesman said of his application to have the footpath closed: The planning application has been received and is under consideration.
Niki Hillier, office manager of Pen Underwriting, said: This is the only disabled access to the offices and surgery as the only other access to goes down a very narrow private road with a small path.
Accountancy firm Croucher Needham is about to commit to a lease of an office in Lime Court and considers the pathway an extremely important access route.
In a letter objecting to the plans, the firm states: As accountants we will not only have staff present in the building, but visiting clients who will expect that public right of way to remain open.
I assume that you are also aware that a doctors surgery and pharmacist operate from the surgery, access via this passageway is vital to their function.
It concludes: Should the council agree to this amendment of this public right of way, then you will agree to closing off access from a dedicated 25,000 square foot purpose built office complex. There is no pavement access to the surgery..
DAcampo rose to fame as a chef on ITVs This Morning after appearing on reality TV show Im A Celebrity Get Me Out of Here.
He has also presented cookery programmes including Lets Do Lunch, Theres No Taste Like Home and Ginos Italian Escape. DAcampo (second right) appears on ITVs comedy panel show Celebrity Juice with Holly Willoughby, Keith Lemon and Fearne Cotton.
In their application, his wife says she has monitored the publics use of the driveway for months and believes most office workers could easily take another route and there are a couple to choose.
Some elderly are dropped off by the gates either by a relative or taxi for the surgery but they could be dropped off at the surgery, she said.
I really do not feel that the short additional walk for people who have a genuine need to access buildings to the rear of our house would cause any real difficulty or concern.
I truly believe that most people would understand our plight. No one wants strangers knocking on their door, shouting at them, entering their home or garden uninvited, its just not fair on us as a young family and is actually quite scary..
She concludes her application by stating they love being part of the community and has insisted local business and people have been so welcoming.
The couple have been approached for comment. A Broxbourne Council spokesman said: The planning application has been received and is under consideration.
No conclusions have been reached about whether the proposal is acceptable or not, and it is not yet possible to say when the application will be determined.
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Exclu Public : Les Anges 10 : cauchemar à L.A., Shanna quitte la villa d'urgence ! - Duration: 2:15. For more infomation >> Exclu Public : Les Anges 10 : cauchemar à L.A., Shanna quitte la villa d'urgence ! - Duration: 2:15.-------------------------------------------
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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Tom Cruise Upset About Katie Holmes, Jamie Foxx "Romance Going Public"? - Duration: 6:47.Tom Cruise Upset About Katie Holmes, Jamie Foxx "Romance Going Public"?
A new tabloid report claims Tom Cruise is "upset" about Katie Holmes and Jamie Foxx "going public" with their romance, but Gossip Cop has learned the entire story is made-up.
We're told by sources close to each of those involved that the story is untrue.
According to OK!, Cruise is "less than pleased" that after "four years of under-the-radar dating," Holmes and Foxx "emerged as a couple last fall.
" A so-called "source" tells the tabloid, "Tom used to consider Jamie a friend.
" "He's upset about the relationship with Katie, especially now that they're no longer keeping it quiet," adds the alleged insider.
The seemingly fabricated "source" maintains Holmes' supposed "romance" with Foxx "hasn't exactly encouraged [Cruise] to have more contact with Katie and Suri." "Unfortunately, it's his daughter who's paying the price," concludes the questionable tipster.
Not only are the claims completely phony, but they also contradict previous assertions made by the untrustworthy outlet.
For starters, Cruise is not "upset" because he doesn't care who Holmes does or doesn't date.
More importantly, as Gossip Cop has noted in the past, prior to Saturday night's pre-Grammys party, Foxx and Holmes never went "public" with anything.
They were photographed, without their knowledge, by paparazzi using long lenses while they were having a private moment.
Additionally, the tabloid's insistence that Holmes and Foxx are "no longer keeping [their relationship] quiet" is absurd.
The truth about Holmes and Foxx's relationship, say multiple sources, is that it's not as serious as the media has been trying to portray for a long time.
