Health System Transformation Playbook and Unified Care Model: an integrated design, systems & complexity thinking approach to health system transformation.

Health system transformation is a complex journey that often results in unintended consequences. Existing methods to drive health system transformation have intrinsic limitations which impede successful implementation in local contexts. The Health System Transformation Playbook is a design-, systems-, and complexity-thinking enabled methodology to systematically design, prioritize and test health system and services transformation actions, anchored on iterative story telling, model building and pathfinding processes that tackles the scale of socially and technologically complex adaptive systems through time.

An Audit of medical thoracoscopy and talc poudrage for pneumothorax prevention in advanced COPD.

Objectives: To prospectively study all patients with COPD and spontaneous pneumothorax (SP) who underwent thoracoscopic talc poudrage (TP) under local anesthesia to determine its efficacy and safety in recurrence prevention.

Methods: Data on clinical measurements, complications, duration of chest tube drainage, length of hospital stay, and outcome were collected.

Results: Forty-one patients (38 men and 3 women) with a mean (+/- SD) age of 70.