Commensality – or bring back the lunch break

Commensality – or bring back the lunch break: Reflecting on insight from the high-performing Mayo Clinic in Minnesota, Chris Ham considers how its values could be applied to improve performance and outcomes in the NHS. Mayo Clinic is widely acknowledged to be a high-performing academic medical centre delivering excellent care to patients. Established more than 150 years ago, it is a not-for-profit system led by doctors and based on multispecialty medical practice. At our annual conference, one of Mayo Clinic’s leaders, Steve Swensen, shared learning and found a receptive audience.

Commensality – or bring back the lunch break

Commensality – or bring back the lunch break: Reflecting on insight from the high-performing Mayo Clinic in Minnesota, Chris Ham considers how its values could be applied to improve performance and outcomes in the NHS. Mayo Clinic is widely acknowledged to be a high-performing academic medical centre delivering excellent care to patients. Established more than 150 years ago, it is a not-for-profit system led by doctors and based on multispecialty medical practice. At our annual conference, one of Mayo Clinic’s leaders, Steve Swensen, shared learning and found a receptive audience.

Commensality – or bring back the lunch break

Commensality – or bring back the lunch break: Reflecting on insight from the high-performing Mayo Clinic in Minnesota, Chris Ham considers how its values could be applied to improve performance and outcomes in the NHS. Mayo Clinic is widely acknowledged to be a high-performing academic medical centre delivering excellent care to patients. Established more than 150 years ago, it is a not-for-profit system led by doctors and based on multispecialty medical practice. At our annual conference, one of Mayo Clinic’s leaders, Steve Swensen, shared learning and found a receptive audience.

Review of a cardiac and respiratory physiotherapy patient case - Bronchiectasis

Patient case details

Diagnosis: Bronchiectasis
Context: Patient admitted to ward via ED with acute chest infection secondary to Bronchiectasis
Setting:Acute medical ward
Gender:Female
Patient age:35 ‐ 45
Occupation:Part‐time at a support shelter
Main Presentation:Acute chest infection secondary to bronchiectasis
CLINICAL HISTORY
Reason for attending physiotherapy:Shortness of breath, pain on coughing, sputum retention and reduced exercise tolerance
History of presenting condition:Patient reported to ED with increased SOB and generally feeling unwell. Past 6 days reports increasing symptoms of SOB, coughing and declining exercise tolerance. Reports development of productive cough with green thick sputum greater in the am. Current observations include, afebrile, HR 105, RR 26 and saturation 93%
Investigations:Haematology reported increased WCC and CRP, arterial blood gasses reported PaO2 65, ph. 7.3, PaCO2 55 and HCO3 normal, indicating respiratory acidosis. Chest x‐ray revealed evidence of shadowing in the right middle/lower lobe
Past Medical History:Diabetes and Bronchiectasis
Past Surgical History:nil
Medications Diabex, Metformin
Alcohol and Drug:nil
Social History :Lives with husband and 4 kids in supportive home environmen t. 4 stairs at rear of house only, nil other home modifications.
Functional History:Previously independent with nil aids, exercise tolerance 3 00m limited by SOB
Patient Goals:To return to work and managing family responsibilities

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