And the contention that Holmes and Foxx's friendship "hasn't exactly encouraged him to have more contact with Katie and Suri" is beyond ridiculous.
One has nothing to do with the other.
Cruise was out of Holmes and his daughter's life long before the actress began spending time with Foxx.
Of course, OK! has not only been repeatedly wrong about Holmes and Foxx and the nature of their relationship, but it also can't keep track of its lies.
In January 2016, for example, the unreliable tabloid ran a cover story that exclaimed, "Katie & Jamie: Wedding & A Baby!" The gossip magazine further alleged it had "details of the secret ceremony," and swore up and down that Cruise gave "his blessing".
But that's not all.
In March of that same year, the publication ran yet another cover story that announced, "Jamie & Katie: It's A Girl!" The issue even claimed that upon hearing Holmes was supposedly pregnant, Cruise was so happy for her and Foxx that he sent a "$2,500 bouquet of flowers" .
To recap: So now the often discredited tabloid would like us to believe that Cruise is "upset" about Holmes and Foxx's "romance," but two years ago he gave them his "blessing" for their wedding that never happened and bought expensive flowers for the baby girl they never had.
The only ones who should be "upset" are those who spend $5.99 a week buying the magazine's lies about Cruise, Holmes, and Foxx.
Regardless, sources close to all three of them confirm to Gossip Cop the outlet's article is not true.
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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.-------------------------------------------
Real Stick fight on street by Ali Abbas Cheetha in public - Duration: 1:21.
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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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The secret behind good (public) products and services - Human-centred design workshop - Duration: 3:24.- [Instructor] So what is the secret behind
every successful product and service?
What do they all have in common?
Without further ado, let's take a look
at what are design thinking
and human-centred approaches to service delivery.
Design thinking is a problem solving process
that integrates the needs of people,
service feasibility, and organisational success.
It is not only used in businesses,
but also in social contexts.
When designing a service, we should always ask,
"Can we do this? Is it feasible?
Can anyone in the organisation bring this to life?
Or do we have that amount of investment
to make this happen?"
This is where the second point comes in.
You might wanna ask the organisation,
"Does it fit into our organisation strategy?
What outcomes do we prioritize?"
But the most important question is, "Is it desirable?
Do people want or need this?
Does it solve a problem in someone's life?"
The secret to success lies in
solutions that sit in this sweet spot.
It is paramount to consider
the capability of the organisation,
the strategy of the business, and the impact on users.
Let us look at an example of how two products
that both appear to successfully make their purpose,
but one of them do not involve
the user in the design process.
Here you can see, that technically,
both chairs serve their function, you can sit on them.
But which do you think is more comfortable to sit on?
The one on the left, inspired by one of
the greatest artists of the 20th century?
Or the one on the right?
This example demonstrates how good and desirable design
is not just about how it looks,
how much it cost, or who designed it.
What is good all boils down to the person using it.
So, how do we define human-centred design?
Human-centred design is really about
solving real problems that exist in people's lives.
Building services that are tailored to their needs.
Let's look at how we get to the real problems
and make sure that our solutions
are effective for real people.
At FutureGov, we use the Double Diamond model,
a model developed by the British Design Council.
It is a design process that goes through
diverging and converging stages.
During the diverging phase, you go wide,
looking at the entire context and issues,
collecting as many insights as possible.
Then, narrowing down, making sense of all
the information you have collected,
defining and prioritizing the opportunity areas.
Then opening up again, generating as many ideas as possible
for potential solutions to build.
Before you narrow down again,
testing and iterating prototypes and delivering solutions.
The truth is, in reality, it is not a linear process.
You probably feel the same in your role.
More often than not, you are jumping between
phases of understanding the needs,
defining the problem, and coming up with solutions.
In our next video, you will hear about why it is
equally important to adopt a human-centred design mindset.
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This Liberal government has a woeful track record when it comes to public health - Duration: 15:05.I rise to speak to the Medicare Guarantee Bill 2017, and to say that it is pretty clearly
nothing more than a fig leaf.
