Tag Archives: facilities

HOW CAN THE ACCESSIBILITY OF SCHOOL FACILITIES AND PROGRAMS BE ASSESSED EFFECTIVELY

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Assessing the accessibility of school facilities and programs is important to ensure all students, including those with disabilities, are able to fully participate in their education. A comprehensive assessment should evaluate multiple areas to determine how accessible and inclusive the overall school environment is.

To start, the physical accessibility of the school building and grounds should be assessed. This involves conducting a thorough accessibility audit to identify any potential barriers. The audit team should include individuals with various disabilities if possible. The audit should examine all areas of the school including classrooms, hallways, playgrounds, bathrooms, the front office, the nurse’s office, the cafeteria, libraries, auditoriums, and more. It should identify any issues with things like entryways, staircases, elevators, signage, water fountains, and emergency equipment being inaccessible. It should also analyze parking areas, paths of travel, and drop-off zones for accessibility. Any findings need to be clearly documented along with recommendations for improvements.

In addition to the physical space, school programs, activities, and communications should be evaluated for accessibility. This involves reviewing how inclusive existing programs are for students with disabilities. It needs to be determined if students have equal access to participate in after-school clubs, performing arts, athletics, field trips, and other enrichment opportunities. The assessment should analyze if any programs, events or activities require modifications to be fully accessible. It also needs to evaluate how effectively disability resources and support services are being provided to ensure equal access to the core curriculum and accommodation of individual needs.

The methods that the school uses to communicate and engage with families is another important area to assess. This involves determining if school communications are provided in accessible formats and languages for families with disabilities or limited English proficiency. The various forums the school uses to engage families like parent-teacher conferences, school council meetings, and guidance sessions need to be evaluated for physical accessibility and the provision of any needed auxiliary aids and services like sign language interpreters. Websites, apps and other digital platforms also need to meet accessibility standards.

When assessing programs and communications, gaining input from students, families, and school staff with disabilities is imperative. Conducting interviews and focus groups can provide valuable first-hand perspectives on areas that may need to be improved. Anonymous accessibility surveys can also collect useful feedback. Reviewing any previous accommodation requests or grievances filed may uncover recurring issues. Similarly, analyzing student performance data can help identify if certain groups, such as those with disabilities, are experiencing inequitable outcomes that could stem from programmatic or other barriers.

To structure the assessment process, it is recommended to establish an accessibility committee made up of administrators, teachers, related services staff, families, and community advocates. Developing a plan with defined timelines, roles and milestones will help ensure a thorough review. Documenting assessment methods and findings in a detailed report is important for developing an appropriate action plan. Outlining prioritized short and long-term goals with target completion dates holds the school accountable. Periodic reassessments should be conducted to ensure ongoing compliance and progress. With a comprehensive, evidence-based assessment process, schools can truly evaluate the inclusiveness and accessibility of the entire school experience for all students.

Effectively assessing the accessibility of school facilities, programs, activities and communication methods is a multifaceted process that requires evaluating physical spaces, instructional programs, engagement opportunities, support services and more from an accessibility lens. Schools must gather input from students and families with disabilities and use measurable data to inform the assessment. Only through a thorough, well-documented review can adequate accessibility improvements be identified and appropriate goals and timelines for progress be established. This commitment to ongoing assessment is key to fulfilling schools’ obligations under disability rights laws and creating fully inclusive learning environments.

WHAT ARE SOME EXAMPLES OF ANTIMICROBIAL STEWARDSHIP PROGRAMS IN HEALTHCARE FACILITIES

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Antimicrobial stewardship refers to coordinated programs that promote the appropriate use of antimicrobials (including antibiotics), improve patient outcomes, reduce microbial resistance, and decrease the spread of infections caused by multidrug-resistant organisms. The core elements of an effective ASP include leadership commitment, accountability, drug expertise, action, tracking, reporting, and education. Various healthcare facilities have developed innovative ASP models encompassing these core elements.

Many hospitals have implemented multidisciplinary antimicrobial stewardship teams or committees that meet regularly to review antimicrobial prescribing across the facility. These teams are usually composed of infectious diseases physicians, clinical pharmacists, microbiologists, infection preventionists, and other stakeholders. They monitor antibiotic use; review culture and susceptibility data; generate regular reports on antibiotic use and resistance patterns; develop evidence-based treatment guidelines, order forms, and preauthorization processes; and provide feedback to physicians on opportunities to optimize prescribing for individual patients.

For example, Mayo Clinic in Rochester, Minnesota has a longstanding and highly successful ASP led by an infectious diseases physician and antimicrobial stewardship pharmacist. They conduct prospective audit and feedback on all patients prescribed restricted or intravenous antibiotics, issue facility-wide guidelines and clinical pathways, and perform ongoing education, surveillance and process improvement. Multidrug-resistant organism infections have decreased substantially since the program’s inception in 1995.

Some health systems have implemented ASPs across all affiliated hospitals, clinics, and long-term care facilities in a coordinated manner. For example, Intermountain Healthcare in Utah consolidated its individual hospital ASPs in 2013 into a system-wide program with standard policies, order sets, reporting, and an inter-facility information-sharing infrastructure. Joint strategies are developed that consider resistance patterns and antibiotic use across the entire delivery network.

Several ASPs have also leveraged clinical decision support within electronic health record (EHR) systems. For instance, Johns Hopkins Hospital incorporates “best practice advisories” into physician order entry to prompt reviews of ongoing therapy need, narrowing of broad-spectrum drugs, and switches to oral step-downs. Many EHRs also interface with laboratory systems to automatically suspend non-ICU antibiotics if blood or urine cultures are finalized as negative after 48-72 hours.

Some innovative ambulatory ASP strategies involve primary care clinics. For example, primary care doctors at Kaiser Permanente Northern California can request real-time infectious diseases consultation for guidance on optimal outpatient antibiotic selections. Their ASP specialists also analyze prescribing patterns across clinics and develop quality improvement initiatives accordingly, focusing both on appropriate treatment and mitigating unnecessary use.

Several long-term care facilities have ASPs tailored to their residents. For instance, an ASP was implemented across 31 nursing homes in Sweden from 2014-2018. It focused on structured implementation of diagnostic and treatment algorithms, facilities-based guidelines, environmental improvements like antimicrobial stewardship rounds and education, and local and national reporting of antimicrobial usage and resistance data. Significant reductions were observed in nursing home antibiotic use and costs over the study period.

ASPs have also been initiated in dental practices and dialysis centers, given their extensive antibiotic exposure risk. They employ strategies like prescribing criteria, local guidelines, environmental cleaning enhancements and antimicrobial mouthwashes or prophylaxis as appropriate. Regular staff education is another core ASP activity in these outpatient specialty settings.

There are many organizational models for implementing successful ASPs to improve antibiotic prescribing across healthcare systems. The most impactful programs utilize multidisciplinary teams, real-time decision support, coordinated education, and standardized surveillance to drive culture and policy changes. With leadership commitment and the engagement of prescribers, ASPs have been shown to yield meaningful reductions in antibiotic overuse and resistance across both inpatient and outpatient care settings.