7.2 Listening
ICP. So, // what do I mean by the integrated care pathway, exactly? // Well, to help you understand this concept, can you look for a moment at the patient leaflet that I have just handed out? As you can see, a patient typically arrives in admissions and then passes through several departments, meeting different members of the emergency team before being discharged at the end of his or her stay. // Let’s look at an example of this. Say a patient arrives with a suspected fractured hip. After being admitted, the patient may spend time in the waiting room before being seen by the triage nurse who will assess their symptoms and vital signs. They will then be sent for an X-ray before going to the surgical assessment unit. Just prior to the operation, the anaesthetist will make an assessment of the patient’s fitness for operation. Immediately after the operation, the patient will spend time in the recovery room, then go back to the orthopaedic ward. And then, finally, the patient is discharged back to the care of their GP or family doctor. // Despite significant advances in technology and increased specialization, the organization of these departments has changed very little. However, looking at it another way, changes in the patient mix and profile – an ageing population, in effect – has brought about certain problems, notably an increase in admissions to acute care hospitals. And that’s for both planned and emergency care. // The point is that the resulting flow of patients is often inefficient and poorly coordinated. This is a phenomenon that has been noted in small regional hospitals as well as the larger teaching hospitals. // In financial terms, hospital wards are under pressure to close or to reduce the number of beds. // But why is ‘patient flow’ so important? Well, with hospitals that are capable of functioning to their optimal capacity, patient waiting times are reduced, the quality of care is improved, and hospitals become more cost-effective – in this way maximizing the benefits of hospital care for all those who need it.
Answers Phrase
1. Now, an important concept (is) …
2. So, what do I mean by …?
3. As you can see, … 4. Say …
5. However, looking at it another way, …
6. T e point is … 7. In fi nancial terms, … 8. … in this way … Type of information
e. a new idea or topic the lecturer wants to discuss
g. an explanation of a word or phrase
f. a comment about a diagram or picture
b. an imaginary example
a. a diff erent way to think about the topic
c. a key statement or idea
h. a general idea put into a fi nancial context
d. a concluding comment giving a result of something
F
Explain to students that this activity will help them to identify when a lecturer is drawing attention to something that they consider important.
Explain that a common way to structure information in sentences is to begin with ‘given’ information – what is already known – and to then move on to ‘new’ information.
However, when a speaker wants to draw attention to something, they can begin the sentence by using a Wh~ cleft sentence structure, which changes the usual order of information.
SKILLS BANK 7.1 Identifying ‘given’ and ‘new’ information in a lecture
You could direct students to Skills Bank 7.1 at this point, which gives an example of the standard ‘given’–‘new’ pattern which many sentences follow.
Set for pairwork. Tell students that they will hear each numbered sentence followed by either sentence a or sentence b. Tell them to read the sentences and check that they understand the meaning.
40
Play Part 4 all the way through. Students should choose sentence a or b and record their answers. Afterwards, give them time to discuss which sentences they heard.
Actual information the concept of an integrated care pathway (ICP) explanation of the concept of an ICP
reference to the depiction of a patient’s journey through A & E
example of a patient journey for someone with a fractured hip
an ageing population has meant many more admissions to acute care and caused problems for hospitals
because of increased admissions, patient fl ow is disorganized (despite the fairly settled organization of acute care departments)
hospitals are under pressure to close or reduce the capacity of acute care wards
the benefi ts of hospital care are maximized when ‘patient fl ow’ is well managed
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