We have already had the government in here today with their bank levy legislation, which
is a fig leaf to protect them from exposure in terms of their work to support the banks
and protect the banks from a royal commission.
Now, we see this fig-leaf legislation, which is all about protecting them from criticism
in relation to their woeful record on Australian public health and Medicare.
This bill is an attempt to set up a special account for a so-called Medicare guarantee.
But the only way to guarantee and protect Medicare is to end the government's freeze
on the Medicare Benefits Schedule, to stop this government from continuing to attack
Medicare and public health in this country and, ultimately, to throw this mob out because,
frankly, all they have ever done in government is to attack public health care in this country.
And their record on private health is not that much better.
The idea of having a special account for Medicare is, of course, an illusion because the Constitution
says that there is one account, and it is called the consolidated revenue.
This idea of having a special account is really just a bit of creative accounting.
It is a bit of trickery from the government to make it appear as though they are taking
action on Medicare, while, at the same time, we are still seeing the consequences of freeze
on the MBS.
What has that meant?
It has meant the equivalent of the GP co-payment.
They could not get a GP co-payment through the front door, so it is a GP co-payment through
the backdoor.
And people are paying for it.
Households are paying for it.
These are the very same households that are suffering from low wages growth, that are
suffering from high housing costs and that are suffering from high energy costs because,
under this government, wholesale energy prices have doubled.
Under this government, wholesale energy prices have doubled and there are flow-on effects
for households.
Those very same households are suffering the consequences of this government's freeze on
the MBS, and why?
Because those costs are being passed on to healthcare consumers or, as I like to call
them, people.
People are paying the costs of this government's MBS freeze and their attempts to pretend as
though they are defending public health are falling flat.
No-one believes a word this Prime Minister and this government have to say when it comes
to health care in this country.
He can complain all he likes about how it is unfair that he is being called out for
his attacks on public health.
He can stand up at the dispatch box and complain about his perceived victimisation—'Oh, it's
not fair; Labor called us out on our public health policies.'
We did call the government out at the last election and we will continue to call the
government out throughout this term of opposition because, in fact, the only party that has
ever defended Medicare in this country is the party that created Medicare—the Australian
Labor Party.
Bill Hayden, Bob Hawke—the Hawke-Keating years were the years under which Medicare
was solidified.
Before that, of course, Gough Whitlam had introduced public health insurance.
But, unfortunately, what happened?
The Liberals, when they replaced Mr Whitlam's government, came in and got rid of the equivalent
of Medicare at the time.
So it took a Labor government to bring Medicare back.
It was greatly sad that there could have been a longer period of time that we had Medicare
in this country, but for the Liberal Party.
I think they learnt the lesson of what happened with then Prime Minister Fraser's decision
to axe universal health care and Prime Minister Hawke's decision to bring it back.
I think they learnt a lesson from that.
But, unfortunately, the Liberals learnt the wrong lesson.
They did not learn the lesson that they should defend public health care.
They learnt the lesson that they should appear to defend public health care.
And that is what this is.
It is the appearance of defending public health care while, at the same time, taking an axe
to it.
But people are not stupid.
My constituents are not stupid.
They know what is going on here.
They know that when you start cutting funds—the cuts to pathology, for example—or when you
start freezing the Medicare Benefit Schedule, and you freeze it for years and years, the
consequences are consequences for them.
They know that when there are attempts to put up the price of medicine over and above
CPI the consequences are felt by them.
And they know that a bill like this is nothing but an attempt to pretend otherwise.
The GP bulk-billing rate in my electorate of Griffith is 68.1 per cent.
That is a woeful rate.
In fact, we are 141 out of 150 electorates in our ranking in terms of our GP bulk-billing
rate.
The overall rate is even lower—66.8 per cent.
What this means is that up to eight per cent of people will delay and put off going to
see the doctor.
In an electorate the size of mine, that is up to 13,000 people.
That is absolutely reckless.
The last thing this country needs or wants is having people not going off to the GP when
they should be.
Early diagnosis matters.
Early treatment matters.
This government, instead of this ridiculous idea of running up this pretend protection
of Medicare, should actually stand up for people and fix bulk-billing rates, not be
sitting around saying, 'Let's brainstorm ways that we can make it appear as though we are
defending Medicare.
Let's come up with ideas to pretend that we are doing something about Medicare.'
Instead of doing that, just fix bulk-billing rates.
Get rid of your Medicare Benefit Schedule freeze—not the pretend getting rid of it
that you announced in the budget but actually move to get rid of the freeze.
Stop trying to introduce a co-payment by stealth.
People understand what you are doing, and they are not going to stand for it.
As I said, this is a government that is really not much better on private health than it
is on public health.
In fact, in my electorate the estimates from the private health association are that more
than 60 per cent of people are covered by private health insurance.
Yet, private health insurance has been 18 per cent higher under the Liberals.
What is the Liberal government doing in relation to these issues?
I wrote to the health minister on the day that he became the health minister—the day
that he was sworn in as the health minister for this country.
I said to him: 'Health Minister, we have these bulk billing problems in my electorate and
we have concerns about private health insurance costs.'
But this Liberal government has done nothing about those costs—absolutely nothing.
All they have done is sit around brainstorming trickery to try to pull the wool over the
eyes of the Australian people, because they know how deeply unpopular it is when Liberal
governments like Mr Fraser's, like Mr Abbott's and now like Mr Turnbull's take the axe to
public health in this country.
Universal health care is something that Australians are rightly proud of.
We are rightly proud of the fact that we live in a country where we believe in universal
health care, where we do not support the American path of private insurance and insurance being
contingent on whether you have got the sort of job that offers the right sort of health
plan.
We have not accepted that American path of health care costing tens of thousands of dollars.
We believe in public health care in this country.
We believe in universal health care.
It is something that Labor introduced.
It is something that Labor has defended for decades, and it is something that the Liberals
have opposed for decades.
The only difference between now and the 1970s is that they are a bit less honest about it—they
are just a little bit less forthright than they have been in the past in relation to
their hatred of universal health care.
They cannot stand it.
They think it is socialism.
They think it is too much state interference in the market.
That is what the people sitting over there think about our universal healthcare system.
They would love to hollow it out.
They would love to reduce the amount of public funding that is going into public health care
in this country, and the reason they want to do that is that they have a fundamental
ideological objection to public health care and to universal health care.
This bill really bells the cat on that.
This idea of creating a special account is an attempt to pretend that some action is
being taken is just deeply embarrassing for the government.
I think the health minister is an intelligent man.
This should be beneath him, and yet this is the sort of thing that is being trotted out
for the attention of this parliament to try to help the government deal with its perceived
political problem in relation to how on the nose it is when it comes to universal health
care and Medicare in this country.
But, as I said, there is a pretty simple way that the government can actually deal with
that political problem–that is just to stop taking the axe to public health care.
It is a pretty simple thing: if you do not want people to be unhappy with you for cutting
public funding to health care, then stop cutting public funding health care.
It is as simple as that.
The finance minister has defended this bill by saying, 'Oh look, the thing about having
this special account is, if a future government touches it, people will know about it.'
That is a pretty frank admission from the finance minister that the Liberals will continue
to seek to touch public health care, that they will continue to seek to do that.
In contrast, the shadow minister for health has made very clear our view on this bill.
In fact, she spoke in this debate incredibly well—I think most people in this chamber
would agree; certainly, people on this side of the House would agree—about our concerns
about what this government is doing to public health care.
She does not agree with the finance minister.
What she has said is that this is some trickery.
This is an accounting mechanism.
This is not something that in any way provides any real protection to public health care.
And how can it?
As I said at the outset, the Constitution makes really clear: there is one fund.
It is the Consolidated Revenue Fund.
This is not some special source of revenue for Medicare.
This is not some special source of guarantee funding as someone might ordinarily understand
the word 'guarantee'.
This is not a guarantee at all in fact.
It is not anything other than a fund being described as a Medicare guarantee fund with
a view to trying to persuade the people of Australia that they do not need to be worried
about the Liberals when it comes to public health care.
But they do.
The people of Australia do need to be worried about the Liberal Party of Australia when
it comes to the protection of our universal healthcare system.
As I said, whether it is cuts to pathology funding, freezes to the MBS, increases in
the price of medicines or cuts to public funding going to the states for the hospital system,
this Liberal government has a woeful track record when it comes to public health care
in this country.
Trickery is not going to help with that.
People are alert to what is happening and what the Liberal Party is trying to do.
People know that simply describing something as a special account does not provide it with
any measure of protection whatsoever, with any additional protection from attacks by
the Liberal government on public health care.
The best way to protect public health care is to vote for a party that actually believes
in public health care, that has a fundamental values-based commitment to saying that every
person in this country—no matter their circumstances, no matter their background—should have the
right to health care.
That is what we believe and that is why we have been the party of universal health care.
We do not believe that your access to health care should be dependent on your credit card.
We believe it that should be dependent on your Medicare card.
If you want to have a party that will actually stand up for Medicare—not with trickery,
not with accounting moves, not with attempts to pretend to be doing something when you
are not really, but genuinely stand up for public health care, genuinely stand up for
the appropriate levels of funding for public health care rather than seeking to cut public
health care—then there is really only one choice and that is to vote Labor.
The Liberal Party of Australia, whether they are led by Malcolm Turnbull, whether they
are led by Tony Abbott, whether they are led by Peter Dutton, will never stand up for public
health care in this country, and they certainly will never do it to the same extent that the
Australian Labor Party will.
Medicare is an important legacy of past Labor governments, and it now falls to the Labor
members of this place to stand up at this time to defend Medicare from the Liberal Party
and from the conservative attacks on universal health care.
My colleagues and I have been standing up on this issue to call on the Liberals to stop
attacking Medicare, to reverse their freezes to the MBS, to genuinely stand for better
bulk-billing rates across the Australian population and to genuinely stand up for people like
the people in my electorate, who, as I say, have an incredibly low rate of bulk-billing,
and GP bulk-billing specifically.
Labor and each member on this side of this House every day fights to support Medicare,
our universal public health care system and access to health care for everybody, dependent
on your Medicare card, not on your credit card.
The question for every single member opposite, whether it is the member for Bonner, the member
for Forde, the member for Capricornia, the member for Dawson or the member for Leichhardt,
is: what are you going to do?
Whether it is the member for Petrie, whether it is the member for— (Time expired)
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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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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.
-------------------------------------------
Leaders and Best Reflect: Social Science in the Public Interest - Duration: 1:40.(upbeat music)
- My entire experience at the University of Michigan
turned out to be the best decision I could have made
in my entire life.
- To aspire to something more than you are now,
came from being here.
- I had a remarkably wonderful interdisciplinary
training at University of Michigan.
- My dissertation committee had two sociologists,
one economist and two folks from the public policy shool,
and everyone just worked together really smoothly,
and it wasn't weird at all, and I think that other
universities often have more barriers
from crossing those kinds of boundaries.
- I got job offers from schools of public policy,
sociology, education and African-American studies.
- I got a chance to take a graduate course
as a senior, and we worked on a documentary
about the Hari Krishnas.
We shot it, we wrote it, I did the voiceover
for it as well.
Opening the doors into an aspect of life
that's not something that you would ordinarily
encounter was, to me, the best reward
or the best benefit.
- I was doing calls to actual American households,
learning about the process of recruiting folks
to respond to surveys and the ways that respondents
interpret questions and answer them,
and that kind of hands-on experience, I think,
is pretty unusual for different social sciences.
- When you work in an environment and a climate
that is filled with people who are the best,
and they are invested in you and they pour their all
into your training, it catches on.
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